Pertreatment radiation induced oedema causing acute hydrocephalus after radiosurgery for multiple cerebellar metastases.

BACKGROUND: Most complications of radiosurgery occur after 6-12 months and some long term complications up to after 5-10 years. Although severe, immediate side effects are rare, we report a patient who shows that this possibility should be taken into account when large volumes are treated especially in the posterior fossa. CASE REPORT: A patient was treated with radiosurgery for multiple brain metastases, of which 5 were located in the posterior fossa. Deterioration occurred, radiosurgery was halted abortion and CT showed acute hydrocephalus caused by a significant edema in the posterior fossa, not present in an MR examination performed some 6 hours earlier. After intubation and external ventricular CSF drainage, a permanent shunt was inserted, the edema resolved, and the patient recovered to her pretreatment condition within 10 days. The remaining metastases were treated during the first session and MR images showed the hydrocephalus resolved when all the radiated tumors had significantly decreased in size. INTERPRETATION: Care should be taken when treating with radiosurgery patients posterior fossa metastases and signs of compressed CSF pathways. Exceptionally, an acute radiation induced edema could result in a block of the CSF pathways, necessitating a surgical intervention. Prophylactic shunt insertion or hospitalization the night following the treatment should be considered.

[Diffusion-weighted MRI of spinal cord infarction. Description of two cases and review of the literature]. / Diffusionsgewichtete MRT bei spinalen Infarkten Darstellung von zwei Fällen und Literaturübersicht.

Spinal cord infarctions occur rarely and are due to various aetiologies. In an emergency setting with acute spinal cord symptoms, magnetic resonance imaging (MRI) is used to exclude space-occupying lesions which require neurosurgical intervention. We report on two patients presenting with an anterior spinal artery syndrome caused by infarction of the thoracolumbar spinal cord including the conus medullaris. While T2-weighted images 4 h and 28 h after onset of clinical symptoms showed only slight unspecific signal changes, diffusion-weighted imaging revealed clear infarction and detected spinal cord ischaemia in an early stage, showing signal intensity conversion comparable to that in acute cerebral stroke.

[Treatment of the rupture of the distal tibiofibular syndesmosis with "Engelbrecht's syndesmosis hook"]. / Die Behandlung der Ruptur der distalen tibiofibularen Syndesmose mit dem "Syndesmosenhaken" nach Engelbrecht.

UNLABELLED: After completing the osteosynthesis of the lateral malleolus, the hook is positioned 3-5 cm cranial of the syndesmosis and fixed to the tibia with a screw. It is expected to allow undisturbed ligament healing of the syndesmosis with early formation or fibres under limited motion. No immobilisation is necessary and no early removing of the implant. RESULTS: Of 62 patients questioned, 53 were examined, after an average of 50 months (2-6 years p. o.). Using the Weber score, 51 had excellent or good results. Twelve patients reported discomfort while jumping, in five cases the ROM concerned dorsal extension, and in three cases plantar flexion was reduced. Four patients showed distinct radiologic signs of osteoarthrosis, and two patients slight signs.

Potential role of nitric oxide and endothelin in the pathogenesis of glaucoma.

Glaucoma is an optic nerve head neuropathy in which retinal ganglion cells are lost. A clear association exists between glaucoma and different risk factors, such as high intraocular pressure (IOP) or blood-flow dysregulation. Nitric oxide (NO) and endothelin, two recently identified cellular mediators, appear to be involved in the regulation of IOP as well as in the modulation of ocular blood flow. To some extent, NO is also involved in apoptosis, a mechanism of cell death that can lead to retinal ganglion cell loss in glaucoma. This article provides a short and simplified overview of the biochemistry of NO and endothelin and highlights the potential role of these two mediators in certain important aspects related to the pathogenesis of glaucoma.

Effect of Ox-LDL on endothelium-dependent response in pig ciliary artery: prevention by an ET(A) antagonist.

PURPOSE: To investigate whether oxidized low-density lipoprotein (Ox-LDL) affects endothelium-dependent responses in isolated porcine ciliary arteries. METHODS: In a myograph system for isometric force measurements, quiescent vessels were incubated with 50 microg/ml, 100 microg/ml, or 200 microg/ml Ox-LDL; 100 microg/ml native LDL (n-LDL); 1 microM of the ET(A)- endothelin receptor antagonist BQ 123; 100 microg/ml Ox-LDL coadministered with 1 microM BQ 123; or 100 microg/ml Ox-LDL coadministered with 50 microM of the protein synthesis inhibitor cycloheximide. Vessels with nonfunctional endothelium (intentionally and mechanically damaged) were also exposed to 100 microg/ml Ox-LDL. Two hours later, vessels were washed, precontracted with the thromboxane A2 analog U 46619 (approximately 0.1 microM), and exposed to bradykinin (0.1 nM to 3 microM), an endothelium-dependent relaxing agent. RESULTS: In quiescent vessels, Ox-LDL evoked delayed contractions. In contrast, no contractions were observed after exposure to n-LDL, BQ 123, Ox-LDL with BQ 123, or Ox-LDL with cycloheximide. In vessels with nonfunctional endothelium, Ox-LDL did not evoke contraction. Bradykinin-induced relaxations were inhibited in a dose-dependent manner by Ox-LDL, but not by n-LDL, BQ 123 alone, Ox-LDL with BQ 123, or Ox-LDL with cycloheximide. CONCLUSIONS: In porcine ciliary arteries, Ox-LDL affects endothelium-dependent responses through the activation of ET(A)- endothelin receptors. As Ox-LDL can accumulate in atherosclerotic plaques, such a mechanism might be involved in the occlusion of the ophthalmic circulation observed in patients with hypercholesterolemia and atherosclerosis.

Modulation of endothelin-1-induced contractions by magnesium/calcium in porcine ciliary arteries.

BACKGROUND: The present study was performed to investigate the influence of extracellular magnesium on changes in contractile tone induced by endothelin-1, and on relaxations to bradykinin in isolated porcine ciliary arteries. METHODS: Vessels were studied in a myograph system for measurement of isometric forces. Concentration-response curves (10(-10)-10(-7) M) to endothelin-1 were constructed in the presence of different concentrations (0, 1.2, 2, 10 mM) of magnesium (MgSO4). Endothelin-1-precontracted vessels (approximately 10(-8) M) were exposed to magnesium (10(-5)-10(-2) M) in the presence or absence of either the inhibitor of nitric oxide formation L-NAME (approximately 10(-4) M), or different concentrations of calcium (2.5, 5, 10 mM). In endothelin-1-precontracted vessels (10(-8) M), relaxations to bradykinin (10(-10)-10(-6) M) were conducted in the presence of different concentrations of magnesium (0, 1.2, 10 mM). RESULTS: Contractions to endothelin-1 were reduced only in the presence of 10 mM magnesium. (1.2 mM vs 10 mM, P = 0.001). In endothelin-1-precontracted vessels, magnesium evoked complete concentration-dependent relaxations (pD2 = 3.1 +/- 0.1), which were shifted to the right by increasing extracellular concentrations of calcium (2.5 vs 5 mM, P < 0.05). L-NAME had no influence on magnesium-induced relaxations. Relaxations to bradykinin remained unaffected by changes in extracellular magnesium concentrations. CONCLUSIONS: In a mechanism which appears to be compatible with a calcium-antagonist effect, magnesium strongly modulates changes in contractile tone evoked by endothelin-1, but has no effect on bradykinin-induced relaxations.

Phosphorus studies in pigs. 2. Assessing phosphorus availability for pigs and rats.

Experiments were conducted with pigs and rats to determine the availability of P in feeds. Initially, the availability of P in a soya-bean meal and field peas (Pisum sativum cultivar Early Dun) was assessed using a slope-ratio assay for grower pigs. Three different levels of either monosodium phosphate (MSP), soya-bean meal or field peas were added to a basal sucrose-soya-bean meal diet (2.5 g/kg P) to give three levels of P (3.0, 3.5 and 4 g/kg) for each source. The diets were offered for 35 d at three times maintenance energy requirements to female pigs initially weighing 20 kg live weight. Several bone variables and the ash and P concentration and retention levels in the empty body were used as criteria of availability. The responses to MSP were linear for all variables. However, responses to P in the test proteins, particularly soya-bean meal, were mostly non-linear, except for ash and P concentrations and retentions in the empty body. The estimates of P availability in the soya-bean meal and in the field peas were dependent on the criteria used to assess availability. Using bone variables as the criterion, the availabilities of P in soya-bean meal and field peas were approximately 0.17 and 0.38 respectively. Using ash or P concentrations or retentions in the empty body as the response criterion, the availabilities of P in soya-bean meal and field peas were 0.61 and 0.38 respectively. The mean retention values for P from MSP, soya-bean meal and field peas were 0.74, 0.33 and 0.21 respectively. Experiments were then conducted to define the conditions necessary for a slope-ratio assay for P availability with growing rats to determine if they could be used as a model to assess P availability for pigs. These experiments examined level of P in the diet, the effect of Ca:P ratio and criteria for assessing response (growth rate, feed intake, feed conversion ratio, bone ash and bone bending moment). The results indicated that a suitable range of dietary P for a slope-ratio assay in rats was 1.8-3.5 g/kg, with Ca:P ratio of between 1.3 and 6.2, and that ash content or bone bending moment of the femur bone were suitable criteria of response. However, using bone bending moment as the criterion of response, the availability of P in soya-bean meal was 0.81, which was considerably higher than the estimate with pigs.(ABSTRACT TRUNCATED AT 400 WORDS)

Phosphorus studies in pigs. 3. Effect of phytase supplementation on the digestibility and availability of phosphorus in soya-bean meal for grower pigs.

Two experiments were conducted (1) to determine the effects of phytase (EC 3.1.3.26) on the digestibility and availability of P in soya-bean meal for growing pigs and (2) to compare growth v. digestibility variables for assessing the availability of P. In the first experiment the effect of phytase on P availability was assessed in a growth assay using a slope-ratio design of treatments. Two different levels of either monosodium phosphate (MSP) or soya-bean meal were added to a basal sugar-soya-bean-meal diet (2.5 g P/kg) to give two levels of P (g/kg): 3.25 and 4.0 for each source. An additional five diets were supplemented with phytase. The ten diets were offered ad lib. for 35 d to female pigs initially weighing 20 kg live weight. In addition, the relative effectiveness of different variables for assessing P availability were compared: bone bending moment, ash in various bones, and ash and P in the empty body. The addition of phytase increased growth rate (g/d) (741 v. 835; P < 0.05), lowered the food conversion ratio (2.37 v. 2.16; P < 0.01), and increased protein deposition (g/d) (108 v. 123; P < 0.05), protein retention (kg/kg) (0.33 v. 0.36; P < 0.05), energy retention (MJ gross energy/MJ digestible energy) (0.36 v. 0.38; P < 0.05) and the availability of P in soya-bean meal from 0.11 to 0.69 when bone bending moment was the criterion of availability. All other criteria for assessing availability were unsuitable. In the second experiment the availability of (P) in soya-bean meal was assessed in a digestibility experiment with grower pigs using diets 1-5 as for Expt 1 arranged in a slope-ratio design of treatments. In addition, the effects of phytase supplementation on the apparent digestibility of P, dry matter, crude protein (N x 6.25) and energy were determined. The diets were offered at three times maintenance energy requirements to male pigs initially weighing approximately 30 kg live weight and total collection of faeces was conducted over a 10 d period. The availability of P in the soya-bean meal was 0.66 using digestible P intake as the criterion of response. The apparent digestibility of P in soya-bean meal was 0.42. Phytase supplementation increased the apparent digestibility of soya-bean meal P to 0.69 (P < 0.01) but had no effect on the faecal digestibility of dry matter or crude protein.(ABSTRACT TRUNCATED AT 400 WORDS)

Production responses to internal parasite control in dairy cattle.

A significant increase in milk production, averaging 164 litres per cow per lactation (a 4.8% increase), was seen after cows infected with gastrointestinal nematodes, paramphistomes and Fasciola hepatica were treated with broad-spectrum anthelmintics. Three hundred and ninety pairs of cows from eight herds with year-round calving were studied. One cow in each matched pair was given 7.5 mg/kg fenbendazole, 7.5 mg/kg levamisole hydrochloride and 15 mg/kg oxyclozanide in March, May and August of one year; the other cow in the pair received no anthelmintic. The number of nematode and trematode eggs was significantly decreased in the faeces of treated cows.

Prediction of the weight of lean and fat yield in bacon weight carcasses. A comparison of predictors used in commercial pig carcass classification.

Alternative methods of pig carcass description were compared as predictors of the weight (kg) of commercial lean yield and fat yield in 209 bacon weight carcasses. The predictors used included hot carcass weight and carcass sex in association with: the backfat measurements used in the Danish grading scheme (minimum loin, 3rd-4th lumbar and 3rd-4th last rib fat thickness); the proposed Australian system (P(2) fat thickness); fat classes published by the South Australian Livestock Marketing Study Group (1980); mid-line carcass measurements (backfat at minimum loin, mid back, maximum shoulder as well as carcass length) and visual carcass grade. There was no difference in precision between the carcass classification systems as predictors of lean yield. (R(2) = 69·0 % and residual standard deviation = 1·5.) Precision varied between the predictors of fat yield. The predictors were ranked as follows with R(2)(%) and residual standard deviation in parentheses. Danish (80·0, 0·50); Australian (70·5, 0·60); fat class (67·8, 0·64); mid-line (64·9, 0·67) and grade (58·1, 0·72).

The New South Wales mastitis control program. 3. The effect on production and economics.

A mastitis control program carried out in 35 commercial dairy heards over three years increased the milk produced by 343 kg per cow per year and the amount of butterfat by 15.8 kg per cow per year, giving a net benefit of $16.10 per cow per year by the end of the third year. The net benefit is considerably understated since benefits other than the increase in milk production were not quantified. The overall disposal rate of 33 herds showed a drop from 19.3% in year 1 to 13.6% in year 3. An analysis of culling records showed that as the severity of mastitis increased so did cow age.