Comparison of ketamine-dexmedetomidine-methadone and tiletamine-zolazepam-methadone combinations for short-term anaesthesia in domestic pigs.

Cardiorespiratory effects, quality of induction, depth of anaesthesia and quality of recovery were compared in pigs anaesthetised with 8 mg/kg ketamine, 20 µg/kg dexmedetomidine and 0.2 mg/kg methadone (KDM, n = 18) or 8 mg/kg tiletamine-zolazepam and 0.2 mg/kg methadone (TZM, n = 9). Anaesthesia with KDM was partially reversed in nine animals with 0.2 mg/kg atipamezole (KDMat). Sedation was observed earlier in the TZM group (47.2 ± 25.3 s) than the KDM group (91.5 ± 37.4 s). Sternal and lateral recumbency were achieved earlier in the TZM group (76.3 ± 36.5 s and 132.1 ± 30.5 s, respectively) than in the KDM group (149.1 ± 58.7 s and 249.2 ± 84.0 s, respectively). PaO2, SaO2 and PaO2:FiO2 were lower in the TZM group (68.7 ± 4.1 mmHg, 93.4 ± 1.4% and 327.2 ± 19.9 mmHg, respectively) than in the KDM group (80.4 ± 5.9 mmHg, 95.7 ± 1.0% and 380.4 ± 25.6 mmHg, respectively). Fshunt and P(A-a)O2 were higher in the TZM group (24.0 ± 11.8% and 31.4 ± 3.8 mmHg, respectively) than in the KDM group (13.4 ± 3.2% and 20.7 ± 7.4 mmHg, respectively). Times from drug injection to first head movements, sternal recumbency and standing/walking were significantly shorter in the KDM group (45.1 ± 10.5, 48.4 ± 12.6 and 54.4 ± 17.8 min, respectively) than in the TZM group (57.8 ± 11.4, 93.1 ± 14.2 and 165.7 ± 56.6 min, respectively). The median recovery score was higher in the TZM group than in the KDMnoat and KDMat subgroups. Both drug combinations provided adequate anaesthesia for minor procedures lasting about 30 min, but TZM was associated with a poor recovery and oxygenation.

Morphologic radiographic study of the proximal sesamoid bones of the forelimb in thoroughbred racehorses in training.

The aim of this study was to identify differences in bone shape (height and width) of proximal sesamoid bones (PSB) in 2-year-old Thoroughbred racehorses in training. Dorsal 15° proximal-palmarodistal oblique images of each metacarpophalangeal joint were acquired before the horses started training and at 1 year after the start of exercise and racing. There were no changes in height and width of PSBs induced by training. There was a significant difference of height and width between medial and lateral PSBs. In both forelimbs, the medial PSB was significantly wider and shorter than the lateral PSB. The medial PSB of the right forelimb was significantly wider than that of the left forelimb. These results might explain some limb predilection for fracture of PSBs. The difference in strain pattern between medial and lateral PSBs in different loading conditions needs to be investigated.

Pattern dystrophy of the retinal pigment epithelium in Crohn's disease. A case report.

The authors describe a case of bilateral pattern dystrophy of the retinal pigment epithelium in a man with Crohn's disease. The patient was examined every 6 months over a follow-up of 30 months. The right eye presented a macroreticular dystrophy while in the left eye a butterfly pattern dystrophy was diagnosed. During the follow-up period the retinal lesion changed; in the right eye the lesion increased in size, while in the left eye the morphology of the lesion passed from the butterfly to Sjögren's type. This report adds a new ocular manifestation of Crohn's disease, emphasizing the importance of the ophthalmological follow-up in the recognition of posterior segment complications associated with this inflammatory bowel disease.

Long-term safety and tolerance of silicone and self-expandable airway stents: an experimental study.

BACKGROUND: A variety of respiratory stents are currently available, but the ideal airway prosthesis seems far from being recognized. The objective of this study was to verify safety and long-term effect on the bronchial wall of three different types of airway stents. METHODS: Twelve healthy adult sheep were divided in three groups, scheduled to receive: (1) bare self-expandable metallic stents (Gianturco); (2) silicone stents (Dumon); and (3) covered self-expandable synthetic stents (Polyflex). Insertions were performed through a rigid bronchoscope under general anesthesia. Chest roentgenogram was performed 1 and 6 months after surgery, and flexible bronchoscopy after 6 months. Twelve months postoperatively, the animals were killed and a postmortem examination was carried out. RESULTS: All Polyflex stents migrated during the observation period; one late migration was observed in the Dumon group. Microscopic study showed: (1) Gianturco stents: full-thickness perforation of the bronchial wall covered by a thick layer of a chronic inflammatory infiltrate. Infection by Candida at the bottom of some ulcerations; (2) Dumon stents: mild bronchial inflammation (squamous metaplasia, submucosal inflammatory infiltrates; granuloma-like infiltrates). In case of displacement, no significant changes of the previously stented bronchus occurred; and (3) Polyflex stents: no changes of the previously stented bronchi. CONCLUSIONS: Gianturco stents proved unsafe in the long term, owing to the risk of severe airway wall damage. The Polyflex stent is well tolerated but presents a high migration rate. Silicone stents show several limitations but appear to be well tolerated by the host mucosa.

Lower motor neuron disease in the Griffon Briquet Vendéen dog.

Two 2-month-old Griffon Briquet Vendéen pups from the same litter were evaluated for progressive weakness and hind limb paresis. The paraparesis progressed rapidly to extensor paralysis with subsequent involvement of the forelimbs with flexor paralysis. The appendicular muscles of all four limbs became progressively atrophied. Lesions included severe loss of neurons in the ventral horns of the spinal cord, Wallerian degeneration of ventral spinal roots, and peripheral nerve and neurogenic appendicular muscular atrophy. The clinical and morphological findings were consistent with a progressive lower motor neuron disease.

Congenital mono-ophthalmia syndrome.

Three patients affected by the congenital mono-ophthalmia syndrome were submitted to horizontal eye movements recording. The aim was to study the nystagmus and its characteristics, in order to give information that could explain signs and symptoms of the syndrome. Eye movements recording and analysis displayed a jerk nystagmus with a decreasing-velocity exponential slow phase, characteristic of a latent/manifest-latent nystagmus. The intensity of nystagmus decreased in adduction of the viewing eye, and increased in abduction in accordance with Alexander's law. The fast phase was toward the viewing eye. There was no reversal of the fast phase, nor an instability of gaze in the blind eye.

Galactose-1-P-uridyl transferase activity in patients with congenital and infantile cataract.

The activity of red blood cell galactose-1-P-uridyl transferase in 22 patients with congenital and infantile cataract and in 18 age-matched controls was investigated. All control subjects examined showed normal enzymatic levels, while 31.8% of patients with congenital and infantile cataract presented a statistically significant reduced enzymatic activity (mean--2 SD in controls). Twenty-four parents of children with congenital and infantile cataract were also examined. Four parents were affected by congenital cataract and the other 20 showed transparent lenses. The parents were compared with a group of 20 age-matched control subjects examined previously. There was no difference in the average enzymatic activities between the groups. The results suggest that a chronic disorder of galactose metabolism may be involved in the development of congenital and infantile cataract.

Wildervanck's syndrome with bilateral subluxation of lens and facial paralysis.

A 15-year-old female was found to have the typical features of Wildervanck's syndrome, including Klippel-Feil anomaly, abducens paralysis, retraction of the bulbi, and deafness. In addition, she had bilateral lens subluxation and facial paralysis, neither of which have been reported in patients with Wildervanck's syndrome.