Changes in serum and faecal zinc concentrations following supplementation with zinc sulphate heptahydrate of extensively grazed dairy cattle in New Zealand.

AIMS: To examine the relationship in dairy cattle between serum and faecal Zn concentrations and daily intake of Zn supplemented with an oral drench; and whether total daily intake (TDI) of Zn in dairy cattle can be predicted from single measurements of Zn concentration in serum or faeces. METHODS: A convenience sample of 20 animals from three stock classes (lactating cows, dry cows, heifers), that had not received Zn supplementation in the previous 60 days, was enrolled in the study. From Days -7 to -1, animals received no Zn supplementation. On Day 0, 15 animals per class were assigned daily drenching with increasing doses of ZnSO4.7H2O while five remained controls. From Days 0-6, treatment animals received 12.5 mg/kg LWT of Zn/day; from Days 7-13, 25 mg/kg LWT Zn/day and from Days 14-20, 37.5 mg/kg LWT Zn/day. Animals co-grazed within each stock class. Pasture, serum and faecal samples were collected at the start and at weekly intervals before each increase in Zn supplementation. Mixed and non-parametric models were used to assess treatment effects and whether daily intake of Zn could be predicted from Zn concentrations in serum and faeces. RESULTS: Dosing with 0, 12.5, 25.0 and 37.5 mg Zn/kg LWT resulted in serum Zn concentrations of 12.1, 16.7, 27.2 and 35.8 µmol/L in heifers, 13.3, 17.1, 26.4 and 40.0 µmol/L in dry and 11.9, 12.1, 23.4 and 27.2 µmol/L in lactating cows. Dosing with the same amounts of Zn resulted in faecal Zn concentrations of 2.95, 21.72, 40.32 and 53.27 mmol/kg DM in heifers, 2.81, 23.77, 55.16 and 68.20 mmol/kg DM in dry and 3.00, 12.71, 34.86 and 57.53 mmol/kg DM in lactating cows, respectively. Treatment elevated serum and faecal Zn concentrations above controls (p < 0.001). Supplemented lactating cows had lower serum Zn concentrations than dry cows or heifers (p < 0.01). Supplemented dry cows had faecal DM Zn concentrations higher than heifers or lactating cows (p < 0.05). Analysis showed serum and faecal Zn concentrations could predict TDI of Zn (p < 0.001). Concentrations of Zn in faeces estimated TDI of Zn within a narrower predictive interval than serum Zn concentrations. CONCLUSIONS AND CLINICAL RELEVANCE: Concentrations of Zn in serum and faeces were positively associated with TDI of Zn in dairy cattle and could predict TDI of Zn. When using serum and faecal Zn concentrations to estimate TDI Zn, stock class must be accounted for.

Effect of a metallic balloon-expanded stent on normal rabbit ureter.

Two-millimeter balloon-expanded Gianturco-Roubin coronary artery stents were placed in the 1-mm-diameter distal ureters of five normal rabbits. Retrograde pyelograms obtained immediately after stent placement showed no obstruction or extravasation of contrast material. Follow-up excretory urograms were obtained for each animal between 4 and 17 days, and autopsy was performed between 35 and 42 days. Findings at excretory urography and autopsy demonstrated severe obstruction at the level of the stent in each animal. Histologic examination of the resected ureter was performed. In four animals, the stent had penetrated into the wall of the ureter and a fibrous reaction had obliterated the lumen. In one animal, although the stent was still present within the lumen of the ureter, a fibrous reaction within the wall had destroyed the muscle layers and narrowed the lumen at the distal end of the stent. It is concluded that the 2-mm Gianturco-Roubin stent is unsuitable for placement in the 1-mm rabbit ureter.

Intraarterial cisplatin and concurrent radiation for locally advanced bladder cancer.

Between 1983 and 1987 25 patients with invasive bladder cancer (16 stage tumor 3 (T3) and nine stage T4) were treated with intraarterial cisplatin and concurrent radical radiation (20/25) or intraarterial cisplatin, concurrent preoperative radiation, and cystectomy (5/25). One patient died from treatment-related toxicity. Other toxicities have been what one would expect from the individual treatment modalities except for a sensory sacral root neuropathy in 11 of 24 (46%) patients. Twenty-three of 24 (96%) patients achieved a complete response (CR) and the projected actuarial 2-year survival is 90%. Only one of the 23 complete responders has had an invasive local recurrence. The excellent complete local response and survival rates achieved warrant further study of the combination of intraarterial cisplatin and radiation as a bladder-preserving strategy.

Mitomycin-C and metronidazole in the treatment of advanced renal-cell carcinoma.

Fifteen patients with advanced renal-cell carcinoma were treated with the combination of mitomycin-C 14-20 mg/m2 i.v. every 7 weeks and metronidazole 1,500 mg/m2 p.o. 12 and 1 h before and 6 and 24 h after the mitomycin-C. Of 12 patients evaluable for response, three (25%) responded with partial remissions. Myelosuppression did not appear to be increased over that seen with mitomycin-C alone. Pulmonary toxicity occurred in three patients and was fatal in two. The incidence of pulmonary toxicity was probably increased over that seen with mitomycin-C alone. Renal toxicity was also seen. Based on this small study, it was our feeling that this dose-schedule of metronidazole did not appear to result in enough of an augmentation of the efficacy of mitomycin-C against renal-cell carcinoma to justify the incidence of serious toxicity.

Intra-arterial cisplatin for bladder cancer.

Cisplatin (25 to 120 mg. per m.2) was injected into the internal iliac arteries of 33 patients with locally advanced bladder cancer. Of the patients 9 were inevaluable for response to the cisplatin, since they began radiotherapy to the bladder before course 2 of cisplatin as part of a preplanned therapeutic approach. One patient received the treatment as postoperative adjuvant therapy, 1 did not return for followup and 1 with metastatic disease did not undergo repeat cystoscopy. Of 21 evaluable patients 3 (14 per cent) achieved complete remission, 12 (57 per cent) achieved partial remission, 2 (14 per cent) were stable and 4 (19 per cent) failed. The response rate was higher in patients receiving 100 to 120 mg. per m.2 per course than in patients receiving lower doses (all except 1 of whom received 60 or less mg. per m.2 per course) (86 versus 64 per cent) and it was higher in patients without prior radiotherapy or chemotherapy. The response rate in patients with previously untreated invasive transitional cell carcinoma was 88 per cent. Of the 33 patients 21 were alive at last followup, with a median duration of followup of 32 weeks. Toxicity was dose-related and local neurotoxicity was excessive at cisplatin doses of 100 to 120 mg. per m.2. Diabetic patients were particularly prone to have neurotoxicity. Other toxicity generally was not severe and consisted of ototoxicity, nephrotoxicity, myelosuppression, nausea, vomiting and diarrhea. Even elderly patients and patients with cardiac disease tolerated the treatment well. We plan to proceed with further intra-arterial cisplatin studies in which all patients except those more than 80 years old will be treated with an intra-arterial cisplatin dose of 90 mg. per m.2 per course combined with radiotherapy with or without cystectomy.

Unusual clinical presentation of a patient with absent inferior vena cava.

We report a case of an absent inferior vena cava that presented clinically in an unusual manner. We believe this condition was caused by a combination of congenital and acquired factors. With the advent of modern imaging techniques such cases are being found with increasing frequency.

Difficulties in diagnosing and treating renal angiomyolipoma: report of three cases and review of the literature.

Renal angiomyolipoma is an uncommon benign tumor that presents diagnostic and therapeutic problems. It may be unilateral or bilateral; in its bilateral form it is usually associated with tuberous sclerosis. As a mass lesion of the kidney, it resembles renal cell carcinoma on pyelography and angiography, but computerized axial tomography and ultrasonography may provide a definitive diagnosis. This benign tumour should be treated conservatively to preserve renal function, but surgical intervention is necessary if renal cell carcinoma cannot be excluded completely.

A case of bilateral renal cell carcinoma in polycystic kidneys.

The authors present the seventh reported case of bilateral renal cell carcinoma in polycystic kidneys. They review the literature on benign and malignant tumours in polycystic kidneys emphasizing the diagnostic problems created by this condition. The diagnosis can be made by renal angiography. Therefore the authors suggest that this procedure should be carried out in all patients with polycystic renal disease who have hematuria.