Using the Unger system to classify 386 long bone fractures in dogs.

A system already described by Unger and others was used to classify long bone fractures in dogs. The present paper reports experiences using the fracture classification system regarding its ease of use and the ability to analyse the data generated. Three hundred and eighty-six canine long bone fractures were classified from radiographs. Results were assessed by reviewing the medical records or by sending questionnaires to referring veterinarians. There were a few inconsistencies, particularly in classifying proximal ulnar fractures, but the system was easy to use and data retrieval was readily accomplished. Data from the system were used to compare the results of repairs of diaphyseal fractures of the radius/ulna, femur and tibia/fibula. A chi square analysis was used to determine significant differences between the outcome scores of the three fracture types. Fractures of the femoral diaphysis had a statistically poorer outcome than did diaphyseal fractures of the radius/ulna or tibia/fibula.

Post-match disorder: how to cope when your program fails to match.

BACKGROUND: Faculty, residents, and staff of programs that fail to match in the National Resident Matching Program may develop a Post-Match Disorder (PMD) that can threaten a program's self-esteem, teamwork, and ability to function. The symptoms of PMD include manifestations of shock, anger, and depression. This report describes the experience of one program that unexpectedly failed to match and the subsequent development of PMD among program personnel. METHODS: A survey of applicants who did not match with the program was conducted. RESULTS: The results indicated that the applicants perceived the program as having many positive attributes and had ranked it highly--but not high enough to match. CONCLUSIONS: The awareness that applicants perceived the program positively helped alleviate symptoms of PMD and allowed faculty and residents to focus on subsequent resident recruitment, leading to a successful match in the following year.

0-7-21 radiation therapy for the palliation of advanced cancer in dogs.

The 0-7-21 radiation therapy protocol was investigated as a palliative treatment in dogs with advanced malignancies. Twenty-four dogs with a variety of tumor types were irradiated using 800 cGy fractions given on days 0, 7, and 21. Twenty-three dogs were evaluated. Palliative response was assessed using a quality of life instrument developed for veterinary use. This pain score was based on owner response to questions regarding analgesic requirement, activity level, appetite, and degree of lameness in the affected dogs. Seventeen (74%) of the 23 dogs experienced complete pain relief, and 3 (13%) obtained partial relief. Of the 17 dogs that achieved a complete response, pain recurred in 8 at a median time of 70 days. Six dogs were alive and free of pain up to 557 days after irradiation. The 0-7-21 protocol was well tolerated; pain relief occurred quickly, and acute radiation reactions were negligible.

0-7-21 radiation therapy for the treatment of canine oral melanoma.

Eighteen dogs with malignant melanoma of the oral cavity were treated with high-dose per fraction (0-7-21) radiation therapy. Eight hundred cGy was administered on days 0, 7, and 21 for a total dose of 2,400 cGy in 3 weeks. Of 17 dogs evaluated, 9 (53%) had a complete remission and 5 (30%) achieved a partial remission with an overall response rate of 83%. Local failure occurred in 2 of the 9 dogs where a complete response was initially observed. One dog died of intercurrent disease, and one died of metastatic disease without evidence of local recurrence. Five dogs are alive and free of disease 9 to nineteen months from the initiation of therapy. The 0-7-21 protocol was well-tolerated, and acute radiation reactions were low-grade and limited to the skin. The results of this study demonstrate that oral melanomas in dogs are responsive to radiation. 0-7-21 radiation therapy offers a viable alternative to radical excision, especially when tumor volume or location would require cosmetically or functionally debilitating surgery.

Comparison of magnetic resonance images and the histopathological findings of lesions induced by interstitial laser photocoagulation in the brain.

Interest has developed in using magnetic resonance (MR) imaging to monitor the volume of tissue destroyed by interstitial laser photocoagulation (ILP). In these experiments, ILP was induced in the normal brains of 9 anesthetized cats by delivering 1.5 W of continuous-wave Nd:YAG laser energy (1,064 nm) from a single 400-microns core optical fiber for 1,000 s. The irradiations were monitored using proton spin-echo MR imaging during and immediately after ILP and at postirradiation survival times of 2, 5, and 14 days. At 2 days postirradiation, the necrotic thermal lesion consisted of a central cavity surrounded by 2 concentric zones of coagulative necrosis, one dense and the other dispersed. The lesion shrank and the zonal appearance became less obvious over the 14 day survival period. An enhancing halo on contrast-enhanced T1-weighted images acquired immediately postirradiation best approximated the total lesion diameter at 2 days. These images also indicated that the volume of tissue destroyed during ILP corresponded better to the necrotic volume determined at 2 days than at 5 days and 14 days postirradiation. T2-weighted images acquired during and immediately after ILP consistently underestimated the total lesion diameter at 2 days.

Magnetic resonance imaging of interstitial laser photocoagulation in brain.

Magnetic resonance (MR) imaging can be used to monitor the development of thermal lesions induced in tissue using interstitial laser photocoagulation (ILP). A potential application for ILP is the treatment of surgically inaccessible brain tumors. For the successful clinical application of MR-monitored ILP, it is necessary to relate MR images of ILP lesions to the actual induced lesions. In this preliminary study we performed ILP in the normal brains of anesthetized cats by delivering interstitially 1.0, 1.5, and 2.0 W of continuous-wave Nd:YAG laser energy (1,064 nm) for 1,000 s via a plane-cut 400 microns core optical fiber. At 48 h post-irradiation the lesions consisted of four sharply demarcated concentric zones of thermal damage. Lesion diameter increased linearly with delivered power. T2-weighted proton spin-echo images acquired during ILP showed a region of complete or near signal loss that underestimated the actual lesion at 48 h. Gadolinium-enhanced T1-weighted spin-echo images acquired immediately post-irradiation showed the actual lesion precisely.

Arthrodesis of the scapulohumeral joint in a miniature horse.

Scapulohumeral arthrodesis was performed successfully as treatment for severe degenerative arthritis in a 62-kg miniature horse. Using an approach similar to that used for a dog, this horse's scapulohumeral joint was opened, the cartilage was removed, and the site was stabilized, using an 11-hole narrow dynamic compression plate. Fusion was uncomplicated. The stallion became a successful pasture-breeding animal.

Strongylus vulgaris in the tunica media of arteries of ponies and treatment with ivermectin.

A preliminary investigation was made into the effect of fourth-stage Strongylus vulgaris larvae sequestered in the tunica media of ileocolic arteries of pony foals treated with ivermectin. The foals had been reared parasite-free, inoculated with infective larvae and given orally a placebo or ivermectin paste. Two foals received subsequently one or two further inoculations with larvae and treatment with ivermectin. Arteriography was used to identify the lesions in the ileocolic artery following inoculation and their regression following treatment. At necropsy, foals were examined for lesions and larvae grossly and histologically. Ivermectin was highly effective against fourth-stage larvae and those present in the media appeared not to unduly affect the integrity of the ileocolic artery. Increased numbers of larvae were not found in the media of foals receiving repeat inoculations and repeat treatments. Larvae were not found in the media of foals treated with a placebo. The major pathological changes in the arterial wall of all foals were attributed to infection with S. vulgaris and there was no strong tendency for the damaged arteries to return to normal after the S. vulgaris were removed.

Intra-articular tissue response to analytical grade metrizamide in dogs.

The effect of analytical grade metrizamide (AM) injected into the canine stifle, for purposes of arthrography, was studied in 12 adult dogs using saline solution as the control solution injected into the contralateral joints. The AM was used at a concentration of 280 mg of iodine/ml and was administered at the dose of 0.3 ml/cm thickness of the stifle joint. For each joint, arthrocentesis was done before and 7 days after injection of either the contrast medium or saline solution. Physical, biochemical, and cytologic examinations were done on the synovial fluid while the synovial membranes and femoral articular cartilages were sectioned, stained, and examined for histopathologic changes. At the 95% confidence level, significant differences in the total and differential mononuclear cell counts were not seen between the AM- and saline solution-injected joints. However, some subtle changes in the synovial membranes were observed. Intra-articular injection of AM or saline solution initiated a mild inflammatory response, the AM causing slightly more response than the saline solution.

Evaluation of analytical grade of metrizamide for canine stifle arthrography.

The use of analytical grade of metrizamide as contrast material in canine stifle arthrography was evaluated in 27 stifle joints. A concentration of 280 mg of I/100 ml was prepared, and the material was injected at a rate of 0.3 ml/cm thickness of the lateral to medial measurement. Acceptable arthrograms were produced in 22 (81.5%) cases. The mediolateral radiographic view was useful in demonstrating the cranial and caudal cruciate ligaments, the infrapatellar fat pad, and the tendon of the long digital extensor muscle. The caudocranial radiographic view was useful in demonstrating the medial and lateral menisci, the articular surfaces of the femoral condyles, and the outline of the joint capsule. Radiographs made within 15 minutes after injection of the contrast medium were acceptable, thus setting this period as the limit for obtaining useful arthrograms. The double contrast technique was found to be of little value.

Effectiveness of fenbendazole against later 4th-stage Strongylus vulgaris in ponies.

Twelve pony foals (reared worm-free) were inoculated with Strongylus vulgaris. Approximately 8 weeks later, 4 of the foals were given fenbendazole (10% suspension) at a dosage rate of 10 mg/kg of body weight daily for 5 days and 4 foals were given the suspension at a dosage rate of 50 mg/kg daily for 3 days; the remaining foals were given a placebo. All treatments were administered by stomach tube. Fenbendazole was 99.6 and 97.9% effective in the 2 treatment groups, respectively, in eliminating later 4th-stage S vulgaris larvae located near the origin of major intestinal arteries. On microscopic examination of the ileocolic artery from fenbendazole-treated foals, a few larval remnants were found beneath the tunica intima in small organized mural thrombi overgrown with endothelium. It would appear that larvae are rapidly destroyed after administration of fenbendazole. A pony foal reared on pasture and with arteriographic evidence of arteritis of the cranial mesenteric and ileocolic arteries was treated with fenbendazole (10% suspension) by stomach tube at a dosage rate of 50 mg/kg of body weight daily for 3 days. By arteriographic examination made 4 weeks later, there was evidence of regression of the lesion, and at necropsy done a week later, there was no arteritis or larvae in the lumen of those arteries.

Cross-cultural family medicine residency training.

Over the past four years the University of California, San Diego (UCSD), Family Medicine Residency Program has developed a cross-cultural training program. The goal of the program is to prepare residents to function as effective health care providers in medically underserved areas with ethnically diverse patient populations. The required training activities include (1) a Spanish language course, (2) a clinical rotation in a community health clinic serving a Hispanic, medically underserved population, (3) a preceptorship in home-based health education and counseling for Spanish-speaking families, and (4) a set of cross-cultural sensitivity training activities that are part of the Residency Behavioral Science Program. The UCSD Cross-Cultural Family Medicine Training Program is described here as a prototype for consideration by other family medicine residency programs.

Effectiveness of ivermectin against later 4th-stage Strongylus vulgaris in ponies.

Twelve pony foals were reared worm-free and inoculated with Strongylus vulgaris. Approximately 8 weeks after they were inoculated, 6 foals were given ivermectin IM at a dosage rate of 200 micrograms/kg of body weight and 6 were given a placebo. All foals were necropsied 35 days after treatment. Ivermectin was 98.9% effective in eliminating later 4th-stage S vulgaris larvae located near the origin of major intestinal arteries and in reducing clinical signs and permitting resolution of lesions associated with verminous arteritis. One pony foal reared on pasture and with evidence of arteritis of the cranial mesenteric and ileocolic arteries on arteriography was treated with ivermectin at a dosage rate of 200 micrograms/kg of body weight. On arteriographs taken subsequently, there was evidence of regression of the lesion, and at necropsy 9 weeks after treatment, there was no arteritis or larvae in those arteries.

Canine hip dysplasia: breed effects.

This paper is a refinement of previous studies in that only suitably radiographed dogs were included in the data base. The rate of hip dysplasia varied widely by breed from five percent in siberian huskies to eighty-three percent in english bulldogs. There was a significant difference in the prevalence of dysplasia within at least two breeds; golden retrievers and old english sheepdogs. Physical size per se did not appear to be an important determinant of hip dysplasia.

Arteriography in ponies with Strongylus vulgaris arteritis.

Radiographs of the aorta and abdominal arteries were obtained from a normal anesthetized pony following catheterization of a femoral artery for nonselective, semiselective or selective arteriography. The arteries had smooth borders and regular diameters and the branches of the cranial mesenteric artery could be followed distally on the angiogram through to the smaller branches proximal to the bowel wall. Following arteriography, the pony walked normally and there were minimal alterations of the levels of serum muscle enzymes and blood lactate. The procedures for arteriography were repeated in three days. At that time the femoral artery was patent and satisfactory angiograms were obtained. Similiarly, radiographs were obtained from two ponies artificially infected with Strongylus vulgaris. The cranial msenteric artery and some of its branches, the right renal artery and segments of the aorta had irregular borders and were enlarged. Branches of the cranial mesenteric artery could not be followed distally because the flow of the contrast material was blocked. Following the above procedures, euthanasia of all ponies was expedited and the findings of arteritis, thrombosis and dilatation of arteries at necropsy compared favorably with interpretations from the radiographs. At least in the pony, arteriography can be a valuable research and diagnostic tool for the demonstration of lesions associated with verminous arteritis.