A new method of computing the vertebral heart scale by means of direct standardisation.

OBJECTIVES: The aim of this study was to describe and compare a simplified vertebral heart scale computation method (Objective VHS) with the original Buchanan method (Buchanan VHS). METHODS: The Objective VHS was compared to the Buchanan VHS method in 42 dogs including 14 healthy dogs and 28 dogs with mitral insufficiency. For the Objective VHS, the sum of the length of the long and short axes of the cardiac silhouette obtained in centimetres using a metric ruler was subsequently converted into units of vertebral length by means of a direct standardization method. The Buchanan VHS was obtained as previously described. RESULTS: No significant differences in vertebral heart scale values were found between the two methods in all dogs. There was a strong positive correlation (0·99) between Objective VHS and Buchanan VHS. CLINICAL SIGNIFICANCE: The use of a direct standardization method based on a unit conversion allows -computation of vertebral heart scale values without transposing long and short axes to the cranial edge of T4.

Effects of epidural anaesthesia-analgesia on intravenous anaesthesia with propofol.

The main purpose of this study was to demonstrate that the use of epidural anaesthesia-analgesia reduces the amount of propofol necessary to maintain surgical anaesthesia in dogs during ovariohysterectomy. The study was carried out on 28 bitches undergoing ovariohysterectomy with general anaesthesia using an intravenous infusion of propofol. Dogs were allocated to one of two groups. Group 1 received systemic buprenorphine together with epidural analgesia using lidocaine and buprenophine, and in Group 2 systemic buprenorphine only was given. The mean propofol infusion rate was significantly lower in dogs with epidural analgesia (P < 0.0001). In addition, the mean endotracheal extubation time was significantly longer in dogs with epidural analgesia (P < 0.0001). No significant differences were detected in any of the physiological parameters measured.

Migration pathways of hypodermically injected technetium-99m in dogs.

Hypodermic injection of technetium-99m (99mTc-pertechnetate) at points of low electrical resistance give rise to rapid, longitudinal, and progressive diffusion of the radioactive tracer. We assessed the effect of cutaneous incisions that did not intersect the migration trajectory of 99mTc-pertechnetate and the re-establishment of pathways after the suture of incisions that intersected the migration trajectory. Linear and rapid migration of 99mTc-pertechnetate was not altered or prevented by incisions that did not intersect the migration pathway. Different patterns of 99mTc-pertechnetate spread were found when incisions intersected the radioactive pathways until restoration of the normal migration pathway observed in undamaged skin occurred. In all experiments in which migration of 99mTc-pertechnetate was observed, lavage of surgical wounds was followed by disappearance of the 99mTc-pertechnetate migration observed around the suture. Linear migration of the tracer was not observed when the incision was left uncovered, filled with petroleum jelly, or with a solid silicone sheet, but it was seen when non-sutured incisions were filled with transonic or silicone gel or covered with a solid silicone sheet parallel to the cutaneous plane. These data show that after a cutaneous incision that intersected the diffusion trajectory of the radioactive tracer, linear migration of 99mTc-pertechnetate hypodermically injected at points of low electrical resistance was restored before healing of the cutaneous incision and was independent of incisions made on the skin not overlying the radioactive pathway. A mechanism similar to that of capillary electrophoresis is suggested to explain the hypodermic diffusion of inert particles through specific and constant linear pathways.

Examination of the thoracic cavity and lung lobectomy by means of thoracoscopy in dogs.

The feasibility of thoracoscopy for viewing the chest cavity and performing pulmonary lobectomy was assessed in 8 mongrel dogs. Previously, selective intubation had been performed in another group of dogs (n = 8) in order to monitor respiratory physiology and assess its safety. Each hemithorax was intubated using a double-barrelled endotracheal tube with one barrel placed in the left main bronchus and the other in the bifurcation of the trachea. The thoracoscope was introduced through a cannula inserted through a 2-cm incision at the ventral third of the left 5th intercostal space. The cranial, dorsal, and caudal surfaces of the pleura, lobes of the left lung, and the mediastinum were examined. A 2nd cannula was located in the dorsal 3rd of the 5th intercostal space with a prior incision and used for the introduction of forceps to separate the viscera. To biopsy, a 3rd cannula was inserted at the dorsal third of the 8th intercostal space with a prior incision, through which a 12-mm diameter stapler was introduced. Should a lobectomy be necessary, a 4th cannula is located in the middle third of the 4th intercostal space. Excision of the left caudal pulmonary lobe was performed through the incision made for the 12-mm diameter cannula (8th intercostal space); a twisting movement facilitated removal. Thoracoscopy is a procedure that can be used in dogs and is particularly suitable for examination, collection of biopsy specimens, and even lung lobectomies.

Kinetics of hypodermically injected technetium-99m and correlation with cutaneous structures: an experimental study in dogs.

We investigated the involvement of cutaneous structures in specific linear migration pathways of technetium-99m pertechnetate hypodermically injected at points of low electrical resistance in the metacarpus of male beagles. Skin-deep incisions were made in the front or back legs on either the same side as the 99mTc injection or on the opposite side. Incisions in the back legs did not affect the migration pattern. Incisions in the front legs before the injection of 99mTc prevented tracer migration. After the injection of 99mTc, incisions in the front contralateral leg caused sudden cessation of the migration, while incisions in the ipsilateral leg caused immediate disappearance of the pathway previously observed. Radioactivity was not detected in flaps obtained from the skin overlying the migration pathway or from the corresponding area of the contralateral leg. In conclusion, the specific linear migration pathways of 99mTc hypodermically injected at points of low electrical resistance cannot be explained by any known biological function. Although the migration of 99mTc does not seem to be strongly linked to any cutaneous structure, the skin overlying the radioactive pathway and the corresponding area of the contralateral leg must be intact if tracer migration is to take place.

Experimental study on radioactive pathways of hypodermically injected technetium-99m.

The objective of this study was to investigate the biological substrate of radioactive pathways of migration of hypodermically injected 99mTc into points of low electrical resistance. Sixteen anesthetized adult male beagles were used. Control and test points were defined by comparing their electrical resistance to that of the pinna. Seventy-three experiments of three different types were performed: (1) separate hypodermic injections of [99mTc] sodium pertechnetate, 201Tl-chloride, 131INa and 99mTc-rhenium sulfide into control and test points; (2) simultaneous injections of [99mTc]sodium pertechnetate and 201Tl chloride into control and test points; and (3) intravascular injections of 99mTcO4 into blood vessels underlying test points. Only the hypodermic injection of 99mTc into points of low electrical resistance gave rise to a specific radioactive pathway characterized by rapid and longitudinal migration, clearly independent of background activity. The specific radioactive pathway detected is not the result of diffusion of the radiotracer through nerves, veins or lymphatic vessels, but its trajectory coincides with that described for one of the acupuncture meridians in the dog.

[Radiological appearances in postoperative obstructions (author's transl)]. / Aspects radiologiques des occlusions post-opératoires.

In the light of 9 cases, the authors study the varioud radiological appearances of postoperative obstructions. These may be early, before the restoration of intestinal transit, or secondary, during the days following the restoration of transit. The authors eliminate late postoperative obstructions from this study. There are various mechanisms of postoperative obstruction: organic obstructions may be due to an adhesion but also to agglutination or incarceration of intestinal loops. Functional obstructions most often accompany a localised area of inflammation. Mixed obstructions are a special feature of the postoperative period: agglutination of loops in contact with an area of inflammation. The authors emphasize the difficulty of radiological interpretation and the frequent disagreement between radiological and surgical findings.

A controlled study of therapeutic portacaval shunt in alcoholic cirrhosis.

A controlled study of therapeutic end-to-side portacaval shunt was carried out from 1968 to 1971 in 89 patients with alcoholic cirrhosis. Recurrent gastrointestinal bleeding was less common and chronic hepatic encephalopathy was more common in patients with shunts than in patients without shunts. The survival-rate was lower, but not significantly, in patients with shunts. No overall benefit of the operation could be demonstrated in cirrhotic patients with the selection criteria and the type of surgical shunt used in this study.

[Benign postoperative intrahepatic cholestasis]. / Cholestase intra-hépatique postopératoire bénigne

The authors report the clinical, biochemical, histological and etiologic characteristics of 24 patients with the syndrome of benign intra-hepatic post-operative cholestasis. Jaundice appeared early in the post-operative period, from the first to the 12th post-operative day. All patients had received blood transfusions. In 23 patients, the post-operative course was complicated, chiefly by local infection or septicemia. Hyperbilirubinemia ranged from 2 to 28 mg per 100 ml and was mainly conjugated; serum alkaline phosphatase activity was normal or moderately elevated; in 3 patients, it was markedly elevated; serum glutamic-pyruvic transaminase activity was normal on 7 patients, moderatly increased in 15, and markedly increased in one. Liver histology was normal in 6 patients, and showed minimal lesions (cholestasis and slight portal inflammatory changes) in 3. Jaundice did not appear to modify the final outcome. It appears to be due both to increased production of bilirubin (as a result of blood transfusions) and to decreased excretion of bilirubin by the liver (as a result of the surgical operation and of infection).

Immune complex type glomerulonephritis in cirrhosis of the liver.

Glomerular lesions were detected in 9 of 10 patients with liver cirrhosis: these lesions consisted of a) thickening of basement-membrane-like material, b) electron-dense deposits in mesangial areas and in capillary walls, c) round areas of rarefaction in the membrane-like material and in some deposits, and d) presence of IgA, with IgG and/or IgM and/or C3, in the deposits. The association of these four abnormalities seems to be characteristic of "cirrhotic glomerulonephritis." The deposits could be the result of precipitation in the glomeruli of either aggregated immunoglobulins or circulating immune complexes.

[Postoperative intraabdominal suppurations due to Ristella. Clinical, bacteriological and therapeutic characteristics]. / Suppurations intra-abdominales post-opératoires Ristella. Particularités cliniques, bactériologiques et thérapeutiques

From 1972 to 1974, 8 intraabdominal postoperative suppurations due to Bacteroides have been observed at Hospital Beaujon. Three characteristic features of such infections have been analysed: the high frequency of associated jaundice; the difficulty of isolation of the Bacteroides; their specific sensitivity to some antibiotics. In 5 patients, jaundice related to the bacterial infection has been observed; jaundice was of the cholestatic type; it was mainly due to conjugated hyperbilirubinemia; in approximately 50 p.cent of the cases, serum alkalin phosphatases activity and serum glutamic-pyruvic transaminase activity were moderately elevated; the presence of jaundice did not seem to have any influence on the prognosis. The frequent association to Bacteroids of enterobacteria makes isolation of the Bacteroides difficult. The necessity of some precautions in the handling (storage at 4 degrees C or immediate inoculation in anaerobic conditions) is emphasized. Bacteroides are always resistant to penicillin and to the other broad spectrum antibiotics usually effective enterobacteria. They are sensitive to tetracyclins (5/8), lincomycin (2/4), clindamycin (2/3), rifampicin (8/8), pristinamycin (7/7), carbenicillin (3/3), erythromycin (8/8) and chloramphenicol (8/8).

Canalicular bile production in man.

Bile flow, erythritol clearance (measured after administration of 14-C-erythritol) and bile acid excretion were studied in 8 non-icteric patients operated upon for gallstone disease without biliary obstruction in whom a T-tube had been inserted. Bile flow increased from the 2nd (0.27 plus or minus SEM 0.01 ml/min) to the 7th (0.50 plus or minus SEM 0.05 ml/min) postoperative days and remained stable thereafter. Because the values obtained between the 7th and the 15th postoperative days (average: 0.46 plus or minus SEM 0.02 ml/min) were not lower and were of the same order of magnitude as those previously reported in the literature for quantitative bile collections, it was assumed that bile collection had been complete. Bile-to-plasma concentration ratio of erythritol was 0.77 plus or minus SEM 0.04. The regression line between erythritol clearance and bile flow had a slope of 0.99 (indicating that increments in clearance were followed by equivalent increments of flow) and an intercept for a zero-clearance of 0.11, suggesting a ductular/ductal secretion of 0.11 ml/min. The relationship between erythritol clearance and bile acid excretion suggested that canalicular bile was formed both of a bile acid-dependent flow (11 mul of water being excreted per mumol of bile acid secreted) and a bile acid-independent flow of 0.16 ml/min (or 35 percent of the average bile flow). These findings indicate that erythritol clearance provides a valid estimate of canalicular bile flow in man and that the three bile fractions previously postulated in animals (canalicular bile acid-dependent, canalicular bile acid-independent and ductular/ductal) may also be present in man.