Histological evaluation of the soft palate in dogs affected by brachycephalic obstructive airway syndrome.

AIMS: To histologically examine tissue obtained from the thick rostral portion of the soft palate in severely affected brachycephalic dogs, and to quantitatively compare the histological findings with a similar region in control dogs. METHODS: Nine dogs examined for treatment of brachycephalic obstructive airway syndrome (BOAS) were prospectively recruited into the study. Four mesaticephalic dogs were also recruited following euthanasia for reasons unrelated to respiratory or gastrointestinal disease. Palatine tissue was harvested using an elliptical incision extending from the junction with the hard palate to the free caudal edge, and passing axial to the tonsilar crypts. The resected portion was fixed in formalin and stained using H&E. Tissues were examined in transverse section and assessments of the palatinus muscles, interstitium, lamina propria and salivary tissue were recorded. Quantitative analysis of the proportions of palatinus muscle, salivary tissue and stroma was performed using ImageJ image analysis software. RESULTS: When compared to the control dogs, the histological findings of the clinically affected dogs showed a marked increase in acute and chronic muscle degeneration and necrosis. This was typified by swollen, hypereosinophilic fibres with centralised nuclei, myofibre atrophy, loss of cross striations and fragmented sarcoplasm. There was reduced proportions of palatinus muscle (p<0.001) and increased proportions of collagenous stroma (p=0.004) and salivary gland tissue (p=0.046) in the clinical samples, compared to control dogs. CONCLUSIONS: Increased thickness of the palate in dogs with BOAS was not due to muscle hypertrophy but was due to increased stroma within the lamina propria, and increased proportions of salivary tissue. There was also a reduction of muscle mass, especially within the paired palatinus muscles, that may have consequences for palate function. CLINCAL RELEVANCE: The results of this study enable us to start investigating the aetiology of the changes seen in brachycephalic compared to mesaticephalic dogs, which will impact timing and extent of treatment of clinical cases.

Total hip arthroplasty outcomes assessment using functional and radiographic scores to compare canine systems.

A retrospective multi-centre study was carried out in order to compare outcomes between cemented and uncemented total hip arthoplasties (THA). A quantitative orthopaedic outcome assessment scoring system was devised in order to relate functional outcome to a numerical score, to allow comparison between treatments and amongst centres. The system combined a radiographic score and a clinical score. Lower scores reflect better outcomes than higher scores. Consecutive cases of THA were included from two specialist practices between July 2002 and December 2005. The study included 46 THA patients (22 uncemented THA followed for 8.3 +/- 4.7M and 24 cemented THA for 26.0 +/- 15.7M) with a mean age of 4.4 +/- 3.3 years at surgery. Multi-variable linear and logistical regression analyses were performed with adjustments for age at surgery, surgeon, follow-up time, uni- versus bilateral disease, gender and body weight. The differences between treatment groups in terms of functional scores or total scores were not significant (p > 0.05). Radiographic scores were different between treatment groups. However, these scores were usually assessed within two months of surgery and proved unreliable predictors of functional outcome (p > 0.05). The findings reflect relatively short-term follow-up, especially for the uncemented group, and do not include clinician-derived measures, such as goniometry and thigh circumference. Longer-term follow-up for the radiographic assessments is essential. A prospective study including the clinician-derived outcomes needs to be performed in order to validate the outcome instrument in its modified form.

Prevalence of Thelohania solenopsae infected Solenopsis invicta newly mated queens within areas of differing social form distributions.

Newly mated queens (NMQs) originating from monogyne red imported fire ant (Solenopsis invicta) colonies and following a mating flight, initiate new colonies by sealing themselves in a nuptial chamber and relying solely on their own fat and crop reserves, as well as no longer needed wing muscles to rear their first workers (claustral colony foundation). This method of colony-founding is rarely successful for polygyne-derived NMQs, whose low weight critically limits the number of first workers they are able to produce. However, this observation may be confounded by the parasitic microsporidium, Thelohania solenopsae, thus far found to persist only in association with polygyne colonies. Infections of this microsporidium reduce the weight of female alates and may explain why polygyne NMQs are unlikely to successfully found colonies claustrally. NMQs collected following mating flights in Gainesville and Ocala, Florida were sorted by weight, checked for insemination and T. solenopsae infection. Insemination levels were greater than 90% for all weight classes at both collection sites and were not related to infection. Infection levels were lower in Gainesville than Ocala, averaging 1.67% and 14.14%, respectively. Polygyne-derived NMQs collected in Ocala, defined here as weighing 12mg (social form correctly assigned in 85% of samples examined by PCR), had the highest infection levels, 25.37% (17/67) in 2003 and 21.43% (6/28) in 2004. We conclude that infection by T. solenopsae cannot be completely responsible for the inability of polygyne NMQs to claustrally establish colonies.

Interleukin-18, neutrophils, and ANCA.

Hewins et al. show that IL-18 is expressed in the kidneys of patients with ANCA-associated glomerulonephritis, and that IL-18 primes neutrophils via p38 MAPK. These findings suggest a role for IL-18, including IL-18-induced T(H)1 polarization and IFN-gamma production, in the progression of ANCA disease.

Arthroscopic management of septic polyarthritis in a dog.

A 4 1/2-month-old male Neapolitan Mastiff was presented with a history of severe non weight-bearing lameness, depression and anorexia, following 6 weeks of intermittent thoracic limb lameness that had deteriorated in the previous 72 hours. Haematogenous septic polyarthritis involving the right elbow joint and left glenohumeral joint was diagnosed, with blood and joint cultures revealing a Pasteurella species. Arthroscopy was utilised to facilitate joint evaluation and effect drainage of both joints. Clinical remission was achieved within 48 hours. Arthroscopy provided a minimally invasive yet thorough joint examination, lavage, and drainage of fibrinopurulent debris, thereby allowing early postoperative mobility and minimal morbidity.

In vitro experimental study of the effect of radial shortening and ulnar ostectomy on contact patterns in the elbow joint of dogs.

OBJECTIVE: To determine effects of incremental radial shortening and subsequent ulnar ostectomies on joint surface contact patterns in a canine elbow joint model. SAMPLE POPULATION: Paired forelimbs from 9 adult dogs. PROCEDURE: Joint casting was performed by placement of colored polymethylmethacrylate in the elbow joint cavity and loading in a materials testing system at physiologic angle and load. Joint casting was performed in unaltered specimens, after radial shortening, and after subsequent distal ulnar ostectomy, proximal ulnar ostectomy, and proximal ulnar ostectomy with intramedullary pinning. Computer-aided analysis of photographs of proximal radial and ulnar articular surfaces without joint casts was performed before and after each casting procedure. RESULTS: All increments of radial shortening changed the size and location of radial and ulnar contact areas. The radial contact area became smaller, the anconeal contact area disappeared, the medial coronoid contact area migrated craniolaterally, and the lateral projection of the coronoid process became a contact area. A proximal ulnar ostectomy stabilized with an intramedullary pin restored normal contact area size and location and restored continuity of the radial and coronoid contact areas across the radioulnar articulation in 6 of 10 specimens. A midshaft ulnar ostectomy, distal to the level of the radioulnar ligament, had no effect on contact patterns. A proximal ulnar ostectomy without stabilization resulted in varus deformity during loading. CONCLUSIONS AND CLINICAL RELEVANCE: Proximal radial shortening, which creates articular step incongruity, changes the location and size of the radioulnar contact areas. Dynamically stabilized ulnar ostectomies proximal to the radioulnar ligament restore contact patterns in vitro.

Nontraumatic rupture of an adrenal gland tumor causing intra-abdominal or retroperitoneal hemorrhage in four dogs.

Diagnosis and surgical management of intra-abdominal or retroperitoneal hemorrhage in 4 dogs with rupture of an adrenal gland tumor were determined. All 4 dogs were lethargic and weak with pale mucous membranes on initial examination. Three dogs did not have any history of clinical signs of hyperadrenocorticism or pheochromocytoma prior to examination. In 3 of the dogs, a mass in the area of the adrenal gland was identified with ultrasonography prior to surgery. All dogs developed ventricular premature contractions before or during anesthesia. Three dogs survived adrenalectomy; 1 dog was euthanatized during surgery because of an inability to achieve adequate hemostasis. The remaining 3 dogs all survived more than 5 months after surgery; 1 was euthanatized 9 months after surgery because of rupture of a hepatic mass. On the basis of these results, we suggest that hemodynamic stabilization followed by adrenalectomy is the treatment of choice for dogs with nontraumatic rupture of an adrenal gland tumor and resulting life-threatening hemorrhage.

In vitro determination of contact areas in the normal elbow joint of dogs.

OBJECTIVE: To evaluate areas of articular contact of the proximal portions of the radius and ulna in normal elbow joints of dogs and the effects of axial load on size and location of these areas. SAMPLE POPULATION: Forelimbs obtained from cadavers of 5 adult mixed-breed dogs. PROCEDURE: After forelimbs were removed, liquid-phase polymethyl methacrylate was applied to articular surfaces of the elbow joint, and limbs were axially loaded. Articular regions void of casting material were stained with water-soluble paint. Relative articular contact areas were determined by computer-assisted image analyses of stained specimens. Repeatability of the technique was evaluated by analyses of casts from bilateral forelimbs of 1 cadaver. Incremental axial loads were applied to left forelimbs from 4 cadavers to determine effects of load on articular contact. RESULTS: Specific areas of articular contact were identified on the radius, the craniolateral aspect of the anconeus, and the medial coronoid process. The medial coronoid and radial contact areas were continuous across the radioulnar articulation. There was no articular contact of the medial aspect of the anconeus with the central trochlear notch. Coefficients of variation of contact areas between repeated tests and between contralateral limbs was < 20%. Significant overall effects of axial load on contact area or location were not identified. CONCLUSIONS: Three distinct contact areas were evident in the elbow joint of dogs. Two ulnar contact areas were detected, suggesting there may be physiologic incongruity of the humeroulnar joint. There was no evidence of surface incongruity between the medial edge of the radial head and the lateral edge of the medial coronoid process.

Distraction osteogenesis to treat premature distal radial growth plate closure in a dog.

A 4-month-old Labrador was presented for forelimb lameness and elbow pain. Radiography revealed asymmetric premature closure of the distal radial physis resulting in humeroradial and humero-ulnar subluxation. A four-ring circular external fixator applied to the antebrachium was used to perform distraction osteogenesis. After a 4 day latency period, varying rates of linear distraction were used to lengthen the radius by 50% of its original length, which is significantly longer than has been previously reported. By 69 days after performing the radial osteotomy, the distraction callus had achieved clinical union and the fixator was removed. One year postoperatively, mild lameness was present after exercise and minimal elbow osteo-arthritis was evident radiographically. Complications observed included pin tract drainage, transient carpal contracture and radio-ulnar synostosis.

Indications for computed tomography in patients with minor head injury.

BACKGROUND: Computed tomography (CT) is widely used as a screening test in patients with minor head injury, although the results are often normal. We performed a study to develop and validate a set of clinical criteria that could be used to identify patients with minor head injury who do not need to undergo CT. METHODS: In the first phase of the study, we recorded clinical findings in 520 consecutive patients with minor head injury who had a normal score on the Glasgow Coma Scale and normal findings on a brief neurologic examination; the patients then underwent CT. Using recursive partitioning, we derived a set of criteria to identify all patients who had abnormalities on CT scanning. In the second phase, the sensitivity and specificity of the criteria for predicting a positive scan were evaluated in a group of 909 patients. RESULTS: Of the 520 patients in the first phase, 36 (6.9 percent) had positive scans. All patients with positive CT scans had one or more of seven findings: headache, vomiting, an age over 60 years, drug or alcohol intoxication, deficits in short-term memory, physical evidence of trauma above the clavicles, and seizure. Among the 909 patients in the second phase, 57 (6.3 percent) had positive scans. In this group of patients, the sensitivity of the seven findings combined was 100 percent (95 percent confidence interval, 95 to 100 percent). All patients with positive CT scans had at least one of the findings. CONCLUSIONS: For the evaluation of patients with minor head injury, the use of CT can be safely limited to those who have certain clinical findings.

Fast track to the trichome: induction of N-acyl nornicotines precedes nicotine induction in Nicotiana repanda.

Nicotiana repanda Wildenow ex Lehmann acylates nornicotine in its trichomes to produce N-acyl-nornicotine (NacNN) alkaloids which are dramatically more toxic than nicotine is to the nicotine-adapted herbivore, Manduca sexta. These NacNNs, like nicotine, were induced by methyl jasmonate (MeJA) and wounding, but the 2-fold increase in NacNN pools was much faster (within 6 h) than the MeJA-induced increase in nornicotine pools (24 h to 4 d), its parent substrate. When 15NO(-)3 pulse-chase experiments with intact and induced plants were used to follow the incorporation of 15N into alkaloids in different plant parts over the plant's lifetime, it was found that the root nicotine pool was most rapidly labeled, followed by the shoot nornicotine and NacNN pools. After 3 d, 3.12% of 15N acquired was in nicotine (0.93%), nornicotine (0.32%) and NacNNs (1.73%) while only 0.14% was in anabasine. Once NacNNs are externalized to the leaf surface, they are not readily re-distributed within the plant and are lost with senescing leaves. The wound- and MeJA-induced N-acylation of nornicotine is independent of induced changes in nornicotine pools and the rapidity of the response suggests its importance in defense against herbivores.

Eating the evidence? Manduca sexta larvae can not disrupt specific jasmonate induction in Nicotiana attenuata by rapid consumption.

As feeding by the tobacco specialist Manduca sexta L. is known to result in significantly higher jasmonate (JA) concentrations in Nicotiana plants than do mechanical simulations of the larval damage, we investigated whether M. sexta, which is known to rapidly consume large quantities of leaf material, can impair this "recognition" response by consuming the leaf tissue before it can respond with amplified JA levels. We report that oral secretions (OS) from M. sexta, but not from the cabbage specialist Pieris rapae, amplified the wound-induced JA response of Nicotiana attenuata Torr. Ex Wats., regardless of larval diet, instar and molting stage, and were still active after boiling and when diluted to 1/1000. The largest JA response occurred within 40 min in tissues adjacent to the OS application site. When 3 mm of leaf tissue immediately adjacent to the OS application site was excised within 40 s, the signal that elicits JA amplification was found to travel rapidly into the leaf, beyond the mandibular reach of the larvae. We conclude that M. sexta is not able to consume the evidence of feeding activity.

Herbivore-induced ethylene suppresses a direct defense but not a putative indirect defense against an adapted herbivore.

Herbivory induces both direct and indirect defenses in plants; however, some combinations of these defenses may not be compatible. The jasmonate signal cascade activated both direct (nicotine accumulations) and indirect (mono- and sesquiterpene emissions) whole-plant defense responses in the native tobacco Nicotiana attenuata Torr. Ex Wats. Nicotine accumulations were proportional to the amount of leaf wounding and the resulting increases in jasmonic acid (JA) concentrations. However, when larvae of the nicotine-tolerant herbivore, Manduca sexta, fed on plants or their oral secretions were applied to leaf punctures, the normal wound response was dramatically altered, as evidenced by large (4- to 10-fold) increases in the release of (i) volatile terpenoids and (ii) ethylene, (iii) increased (4- to 30-fold) accumulations of endogenous JA pools, but (iv) decreased or unchanged nicotine accumulations. The ethylene release, which was insensitive to inhibitors of induced JA accumulation, was sufficient to account for the attenuated nicotine response. Applications of ethylene and ethephon suppressed the induced nicotine response and pre-treatment of plants with a competitive inhibitor of ethylene receptors, 1-methylcyclopropene, restored the full nicotine response. This ethylene burst, however, did not inhibit the release of volatile terpenoids. Because parasitoids of Manduca larvae are sensitive to the dietary intake of nicotine by their hosts, this ethylene-mediated switching from direct to a putative indirect defense may represent an adaptive tailoring of a plant's defense response.

Total hip arthroplasty in nine canine hind limb amputees: a retrospective study.

OBJECTIVE: To determine the outcome of total hip arthroplasty in canine hindlimb amputees. STUDY DESIGN: Retrospective evaluation of clinical cases. METHODS: Data recorded from the medical records of nine dogs included patient signalment, indication for amputation and total hip arthroplasty (THA), interval between amputation and THA, and surgical complications. Radiographs were used to assess implant orientation and evidence of complications. Functional outcome was assessed using direct patient evaluation by one of the authors or primary surgeons, or through telephone interview between the primary author and the owner. RESULTS: Seven dogs ultimately had a good or excellent clinical results. Complications occurred in five dogs. Four dogs luxated the prosthetic joint without an obvious traumatic event within 9 weeks of the initial surgery. Revision surgeries resulted in successful coxofemoral reduction in three of four dogs. There were no clinical or radiographic findings suggestive of implant loosening or infection. CONCLUSION: THA can be a successful salvage procedure in the canine hindlimb amputee with disabling, non-neoplastic, noninfectious coxofemoral disease. The risk of luxation in the early postoperative period is high and revision surgery is required for stabilization.

Tobacco mosaic virus inoculation inhibits wound-induced jasmonic acid-mediated responses within but not between plants.

Jasmonic acid (JA) and salicylic acid (SA) have both been implicated as important signal molecules mediating induced defenses of Nicotiana tabacum L. against herbivores and pathogens. Since the application of SA to a wound site can inhibit both wound-induced JA and a defense response that it elicits, namely nicotine production, we determined if tobacco mosaic virus (TMV) inoculation, with its associated endogenous systemic increase in SA, reduces a plant's ability to increase JA and nicotine levels in response to mechanical damage, and evaluated the consequences of these interactions for the amount of tissue removed by a nicotine-tolerant herbivore, Manduca sexta. Additionally, we determined whether the release of volatile methyl salicylic acid (MeSA) from inoculated plants can reduce wound-induced JA and nicotine responses in uninoculated plants sharing the same chamber. The TMV-inoculated plants, though capable of inducing nicotine normally in response to methyl jasmonate applications, had attenuated wound-induced JA and nicotine responses. Moreover, larvae consumed 1.7- to 2.7-times more leaf tissue from TMV-inoculated plants than from mock-inoculated plants. Uninoculated plants growing in chambers downwind of either TMV-inoculated plants or vials releasing MeSA at 83- to 643-times the amount TMV-inoculated plants release, exhibited normal wound-induced responses. We conclude that tobacco plants, when inoculated with TMV, are unable to elicit normal wound responses, due likely to the inhibition of JA production by the systemic increase in SA induced by virus-inoculation. The release of volatile MeSA from inoculated plants is not sufficient to influence the wound-induced responses of neighboring plants.

The grief experienced by spousal caregivers of dementia patients: the role of place of care of patient and gender of caregiver.

A comparison of the grief responses of spousal caregivers who cared for their demented partners at home with those who provided ongoing nursing home care, together with an examination of gender differences, is reported here. Four psychological states of grief were examined: anxiety, sadness, anger, and guilt. Sixty spousal caregivers participated in the study: thirty husbands and thirty wives, with equal numbers of home and nursing home caregivers. Content analysis scales were scored to assess the four psychological states. A self-rating, adjective mood scale was also used as a secondary measure of those states. A personal construct model of spousal caregivers' bereavement for their demented partners was developed and provided the two hypotheses about differences in grieving. As predicted, nursing home caregivers expressed significantly higher levels of sadness and guilt than home caregivers. Against prediction, home caregivers expressed significantly more anger than nursing home caregivers. Home caregiving wives were found to be the most angry cohort. Also, as predicted, caregiving wives expressed significantly higher levels of anxiety, sadness, and anger than caregiving husbands. The results of the content analysis scales were confirmed by the secondary measure, but the former measure proved more powerful for detecting statistically significant differences. The inclusion of severity of the patients' dementia, and the spiritually and age of the spousal caregivers as covariates in the statistical analyses showed place of care and gender of caregiver to remain the most powerful predictors of the four psychological states of grief.

Reduction of "callbacks" to the ED due to discrepancies in plain radiograph interpretation.

Retrospective and prospective chart review was conducted to study patient callbacks to the emergency department (ED) based on plain radiograph interpretation discrepancies between radiologists and emergency physicians before and after a continuous quality improvement (CQI) intervention. Patients who were called back to the ED because of radiograph interpretation discrepancies were retrospectively studied. These results were reviewed by a CQI team, which recommended greater communication and consultation. A prospective study was then performed. Before quality intervention, 0.7% of the patients were recalled; 0.4% required recall after quality assurance, a reduction of 42.9% (P = .0001). Emergency physicians in this study had a low percentage of patient recall due to discrepancies in radiologic interpretation. CQI further reduced this percentage. The proficiency of emergency physicians interpreting radiographs validates the current practice of emergency physicians rendering treatment based on their interpretations and supports the notion of emergency physicians billing for this service.

Pseudomonas aeruginosa biofilms are more susceptible to ciprofloxacin than to tobramycin.

The objective of this study was to determine and compare the biofilm elimination concentrations (BEC: the concentration which reduced the viability of biofilm organisms by at least 99.9%) of ciprofloxacin and tobramycin for Pseudomonas aeruginosa, a common cause of nosocomial biomaterial-related infections. Bacterial biofilms were produced in the modified. Robbins device using continuous culture flow at 60 ml/h for 40-44 h, and the sessile organisms were then exposed to either ciprofloxacin or tobramycin at a range of concentrations for 12 or 36h. The BEC of ciprofloxacin was 5 mug/ml for the 12 and 36 h treatments, a value 10 x greater than the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). In contrast, the BEC of tobramycin was > 100 mu/ml after 12h and 75 ug/ml following 36 h of drug exposure, that is 75-100 x the MIC and MBC. The results demonstrated that the BEC is a more suitable indicator of the antibiotic susceptibility of P. aeruginosa biofilms than the MIC and MBC. Ciprofloxacin was significantly more effective than tobramycin in the treatment of P. aeruginosa adherent to biomaterials. With respect to clinical application, if the intention of antibiotic use is to eradicate bacteria adherent to devices, only biofilm-active agents should be used.

Influence of dextrose dialysis solutions on adhesion of Staphylococcus aureus and Pseudomonas aeruginosa to three catheter surfaces.

Peritonitis is serious problem associated with continuous ambulatory peritoneal dialysis. The process can be initiated by intraluminal contamination and colonization of the peritoneal cavity as well as by bacterial adhesion to biomaterials, including catheters and exit site dressings. The aim of this study was to determine the degree to which two pathogenic organisms could adhere to three biomaterial surfaces, and the extent to which dextrose concentration influenced the binding and survival. Using a 24-hour in vitro assay, it was found that the Staphylococcus aureus strain consistently adhered significantly better than the Pseudomonas aeruginosa isolate, and only the adhesion of the latter was decreased with higher concentrations of dextrose in dialysis solutions. Electron microscopy demonstrates that within this short time period, bacterial biofilms had begun to form on the catheter surfaces.