Spawning behaviour of Allis shad Alosa alosa: new insights based on imaging sonar data.

Spawning behaviour of Alosa alosa was observed by high resolution imaging sonar. Detected clouds of sexual products and micro bubbles served as a potential indicator of spawning activity. Peak spawning time was between 0130 and 0200 hours at night. Increasing detections over three consecutive nights were consistent with sounds of mating events (bulls) assessed in hearing surveys in parallel to the hydro acoustic detection. In 70% of the analysed mating events there were no additional A. alosa joining the event whilst 70% of the mating events showed one or two A. alosa leaving the cloud. In 31% of the analysed mating events, however, three or more A. alosa were leaving the clouds, indicating that matings are not restricted to a pair. Imaging sonar is suitable for monitoring spawning activity and behaviour of anadromous clupeids in their spawning habitats.

A review of the effects of insulin-like growth factor and platelet derived growth factor on in vivo cartilage healing and repair.

Growth factors may enhance current cartilage repair techniques via multiple mechanisms including recruitment of chondrogenic cells (chemotaxis), stimulation of chondrogenic cell proliferation (mitogenesis) and enhancement of cartilage matrix synthesis. Two growth factors that have been studied in cartilage repair are insulin-like growth factor (IGF) and platelet derived growth factor (PDGF). IGF plays a key role in cartilage homeostasis, balancing proteoglycan synthesis and breakdown. Incorporating IGF into a fibrin clot placed in an equine cartilage defect improved the quality and quantity of repair tissue and reduced synovial inflammation. PDGF is a potent mitogenic and chemotactic factor for all cells of mesenchymal origin, including chondrocytes and mesenchymal stem cells. Resting zone chondrocytes cultured with PDGF demonstrated increased cell proliferation and proteoglycan production, while maturation of these cells along the endochondral pathway was inhibited. Pretreating chondrocytes with PDGF promotes heterotopic cartilage formation in the absence of any mechanical stimulus. PDGF has also been shown to be a potent stimulator of meniscal cell proliferation and migration. These studies and others suggest a potential role for these potent biological regulators of chondrocytes in cartilage repair. More work needs to be performed to define their appropriate dosing and the optimum delivery method. Combining tissue growth factors with a biological matrix can provide a physical scaffold for cell adhesion and growth as well as a means to control the release of these potent molecules. This could result in biological devices that enhance the predictability and quality of current cartilage repair techniques.

Transthoracic echocardiography for cardiopulmonary monitoring in intensive care.

BACKGROUND AND OBJECTIVE: To evaluate the feasibility of an abbreviated focus assessed transthoracic echocardiographic protocol, consisting of four standardized acoustic views for cardiopulmonary screening and monitoring. METHODS: The protocol was applied in 210 patients in a 20-bed multidisciplinary intensive care unit in a university hospital. When inconclusive, an additional transoesophageal echocardiographic examination was performed. Diagnosis, indication, acoustic window, position and value were recorded. Significant pathology, load, dimensions and contractility were assessed. RESULTS: Two-hundred-and-thirty-three transthoracic and four transoesophageal echoes were performed. The protocol provided usable images of the heart in 97% of the patients, 58% subcostal, 80% apical and 69% parasternal. Images through one window were obtainable in 23%, through two windows in 41% and through three windows in 34%. In 227 patients (97.4%) the focus assessed echo protocol contributed positively. In 24.5% of cases the information was decisive, in 37.3% supplemental and in 35.6% supportive. CONCLUSIONS: By means of an abbreviated, focus assessed transthoracic echo protocol it is feasible to visualize the haemodynamic determinants for assessment and optimization. One or more useful images are obtainable in 97% of critically ill patients.

Pediatric voiding cystourethrography: a pictorial guide.

Voiding cystourethrography is commonly performed in children with prenatally diagnosed hydronephrosis, urinary tract infections, and voiding abnormalities. Voiding cystourethrography can be performed with many variations designed to optimize visualization of disease and minimize radiation exposure. The procedure should include assessment of the spine and pelvis; masses or opaque calculi; bladder capacity, contour, and emptying capability; presence and grade of reflux; and urethral appearance. Radiologists differ as to whether the patient should void prior to catheterization. Anteroposterior imaging of the bladder is performed during early filling; little or no imaging is necessary during intermediate filling. When bladder filling is complete, steep oblique images that are centered on the ureterovesical junction should be obtained. If reflux is observed, the ipsilateral renal fossa may be imaged prior to voiding. With a smaller than expected voiding volume, bladder refilling is recommended. Voiding around the catheter is also strongly recommended. In girls, one anteroposterior image of the urethra is usually sufficient; in boys, the entire urethra must be imaged. Steep oblique imaging is optimal. At the conclusion of voiding, each renal fossa should be imaged to detect reflux missed at fluoroscopy as well as other anomalies. Familiarity with these abnormalities and use of proper techniques will allow detection of most common pathologic conditions with very low radiation exposure.

New equipment for neuromuscular transmission monitoring: a comparison of the TOF-Guard with the Myograph 2000.

OBJECTIVE: The present study is to clarify whether the bias and limits of agreement of the TOF-Guard and the mechanomyograph differ from those of two mechanomyographs on contra lateral arms. Previous studies of the bias and limits of agreement between acceleromyographical (TOF-Guard) and mechanomyographical measurements of neuromuscular transmission did not take the error introduced by using contra lateral arms into consideration. METHODS: Fifty-two women undergoing gynecological surgery were anesthetized with midazolam, fentanyl, thiopental, halothane and nitrous oxide. Neuromuscular blockade was induced and maintained with atracurium. In 32 patients, neuromuscular monitoring was performed with a Myograph 2000 on one hand and a TOF-Guard at the other (M/T group). In 20 patients, monitoring was performed with a Myograph 2000 at both hands (M/M group). Train-of-four stimulations were applied to the ulnar nerve at the wrist in both groups. Bias and limits of agreement between the contra lateral hands in each group were calculated as proposed by Bland and Altman. RESULTS: When the TOF ratio was 0.25, TOF ratio bias and limits of agreement in the M/T group were 0.86 and 17.58 to -15.85, respectively. Corresponding values in the M/M group were -1.75 and 12.3 to -8.8. Bias in the M/T group decreased significantly to -8.1 when TOF ratio increased to 0.70, resulting in limits of agreement of 12.1 to -28.4. The corresponding values in the M/M group were bias 2.0 and limits of agreement 10.7 to -6.7. TOF-Guard bias for onset time and time to 5% recovery of T1 (first twitch in TOF) were -19s and -1.5 min, respectively; both values differed significantly from zero (P < 0.05). Taken together with the changing TOF-ratio bias during recovery in the M/T group, these results indicate different onset and recovery curves for the two monitoring devices. CONCLUSIONS: Due to wide limits of agreement and different recovery courses, acccleromyographic and mechanomyographic recordings of neuromuscular transmission cannot be used interchangeably. The substantial variation between simultaneous mechanomyographical recordings of neuromuscular transmission obtained in contra lateral arms suggests that this factor should be taken into account when studying new neuromuscular monitoring techniques using the two-arm technique.

Comparison of tactile and mechanomyographical assessment of response to double burst and train-of-four stimulation during moderate and profound neuromuscular blockade.

It is common clinical practice to estimate the degree of neuromuscular blockade by tactile evaluation of twitch responses. The aim of the present study was to evaluate the use of tactile responses of adductor pollicis to double-burst stimulation (DBS) and train-of-four (TOF) peripheral nerve stimulation for monitoring moderate and profound levels of neuromuscular blockade. The study comprised 44 women scheduled for gynaecological laparotomy and anaesthetised with midazolam, fentanyl, thiopentone, halothane, nitrous oxide and atracurium. The tactile responses of the adductor pollicis were compared with mechanomyographical measurements in the contra lateral arm during recovery from neuromuscular blockade. The observers (anaesthetic nurses) of the tactile responses were blinded with regard to the stimulation pattern and the mechanomyographical measurements. The time from injection of the initial dose of atracurium until tactile reappearance of the first twitch in DBS (D1), was 24.6 (0-39.8) min, median (range). This was more rapid than the time until tactile reappearance of the first twitch in TOF (T1) 32.8 (18.2-43.4) min (P < 0.05). The median time from tactile reappearance of D1 until T1 recovered to 15% of the control twitch height was longer than the median time from tactile reappearance of T1 (14.6 versus 10.5 min) (P < 0.05). One or two responses to DBS or TOF were often felt before any responses had been detected mechanomyographically in the contralateral arm. When three or four responses to TOF were felt, responses were always detected mechanomyographically. It is concluded that tactile evaluation of responses ot DBS stimulation can estimate deeper levels of blockade than tactile evaluation of responses to TOF.

Radiologic case study. Trevor disease: dysplasia epiphysealis hemimelica.

Although Trevor disease is a rare entity, early recognition is important because early treatment can decrease or prevent limitation in some patients. The clinical presentation and radiographic appearance in combination are unique, enabling both a precise diagnosis and the development of an appropriate management scheme.

Effects of proteoglycan extraction on the tensile behavior of articular cartilage.

We undertook an interdisciplinary biomechanical and biochemical study to explore the extent and manner in which the total pool of proteoglycans influences the kinetic and static behavior of bovine articular cartilage in tension. Two biomechanical tests were used: (a) the viscoelastic creep test and (b) a slow constant-rate uniaxial tension test; and two enzymatic proteoglycan extraction procedures were used: (a) chondroitinase ABC treatment and (b) a sequential enzymatic treatment with chondroitinase ABC, trypsin, and Streptomyces hyaluronidase. We found that the viscoelastic creep response of all cartilage specimens may be divided into two distinct phases: an initial phase (less than 15 s), characterized by a rapid increase in strain following load application, and a late phase (15 s less than or equal to t less than 25,000 s), characterized by a more gradual increase in strain. A major finding of this study is that the kinetics of the creep response is greatly influenced by the glycosaminoglycan content of the tissue. For untreated and control specimens, the initial response comprises about 50% of the total strain, while for chondroitinase ABC and sequentially extracted specimens, the initial response comprises up to 83% of the total strain. Furthermore, most untreated and control specimens did not reach equilibrium within the 25,000 s test period, while enzymatically digested specimens often reached equilibrium in less than 100 s. Thus, we conclude that through their physical restraints on collagen, the bulk of proteoglycan present in the tissue acts to retard fibrillar reorganization and alignment under tensile loading, thereby effectively preventing sudden extension of the collagen network. In contrast, the results of our slow constant-rate uniaxial tension experiment show that essentially complete extraction of proteoglycan glycosaminoglycans does not affect the intrinsic tensile stiffness and strength of cartilage specimens or the collagen network in a significant manner. Hence, an important function of the bulk proteoglycans (i.e., the large aggregating type) in cartilage is to retard the rate of stretch and alignment when a tensile load is suddenly applied. This mechanism may be useful in protecting the cartilage collagen network during physiological situations, where sudden impact forces are imposed on a joint.

Material properties of the normal medial bovine meniscus.

The intrinsic compressive and tensile properties of normal bovine medial menisci were measured, and the variations in these properties with respect to the structural organization of the tissue and test specimen location were examined. Using a confined compression experiment, the compressive aggregate modulus and permeability of the meniscus were determined. The permeability of the tissue was also compared with the permeability as measured experimentally using a direct permeation experiment. Deep posterior specimens are significantly stiffer in compression than deep anterior and central-anterior specimens, while deep anterior specimens are significantly less stiff than deep posterior and central-posterior specimens. Posterior specimens have a significantly higher average water content. In addition, the permeability of the bovine meniscus was found to be about one-tenth that of bovine articular cartilage. The tensile stiffness of meniscal tissue was determined from constant strain rate uniaxial tension tests. To asses the directional variations in the tensile properties, specimens were obtained from the circumferential and radial orientations. The results indicate that the femoral surface of the meniscus is isotropic in tension, while specimens from within the meniscus are anisotropic--the circumferential specimens are much stiffer than the radial specimens. Furthermore, circumferential posterior specimens from the interior of the meniscus are significantly stiffer than similar anterior specimens. Layer inhomogeneities in the tensile properties with respect to distance from the femoral surface are also present.

The effect of cryopreservation on canine menisci: a biochemical, morphologic, and biomechanical evaluation.

This study evaluated the effect of cryopreservation on the structural organization, biosynthetic activity, and material properties of canine menisci. The menisci were cryopreserved by incubating them in a 4% solution of dimethyl sulfoxide (DMSO) in physiologic media and freezing them to -100 degrees C using a controlled rate freezing system. The menisci were then stored for varying periods of time from zero to 12 weeks in liquid nitrogen (-196 degrees C). Following rapid thawing, changes in the histological appearance and biosynthetic activity of the menisci were evaluated as functions of storage time. In addition, the effects of the cryopreservation process on the tensile strength and modulus of the meniscal tissue were assessed. Although cryopreservation and short-term storage did not appear to affect the morphological appearance or biomechanical character of the menisci, biosynthetic activity, as determined by Na2S35SO4 incorporation, was diminished to less than 50% of normal control values immediately following cryopreservation and thawing. Autoradiographic examination of these tissues revealed that only approximately 10% of the meniscal cells were metabolically active, however, indicating that a marked increase in the metabolic activity of individual cells occurs following the freeze-thaw cycle. Total metabolic activity continued to decline with storage time.

The significance of hemarthrosis of the knee in children.

Diagnostic arthroscopy was performed in 40 consecutive patients under 16 years of age with hemarthrosis of the knee. The age of the patients ranged from 10 to 15 years, median 13.7 years. Eighteen patients had ruptures of the anterior cruciate ligament; seven ruptures were partial. Only two cases of fractures of the tibial spine were encountered. Seven patients had midsubstance tears of the anterior cruciate ligament. Eleven patients had patellar dislocations. Six patients had minimal capsular disruptions as the cause of hemarthrosis. Three patients had osteochondritis dissecans of the knee and two patients had isolated ruptures of the medial collateral ligament. Twenty-eight of the patients underwent some form of operative repair. The clinical diagnosis was confirmed at arthroscopy in 17 of the 40 cases. The appearance of hemarthrosis of the knee usually signifies a serious knee injury and should be treated with the same importance as in adults, and as a rule arthroscopy should be carried out.

Relationship of dose to morphine tolerance in the chick embryo.

Morphine tolerance and dependence can be produced in chick embryos by injecting 20 mg/kg into the airspace of the egg daily for 4 days beginning on incubation day 12. The experiments in this report examined the production of tolerance with lower doses of morphine (2.5, 5.0 and 10.0 mg/kg). Treatment of embryos for 4 days did not produce tolerance on day 16 when the challenge dose was the same as the dose used for pretreatment and when activity was recorded at only one time after injection. Further studies measuring activity at multiple time-points and/or utilizing a lower challenge dose indicated that tolerance was present. Studies of activity after 4 or 8 days of pretreatment revealed a dose-effect relationship. Pretreatment with 2.5 mg/kg produced a lesser degree of tolerance than that produced by the higher pretreatment doses. These embryos were tolerant on day 16 after four injections but not on day 19 after eight injections, due perhaps to more rapid metabolism of morphine with age. There were no differences between the responses of the 5.0 and 10.0 mg/kg groups to morphine challenge. While both of these doses produced tolerance to a low challenge dose of morphine by day 16, pretreatment at doses higher than 10.0 mg/kg was necessary for production of tolerance to high doses.

Forebrain damage in chick embryos exposed to carbon monoxide.

The consequences of CO-induced hypoxia to the forebrain of seven-day-old chick embryos were investigated. Exposure of embryos to CO for three hours caused hemorrhages in developing forebrain areas. Carboxyhemoglobin levels reached about 50% in the embryos. Two weeks later, about one day prior to hatching, morphology of large neurons in the paleostriatum primitivum was evaluated. In Golgi-stained sections examined under the light microscope, the CO-exposed chicks were found to have reduced branching of the dendritic tree. In addition, the nuclear size of the paleostriatum primitivum neurons was reduced in the CO-exposed chicks. These findings in chick embryos are comparable to results in previous experiments with fetal rats.

Drug withdrawal prior to hatch in the morphine tolerant chick embryo.

Morphine tolerance and dependence were produced in chick embryos by injecting 20 mg/kg into the air space of the egg daily from incubation day 12. Starting on day 16, two groups of eggs were withdrawn from morphine by either substituting water or by treating with naloxone. Chick embryo activities were monitored on incubation day 18. Activities of the embryos withdrawn from morphine did not differ from control, but naloxone injection produced a substantial increase in activity. Neither regimen of morphine withdrawal affected the hatchability of the eggs. When these chicks were 1 day old, the effect of 1 mg morphine/kg on the rate of distress vocalization was measured. The withdrawn chicks were 1 day old, the effect of 1 mg morphine/kg on the rate of distress vocalization was measured. The withdrawn chicks vocalized at a rate that was intermediate between that of controls and that of nonwithdrawn chicks indicating that tolerance was still present one week after the last morphine injection.

Alterations of chick locomotion produced by morphine treatment in ovo.

Analysis of walking of young chicks showed that morphine treatment of the chick embryo resulted in motor difficulties that depended on the timing of initial morphine exposure. Morphine sulfate was injected daily at a dose of 20 mg/kg egg into the air sac of viable eggs. Groups of eggs were treated starting on either day 12 or day 16 of incubation with either morphine or sterile water. Injections were continued through incubation day 19 and the eggs were allowed to hatch. The chicks started on morphine on day 16 showed signs of neuromuscular weakness at the posthatching age of 1-2 days. At 7 days of age they had a wider stride and greater angle of placement of the feet compared to both the controls, and to the chicks that were started on morphine on day 12. Since tolerance to morphine can develop in the chick embryo after only 4 daily injections, the chicks receiving morphine from day 12 may have been tolerant to the deleterious effects produced by morphine on locomotion at a critical period of motor development around day 16.

Development of opiate tolerance in the chick embryo.

Tolerance to morphine was produced in the chick embryo. Eggs were injected with morphine sulfate (MS) (20 mg/kg egg) or H2O daily starting on incubation day 12. On day 16, embryo activities were recorded and eggs were injected with either MS or naloxone. Activity of H2O-pretreated controls decreased after both MS and naloxone. Embryos treated with MS from incubation days 12-15 showed no activity change after morphine and responded to naloxone with increases in activity. Baseline rates of distress vocalizations (DV) of 1-2 day old chicks were not affected by MS pretreatment during incubation days 12-19. However, 1 mg/kg MS decreased the rate of DV of control chicks by 90% whereas MS-pretreated chicks were unaffected. At age 4-5 days, the baseline rate of DV and rate after MS were higher in MS-pretreated chicks. However, all chicks showed significant decreases in rate of DV after MS injection. Naloxone increased the rate of DV of paired 1-2 day old chicks, but response of MS-pretreated chicks was significantly greater than controls.

Assessing complaints about itching eyes.

It is better to be overcautious than have a worker lose his sight through misdiagnosis. Avoidance measures are first suggested in order to remove the real cause.