Seasonal influence on the hematological parameters in cultured Nile tilapia from southern Brazil.

This study evaluated seasonality in hematological parameters of Nile tilapia cultured in the state of Santa Catarina, southern Brazil. A total of 240 fish were examined during four seasons between April 2007 and March 2008 in three different fish farms. After being anesthetised in a benzocaine solution, blood samples were withdrawn into syringes containing a drop of 10% EDTA for hematological analysis. The results were compared between fish farms and seasons, which are well delimited in southern Brazil. In a traditional fish farm in Joinville in the summer, there was an increase in the percentage of hematocrit and in the red blood cell count. The highest values of total leukocytes were found in fish from fee-fishing in Blumenau in the autumn while the lowest values occurred in those from swine consorted system in Ituporanga in the summer. Thrombocytosis was observed in the autumn, and lymphocytosis was found in both the autumn and winter in tilapia from all fish farms investigated. Neutrophilia was only observed in winter and autumn in fish from Blumenau and Ituporanga. This work demonstrated the influence of seasonality and the handling characteristics of each fish farm on certain hematological parameters in Nile tilapia.

Seasonal variation on the ectoparasitic communities of Nile tilapia cultured in three regions in southern Brazil.

A total of 240 Nile tilapia were examined between April 2007 and March 2008, gathered from three different fish farms, 20 fish in each fish farm, in the four seasons of the year. Fish ponds were located in Joinville, Blumenau and Ituporanga, Santa Catarina state, Brazil and each pond had a different culture system. Prevalence, mean intensity, mean abundance and mean relative dominance were compared among fish ponds and seasons. During this period, the water quality was kept in normal values. Piscinoodinium pillulare (Dinoflagellida) was the most dominant parasite followed by Trichodina magna e T. compacta (Ciliophora), Cichlydogyrus sclerosus, C halli, C. thurstonae, Scutogyrus longicornis (Monogenoidea), copepodids Lernaeidae gen. sp. The highest prevalence, mean intensity and mean abundance of ectoparasites were found on the body surface in fish from Joinville followed by Blumenau and Ituporanga. In the gills, the highest mean intensity and mean abundance were found in fish from Blumenau and Ituporanga in the winter. Piscinoodinium pillulare showed prevalence 100% during autumn in Blumenau and Ituporanga. In winter P. pillulare occurred in all study facilities. Fish from Joinville showed 100% prevalence of Monogenoidea during all seasons, as well as the highest mean intensity and abundance. The results showed that the majority of examined fish had higher infestations by protozoan during autumn and winter and higher infestations by metazoan have occurred in spring and summer.

The success of laser laparoscopy in the treatment of endometriosis: a two-step analysis.

BACKGROUND AND OBJECTIVES: The most advantageous treatment for nonextensive endometriosis has long been the subject of debate. In recent years, the ability to detect atypical presentations has allowed the gynecological surgeon to treat this disease more readily. The treatment in the past has only been concerned with the singular treatment being applied at the time, not on the effects that previous treatments have had. The purpose of the current study was to see whether previous unsuccessful treatment modalities affected subsequent laser laparoscopy treatment of endometriosis. METHODS: Patients who were previously treated for their endometriosis (minimal and mild) underwent treatment of their disease by laser laparoscopy and the results were analyzed by chi2 (chi-square) analysis. RESULTS: Those patients previously treated with laser laparoscopy and laparotomy demonstrated poorer results than those previously treated with expectant, medical, or cautery. The sum of the original treatments plus the second treatment of laser laparoscopy was equal in all groups. CONCLUSIONS: If endometriosis is diagnosed at the time of laparoscopy and is easily amenable to treatment, it behooves the physician to treat it at the time of surgery.

In vitro and in vivo pharmacological characterization of BIIL 284, a novel and potent leukotriene B(4) receptor antagonist.

BIIL 284 is a new LTB(4) receptor antagonist. It is a prodrug and has negligible binding to the LTB(4) receptor. However, ubiquitous esterases metabolize BIIL 284 to the active metabolites BIIL 260 and BIIL 315, the glucuronidated form of BIIL 260. Both metabolites have high affinity to the LTB(4) receptor on isolated human neutrophil cell membranes with K(i) values of 1.7 and 1.9 nM, respectively. On vital human neutrophilic granulocytes K(i) was around 1 nM. BIIL 260 and BIIL 315 interact with the LTB(4) receptor in a saturable, reversible, and competitive manner. BIIL 260 and its glucuronide BIIL 315 also potently inhibited LTB(4)-induced intracellular Ca(2+) release in human neutrophils (IC(50) values of 0.82 and 0.75 nM, respectively) as measured with Fura-2. High efficacy of BIIL 284 has been demonstrated in various in vivo models. BIIL 284 inhibited LTB(4)-induced mouse ear inflammation with ED(50) = 0.008 mg/kg p.o., LTB(4)-induced transdermal chemotaxis in guinea pigs with ED(50) = 0.03 mg/kg p.o., LTB(4)-induced neutropenia in various species (monkey: ED(50) = 0.004 mg/kg p.o.), and LTB(4)-induced Mac1-expression in monkeys (ED(50) = 0.05 mg/kg p.o. in Tylose). Full blockade of LTB(4) receptors over 24 h was achieved by 0.3 mg/kg BIIL 284 after single oral dose as measured by LTB(4)-induced neutropenia or Mac1-expression in the monkey model. BIIL 284 is an unusually potent and long-acting orally active LTB(4) antagonist, and is therefore under clinical development as a novel anti-inflammatory principle.

Estrogen and progesterone receptors in gynecomastia.

The etiology of gynecomastia is unknown. There seems to be no increased incidence of malignancies in patients with idiopathic gynecomastia; however, patients with Klinefelter syndrome exhibit an increased incidence of malignancy. The authors reviewed the results of 34 patients with gynecomastia diagnosed in adolescence who, following initial evaluation, had a mastectomy. The estrogen and progesterone receptors were analyzed in these patients. Three of the patients were diagnosed with Klinefelter syndrome. These three patients exhibited elevated amounts of estrogen and progesterone receptors. None of the patients who were not diagnosed with this syndrome demonstrated significant elevation of their estrogen or progesterone receptors. The presence of elevated estrogen and progesterone receptors in patients with Klinefelter syndrome provides a potential mechanism by which these patients may develop breast neoplasms. The absence of elevated estrogen and progesterone receptors in patients with idiopathic gynecomastia may serve to clarify why these patients' disease rarely degenerates into malignancy.

Waiting times for appointments with orthopaedic surgeons in Victoria: 1995-97.

BACKGROUND: A number of different models have been proposed for determining surgical workforce requirements. METHODS: In 1995 the Workforce Subcommittee of the Victorian Regional Branch of the Australian Orthopaedic Association commenced a prospective evaluation of waiting times for both urgent and nonurgent appointments with orthopaedic surgeons in Victoria. RESULTS: The results for the 3 years, 1995-97, show no significant change in the waiting time for nonurgent appointments and no difference between metropolitan and rural areas. The waiting time for an urgent appointment increased from 1995 to 1997 for the state of Victoria and for metropolitan Melbourne but not for rural areas. However, the median waiting time for an urgent appointment did not change. CONCLUSION: Overall the waiting times were found to be satisfactory by previously reported standards.

Tiotropium (Spiriva): mechanistical considerations and clinical profile in obstructive lung disease.

Inhaled antimuscarinics, often called anticholinergics in clinical medicine, are established as first line bronchodilators in COPD. Tiotropium has been developed as a new generation antimuscarinic following ipratropium. Tiotropium is a specific, highly potent antimuscarinic, demonstrating very slow dissociation from muscarinic receptors. Dissociation from M2-receptors is faster than from M3 or M1, which in functional in vitro studies, appeared as kinetic receptor subtype selectivity of M3 and M1 over M2. The high potency and slow receptor dissociation found its clinical correlate in significant and long lasting bronchodilatation and bronchoprotection in patients with COPD and asthma. In asthma, protection against methacholine challenge exceeded the study period of 48 hours. In COPD, bronchodilatation of about 80% of the plateau was demonstrated after the first dose. Following chronic once daily inhalation for 28 days, the improvement in pulmonary function was sustained and there was a further increase in peak effects, but more importantly a rising baseline, achieving steady state within 2 weeks. Tiotropium achieves very stable long lasting effects with comparatively low variation of bronchodilatation between peak and trough (the level before the next administration). Stable 24 hour effectiveness profiles the compound as the first once daily bronchodilator. Clinical correlates of kinetic receptor subtype selective blockade remain to be shown. Plasma levels of tiotropium at trough are in the low pg/ml range and are unlikely to explain the sustained effectiveness in the airways. Slow dissociation from muscarinic receptors is likely to be responsible for the long duration of action.

Ba 679 BR, a novel long-acting anticholinergic bronchodilator.

The use of anticholinergics in antiobstructive therapy is well established in pulmonary medicine. We sought to improve the duration of action of inhaled antimuscarinics. A newly developed compound, Ba 679 BR (abbreviated Ba 679) proved to be a highly potent muscarinic antagonist in guinea pig tracheal rings. Its binding to human receptors (Hm1, Hm2, Hm3) was characterized by KD-values in the 10(-10) M concentration range. Assessment of the dissociation rate of complexes of labelled Ba 679 and human muscarinic receptors revealed very slow dissociation in comparison to ipratropium. The half-lives in hours were: Ba 679-Hm3: 34.7, -Hm1: 14.6, -Hm2: 3.6; ipratropium-Hm3: 0.26, -Hm1: 0.11, -Hm2: 0.035. The duration of action in vivo was determined by means of acetylcholine-induced bronchospasms in dogs following inhalation of the drugs. Ba 679 demonstrated a significantly longer duration of protection than an equipotent dose of ipratropium. The plasma levels following inhalation in dogs declined rapidly and are unlikely to reflect the duration of the pharmacological activity. In summary, Ba 679 represents a novel type of antimuscarinic bronchodilator with a long duration of action, most likely due to its slow dissociation from Hm3-receptors. In addition, the drug showed "kinetic receptor subtype selectivity" by having a more rapid dissociation from Hm2 than from Hm1 and Hm3 receptors.

Corrective shoes and inserts as treatment for flexible flatfoot in infants and children.

We performed a prospective study to determine whether flexible flatfoot in children can be influenced by treatment. One hundred and twenty-nine children who had been referred by pediatricians, and for whom the radiographic findings met the criteria for flatfoot, were randomly assigned to one of four groups: Group I, controls; Group II, treatment with corrective orthopaedic shoes; Group III, treatment with a Helfet heel-cup; or Group IV, treatment with a custom-molded plastic insert. All of the patients in Groups II, III, and IV had a minimum of three years of treatment, and ninety-eight patients whose compliance with the protocol was documented completed the study. Analysis of radiographs before treatment and at the most recent follow-up demonstrated a significant improvement in all groups (p less than 0.01), including the controls, and no significant difference between the controls and the treated patients (p greater than 0.4). We concluded that wearing corrective shoes or inserts for three years does not influence the course of flexible flatfoot in children.

Treatment of acquired hip subluxation in cerebral palsy.

Fifty-seven children with cerebral palsy and subluxated hips underwent soft tissue releases to obtain hip reductions. Eight patients in Group I (preoperatively mildly subluxated hips) had postoperative bracing, all with good results. Twenty-two unbraced patients in Group I had 14 good, 5 fair, and 3 poor results. Thirteen patients in Group II (preoperatively severely subluxated hips) received postoperative splinting with nine good, one fair, and three poor results. The 14 unbraced patients in Group II had one fair and 13 poor results. This study indicates that even severely subluxated hips in spastic children less than 6 years of age can eventually achieve stable reductions provided long-term abduction bracing is used following adequate soft tissue releases.

The surgical treatment of Scheuermann's kyphosis.

The results of surgery in 59 patients with Scheuermann's kyphosis are reported at an average follow-up of 56 months. These show that in skeletally immature patients, in whom the iliac apophysis has not yet fused to the body of the ilium, posterior fusion alone is adequate and is followed by little loss of correction. For skeletally mature patients combined anterior and posterior surgery is recommended. In all cases a period of pre-operative treatment is important. It is stressed that the indications for surgery are limited.

Simultaneous combined anterior and posterior fusion. A surgical solution for failed spinal surgery with a brief review of the first 150 patients.

Simultaneous combined anterior and posterior fusion (SCAPF) is recommended for patients with severe disability and failed spinal operations. In 150 patients treated over the past five years, emphasis is placed on the evolution of the technique and the surgical principles that exclude decompression of the nerve roots. The available evidence suggests that 86% of the patients were improved; 60% were significantly improved.

Arthrogryposis multiplex congenita. A long-term follow-up study.

Most patients with arthrogryposis function well in adult life; however, many remain partially dependent upon others (parents, relatives, government subsidy). This dependency was more closely related to personality, education, and overall coping skills than to degree of physical deformity. Properly sequenced corrective surgical procedures are required to maximize musculoskeletal function. In addition to appropriate surgical correction, good family support, a proper educational environment, and promotion of independence at an early age are required to achieve maximal adult function.

Role of exercises in the Milwaukee brace treatment of scoliosis.

Specific exercises designed to strengthen trunk muscles are an integral part of most Milwaukee brace treatment protocols. To assess the effectiveness of these exercises, we established a prospective study evaluating a closely monitored exercise program coordinated with the use of a Milwaukee brace. Between 1973 and 1979, 24 girls treated with a Milwaukee brace for documented progression of primary right thoracic idiopathic scoliosis were selected for the study. All patients were instructed to perform a standard set of exercises based on the program of Blount and Moe (The Milwaukee Brace [Williams and Wilkins, 1973]). Twelve patients who were regular exercisers constituted the exercise group; 12 patients noncompliant in performing regular exercises composed the control group. Both groups remained faithful brace wearers. No significant difference was found between the two groups regarding age at onset, initial curve degree, skeletal maturity, total time in brace, or general activity level. There was no statistically significant difference in curve improvement between the two groups (p = 0.95). This preliminary study suggests that the Milwaukee brace alone is as effective in halting curve progression as a Milwaukee brace plus standard prescribed exercises.

The renal kallikrein-kinin system in spontaneously hypertensive rats.

In male spontaneously hypertensive rats (SHRSP) of the stroke prone strain (Okamoto) and in normotensive Wistar-Kyoto rats (WKY) urinary kallikrein excretion was investigated at different age and at drug-induced diuresis. In rats of both strains from 7th till 19th week of age urinary kallikrein excretion increased with age. In SHRSP of 7th till 11th week of age kallikrein excretion was higher than in WKY rats, while it was lower in the 48-week-old SHRSP. No correlation was found between urinary kallikrein excretion and systolic blood pressure. In SHRSP and WKY rats a similar daily rhythm of kallikrein excretion in urine was found being high in the early morning and low in the afternoon. Kallikrein excretion correlated significantly with urine volume. The loop diuretic bumetanide (4 and 40 mg/kg) induced diuresis and natriuresis in both strains, however more marked in the WKY rats than in the SHRSP. Urinary kallikrein excretion, however, showed in both strains the same biphasic course with a short lasting increase and a secondary decrease. Thus, in the average urinary kallikrein excretion was not effected by the drug. Prolonged treatment with furosemide over 5 days (125 mg/kg) resulted in an increase in kallikrein excretion in urine, more pronounced in the WKY rats than in the SHRSP. The observed results suggest that renal kallikrein-kinin system is not involved in the development of spontaneous hypertension as a pathogenetic factor, but rather is influenced by other factors like hormone interactions, i.e. mineralocorticoids and catecholamines, as well as renal function and acute changes in urine flow.

Steroid induced changes of the renal kallikrein-kinin system in rats.

In male Sprague-Dawley rats the influence of salt loading (1% NaCl), deoxycorticosterone acetate (2 X 15 mg/kg/day resp. 250 mg/kg sc), corticosterone (2 X 20 mg/kg/day sc) and adrenocorticosterone (0.5 mg/kg/day tetracosactid sc) on the activity of renal kallikrein and renal renin activity was investigated. Salt loading lowered renal kallikrein activity, deoxycorticosterone stimulated its activity and in combination they had no effect on renal kallikrein activity. The time course of kallikrein stimulation by deoxycorticosterone showed no relationship to the escape phenomenon of the kidney from the sodium retaining effect of the mineralocorticoid hormone. Reduction of endogenous mineralocorticoid hormones by adrenalectomy caused a marked reduction of urinary and renal kallikrein activity. Corticosterone suppressed the activity of the renal kallikrein-kinin system at the same time as the reduction in urinary aldosterone excretion. Adrenocorticotrophin caused the same decrease in the activity of renal kallikrein as corticosterone. Urinary aldosterone excretion, however, was significantly stimulated. Thus, the known positive correlation between kallikrein and aldosterone was missing. In all experiments the urinary excretion of kallikrein correlated highly with the kallikrein activity measured in renal cortical tissue. However, no correlation was found between kallikrein and urine volume or urinary excretion of sodium and potassium. In our experiments no relationship between the activity of the renin-angiotensin system and that of the renal kallikrein-kinin system was observed. Furthermore, no clear relationship was found between systemic blood pressure and the activity of the renal kallikrein-kinin system.

Spondylolisthesis: the angle of kyphosis.

A reproducible method of measurement of kyphosis in spondylolisthesis using the cranial surface of the fifth lumbar vertebra and the caudal surface of the first sacral vertebra is described. This measurement is useful in the prognosis of spondylolisthetic patients as the progression of slipping is determined by both the angle of kyphosis and degree of slip. The angle is also important in operative correction of spondylolisthesis. This method is readily used and reproduced in severe slips.