Comparison of routinely used intestinal biopsy forceps in dogs: an ex vivo histopathological approach.

OBJECTIVES: To compare the quality of duodenal and ileal samples obtained with different biopsy forceps. METHODS: Fifteen dogs were included in a prospective ex vivo study. After euthanasia, the duodenum and the ileum were sampled with four different forceps and evaluated according to a standardised scoring system. The biopsy forceps evaluated had alligator jaws or cups with smooth edge with or without a needle. RESULTS: The global quality of the biopsies was better in the ileum that in the duodenum regardless of the biopsy forceps. Biopsy forceps with smooth edge including a needle resulted in fewer artefacts than biopsy forceps with smooth edge but no needle in both sites and those with alligator jaws without a needle provided deeper biopsies than those with smooth edge without a needle only in the duodenum. There was no effect of the biopsy forceps type on the size of the biopsies. CLINICAL SIGNIFICANCE: Our findings may aid in choosing the appropriate type of forceps for intestinal biopsy.

War-related extremity injuries in children: 89 cases managed in a combat support hospital in Afghanistan.

BACKGROUND: Meeting paediatric needs is among the priorities of western healthcare providers working in Afghanistan. HYPOTHESIS: Insufficient information is available on paediatric wartime injuries to the extremities. Our objective here was to describe these injuries and their management on the field. MATERIALS AND METHODS: We retrospectively reviewed consecutive cases of injuries to the extremities in children (< 16 years of age) due to weapons and managed at the Kabul International Airport (KaIA) Combat Support Hospital between June 2009 and April 2013. We identified 89 patients with a mean age of 10.2 ± 3.5 years and a total of 137 elemental lesions. RESULTS: Explosive devices accounted for most injuries (78.6%) and carried a significantly higher risk of multiple lesions. There were 54 bone lesions (traumatic amputations and fractures) and 83 soft-tissue lesions. The amputation rate was 18%. Presence of bone lesions was associated with a higher risk of injury to blood vessels and nerves. Of the 89 patients, four (4.5%) died and eight (9%) were transferred elsewhere. Of the 77 remaining patients, at last follow-up (median, one month; range, 0.1-16 months), 73 (95%) had achieved a full recovery (healed wound and/or fracture) or were recovering with no expectation that further surgery would be needed. DISCUSSION: Despite the absence of paediatric surgeons, the combat support hospital provided appropriate care at the limb salvage and reconstruction phases. The highly specialised treatments needed to manage sequelae were very rarely provided. These treatments probably deserve to be developed in combat support hospitals.

Cryptogein affects expression of alpha3, alpha6 and beta1 20S proteasome subunits encoding genes in tobacco.

Twelve alpha and beta 20S proteasome subunits cDNAs showing 70-82% identity with the corresponding genes in Arabidopsis or rice, and features of eukaryotic proteasome subunits were cloned in tobacco. Only beta1-tcI 7, alpha3 and alpha6, 20S proteasome subunits encoding genes were up-regulated by cryptogein, a proteinaceous elicitor of plant defence reactions. These results led to the hypothesis that the activation of beta1-tcI 7, alpha3 and alpha6 could induce a specific proteolysis involved in the hypersensitive response and systemic acquired resistance monitored by cryptogein.

[Treatment of traumatic false aneurysm of the thoracic aorta with stent graft].

UNLABELLED: The treatment of traumatic false aneurysm of the thoracic aorta by endovascular stent graft may have advantages over conventional surgery. This is a case study of two women suffering from false aneurysm of the thoracic aorta caused in one by a knife injury and in the other by a car accident. After the patients became hemodynamically stable, a commercially available endothelial stent graft (Talent, Gor) was deployed. Recovery was rapid in the first patient. The second patient required emergency laparotomy for venous bleeding one day after stent placement; she died two weeks later, mainly from organ failure. CONCLUSIONS: Endovascular techniques can be used in selected cases to treat thoracic false aneurysms thereby avoiding the complexity and morbidity of conventional surgery.

Saphenous vein harvesting for coronary artery bypass grafting. Retrospective analysis of possible causes of major wound complications in patients with peripheral arterial disease.

OBJECTIVES: to retrospectively evaluate the possible reasons for major wound complications at the saphenous vein harvesting site in patients with peripheral arterial disease (PAD). DESIGN: retrospective study. MATERIALS AND METHOD: fifteen consecutive patients admitted to the vascular department for impaired healing at the saphenous vein harvesting site after successful coronary bypass artery grafting (CABG) (Group A) were evaluated for medical, perioperative, laboratory and pathological factors and outcome. Findings were compared with those in 15 matched controls followed in the outpatient clinic after CABG (Group B). RESULTS: absence of pedal pulses in the affected leg was noted in 13 patients in group A and 3 patients in group B. Ankle brachial index ranged from 0.4--0.7 in group A and 1.7--1.1 in group B; corresponding ankle pressures were 40--100 mmHg (mean 60 mmHg) and 80--160 mmHg (mean 110 mmHg). All patients in group A had PAD, whereas none did in group B, and all patients in group A required intervention to save the leg. Wound healing was noted in 11 group A patients; four patients underwent below-knee amputation. CONCLUSION: saphenous vein harvesting from limbs with severe PAD can lead to significant morbidity, including limb loss. In patients lacking a palpable pedal pulse, we recommend harvesting only the proximal saphenous vein.

Oral perception in tongue thrust and other oral habits.

Oral stereognosis is the ability of the mouth to recognize shape and texture. Oral shape recognition is sensitive to repetition and to topical mucosal anesthesia. Age, upper and lower arch perimeter, and labiolingual dysfunction also interact with oral stereognosis. The purpose of this investigation was to define the influence of age, arch size, and oral dysfunction on oral stereognosis when submitted to repeated trials. Fifty subjects were selected before orthodontic treatment. Each subject underwent 4 trials: T1 and T4 without anesthesia and strictly similar, T2 with topical anesthesia of the tongue, and T3 with topical anesthesia of the palate. Five test pieces or stimuli were used. The recognition time (RT) of each stimulus, the perimeter of upper and lower anterior dental arch, and the labiolingual dysfunction index (LLDI) were the main variables statistically evaluated. Subjects with a mild degree of dysfunction needed more time to recognize the stimuli in T3 when compared with T2. The number of RT3 > RT2 was 2.5 +/- 1.12 in the group with a low LLDI (12 +/- 1.5), and 1.57 +/- 0.63 in the group with an LLDI of 16 +/- 2.5 (P >.05). This may be attributed to different manipulation of the test pieces between the 2 groups, which could have been modified through sensory deprivation. Bolus recognition before the swallowing act needs to be paralleled to stereognostic performance.

Femorofemoral bypass, even in pregnancy--a case report.

A 29-year-old pregnant woman sustained blunt, left lower abdominal trauma, with hip and pelvic fractures, and progressive dissection of an intimal flap in the left iliac artery, which manifested two days later as profound ischemia of the left leg. The patient underwent distal thromboembolectomy, fasciotomies and revascularization of the leg by femorofemoral polytetrafluoroethylene bypass. The patient recovered completely and gave normal birth three months later to a healthy child. Four years after the operation she gave uneventful birth to another child. Various considerations pertinent to this complex traumatic-vascular-gestational state are discussed.

Occlusal and functional evaluations in adults: a case report.

The findings on an adult patient with mandibular asymmetry and temporomandibular dysfunction are presented. The patient had four first premolars extracted earlier, followed by a short treatment attempt. Control of tongue function and jaw posture before, during, and after active treatment helped achieve a functional occlusion and a relief of the symptoms of the temporomandibular dysfunction. Specific diagnostic (assessment of occlusion and jaw movements) as well as therapeutic means (lower removable appliance and crown reshaping) are described.

Antiviral activity of mice with chronic renal failure--an assessment using peritoneal effluents.

Antiviral activity (AVA) determined by the inhibition of the cytopathic effect (CPE) of vesicular stomatitis virus (VSV) on mice fibroblasts, was measured in the peritoneal effluent of mice. Four groups of animals (each group numbering 30 mice) were studied. Group 1 consisted of sham operated mice and served as the control group. Group 2 underwent implantation of silastic matter (of which the Tenckhoff catheter is made). In group 3, chronic renal failure was induced. Group 4 comprised those mice in which both chronic renal failure was induced and silastic matter implanted. Optical density readings, directly related to the inhibition of CPE were 0.66 +/- 0.01, 0.59 +/- 0.08, 0.85 +/- 0.06 and 0.86 +/- 0.13 for groups 1, 2, 3 and 4, respectively (p < 0.01 for groups 1 and 2 versus 3 and 4). Virus control readings indicative of the CPE of VSV without the presence of peritoneal effluent were 0.58 +/- 0.07, not significantly different from those obtained in groups 1 and 2. They were, however, significantly below values from groups 3 and 4 (p < 0.05). These data show that AVA is undetectable in the peritoneal effluent of normal mice. Chronic renal failure produces an enhancement of AVA. Silastic matter (Tenckhoff catheter) implantation does not play a role in the production of AVA.

Effect of leukotriene inhibitor LY-171883 on the pulmonary response to Escherichia coli endotoxemia.

The effect of the leukotriene D4 (LTD4) receptor antagonist, LY-171883, on the respiratory and cardiovascular changes in endotoxemia was studied in 20 unanesthetized sheep. In group 1 (n = 2), 4 mg/kg LY-171883 was injected iv. In group 2 (n = 12), Escherichia coli endotoxin (1 micrograms/kg) was infused iv, and in group 3 (n = 6), 4 mg/kg LY-171883 was administered 15 min before and 30 min after the same dose of endotoxin. Infusion of LY-171883 in group 1 did not alter baseline ventilatory and cardiovascular measurements. A two-phase pulmonary response was observed in group 2: an early pulmonary hypertension phase in which pulmonary artery pressure (PAP) increased from 18.7 to 51.2 mm Hg (p less than .001), with a fall in cardiac index (CI) from 171 to 114 ml/min.kg (p less than .01). The ratio of peak inspiratory/expiratory flow rate (PIF/PEF) increased from 1.08 to 1.35 (p less than .01) and the respiratory rate from 50 to 70 breath/min (p less than .005) 30 min postendotoxin. The flow rate measured at midexpiration time (V50) decreased from 81% to 25% of its peak expiration (p less than .001) and the airway resistance increased from 3.8 to 32.7 cm H2O/L.sec (p less than .001). The second permeability phase was characterized by an increase in pulmonary lymph flow (QL) from 8.5 to 35.2 ml/h (p less than .01), a decrease in PaO2 from 76 to 61 torr (p less than .01), and an increase in pulmonary shunt ratio (Qsp/Qt) from 16% to 31% (p less than .005).(ABSTRACT TRUNCATED AT 250 WORDS)

[Tongue disorders and jaw deformities. Nosological aspects and therapeutic concepts]. / I disturbi linguali nelle deformazioni mascellari. Aspetto nosologico e concetti terapeutici.

Tongue's disorders as abnormal volume, modified position and mobility can cause maxillary deformation. Nosological and therapeutic aspects are considered.

[Current aspects of the vascular hand]. / Le point sur la main vasculaire.

In this report, we recall that Raynaud's phenomenon is a "key" symptom at the center of vascular disorders of the hand, since in the positive, differential diagnosis, among its etiologies, good clinical knowledge of acrosyndromes, arteritis of the palm and digits, and the thoracic outlet syndrome is necessary. The importance of capillaroscopy and certain therapeutic techniques have been emphasized (value of Phlebotonic Agents in the treatment of microcirculatory alterations induced by stress or emotional disturbances.

Cephalometric changes in Class II, Division 1 cases after orthopedic treatment with the bioactivator.

The bioactivator is an orthopedic appliance that has been used for 20 years in the treatment of Class II, Division 1 cases. The evaluation of its therapeutic effects was performed in this study of 76 9- to 10-year-old patients (at the beginning of treatment). The treated subjects were separated into two groups: group A (bioactivator only) and group B (bioactivator plus headgear). Group C comprised 14 untreated subjects selected as controls. Various statistical assessments were made to separate growth phenomena from treatment effects. It appears that the bioactivator has an effect not only on the dentition but also on the skeletal structures. In both treated groups, the maxillary changes were related to an increased anterior vertical growth and a posterior sagittal growth. The addition of extraoral force helped to achieve a posterior rotation of the upper jaw. When only the bioactivator was worn, the mandibular changes were more vertical than sagittal. The lower jaw appeared more forward, however. When the bioactivator and the headgear force were used simultaneously, the therapeutic effects seemed to be more sagittal than vertical, as if the occipitally directed force vector inhibits or at least exerts a control on the downward growth tendency. Without being significantly different statistically from one to the other, the treated groups showed a marked improvement of the sagittal jaw discrepancy.

[A case of thromboangiitis obliterans in a young woman. A rarity and diagnostic difficulties]. / A propos d'un cas de thromboangéite oblitérante (TAO) chez une femme jeune. Rareté et difficulté de diagnostic.

The diagnosis of thromboangiitis obliterans (Buerger's Disease) in a young patient can only be arrived at by means of a number of different arguments: clinical, biological and immunological, angiography, capillaroscopy especially if it concerns a young female patient; the rarity of TAO in a young woman ought to mean that scleroderma and lupus can be discounted; it also necessitates an annual clinical and paraclinical check-up.

Effect of the leukotriene receptor antagonist LY-171883 on endotoxemia in awake sheep.

The effect of the leukotriene D4, leukotriene E4 (LTD4/E4) receptor antagonist LY-171883 was studied in endotoxemia. Eighteen awake sheep were divided into three groups. In Group (n = 4) 4 mg/kg LY-171883 was twice injected intravenously. In Group II (n = 9) 1 microgram/kg E. coli endotoxin was administered intravenously. In Group III (n = 5) 4 mg/kg LY-171883 was given 15 min before, and 30 min after endotoxin. Infusion of LY-171883 in Group I did not alter baseline hemodynamic and pulmonary measurements. Infusion of endotoxin in Group II was followed by an initial rise of pulmonary artery pressure (PAP) to 51 torr (P less than 0.001), pulmonary microvascular pressure (Pmv) to 25 torr (P less than 0.005), pulmonary vascular resistance (PVR) to 1,019 dynes sec. cm-5 (P less than 0.001), systemic vascular resistance (SVR) to 2,830 dynes sec. cm-5 (P less than 0.001), plasma thromboxane B2 (TXB2) to 4,971 pg/ml (P less than 0.001), lymph TXB2 to 5,500 pg/ml (P less than 0.001), plasma 6-Keto PGF1 alpha to 1,469 pg/ml (P less than 0.005), and lymph 6-Keto PGF1 alpha to 2,518 pg/ml (P less than 0.005). The cardiac index (CI) fell to 100 ml/min. kg (P less than 0.01), PaO2 to 61 torr (P less than 0.01), and circulating WBC to 2,800 microliter (P less than 0.001). This was followed by a rise in pulmonary lymph flow (QL) to 35 ml/h (P less than 0.01) and lymph protein clearance (L/P.QL) to 23 ml/h (P less than 0.01). Pretreatment with LY-171883 in Group III resulted in rise of PAP to 35 torr (P less than 0.005), PmV to 18 torr (P less than 0.05), PVR to 398 dynes sec. cm-5 (P less than 0.01), SVR to 1,732 dynes sec. cm-5 (P less than 0.05), and CI increased to 170 ml/min.kg (P less than 0.005). L/P.QL, QL, Hgb, WBC, PaO2, PaCO2, Qs/QT, plasma and lymph TXB2, and plasma and lymph 6-Keto PGF1 alpha were not significantly changed by LY-171883. It is concluded that LY-171883 inhibited the smooth muscle effects of endotoxin, namely reduced PAP, Pmv, PVR, and SVR and increased cardiac output. Hypoxemia and increased pulmonary vascular permeability were unaffected by this leukotriene receptor antagonist.