Effects of a single trace mineral injection at beginning of fixed-time AI treatment regimen on reproductive function and antioxidant response of grazing Nellore cows.

Two experiments evaluated the effects of injectable trace minerals (ITM) administered 11 d before artificial insemination (AI) on body weight (BW), body condition score (BCS), ovarian structures, pregnancy rate, and antioxidant response of Nellore cows. In Experiment 1, 20 multiparous cows were assigned to one of two treatments: subcutaneous injection (6 mL/cow; 11 d before AI) of saline solution or ITM (60, 10, 5, and 15 mg/mL of Zn, Mn, Se and Cu, respectively) and BW, BCS, ovarian structures and blood were evaluated. In Experiment 2, 1,144 multiparous cows were assigned to same treatments described in Experiment 1 and pregnancy rate on d 30 was evaluated. In Experiment 1, ITM did not affect (P ≥  0.23) BW, dominant follicle size, ovulation rate, and plasma concentrations of haptoglobin, ceruloplasmin and progesterone (P4). The ITM treatment tended to increase (P =  0.06) cow BCS and reduce (P ≤  0.06) corpus luteum (CL) diameter and volume. Furthermore, ITM treatment tended to increase (P =  0.06) plasma concentrations of SOD and increased (P =  0.007) GSH-Px compared with saline injection. In Experiment 2, ITM treatment tended (P =  0.06) to increase pregnancy rate of cows with BCS ≤ 5.0 but not cows with BCS > 5.0 (P =  0.99). The ITM treatment did not alter BW, plasma P4, and acute phase response, but enhanced plasma concentrations of antioxidant enzymes, and tended to enhance BCS and pregnancy rates to AI of cows with BCS ≤ 5.0, even though there was a smaller corpus luteum size.

Patient satisfaction after hook plate treatment of bony avulsion fracture of the distal phalanges.

BACKGROUND: Bony avulsion fractures of the distal phalanges can result in mallet finger deformity if not treated appropriately. Therefore, only minimally displaced fractures can be treated conservatively with a good outcome, as dislocation occurs very often. Several surgical treatment options have been developed during the past decades. Data concerning the recently developed hook plate are promising. So far, no data concerning the subjective satisfaction with this method have been published. Therefore, we have analyzed the outcome after hook plate implantation using a self-assessment score, which focuses also on subjective parameters and satisfaction. METHODS: Standardized questionnaires (self-assessment scores and SF-36 questionnaire) were sent to each patient treated with a hook plate due to fracture of the distal phalanx, type Doyle IVb and IVc. Clinical data were evaluated according to the medical record. Scores given per question range from 0 to 10, 10 is the worst and 0 the best outcome. RESULTS: From 69 patients treated, 38 (58%) were enrolled. The whole collective (n = 38) reached a score of 39.7 ± 28.7 points, while men had slightly better results. Men (n = 24) achieved 37.3 ± 27.9 points, women (n = 14) 43.9 ± 30.7 points. Women had significantly better results when analyzed later than 12 months after surgery (52.1 ± 27.9 vs. 29.1 ± 32.8), whereas no changes could be detected in the male group (37.1 ± 29.9 vs. 37.4 ± 27.6). Overall, men were slightly more satisfied than women. Most satisfaction was found regarding pain and fine motor skills (0-0.46 points). Esthetic aspect and nail deformities (3.65 points average) led to the highest dissatisfaction. No differences in the SF 36 score could be detected. CONCLUSIONS: The hook plate is not only a convenient method but it also results in high patient satisfaction. Nail deformities are challenging; however, with increasing experience of the surgeon they decrease. SF 36 score is not an appropriate testing tool for this problem.

[Strategies for complex injuries of the hand]. / Strategien bei Komplexverletzungen an der Hand.

The quality of the reconstruction, follow-up treatment and care determine the treatment outcome of complex hand injuries. The initial estimation and therapy are decisive. Optimal results necessitate a structured approach with strategic planning, including thorough débridement, precise analysis of the resulting defect and loss of function and if possible unilateral reconstruction and well-founded planning of secondary interventions. Within the framework of the detailed patient clarification the perspectives, possibilities and alternatives must be realistically presented. Taking these fundamental strategic steps into consideration, the primary aims of reconstruction and preservation of function, rapid occupational and social reintegration and avoidance of delayed complications can best be realized. There is no standard approach for these extremely variable injuries. Decisive is that even in cases of apparently harmless injuries, the involvement of functional structures must be considered early in the initial stages.

Efficacy of caudal epidural injection of lidocaine, xylazine and xylazine plus hyaluronidase in reducing discomfort produced by electroejaculation in bulls.

To test the hypothesis that epidural administration of lidocaine, xylazine or xylazine plus hyaluronidase provides reduced pain and stress during electroejaculation in bulls, eight 30-month-old Nellore bulls received saline solution (control), 2% lidocaine, 2% xylazine or 2% xylazine plus hyaluronidase injected into the first intercoccygeal (Co1-Co2) epidural space in randomized order. Heart rate, respiratory rate, mean arterial pressure, analgesia, animal behavior and motor blockade were evaluated before treatment and at predetermined intervals during and after treatment. Pain and stress were scored subjectively, and semen quality was evaluated. The onset of anesthetic action was significantly faster with lidocaine (3.0 ± 1.2 min) than with xylazine or xylazine plus hyaluronidase (8.9 ± 1.5 and 5.5 ± 2.6 min, P=0.021 and P=0.012, respectively), and the onset of anesthesia with xylazine plus hyaluronidase was significantly faster than that with xylazine alone (P=0.032). Treatment with xylazine or xylazine plus hyaluronidase resulted in less discomfort than treatment with lidocaine, as indicated by animal behavior. Changes in heart rate, respiratory rate and arterial pressure were within acceptable limits. Penile protrusion and semen emission occurred in all animals during all four treatments. Our results suggest that xylazine plus hyaluronidase reduced discomfort during electroejaculation more effectively than xylazine or lidocaine alone. Further experiments are necessary to determine whether electroejaculation with xylazine plus hyaluronidase is feasible for obtaining semen from Nellore bulls unaccustomed to being handled or restrained.

[Operation well performed but insufficiently documented and not indicated]. / Operation lege artis, jedoch mangelhaft dokumentiert und nicht indiziert.

A 50-year-old patient presented with a lump in the main joint of the fourth finger of the left hand, which was suspected of being malignant, for an operation. Following surgery the lump was still present and, furthermore, the patient reported a wound resulting from surgery on the third finger accompanied by swelling, pain and a loss of mobility. The patient accused the physician of performing surgery without indications on the wrong finger together with failure to remove the lump. The surgeon stated that lysis had been performed on the flexor tendon in the area of the lump. An external expert admonished the cursory surgery report; however, the expert stated that removal of the lump at the tendon would have been medically indicated and the operation was performed according to professional surgical standards. The decision of the arbitration board differed from the expert opinion as the insufficient documentation presented at first could have been understood to mean that a tendon node on the fourth finger was to be removed which was not the case. Furthermore, the operation performed would only have been indicated if a "trigger finger" were present; therefore, the surgery as well as the resulting afflictions and follow-up treatment were to be assessed as faulty. The handwritten surgery report had several shortcomings as well and led to a reversal of the burden of proof.

[High-pressure injection injury of the hand. Underestimation of injury severity]. / Hochdruckinjektionsverletzung an der Hand. Unterschätzung der Verletzungsschwere.

A 44-year-old man sustained a high-pressure injection injury of the left index finger with hot hydraulic oil in an occupational accident. On presentation to the occupational physician 4 h later the wound was irrigated and cleaned. At this time X-ray diagnostics, wound revision, administration of antibiotics and immobilization were not performed. The following day the patient presented to a hospital with painful swelling and reddening of the left index finger where an emergency surgical wound revision, administration of antibiotics and immobilization of the finger were performed due to a phlegmon of the flexor tendon. Despite subsequent revision operations, necrosis of the flexor tendon sheath occurred with a skin subcutis defect necessitating a full thickness skin transplantation and ultimately operative fusion of the distal interphalangeal joint of the index finger. After a total period of treatment of 9 months the patient still presented with local soft tissue swelling and paresthesia as well as a limited range of motion of the proximal interphalangeal joint. The patient filed a complaint for wrong treatment of the high-pressure injection injury in terms of an inaccurate examination and lack of administration of antibiotics at the first presentation. The expert opinion of the arbitration board ascertained medical malpractice at the first presentation. An emergency surgical wound revision had already been indicated at the first presentation and the revision procedures would have been less extensive and it was highly probability that surgical fusion of the distal interphalangeal joint could have been avoided. The arbitration furthermore concluded that iatrogenic maltreatment led to a phlegmon of the flexor tendon with the need for subsequent revision operations including surgical fusion of the distal interphalangeal joint which resulted in an affected grip control. The delay in surgical treatment must be considered as the reason for the much worse initial situation that finally led to the functional impairment of the left index finger.

Testis morphometry and kinetics of spermatogenesis in the feral pig (Sus scrofa).

The feral pig (Sus scrofa sp) also known as Monteiro pig, originated from a domestic pig breed that was introduced into Pantanal region in Brazil in the eighteenth century. Although the feral pig has commercial potential, there are few reports in the literature concerning the reproductive biology of this species. Therefore, the aim of this study was to further describe the feral pig testis parenchyma as well as characterize the stages of the seminiferous epithelium cycle by tubular morphology method, and to evaluate the number of differentiated spermatogonia generations in this species. Eight sexually mature feral pigs were analyzed. Fragments of testes were embedded in plastic resin and used to prepare slides for morphometrical studies. It was concluded that the feral pig has six generations of differentiated spermatogonials (A1, A2, A3, A4, In, B) and that the cellular composition in the eight stages of the seminiferous epithelium cycle of these animals were very similar to those reported in species of suidae and tayssuidae already studied.

[Arthroscopy-assisted management of wrist fractures]. / Arthroskopisch unterstützte Frakturversorgung am Handgelenk.

Distal radius fractures are the most common fractures in humans and early surgical intervention with modern plating systems is becoming increasingly more established to avoid secondary dislocation. Even fractures with slight dislocations are adequately stabilized and the affinity for surgical intervention and plating procedures is applied to secure these simple fractures. In this aspect the surgical indications are significantly dependent on X-ray examination results. Further diagnostics with respect to ligamentous and soft tissue injury are the exception although the impact energy which creates osseus fractures is sufficient by far to destroy functional soft tissue, cartilage and ligaments. The ongoing development of wrist arthroscopy enables new possibilities especially concerning concomitant articular involvement of distal radius fractures. Arthroscopy-assisted reduction and stabilization as well as minimally invasive soft tissue repair and loose body removal seem to be adequate methods to improve the surgical treatment of distal radius fractures.

Proliferation of seminiferous epithelium cells during the postnatal development in goats.

The objective of this research study was to evaluate the proliferation of somatic and germ cells in the seminiferous epithelium of Alpine goats. A total of 47 goats reared in semi-intensive conditions were used, divided into age groups from birth up to 12 months of age. Following castration, testis fragments were included in plastic resin and were mounted in Entellan(®) for histometric evaluations. In general, the total number of germ cells per seminiferous cord transverse section was low until 4 months of age. An increase was observed between 4 and 5 months, lasting until 9 months of age. From that age on, this number tended to stabilize, until 12 months. The population of support cells (undifferentiated support cells and Sertoli cells) remained constant from birth to the first month, when it peaked. This was followed by a reduction until the fifth month of age. From that age on, there was differentiation in mature Sertoli cells, and its population remained constant until 12 months of age. It can be concluded that Alpine goats were in the impuberal phase from birth to 3 months of age, prepuberal phase during the fourth month, reached puberty at 5 months of age, postpuberal phase from 6 to 8 months, and reached sexual maturity at 9 months of age. Overall yield of spermatogenesis and Sertoli cell index increased from puberty up to the 12th month of age.

Characterization and activity of angiotensin-converting enzyme in Holstein semen.

The study was designed to perform immunodetection in spermatozoa and seminal plasma, immunolocalization in spermatozoa, and evaluation of the enzymatic activity of angiotensin-converting enzyme (ACE) in the semen of Holstein bulls. We used ejaculates from five bulls as part of a regular collection of semen. The monoclonal anti-ACE antibody recognized a single protein band with 100 kDa in detergent extract prepared from sperm and in seminal plasma. ACE enzymatic activity in sperm was 43.7, 21.3, 45.6, 60.0, and 57.7 mU/mL in bulls 1, 2, 3, 4, and 5, respectively, and 0.3, 2.3, 3.0, 2.3, and 2.6 mU/mL in seminal plasma of the same bulls, respectively. The average percentages of sperm with acrosome reactions after treatment with heparin were 28.3%, 28.6%, 35.2%, 25.0%, and 32.3%, respectively. These values were higher than the percentages of acrosome reactions in controls and the captopril group (P<0.05), although no difference was seen between the captopril and control groups (P>0.05). After 4h of incubation, motility in the control group (32.9%) was significantly higher than that in the heparin (15.7%) and captopril (12.1%) groups. No difference was found in motility after the capacitation assay in the heparin and captopril groups (P>0.05). In conclusion, ACE was immunologically localized in the acrosome of the spermatozoa of Holstein bull, the specific enzymatic activity of ACE in detergent-extracted spermatozoa and seminal plasma was inhibited by captopril, and this ACE inhibitor reduced the percentage of sperm with progressive motility and acrosome reactions after capacitation in vitro.

[Alterations of cell phenotype in Dupuytren's disease--an in vitro analysis]. / Veränderung des Zell-Phänotyps durch Morbus Dupuytren--eine in-vitro-Analyse.

INTRODUCTION: Despite its potential complications, partial aponeurectomy still is the mainstay of treatment whenever it comes to significant contracture in Dupuytren's disease. With the goal in mind to identify new therapeutic strategies we isolated and characterised cells from healthy palmar aponeurosis (Kon) and compared them to cells isolated from palmar aponeurosis of patients with a primary manifestation of Dupuytren's disease (PrimDup) as well as from patients with recurrent Dupuytren's disease (RezDup). As cells from palmar aponeurosis from patients with Dupuytren's disease share characteristics with stem cells, such as the ability to differentiate into other cell types, we analysed the stemness, morphology and integrin receptor profiles of the cells. MATERIALS AND METHODS: A total of 15 Dupuytren samples were collected from regular partial aponeurectomy procedures. From these, 3 donors without extrinsic risk factors were selected per group (RezDup, PrimDup). Cells were isolated and expanded under standard cell culture conditions. Cells from healthy patients served as control (Kon). Growth curves were produced. Cells were subjected to osteogenic and adipogenic differentiation using standard protocols. Semiquantitative PCR analysis of the integrins α2, ß3, ß5 and fibronectin was performed. RESULTS: PrimDup cells proliferated significantly faster than control cells, which in turn proliferated faster than RezDup cells. Both PrimDup and control cells went into senescence after approximately 40 days whereas RezDup cells proliferated over the entire period of 100 days. Osteogenic and adipogenic differentiation was best in cells derived from Dupuytren patients while Kon cells differentiated poorly. PCR analysis revealed that fibronectin-binding integrins ß3 and ß5 are upregulated in Dupuytren's disease. CONCLUSIONS: PrimDup cells grow faster than the other cell types suggesting that their growth regulation may be altered. The fact that RezDup cells do not reach senescence over 100 days in culture indicates that senescence regulating factors may be altered. As cells from Dupuytren patients differentiate better along the osteogenic and adipogenic lineages, they probably possess a higher level of stemness. Their modified integrin profile may be a key to future therapies.

Pregnancy rate of Nelore females inseminated with male-sexed semen.

Pregnancy rates of Nelore females inseminated with male-sexed semen and conventional semen from the same bulls were evaluated. The females included 433 heifers (2 years old) and 230 non-suckling cows, totaling 663 animals. Average body condition score was 3.5 (1-5 scale). Estrus was induced with prostaglandin F2α. The total pregnancy rate of females inseminated with male-sexed semen of bulls A, B and C was 38.8% (131/338) less (P<0.0001) than the total pregnancy rate observed for females inseminated with conventional semen from the same bulls (57.9% [188/325]). Pregnancy rates of non-suckling cows inseminated with male-sexed semen was 43.3% (49/113), which was similar (P≥0.05) to the values found for heifers inseminated with male-sexed semen from the same bulls (36.4% [82/225]). The pregnancy rate of females inseminated with male-sexed semen was less compared with females inseminated with conventional semen. In addition, there was no significant difference in the pregnancy rate of heifers versus non-suckling cows.

Kinetics of spermatogenesis in the white-lipped peccary (Tayassu pecari).

This study aimed to characterize the stages of the seminiferous epithelium cycle by the tubular morphology method, and to determine the number of differentiated spermatogonia generations in the adult white-lipped peccary. Twenty adult white-lipped peccaries, obtained from commercial slaughterhouse, were used. Fragments of the testicular parenchyma were fixed in 3% glutaraldehyde and embedded into a methacrylate resin. The number of germ and Sertoli cells was estimated by the analysis of cell populations in 50 transversal sections of seminiferous tubules in different stages of the cycle. The tubular morphology method allowed the identification of cellular associations characteristic of the eight stages of the seminiferous epithelium cycle in white-lipped peccaries. The results showed the presence of six generations of differentiated spermatogonia in white-lipped peccaries, and that the cell composition of the eight stages of the seminiferous epithelium cycle in this species is very similar to that described for collared peccaries.

Intrinsic rate of spermatogenesis in free-ranging feral pigs (Sus scrofa sp).

The aim of this research was to evaluate the intrinsic rate of spermatogenesis in adult free-ranging feral pigs. Twelve adult male free-ranging feral pigs were captured, sedated, and orchidectomized, and then were released and observed to complete recovery and return to their natural environment. Fragments of the testes were embedded in plastic resin and used to prepare slides for histometric analysis. Characteristics investigated included cell populations in the seminiferous epithelium in stage 1 of the cycle of the seminiferous epithelium, intrinsic rate of spermatogenesis and Sertoli cell index. The efficiency coefficient of spermatogonial mitosis was 7.59, the meiotic index was 3.03, the overall yield of spermatogenesis was 23.97 and the cell loss ratio during the meiotic prophase was 1.04. Each Sertoli cell supported an average of 0.92 type A spermatogonia, 7.01 primary spermatocytes in preleptotene/leptotene, 7.30 primary spermatocytes in pachytene and 22.16 round spermatids. In conclusion, the results of the present study indicate that the supporting capacity of Sertoli cells in free-ranging feral pigs is among the greatest values reported for most domestic animals, and the overall yield of spermatogenesis is comparable to that reported in wild boars.

Somatic and germ cell proliferation during post-natal development of the testis in the wild boar (Sus scrofa scrofa).

This study aimed to investigate the proliferation of cells in the seminiferous epithelium, the intrinsic rate of spermatogenesis and Sertoli cell index in wild boars, during the period from birth to 12 months of age. A total of 52 animals raised in captivity were assigned to 13 experimental groups. After unilateral orchidectomy, fragments of the testes were embedded in plastic resin and used to prepare slides for histometric analysis. Variables assessed in each age group included the characterization of cell populations in the seminiferous epithelium, the intrinsic rate of spermatogenesis, Sertoli cell index and the stages of testicular development in each animal. Gonocytes were in greater numbers in newborn animals, and by the fourth month were no longer identified. The population of spermatogonias increased from 3 to 9 months, after that showed a tendency to stabilization. Primary spermatocytes in pre-leptotene/leptotene were first seen in 8-month-old animals. Primary spermatocytes in pachytene, and round spermatids increase gradually in frequency in animals from 9 to 12 months of age. Undifferentiated support cells were very frequent at birth to 7 months and increased between 7 and 8 months, after that there was a tendency for no further increase in this cell type. We conclude that the Sertoli cell population stabilized in the pre-pubertal phase and germ cell population increased after puberty. The overall yield of spermatogenesis and Sertoli cell index were greater in animals around 12 months of age.

Spermatogenesis in white-lipped peccaries (Tayassu pecari).

We describe here morphological and functional analyses of the spermatogenic process in sexually mature white-lipped peccaries. Ten sexually mature male animals, weighing approximately 39 kg were studied. Characteristics investigated included the gonadosomatic index (GSI), relative frequency of stages of the cycle of seminiferous epithelium (CSE), cell populations present in the seminiferous epithelium in stage 1 of CSE, intrinsic rate of spermatogenesis, Sertoli cell index, height of seminiferous epithelium and diameter of seminiferous tubules, volumetric proportion of components of the testicular parenchyma and length of seminiferous tubules per testis and per gram of testis. The GSI was 0.19%, relative frequencies of pre-meiotic, meiotic and post-meiotic phases were, respectively 43.6%, 13.8% and 42.6%, general rate of spermatogenesis was 25.8, each Sertoli cell supported an average 18.4 germinative cells, height of seminiferous epithelium and diameter of seminiferous tubules were, respectively, 78.4 microm and 225.6 microm, testicular parenchyma was composed by 75.8% seminiferous tubules and 24.2% intertubular tissue, and length of seminiferous tubules per gram of testis was 15.8m. These results show that, except for overall rate of spermatogenesis, the spermatogenic process in white-lipped peccaries is very similar to that of collared peccaries, and that Sertoli cells have a greater capacity to support germinative cells than most domestic mammals.

Tensor fasciae latae perforator flap for reconstruction of composite Achilles tendon defects with skin and vascularized fascia.

The surgical management of large defects of the Achilles tendon and overlying skin is very demanding and necessitates, as a rule, a free vascularized graft. The ideal characteristics of a thin layer of skin and a strong tendon component, combined with a reliable blood supply and minimal morbidity at the donor site, have only been partially met by all previous grafts used in this situation. The authors performed reconstructions in five patients with large defects of the Achilles tendon and overlying skin by using a perforator flap derived from the tensor fasciae latae flap. A vascularized skin-subcutis-fascia lata flap could be raised by dissecting out two to three perforating arteries through the tensor fasciae latae muscle to the ascending branch of the lateral circumflex femoral artery; the muscle was left in situ in the process. All the flaps took well without complications. At final examination after an average of 20 months, the reconstructed Achilles tendon showed good functional results, although there was a 50 to 70 percent reduction in power during plantar flexion when compared with the normal side. A very good aesthetic result could be obtained after a debulking operation was performed on the skin flap.

[Implementation of a quality management system for the curriculum in emergency medicine education]. / Implementierung eines Qualitätsmanagementsystems für die Unterrichtsdurchführung des Notfallkurses.

Medical teaching, training and education in basic and advanced life support were improved by basic quality management procedures. 3rd year medical students (n = 276) of two consequent semesters were questionnaired about their acute emergency medicine curriculum. While Group A (n = 134) received a standard course, the new course for group B (n = 142) was reorganised on the basis of the results of group A. Interventive educational measures were an increased number of models provided for exercising the students skills, and an extension of megacode training possibilities. Participation of students in course design improved the overall performance in respect of knowledge, skills and decision-making (p < 0.05). Curriculum acceptance and intrinsic motivation of students however were not positively influenced by practical training compared to traditional knowledge transfer.

[The biological reaction in atrophic and hypertrophic pseudarthrosis of diaphysis of long bone. Causes and forms of appearance]. / Die biologischen Bedingungen atropher und hypertropher Pseudarthrosen der Schaftknochen. Ursachen und Erscheinungsbild.

The grading of long-tubular-bone pseudarthrosis depends on the biological reaction or lack of reaction in pseudarthrosis or non-unions. Hypertrophic and oligotrophic pseudarthrosis belongs to biologically reacting non-unions, whereas non-reacting non-unions are necrotic pseudarthrosis and defective non-unions with partial decline or complete destruction of cortical substance. Pseudarthrosis is a serious disturbance or disorder within the regulation cycle in fracture healing, which consists of osteoregeneration, osteovascularization and stabilization. The causes and underlying reasons for disturbance of this regulation cycle are primarily massive destruction of the biological and functional very important unity of periost, cortical substance and medullary space. This can occur from trauma, but it happens more often from surgical procedures that do not take the biological principles of bone-healing into account. Surgical strategies and interventions that respect the importance of periosteal tissue, cortical tissue and medullary space do fill the biological principles of fracture-healing and fracture union.