A step-down protein program for commercial pullets.

Three experiments were conducted to evaluate the protein requirement of commercial egg production pullets from 8 to 20 weeks of age. Hyline W-36 pullets were used in Experiments 1 and 3, and Hisex White pullets were used in Experiment 2. They were fed a 20% protein diet for the first 8 weeks. In Experiment 1, a diet containing 14% protein did not result in body weight at 16 weeks equal to that obtained from feeding a diet containing 17% protein. In Experiments 2 and 3, body weights of pullets fed a diet containing 17% protein from 8 to 10 weeks followed by 1% protein reduction biweekly thereafter (12% from 18 to 20 weeks) was equal to that obtained by feeding 18% for the entire period. Performance in the laying house for four 28-day periods was equal for the two treatment groups. Feeding diets with suboptimal protein from 8 to either 12 or 14 weeks of age resulted in reduced body weight. However, when 14% protein was fed for the remainder of the growing period, body weight was restored.

Diagnosis of abdominal abscesses with computed tomography, ultrasound, and 111In leukocyte scans.

Computed tomography (CT), ultrasound, and 111In-labeled leukocyte scans are all used in the evaluation of abdominal abscesses. In this study, 170 patients in whom one, two, or all three of these modalities were used retrospectively reviewed. Diagnostic accuracy of 96% for CT, 90% for ultrasound, and 92% for 111In leukocyte scans was achieved. It was often necessary to use more than one modality to arrive at a correct diagnosis. The advantages and disadvantages as well as the causes for false positive or false negative interpretations of each of these modalities are reviewed. Analysis of the different examinations resulted in a suggested sequence by which patients can be examined, based upon their clinical condition. Patients who are not critically ill and/or who have no localizing signs should be studied first with 111In-labeled leukocyte scans. If, however, localizing signs should or the patient's condition necessitates prompt intervention, CT or ultrasound should be the first study performed.

Indium-111 labeled leukocytes in the evaluation of suspected abdominal abscesses.

Sixty-eight indium-111-labeled leukocyte imaging studies were performed in 53 patients with suspected abdominal abscesses. Twenty-nine studies gave abnoramal results. Nine wound infections were demonstrated, and 14 abscesses were correctly identified. Four studied demonstrated colonic accumulation, one of which remains unexplained, and two accessory spleens were identified. Indium-111 leukocyte imaging is a sensitive and specific study in evaluating patients with suspected abdominal abscess. Differentiation of abscess from other causes of inflammation has not been a problem. The exact role of leukocyte imaging compared with gallium-67 citrate imaging, ultrasound and computerized tomography remains to be determined.

The efficacy of the brain scan in diagnosis of brainstem gliomas.

Nineteen cases of brainstem glioma were reviewed to evaluate lesion detection by brain imaging and other radiological methods. 99m-Tc-pertechnetate brain imaging was definitely abnormal in only one patient. Other techniques proved to be more sensitive and specific. Angiograms were abnormal in 10 of 18 cases while pneumoencephalography demonstrated the lesion in 16 of 19 cases. Brain imaging is not a sensitive diagnostic study in patients with suspected brainstem glioma. A normal brain scan is not useful in excluding this diagnosis and further radiological evaluation is necessary.

Cisternographic imaging patterns: effects of partial extra-arachnoid radiopharmaceutical injection and postinjection CSF leakage.

A cisternographic pattern of subarachnoid block with transient or no ventricular radiopharmaceutical reflux was observed in 52% of 105 patients with partial extra-arachnoid injections or postinjection leakage of CSF or both at the lumbar puncture site. In several patients, adequate repeat studies demonstrated considerably different CSF flow patterns. This block pattern was seen in only 11% of 217 patients with adequate intrathecal injections. Lumbar CSF leakage may alter the pattern seen on a cisternographic study and, if present, the study should be interpreted with caution.

Brain scanning in cerebral vascular disease: a reappraisal.

The frequency of abnormal brain scans in patients with cerebral vascular disease admitted to a stroke intensive care unit has been evaluated in relation to diagnosis, time after onset of symptoms, effect of delayed imaging and the degree of clinical neurological recovery. In patients with completed thromboembolic infarction, 33% had abnormal scans including 39% of those with hemispheric lesions and 14% with posterior fossa lesions. Completed hemorrhagic infarction occurred in seven patients, and three (43%) had abnormal brain scans. Of 14 patients with either transient ischemic attacks or reversible ischemic neurological deficit, two (14%) had abnormal scans. Twenty-seven percent of brain scans in patients with completed thromboembolic infarction were abnormal in the first two days after infarction, a higher frequency than previously reported. Delayed images confirmed the initial interpretation that the scan was either normal or abnormal in 71% of the cases while in 10% of the cases only the delayed views were abnormal. The frequency of abnormal scans was significantly greater in patients who died or had a large neurological deficit at discharge than in patients with lesser residual deficit.