Validation of the Berlin Grading System for moyamoya angiopathy with the use of [15O]H2O PET.

The Berlin Grading System assesses clinical severity of moyamoya angiopathy (MMA) by combining MRI, DSA, and cerebrovascular reserve capacity (CVRC). Our aim was to validate this grading system using [15O]H2O PET for CVRC. We retrospectively identified bilateral MMA patients who underwent [15O]H2O PET examination and were treated surgically at our department. Each hemisphere was classified using the Suzuki and Berlin Grading System. Preoperative symptoms and perioperative ischemias were collected, and a logistic regression analysis was performed. A total of 100 hemispheres in 50 MMA patients (36 women, 14 men) were included. Using the Berlin Grading System, 2 (2.8%) of 71 symptomatic hemispheres were categorized as grade I, 14 (19.7%) as grade II, and 55 (77.5%) as grade III. The 29 asymptomatic hemispheres were characterized as grade I in 7 (24.1%) hemispheres, grade II in 12 (41.4%), and grade III in 10 (34.5%) hemispheres. Berlin grades were independent factors for identifying hemispheres as symptomatic and higher grades correlated with increasing proportion of symptomatic hemispheres (p < 0.01). The Suzuki grading did not correlate with preoperative symptoms (p = 0.26). Perioperative ischemic complications occurred in 8 of 88 operated hemispheres. Overall, complications did not occur in any of the grade I hemispheres, but in 9.1% (n = 2 of 22) and 9.8% (n = 6 of 61) of grade II and III hemispheres, respectively. In this study, we validated the Berlin Grading System with the use of [15O]H2O PET for CVRC as it could stratify preoperative symptomatology. Furthermore, we highlighted its relevance for predicting perioperative ischemic complications.

Towards discovering structural signatures of protein folds based on logical hidden Markov models.

With the growing number of determined protein structures and the availability of classification schemes, it becomes increasingly important to develop computer methods that automatically extract structural signatures for classes of proteins. In this paper, we introduce and apply a new Machine Learning technique, Logical Hidden Markov Models (LOHMMs), to the task of finding structural signatures of folds according to the classification scheme SCOP. Our results indicate that LOHMMs are applicable to this task and possess several advantages over other approaches.

Osseous sequestration in cattle: 110 cases (1987-1997).

OBJECTIVE: To determine risk factors for development of sequestra in cattle and identify factors associated with a successful outcome. DESIGN: Retrospective study. ANIMALS: 110 cattle. PROCEDURE: Medical records of cattle treated at veterinary teaching hospitals in North America were reviewed. To determine risk factors for osseous sequestration, breed, age, and sex of cattle with osseous sequestration were compared with breed, age, and sex of all other cattle admitted during the study period. RESULTS: 110 cattle were included in the study. Three had 2 sequestra; thus, 113 lesions were identified. Most sequestra were associated with the bones of the extremities, most commonly the third metacarpal or third metatarsal bone. Ninety-two animals were treated surgically (i.e., sequestrectomy), 7 were treated medically, 3 were initially treated medically and were then treated surgically, and 8 were not treated. Follow-up information was available for 65 animals treated surgically and 6 animals treated medically. Fifty-one (78%) animals treated surgically and 5 animals treated medically had a successful outcome. Cattle that were 6 months to 2 years old had a significantly increased risk of developing a sequestrum, compared with cattle < 6 months old. Cattle in which sequestrectomy was performed with the aid of local anesthesia were significantly more likely to undergo 2 or more surgical procedures than were cattle in which sequestrectomy was performed with the aid of general anesthesia. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that sequestrectomy will result in a successful outcome for most cattle with osseous sequestration.

Lymphosarcoma of the pharyngeal region in a 7-month-old beef steer.

A steer presented for retropharyngeal swelling and dyspnea. Biopsy of the swelling indicated lymphoblastic lymphosarcoma, and necropsy revealed involvement of regional veins and arteries. The tumor was classified as a non-T, non-B lymphoma based on CD3 polyclonal antibody stains. Lymphosarcoma is unusual in this location, but should be considered with retropharyngeal swelling.

Microbiologic effect of bovine cerebrospinal fluid and azithromycin against Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae.

Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of azithromycin against reference strains of Streptococcus pneumoniae ATCC 49619, Neisseria meningitidis ATCC 13090, and Haemophilus influenzae ATCC 49247 were determined by the macrodilution broth method with and without 10% bovine cerebrospinal fluid (CSF) supplementation. The MICs and MBCs were within one to two dilutions for N. meningitidis and S. pneumoniae, and no difference was observed for H. influenzae. Time-kill curves demonstrated enhanced killing by azithromycin when 10% bovine CSF was added to media for N. meningitidis. The minimum azithromycin concentration for a greater than 3 log10 reduction in inoculum with bovine CSF was 0.03 microg/ml and without CSF was 0.12 microg/ml, a 3-fold difference. Killing was not significantly different for either H. influenzae nor S. pneumoniae.

An evaluation of four types of freshwater model ecosystem for assessing the hazard of pesticides.

Experimental results are reported on four types of freshwater model ecosystem after administration of a single dose of chlorpyrifos. The fate, and primary and secondary effects of chlorpyrifos were compared between the model ecosystems, and were evaluated in the light of the predictive value of the current ecotoxicological hazard assessment procedure for pesticides. 'Slootbox', a fate model used in the ecotoxicological risk assessment of pesticides in the Netherlands, overestimated chlorpyrifos concentrations. The primary effects of chlorpyrifos can be predicted accurately on the basis of single species laboratory toxicity data. The population effects observed in the microecosystems, microcosms, and mesocosms were consistent between all experiments and with the single species tests. Community metabolism, as a functional endpoint, was less sensitive than the structural parameters measured. Secondary effects, both for structural and functional endpoints, varied between the micro- and mesocosm experiments. At the present 'state of the art' in ecotoxicology, no a priori prediction of secondary effects in natural ecosystems will generally be possible. 0.1 times the lowest acute L(E)C50 for chlorpyrifos, as measured in the current ecotoxicological hazard assessment procedure, matched the NOECmesocosm for a single dose of chlorpyrifos. Recovery of populations affected by insecticide stress was found to depend on factors such as life cycle characteristics and ecological infrastructure, in addition to the toxicant concentration. The onset of (potential) recovery is likely to start at an approximate concentration of the EC10(48 h).

Osteosarcoma in a cow.

A mass involving the maxilla of a cow was determined to be an osteosarcoma. Microscopically, the mass was composed of plump pyriform cells aligned along thin trabeculae of osteoid. Osteosarcoma rarely develops in large animal species, but when it does, it is usually found in the skull and must be differentiated from more common diseases, such as actinomycosis and tooth abscesses.

Splenectomy in cattle via transthoracic approach.

Sixty-eight cattle under general anesthesia were splenectomized. The transthoracic approach was used to provide better access to the spleen and to facilitate ligature of the major splenic vessels. The procedure was easier and less time-consuming, compared with other surgical approaches, and is considered to be less stressful to the animals. Post-operative recovery was complete in 67 of 68 cattle. After surgery, 1 animal developed respiratory tract disease that was thought to have been unrelated to the surgery.

Antagonistic effect of atipamezole on xylazine-induced sedation, bradycardia, and ruminal atony in calves.

Three doses of an alpha 2-adrenoreceptor antagonist, atipamezole, were administered to reverse xylazine-induced sedation, bradycardia, and ruminal atony in calves. Once a week for 4 weeks, each of 6 calves was administered IV 1 treatment of: 0.3 mg of xylazine/kg of body weight, followed in 10 minutes by 1 ml of 0.9% NaCl; 0.3 mg of xylazine/kg, followed in 10 minutes by 3 micrograms of atipamezole/kg; 0.3 mg of xylazine/kg, followed in 10 minutes by 10 micrograms of atipamezole/kg; or 0.3 mg of xylazine/kg, followed in 10 minutes by 30 micrograms of atipamezole/kg. The order of the 4 treatments in each calf was selected at random. Xylazine alone caused lateral recumbency for 33.6 +/- 7.1 minutes (mean +/- SEM). Atipamezole administered at dosages of 3, 10, and 30 micrograms/kg shortened xylazine-induced lateral recumbency to 20.5 +/- 3.0, 10.2 +/- 0.2, and 9.3 +/- 0.5 minutes, respectively. Calves given xylazine alone stood at greater than 60 minutes after the onset of recumbency. Atipamezole given at 3, 10, and 30 micrograms/kg shortened the time from onset of lateral recumbency to standing to 40.2 +/- 6.9, 12.8 +/- 1.1, and 10.0 +/- 0.7 minutes, respectively. Drowsiness was found in calves given the lowest dosage of atipamezole (3 micrograms/kg) after the calves stood. Atipamezole given at dosages of 10 and 30 micrograms/kg reversed xylazine-induced ruminal atony in a dose-dependent manner. In addition, 30 micrograms of atipamezole/kg reversed xylazine-induced bradycardia, but the lower dosages of this antagonist did not. Results indicated that 30 micrograms of atipamezole/kg should be a useful antidote for xylazine overdose in cattle.

Antagonistic effect of idazoxan on xylazine-induced central nervous system depression and bradycardia in calves.

Two doses of an alpha 2-adrenoreceptor antagonist, idazoxan, were administered to reverse the CNS depressant and bradycardia effects of xylazine in calves. Once a week for 3 weeks, each of 6 calves were administered IV one treatment of: (1) 0.2 mg of xylazine/kg of body weight followed in 10 minutes by 1 ml of 0.9% NaCl, (2) 0.2 mg of xylazine/kg followed in 10 minutes by 10 micrograms of idazoxan/kg, or (3) 0.2 mg of xylazine/kg followed in 10 minutes by 30 micrograms of idazoxan/kg. The order of the 3 treatments in each calf was selected at random. Xylazine alone caused lateral recumbency for 27.2 +/- 3.0 minutes (mean +/- SEM). Idazoxan administered at dosages of 10 and 30 micrograms/kg shortened xylazine-induced lateral recumbency to 11.5 +/- 0.8 and 10.3 +/- 0.2 minutes, respectively. Calves given xylazine alone stood at greater than 60 minutes after the onset of recumbency. Idazoxan given at dosages of 10 and 30 micrograms/kg shortened the time to standing to 16.8 +/- 1.7 and 11.3 +/- 0.2 minutes, respectively. Idazoxan given at a dosage of 30 micrograms/kg also reversed xylazine-induced bradycardia. Results indicated that idazoxan should be a useful antidote for xylazine overdose in cattle.

Prognostic value of anion gap calculation in cattle with abomasal volvulus: 58 cases (1980-1985).

Values for anion gap, serum chloride, and base excess were tabulated for 58 dairy cows with abomasal volvulus. Test values for survivors (n = 40) and nonsurvivors (n = 18) were compared. Surviving cattle were released for production or salvage. Nonsurviving cows died or were euthanatized. Accuracy of preoperative anion gap, serum chloride, and base excess values in predicting outcome was evaluated by calculating the sensitivity, specificity, predictive value, and negative predictive value of these at assigned cutoff values. Anion gaps greater than or equal to 30 mEq/L were indicative of a poor prognosis. At this value, the sensitivity (0.889), specificity (0.925), predictive value (0.842), negative predictive value (0.949), and efficiency (0.914) were higher than when serum chloride concentration less than or equal to 84 mEq/L or base excess value less than or equal to 0 were used to denote poor prognosis. We concluded that preoperative anion gap calculation could reliably predict the outcome of cows with abomasal volvulus and was more accurate than either serum chloride concentration or base excess value.

Ammoniated forage toxicosis in calves.

Two calves developed a CNS syndrome characterized by hyperesthesia, tremors, and incoordination while nursing dams that had been feeding on ammoniated forage. To increase digestibility, intake, and nitrogen content, low-quality forages were ammoniated at a rate of 3% dry weight. However, a CNS syndrome of unknown cause has been observed in cows and calves nursing cows that have ingested ammoniated forage. Serum electrolytes, glucose, and blood differentials of the 2 calves in this report were normal. However, the older calf had high serum and CSF ammonia concentrations. Both calves, sedated with acepromazine and given thiamine injections, were clinically normal 12 hours later.

Abomasal emptying defect in Suffolk sheep.

Twelve Suffolk sheep were examined because of an abomasal emptying problem. Anorexia and weight loss were evident in 11 of the sheep. Ventral abdominal distention was observed in 5 sheep. Laboratory analyses failed to show the hypochloremic, hypokalemic metabolic alkalosis commonly found in cattle with a similar problem. Rumen chloride concentrations in 3 sheep indicated reflux of abomasal contents into the rumen.

[Extra-anatomical bypass in aorto-iliac obstruction]. / Extraanatomische Umgehung beim aorto-iliacalen Verschluss.

Our report describes the results of 35 extra-anatomic bypass operations for the treatment of aortoiliac occlusion in high-risk patients. This operation is an alternative to amputation for the therapy of claudication intermittens or gangrene. Long-term results are difficult to obtain, as many patients in this group die early from other causes. The problem of iatrogenic steal phenomenon is discussed. We consider Doppler ultrasound assessment a very valuable method for excluding aortoiliac insufficiency of the donor limb, not detected by other means.

[The value of measuring intraoperative pressure in carotid endarterectomy (author's transl)]. / Die Bedeutung der intraoperativen Druckmessung in der Karotischirurgie.

During the last 4 years 92 operations at the carotid bifurcation were performed. In almost all cases carotid stump pressure was measured. If the stump pressure was below one third of the systemic pressure endarterectomy was done with intraluminal shunt. Under these conditions neurologic symptome deteriorated 3 times, but improved after a few days. There was no hospital mortality.

[Pressure-and flow measurements during carotid-subclavian-bypass operations (author's transl)]. / Intraoperative Fluss-und Druckmessungen beim Karotis-Subklavia-Bypass.

In 7 Carotid-Subclavian-Bypass operations pressure and blood-flow were studied. In 4 patients a reduced flow in the common carotid artery was noticed after opening the bypass. There were no neurological complications in the postoperative period in any patient. This decreased flow can be explained as a so-called "pseudosteal" due to changing in direction of flow in numerous and good functioning collaterals of this area.

[Carcinoma of the head of the pancreas--diagnosis, surgical indications and results (author's transl)]. / Das Pankreaskopfkarzinom. Diagnostik, chirurgische Indikation und Ergebnisse

UNLABELLED: 89 cases of pancreatic or periampullary carcinoma were analysed and the following problems discussed: 1. DIAGNOSIS: "early" diagnosis is at present impossible--not even with E.R.C.P. or angiography, although these provide valuable information for planning the operation. 2. Indication for operation: a curative resection was possible in only 20% of cases. The apparent advantages of total pancreatectomy as against the conventional Whipple operation (increased radicality and reduced post-op. complications) have not yet paid off in terms of improved long-term survival. 3. RESULTS: in 46 pancreato-duodenectomies (for carcinoma as well as complicated chronic pancreatitis) the operative and hospital mortality was 4.3%.

[Postoperative total parenteral feeding with a carbohydrate mixture (autor's transl)]. / Postoperative totale parenterale Ernährung unter Verwendung einer Kohlenhydratmischung

After gastric operations, patients were fed completely by the parenteral route. Aminoacids, caloric nutrients and electrolytes were infused simultaneously and continuously 24 hours daily until the fourth postoperative day. The daily supply of aminoacids amounted to 80 g. Glucose, fructose and xylite in equal proportions were used to supply calories. The total daily amount was 605 g. The important electrolytes were contained in the infusion solutions in amounts corresponding to basic requirement. The results of the investigation confirmed that patients can be successfully nourished parenterally after extensive operations with the combined daily additives we have selected.