Relationship between serum estradiol, cathepsin K, and N-telopeptide of type I collagen in female dogs.

Ovariohysterectomized (OHE) female dogs do not develop the osteopenia and osteoporosis associated with decreasing estrogen in post-menopausal women, possibly due to post-OHE bone mineral density retention through a mechanism that remains unclear. In this study, we aimed to elucidate this mechanism by investigating estradiol (E2) and bone markers. Samples were collected from 56 OHE and 43 intact bitches (0.33 to 17.58 years old) and analyzed for serum E2, osteoclast-secreted cysteine protease cathepsin K (CTK), and N-telopeptide of type I collagen (NTx) by ELISA. OHE and intact bitches showed no significant difference in serum E2 or NTx, and there was no correlation between serum E2 and NTx and age and time since OHE. Intact bitches showed a very low correlation between E2 and NTx, but OHE bitches showed no correlation, and serum CTK was generally undetectable in both groups. Our findings suggest the influence of gonadal hormones on bone metabolism does not work effectively in dogs; this is consistent with a shorter duration of exposure to E2 in bitches (through the 4-to-8-month anestrus phase) than women.

Monitoring of Brain Oxygenation During and After Cardiopulmonary Resuscitation: A Prospective Porcine Study.

This study aimed to evaluate the usefulness of near-infrared time-resolved spectroscopy (TRS) for the monitoring of post-resuscitation encephalopathy. Cardiac arrest (CA) was induced in pigs by electrical stimuli; then, return of spontaneous circulation (ROSC) was achieved by direct current. The changes in cerebral oxygenation were analyzed by two methods: (1) the time-independent calculation based on the modified Beer-Lambert law (MBL), and (2) the curve-fitting method based on the photon diffusion theory (DT). The changes in reduced scattering coefficient (µs') in DT were also calculated. Post-resuscitation encephalopathy was evaluated by MRI findings. During CA, cerebral oxygen saturation (ScO2) decreased to the lowest level, and then gradually increased during the chest compression period. When ROSC was achieved, ScO2 (DT) increased further, but ScO2 (MBL) decreased transiently. This strange phenomenon disappeared when the scalp was peeled off and the probes were directly fixed to the cranial bone. In some cases, a sustained decrease in µs' was observed several hours after ROSC and, in such cases, MRI Diffusion Enhancement Image (DWI) showed findings suggestive of post-resuscitation encephalopathy. In conclusion, simultaneous monitoring of cerebral oxygenation with MBL and DT may provide more information about the vascular response of different layers. Also, the monitoring of µs' may help us to recognize the occurrence of post-resuscitation encephalopathy in real time.

Anesthetic and cardiorespiratory effects of propofol, medetomidine, lidocaine and butorphanol total intravenous anesthesia in horses.

Anesthetic and cardiorespiratory effects of medetomidine, lidocaine, butorphanol and propofol total intravenous anesthesia (MLBP-TIVA) were evaluated in horses undergoing an experimental surgery. Ten horses were premedicated with an intravenous injection (IV) of medetomidine (5 µg/kg) and butorphanol (20 µg/kg). Anesthesia was induced by administration of 1% propofol (3 mg/kg, IV) at a rate of 1 mg/kg/min (n=5, group-1) or 2% propofol administered at a rate of 6 mg/kg/min (n=5, group-2) following administration of lidocaine (1 mg/kg, IV) and then maintained by infusions of propofol, medetomidine (3.5 µg/kg/hr), lidocaine (3 mg/kg/hr) and butorphanol (24 µg/kg/hr). The mean durations of anesthesia and propofol infusion rate required for maintaining surgical anesthesia were 130 ± 17 min and 0.10 ± 0.01 mg/kg/min in group 1 and 129 ± 14 min and 0.10 ± 0.02 mg/kg/min in group 2. Four horses in group 1 and 2 horses in group 2 paddled following recumbency during induction of anesthesia. The median quality scores for induction (0-4: poor-excellent) and recovery (0-5: unable to stand-excellent) were 3 and 4 for both groups, respectively. Transition to anesthesia (the first 20-min period after induction) was uneventful in group 2, while all horses showed a light plane of anesthesia in group 1. The quality score (0-3: poor-excellent) for the transition to anesthesia in group 2 was significantly higher than in group 1 (median 3 versus 1, P=0.009). Heart rate and arterial blood pressure were maintained within acceptable ranges, but hypercapnia occurred during anesthesia in both groups. In conclusion, MLBP-TIVA may provide clinically useful surgical anesthesia in horses. A rapid induction with propofol may improve the qualities of induction and transition to MLBP-TIVA.

Magnitude of combination therapy of radical resection and external beam radiotherapy for patients with carcinomas of the extrahepatic bile duct and gallbladder.

The present study sought to identify the therapeutic efficacy of adjuvant external beam radiotherapy (EBRT) for carcinomas of the extrahepatic bile duct (EHBD) and gallbladder. Twenty-one patients with pathologically verified EHBD carcinoma and 18 patients with gallbladder carcinoma were analyzed retrospectively by Cox regression analysis for predictors of survival. The overall 5-year survival rates after resection were 33% for EHBD carcinoma and 56% for gallbladder carcinoma. The overall 5-year survival rate for EHBD carcinoma was 60% in 8 patients without microscopic residual disease (R0), 15% in 9 patients with microscopic residual tumor (R1), and 0% in 4 patients with macroscopic residual tumor (R2). The overall 5-year survival rate of gallbladder carcinoma patients was also decreased with R status equal to 73%, 40%, and 0% for R0, R1 and R2, respectively. Adjuvant radiotherapy significantly improved the 5-year survival rate in 7 patients with R1 disease of EHBD carcinoma (P = .035), compared with survival in 2 patients who underwent resection alone. However, no significant difference was noted in the 5-year survival rate between the resection plus EBRT group and the resection alone group for gallbladder carcinoma. Multivariate analysis revealed that histopathologic grade (G) was an independent predictor of survival for EHBD carcinoma and that direct invasion of liver parenchyma was a predictor of survival for gallbladder carcinoma. This study suggests that curative resection provides the best survival for patients with EHBD and gallbladder carcinoma, and that radiotherapy may play a beneficial role in controlling local-regional residual EHBD carcinoma tumors. However, new strategies for adjuvant therapy are needed to improve survival in patients with gallbladder carcinoma.