Prevalence of Tritrichomonas foetus in several subpopulations of Alabama beef bulls.

The objective of this study was to estimate the prevalence of Tritrichomonas foetus infections in Alabama (USA) beef bulls through prospective and retrospective surveys. The prospective survey included 240 Alabama beef bulls that were sampled between January 2005 and March 2006. Preputial smegma was collected from the 240 bulls with a dry pipette and cultured in an InPouch TF T. foetus culture pouch (BioMed Diagnostics; White City, OR, USA). The samples were evaluated microscopically once a day for 6 days for growth resembling T. foetus. To avoid false-positives due to fecal trichomonads, all suspect cultures were sent to both the Alabama Department of Agriculture Veterinary Diagnostic Laboratory in Auburn, AL, USA and the Auburn University College of Veterinary Medicine Parasitology Laboratory (Auburn, AL, USA) for polymerase chain reaction (PCR) confirmatory assays. Of the 240 bulls cultured in the prospective survey, 3 (1.25%) cultures were considered suspect on microscopic evaluation. However, PCR-based assays were negative for T. foetus, suggesting that the samples most likely contained fecal trichomonads. The retrospective analysis included 374 T. foetus cultures performed at the Alabama Department of Agriculture Veterinary Diagnostic Laboratory between October 2002 and March 2005. Of the 374 bulls included in the retrospective analysis, only 1 (0.27%) was confirmed positive by a PCR-based assay.

Long-term expressing of breastmilk.

This article focuses on the breastfeeding experience of a midwife after the birth of her first child. He was born with a bilateral cleft lip and palate and despite attempting to breastfeed it was not possible physiologically. The decision was made to express breastmilk long-term and feed the baby by Chu Chu teat and squeeze bottle. This article describes the hints and ideas found along the way to make long-term expressing of breastmilk easier. It comes from personal experience, literature and asking other women in similar situations how they managed.

Radionuclide imaging of abomasal emptying in sheep.

A liquid radionuclide tracer was administered to nine sheep in order to visualise the abomasum with a gamma camera computer system. The aim was to develop a method of studying gastric emptying, with minimal surgical intervention. Oral administration of the tracer gave good images of the whole complex stomach, but quantifying abomasal emptying was not possible because of the superimposition of the stomach compartments. When the reticular groove reflex was stimulated with oral copper sulphate the radionuclide bypassed the reticulorumen, allowing quantitative analysis of abomasal activity. However, the repeatability of the reflex activation was low. Radionuclide administered directly into the abomasum produced good images of abomasal outflow and provided digital data which were analysed quantitatively. A wide range of emptying rates was observed, generally with a stepped pattern.

Fat malabsorption in elderly patients with cardiac cachexia.

Malnutrition resulting from chronic congestive heart failure (cardiac cachexia, CC) is not uncommon and contributes to mortality and morbidity especially of elderly people. The aetiology of cardiac cachexia is probably multifactorial. We have assessed whether malabsorption of fat is associated with CC and if so whether it is due to small-bowel bacterial overgrowth. Three groups of subjects were studied: 29 (20 women) patients (mean age 76.1 years) with controlled congestive heart failure and weight loss (CC); 14 (seven women) patients (mean age 74.0 years) with controlled congestive heart failure and no weight loss (non-cachexia, NON-CC); and 29 (20 women) healthy controls (mean age 74.9 years). Fast absorption was quantified using the cumulative 6 h 14CO2 exhalation in the 14C-triolein breath test and small-bowel bacterial overgrowth was quantified using the cumulative 8 h 14CO2 exhalation in the 14C-glycocholic acid breath test. The cumulative 6 h 14CO2 exhalation in the triolein breath test was reduced in the CC group (p = 0.001) implying impaired fat absorption. There was no evidence of small-bowel bacterial overgrowth in any group. Impaired absorption of fat was related to the clinical severity of heart failure and its duration. Impaired fat absorption is associated with cardiac cachexia. It is not due to small-bowel bacterial overgrowth. The aetiology of fat malabsorption in heart failure requires further studies.

Use of radionuclide imaging to determine gastric emptying of carbohydrate solutions during exercise.

OBJECTIVE: To investigate the repeatability of continual assessment of the gastric emptying rates of carbohydrate solutions in exercising subjects using 99mtechnetium labelling. METHODS: Gastric emptying of a 5% glucose solution and an iso-osmotic maltodextrin solution was measured using 3 MBq of 99mtechnetium labelled diethylene triamine penta-acetic acid (DTPA) and continuous gamma camera imaging in five male subjects. The subjects performed four 1 h trials at 70% VO2 peak on a cycle ergometer. After 15 min, 200 ml of a radiolabelled solution of glucose or maltodextrin were ingested in a blind crossover protocol. The two solutions were each ingested on separate occasions (trial 1 and trial 2) to establish repeatability. RESULTS: Statistical analysis showed no differences between trial 1 and trial 2 for both solutions. There were no significant differences for the emptying rates between the two test solutions. CONCLUSIONS: Posterior imaging using a computer linked gamma camera following the ingestion of 99mtechnetium labelled DTPA mixed with carbohydrate solutions provides a repeatable method of assessing gastric emptying characteristics in exercising subjects. This technique showed no significant differences between the emptying rates of a single dose of iso-osmotic glucose or maltodextrin solution.

Renal tubular protein degradation of radiolabelled aprotinin (Trasylol) in patients with chronic renal failure.

1. The new method developed to measure renal tubular degradation of small filtered proteins in patients with normal renal function, using radiolabelled aprotinin (Trasylol) (R. Rustom, J. S. Grime, P. Maltby, H. R. Stockdale, M. Critchley, J. M. Bone. Clin Sci 1992; 83, 289-94), was evaluated in patients with chronic renal failure. 2. Aprotinin was labelled with either 99mTc (40 MBq) or 131I (0.1 MBq), and injected intravenously in nine patients, with different renal pathologies. 51Cr-EDTA clearance (corrected for height and weight) was 40 +/- 5.4 (range 11.2-81) ml min-1 1.73 m-2. Activity in plasma and urine was measured over 24-48 h, and chromatography on Sephadex-G-25-M was used to separate labelled aprotinin from free 99mTcO4- or 131I-. Renal uptake was measured for 99mTc-labelled aprotinin only. 3. The volume of distribution was 20.2 +/- 2.3 litres. Chromatography showed all plasma activity as undegraded aprotinin, and urine activity only as the free labels (99mTcO4- or 131I-). 4. As in patients with normal renal function, activity in the kidney appeared promptly, with 5.7 +/- 2.5% of the dose detected even at 5 min. Activity rose rapidly to 9.4 +/- 1.6% of dose after 1.5 h, then more slowly to 15.0 +/- 0.5% of dose at 4.5 h, and even more slowly thereafter, reaching 24.1 +/- 2.8% of dose at 24 h. Extra-renal uptake was again insignificant, and both 99mTcO4- and 131I- appeared promptly in the urine, with similar and uniform rates of excretion over 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Observations on the early renal uptake and later tubular metabolism of radiolabelled aprotinin (Trasylol) in man: theoretical and practical considerations.

1. The novel method recently developed to measure renal tubular degradation of filtered proteins in man using radiolabelled aprotinin (Trasylol) has been modified to allow the fate and the significance of the renal catabolism of radiolabelled aprotinin to be determined beyond 24h. 2. Ten renal patients with normal kidney function and variable proteinuria each received two separate intravenous injections of radiolabelled aprotinin, 5.0 mg of 99mTc-labelled aprotinin (40MBq) and 0.5mg of 131I-labelled aprotinin (5MBq). Chromatography (Sephadex-G-25-M) was used to separate undegraded radiolabelled aprotinin from the free isotope in urine and plasma. Renal uptake from gamma-camera images (24h for 99mTc-labelled aprotinin and up to 96h for 131I-labelled aprotinin) and urinary activity (48 and 96h, respectively) were measured. 3. The renal handling of radiolabelled aprotinin was similar with the two isotopes. Chromatography showed that all plasma activity was undegraded radiolabelled aprotinin, and urine activity was only the free isotopic label. 4. Kidney uptake of 131I-labelled aprotinin was prompt, reaching a cumulative maximum of 37.1 +/- 3.0% of dose at 24h, but falling exponentially thereafter to 5.6 +/- 1.0% of dose at 96h. 5. The rate of excretion of the free label in urine, i.e. the metabolic rate of radiolabelled aprotinin, was relatively constant over the first 24h (1.6 +/- 0.09% of dose/h), but then fell in parallel with the diminishing activity over the kidney, i.e. to 1.0 +/- 0.1% of dose/h over 24-48h and to only 0.4 +/- 0.08% of dose/h over 72-96h.(ABSTRACT TRUNCATED AT 250 WORDS)

A new method to measure renal tubular degradation of small filtered proteins in man using radiolabelled aprotinin (Trasylol).

1. A method has been developed to measure the renal tubular degradation of small filtered proteins in man using radiolabelled aprotinin (Trasylol), a 6500 Da cationic polypeptide. 2. Aprotinin (0.5 or 5.0 mg) was labelled with either 99mTc (40 MBq) or 131I (1 MBq) and injected intravenously in 19 renal patients (10 with normal renal function and nine on haemodialysis). Activity in plasma and urine was measured over 48 h, and chromatography with Sephadex-G-25-M was used to separate labelled aprotinin from free 99mTcO4- or 131I-. Renal uptake was measured for 99mTc-labelled aprotinin only. 3. The volumes of distribution were similar in all patients: 18.2 +/- 0.4 litres in those with normal renal function and 20.2 +/- 0.1 litres in the others. Chromatography showed all plasma activity as undegraded aprotinin and urine activity only as the free labels (99mTcO4- or 131I-). 4. In patients with normal renal function, activity in the kidneys rose rapidly to 24.2 +/- 2.8% of dose after 90 min and to 42.2 +/- 3.4% of dose after 24 h. In the dialysis patients, activity over the kidneys was only 2.7 +/- 0.8% of dose at 24 h. Extra-renal uptake was insignificant in all patients with normal kidney function. 5. Both 99mTcO4- and 131I- appeared in the urine promptly after injection, and the rates of excretion of the two isotopes were similar, varying little over 24 h (1.8 +/- 0.04% of dose/h and 1.7 +/- 0.04% of dose/h for 99mTc and 131I, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of lysine infusion on the renal metabolism of aprotinin (Trasylol) in man.

1. Aprotinin (Trasylol) is a cationic 6500 Da polypeptide that inhibits proteolytic enzymes, and when labelled with 99mTc it is a reproducible marker for the renal tubular turnover of small filtered proteins in man. Lysine potently inhibits tubular peptide uptake, and may thus depress the uptake and metabolism of aprotinin. This was investigated in 14 glomerulonephritic patients with normal renal function and variable proteinuria and in one healthy subject. 2. 99mTc-labelled aprotinin was given intravenously alone, and again 3 days later, immediately after the intravenous administration of 3-6 g of lysine, followed by an infusion over 1 h of 0.3-1.9 g of lysine/kg in individual patients. Activity over kidneys and in urine was measured over 24 h and chromatography was used to separate the undegraded peptide from free isotope. 3. At the low dosage of lysine (< 0.8 g/kg) given to six patients, kidney activity (representing tubular uptake) was unchanged, but early urine samples contained some undegraded aprotinin. Urinary excretion of free isotope, representing tubular metabolism, fell from 1.6 +/- 0.2% of dose/h with no lysine to 0.9 +/- 0.1% of dose/h in the 24 h after lysine, suggesting suppression of tubular aprotinin degradation. Corrected fractional degradation was calculated from the mean urinary excretion of free isotope over a given interval, determined by chromatography, divided by the mean cumulative kidney counts over this same interval, and this also fell after lysine from 0.06 +/- 0.006 to 0.03 +/- 0.006 h-1 (P < 0.005) between 3.75 and 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of changes of water and electrolytes on the validity of conventional methods of measuring fat-free mass.

Fat-free mass was measured by hydrodensitometry, electrical impedance and total body potassium before and after water and electrolyte loss induced by (a) the administration of the diuretic frusemide, and (b) sweat loss. All methods of measuring fat-free mass were shown by pilot experiments to have procedural reliability. The diuretic caused a reduction in apparent fat-free mass of 2.63 kg by the impedance method, of 2.33 kg by hydrodensitometry and of 1.8 kg by total body potassium. Water and electrolyte loss from sweating caused a fat-free loss of 2.3 kg, 2.7 kg and 1.3 kg by the same three procedures. Urinary potassium accounted for about one fifth of the observed 40K fat-free mass loss. Each method was thus clearly sensitive to the induced water loss. These data suggest that in evaluating the composition of weight loss, existing methods of measuring body composition do not distinguish between water and other more critical components of fat-free mass. It is thus essential that stable hydration levels are established for any longitudinal comparison of weight loss by these methods.

Colonic transit in man is slowed by ondansetron (GR38032F), a selective 5-hydroxytryptamine receptor (type 3) antagonist.

Ondansetron (GR38032F) is a selective antagonist of 5-hydroxytryptamine (5-HT) type 3 receptors. This randomized, double-blind, cross-over study was undertaken to evaluate and compare the effect of ondansetron with placebo on gastrointestinal transit in 10 healthy male volunteers. There were no significant differences between the effects of placebo and ondansetron on gastric emptying or mouth-to-caecum transit time. However, significant differences in mean whole-gut transit time were observed, that is 54.8 h with ondansetron and 32.1 h with placebo. Therefore, 5-HT3 receptors may be involved in the regulation of colonic transit and ondansetron may prove useful as an anti-diarrhoeal agent.

Salivary gland scintigraphy--a suitable substitute for sialography?

By comparing 27 patients who had both scintigraphy and sialography in the assessment of salivary gland disease, scintigraphy has been shown to correlate well with abnormal sialograms. It is suggested that scintigraphy could become the initial screening procedure in the assessment of salivary gland disease. A normal scintiscan is unlikely to miss significant pathology (as demonstrated by sialography), but sialography must always be performed if there is a suspicion of duct obstruction on scintigraphy. Patients suspected of focal salivary gland pathology such as tumour have not been investigated. The series documents the findings in patients who presented with facial pain, swelling or xerostomia suggesting sialadenitis, duct occlusion or Sjögren's syndrome.

Comparison between the cellobiose/mannitol and 51Cr-labelled ethylenediaminetetra-acetate absorption tests in the detection of coeliac disease.

1. The cellobiose/mannitol and 51Cr-labelled ethylenediaminetetra-acetate (51Cr-EDTA) absorption tests have been compared with respect to their ability to detect altered intestinal permeability in coeliac disease. 2. In patients with clinically proven coeliac disease, 13 out of 14 (93%) had abnormal urinary cellobiose/mannitol ratios, while only five out of 12 (42%) had abnormal urinary recoveries of 51Cr-EDTA. Thus, the cellobiose/mannitol absorption test is more sensitive in recognizing coeliac disease and this difference was significant (P less than 0.02). 3. Possible reasons for this difference in the sensitivity of the two absorption tests are discussed.

The effect of postural changes on the inferred pressures within the nucleus pulposus during lumbar discography.

By observing the variation of intradiscal pressure occurring at different body postures, it is possible to infer a functional hydrostatic behavior of a lumbar disc. Results from such observations on normal discs are already available. However, observations on degenerate discs are largely restricted to in vitro studies. The authors are now able to report a series of recordings taken from discographically degenerate lumbar discs in patients presenting with low-back pain. In this study of twenty patients, pressure observations were made on 21 normal and 19 abnormal discs. From the results that the authors have obtained, they can reaffirm that normal discs behave predictably and as previously described. The abnormal discs, however, did not behave as a single group. They showed patterns of pressure changes in different postures often dissimilar from that shown by the normal discs both in the absolute values recorded and the sequential changes that occur during the postural change. Unfortunately, the authors were unable to correlate either the extent or character of disc degeneration with the observed variation in pressure changes.

Flexion and extension radiography of the lumbar spine: a comparison with lumbar discography.

Four methods of quantifying relative intervertebral body movement from static flexion/extension radiographs are reviewed and the ability of each of these techniques to indicate the site(s) of disc degeneration is compared with that of lumbar discography. Of the methods examined, that of measuring the linear displacement of one vertebra in the antero-posterior plane was found to be the most accurate method of indicating disc degeneracy. None of the methods examined was free from artefacts. With regard to the clinical usefulness of flexion/extension radiography, we discuss two separate situations. Firstly, the taking of a single set of flexion/extension radiographs is concluded to be of little value in the management of patients with low back pain. Secondly, flexion/extension radiography, on a serial basis, is considered to be of possible value in specific situations (for example, follow-up of a spinal fusion).

Is cervical discography of any value?

Following the successful use of lumbar discography in the management of lumbo-sciatic pain, attention focused on the possibility of using such intradiscal injections in the management of cervico-brachial disorders. Much has been written on the subject of cervical discography. However, little is of use to the clinician seeking objective validation of this procedure. Many papers relate to specific workers' own experiences and one cannot but be disturbed at the wide diversity of opinion that has been expressed on the efficacy of cervical discography. In this paper, we review the extensive literature on cervical discography and present our own findings from both in vitro and clinical studies. We conclude that as a technique to locate symptomatic levels, cervical discography is worthless but that the findings of a normal nuclear image will probably indicate an asymptomatic level. Also, we feel that reliance on pain reproduction during injection is doubtful.

The use of in vivo lumbar discography to assess the clinical significance of the position of the intercrestal line.

An investigation of the clinical relevance of the location of the intercrestal line in relation to the pattern of disc degeneration in the lower lumbar spine is presented. An analysis of the discograms from 89 symptomatic patients has demonstrated a difference in the incidence of disc degeneration in the L4-5 and L5-S1 disc spaces dependent on the position of the intercrestal line. This difference supports the hypothesis that additional protection will be given to those L5-S1 discs with which high intercrestal lines are associated as compared to those associated with intercrestal lines lying lower down the spine. A corollary of this hypothesis is that for any individual there is an increased likelihood that the L4-5 disc space will undergo degeneration from the influence of normal mechanical stresses before the L5-S1 disc space if the intercrestal line lies comparatively high up the spine.