Breeding soundness evaluation of bulls by semen analysis, testicular fine needle aspiration cytology and trans-scrotal ultrasonography.

The aim of this study was to evaluate the usefulness of trans-scrotal ultrasonography and testicular fine needle aspiration cytology in assessing bulls for breeding suitability. These two techniques were also compared with semen analysis. Bulls presented for breeding soundness evaluation were assessed using all three techniques. The findings of each technique were compared. There was agreement in classification of fertile bulls using all three techniques, suggesting that the combined use of these techniques enhances routine breeding soundness examination. Use of the three techniques also enhances detailed investigation of suspected sub-fertile bulls while accurately identifying testicular cause(s) of sire sub-fertility.

Phospholipase activation triggers apoptosis in photosensitized mouse lymphoma cells.

Photodynamic therapy (PDT), an experimental cancer treatment employing a photosensitizer and visible light, is a highly efficient inducer of apoptosis (or programmed cell death) in mouse L5178Y lymphoma cells, resulting in extensive DNA fragmentation within 1-2 h. The major targets for PDT are in cellular membranes, and we now find that PDT sensitized by aluminum phthalocyanine causes the rapid (< 1 min) activation of phospholipase C and the breakdown of membrane phosphoinositides, as well as a similarly rapid release of Ca2+ from intracellular pools. A phospholipase C inhibitor, U73122, blocks the rapid transient increases in both inositol-1,4,5-trisphosphate and intracellular Ca2+ levels as well as the subsequent fragmentation of nuclear DNA, whereas the analogue U73343 is much less effective against all of the aforementioned responses. In addition, p-bromphenacyl bromide, an inhibitor of phospholipase A2, blocks DNA fragmentation, and PDT stimulates the release of arachidonic acid, probably by phospholipase A2-dependent breakdown of membrane phospholipids. Thus, photodynamic damage to cell membranes can mimic natural stimuli of phospholipases and initiate apoptosis in L5178Y cells.

Efficacy and tolerability of atenolol, nifedipine and their combination in the management of hypertension.

This randomised, double-blind, crossover study investigated the haemodynamic effects of a beta-blocker (atenolol 50mg) and a calcium antagonist (sustained release nifedipine 20mg) given either separately or in combination in 3 groups of patients with mild to moderate essential hypertension. Each treatment was administered twice daily. The fixed combination given twice daily for 4 weeks produced reductions in blood pressure which lasted for at least 12 hours after administration of the final dose. The control of blood pressure by the combination was superior to that achieved by its individual components. Side effects normally associated with nifedipine therapy were less frequent when it was administered with atenolol. Compliance with treatment was good, but it was best when the drugs were given together rather than separately. A fixed combination of atenolol and nifedipine may prove useful in treating hypertensive patients inadequately controlled on beta-blocker therapy alone.

The induction of partial resistance to photodynamic therapy by the protooncogene BCL-2.

Photodynamic therapy (PDT) is an efficient inducer of apoptosis, an active form of cell death that can be inhibited by the BCL-2 oncoprotein. The ability of BCL-2 to modulate PDT-induced apoptosis and overall cell killing has been studied in a pair of Chinese hamster ovary cell lines that differ from one another by a transfected human BCL-2 gene in one of them (Bissonnette et al, Nature 359, 552-554, 1992). Cells were exposed to the phthalocyanine photosensitizer Pc 4 and various fluences of red light. Pc 4 uptake was identical in the two cell lines. The parental cells displayed a high incidence of apoptosis after PDT, whereas at each fluence there was a much lower incidence of apoptosis in the BCL-2-expressing cells. Apoptosis was monitored by (a) observation of 50 kbp and oligonucleosome-size DNA fragments by gel electrophoresis, (b) flow cytometry of cells labeled with fluorescently tagged dUTP by terminal deoxynucleotidyl transferase and (c) fluorescence microscopy of acridine orange-stained cells. The time course of apoptosis varied with the PDT dose, suggesting that only after moderately high doses (> 99% loss of clonogenicity) was there a relatively synchronous and rapid entry of many cells into apoptosis. At PDT doses reducing cell survival by 90 or 99%, significant increases in apoptotic cells were found in the population after 6-12 h. Clonogenic assays showed that BCL-2 protein inhibited not only apoptosis but overall cell killing as well, effecting a two-fold resistance at the 10% survival level. Thus, BCL-2-expressing cells may be relatively resistant to PDT.

The synthesis, photophysical and photobiological properties and in vitro structure-activity relationships of a set of silicon phthalocyanine PDT photosensitizers.

Four silicon phthalocyanine photosensitizers have been prepared and studied in an effort to learn more about the structural features that a silicon phthalocyanine must have in order to be a good photodynamic therapy (PDT) photosensitizer. The compounds that have been studied are the known phthalocyanines HOSiPcOSi(CH3)2-(CH2)3N(CH3)2, Pc 4; and SiPc[OSi(CH3)2(CH2)3N(CH3)2]2, Pc 12; and the new photosensitizers HOSiPcOSi(CH3)2- (CH2)3N(CH2CH3)(CH2)2N(CH3)2, Pc 10; and SiPc[OSi (CH3)2(CH2)3N(CH2CH3)(CH2)2N(CH3)2]2, Pc 18. The triplet lifetimes of the four photosensitizers, their singlet oxygen quantum yields, their ability to photoenhance the generation of lipid peroxidation products in human erythrocyte ghosts, their ability to partition into V79 cells and their ability to photokill V79 and L5178Y-R cells have been determined. It is concluded that the presence of a small axial ligand (e.g. an OH ligand) is not necessary for efficient photosensitization, the presence of two aminosiloxy ligands generally provides at least as good photosensitization as one such ligand, and the presence of an elongated diaminosiloxy axial ligand rather than a short aminosiloxy ligand is less desirable. Further, it is concluded that the presence of structural features leading to improvement in the association between the photosensitizers and important cellular targets are more useful than those leading to improvements in their already acceptable photophysical and photochemical properties.

Predictive value of stool examination in acute diarrhea.

We prospectively evaluate the value of fecal blood and fecal leukocytes in predicting whether acute diarrhea in adults is associated with a stool culture positive for a bacterial pathogen. One hundred thirteen patients, aged 19 to 50 years, seen in a two-year period in an urban adult outpatient setting underwent stool culture for the presenting symptom of diarrhea. Heterosexual men represented 48% of the cohort, women represented 17%, and homosexual men represented 35%. Overall, 53 (47%) of the patients had positive stool cultures for enteric pathogens. Campylobacter jejuni was the most common organism in the entire cohort, but Shigella species were most common in homosexual men. The best predictive variables for a stool culture positive for a bacterial pathogen were the presence of both fecal leukocytes and fecal blood in the stool, compared with only one or neither. When both were present, the sensitivity was 81%, the specificity 74%, and the predictive values of a positive and negative test were 81% and 83%, respectively; the likelihood ratio was 4.87. When homosexual men and the rest of the cohort were analyzed separately, the combination of fecal leukocytes and fecal blood remained the best method of predicting a positive stool culture in both. Examination of stool for fecal leukocytes and fecal blood is a rapid, reliable, and inexpensive way to differentiate between bacterial and other causes of acute diarrhea in the adult acute care setting.

Gastrointestinal flora in iron-deficient piglets.

The pH and microflora of the contents of the stomach and small intestine were studied in iron-treated and iron-deficient piglets. Compared with their iron-treated littermates, the gut contents at several sites in iron-deficient animals had a higher pH and contained greater numbers of coliforms, lactobacilli, total aerobes and total anaerobes. The possible relationship of these findings to previous findings in such animals and to their high incidence of diarrhoea is discussed.

Gentamicin-induced nephrotoxicosis in lambs.

Lambs injected with gentamicin sulphate remained bright and continued to eat, but their plasma creatinine and urinary microprotein concentrations and activities of alkaline phosphatase, gamma glutamyltransferase, leucine aminopeptidase, and N-acetyl-beta-glucosaminidase were significantly increased. Urinary creatinine and specific gravity were significantly decreased. The kidneys of lambs killed shortly after the last treatment with gentamicin were pale and oedematous and microscopic changes included marked tubular necrosis and dilation. Mild tubular dilation was the only lesion in lambs killed later. Reduced enzyme activity was observed histochemically in cells of the convoluted tubules. The lambs showed little clinical evidence of gentamicin toxicity, but the urinary enzyme activity and protein content were sensitive and reliable markers of renal injury, in agreement with the pathological findings. The lesions were different from those reported in naturally occurring tubular nephrosis of lambs.

Gastric structure and function in iron-deficient piglets.

Gastric motility, secretion and structure were studied in piglets which were weaned at two weeks of age and reared in iron-free cages on a low-iron diet. Piglets which were not given iron parenterally rapidly developed iron deficiency anaemia. Gastric motility was studied fluoroscopically after dosing the piglets with barium sulphate. Gastric secretion was studied in piglets with gastric cannulae after stimulation with betazole hydrochloride. There was no difference between iron-treated and iron-deprived pigs in the motility of the stomach but in iron-deprived animals there was marked impairment of acid and chloride secretion from an early age and histological evidence of atrophic gastritis.

Intestinal absorption and structure in iron deficient piglets.

Absorption of D xylose by iron deficient piglets from three litters was as rapid as in their iron treated littermates, except when they were affected by diarrhoea. The dry matter content of the faeces of iron deficient piglets was marginally decreased, but the fat content of the faeces was significantly increased in two tests out of four. Diarrhoea in iron deprived piglets was associated with a small decrease in dry matter content and a large increase in fat content of the dry matter of the faeces and in fat excreted per kg bodyweight. Frank villous atrophy was evident histologically in iron deficient piglets which had diarrhoea when they were killed. Morphometric analysis of small intestinal specimens showed a significant decrease in villous length, villus-to-crypt ratio and mucosal complexity among iron deficient piglets. Crypt depth was not reduced.

A study of greyhounds with tonsillar enlargement and a history of poor racing performance.

Fifteen greyhounds with tonsillar enlargement were subjected to detailed investigation. Affected greyhounds exhibited coughing, poor racing performance and tonsillar lymphoid hyperplasia over a period of months. Each of the 15 affected animals had evidence of respiratory tract disease. Twelve had non-specific respiratory tract disease, two had pneumonia and one had pulmonary infiltration with eosinophils (PIE). Histopathological examination of the tonsils from affected dogs revealed that greyhounds with tonsillar enlargement are more likely to have tonsillar lymphoid hyperplasia than tonsillitis. As a result, lymphoid hyperplasia would be a suitable term to describe this tonsillar condition. Respiratory tract diseases, rather than tonsillar hyperplasia, was the more likely cause of the poor racing performance of affected dogs. The aetiological relationship, if any, between respiratory disease and tonsillar enlargement is unclear from this study and requires further investigation.

Health surveillance of cattle in the vicinity of a chemical industrial complex.

Following allegations of environmental contamination, a scheme for the surveillance of animal health on dairy farms in the vicinity of a large complex of chemical industries in the region of Cork harbour was initiated in 1991. Multidisciplinary investigations were undertaken as a result of unusual incidents of animal ill-health or decreased productivity, and an explosion and fire at one of the industrial plants. There was no evidence that exposure to environmental pollutants caused variations in either productivity or the incidence of disease. Many incidents which might have been linked with environmental pollution were found to have other causes. A broad database of animal disease incidence, productivity and blood composition has been established, and a bank of tissues taken from animals submitted for routine slaughter has been frozen, so that they may be analysed for toxins if required. The main difficulty encountered during the study was inadequate disclosure of information by some herd owners.

Clinical disease associated with Trypanosoma theileri infection in a calf in Ireland.

A four-month-old calf had a clinical history of pyrexia, anaemia, weight loss and behavioural abnormality. Clinical examination revealed evidence of regenerative anaemia and a lymphocytosis which was characterised by a relatively large B cell population. The calf deteriorated clinically while under observation and its prescapular and prefemoral lymph nodes became enlarged. Examination of a blood smear revealed the presence of a large number of circulating Trypanasoma theileri. Serological examination showed the presence of the invariant, stage-specific, trypanosome surface antigen, ISG70 and antibodies against ISG70. ISG70 was first identified in the bloodstream forms of Trypanosoma brucei and has not previously been found in T theileri. Clinical recovery was associated with an increase in packed cell volume, a decrease in the levels of circulating anti-ISG70 antibodies and the complete disappearance of circulating ISG70.

The effects of buscopan compositum on calf nutritional diarrhoea.

Nutritional diarrhoea was induced in male Friesian calves by the addition of sucrose to their milk replacer diet in two experiments. In each study the calves were paired on the basis of the severity of the diarrhoea and each of a pair of calves was assigned at random to receive a course of six intramuscular injections (5 ml/50 kg body weight) of either a placebo or Buscopan compositum (morning and evening) over a period of 3 days. In an initial study, which involved 10 pairs of calves, daily faecal and urine output were collected separately for each calf on the day prior to the start of treatment and on each day of the 3 treatment days. The daily output of fresh faeces were reduced as a result of treatment with Buscopan compositum and the overall reduction for the complete 3 day period was 18.7%. This was also reflected in a reduced output of faecal water (18.4%) during the same period. The digestibility of the dry matter component of the diet was significantly increased by 5.8%. In a second experiment, which involved 24 pairs of calves, faecal samples were collected daily, commencing before initiation of treatment, for determination of faecal dry matter content. The pattern of change in the faecal dry matter content during the course of the study differed clearly for the two treatments. Faecal dry matter increased from its lowest level (11.7%), immediately prior to first treatment, to its maximum (21.8%) on the second day of treatment in the Buscopan compositum-treated calves.(ABSTRACT TRUNCATED AT 250 WORDS)

Patient accounts: getting it from all sides and PPS, UB-82, and DRGs. Roundtable on patient accounts management.

Patient accounts management today is facing new challenges. And the patient accounts manager is beseiged by a multitude of threats and opportunities, forcing the manager to seek ways to improve productivity, maintain cash flow, and enhance working relationships. In response, HFMA conducted a roundtable discussion with patient accounts managers from the American Guild of Patient Account Management and HFMA to determine some of these threats and opportunities confronting the manager. This article presents the highlights of that discussion.

Count on quality.

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It serves you right. Hassle-free health care builds loyalty, volume--and the bottom line.

Zero barriers to care, zero waiting times: Tough as those targets sound, today's stars of customer service are scoring direct hits. "It's not a change in the services that are delivered," says one patient satisfaction pro. "It's a change in the way they're being delivered."