Effects of acute femoral head ischemia on the growth plate and metaphysis in a piglet model of Legg-Calvé-Perthes disease.

OBJECTIVE: To determine the effects of acute (≤7 days) femoral head ischemia on the proximal femoral growth plate and metaphysis in a piglet model of Legg-Calvé-Perthes disease (LCPD). We hypothesized that qualitative and quantitative histological assessment would identify effects of ischemia on endochondral ossification. DESIGN: Unilateral femoral head ischemia was surgically induced in piglets, and femurs were collected for histological assessment at 2 (n = 7) or 7 (n = 5) days post-ischemia. Samples were assessed qualitatively, and histomorphometry of the growth plate zones and primary spongiosa was performed. In a subset of samples at 7 days, hypertrophic chondrocytes were quantitatively assessed and immunohistochemistry for TGFß1 and Indian hedgehog was performed. RESULTS: By 2 days post-ischemia, there was significant thinning of the proliferative and hypertrophic zones, by 63 µm (95% CI -103, -22) and -19 µm (95% CI -33, -5), respectively. This thinning persisted at 7 days post-ischemia. Likewise, at 7 days post-ischemia, the primary spongiosa was thinned to absent by an average of 311 µm (95% CI -542, -82) in all ischemic samples. TGFß1 expression was increased in the hypertrophic zone at 7 days post-ischemia. CONCLUSIONS: Alterations to the growth plate zones and metaphysis occurred by 2 days post-ischemia and persisted at 7 days post-ischemia. Our findings suggest that endochondral ossification may be disrupted at an earlier time point than previously reported and that growth disruption may occur in the piglet model as occurs in some children with LCPD.

Quantitative T2 and T1ρ mapping are sensitive to ischemic injury to the epiphyseal cartilage in an in vivo piglet model of Legg-Calvé-Perthes disease.

OBJECTIVE: To determine if the quantitative MRI techniques T2 and T1ρ mapping are sensitive to ischemic injury to epiphyseal cartilage in vivo in a piglet model of Legg-Calvé-Perthes disease using a clinical 3T MRI scanner. We hypothesized that T2 and T1ρ relaxation times would be increased in the epiphyseal cartilage of operated vs contralateral-control femoral heads 1 week following onset of ischemia. DESIGN: Unilateral femoral head ischemia was surgically induced in eight piglets. Piglets were imaged 1 week post-operatively in vivo at 3T MRI using a magnetization-prepared 3D fast spin echo sequence for T2 and T1ρ mapping and a 3D gradient echo sequence for cartilage segmentation. Ischemia was confirmed in all piglets using gadolinium contrast-enhanced MRI. Median T2 and T1ρ relaxation times were measured in the epiphyseal cartilage of the ischemic and control femoral heads and compared using paired t-tests. Histological assessment was performed on a subset of five piglets. RESULTS: T2 and T1ρ relaxation times were significantly increased in the epiphyseal cartilage of the operated vs control femoral heads (ΔT2 = 11.9 ± 3.7 ms, 95% CI = [8.8, 15.0] ms, P < 0.0001; ΔT1ρ = 12.8 ± 4.1 ms, 95% CI = [9.4, 16.2] ms, P < 0.0001). Histological assessment identified chondronecrosis in the hypertrophic and deep proliferative zones within ischemic epiphyseal cartilage. CONCLUSIONS: T2 and T1ρ mapping are sensitive to ischemic injury to the epiphyseal cartilage in vivo at clinical 3T MRI. These techniques may be clinically useful to assess injury and repair to the epiphyseal cartilage to better stage the extent of ischemic damage in Legg-Calvé-Perthes disease.

Surgical induction, histological evaluation, and MRI identification of cartilage necrosis in the distal femur in goats to model early lesions of osteochondrosis.

OBJECTIVE: Identify and interrupt the vascular supply to portions of the distal femoral articular-epiphyseal cartilage complex (AECC) in goat kids to induce cartilage necrosis, characteristic of early lesions of osteochondrosis (OC); then utilize magnetic resonance imaging (MRI) to identify necrotic areas of cartilage. DESIGN: Distal femora were perfused and cleared in goat kids of various ages to visualize the vascular supply to the distal femoral AECC. Vessels located on the axial aspect of the medial femoral condyle (MFC) and on the abaxial side of the lateral trochlear ridge were transected in eight 4- to 5-day-old goats to induce cartilage necrosis. Goats were euthanized 1, 2, 3, 4, 5, 6, 9, and 10 weeks post operatively and operated stifles were harvested. Adiabatic T1ρ relaxation time maps of the harvested distal femora were generated using a 9.4 T MR scanner, after which samples were evaluated histologically. RESULTS: Interruption of the vascular supply to the MFC caused lesions of cartilage necrosis in 6/8 goat kids that were demonstrated histologically. Adiabatic T1ρ relaxation time mapping identified these areas of cartilage necrosis in 5/6 cases. No significant findings were detected after transection of perichondrial vessels supplying the lateral trochlear ridge. CONCLUSIONS: Cartilage necrosis, characteristic of early OC, can be induced by interrupting the vascular supply to the distal femoral AECC in goat kids. The ability of high field MRI to identify these areas of cartilage necrosis in the AECC using the adiabatic T1ρ sequence suggests that this technique may be useful in the future for the early diagnosis of OC.

Articular osteochondrosis: a comparison of naturally-occurring human and animal disease.

BACKGROUND: Osteochondrosis (OC) is a common developmental orthopedic disease affecting both humans and animals. Despite increasing recognition of this disease among children and adolescents, its pathogenesis is incompletely understood because clinical signs are often not apparent until lesions have progressed to end-stage, and examination of cadaveric early lesions is not feasible. In contrast, both naturally-occurring and surgically-induced animal models of disease have been extensively studied, most notably in horses and swine, species in which OC is recognized to have profound health and economic implications. The potential for a translational model of human OC has not been recognized in the existing human literature. OBJECTIVE: The purpose of this review is to highlight the similarities in signalment, predilection sites and clinical presentation of naturally-occurring OC in humans and animals and to propose a common pathogenesis for this condition across species. STUDY DESIGN: Review. METHODS: The published human and veterinary literature for the various manifestations of OC was reviewed. Peer-reviewed original scientific articles and species-specific review articles accessible in PubMed (US National Library of Medicine) were eligible for inclusion. RESULTS: A broad range of similarities exists between OC affecting humans and animals, including predilection sites, clinical presentation, radiographic/MRI changes, and histological appearance of the end-stage lesion, suggesting a shared pathogenesis across species. CONCLUSION: This proposed shared pathogenesis for OC between species implies that naturally-occurring and surgically-induced models of OC in animals may be useful in determining risk factors and for testing new diagnostic and therapeutic interventions that can be used in humans.

Detailed modelling of delamination buckling of thin films under global tension.

Tensile specimens of metal films on compliant substrates are widely used for determining interfacial properties. These properties are identified by the comparison of experimentally observed delamination buckling and a mathematical model which contains the interface properties as parameters. The current two-dimensional models for delamination buckling are not able to capture the complex stress and deformation states arising in the considered uniaxial tension test in a satisfying way. Therefore, three-dimensional models are developed in a multi-scale approach. It is shown that, for the considered uniaxial tension test, the buckling and associated delamination process are initiated and driven by interfacial shear in addition to compressive stresses in the film. The proposed model is able to reproduce all important experimentally observed phenomena, like cracking stress of the film, film strip curvature and formation of triangular buckles. Combined with experimental data, the developed computational model is found to be effective in determining interface strength properties.

Measurement of C-peptide concentrations and responses to somatostatin, glucose infusion, and insulin resistance in horses.

REASONS FOR PERFORMING STUDY: Hyperinsulinaemia is detected in horses with insulin resistance (IR) and has previously been attributed to increased pancreatic insulin secretion. Connecting peptide (C-peptide) can be measured to assess pancreatic function because it is secreted in equimolar amounts with insulin and does not undergo hepatic clearance. HYPOTHESIS: A human double antibody radioimmunoassay (RIA) detects C-peptide in equine serum and concentrations would reflect responses to different stimuli and conditions. METHODS: A validation procedure was performed to assess the RIA. Six mature mares were selected and somatostatin administered i.v. as a primed continuous rate infusion, followed by 50 nmol human C-peptide i.v. Insulin and C-peptide concentrations were measured in horses (n = 6) undergoing an insulin-modified frequently sampled i.v. glucose tolerance test, and in horses with insulin resistance (n = 10) or normal insulin sensitivity (n = 20). RESULTS: A human RIA was validated for use with equine sera. Endogenous C-peptide secretion was suppressed by somatostatin and median (range) clearance rate was 0.83 (0.15-1.61) ml/min/kg bwt. Mean + or - s.d. C-peptide-to-insulin ratio significantly (P = 0.004) decreased during the glucose tolerance test from 3.60 + or - 1.95 prior to infusion to 1.03 + or - 0.18 during the first 20 min following dextrose administration. Median C-peptide and insulin concentrations were 1.5- and 9.5-fold higher, respectively in horses with IR, compared with healthy horses. CONCLUSIONS: Endogenous C-peptide secretion decreases in response to somatostatin and increases after dextrose infusion. Results suggest that relative insulin clearance decreases as pancreatic secretion increases in response to dextrose infusion. Hyperinsulinaemia in insulin resistant horses may be associated with both increased insulin secretion and decreased insulin clearance. POTENTIAL RELEVANCE: Both C-peptide and insulin concentrations should be measured to assess pancreatic secretion and insulin clearance in horses.

Association of season and pasture grazing with blood hormone and metabolite concentrations in horses with presumed pituitary pars intermedia dysfunction.

BACKGROUND: Pituitary pars intermedia dysfunction (PPID) is a risk factor for pasture-associated laminitis, which follows a seasonal pattern. HYPOTHESIS: Hormonal responses to season differ between PPID and unaffected horses. ANIMALS: Seventeen horses aged 8-30 years (14 horses ≥ 20 years of age). METHODS: Longitudinal observational study. Blood was collected monthly from August 2007 until July 2008 after pasture grazing and again after overnight stall confinement. Blood hormone and metabolite concentrations were measured and pasture grass samples were analyzed to determine carbohydrate content. Analysis of variance analysis for repeated measures was performed. RESULTS: Mean ACTH concentrations varied significantly over time (P < .001), with higher concentrations detected in August, September, and October compared with November-April. Pasture × time effects were detected for glucose and insulin concentrations, with peaks observed in September. Horses were retrospectively allocated to PPID (n = 8) and control (n = 9) groups on the basis of plasma ACTH concentrations. Changes in insulin concentrations over time differed in the PPID group when compared with the control group. Insulin concentrations were positively correlated with grass carbohydrate composition. CONCLUSIONS AND CLINICAL IMPORTANCE: PPID did not affect the timing or duration of the seasonal increase in ACTH concentrations, but higher values were detected in affected horses. Insulin concentrations differed between groups, but hyperinsulinemia was rarely detected. Glucose and insulin concentrations peaked in September when horses were grazing on pasture, which could be relevant to the seasonal pattern of laminitis.

The association between collagen and bone biomarkers and radiographic osteoarthritis in the distal tarsal joints of horses.

BACKGROUND: Osteoarthritis (OA) of the distal intertarsal (DIT) and tarsometatarsal (TMT) joints occurs commonly. Synovial fluid (SF) biomarkers of collagen and bone turnover have potential clinical value. OBJECTIVES: To measure SF biomarker concentrations from DIT and TMT joints in adult horses and determine if they correlate with radiographic OA severity and are higher in joints with radiographic OA compared to controls. STUDY DESIGN: Cross-sectional. METHODS: Radiographic OA of DIT and TMT joints was evaluated from adult horses (5-35 years old). Overall radiographic scores divided horses into those with mild or moderate radiographic OA (16 joints from 9 horses) or controls (13 joints from 9 horses). Direct biomarkers of OA (Carboxypropeptide of type II collagen = CPII, carboxy-neoepitope of type II collagen exposed after collagenase-cleavage = C2C, Bone alkaline phosphatase = BAP and Chondroitin sulfate epitope = CS846) were measured via ELISA and CPII/C2C was calculated. Biomarkers were correlated with radiographic findings and concentrations from those with radiographic OA to control joints and were compared. RESULTS: Concentrations of CPII (R = 0.84, P<0.001), C2C (R = 0.69, P<0.001) and BAP (R = 0.41, P = 0.03) as well as CPII/C2C (R = 0.69, P<0.001) values positively correlated with overall radiographic scores. Adjusted means ± s.d., after controlling for age, for CPII (P<0.001), C2C (P<0.001), CPII/C2C (P = 0.004) and BAP (P = 0.05) were significantly higher in DIT and TMT joints with radiographic OA (CPII: 2174.45 ± 1064.01; C2C: 233.52 ± 51.187; CPII/C2C: 9.01 ± 4.09; BAP: 21.98 ± 15.34) compared to controls (CPII: 594.53 ± 463.05; C2C: 153.12 ± 48.95; CPII/C2C: 3.96 ± 2.38; BAP: 12.76 ± 3.61). CPII (P<0.001), C2C (P = 0.001) and CPII/C2C (P = 0.001) were significantly higher with moderate radiographic OA (CPII: 2444.61 ± 772.78; C2C: 248.90 ± 44.94; CPII/C2C: 9.47 ± 2.97) compared to controls (CPII: 658.38 ± 417.36; C2C: 156.49 ± 47.61; CPII/C2C: 4.15 ± 2.04), with CPII also showing significantly higher concentrations (P = 0.04) with mild radiographic OA compared (1515.00 ± 584.95) to controls (658.38 ± 417.36). There were no differences in CS846 concentrations between radiographic OA and control joints. Age positively correlated with CPII (R = 0.48, P = 0.01) and C2C (R = 0.44, P = 0.02) concentrations. MAIN LIMITATIONS: Radiographic OA was assessed, not clinical lameness. Controls were not age-matched to those with spontaneous radiographic OA. CONCLUSIONS: There is an association between collagen (CPII, C2C and CPII/C2C) and bone (BAP) biomarkers and radiographic OA in the distal tarsal joints of horses.

Effects of endotoxaemia and carbohydrate overload on glucose and insulin dynamics and the development of laminitis in horses.

REASONS FOR PERFORMING STUDY: Insulin resistance (IR) is a risk factor for pasture-associated laminitis in equids and alimentary carbohydrate overload may trigger laminitis. Whether glucose metabolism responses to carbohydrate overload are more pronounced in insulin-resistant horses requires further study. HYPOTHESIS: Horses pretreated with endotoxin to alter insulin sensitivity differ significantly in their glucose and insulin responses to carbohydrate overload. METHODS: Horses (n=24) were divided into 3 groups. A lipopolysaccharide (LPS; n=8) group that received endotoxin as an 8 h 7.5 ng/kg bwt/h i.v. continuous rate infusion, an oligofructose (OF; n=8) group that received an infusion of saline followed by 5 g/kg bwt OF via nasogastric intubation, and a LPS/OF (n=8) group that received LPS followed 16 h later by OF. Glucose and insulin dynamics were evaluated at -24 h and 48 h using the frequently sampled i.v. glucose tolerance test and minimal model analysis. Physical examinations and haematology were performed and the severity of laminitis assessed. RESULTS: Horses receiving LPS developed leucopenia and both LPS and OF induced clinical signs consistent with systemic inflammation. Insulin sensitivity significantly decreased (P < 0.001) over time, but responses did not differ significantly among groups. Time (P < 0.001) and treatment x time (P = 0.038) effects were detected for the acute insulin response to glucose, with mean values significantly increasing in LPS and LPS/OF groups, but not the OF group. Five horses in the LPS/OF group developed clinical laminitis compared with 0 and 2 horses in the LPS and OF groups, respectively. CONCLUSIONS: Endotoxaemia and carbohydrate overload reduce insulin sensitivity in horses. Endotoxin pretreatment does not affect the alterations in glucose metabolism induced by carbohydrate overload. POTENTIAL RELEVANCE: Insulin sensitivity decreases after carbohydrate overload in horses, which may be relevant to the development of pasture-associated laminitis.

Optimisation of the frequently sampled intravenous glucose tolerance test to reduce urinary glucose spilling in horses.

REASONS FOR PERFORMING STUDY: The frequently sampled i.v. glucose tolerance test (FSIGTT) is used to evaluate glucose and insulin dynamics in horses, but it has not been determined whether urinary glucose spilling (UGS) affects results. HYPOTHESIS: UGS occurs in horses during the FSIGTT and this problem can be minimised by adjusting the dextrose and insulin dosages used. METHODS: Six mature mares were included in this study. In the first phase, 6 FSIGTT procedures were performed in each horse to evaluate 6 different dextrose dosages. Six different insulin dosages were evaluated during the second phase of the study after administration of 300 mg/kg bwt dextrose. Area under the glucose (AUCg) and insulin (AUCi) curves were calculated and minimal model analyses performed. UGS was measured in the third and fourth phases of the study during the combined glucose insulin test and established FSIGTT. A new FSIGTT was developed and evaluated. RESULTS: Positive linear effects of dextrose dosage on AUCg, AUCi and acute insulin response to glucose were detected, with AUCg reaching a plateau at doses > or =200 mg/kg bwt. Insulin dosage had an inverse linear effect on AUCg, but other values remained unaffected. UGS occurred during all 3 tests and was the highest for the established FSIGTT and the lowest for the new FSIGTT. The type of FSIGTT performed did not affect minimal model results. CONCLUSIONS: Results indicate that the dextrose dosage of 300 mg/kg bwt used in the established FSIGTT is too high. UGS can be reduced by lowering the dextrose dosage to 100 mg/kg bwt. POTENTIAL RELEVANCE: A new FSIGTT involving the administration of 100 mg/kg bwt dextrose followed by 20 mu/kg bwt insulin 20 min later is recommended for use in horses because this test provides adequate data for minimal model analysis while minimising UGS.

Different head morphology of full-term gypsy and non-gypsy newborns from Slovak Republic.

BACKGROUND: Early detection of cranial growth defects in childhood is extremely important for subsequent growth, development of head and could be a screening aid for early detection of growth deviations. METHODS: Seven head dimensions and two indexes of 90 Gypsy and 99 non-Gypsy newborns from Slovakia were examined to asses the potential differences between the groups. RESULTS: Gypsy newborns had significantly lower head circumference, lower head length, lower width of head basis and facial width compared to non-Gypsy newborns. Gypsy newborns have shown significantly higher value of the index cephalicus while in non-Gypsy newborns mesocephalic values have been detected. Moreover, Gypsy newborns had significantly higher cranium as compared to non-Gypsy. CONCLUSIONS: Gypsy subpopulation has a different head morphology compared to the majority of the population. Knowledge about the different head morphology between these ethnic groups could give us clues about the genetic influences determining head morphology in the prenatal development and therefore might be a helpful diagnostic tool in neonatology (Tab. 1, Ref. 14).

Anthropometry, nutrition status and thymic size of Gypsy newborns from southwestern Slovakia.

Gypsy population represents a specific minority in Slovakia that differs from the majority population by its origin and genetic markers, as well as by generally lower social and economic status and lower hygienic standards of living. The aim of the present work is the analysis of anthropometric dimensions and indexes, as well as of thymus size, in the group of Gypsy and non-Gypsy newborns from the Southern Slovakia. Our group of 212 physiological newborns consisted of 33 Gypsy and 179 non-Gypsy newborns. All newborns were underwent anthropometric examination and their thymus size was assessed by ultrasonography and calculated as so-called Thymic Index". Gypsy newborns show statistically significant lower anthropometric dimensions (birth weight and birth body length, head and chest circumference) when compared to non-Gypsy newborns, however, they do not differ in the values of nutritional status indicators (arm circumference, Quételet index and Rohrer index). They do not differ even in the thymus size that can be regarded as a "barometer" of the nutrition and of some negative stimuli. In spite of generally deficient nutrition and lower health status of the Gypsy minority in Slovakia, we did not find any significant differences in the indicators of nutritional status or in thymus size (Tab. 2, Ref. 34).

Early experience on a modern, thin cochlear implant family. A retrospective, international multicenter study.

RATIONALE: Cochlear implantation is the most effective method of rehabilitation for patients with severe to profound sensorineural hearing loss. Binaural hearing forms the basis of the development of hearing-associated cortical networks in infants and toddlers, but simultaneous bilateral implantation is often postponed due to the demands of classical surgical methods, which are associated with large incisions and a deep bony well. OBJECTIVE: The authors report on the use of a modern, thin implant type and the possibilities it provided to simplify the surgical technique. METHODS AND RESULTS: Recent models of the Cochlear™ Nucleus® implant family were studied in an international retrospective multi-center study: 6 otolaryngologists in 5 centers shared their experiences on 73 consecutively implanted, thin implants. The surgical incision could be made shorter than before and only shallow bony wells or none at all were created in 4 out of 5 centers. No complications occurred. DISCUSSION: This study underlines that implants with thin electronics capsules enable a simplified, fast and safe implantation procedure that allows simultaneous bilateral cochlear implantation.

The impact of four-wheel drives on traffic disability and deaths compared to passenger cars.

OBJECTIVE: The aim of this study was to examine the pattern of injuries resulting from road traffic crashes involving four wheel drives (4WD) vehicles and passenger cars in the United Arab Emirates (UAE). DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Al-Ain and Tawam Hospital, UAE, during a period from 1st January to 31st December 2000. PATIENTS AND METHODS: A questionnaire was created and filled out concerning: sociodemographic information; data about driving behavior and attitude which included driving experience, adherence to traffic laws (including speed limits and wearing seat belt), driving habits, and assessment of sustained injury was performed according to the Abbreviated Injury Score (AIS). RESULTS: A total of 1157 motor vehicle crashes related casualty patients were hospitalized during the year 2000. Of these total patients, 495 victims (42.8%) were involved with 4WDs road traffic crashes related injuries and 72.9% of them required hospitalization. Of these, 76.8% were males, 60.7% were non-UAE nationals. The head injury was more common in those who had crashes from 4WD vehicles (45.6%) than those who had crashes from small cars (37.3%). Abbreviated injury scare showed that four wheelers caused more severe (9.1%), serious (10.3%), critical (8.3%) and moderate injuries (13.9%). A significant higher risk was observed for speed violations (OR=2.06; 95% CI=1.55 - 2.76, p<0.001) property damage (OR=1.54; 95% CI=1.07-2.22, p<0.014) and pedestrian accident (OR=2.09; 95% CI=1.46-2.99, p<0.001). CONCLUSION: The present study findings indicated that nearly half of the road traffic crashes were involved with 4WD vehicles and that most of the injured individuals were pedestrian and younger drivers. Reduction in motor vehicle injuries and deaths represents a major public health success.

A novel non-opioid binding site for endomorphin-1.

Endomorphins are natural amidated opioid tetrapeptides with the following structure: Tyr-Pro-Trp-Phe-NH2 (endomorphin-1), and Tyr-Pro-Phe-Phe-NH2 (endomorphin-2). Endomorphins interact selectively with the µ-opioid or MOP receptors and exhibit nanomolar or sub-nanomolar receptor binding affinities, therefore they suggested to be endogenous agonists for the µ-opioid receptors. Endomorphins mediate a number of characteristic opioid effects, such as antinociception, however there are several physiological functions in which endomorphins appear to act in a fashion that does not involve binding to and activation of the µ-opioid receptor. Our recent data indicate that a radiolabelled [3H]endomorphin-1 with a specific radioactivity of 2.35 TBq/mmol - prepared by catalytic dehalogenation of the diiodinated peptide precursor in the presence of tritium gas - is able to bind to a second, naloxone insensitive recognition site in rat brain membranes. Binding heterogeneity, i.e., the presence of higher (Kd = 0.4 nM / Bmax = 120 fmol/mg protein) and lower (Kd = 8.2 nM / Bmax = 432 fmol/mg protein) affinity binding components is observed both in saturation binding experiments followed by Schatchard analysis, and in equilibrium competition binding studies. The signs of receptor multiplicity, e.g., curvilinear Schatchard plots or biphasic displacement curves are seen only if the non-specific binding is measured in the presence of excess unlabeled endomorphin-1 and not in the presence of excess unlabeled naloxone. The second, lower affinity non-opioid binding site is not recognized by heterocyclic opioid alkaloid ligands, neither agonists such as morphine, nor antagonists such as naloxone. On the contrary, endomorphin-1 is displaced from its lower affinity, higher capacity binding site by several natural neuropeptides, including methionine-enkephalin-Arg-Phe, nociceptin-orphanin FQ, angiotensin and FMRF-amide. This naloxone-insensitive, consequently non-opioid binding site seems to be present in nervous tissues carrying low density or no µ-opioid receptors, such as rodent cerebellum, or brain of µ-opioid receptor deficient (MOPr-/-) transgenic or 'knock-out' (K.O.) mice. The newly described non-opioid binding component is not coupled to regulatory G-proteins, nor does it affect adenylyl cyclase enzyme activity. Taken together endomorphin-1 carries opioid and, in addition to non-opioid functions that needs to be taken into account when various effects of endomorphin-1 are evaluated in physiological or pathologic conditions.

Bacterial Infections After Kidney Transplantation: A Single-Center Experience.

BACKGROUND: Bacterial infections significantly affect graft loss and mortality after kidney transplantation (KT). We reviewed the frequencies, risk factors, and sources of bacterial infections after KT and their impact on graft and patient survivals. METHODS: The data of 154 kidney recipients who underwent transplantation from 2010 to 2015 were explored. Donor, recipient, and surgical parameters were collected, and source, type, and frequency of infectious complications, number of infective episodes, multidrug-resistant (MDR) bacteria, and the bacterial spectrum were established. RESULTS: The most common infection was urinary tract infection, which is in line with the literature. Out of the 154 recipients, 72.1% (n = 111) had at least 1 occasion of a bacterial infection episode with clinical symptoms. It occurred 0-43 months (mean, 19.5 mo) after transplantation. Ninety-three KT recipients (67.9%) developed 274 episodes of infection in the postoperative 1st year (1.8 episodes/patient/y), and 42 patients had admission to the hospital ward (5.2 d/patient/y). MDR was detected in 19.8% of the infections. CONCLUSIONS: A bacterial infection had no significant impact on survival by itself. However, in case of sepsis graft and patient survivals were lower compared with normal control subjects.

A Single-center Experience of Allograft Nephrectomies Following Kidney Transplantation.

INTRODUCTION: Approximately 10% of renal allografts fail during the first year after kidney transplantation (KT) and 3%-5% thereafter yearly. The indication and timing of allograft nephrectomy (AN) is still uncertain in some cases. The aim of this study was to reveal the ratio, etiology, and complications of AN at our center. MATERIAL AND METHODS: This is a retrospective study of all patients who underwent KT at our center between January 1, 2004 and December 31, 2014. We analysed the frequency, indications, timing, and complications of ANs. Also early and late ANs were compared. RESULTS: From 417 renal transplantations 49 ANs were performed (11.7%). The most frequent indications were chronic allograft nephropathy (25; 51%), arterial blood supply complications, like arterial thrombosis and stenosis (7; 15%), treatment-resistant acute rejection (3; 6%), and nonreparable ureter complications (3; 6%). The average time of AN since KT was 28 months. ANs were performed as an urgent setting in 16 (33%) cases, whereas it was elective in 33 cases (67%). The AN was executed within 30 days (early) in 11 (22%) cases, and thereafter (late) in 38 (78%) cases. The main indication for early AN was renal artery thrombosis (4; 37%) and chronic allograft nephropathy (25; 66%) for late AN. Surgical complications occurred in 10 cases (20; 4%). The most common was hematoma. CONCLUSION: The majority of the ANs were elective and late (more than 30 days; average time, 47 months). Leading indication was chronic allograft nephrectomy. Early ANs were urgent and life-saving in all cases.

Surgical Complications Following Kidney Transplantations: A Single-Center Study in Hungary.

Surgical complications (SCs) are still high potential causes of graft loss. The incidence has a huge amount of variations depending on many factors. Our aim was to study the postoperative technical complications following kidney transplantations (KTs) during a 5-year period between 2011 and 2015. In the observed time frame there were 47 SCs occurring in 32 (19.4%) patients of 165 KTs. Every complication was classified into 3 groups: vascular (11; 6.6%), urologic (16; 9.7%), and any others (20; 12.1%). The most common postoperative SCs in our center were hemorrhage (14; 8.5%), urinary leakage (12; 7.2%), and renal artery stenosis (6; 3.6%). Twenty-seven patients, 84% of those having had a SC, needed an intervention, mainly a surgical correction (28; 62%). Half of these interventions (21; 51%) were performed due to urologic reasons. As possible predicting factors, we studied the type of arterial and ureter anastomosis in relation to onset of vascular and urologic complications. There was no significant correlation. The same was true for any donor and/or recipient demographic parameters. However, the presence of SCs impaired both patient and graft survival. The cumulative 6-month, 1-, 3-, and 5-year patient survival rates were 97% versus 99%, 93% versus 99%, 84% versus 97%, and 84% versus 97% for patients with/without (w/wo) a SC, respectively (P = .028). The cumulative 6-month, 1-, 3-, and 5-year graft survival rates were 81% versus 96%, 77% versus 94%, 68% versus 86%, and 54% versus 86% for the same 2 groups, respectively (P = .003).

Osteochondrosis prevalence and severity at 12 and 24 weeks of age in commercial pigs with and without organic-complexed trace mineral supplementation.

Maternal and progeny diets supplemented with 2 sources of trace mineral (TM) were evaluated for effects on the size and severity of osteochondrosis (OC) lesions in progeny produced by 64 Landrace × Large White sows. At breeding, sows were randomly assigned to maternal diets (gestation and lactation) consisting 1 of 2 TM treatments. One treatment consisted of inorganic TM (ITM) with ZnO, MnSO, and CuSO at concentrations to provide 150, 50, and 16.5 mg/kg diet of Zn, Mn, and Cu, respectively. The other treatment consisted of the same ITM concentrations plus an additional 50, 20, and 10 mg/kg diet of Zn, Mn, and Cu, respectively, supplied by a blend of AA-complexed TM (CTM) using Availa Sow. Within maternal dietary treatment groups, selected progeny ( = 280) were fed either ITM- or CTM-supplemented diets. The humerus and femur (1 each) from progeny euthanized at 12 ( = 80) or 24 wk ( = 200) were collected for microscopic (12 wk) or gross (24 wk) assessment of OC lesions. Microscopic OC lesions were present in all pigs at 12 wk. Dietary treatments had limited effects on OC prevalence or severity. A maternal × progeny diet interaction ( = 0.044) revealed femoral OC latens lesions that were approximately twice the size in progeny fed CTM that were produced by sows fed CTM compared with those found in pigs in the other 3 dietary treatment groups. At 24 wk, the sum of gross OC scores at predilection sites of the thoracic (elbow joint) and pelvic (stifle and hock joints) limbs remained similar among treatments, despite greater ( = 0.004) gross OC scores of the medial femoral condyle in progeny from sows fed CTM diets than in progeny from sows fed ITM diets, regardless of progeny diet. Progeny produced by sows fed CTM vs. ITM had increased ADG (0.71 vs. 0.68 ± 0.01 kg/d), regardless of the diet fed to progeny during the growth phases. Covariant analysis using ADG did not alter inferences about maternal or progeny diet effects on OC responses. Although 100% of progeny at 12 wk had histologically apparent OC lesions, only 3 of the 200 pigs examined at 24 wk had gross lesions of sufficient severity to potentially result in clinically apparent disease. Therefore, although some results imply that maternal and progeny CTM diets increased the size (12 wk) and severity (24 wk) of OC in 1 site (the femur), on the whole animal level, no evidence of lameness was noted.