A genome-wide association study identifies a region strongly associated with symmetrical onychomadesis on chromosome 12 in dogs.

Symmetrical onychomadesis causes periodic loss of claws in otherwise healthy dogs. Genome-wide association analysis in 225 Gordon Setters identified a single region associated with symmetrical onychomadesis on chromosome 12 (spanning about 3.3 mb). A meta-analysis including also English Setters indicated that this genomic region predisposes for symmetrical onychomadesis in English Setters as well. The associated region spans most of the major histocompatibility complex and nearly 1 Mb downstream. Like many other autoimmune diseases, associations of symmetrical onychomadesis with DLA class II alleles have been reported. In this study, no associated markers were revealed within any of the DLA-DRB1, -DQA1 or -DQB1 genes, and the odds for symmetrical onychomadesis in the Gordon Setters were much higher, carrying significant single nucleotide polymorphisms compared to the odds of any of the recorded DLA-DRB1/DQA1/DQB1 haplotypes. We noticed that some of the associated DLA haplotypes were different between the English Setters and the Gordon Setters. Interestingly, associated SNP chip markers showed a more consistent pattern of allelic variants related to cases or controls regardless of breed. In conclusion, the associated genetic markers identified in this study hold the potential to aid in selection of breeding animals to reduce the frequency of symmetrical onychomadesis in the dog.

First record of natural Tritrichomonas foetus infection of the feline uterus.

Tritrichomonas foetus was found in the uterus of a cat with pyometra and in the faeces of three other cats in the same household, one of which had chronic diarrhoea. This is the first report of a feline uterine infection with T. foetus and also the first time T. foetus has ever been diagnosed in animals in Norway. The diagnosis was made by microscopic examination and sequencing studies.

Effect of oat bran on plasma cholesterol and bile acid excretion in nine subjects with ileostomies.

A higher excretion of dry matter, fat, nitrogen, energy, and total bile acids in ileal effluents; a lower plasma low-density-lipoprotein (LDL) and total cholesterols (12.1% and 9.0% lower respectively); but no change in plasma high-density-lipoprotein (HDL) cholesterol or apolipoproteins A-I and B were observed in nine subjects with ileostomies when they consumed an oat-bran, bread-based, high-fiber diet (HFD) as compared with a wheat-flour, bread-based, low-fiber diet (LFD) for 3 wk with a crossover design. Of the nine subjects only the subjects with a low daily excretion of bile acids had an elevated excretion of total bile acids during the HFD compared with the LFD. Total cholesterol, LDL cholesterol, and apolipoprotein B in plasma also decreased by 11.3%, 15.3%, and 10.7%, respectively, after consumption of the HFD for 3 wk.

Effect of rye bran on excretion of bile acids, cholesterol, nitrogen, and fat in human subjects with ileostomies.

The excretion of bile acids, cholesterol, dry matter, nitrogen, fat, and energy in ileostomy effluent, and plasma lipid concentrations were studied in eight subjects with ileostomies. The subjects consumed a wheat bread-based, low-fiber diet (LFD) for 3 wk and a rye bran bread-based, high-fiber diet (HFD) for 3 wk. The ileal excretion of dry matter, nitrogen, fat, and energy was higher during the HFD period. The daily excretion and the percentage of conjugated bile acids were significantly higher and the percentage of free bile acids lower in the ileostomy effluents during the HFD as compared with the LFD period. No significant difference in the excretion of cholesterol, net cholesterol, sterol, or net sterol was noted between the HFD and LFD periods. No significant differences in plasma concentrations of HDL-, LDL-, and total cholesterol, and apolipoprotein A-I and B were observed between the two 3-wk dietary periods.

The effects of omeprazole and cimetidine on duodenal ulcer healing and the relief of symptoms.

In a Swedish double-blind multicentre study, omeprazole (30 mg o.m.) was compared with the H2-receptor antagonist cimetidine (400 mg b.d.) in 152 patients. Clinical assessments and laboratory investigations were carried out at 2 and 4 weeks, and again at 6 weeks in unhealed patients. Endoscopy was performed at 2 weeks, and again at 4 and 6 weeks in unhealed patients. The patients in the two groups were well-matched prior to treatment. Omeprazole was superior to cimetidine in ulcer-healing rate after 2, 4 and 6 weeks. After 2 weeks of treatment, 66% of the omeprazole- and 45% of the cimetidine-treated patients were healed (P = 0.02), after 4 weeks 97 and 84% (P = 0.01), and after 6 weeks 100 and 92% (P = 0.02), respectively. There was a more pronounced improvement in the patients' symptoms in the omeprazole group after 2 weeks (P = 0.05). Both drugs were well-tolerated, but there was a high prevalence of patients with adverse events in the cimetidine group (51%, compared to 30% of the omeprazole group; P = 0.02). A total of 125 patients were followed for 6 months after healing. The patients were investigated by endoscopy after 6 months, or whenever symptoms occurred. There was no significant difference in the rate of relapse within 6 months between the two treatment groups: 54% relapsed in the omeprazole group and 52% in the cimetidine group. In conclusion, 30 mg of omeprazole, given once daily, is superior to 400 mg of cimetidine twice daily in duodenal ulcer healing; but ulcer relapse in the two groups appears to be equivalent.

Tissue reaction to polypropylene and polyester in obese patients.

Local tissue reaction was examined after subcutaneous implantation for 8 wk of small pieces of Marlex (polypropylene) and Dacron (polyester) in 11 extremely obese patients. Dacron gave a stronger chronic inflammatory reaction in 7 out of 11 patients, and a stronger foreign body giant cell reaction in all of them: Marlex is therefore perhaps more suitable than Dacron as a reinforcement band in gastric surgery for obesity. At reoperations due to complications after gastric banding the tissue reaction in the omentum which covered the band, was examined in 9 patients. No major difference in tissue reaction in the omentum compared to that in subcutaneous fat was found. None of the reoperations was caused by too strong a tissue reaction to the reinforcement band i.e. Marlex in 8 patients and Gore-tex (Teflon) in one patient.

Inflammatory response to subcutaneously implanted Marlex and GORE-TEX in massively obese patients.

In both vertical banded gastroplasty and in gastric banding, synthetic bands are used to reinforce the outlet from the pouch to the rest of the stomach. Two materials commonly used for these bands are polypropylene (Marlex) and polytetrafluoroethylene (GORE-TEX). As a measure of their suitability, human inflammatory response to subcutaneous implants was investigated. In a randomized series of 17 superobese patients a patch of GORE-TEX was implanted subcutaneously in one groin under local anaesthesia and Marlex mesh was implanted in the other groin. After about 2 months the implants were exstirpated and investigated in a single blind procedure by an experienced pathologist. Marlex gave a significantly greater chronic inflammatory reaction and fibrosis than GORE-TEX. The foreign body giant cell reaction was, however, significantly greater with GORE-TEX. The possible implications of these results are discussed.

Primary hyperparathyroidism in pregnancy.

The history of a pregnant woman with primary hyperparathyroidism is presented. The patient underwent successful operation during the second trimester and the subsequent pregnancy and delivery were completely normal. Previously, 72 women with an established diagnosis of hyperparathyroidism in pregnancy are reported in the English literature. Twenty-three women underwent operation during pregnancy and 18 normal children were born. Fifty women with a total of 79 pregnancies during a hyperparathyroid state bore 35 normal children while 40 births had different kinds of complications. It is thus clearly documented that the risk of severe fetal complications is much higher if the hyperparathyroidism is left untreated than if the mother undergoes operation during the pregnancy. Therefore when the diagnosis is established the mother should undergo operation, if possible during the second trimester, which minimizes the complication rate significantly in both mother and child. Correction of the hypercalcemic state enables the development of adequate parathyroid gland function in the baby.

Oral prophylaxis with neomycin and erythromycin in colorectal surgery. More proof for efficacy than failure.

In an open, prospective, and randomized investigation on the prophylactic efficacy of peroral neomycin sulfate-erythromycin base vs intravenous ceftriaxone-metronidazole preparation in colorectal surgery, no significantly diverging results between regimens were recorded (1/27 [3.7%] and 2/27 [7.4%] wound infections, respectively). Commentary is made about the diverging results from earlier studies on antimicrobial prophylaxis and on the multifactorial causality of surgical infection. We believe that variables such as physical condition of the patients, virulence and local resistance patterns of bacteria, and technical skill of the surgeons are far more important in regard to the postoperative outcome concerning septic complications than is the choice of proper antibiotics. Thus, to determine the efficacy of antimicrobial prophylaxis, we call for larger investigations in the future, preferably double-blind, where it is possible to better control and diminish the influence of determinants other than the antibiotics being compared.

Parenteral superoxide dismutase plus catalase diminishes pancreatic edema in sodium taurocholate-induced pancreatitis in the rat.

Scavengers of toxic oxygen reduction products have been reported to reduce the inflammatory reaction in some models of pancreatitis. In a blinded study, the effect of parenteral pretreatment with superoxide dismutase plus catalase was compared with placebo on pancreatitis induced in rats by infusion of 0.25% or 2% sodium taurocholate into the hepatopancreatic duct. The degree of inflammation was assessed by macroscopic examination of the pancreas, dry/wet weight ratios of pancreatic specimens, amylase activity in plasma and peritoneal exudate, the weight of the exudate, and its content of total protein. All parameters were indicative of a more severe inflammation in rats given the higher concentration of sodium taurocholate. The only significant effect of the superoxide dismutase plus catalase treatment was a moderate reduction of the dry/wet weight ratio, i.e., pancreatic edema, in rats given 2% sodium taurocholate. Our results indicate that toxic oxygen reduction products, available for interception by parenterally administered superoxide dismutase plus catalase, are of only minor importance in the pathogenesis of sodium taurocholate-induced pancreatitis in the rat.

Relationship between preoperative status of the fibrinolytic system and occurrence of deep vein thrombosis after major abdominal surgery.

This study comprised 50 patients subjected to major abdominal surgery, of which 13 developed deep vein thrombosis (DVT) according to the 125I-fibrinogen test. Plasma was sampled preoperatively, for the specific analysis of tissue plasminogen activator (t-PA) before and during venous occlusion. The recently described fast t-PA inhibitor and plasmin alpha 2-antiplasmin complex (PAP) were also measured. The result of the laboratory analyses were correlated to the development of DVT. From the data obtained it is concluded that the evaluation of t-PA release during venous occlusion is a poor predictive factor for the occurrence of DVT after major abdominal surgery. The level of the t-PA inhibitor appears to be raised in these patients, but the values obtained in this material were not related to the development of postoperative DVT. Patients with elevated PAP levels, as shown previously, have a lesser tendency to develop postoperative DVT.

Fibrinolytic activity in plasma and deep vein thrombosis after major abdominal surgery.

In a prospective study of the frequency of deep vein thrombosis (DVT) in 45 patients subjected to major abdominal surgery, 17 patients showed signs of DVT as assessed by the 125I-fibrinogen test. In 15 of the patients the DVT was diagnosed during the first four postoperative days. Blood samples were taken pre- and postoperatively and analysed for fibrinogen, prothrombin complex, APTT, platelet-count, plasminogen, alpha 2-antiplasmin, fibrin(ogen) degradation products, and plasmin-alpha 2-antiplasmin complex (PAP). The latter was used in order to reflect the fibrinolytic activity. Preoperatively, and postoperatively on day 3, the levels of PAP were significantly higher in patients without postoperative DVT. The data suggests that patients subjected to major abdominal surgery, who have enhanced fibrinolytic activity preoperatively, have a lesser tendency to develop postoperative DVT. Patients with postoperative DVT may have decreased fibrinolytic ability. From the data of the other parameters it is concluded that patients with DVT can have increased levels of FDP at the time of development of thrombosis.

Astra Tech and Brånemark System implants: a prospective 5-year comparative study. Results after one year.

BACKGROUND: Endosseous dental implants are used frequently, and many implant systems are available. The scientific documentation of the implant system presents a great variation, and it is often difficult to compare studies of different systems. PURPOSE: The aim of this study was to compare two Swedish implant systems (Astra Tech and Brånemark System implants), in a prospective randomized study. MATERIALS AND METHODS: Sixty-six patients were equally distributed between the two implant systems; 184 Astra Tech and 187 Brånemark System implants were used. The patients have been followed annually with clinical and radiographic examinations. The results after 1 year are reported. RESULTS: The abutment procedure was found to be easier and less time-consuming with Astra Tech than with Brånemark implants. The operation times in minutes (mean +/- SEM) were for the respective implant 35 +/- 4.0 and 51 +/- 4.8 in the maxilla and 32 +/- 3.8 and 43 +/- 2.4 in the mandible. The differences in both cases were significant: p < .02 and p < .05, respectively. The failure rate for Astra Tech implants was 0.5% and for Brånemark implants 4.3%. The difference was significant (p < .05); however, taking into account that five of the eight implant losses in the Brånemark implant group occurred in one patient, an intraindividual correlation cannot be excluded. Therefore, this result should be interpreted with caution. The marginal bone level changes were examined already from the fixture installation. The major bone loss was found between fixture installation and baseline. This bone loss was several times greater than the bone loss between the baseline and the 1-year follow-up. The total bone loss during the observation period did not differ significantly between the systems, but they had different resorption patterns. The bone loss in the upper jaw between baseline and 1-year follow-up was 0.22 +/- 0.14 and 0.03 +/- 0.09 mm for the Astra Tech and Brånemark implants, respectively. In the lower jaw, the loss was -0.31 for both systems. The frequency of plaque accumulation and bleeding on probing did not differ between the implant systems. CONCLUSIONS: Abutment connection with Astra Tech implants was simpler than the corresponding surgery with Brånemark System implants and the survival rate of Astra Tech implants was higher than that of Brånemark system implants.

Imitation in autism. A preliminary research note.

Previous studies have claimed that children with autism are poor imitators and a lack of imitative capacity has been included by some investigators as one early sign of autism. Presented here are results from a pilot study focusing on observed imitation after presenting 15 tasks to five children with autism (mental age 25-51 months). Imitation tasks involving simple object manipulation, vocal responses, facial and manual gestures, and object substitution were presented to each child. The performance of the children with autism is compared with (1) three normal 4-year-old children (for all 15 tasks), and (2) observations from 28 healthy 1-year-olds (for 10 of the tasks used). The findings indicate that the autistic group displayed the highest level of imitation on object manipulation and vocal tasks while object substitution, facial, and motor imitation acts seemed to be difficult for children with autism. However, the small number of children included as well as the individual variation observed among the autistic subjects precludes any definite conclusions from these pilot observations. It is hypothesized that imitation in children with autism has to be studied separately for different domains and probably also for different subgroups within the autistic population.

Some important factors in the molding of the fetal head during vaginal delivery--a photographic study.

The molding of the fetal head was studied in 319 vaginal deliveries. A photographic method was used to document the size and form of the infants' heads immediately postpartum and 3 days later. Six different diameters were measured but only three changed significantly during early neonatal restitution. A molding index was calculated and compared with the conventional occipitofrontal circumference. Infants born by primiparous women showed significantly higher degrees of molding of the head than those born by multiparous women. Oxytocin stimulation during labor as well as instrumental deliveries resulted in increased fetal head molding. The importance of fetal presentation at birth, the duration of labor, the age of the mother and birth weight of the infant was also analyzed with regard to the molding of the fetal skull during labor.

Fine needle aspiration cytology of thymic tumors.

Cytologic material was reviewed from 23 mediastinal tumors clinically suspected as thymomas. The thymomas had a characteristic biphasic cell pattern in material obtained by fine needle aspiration biopsy that was easy to recognize and possible to differentiate from carcinoid tumors, malignant lymphomas and oat-cell carcinomas.

Gastric evacuation and propulsive intestinal motility in acute afferent loop syndrome in the rat.

The acute afferent loop syndrome, i.e. occlusion of the afferent loop after partial gastrectomy by the Billroth II method, was produced in the rat. In a primary session a gastrojejunostomy with division of the pylorus was performed. 2-3 months later the afferent loop was ligated. The gastric evacuation and the propulsive motility of the intestine were studied quantitatively, using an inert radioisotope. Both the gastric evacuation and the propulsive intestinal motility were considerably delayed in ALS, both in relation to the laparotomized controls and in relation to previous findings in mechanical intestinal obstruction and paralytic ileus due to retroperitoneal irritation or bacterial peritonitis.

Acute pancreatitis and hepatic necrosis in the acute afferent loop syndrome. A histopathological study in the rat.

The morphological changes in the liver and pancreas during the first 12 hours in the acute afferent loop syndrome were studied in rats with a Billroth II gastric resection. Two essentially different types of changes were found in the pancreas. One was a coagulative necrosis without an inflammatory reaction, which has been found after instillation of bile, bile salts and the detergent sodium lauryl sulphate into the pancreatic ducts. The other type of pancreatitis was an intense, acute purulent inflammation often with bacteria visible in the histological sections. In the liver, large areas of necrosis were often encountered, sometimes mixed with polymorphonuclear leukocytes and bacteria, in a few cases combined with thrombi in small portal veins. The changes in the pancreas occurred very rapidly; only 4 hours after occlusion of the afferent loop there were signs of pancreatitis in some cases and 12 hours after occlusion there was an acute pancreatitis in all cases.

Local inhibition of the fibrinolytic system in patients with massive upper gastrointestinal hemorrhage.

The effect or oral tranexamic acid on massive upper gastrointestinal hemorrhage was evaluated in a randomized double-blind study. Totally 50 patients entered the trial and seven were excluded, leaving 22 placebo treated and 21 tranexamic acid treated for analysis. The groups were comparable regarding sex, age, diagnosis, and initial laboratory data. Transfusions requirements and operation frequency did not differ. Mortality was slightly reduced and death delayed in tranexamic acid treated patients.

The incidence of venous thrombosis in the lower limbs following elective gallbladder surgery.

The frequency of postoperative venous thrombosis and the prophylactic effect of dextran 40 and 70 were studied in 90 otherwise healthy patients undergoing cholecystectomy. The 125-I-fibrinogen test was employed as the diagnostic method. The frequency of thrombosis was very low (1.1%) compared with other investigations on patients undergoing elective general surgery. Thus nothing can be concluded about the prophylactic effect of dextran from this series, but it can be presumed that this type of patient does not need routine prophylaxis against deep venous thrombosis.