Advances in Regional Vascular Injection Techniques for the Delivery of Stem Cells to Musculoskeletal Injury Sites.

Vascular injections of stem cells are a pertinent alternative to direct intralesional injections when treating multiple or extensive lesions or with lesions impossible to reach directly. Extensive research using stem cell tracking has shown that intra-arterial injections without the use of a tourniquet should be preferred over venous or arterial regional limb perfusion techniques using a tourniquet. The median artery is used for the front limbs and the cranial tibial artery for the hind limbs. Proper efficacy studies are still lacking but early clinical work seems promising.

Scintigraphic Tracking of Allogeneic Mesenchymal Stem Cells in the Distal Limb After Intra-Arterial Injection in Standing Horses.

OBJECTIVE: To assess the feasibility of intra-arterial administration of allogeneic mesenchymal stem cells (MSC) in the median artery of standing horses and evaluate the distribution and retention of radiolabeled cells. STUDY DESIGN: In vivo experimental study. ANIMALS: Six research horses. METHODS: Technetium(99m) -HexaMethyl-Propylene-Amine Oxime-labeled MSC were injected under ultrasound guidance in the median artery of 6 front limbs of 3 horses, standing under sedation. Scintigraphic images were obtained at the time of injection, and at 1, 6, and 24 hours postinjection. Six additional limbs from 3 horses were similarly injected with unlabeled MSC. Ultrasound was performed the following day for assessment of vascular changes. RESULTS: Intra-arterial injection was performed successfully in 11 of 12 limbs. In 1 limb, partial periarterial injection compromised the success of the procedure. Homogeneous distribution of radiolabeled MSC was observed through the entire distal limb, including within the hoof. Partial venous thrombosis was found in both groups of horses, but was subjectively less severe in horses injected with unlabeled MSC. No lameness was observed. Transient swelling of the distal limb occurred in only 1 limb. CONCLUSION: Intra-arterial injection of MSC can be performed in standing horses under sedation and successfully distribute MSC to the distal limb. A risk of periarterial injection was identified but can be reduced with proper sedation, local anesthesia, and increased experience. Partial venous thrombosis was observed as a complication, but did not cause changes of clinical importance, other than rare transient swelling.

FEASIBILITY AND SAFETY OF CONTRAST-ENHANCED ULTRASOUND IN THE DISTAL LIMB OF SIX HORSES.

Vascular alterations play important roles in many orthopedic diseases such as osteoarthritis, tendonitis, and synovitis in both human and equine athletes. Understanding these alterations could enhance diagnosis, prognosis, and treatment. Contrast-enhanced ultrasound (CEUS) could be a valuable method for evaluation of blood flow and perfusion of these processes in the equine distal limb, however no reports were found describing feasibility or safety of the technique. The goal of this prospective, experimental study was to describe the feasibility and safety of distal limb CEUS in a sample of six horses. For each horse, CEUS of the distal limb was performed after intravenous injections of 5 and 10 ml, as well as intra-arterial injections of 0.5 and 1 ml contrast medium. Vital parameters were monitored and CEUS images were assessed qualitatively and quantitatively for degree of contrast enhancement. None of the horses had clinically significant changes in their vital parameters after contrast medium injection. One horse had a transient increase in respiratory rate, and several horses had mild increases of systolic blood pressure of short duration after intravenous, but not after intra-arterial injections. Intra-arterial injection was possible in all horses and resulted in significantly improved contrast enhancement both quantitatively (P = 0.027) and qualitatively (P = 0.019). Findings from this study indicated that CEUS is a feasible and safe diagnostic test for evaluation of the equine distal limb. Future studies are needed to assess the clinical utility of this test for horses with musculoskeletal diseases.

Cerebral injury from intracarotid injection in an alpaca (Vicugna pacos).

A mixture of ketamine, xylazine, and butorphanol was inadvertently injected into the right carotid artery of a 1-year-old alpaca. Injection was followed by a brief period of recumbency and seizure activity. The alpaca recovered, but was euthanatized 72 hr later because of development of progressive neurologic deficits. Pathologic findings were confined to the right cerebrum, meninges, thalamus, and hippocampus. Cerebrocortical edema with astrocytic reaction, perivascular hemorrhage and neutrophilic infiltration, and fibrinoid necrosis of vasculature within the meninges and thalamus were the most prominent lesions. Neuronal necrosis was mild. Astrocytic reaction within the right cerebral cortex was confirmed with immunohistochemistry for glial fibrillary acidic protein.

Pilot study comparing serum chemotherapy levels after intra-arterial and intravenous administration in dogs with naturally occurring urinary tract tumors.

The proposed advantages of intra-arterial chemotherapy (IAC) are based on the premises of local dose escalation to the tumor and reduced availability of systemic drugs. There is a lack of objective pharmacokinetic data to confirm the advantage of IAC in dogs with naturally occurring urogenital tumors. The objective of this study was to determine if IAC administration in urogenital tumors would result in decreased systemic drug exposure when compared to intravenous routes. Twenty-two dogs with naturally occurring urogenital tumors were enrolled in this prospective case-controlled study. Mitoxantrone, doxorubicin, or carboplatin were administered by IAC and intravenous routes [intravenous awake (intravenous chemotherapy - IVC) and under general anesthesia (IVGAC)] 3 weeks apart. Serum assays were used to determine the extent of systemic drug exposure. Dose-normalized peak systemic serum concentration (Cmax) and area under the serum drug concentration-time curve (AUC) were used to quantify systemic exposure. A total of 26 mitoxantrone treatments were administered to 10 dogs. While there was no significant difference in Cmax, the AUC was significantly lower after IAC compared with IVGAC. Ten doxorubicin treatments were administered to 5 dogs. There were no significant differences in Cmax or AUC. A total of 14 carboplatin treatments were administered to 7 dogs. The Cmax was significantly lower for IAC compared to IVC, while the AUC values were equivocal. This study demonstrates certain lower serum values may be achieved after IAC delivery of carboplatin and mitoxantrone. These chemotherapy agents may have a preferred pharmacological profile for regional chemotherapy delivery in dogs with urogenital tumors.

Les avantages proposés de la chimiothérapie intra-artérielle (CIA) sont basés sur les prémisses d'une escalade de la dose locale à la tumeur et d'une disponibilité réduite des drogues systémiques. Il y a un manque de données pharmacocinétiques objectives pour confirmer l'avantage de l'administration de CIA chez les chiens avec des tumeurs urogénitales se produisant naturellement. L'objectif de la présente étude était de déterminer si l'administration de CIA lors de tumeurs urogénitales résulterait en une diminution de l'exposition systémique aux drogues lorsque comparé aux voies intraveineuses. Vingt-deux chiens avec des tumeurs urogénitales d'occurrence naturelle participèrent à cette étude cas-témoin prospective. De la mitoxantrone, de la doxorubicine, ou de la carboplatine furent administrées par CIA et voies intraveineuses [intraveineuse éveillée (chimiothérapie intraveineuse ­ CIV) et sous anesthésie générale (CIVAG)] à 3 sem d'intervalle. Des analyses du sérum furent utilisées afin de déterminer l'étendue de l'exposition systémique aux drogues. Le pic de la concentration sérique systémique normalisé pour la dose (Cmax) et la surface sous la courbe de la concentration sérique de la drogue-temps (SSC) furent utilisés pour quantifier l'exposition systémique. Un total de 26 traitements à la mitoxantrone fut administré à 10 chiens. Bien qu'il n'y ait pas de différence significative dans le Cmax, la SSC était significativement plus basse après la CIA comparativement à la CIVAG. Dix traitements de doxorubicine furent administrés à cinq chiens. Il n'y avait pas de différence significative dans le Cmax ou ls SSC. Un total de 14 traitements de carboplatine fut administré à sept chiens. Le Cmax était significativement plus bas pour la CIA comparativement à la CIV, alors que les valeurs de SSC étaient équivoques. Cette étude démontre que certaines valeurs sériques plus faibles peuvent être obtenues après CIA avec la carboplatine et la mitoxantrone. Ces agents de chimiothérapie pourraient avoir un profil pharmacologique préférentiel pour livraison régionale de chimiothérapie chez les chiens avec des tumeurs urogénitales.(Traduit par Docteur Serge Messier).

Evaluation of two combinations of Domitor, Zoletil 100, and Euthatal to obtain long-term nonrecovery anesthesia in Sprague-Dawley rats.

We sought to evaluate a new protocol designed to maintain long-term, nonrecovery, surgical anesthesia in Sprague-Dawley rats. In the first phase, two groups of rats were anesthetized with two different dose combinations of Domitor (medetomidine) and Zoletil 100 (tiletamine-zolazepam) to investigate their efficacy in induction of anesthesia. One combination comprised Domitor at 35 microg/kg and Zoletil 100 at 40 mg/kg, whereas the other comprised Domitor at 50 microg/kg and Zoletil 100 at 20 mg/kg. Both combinations effectively induced deep anesthesia and caused no mortality, but the duration of anesthesia differed statistically. In the second phase, we induced anesthesia with both Domitor-Zoletil 100 dose combinations then investigated the possibility of maintaining anesthesia for 5 h by administering Euthatal (pentobarbitone) intra-arterially at 10 mg/kg hourly. Depth of anesthesia, mortality, physiological parameters, blood gas analysis, hematology, clinical chemistry, and postmortem histopathology were recorded. Euthatal provided stable long-term anesthesia with both dose combinations of Domitor-Zoletil 100. Seven of 8 (88%) animals anesthetized with Domitor at 50 microg/kg and Zoletil 100 at 20 mg/kg successfully were maintained under deep anesthesia for 5 h. Higher mortality (36% versus 12%) occurred in group of animals treated with Domitor at 35 microg/kg and Zoletil 100 at 40 mg/kg. This difference may be linked to dose-related respiratory depression, as alterations of arterial gas levels were noted. Our findings suggest that, when long-term nonrecovery anesthesia is required, doses of 50 microg/kg Domitor and 20 mg/kg Zoletil 100 are preferable when given with Euthatal to maintain physiological conditions in animals.

Ultrasound-guided injection of the median artery in the standing sedated horse.

REASONS FOR PERFORMING STUDY: Injection of the median artery of horses leads to better distribution and persistence of mesenchymal stem cells than i.v. regional limb perfusion. Due to technical difficulties, intra-arterial injections thus far have only been performed under general anaesthesia. OBJECTIVES: To assess the feasibility of injection of the median artery in standing sedated horses. STUDY DESIGN: Experimental study. METHODS: Six horses were included in the study. After median and ulnar regional analgesia, radiographic contrast material was injected in the median artery of both front limbs, using a catheter in one limb and a direct needle injection in the other. Ultrasound guidance was used for catheter and needle placement. Radiographs were obtained for confirmation of successful injection. Post procedural ultrasound examination was performed to assess vascular compromise. RESULTS: Catheter placement was successful in all 6 limbs, but in one limb injection was not possible due to arterial spasm. Movement of the limbs after the initial injection resulted in loss of functionality of the catheter in 2 other horses. Direct needle injection was successful on all 6 limbs, with periarterial extravasation observed in 2 limbs. No clinical complications were observed. CONCLUSIONS: Injection of the median artery can be performed in standing horses under sedation. Direct needle injection is a more practical technique than catheterisation, as it is easier to perform and less likely to induce arterial spasm. Periarterial extravasation remains a possible limitation of the technique. Intra-arterial injections may be useful for administration of therapeutic agents such as mesenchymal stem cells on standing sedated horses.

Suppressive action of gonadotropin-releasing hormone and luteinizing hormone on function of the developing ovine corpus luteum.

Experiments were conducted to examine the effects of exogenous GnRH and LH on serum concentrations of progesterone (P4) in the ewe. Ewes in Exp. 1 and 2 were laparotomized on d 2 of an estrous cycle and ewes with corpora lutea (CL) in both ovaries were unilaterally ovariectomized. Ewes with CL in one ovary only were not ovariectomized. While they were anesthetized, ewes (n = 5) were injected with 25 micrograms GnRH (Exp. 1) or 50 ng GnRH (Exp. 2) into the artery supplying the ovary bearing the CL. Control ewes (n = 5 in each experiment) were injected similarly with saline. In Exp. 3, six ewes were injected i.v. (jugular) on d 2 with 100 micrograms oLH (t = 0) and 50 micrograms oLH at 15, 30 and 45 min; six control ewes were injected similarly with saline. Jugular blood was collected from all ewes at frequent intervals after treatment for LH analysis and on alternate days of the cycle through d 10 or 11 for P4 analysis. Treatment with 25 micrograms GnRH increased serum concentrations of LH at 15, 30, 45 and 60 min postinjection (P less than .001) and reduced serum concentrations of P4 on d 7 through 11 (treatment x day interaction; P less than .05). Injection with 50 ng GnRH caused a slight increase in serum concentrations of LH at 15 min but had no effect on serum concentrations of P4.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of porcine growth hormone on glucose metabolism of pigs: I. Acute and chronic effects on plasma glucose and insulin status.

The acute and chronic effects of porcine growth hormone (pGH) administration on glucose homeostasis of pigs were investigated in the present study. Twelve Yorkshire barrows (average BW = 65 kg) fitted with femoral artery catheters were allotted to three groups. Pigs received acute, intra-arterial injections of either pituitary pGH, a recombinantly derived pGH analog (ppGH or rpGH, 100 micrograms/kg BW) or saline. Acute injection of pGH did not affect fasting plasma glucose or insulin status. Pigs then were treated daily by i.m. injection for 24 d with 70 micrograms ppGH/kg BW. Serum glucose and insulin concentrations during the fed and fasted states were higher in pGH-treated than in control pigs. On d 25, an acute intra-arterial injection of ppGH (100 micrograms/kg BW) elicited increases in plasma glucose and insulin in pigs chronically treated with pGH. The area circumscribed by the glucose and insulin response curves 5 min to 7 h postinjection was 40% (P less than .005) and 177% (P less than .001), respectively, higher in ppGH-treated than in control pigs. These data indicate that pGH does increase plasma glucose and insulin in the fed and fasted states; however, this response is only observed after chronic pGH administration. In addition, pGH is capable of increasing plasma glucose and insulin acutely in the pig. This effect, however, only is observed in pigs treated chronically with pGH. The mechanisms by which pGH elicit these effects on glucose homeostasis are not known.

Action of epinephrine on the function of the teat sphincter in the lactating cow.

Under continuous IV infusion of oxytocin, milk leakage was elicited in 6 lactating cows with full udders by induction of a vacuum (-30 cm of water) around 1 mammary papilla (teat) with a plethysmographic apparatus. The volumes of milk loss were measured every minute. Epinephrine injected either into the jugular vein (20, 100, and 500 micrograms) or into the external pudic artery (1.5, 7.5, and 37.5 micrograms) induced an increase in milk leakage in 5 cows. This effect could be antagonized by the beta-blocking agent sotalol hydrochloride (0.5 to 4 mg) injected into the external pudic artery. In 1 cow, however, epinephrine given intra-arterially exerted a biphasic effect, small doses inducing stimulation, and large doses evoking inhibition of milk loss. The stimulating effects were blocked by sotalol (2 mg). The inhibiting effects were antagonized by the alpha-blocking agent prazosin (2 mg).

Injection technique and scanning electron microscopic study of the arterial pattern of the 20 gestation days (G20) rat fetus.

A technique to obtain microvascular corrosion casts of the G20 rat fetus and the normal pattern of the main arteries of the G20 rat fetus are described. The casts were studied by means of scanning electron microscopy (SEM). The arterial pattern is similar to that described in the adult; however, several variations have been found. It is concluded that the use of vascular corrosion casts studied by SEM may be particularly helpful to observe the extremely small arteries of rat fetuses. Moreover, we suggest that this technique may be useful in practical teratological studies.

Evaluation of cisplatin-induced emesis in dogs with malignant neoplasia: 115 cases (1984-1987).

A retrospective review of the records of 115 dogs with 13 types of malignant tumors was performed in an attempt to identify factors that influence the degree of emesis observed within 24 hours after cisplatin therapy. Six groups were established on the basis of dosage of cisplatin and on the route of administration: 10 mg/m2 IV (n = 17), 40 mg/m2 IV (n = 10), 50 mg/m2 IV (n = 19), 60 mg/m2 IV (n = 7), 70 mg/m2 IV (n = 36), and 70 mg/m2 intra-arterially (IA; n = 26). Age, gender, weight, dose of cisplatin, route of administration (IV vs IA), and duration of infusion were evaluated. Increasing doses of cisplatin (P less than 0.01) and the IV route of drug administration (P less than 0.0006) were associated with an increased occurrence of vomiting in response to the first treatment. Anesthesia, performed in dogs that were given cisplatin IA, was a confounding variable that may have reduced the emetic potential of the drug after the dogs were awakened. If the dog vomited in response to the first treatment, there was a greater tendency to vomit after subsequent cisplatin treatments (P = 0.08). Multivariable analysis, after correcting for the effects of age, gender, and weight, indicated that high doses of cisplatin (P less than 0.001) and lower weight of the dog (P less than 0.04) were significantly associated with an increased likelihood of vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)

Successful treatment of retained placenta with umbilical cord injections of collagenase in cows.

Fetal membranes usually are released from the uterus between 2 and 6 postpartum hours. However, in a substantial percentage of cows (11%), fetal membranes are retained for several days. In part, failure of collagen breakdown seems to be related to retention of fetal membranes. Injections of 200,000 U of bacterial collagenase in 1,000 ml of physiologic saline solution via umbilical arteries (1 or 2) between 24 and 72 hours of retention caused release of retained fetal membranes in 23 of 27 cows (85%) with noninduced retained fetal membranes and in 10 of 14 cows (71%) with experimentally induced retained fetal membranes, within 36 hours after injection. Controls (n = 36) did not release retained fetal membranes within this time. Injections of collagenase via a jugular vein (2.2 x 10(6) U in 1,000 ml of physiologic saline solution), administered over a 30-minute period, caused release of retained fetal membranes within 36 hours in 3 of 6 cows with experimentally induced retained fetal membranes. Clinical complications did not follow treatments with collagenase. Umbilical injections of bacterial collagenase were highly effective in the treatment of retained fetal membranes in cows. The procedure is simple, safe, affordable, and can be completed in 25 minutes.

Review: reticuloruminal motility--a pharmacological target with a difference?

The vagal sensory inputs to and motor outputs from the hindbrain gastric centres required for reticuloruminal motility were sampled directly in anaesthetized sheep using electrophysiological 'single fibre' techniques and indirectly in conscious, surgically prepared sheep. Drugs were administered by close-arterial injection into a carotid artery to observe central effects and into the coeliac artery to observe peripheral effects on the reticulorumen. Escherichia coli lipopolysaccharide produced intermediates responsible for the smooth muscle relaxation in the first phase of reticuloruminal stasis and for gastric centre depression in the second phase. Adrenergic influences on reticuloruminal motility comprise (a) an alpha1 adrenoreceptor-induced contracture and raised tension receptor sensitivity, (b) an alpha2 adrenoreceptor-mediated depression of the gastric centres causing stasis, excitation of epithelial receptors evoking rumination, and interference with acetylcholine release in the parasympathetic pathway, (c) abeta1 adrenoreceptor-mediated inhibition of the gastric centres, and (d) abeta2 adrenoreceptor-mediated inhibition of intrinsic and extrinsic motility.

Effect of injecting collagenase into the uterine artery during a caesarean section on the placental separation of cows induced to calve with dexamethasone.

A caesarean section was performed on 30 cows before normal term and 16 to 20 hours after the induction of parturition with dexamethasone. During the surgical procedure, 20,000 U of bacterial collagenase was injected into the uterine artery of 15 of the cows. The average periods of retention of the fetal membranes were 40 hours in the treated cows and 114 hours in the control cows (P<0.001). At 36 hours after the surgery six of the treated cows (40 per cent) but all 15 of the control cows had retained fetal membranes. The collagenase-treated cows showed no abnormal clinical signs during the 10 days after the operation.

[The arthrographic presentation of the hip, knee and tarsal joints of the cat]. / Beitrag zur arthrographischen Darstellung von Hüft-, Knie- und Tarsalgelenk der Katze.

The purpose of the present paper was to find out the most suitable localizations to puncture of hip, stifle and hock joints of the domestic cat. These joints are arthrographically presented. Further six contrast mediums in normal commercial usage were tested with regard to there contrast intensity. The only recommendable localization to arthrocentesis of the hip joint is at the cranial border of the greater trochanter of the femur. The stifle joint is approachable either at the medial or lateral border of the Lig. patellae. To puncture the proximal row of the hock joint the recommendable puncture site was found distal of the lateral malleolus between the tendons of the lateral digital extensor muscle and m. extensor digitorum longus. Any arthrocentesis of the distal row of the hock joint isn't recommendable. Contrast mediums with a iodine concentration below 300 mg/ml were not sufficient for arthrography.

Novel microcatheters for selective intra-arterial injection of fluid in the rat brain.

BACKGROUND AND PURPOSE: The internal carotid artery (ICA) in the rat has a single extracranial branch, which supplies the muscles of mastication. The rat ICA also has multiple intracranial branches including (from proximal to distal): multiple small perforating arteries which supply the hypothalamus and the anterior choroidal artery which supplies the choroid plexus and part of the basal ganglia. At the ICA terminus, the vessel bifurcates into the anterior and middle cerebral arteries. The purpose of this study was to demonstrate selective injection of ICA branches in the rat. MATERIALS AND METHODS: Microcatheters (mucath1 and mucath2) were fabricated by plugging the tip of 169-mum outer diameter polyimide tubing and perforating the sidewalls. A 450-mum polydimethyl-siloxane cylinder was affixed to the distal tip of mucath2 but not mucath1. We evaluated the territory of mucath1 injection ex vivo using magnetization-prepared rapid acquisition of gradient echo MR imaging of brain specimens injected at necropsy. Territories of mucath1 and mucath2 injection were evaluated in vivo with dynamic susceptibility-weighted contrast-enhanced MR imaging. The territory of mucath2 also was evaluated in vivo with fused static microPET/T1 MR images performed after [(18)F] fluorodeoxyglucose ((18)FDG) injection. We evaluated additional catheterized and injected animals at 48 hours using physical examination, T2 MR images, and postmortem brain histologic specimens. RESULTS: Gadolinium-diethylene-triamine pentaacetic acid (Gd-DTPA) and (18)FDG injected through mucath1 selectively opacified the ipsilateral cerebral hemisphere, with no contralateral opacification. Gd-DTPA injected through mucath2 selectively opacified the territories of the hypothalamic perforating arteries, and anterior choroidal artery. There was no iatrogenic complication 48 hours after 20- to 25-minute injections performed with mucath1 or mucath2. CONCLUSIONS: We have developed 2 microcatheters which can be placed in the ICA for selective injection of its branches. One microcatheter selectively injects the ipsilateral cerebral hemisphere. The other selectively injects only the hypothalamus and lateral thalamus.

Cardiovascular actions of rattlesnake bradykinin ([Val1,Thr6]bradykinin) in the anesthetized South American rattlesnake Crotalus durissus terrificus.

Incubation of heat-denatured plasma from the rattlesnake Crotalus atrox with trypsin generated a bradykinin (BK) that contained two amino acid substitutions (Arg1 --> Val and Ser6 --> Thr) compared with mammalian BK. Bolus intra-arterial injections of synthetic rattlesnake BK (0.01-10 nmol/kg) into the anesthetized rattlesnake, Crotalus durissus terrificus, produced a pronounced and concentration-dependent increase in systemic vascular conductance (Gsys). This caused a fall in systemic arterial blood pressure (Psys) and an increase in blood flow. Heart rate and stroke volume also increased. This primary response was followed by a significant rise in Psys and pronounced tachycardia (secondary response). Pretreatment with N(G)-nitro-L-arginine methyl ester reduced the NK-induced systemic vasodilatation, indicating that the effect is mediated through increased NO synthesis. The tachycardia associated with the late primary and secondary response to BK was abolished with propranolol and the systemic vasodilatation produced in the primary phase was also significantly attenuated by pretreatment, indicating that the responses are caused, at least in part, by release of cathecholamines and subsequent stimulation of beta-adrenergic receptors. In contrast, the pulmonary circulation was relatively unresponsive to BK.