Neurologic, psychiatric, and cardiovascular complications in children struck by lightning.

The neurologic changes following lightning injury include coma with cerebral edema, inappropriate secretion of antidiuretic hormone (ADH), seizures, cerebellar ataxia, and painful sensory disturbances. Deteriorating neurologic status may warrant the use of intracranial pressure monitoring devices. Myocardial injury and transient hypertension are generally evident at the onset. Monitoring of the cardiac rhythm may be needed for as long as a week for late onset arrythmia. Abnormalities of memory, mood, and affect noted on recovery of consciousness may persist for months, necessitating close psychiatric and neurlologic follow-up.

Effect of long-term aspirin treatment on platelet adhesion to chronically damaged canine pulmonary arteries.

The effect of aspirin on platelet adhesion to chronically damaged pulmonary arteries was studied in 18 dogs. Chronic injury was produced in all dogs by infection with the canine heartworm Dirofilaria immitis (DI). Ten dogs were subjected to 4 days of chronic injury. Eight dogs were subjected to 30 days of chronic injury. Five of the 4 day injury and 4 of the 30 day injury dogs received aspirin daily; (325 mg/day orally). Aspirin was started 3 days prior to infection with DI. Pulmonary arteries were perfusion fixed in situ at physiologic pressure. The damaged pulmonary arteries were located by Evan's blue staining (2 ml/kg of 1% dye given one hr prior to perfusion) and prepared for scanning electron microscopy. Both groups of dogs with 4 day DI infection had monolayers of platelets adhered to exposed subendothelium. Aspirin treated dogs had enhanced platelet adhesion to damaged arteries. Aspirin treatment for 33 days reduced platelet adhesion. The damaged arteries of treated dogs infected with DI for 30 days had very few platelets adhering to the damaged surface. However, non-treated dogs subjected to 30 days of infection had platelet adhesion equivalent to the 4 day non-treated infection group. These results suggest that although aspirin is ineffective in preventing platelet adhesion in short term therapy it is effective when given for longer time periods. This inhibitory effect may occur due to platelet membrane changes rather than because of aspirin inhibition of cyclooxygenase.

Smooth muscle proliferation in chronically injured canine pulmonary arteries is reduced by a potent platelet aggregation inhibitor U-53,059.

Dirofilaria immitis (DI) infection chronically injures canine pulmonary arteries. This injury produces endothelial cell loss, platelet/leukocyte adhesion, and smooth muscle proliferation. In the present study we assessed the effect of the cyclooxygenase inhibitor, U-53,059, on platelet function, platelet kinetics, coagulation, and smooth muscle proliferation in DI infected dogs. Platelet aggregation to the combination of arachidonic acid/ADP was significantly inhibited by U-53,059. Coagulation and hematologic parameters were not effected by either DI infection or U-53,059 treatment. Platelet survival and the number of platelet dense granules were reduced in DI infection. Quantification of the lesions demonstrated that U-53,059 reduced both severity and density compared to non-treated dogs. U-53,059 is a potent and effective inhibitor of platelet aggregation which modifies smooth muscle proliferation produced by chronic vascular injury.

Prolonged perfusion with a membrane oxygenator in awake ponies.

Prolonged extracorporeal membrane oxygenation (PEMO) was performed in 6 adult ponies with the membrane oxygenator in vein-to-artery bypass circuit. A flow rate equal to 46 per cent of control cardiac output was diverted through the PEMO circuit of 10 to 24 hours. Three of the 6 ponies were perfused for at least 20 hours and developed no complications. Immediately following initiation of PEMO, left ventricular output decreased; however, in the interval between 6 and 24 hours, left ventricular output was increased above control levels. Aortic pressure and left ventricular work were markedly elevated during PEMO. Pulmonary ventilation and oxygen uptake also decreased initially but were elevated during later stages of bypass. Pulmonary compliance did not change, except in those studies in which problems were encountered with perfusion techniques. Hepatic glycolysis and hyperglycemia occurred and were more severe in ponies with catheter-produced thrombi. Marked diuresis, which could be attributed only partially to the hyperglycemia, was present throughout PEMO. Based on the minimal morphologic changes observed in the ponies, extracorporeal circulation diverting one half of the cardiac output through a membrane oxygenator can be safely performed for up to 24 hours.

Development of a molecular probe to baboon interleukin-10 mRNA for in situ hybridization during experimental schistosomiasis.

A nucleic acid probe complementary to baboon interleukin 10 (IL-10) mRNA was developed for in situ hybridization. Highly conserved IL-10 protein sequences from several mammals were aligned to design oligonucleotide primers flanking a 270-bp sequence of the target cDNA. RNA was isolated from stimulated peripheral blood mononuclear cells (PBMC). IL-10 cDNA was reverse-transcribed from the total PBMC RNA and amplified with the polymerase chain reaction (PCR). Cloning and sequencing of the PCR product confirmed it to be of baboon IL-10 origin, with 97.8% identity to human and 100% identity to macaque mRNA sequences. The baboon IL-10 DNA probe hybridized in Southern blots to a 7.9-Kbp or 8.6-Kbp band after digestion of genomic baboon DNA with Bam H1 or Eco R1, respectively. Preliminary results with an antisense riboprobe derived from this sequence showed the presence of IL-10 mRNA in sections of granulomatous tissues.

Tumor necrosis factor production in cats in response to lipopolysaccharide: an in vivo and in vitro study.

Supernatants from feline peritoneal exudate cells (PECs) exposed to lipopolysaccharde (LPS) produced significantly (P < 0.05) more tumor necrosis factor (TNF) activity than supernatants from cells exposed to media. An in vitro LPS response was obtained following incubation of whole blood with 10 micrograms ml-1 LPS for 2 h. Intravenous infusion of LPS (750 micrograms kg-1 rapidly increased plasma TNF activity to a maximum at 60 min after initiation of LPS infusion. By 180 min, TNF activity returned to baseline. Cats produce TNF in response to LPS in a manner similar to other species. Measurement of TNF activity in plasma or in LPS-stimulated whole blood are methods to further characterize the inflammatory response in feline diseases.

Video-assisted percutaneous cystoscopy of the bladder and prostatic urethra in the dog: new approach for visual laser ablation of the prostate.

A new minimally invasive approach for video laparoscopy was developed to access the bladder and prostatic urethra of the dog in order to perform laser ablation of the prostate without using either an open laparotomy or urethrostomy. During general anesthesia, a 10-mm laparoscope was introduced into the peritoneal cavity. Under direct vision, the bladder was distended, and trocars were placed percutaneously by two different methods. A 22F cystoscope was introduced through the transcystic trocar into the prostatic urethra for visual laser ablation of the prostate (VLAP). In all eight dogs, the video-assisted technique for percutaneous access to the prostatic urethra was successful. No complications were associated with placement of the Veress needle, creation of the pneumoperitoneum, or accessing of the bladder lumen and proximal urethra. The visibility in the peritoneal cavity was excellent, and hemorrhage was minimal in all cases. In two dogs, a laparotomy was performed after displacement of the cystoscope from the urinary bladder. Irrigation fluid for the cystoscope drained primarily around the trocar cuff surrounding the instrument. In one case, the irrigation fluid drained around the trocar in the bladder and filled the peritoneal cavity.

Serial laparoscopic biopsies of liver and spleen from Schistosoma-infected baboons (Papio spp.).

PURPOSE: To obtain large, serial biopsy samples from the liver and spleen by using laparoscopy. Large samples were needed for measurement of inflammatory mediators during various stages of schistosomiasis. METHODS: Each of the seven female baboons (Papio sp.) underwent as many as three laparoscopies, for a total of 19 laparoscopic procedures. This process permitted sampling of the liver, spleen, and mesenteric lymph nodes before and at 6 and 9 weeks after infection with Schistosoma mansoni. All surgery was performed through three trocar sites. Postoperative care included preemptive analgesia. After surgery, we monitored the animals' appetite and measured the core body temperature and activity by using implanted radiofrequency transmitters. RESULTS: We obtained samples of the liver and splenic biopsies during all 19 laparoscopic procedures. The mean weight of the liver biopsies was 3.7 g and that of the spleen samples was 5.3 g. We encountered small adhesions during 5 of the 12 reoperations. Eating and activity rapidly returned after surgery. CONCLUSIONS: Laparoscopy permitted collection of large, serial biopsies with apparently limited stress to the animals. Laparoscopy can be used for biopsies in studies to characterize disease response, confirm normal organ histology prior to drug toxicity studies, determine target-organ drug concentrations in pharmacokinetic studies, and measure drug residues. This refinement likely will reduce required animal numbers by decreasing the effect of surgery compared to that of the experimental conditions, enhance animal well-being, and permit repeated measurements in an animal that serves as its own control.

The fecundity of Schistosoma mansoni in chronic nonhuman primate infections and after transplantation into naive hosts.

Adult Schistosoma mansoni worms were transplanted from 8 nonhuman primates with chronic infections into 8 naive recipients, in an effort to test the hypothesis that worm fecundity reduction in chronic infections is the result of host immunity or some other host effect. Techniques for perfusing living donors without the added use of anti-schistosomal drugs and for reducing the likelihood of post-operative bacterial endotoxemia and septic shock are described. Fecundity values in terms of eggs per day per female worm were obtained for the worms in their original and in their new hosts and compared. In 3 experiments, perfusions were incomplete and the donors were saved, enabling direct comparisons of fecundity to be made in subpopulations of worms in both their original and new hosts, after equal life spans. In only 1 of the 8 transplantations was there a clear increase in fecundity after surgical introduction into a naive host. Therefore, these experiments fail to support the hypothesis that reduced fecundity of S. mansoni worms in permissive nonhuman primate hosts is a reversible result of host immunity or some other host-derived factor. Despite this negation, further evidence for reduced worm fecundity in older infections was obtained. In the absence of in vivo evidence for immune-mediated antifecundity, worm senescence is the most likely explanation for this finding, with irreversible immune damage to the worms being a less attractive alternative hypothesis.

Long term comparison of fresh arterial allografts and autografts for coronary artery bypass in dogs.

Femoral artery grafts were anastomosed end-to-end to the left internal mammary artery proximally and end-to-side to the circumflex coronary artery distally in 21 adult mongrel dogs. Fourteen dogs received allografts and seven received autografts. All autografts studied from one to 11 months were patent. Eleven of the fourteen homografts studied from one to thirteen months were occluded. Histologically, extensive interstitial edema and leukocytic infiltration with subintimal fibrosis and thrombotic occlusion were seen. This study shows that fresh arterial autografts have excellent long term patency, but that most arterial allografts have early thrombotic occlusion.

Pulmonary arteriography and hemodynamics during feline heartworm disease. Effect of aspirin.

The ability of aspirin to block arterial disease and thromboembolism of the pulmonary arteries was studied in heartworm-infected cats. Three groups of cats were transplanted with four heartworms per cat and studied. One group of eight cats (aspirin group) received aspirin (97.5 mg, twice a week) for the five-month infection and another group of eight cats served as the nontreated control group (nontreated group). Based upon the results of the first two groups, the third group (adjusted aspirin group) of six cats was studied in which the aspirin dosage was adjusted in order to maintain an inhibition of in vitro platelet aggregation. Cats were studied by nonselective pulmonary arteriograms before heartworm transplantation and by selective arteriograms, aortograms, and pulmonary hemodynamics five months after heartworm transplant. Pulmonary hypertension, (mean pulmonary artery pressures greater than 16 mmHg), was discovered in three cats with one cat in each group. There were no differences in the mean pulmonary artery pressure or vascular resistance between the groups. Many of the arterial diameters for the nontreated and aspirin groups were greater after the five-month infection than before heartworm infection. All of the postinfection caudal arteries were tortuous and had aneurysms. Some of the caudal lung lobes had perfused areas that appeared to have a hypervascular microvasculature. The proportion of obstructed right and left distal caudal pulmonary arteries and the resulting nonperfused area of the caudal lung lobe in the nontreated and aspirin treated groups were each greater than in the adjusted aspirin group.(ABSTRACT TRUNCATED AT 250 WORDS)

Morphologic changes in the lungs of cats experimentally infected with Dirofilaria immitis. Response to aspirin.

The morphologic response of the pulmonary arteries and lungs in cats was studied after a five month heartworm infection produced by transplantation of four adult heartworms/cat. One group of seven heartworm infected cats was not treated, another group of seven cats was treated with 97.5 mg of aspirin given twice a week, and the third group of six cats was given aspirin at a sufficient dosage to block in vitro platelet aggregation throughout the study. A fourth group of eight noninfected cats served as controls. Five months after heartworm infection, the cats were euthanized and the lungs perfusion fixed for light microscopy and scanning electron microscopy of the pulmonary arterial surfaces. All cats in the three heartworm-infected groups had live heartworms and the typical pulmonary arterial changes of heartworm disease at necropsy. The arterial surfaces, as viewed with scanning electron microscopy, had villus proliferations that were more numerous and exuberant than similar infections in dogs. Mean percentage of arterial surface involvement with villus proliferation of the nontreated heartworm infected cats was 67.3%; the aspirin treated cats, 73.8%; and the adjusted aspirin treated cats, 75.9%. The villi were myointimal proliferations in the small and medium-sized arteries. The more elastic arteries had a predominance of fibromuscular proliferation. All heartworm infected cats had arterial muscular hypertrophy of the small arteries, in contrast to only three of eight of the nonheartworm infected cats. The caudal lobar arteries were frequently obstructed with either villus proliferation, thrombi, and/or dead heartworms. The muscular arteries had branches with marked dilation, a condition associated with pulmonary hypertension in man. However, only three cats, one in each group, had pulmonary hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Efficacy of azathioprine versus cyclosporine on kidney graft survival in transfused and nontransfused unmatched mongrel dogs.

Sixteen mongrel dogs had bilateral nephrectomy and received a renal allograft from an unmatched mongrel. One group of eight dogs was treated orally with azathioprine and prednisone; another group of eight dogs was treated orally with cyclosporine and prednisone. Four dogs of each group received four blood transfusions each prior to surgery. Mean survival time was nearly the same in the azathioprine-treated and the cyclosporine-treated dogs. Transfusions prolonged survival in the azathioprine-treated group but not in the cyclosporine-treated group. Retrospective measurement of whole blood trough cyclosporine concentrations indicated marked variation between dogs and in the same dog at different times. This variation may have influenced graft survival. Only one dog survived the 9-month period of observation, indicating that refinements of the techniques used in this study will be required for long-term survival of renal allografts in unrelated mongrel dogs.

Acute response of pulmonary blood flow and right ventricular function to Dirofilaria immitis adults and microfilaria.

Pulmonary arterial pressures, right ventricular pressures, and right ventricular force of contraction (max dP/dt) were measured before and after the surgical addition of Dirofilaria immitis adults and microfilaria. Six adult anesthetized and heparinized dogs were studied during thoracotomy to compare these pressure measurements with left caudal pulmonary arterial flow. Diversion of pulmonary flow was performed to obtain incremental increases in pulmonary flow through the left caudal lobar artery and to increase right ventricular afterload. The addition of adult heartworm disease, microfilaria, or both did not produce either pulmonary arterial hypertension or increase right ventricular pressure and force of contraction.

Cardiopulmonary function in the dog with Dirofilaria immitis infection: during infection and after treatment.

Cardiopulmonary function in seven Beagles (under pentobarbital anesthesia) was determined before they were inoculated with Dirofilaria immitis larvae, at 6 and at 12 months after 50 infective larvae were inoculated, and at 7 and 12 months after adulticide and microfilaricide treatment was begun. Pulmonary hypertension (26.4 mm of Hg +/- 3.5 (SD)) was present at 12 months after the dogs were inoculated, as compared with base-line pulmonary arterial pressure (16.0 mm of Hg +/- 2.4), and was resolved within 7 months after initial adulticide treatment (19.8 mm of Hg +/- 1.4). Pulmonary artery pressure response to hypoxia (33.3 mm of Hg +/- 2.4) at 12 months after inoculation (vs base line of 25.3 mm of Hg +/- 2.2) and to isoproterenol infusion (37.6 mm of Hg +/- 4.8) at 12 months (vs base line of 14.3 mm of Hg +/- 1.7) revealed an accelerated pulmonary hypertensive response. This pulmonary hypertensive response to isoproterenol infusion (17.7 mm of Hg +/- 1.4) at 7 months after treatment resolved following treatment. The pulmonary hypertensive response to hypoxia was still present (32.5 mm of Hg +/- 3.0) 7 months after treatments. Resolution of pulmonary hypertension reinforces the clinical decision to treat dirofilariasis in an effort to prevent further development of pulmonary hypertension, as well as to permit resolution of this clinical sign.

Exercise in the dog with Dirofilaria immitis infection.

Cardiopulmonary function in Beagles that had been infected 18 months previously with 100 infective Dirofilaria immitis larvae was studied before and after an exercise program. The treadmill exercise program lasted for 2.5 months at 5 days per week until the dogs were running for 20 minutes at 11.3 km/hr up a 9% grade. Although the Beagles had mild pulmonary hypertension (mean pulmonary arterial pressure before training of 26.8 +/- 2.2 [SD] mm of Hg) and radiographic signs of cardiopulmonary disease, the dogs tolerated the program without signs of congestive heart failure or further development of pulmonary hypertension. Pulmonary arterial pressure was not increased during the 20-minute exercise period when measured at the completion of the 10-week exercise program.

Coronary arterial anatomy of the small pony.

Ventricular weights and coronary arterial distribution and diameters were determined in 10 small adult ponies (139 +/- 32 kg). Combined ventricular weights averaged 0.52% of the body weight, with an average of 77% of the total ventricular weight being the left ventricle. The pony is right coronary predominant, with the interventricular subsinusoidal branch of the right coronary artery and interventricular paraconal branch of the left coronary artery providing comparable blood supply to the left ventricular free wall and septum.

Right ventricular enlargement in heartworm disease.

The size of the right ventricle of 15 dogs with spontaneous Dirofilaris immitis microfilaria was evaluated by thoracic radiography, electrocardiography, and right ventricular free wall weights. Based on electrocardiography and right ventricular weights, none of the 15 dogs had evidence of right ventricular hypertrophy. Based on radiography, only 2 of the 15 dogs had right ventricles of normal size. Right ventricular dilation in the absence of right ventricular hypertrophy was demonstrated. The right ventricle appears to dilate, prior to hypertrophy, in response to D immitis infestation.

Renal clearance and excretion of endogenous substances in the small pony.

Renal clearance and excretion of endogenous substances were studied in 13 small adult ponies (152 plus or minus 93 (standard deviation (SD)) kg). Normal data of serum and urinary concentrations, clearance, and excretion of creatinine, osmolality, free water, sodium, potassium, and chloride during a 12-hour period are presented. Significant linear regressions on body weight (BW) were obtained for creatinine clearance (Ccr (ml/hr) = 127.2 times BW (kg) - 1553), osmolar clearance (Cosm(ml/hr) = 1.81 times BW (kg) m0.3), and free water (CH2O(ml/hr) = - 1.43 BW (kg) - 25.0). Compared with renal excretion of man, kidneys of ponies seem to conserve more sodium and chloride and excrete more potassium.

Pulmonary vascular response during phases of canine heartworm disease: scanning electron microscopic study.

Pulmonary arteries and veins of 14 dogs in phases of heartworm disease (Dirofilaria immitis infection) were examined by scanning electron microscopy. Two dogs were infected with D immitis microfilaria only, whereas 12 dogs were infected with adult D immitis. Seven of the dogs infected with adult worms were untreated. Two of these 7 dogs had natural infections of unknown duration introduced by mosquito bite, whereas 5 were experimentally infected for 30 days. The remaining five dogs were experimentally infected for 1 year and had worms removed by drug therapy. These five dogs were maintained 12 months after treatment. Arteries and veins from dogs infected with microfilaria had a continuous sheet of endothelial cells. Arterial endothelium from the seven nontreated dogs infected with adult heartworms exhibited swirling patterns, pore formation, and separation of intercellular junctions. Arteries from all dogs had numerous endothelialized villus protrusions; veins had similar, less extensive changes. Arteries and veins from experimentally infected dogs were similar to naturally infected dogs, indicating the infection procedure produced lesions similar to that normally seen in heartworm disease. The extent of vascular lesions was reduced in four of the five treated dogs that had been infected with adult worms. Adult worms, not microfilaria, may produce the vascular lesions seen in heartworm disease. Lesions will regress if worms are removed from the circulation. Lesions may be caused by generation of humoral factors initiated by the presence of adult worms.