A modified triple tibial osteotomy for management of canine cranial cruciate ligament disease: retrospective assessment of 309 procedures (2017-2020).

CASE HISTORY: Medical records from a single referral hospital (Animal Referral Hospital, Sinnamon Park, Australia) of dogs treated with modified triple tibial osteotomy (TTO) for management of cranial cruciate ligament (CrCL) disease from June 2017 to June 2020 were reviewed. Modifications to the originally described TTO procedure included a modified wedge angle calculation and performing the tibial osteotomies without the use of pre-drilled guide holes. CLINICAL FINDINGS: A total of 253 dogs met the inclusion criteria. Two dogs were excluded, leaving 251 dogs that had undergone 309 procedures for assessment, and data from these, including complications, were reviewed. Complete, partial competent, and partial incompetent rupture of the cranial cruciate ligament was identified in 202/309 (65.4%), 79/309 (25.6%), and 28/309 (9.1%) stifles, respectively. Medial meniscal injury was identified in 207/309 (67.0%) stifles at the time of initial surgery. TREATMENT AND OUTCOME: Fifty-eight dogs had bilateral procedures, including both single-session and staged surgeries, and 48 of these were available for analyses. The modifications to the TTO procedure described herein resulted in a median wedge angle of 21° and a median post-operative tibial plateau angle of 5.8°. Tibial compression testing following surgery indicated elimination of cranial tibial thrust in all stifles in this series. The most common intra-operative complication was tibial tuberosity fracture (15/309; 4.9%). Minor post-operative complications occurred in 37/309 (12.0%) procedures, with infection being the most common (27/309; 8.7%). Major post-operative complications occurred in 9/309 (2.9%) procedures. The intra- and post-operative complication rates for dogs undergoing bilateral single-session TTO were both 8.3% (2/24). The intra- and post-operative complication rates for dogs undergoing bilateral staged TTO were both 4.2% (1/24). The low number of complications for both the bilateral single-session and bilateral staged TTO groups precluded statistical analysis. All complications resolved uneventfully as determined by the attending surgeon. CLINICAL RELEVANCE: The modified TTO technique described here was safe and effective for the management of canine CrCL disease in the dogs included in the case series. Findings of this study suggest that, with careful case selection, the modified TTO may be performed as a bilateral single-session procedure in dogs with concurrent bilateral cranial cruciate ligament disease. Future studies analysing the effects of these modifications on stifle biomechanics would be beneficial. ABBREVIATIONS: CrCL: Cranial cruciate ligament; SSI: Surgical site infection; TPA: Tibial plateau angle; TPLO: Tibial plateau levelling osteotomy; TTA: Tibial tuberosity advancement; TTO: Triple tibial osteotomy.

Turbidity current activity in a british columbia fjord.

A year-long monitoring program within an elongated channel-fan system in Bute Inlet of British Columbia, Canada, detected active sand-transporting turbidity currents. Measurements of bottom velocities and sediment collected in traps, as well as damage to moorings and equipment, captured the signatures of frequent energetic events. Maximum calculated velocities achieved were 335 centimeters per second, with flow thicknesses of more than 30 meters. Coarse sand was transported at least 6 to 7.5 meters above the sea floor. Turbidity currents flowed a minimum distance of 25.9 kilometers, but possibly as far as 40 to 50 kilometers, over bottom slopes of generally less than 1 degrees.

Oxidation of bovine beta-casein by hypochlorite.

We recently observed two 2,4-dinitrophenylhydrazine (DNPH)-reactive proteins of 40 and 120 kDa in the bronchoalveolar lavage fluids of rats exposed to >95% O(2) for 48 h. The N-terminal sequences of these proteins were both identical over 16 amino acids with rat beta-casein, which, in addition to its more common association with milk, is produced by cytotoxic T-lymphocytes, and has been found to have proinflammatory properties. Because of the inflammatory response that accompanies hyperoxic lung injury, we investigated the oxidation of bovine beta-casein by HOCl. Following exposure to HOCl at 4 degrees C for 15 min, derivatization with DNPH, washing, and digestion with trypsin, the resultant peptides were separated by reverse-phase HPLC. One peptide isolated from a peak absorbing at 365 nm was identified as AVP(Y*)PQR, corresponding to amino acids 177-183 of bovine beta-casein. Analysis of the peptide by both electrospray and matrix assisted laser desorption ionization (MALDI) mass spectrometry identified a molecular ion MH+ of 1008.5 Da, which represents an increase of 178 Da from the calculated monoisotopic MH+ of the unmodified peptide of 830.45 Da. Daughter ion spectra of the doubly charged parent ion of the peptide further support the oxidation of the tyrosine to the quinone methide, with subsequent conversion to the corresponding hydrazone with DNPH. A second pair of products were identified as arising from oxidation of Y(193) within the tryptic peptide constituted by amino acids 184-202, and the corresponding chymotryptic cleavage side product, 191-202. Exposure of beta-casein to increasing amounts of HOCl revealed that M and Y residues were the most susceptible, although bovine beta-casein contains no C, and a single W, which would not be detected by our methods. The approach described in the present report can be used to evaluate the contributions of distinct mechanisms of oxidation in other experimental or pathological models.

A comparison of single doses of lisinopril and enalapril in hypertension.

Sixteen patients with mild to moderate hypertension were studied in a double-blind crossover comparison of single oral doses of lisinopril 10 mg and enalapril 10 mg. Both drugs caused a marked fall in blood pressure (BP) with a clinically useful effect persisting for 24 h postdose and with no significant difference between treatments in this respect. The time to minimum systolic BP was 2 h (95% confidence limits 0-19 h) longer for lisinopril. The fall in ACE activity at 24 h was 18.5 (8.2-28.8) U/l greater for lisinopril. We conclude that, within the limits of this small study, lisinopril appears to be as effective as enalapril in lowering BP and that it may have a slower onset of action that could be clinically valuable.

Hypoxia in the Gulf of Mexico.

Seasonally severe and persistent hypoxia, or low dissolved oxygen concentration, occurs on the inner- to mid-Louisiana continental shelf to the west of the Mississippi River and Atchafalaya River deltas. The estimated areal extent of bottom dissolved oxygen concentration less than 2 mg L-1 during mid-summer surveys of 1993-2000 reached as high as 16,000 to 20,000 km2. The distribution for a similar mapping grid for 1985 to 1992 averaged 8000 to 9000 km2. Hypoxia occurs below the pycnocline from as early as late February through early October, but is most widespread, persistent, and severe in June, July, and August. Spatial and temporal variability in the distribution of hypoxia exists and is, at least partially, related to the amplitude and phasing of the Mississippi and Atchafalaya discharges and their nutrient flux. Mississippi River nutrient concentrations and loadings to the adjacent continental shelf have changed dramatically this century, with an acceleration of these changes since the 1950s to 1960s. An analysis of diatoms, foraminiferans, and carbon accumulation in the sedimentary record provides evidence of increased eutrophication and hypoxia in the Mississippi River delta bight coincident with changes in nitrogen loading.