The response of zinc transporter gene expression of selected tissues in a pig model of subclinical zinc deficiency.

This study compared the relative mRNA expression of all mammal zinc (Zn) transporter genes in selected tissues of weaned piglets challenged with short-term subclinical Zn deficiency (SZD). The dietary model involved restrictive feeding (450 g/animal*day-1) of a high-phytate diet (9 g/kg) supplemented with varying amounts of zinc from ZnSO4*7H2O ranging from deficient to sufficient supply levels (total diet Zn: 28.1, 33.6, 38.8, 42.7, 47.5, 58.2, 67.8, 88.0 mg Zn/kg). Total RNA preparations comprised jejunal and colonic mucosa as well as hepatic and nephric tissue. Statistical modelling involved broken-line regression (P≤.05). ZIP10 and ZIP12 mRNAs were not detected in any tissue and ZnT3 mRNA was only identified in the kidney. All other genes were expressed in all tissues but only a few gene expression patterns allowed a significant (P<.0001) fitting of broken-line regression models, indicating homeostatic regulation under the present experimental conditions. Interestingly, these genes could be subcategorized by showing significant turnarounds in their response patterns, either at ~40 or ~60 mg Zn/kg diet (P<.0001). In conclusion, the present study showed clear differences in Zn transporter gene expression in response to SZD compared to the present literature on clinical models. We recognized that certain Zn transporter genes were regulated under the present experimental conditions by two distinct homeostatic networks. For the best of our knowledge, this represents the first comprehensive screening of Zn transporter gene expression in a highly translational model to human physiology.

Effects of whole plant brown algae (Laminaria japonica) on zootechnical performance, apparent total tract digestibility, faecal characteristics and blood plasma urea in weaned piglets.

Two trials were conducted with 48 newly weaned piglets (28 d old) each 8.6 ± 0.05 kg to study how Laminaria japonica plants (LJ) affect zootechnical performance, feed conversion and the apparent total tract digestibility (ATTD) of crude nutrients. All basal diets consisted of cereals, soybean meal, skim milk powder and premixes according to recommendations (no growth promoters or enzymes). For Trial 1, piglets from 16 litters (50% male-castrated, 50% female) were assigned to three treatment groups (n = 16) in a completely randomised block design. Groups received either 2.5% supplementation with sun dried (SD) or drum dried (DD) LJ powder or 2.5% of diatomaceous earth (control). For Trial 2, piglets from 12 litters received either 5% of diatomaceous earth (control) or one of three mixtures of diatomaceous earth + DD LJ powder (3.3%+1.7%, 1.7%+3.3% or 0.0%+5%; n = 12). Data collection included zootechnical performance, faecal consistency, blood plasma urea (Trial 1 and 2) and ATTD (Trial 2). Metabolisable energy (ME) of DD LJ and diets in Trial 2 was estimated using digestible nutrients. Statistical analysis included two-way ANOVA (treatment, block) and mixed linear regression. During both trials, LJ at dosages ≥2.5% significantly reduced feed:gain ratio compared to control (p ≤ 0.0001, = 0.01 for Trial 1, Trial 2) irrespective of the drying method. ATTD from Trial 2 significantly increased digestibilities of dry matter (DM) and crude ash (CA) (p ≤ 0.01) and significantly decreased digestibilities of organic matter and crude fibre in animals fed ≥3.33% DD LJ (p = 0.01). Fractional digestibility of the DD LJ resulted in limited ME of ~9.3 ± 2.5 MJ/kg DM. Dietary conversion ratios of ME and digestible DM of DD LJ diets from Trial 2 decreased linearly with increasing algal supplementation (R2 = 0.93, 0.94 and pslope = 0.002, 0.002 for MCR, DCR). In conclusion, dried LJ powder was included up to 5% into diets without impairing zootechnical performance. The improved feed conversion in the presence of LJ was partly due to slightly higher ME within the algae diets compared to control. However, piglets receiving LJ during Trial 2 needed significantly lower dietary ME and digestible DM to maintain growth performance. Thus, LJ exerted a performance enhancing effect on weaned piglets. The precise mode-of-action is yet unclear.

Vestibular Stimulation Modulates Neural Correlates of Own-body Mental Imagery.

There is growing evidence that vestibular information is not only involved in reflexive eye movements and the control of posture but it also plays an important role in higher order cognitive processes. Previous behavioral research has shown that concomitant vestibular stimuli influence performance in tasks that involve imagined self-rotations. These results suggest that imagined and perceived body rotations share common mechanisms. However, the nature and specificity of these effects remain largely unknown. Here, we investigated the neural mechanisms underlying this vestibulocognitive interaction. Participants (n = 20) solved an imagined self-rotation task during caloric vestibular stimulation. We found robust main effects of caloric vestibular stimulation in the core region of the vestibular network, including the rolandic operculum and insula bilaterally, and of the cognitive task in parietal and frontal regions. Interestingly, we found an interaction of stimulation and task in the left inferior parietal lobe, suggesting that this region represents the modulation of imagined body rotations by vestibular input. This result provides evidence that the inferior parietal lobe plays a crucial role in the neural integration of mental and physical body rotation.

The effectiveness of superficial versus deep dry needling or acupuncture for reducing pain and disability in individuals with spine-related painful conditions: a systematic review with meta-analysis.

Objective: The purpose of this systematic review was to evaluate the effects of deep versus superficial dry needling or acupuncture on pain and disability for spine-related painful conditions. A secondary purpose was to account for the differences of needling location in relation to the painful area. Methods: This PROSPERO (#CRD42018106237) registered review found 691 titles through a multi-database search. Following a comprehensive search, 12 manuscripts were included in the systematic review and 10 in the meta-analysis. Standardized mean differences (SMD) with 95% confidence intervals were calculated for pain and disability. Results: The included studies demonstrated an unclear to high risk of bias recommending a cautious interpretation of the results. A consistent effect supporting deep needling over superficial with an SMD of 0.585 [0.335, 0.835], p < 0.001 from 10 articles for pain but a non-significant effect of 0.197 [-0.066, 0.461], p = 0.14 from 2 studies for disability. A temporal examination was similar for effects on pain with an SMD of 0.450 [0.104, 0.796] immediately, 0.711 [0.375, 1.048] short-term (1 to 11 weeks), and 0.470 [0.135, 0.805] for time-points ≥12 weeks. Regionally, there was a greater effect needling the area of pain locally (SMD = 0.754) compared to remotely (SMD = 0.501). Discussion: Statistically significant between-group differences were observed favoring deep needling over superficial. Both superficial and deep needling resulted in clinically meaningful changes in pain scores over time. However, differences between groups may not be clinically meaningful. More high-quality trials are needed to better estimate the effect size of deep versus superficial needling while controlling for location and depth of the lesion. Level of evidence: 1a.

Adaption of body zinc pools in weaned piglets challenged with subclinical zinc deficiency.

The effects of subclinical Zn deficiency on depletion and redistribution of body Zn were studied in weaned piglets. Forty-eight weaned piglets (German-Large-White×Land-Race×Piétrain; 50 % female, 50 % male-castrated; body weight 8·5 (sd 0·27) kg) were fed restrictively (450 g/d) a basal maize-soyabean meal-based diet supplemented with varying amounts of ZnSO4.7H2O (analysed dietary Zn: 28·1, 33·6, 38·8, 42·7, 47·5, 58·2, 67·8, 88·0 mg/kg diet) for an experimental period of 8 d. Analyses comprised Zn concentrations in soft tissues. Statistical analyses included regression models and k-means cluster analysis. Jejunum and kidney Zn correlated positively with dietary Zn (P<0·05). Other Zn pools responded in a non-linear fashion by declining (colon, epidermis, spleen) or increasing (mesenteric lymph follicles, thymus, skeletal muscle) below 63·6, 48·0, 47·5, 68·0, 43·0 and 53·1 mg Zn/kg diet, respectively (P<0·01). Above these thresholds, Zn concentrations in epidermis, mesenteric lymph follicles and skeletal muscle plateaued (P<0·0001), whereas they exhibited a decrease in colon and thymus (P<0·01) as well as a numerical increase in spleen. Clustering by dietary Zn concentration indicated clusters of varying Zn supply status and pathophysiological status. Clustering by biological matrices revealed a discrimination between storage, transport and excretion media as well as soft tissues. Taken together, novel response patterns indicated compensation reactions in tissues that are essential for the acute survival of growing animals (heart, skeletal muscle, immune tissues). Furthermore, this is to our knowledge the first study that mapped the gross Zn requirement by clustering tissue Zn concentrations between treatment groups.

Effects of different iron supply to pregnant sows (Sus scrofa domestica L.) on reproductive performance as well as iron status of new-born piglets.

The present study aimed to investigate the effects of different iron (Fe) supply to sows during gestation on their reproductive performance and placental Fe load. Additionally, the Fe status of the corresponding offspring was assessed. Twenty multiparous sows were fed from insemination to farrowing with isoenergetic and isonitrogenic balanced diets differing in Fe content. The diet low in Fe (Group -Fe) was mainly composed of soybean meal and maize meal and had a Fe content of 114 mg/kg DM. For the diet high in Fe (Group +Fe), the diet was supplemented with Fe(II)SO4 · 7H2O to a total Fe content of 256 mg/kg. Blood characteristics (haemoglobin, haematocrit, mean corpuscular haem concentration, total Fe-binding capacity, transferrin saturation) of all sows were measured at the beginning and at the end of gestation. Daily Fe retention was calculated at the day of farrowing. After birth, reproductive performance (litter size, piglet weight, litter weight), placental Fe content and Fe blood characteristics of the piglets were determined. Apparent daily Fe retention tended to be greater in Group +Fe (p < 0.1). Blood parameters of the sows did not show any variations between feeding groups, neither at the beginning nor at the end of pregnancy, whereas placental Fe content was lower in Group -Fe (p < 0.05). In addition, Fe supply during gestation improved litter size (p < 0.01) and litter weight (p < 0.05). Although all sows were supplied according to the current Fe recommendations, a significant decline in reproductive performance of Group -Fe was recognised. Therefore, it was concluded that the re-evaluation of the gross Fe requirements of pregnant sows is inevitable to accommodate the current feeding recommendations.

Strategies and challenges to increase the precision in feeding zinc to monogastric livestock.

Practical diets for monogastric livestock must be supplemented with zinc (Zn) due to their high contents of antagonistic substances like phytates. Current feeding recommendations include quite generous safety margins because of uncertainties regarding the gross Zn requirements under varying rearing conditions. Furthermore, the use of pharmacological Zn doses to stabilise animal performance and wellbeing is widespread. Taken together, modern diets for pigs and poultry contain considerably more Zn than necessary to meet animal requirements, which is associated with concerns related to the environment as well as animal and consumer safety. Therefore, European authorities most recently reduced the allowed upper limits for Zn in complete feed. To maintain animal productivity and wellbeing while reducing the Zn load in complete feed, all measures that stabilize feed Zn bioavailability must be applied. Most importantly, reliable information on the gross Zn requirement under practical conditions must be provided, considering the bioavailability of native or supplemented feed Zn, antagonisms with dietary factors as well as the physiological status of the animal.

Environmental responsibilities of livestock feeding using trace mineral supplements.

Trace elements are essential dietary components for livestock species. However, they also exhibit a strong toxic potential. Therefore, their fluxes through the animal organism are tightly regulated by a complex molecular machinery that controls the rate of absorption from the gut lumen as well as the amount of excretion via faeces, urine and products (e.g., milk) in order to maintain an internal equilibrium. When supplemented in doses above the gross requirement trace elements accumulate in urine and faeces and, hence, manure. Thereby, trace element emissions represent a potential threat to the environment. This fact is of particular importance in regard to the widely distributed feeding practice of pharmacological zinc and copper doses for the purpose of performance enhancement. Adverse environmental effects have been described, like impairment of plant production, accumulation in edible animal products and the water supply chain as well as the correlation between increased trace element loads and antimicrobial resistance. In the light of discussions about reducing the allowed upper limits for trace element loads in feed and manure from livestock production in the European Union excessive dosing needs to be critically reconsidered. Moreover, the precision in trace element feeding has to be increased in order to avoid unnecessary supplementation and, thereby, heavy metal emissions from livestock production.

[Periinterventional cone-beam-CT: application at transarterial chemoembolization of liver tumors]. / Periinterventionelle Cone-Beam-CT: Anwendung bei transarterieller Chemoembolisation von Lebertumoren.

Periinterventional Cone-Beam CT (CBCT) today is a valuable tool in complex radiological interventions. Only little experience exists about CBCT in transarterial chemoembolisations (TACE) of liver tumors. 25 patients underwent periinterventional CBCT. We used a C-arc DSA with 30 × 40 cm flat panel detector. Image data with axial, coronal and 3D-reconstruction were acquired by 217° rotation in 8 seconds. In all 25 cases CBCT had an influence on the TACE regarding the decision which vessels to catheterize, the amount of retention of the embolisation agent or an abort because of insufficient vascularisation. In comparison with DSA alone, CBCT allows a better visualisation of tumour vessels, simplifies selective catheterisation, the decision whether an embolisation is possible and enables a good visualisation of Lipiodol retention. Hence, CBCT is a helpful periinterventional tool but cannot substitute CT and MRI in follow up.

A therapeutic platelet transfusion strategy is safe and feasible in patients after autologous peripheral blood stem cell transplantation.

Prophylactic platelet transfusions are considered as standard in most hematology centers, but there is a long-standing controversy as to whether standard prophylactic platelet transfusions are necessary or whether this strategy could be replaced by a therapeutic transfusion strategy. In 106 consecutive cases of patients receiving 140 autologous peripheral blood stem cell transplantations, we used a therapeutic platelet transfusion protocol when patients were in a clinically stable condition. Platelet transfusions were only used when relevant bleeding occurred (more than petechial). Median duration of thrombocytopenia <20 x 10(9)/l and <10 x 10(9)/l was 6 and 3 days, which resulted in a total of 989 and 508 days, respectively. In only 26 out of 140 transplants (19%), we observed clinically relevant bleeding of minor or moderate severity. No severe or life-threatening bleeding was registered. The median and mean number of single donor platelet transfusions was one per transplant (range 0-18). One-third of all transplants, and 47% after high-dose melphalan could be performed without any platelet transfusion. Compared with a historical control group, we could reduce the number of platelet transfusions by one half. This therapeutic platelet transfusion strategy can be performed safely resulting in a considerable reduction in prophylactic platelet transfusions.

Methicillin-resistant Staphylococcus aureus whole-body decolonization among hospitalized patients with variable site colonization by using mupirocin in combination with octenidine dihydrochloride.

The object of this study was to investigate the efficacy of a methicillin-resistant Staphylococcus aureus (MRSA) multisite carriage decolonization in 32 hospitalized carriers--25 from surgical and seven from medical wards. Twenty-four of the patients had wounds (e.g. chronic ulcers, surgical sites) and 17 were spinal cord injury patients. Decolonization was performed by intranasal application of mupirocin, combined with an octenidine dihydrochloride bodywash over a period of five days. Samples from the nose, forehead, neck, axilla and groin were taken 24-48 h before beginning decolonization (sample point I, N=32) and 24-48 h afterwards (sample point II, N=32). Further samples, were taken seven to nine days after the procedure (sample point III, N=25). Contact sheep blood agar plates (24 cm2) were used to quantify MRSA colonies on forehead and neck. MRSA from other sample sites was determined semi-quantitatively. All patients were proven to be MRSA positive at one or more extranasal site(s); 18.8% did not have nasal carriage. The overall decolonization rate for all sites was 53.1% (sample point II) and 64% (sample point III), respectively. The reduction was significant for every site, showing a rate of 88.5% for nose (II, III) and of 56.3% (II) and 68% (III) for all extranasal sites together. Of 32 patients, a median of 6.5 cfu MRSA/24 cm2 was obtained for the forehead before decolonization and 0.5 cfu MRSA/24 cm2 for the neck. A significant reduction (0 cfu MRSA/24 cm2) from both sites was shown after treatment. Before decolonization procedures, median MRSA levels for the nose, groin and axilla were 55, 6 and 0 cfu/swab. After treatment, MRSA from each of these sites was significantly reduced. We conclude that nasal mupirocin combined with octenidine dihydrochloride whole-body wash is effective in eradicating MRSA from patients with variable site colonization.

Dietary intake of lead, cadmium, copper and zinc by children from the German North Sea island Amrum.

The dietary intake of metals was studied in seven male and seven female children at the age of 1.5 to 5.3 years living in a remote area of Germany, the North Sea island Amrum. The dietary intake of lead and cadmium was measured by a seven-day-duplicate study using atomic absorption spectrometry. The dietary intake of copper and zinc were calculated from food diaries. The median lead and cadmium intakes were 2.1 micrograms/(kgbw x week) [range: 0.63-5.1 micrograms/(kgbw x week)] and 2.7 micrograms/(kgbw x week) [range: 1.7-4.4 micrograms/(kgbw x week)]. The median daily intake of copper and zinc were 1.1 mg/d (range: 0.54-2.5 mg/d) and 5.7 mg/d (range: 2.7-14 mg/d). Compared to the provisional tolerable weekly intake (PTWI) of 25 micrograms/(kgbw x week) proposed by the WHO the dietary intake of lead was low. The median amounted to 8.5% and the maximum to 20% of the PTWI. The cadmium intake was comparatively high. The median amounted to 39% and the maximum to 63% of the PTWI [7 micrograms/(kgbw x week)]. The median intake of copper was in the range of the values recommended by the German Society of Nutrition (0.7-1.0 mg/d and 1.0-1.5 mg/d for children at the age of 1-< 4 years and 4-< 7 years). Twenty-three percent of the calculated intakes were below these values. The median intake of zinc however did not reach the recommended dietary intake of 7 and 10 mg/d for children at the age of 1-< 4 years and 4-< 7 years.

Acute effects of LDL-apheresis on cholesterol oxidation products and antioxidants in plasma and lipoproteins of patients with familial hypercholesterolemia.

Regular LDL-apheresis treatment of hypercholesterolemic patients has proven to reduce the formation of atherosclerotic lesions. Regarding the underlying mechanisms, cholesterol oxidation products (COP) may play a detrimental role. Therefore, COP levels were determined before and after regular LDL-apheresis treatment in ten patients with familial hypercholesterolemia. - The patients had approximately twofold elevated plasma and LDL COP concentrations on the average as compared to healthy subjects. LDL-apheresis treatment efficiently removed COP from the circulation. As a consequence of a smaller reduction of the COP content (- 52 %) than of the total cholesterol content (-71 %) in LDL, the LDL COP:cholesterol ratio increased. Lipid-soluble antioxidants in the plasma of the hypercholesterolemics decreased to a comparable extent as did plasma lipids. In contrast to nearly stable vitamin C concentrations, plasma selenium concentrations also decreased, resulting altogether in a decreased but still normal serum total antioxidant capacity. - In conclusion, LDL-apheresis treatment effectively reduced potentially atherogenic COP from the plasma. With normal plasma antioxidant concentrations before LDL-apheresis in long-term treated hypercholesterolemics, the observed acute decrease in lipid-soluble antioxidants and selenium by treatment seems not to be as meaningful. The higher LDL COP:cholesterol ratio after treatment needs further elucidation.

Reference values and human biological monitoring values for environmental toxins. Report on the work and recommendations of the Commission on Human Biological Monitoring of the German Federal Environmental Agency.

This article describes the working principles and working procedures of the Commission on Human Biological Monitoring, which was established in 1993 as a joint commission of the Federal Health Office (Bundesgesundheitsamt) and the Federal Environmental Agency (Umweltbundesamt) in Germany. One of the main tasks of the commission is to develop scientifically based criteria for the application of human biological monitoring and for the evaluation of human monitoring data in environmental medicine. In principle, two different kinds of criteria are recommended: (a) reference values and (b) human biological monitoring values (HBM values). Reference values are intended to indicate the upper margin of the current background exposure of the general population to a given environmental toxin at a given time. Reference values can be used to identify subjects with an increased level of exposure (in relation to background exposure) to a given environmental toxin. However, reference values do not represent health-related criteria for the evaluation of human biological monitoring data. HBM values are derived from human toxicology and epidemiology studies and are intended to be used as a basis for a health-related evaluation of human biological monitoring data. Usually the commission recommends two different HBM values: HBM I, the concentration of an environmental toxin in a human biological material (usually blood, serum, plasma, or urine) below which there is--according to the knowledge and judgement of the commission--no risk for adverse health effects in individuals of the general population: and HBM II, the concentration of an environmental toxin in a human biological material (usually blood, serum, plasma, or urine) above which there is--according to the knowledge and judgement of the commission and with regard to the environmental toxin under consideration--an increased risk for adverse health effects in susceptible individuals of the general population. The HBM I value can be considered a kind of alert value (from the toxicological point of view), whereas the HBM II value represents a kind of action level, at which attempts should be undertaken to reduce the level of exposure immediately and to carry out further medical examinations. Values between HBM I and HBM II should be considered a warning signal of the need to control the analytical measurement and to reduce the level of exposure of the concerned individual as reasonably as is achievable. At present, reference and HBM values are available for lead in blood, for cadmium and mercury in blood and urine, and for pentachlorophenol in plasma/serum and urine. Reference values have been established for some polychlorinated biphenyls in blood and plasma as well as for hexachlorocyclohexane and hexacholorobenzene in blood as well as for some organochlorine in human milk.

Hair analysis in environmental medicine.

Hair analysis comprises the determination of minerals, trace elements and drugs. It is applied in Germany with increasing frequency in the recently established field of environmental medicine for biological monitoring of the internal metal/metalloid exposure. Besides a number of advantages hair analysis is impaired by the difficulty-to distinguish between endogenous and exogenous sources of metals in hair. Except for methylmercury, there are no critical limit values for trace elements in hair available. However, valid reference values for some metals and for nicotine in hair have been recently presented in the German Environmental Survey. The significance of selected substances in hair are as follows: Aluminium in hair is of no value in environmental medicine. For assessment of cadmium and inorganic arsenic exposure hair analysis is only suitable as a screening method based on large populations. Monitoring of lead in hair is a valuable screening method also for small groups, especially for children. Based on toxicokinetics and under consideration of practicability the optimal biomarker of methylmercury exposure is the hair concentration. For other mercury compounds hair analysis is of lower significance. Nicotine and cotinine measurements in hair provide a practical and proper method for estimating environmental tobacco smoke exposure and to validate smoker status in epidemiological studies.

Hyperthermic isolated limb perfusion with cis-diamminedichloro-platinum. II. An experimental study in dogs with a balloon-occlusion technique for repeated high-dose treatment.

Isolated organ perfusion is attractive for regional high-dose chemotherapy because of its advantage to reduce whole body toxicity. Intraoperative hyperthermic isolated perfusion procedures involving a heart-lung machine have been developed, but repeated treatments carry a high risk of vessel and tissue damage. Therefore, a study of isolated hyperthermic limb perfusion in four dogs was conducted using a balloon-occlusion technique including a hyperthermia unit, two low-flow rotary pumps, a bubble oxygenator, and two polyurethane balloon catheters. After 15 min infusion of cisplatinum the concentrations of serum platinum (Pt) in the isolated limb and in the whole body were measured by atomic absorption spectroscopy. Regional exposure to Pt was more than 10-fold higher than systemic exposure. After 60 min isolated limb perfusion, the area under the curve (AUC) of Pt concentrations in the isolated limb showed values between 767.4 and 1055.6 micrograms/l x 60 min, whereas in the whole body values between 59.8 and 75.9 micrograms/l x 60 min were obtained. Repeated isolated limb perfusions with the balloon-occlusion technique were performed in three dogs without systemic side effects. This model of regional chemotherapy may be useful for preoperative chemotherapy in malignant tumors of the limbs.

Analysis of mutant tRNA gene transcripts in vivo in Saccharomyces cerevisiae by abortive primer extension.

When the primer extension of a synthetic oligonucleotide hybridized to a complementary region of RNA is made in the presence of only three deoxyribonucleosides triphosphates, elongation of the primer stops as soon as the missing nucleotide is needed. This abortive primer extension assay has been adapted to analyse tRNA gene transcripts and has two main advantages. First it is specific and allows the identification of particular tRNA gene products in an homologous system provided the gene bears a point mutation. Second, it is highly sensitive and can be used to complement and confirm results of Northern blot hybridization. This assay should be a useful tool in the further in vivo study of the transcription and processing of particular tRNA genes in the homologous system. In this report the expression of wild-type and mutant yeast Sup4- tyrosine inserting suppressor gene was studied.

Seroma prevention using fibrin glue in a rat mastectomy model.

Seromas are a frequent complication of mastectomy (17% to 53%) in humans and are correlated to skin flap elevation, lymphovascular interruption, and drainage into surgically created potential spaces. The use of intraoperative topical fibrin glue to reduce morbidity in rats undergoing radical mastectomies has been evaluated. A model consistently producing seromas was developed by radical mastectomy and lymphadenectomy in the Sprague-Dawley rat. A fibrin glue application procedure was tested using this model. The double-blinded protocol called for spray application of saline or fibrin glue to mastectomy wounds followed by sequential inspection and necropsy on postoperative days 5, 8, 11, and 14. Topical fibrin glue was shown to be statistically significant in decreasing the presentation of seromas following a radical mastectomy in the Sprague-Dawley rat.

Vancomycin.

Vancomycin is a narrow-spectrum bactericidal antibiotic used primarily for treatment of serious staphylococcal infections. It is the alternative therapy of choice when the penicillins and cephalosporins cannot be used. Vancomycin is also used in (1) methicillin-resistant Staphylococcus aureus infections; (2) streptococcal endocarditis in conjunction with an aminoglycoside in patients intolerant of penicillin or ampicillin; (3) infections, including those involving prosthetic devices, caused by gram-positive organisms with multiple antibiotic resistance; (4) antibiotic-induced enterocolitis caused by Clostridium difficile; and (5) prophylaxis for endocarditis in patients who are at risk and cannot tolerate a penicillin, cephalosporin, or erythromycin. The major toxic effect associated with the use of vancomycin is ototoxicity, which may develop when serum levels exceed 30 micrograms/ml.