Differences in uterine position of reproductively normal mares and those with delayed uterine clearance detected by scintigraphy.

The position of the uterus within the abdomen may affect a mare's ability to rapidly clear the uterine lumen of contamination. In this study, the position of the uterus was determined from left and right lateral flank scintigrams taken 1 and 2 h after intrauterine infusion of radiocolloid. Scintigraphy was performed during estrus in 44 mares, 24 were reproductively normal and 20 exhibited a delay in uterine clearance. Reproductively normal mares were nulliparous (n = 14) or pluriparous (n = 10), 3 to 21 yr of age, had no history of persistent uterine infections and cleared > 50% of a radiocolloid within 2 h of infusion into the uterus. Mares that exhibited a delay in uterine clearance were pluriparous (n = 18) or nulliparous (n = 2), 12 to 24 yr of age, had a history of endometritis and cleared < 30% of a radiocolloid within 2 h. The angle between the caudal-ventral aspect of the uterine image and cervix relative to horizontal as visualized on the scintigram was measured with a protractor. Results were analyzed by the General Linear Model System. The uterine-cervical angle relative to horizontal was more ventral in mares with delay in uterine clearance and was more horizontal in reproductively normal mares (mean +/- SEM-111.6 +/- 3.6 for delay in uterine clearance mares; 147.6 +/- 3.9 for reproductively normal mares; P < 0.0001). The mean angle for reproductively normal, pluriparous mares was steeper than that for nulliparous mares (141.1 +/- 2.9, 152.3 +/- 2.44 respectively; P = 0.004). There were no differences in angles between left and right lateral views within individuals. We conclude that a uterus that tilts ventrally in relation to the pelvic brim may contribute to the inability of delay in uterine clearance mares to rapidly clear their uterine lumen of contamination. Parity may contribute to the more ventral orientation of the uterus.

Oxytocin enhances clearance of radiocolloid from the uterine lumen of reproductively normal mares and mares susceptible to endometritis.

The effects of oxytocin on the percentage of technetium 99m albumin colloid (99mTc-microAA), cleared from the uterine lumen was measured in 13 mares. Scintigraphy was performed during 4 consecutive oestrous cycles, on Day 3 of oestrus during Cycles one and 3 and 48 h after ovulation during Cycles 2 and 4. Oxytocin (20 iu) was given i.v. after the initial scintigraphy image during Cycles 3 and 4. Seven multiparous mares (Group 1) were classified as 'susceptible' and 6 mares (2 nulliparous and 4 multiparous; Group 2) were classified as 'resistant' to endometritis. All mares cleared > 90% of 99mTc-microAA within 30 min of oxytocin injection. When no drug was given, Group 1 mares cleared negligible amounts of radiocolloid (< 5%) and Group 2 mares cleared 50-80%. No mares showed signs of colic after oxytocin administration. It is concluded that oxytocin enhances uterine clearance of radiocolloid and may be useful for treating mares exhibiting impaired uterine clearance.

Scintigraphic measurement of uterine clearance in normal mares and mares with recurrent endometritis.

The percentage of Technetium 99m-albumin colloid (99mTc-microAA), a radiocolloid, cleared from the uterine lumen within 4 h of intrauterine infusion, was measured in 15 mares during 2 consecutive cycles, on Day 3 of oestrus and 48 h after ovulation. Four nulliparous (Group 1) and 4 multiparous (Group 2) mares were classified as resistant and the remaining 7 multiparous mares were classified as susceptible (Group 3) to endometritis. Mares in Groups 1 and 2 cleared more 99mTc-microAA from their uteri than did mares in Group 3 during oestrus (P < 0.01) and 48 h after ovulation (P < 0.001). In the Group 1 + 2 mares, > 50% of the colloid was cleared in 7 and none in the remaining mare, apparently related to lack of cervical relaxation. Mean percentage of 99mTc-microAA cleared by Group 3 mares was negligible (< 5%), but some 99mTc-microAA was cleared by 3 of the 7 mares during 4 of the 6 studies conducted. Clearance of radiocolloid infused into the uterus of 3 reproductively normal mares during dioestrus was negligible. 99mTc-microAA infused into the uterus did not adversely affect endometrial integrity as determined by endometrial biopsy. Mares tolerated the procedures well. We conclude that scintigraphy can be used to detect impaired mechanical clearance of the uterus: reproductively normal mares clear > 50% 99mTc-microAA within 2 h of infusion whereas those susceptible to endometritis or mares with poor cervical dilatation may exhibit delayed uterine clearance.

Effect of bethanechol or erythromycin on gastric emptying in horses.

OBJECTIVE: To investigate the prokinetic effect of bethanechol and erythromycin in the upper gastrointestinal tract of healthy horses by measuring the gastric emptying (GE) rate of a radioactive meal. ANIMALS: 4 healthy adult horses. PROCEDURE: After food was withheld for 12 hours, horses were given 370 MBq of 99mTc-labeled sulfur colloid incorporated into egg albumen and 37 MBq of 111In-labeled diethyltriaminepentaacetic acid in 120 ml of water via nasogastric intubation. Intravenously administered treatments were 0.9% NaCl solution, erythromycin (0.1 or 1.0 mg/kg of body weight), or bethanechol (0.25 mg/kg). All drugs were given in 10 ml of 0.9% NaCl solution. Dual-phase scintigraphic images were obtained by use of a gamma camera. The best-fit function was determined for each study, and the resultant curves were then analyzed by use of least squares nonlinear regression. Two variables, time to 50% emptying of the stomach (T-50) and slope of the emptying curve, were derived from the calculated power exponential equation. CONCLUSIONS: Treatment had a significant (P < 0.05) overall effect on T-50 of solid-phase GE. The T-50 of bethanechol (30.09 +/- 10.01 minutes), erythromycin at 0.1 mg/kg (59.08 +/- 10.01 minutes), and erythromycin at 1 mg/kg (60.50 +/- 10.01 minutes) were significantly shorter than T-50 after saline administration (89.97 +/- 10.01 minutes). There was a trend (P = 0.09) for the slope of solid-phase GE of bethanechol and erythromycin (0.1 mg/ kg; P = 0.37) to be steeper than that of saline solution. For liquid-phase GE, the T-50 and the slope of bethanechol differed significantly (P < or = 0.05) from those for saline solution. CLINICAL RELEVANCE: Bethanechol and erythromycin significantly increased solid-phase GE in healthy horses and may have value for use as prokinetic agents in certain gastrointestinal tract diseases.

Comparison of excretory urography and ultrasonography for detection of experimentally induced pyelonephritis in dogs.

Pyelonephritis was experimentally induced in 10 clinically normal dogs by nephropyelocentesis and introduction of Proteus mirabilis into the randomly chosen right or left renal pelvis. Dogs were examined by nephrosonography and excretory urography before and 2 weeks after infection. The major nephrosonographic findings of pyelonephritis were renal pelvic dilatation, usually with proximal ureteral dilatation, and a hyperechoic mucosal margin line within the renal pelvis, proximal portion of the ureter, or both. In addition, at least one or more of the following were observed: generalized hyperechoic renal cortex, focal hyperechoic areas within the medulla, and focal hyperechoic or hypoechoic cortical lesions. Interpretation of excretory urograms resulted in 3 false-negative and 1 false-positive conclusions, compared with the histologic findings. Interpretation of nephrosonograms resulted in 2 false-negative and no false-positive conclusions. Of the kidneys with histologic evidence of pyelonephritis, 73% were detected by excretory urography, whereas 82% were detected by nephrosonography. Nephrosonography appeared to be useful for detection of mild to moderate cases of acute pyelonephritis that may be be interpreted as such by excretory urography.

Effect of alpha 2-adrenergic, cholinergic, and nonsteroidal anti-inflammatory drugs on myoelectric activity of ileum, cecum, and right ventral colon and on cecal emptying of radiolabeled markers in clinically normal ponies.

OBJECTIVE: To determine effect of xylazine hydrochloride (XYL), yohimbine hydrochloride (YOH), bethanechol chloride (BET), neostigmine methyl sulfate (NEO), or flunixin meglumine (FLU) on ileocecocolic myoelectric activity and passage of radiolabeled markers from the cecum. ANIMALS: 6 healthy adult ponies. PROCEDURE: A cecal cannula was surgically implanted, and 12 were sutured to the ileum, cecum, and right ventral colon. After a 12-hour nonfeeding period, 370 MBq of technetium 99m-labeled sulfur colloid in egg albumen and 37 MBq of indium 111-labeled diethyltriaminepentaacetic acid in 60 ml of water were injected into the cecal apex. All drugs were administered i.v. as a bolus, with the exception of NEO, which was given SC: XYL, 0.5 mg/kg of body weight; YOH, 0.075 mg/kg; BET, 0.025 mg/kg; NEO, 0.025 mg/kg; FLU, 1.1 mg/kg; and saline solution (SAL), 10 ml. Drugs were administered in a randomized complete block design, each treatment was administered twice to each pony, and dual-phase scintigraphic images were obtained. The time to 50% emptying (t50) and the slope of the emptying curve (beta) were derived from the calculated power exponential equation. RESULTS: The t50 after BET (184.8 +/- 16.5 minutes) and NEO (124.7 +/- 16.5 minutes) administration were significantly shorter than values after saline (230.2 +/- 17.1 minutes) administration. The t50 after XYL administration (250.5 +/- 18.6 minutes) was longer, and that after YOH administration (190.1 +/- 16.2 minutes) was shorter, than the t50 after saline administration, but neither difference was significant. The t50 and beta after FLU administration differed from those after saline administration. Myoelectric data appeared to be well correlated with drug-induced alterations in isotope clearance. CONCLUSIONS AND CLINICAL RELEVANCE: Cholinergic agonists, BET and NEO, have significant effects on the myoelectric activity of ileum, cecum, and right ventral colon, with the net effect of hastening cecal emptying.

Effect of erythromycin lactobionate on myoelectric activity of ileum, cecum, and right ventral colon, and cecal emptying of radiolabeled markers in clinically normal ponies.

OBJECTIVE: To determine the effect of erythromycin lactobionate (ERY) on ileocecocolic myoelectric activity and passage of radiolabeled markers from the cecum. ANIMALS: 6 healthy adult ponies. PROCEDURE: After a 12-hour nonfeeding period, 370 MBq of technetium 99m-labeled sulfur colloid in egg albumen and 37 MBq of indium 111-labeled diethyltriaminepentaacetic acid in 60 ml of water were administered directly into the cecal apex. The following drug concentrations were tested: ERY, 0.01, 0.10, 1.0, and 10.0 mg/kg of body weight; ERY, 0.10 mg/kg bolus; and saline (0.9% NaCl) solution, 10 ml. All treatments, with the exception of the 0.10-mg/kg bolus and saline solution, were infusions administered i.v. during a 60-minute period in a randomized complete block design. Each treatment was administered 2 times/pony. Dual-phase scintigraphic images were obtained, and the best-fit function was determined for each study, using data from the right side. Myoelectric data were collected before and after each treatment and analyzed for spike burst rate, relative activity, and burst duration. RESULTS: The time to 50% emptying (t50) after ERY administration was dose dependent, and all treatments, with the exception of the 0.01-mg/kg infusion, resulted in a significantly shorter t50 than that observed after saline administration (230.2 +/- 17.12 minutes). The shortest t50 was observed after the 1.0 mg/kg dosage of ERY (76.9 +/- 22.0 minutes). Although not significantly different, the t50 and beta were shorter (108.6 +/- 25.9 minutes) and steeper after a bolus dose of 0.10 mg/kg of ERY than after infusion at the same dosage (131.1 +/- 18.7 minutes). CONCLUSIONS AND CLINICAL RELEVANCE: ERY may be a useful prokinetic for prevention or treatment of cecal motility dysfunction. The ability of ERY to evoke a similar response during the early postanesthetic or postoperative period remains to be determined.

Use of a hyaluronate membrane for jejunal anastomosis in horses.

OBJECTIVE: To compare the outcomes of double-layer inverting anastomosis (DIA), single-layer anastomosis (SLA), and single-layer anastomosis combined with a hyaluronate membrane (SLA+HA-membrane) with respect to stomal diameter, adhesion formation, surgery time, and anastomotic healing in horses. ANIMALS: 18 adult horses. PROCEDURE: Midline celiotomy and end-to-end anastomoses were performed. In control horses (n = 6), DIA was performed; in treated horses, SLA was performed (6) or SLA+HA-membrane was performed (6). Horses were euthanatized 21 days after surgery. Abdominal adhesions were evaluated grossly and histologically. Stomal diameters were measured ultrasonographically and compared with adjacent luminal diameters. Anastomotic healing was evaluated histologically for fibrosis and inflammation, tissue alignment, and inversion. Surgery times were recorded for the anastomotic procedure and compared among groups. RESULTS: There were significantly more adhesions in the SLA group, compared with the DIA and SLA+HA-membrane groups. Reduction in stomal diameters in the DIA group was significantly greater than the SLA and SLA+HA-membrane groups. Surgery times for the DIA group were significantly greater than the SLA and SLA+HA-membrane groups. Histologic findings of fibrosis, inflammation, and mucosal healing were similar among groups. There was significant tissue inversion in the DIA group, compared with the 2 treatment groups. Tissue alignment was not different among groups. CONCLUSIONS AND CLINICAL RELEVANCE: Use of a SLA+HA-membrane was an effective small intestinal anastomotic technique. This technique was faster to perform and resulted in a larger stomal diameter, compared with the DIA technique and significantly fewer perianastomotic adhesions, compared with the SLA technique.

Myoelectric activity of the ileum, cecum, and right ventral colon, and cecal emptying of radiolabeled markers in clinically normal ponies.

OBJECTIVES: To determine normal cecal emptying curves for liquid- and solid-phase radiolabeled markers and to further define myoelectric patterns of the ileum, cecum, and colon in healthy ponies. ANIMALS: 6 adult ponies. PROCEDURE: A cecal cannula and 12 bipolar Ag-AgCl recording electrodes were sutured to the ileum, cecum, and right ventral colon of the ponies. Radioisotopes, indium 111-labeled diethyltriaminepentaacetic acid (111In-DTPA) and technetium 99m (99mTc)-labeled sulfur colloid bound to egg albumen, were introduced through the cannula directly into the cecal body. Movement of these markers from the cecum was monitored by a gamma camera, and power exponential clearance curves were generated. Myoelectric data were collected before and after i.v. administration of isotonic saline (0.9% NaCl) solution, and were analyzed for spike burst (SB) rate, relative activity index, and mean burst duration. Myoelectric complexes were identified from observation of chart recordings or compressed, digitized data. RESULTS: Clearance curves were generated for liquid (111In-DTPA)- and solid (99mTc)-phase markers. Marker types were not different with respect to lag phase, but liquid markers emptied at a slightly faster rate than did solids. Baseline values were calculated after saline solution administration for each of the myoelectric variables investigated. A relation between ileal, cecal, and colonic myoelectric activity was identified. Activity consistent with the previously described colonic migrating myoelectric complex in the pelvic flexure was identified in the right ventral colon. CONCLUSIONS AND CLINICAL RELEVANCE: Baseline data on normal cecal emptying was obtained; this technique could be used to evaluate the effect of postulated motility-modifying treatments used in equine practice.

Effect of radiographic positioning on interpretation of cubital joint congruity in dogs.

OBJECTIVE: To ascertain effects of x-ray beam centering and limb position on apparent congruity of a normal cubital joint (elbow). ANIMALS: 6 skeletally mature male Treeing Walker Coonhounds without physical, radiographic, or gross evidence of elbow abnormalities. PROCEDURE: Relative movement among humerus, radius, and ulna and measured joint space width on mediolateral and craniocaudal radiographic views was compared, using various x-ray beam centering and limb positions. RESULTS: Highest agreement and greatest certainty on subjective determination of congruity was for the flexed 90 degrees mediolateral radiographic view with the x-ray beam centered on the elbow. Distortion artifact of the proximal ulnar measurements was significant when the x-ray beam was centered on the midpoint of the radius. On the mediolateral view, the humeroradial joint space became significantly wide when the elbow was flexed. On the craniocaudal view, maximal humeroradial joint space width was obtained when the x-ray beam bisected the angle of the joint or was angled +30 degrees toward the humerus. CONCLUSIONS: Artifact distortion of joint width affected objective and subjective assessment of elbow congruity when the limb was placed in extreme flexion or extension or when the x-ray beam was not centered over the area of interest. Optimal visualization of the humeroradial joint space on the craniocaudal view was achieved when the x-ray beam bisected the angle of the elbow or was slightly angled toward the humerus. CLINICAL RELEVANCE: Elbow congruity was best assessed on the flexed 90 degrees lateral radiographic view with the x-ray beam centered on the joint.

Radiographic evaluation of elbow joints before and after surgery in dogs with possible fragmented medial coronoid process.

OBJECTIVE: To determine the usefulness of 5 radiographic projections of the elbow joint for identification of fragmented coronoid process (FCP) and associated secondary degenerative changes in dogs. DESIGN: Longitudinal clinical study. ANIMALS: 19 dogs suspected of having FCP (7 dogs, 1 elbow joint; 12 dogs, both elbow joints). PROCEDURE: 5 radiographic projections were obtained before and after surgery for all elbow joints on which exploratory arthrotomy was performed because of suspected FCP. Radiographs obtained before surgery were compared with radiographs obtained after surgery and radiographs taken of the excised fragments. Each projection was evalated for its utility in definitively identifying FCP and 7 specific degenerative changes. Interevaluator agreement, use of each radiographic projection for definitively identifying a feature, and ability of the 4 evaluators to definitively identify a feature were analyzed. RESULTS: The craniolateral-caudomedial oblique (Cr15L-CdMO) projection had a significantly higher sensitivity for definitively identifying FCP, compared with the other 4 projections. Interevaluator and kappa agreement for the 5 projections did not differ significantly among the 7 degenerative changes evaluated. The radiographic projection with the highest sensitivity and specificity for detection of a particular degenerative change varied by feature. CLINICAL IMPLICATIONS: Of the 5 radiographic projections evaluated, the Cr15L-CdMO projection provided the highest sensitivity and was the best projection to use for definitively identifying FCP. The craniocaudal, Cr15L-CdMO, and mediolateral projections most reliably allowed for identification of secondary degenerative changes.

Mycobacterium avium-intracellulare infection in a white-faced saki (Pithecia pithecia).

Physical examination of an adult female white-faced saki (Pithecia pithecia) revealed midabdominal multiple cystic structures. The animal developed a grade 3/4 reaction to old mammalian tuberculin injected into the right eyelid. Significant clinicopathologic findings included marked hyperproteinemia (9.2 g/dl), hyperglobulinemia (6.1 g/dl), and hypoalbuminemia (3.1 g/dl). Ultrasonography revealed multiple abdominal masses of varying echogenicity. The animal was euthanized and necropsied. Significant histopathologic findings included multifocal lymphadenitis with cystic degeneration of multiple visceral lymph nodes. Mycobacterium avium-intracellulare was cultured from a mesenteric lymph node.

[Recent legal aspects of contraception]. / Aspects legislatifs recents de la contraception.

PIP: This is the question and answer session after a presentation by A.-M. DOURLEN-ROLLIER (ibid 4(4): 185-187. 1972). The panel includes L. NEUWIRTH, sponsor of legislation to liberalize anticontraception law in France. The status of legislation on the following topics was mentioned in questions: prescription of contraception to minors, government records of prescription forms, a national office of information on family education, abortion (in general, for minors and procured abroad), the Carpenter conviction, the bearing of 1973 election outcome on passing this legislation and the the legality of contraception being forbidden in France but strongly encouraged in her overseas territories. Answers tended to be complex.^ieng

Ancillary equipment to increase quality and reduce radiation exposure in the equine nuclear medicine laboratory.

The construction of ancillary equipment used to improve image quality and reduce personnel radiation exposure in the equine nuclear medicine laboratory is illustrated. The devices include a self supporting lead sheet for shielding the distal limb or limb pair, a hanging lead sheet for shielding the proximal limb, a lead square for shielding the urinary bladder or jugular catheter, a restraining board for acquiring a palmar view of the foot, a head support to stabilize the head for imaging and a head support for stabilizing the neck for imaging. The restraining board and head supports decrease patient motion, improve image quality, and decrease the number of repeat acquisitions so that the time to perform the complete study is shortened. The self supporting shielding device allows the handlers to increase their distance from the horse which enhances radiation safety.

An expanded social work role in a university hospital-based group practice: service provider, physician educator and organizational consultant.

This paper reports the development of social work role and functions in a primary medical group practice which was established to replace the general medical clinics of a large urban voluntary teaching hospital in an academic medical center. It traces the shaping and implementation of a role which is functionally integral to the care, teaching and research goals of the practice; is operationalized into its service delivery system; and utilizes a full range of sophisticated social work skills. Along with physicians and nurse practitioners, the social worker is a principal provider of patient care, as well as physician educator and organizational consultant who contributes to coordinated, comprehensive and resource conservative care. Implications for other settings are noted.

Adrenal ultrasonography correlated with histopathology in ferrets.

The adrenal glands of twenty-six, 12- to 53-month-old, ferrets without clinical signs of adrenal disease were examined and measured by ultrasonography and the findings compared with those from gross examination and histopathology. Of 51 adrenal glands examined, 27 were normal, 23 had either nodular or diffuse cortical hyperplasia and 1 had an adenocarcinoma. There was no statistically significant difference between the sonographic nor gross size of normal adrenal glands and those with hyperplasia. Moderate correlation was found between gross and sonographic measurements of length for both right (r = 0.783; p < 0.0001) and left (r = 0.609; p < 0.001) and width (p < 0.02). In female ferrets, the length, width, and depth of the right adrenal gland sonographically measured (mean +/- sd) 7.5 +/- 1.2 mm, 3.7 +/- 0.6 mm, 2.8 +/- 0.4 mm, respectively, and the left measured 7.4 +/- 1.0 mm, 3.7 +/- 0.4 mm, 2.8 +/- 0.4 mm; in males, the right adrenal measured 8.9 +/- 1.6 mm, 3.8 +/- 0.6 mm, 3.0 +/- 0.8 mm and the left measured 8.6 +/- 1.2 mm, 4.2 +/- 0.6 mm, 3.0 +/- 0.6 mm. Accessory adrenal tissue was not identified during the sonographic examination but was grossly found in 10 of the ferrets. It was associated with either the right, left or both adrenal glands.

True diaphragmatic hernia in a cat.

A report of a cat with a true diaphragmatic hernia in which only falciform fat had herniated is presented. The lesion was misinterpreted as a pulmonary mass. Additional radiographic studies which may have been of diagnostic benefit are briefly discussed.