The existence of intertransverse joints in young warmblood foals.

OBJECTIVE: To verify the existence of intertransverse joints (ITJs) in young foals. ANIMALS: 11 warmblood foals. PROCEDURES: Postmortem examination of the lumbar area in foals < 200 days old using CT, MRI, dissection, and histomorphology. Data were analyzed with descriptive statistics. RESULTS: Age of foals varied between 1 and 200 days (median, 11 days). Ten foals had 6 lumbar (L) vertebrae, and 1 foal had 5. All 11 foals, irrespective of age, had ITJs between the first sacral and last lumbar vertebrae and between the last and second-to-last lumbar vertebrae. In 6 foals (all with 6 L vertebrae), ITJs also existed between the fourth and fifth L vertebra. One foal, also with 6 L vertebrae, additionally had a unilateral (right) ITJ between the transverse processes of the third and fourth L vertebra. Based on CT, width of ITJs was seemingly greater in young (< 1 month old) foals because of the incomplete ossification of the transverse processes. The ITJs were confirmed and further characterized by MRI, dissection, and histomorphology. CLINICAL RELEVANCE: ITJs already exist in very young warmblood foals and are present at birth. During the first months of life, these juvenile ITJs develop similarly to other synovial joints with increasing ossification and concomitant decrease of thickness of the cartilage layer. Knowledge of the presence of these ITJs in young animals is clinically relevant, as they should be recognized as nonpathologic when for instance a young foal is presented for presumed arthropathy and examined with advanced imaging techniques.

A knockout mutation associated with juvenile paroxysmal dyskinesia in Markiesje dogs indicates SOD1 pleiotropy.

A juvenile form of paroxysmal dyskinesia segregated in the Markiesje dog breed. Affected pups exhibited clinical signs of a severe tetraparesis, dystonia, cramping and falling over when trying to walk. In most cases, the presentation deteriorated within weeks and elective euthanasia was performed. Pedigree analysis indicated autosomal recessive inheritance. Genome-wide association and homozygosity mapping of 5 affected dogs from 3 litters identified the associated locus on chromosome 31 in the region of SOD1. The DNA sequence analysis of SOD1 showed that the patients were homozygous for a frameshift mutation in the fourth codon. None of the other analyzed dogs of the breed was homozygous for the mutation, indicating full penetrance of the genetic defect. Mutations in SOD1 are known to cause recessive degenerative myelopathy in middle-aged dogs with low penetrance and dominant amyotrophic lateral sclerosis in humans with variable age of onset. Our findings are similar to recent observations in human patients that a loss of function mutation in SOD1 leads to a juvenile neurologic disease distinct from amyotrophic lateral sclerosis.

Quantitative motor unit action potential analysis of paraspinal muscles, diagnostic imaging and necropsy findings in 36 horses suspected of cervical impairment.

INTRODUCTION: Aims: To determine the relation between quantitative electromyography (QEMG) of the cervical ventral serratus muscle, radiographic findings and post-mortem gross and histopathological examination in order to calculate the ability of QEMG to localize the region of cervical compressive neuropathy and myelopathy in horses. Methods: In this clinical, non-randomised, partially blinded study (QEMG and histology), 36 warmblood horses with clinical suspicion of cervical spine disease were examined with QEMG in different segments of the ventral serratus muscle. Results were compared to normative data. Diagnostic imaging was performed in 28 cases. All horses were euthanized because of poor clinical prognoses and/or recurrent clinical neurological signs despite treatment and underwent necropsy with emphasis on the cervical nervous tissue and vertebrae. Clinical and diagnostic imaging findings, QEMG results and post mortem findings were compared with each other. Results: Overall mean values of duration (9.54 ms), polyphasia, number of phases (3.6) and size index (0.67) in horses with cervical lesions were significantly (P.

INTRODUCTION: Objectifs: Déterminer la relation entre l>électromyographie quantitative (QEMG) du muscle serratus ventral cervical, les résultats radiographiques et les examens macroscopiques et histopathologiques post mortem afin de calculer la capacité de la QEMG à localiser la région de compression neurogène dans l'encolure des chevaux. Méthodes: Dans cette étude clinique, non randomisée, partiellement aveugle (histologie et QEMG), 36 chevaux de sang soupçonnés d'affection du rachis cervical ont été examinés par QEMG sur différents segments du muscle serratus ventral. Les résultats ont été comparés aux données de référence. L'imagerie diagnostique a été réalisée dans 28 cas. Tous les chevaux ont été euthanasiés en raison de mauvais pronostics cliniques et/ou de signes neurologiques cliniques récurrents malgré le traitement et ont subi une autopsie en mettant l'accent sur le tissu nerveux cervical et les vertèbres. Les résultats de l'imagerie clinique et diagnostique, les résultats de la QEMG et les résultats post mortem ont été comparés les uns aux autres. Résultats: Les valeurs moyennes globales de durée (9,54 ms), de polyphasie, de nombre de phases (3,6) et d'indice de taille (0,67) chez les chevaux présentant des lésions cervicales étaient significativement (P.

What predicts the outcome in patients with intestinal ischemia? A single center experience.

BACKGROUND: Acute mesenteric ischemia (AMI) is associated with a mortality of 60-80%. Early diagnosis and rapid treatment have a decisive influence on therapy. The aim of this study was to evaluate the prognostic value of AMI markers on mortality, in order to better anticipate the clinical course and to initiate therapeutic steps at an early stage. STUDY DESIGN: An analysis from our prospective database of 302 consecutive patients with AMI who were treated surgically in the Department of General Surgery between February 2003 and October 2014 was performed. Uni- and multivariate analysis of risk factors for mortality have been performed in the total cohort and in two subgroups according to their stay in intensive care unit (ICU) at the time of AMI diagnosis. RESULTS: Of the 302 patients with AMI, 115 were in ICU at the time of diagnosis. Totally, 203 patients underwent computed tomography scan (CT-scan) of the abdomen for diagnosis and 68% of them showed specific signs of AMI. A total of 63 (21%) embolectomies were performed during the surgical procedure. The post-operative mortality rate was 68% (204 patients). Among survivors, 85 (87%) patients developed a short bowel syndrome in the post-operative course. Multivariate analysis showed a significant association between mortality and preoperative lactate>3mmol/L, C-reactive protein>100mg/L and ICU stay at the time of AMI diagnosis. CONCLUSION: Mortality of patients with AMI remains high. Elevated lactate, elevated C-reactive protein and ICU stay are factors associated with increased mortality. Their presence in a patient with suspicion of AMI should trigger a multidisciplinary management in emergency.

Primary splenic peripheral nerve sheath tumour in a dog.

An 8-year-old crossbred dog was presented with a one-month history of progressive weakness, respiratory impairment and abdominal distension. Surgical exploration revealed the presence of a splenic mass that infiltrated the mesentery and was adherent to the stomach and pancreas. The mass was composed of highly cellular areas of spindle-shaped cells arranged in interlacing bundles, streams, whorls and storiform patterns (Antoni A pattern) and less cellular areas with more loosely arranged spindle to oval cells (Antoni B pattern). The majority of neoplastic cells expressed vimentin, S-100 and glial fibrillary acidic protein (GFAP), but did not express desmin, alpha-smooth muscle actin or factor VIII. These morphological and immunohistochemical findings characterized the lesion as a malignant peripheral nerve sheath tumour (PNST). Primary splenic PNST has not been documented previously in the dog.

Appearance of red mark syndrome/ cold water strawberry disease in Switzerland and Austria.

Red mark syndrome (RMS) or cold water strawberry disease (CWSD) is a non-lethal skin disease of rainbow trout Oncorhynchus mykiss that is of high economic importance in the UK. The disease is temperature-dependent, with up to 60% morbidity at water temperatures below 15 degrees C. Although CWSD is horizontally transmissible, the aetiology is still unknown. Here we describe the first cases of RMS on the European mainland in the alpine regions of Switzerland and Austria. In Switzerland, morbidity remained around 1% after the first outbreak, whereas in Austria no further cases were diagnosed.

Influence of age, frailty and liver function on the pharmacokinetics of brofaromine.

OBJECTIVE: The pharmacokinetics of brofaromine, a selective inhibitor of monoamine oxidase A, was evaluated in 12 frail elderly patients (66-92 y) and 12 healthy volunteers (20-35 y). METHODS: Quantitative liver function tests were performed to show whether brofaromine elimination in the elderly could be predicted from noninvasive assessment of CYP1A2 activity (caffeine clearance) or liver plasma flow (sorbitol clearance). RESULTS: In the elderly the AUC of brofaromine was significantly increased (e.g. for the 75 mg dose 43.2 vs 19.9 mumol*h.l-1, clearance was reduced (5.0 vs. 11.8 l.h-1), the volume of distribution was smaller (130 vs. 230 l), and the half-life was slightly increased (19.0 vs. 14.2 h). No significant correlation was observed between hepatic plasma flow and brofaromine clearance (r = 0.41, P = 0.05), whereas CYP1A2 activity and brofaromine clearance were tightly correlated (r = 0.94, P < 0.0001). CONCLUSION: Caffeine clearance, a simple, noninvasive test of CYP1A2 activity, is predictive of brofaromine clearance.

[Long-term outcome of monoradicular lumbosacral compression syndromes-a comparison of pain and neurological deficits with lumbar CT scan.]. / Monoradikuläre, lumbosakrale Wurzelkompressionssyndrome in Längsschnitt : Eine Korrelation der Schmerzen und neurologischen Ausfälle mit den Ergebnissen der lumbalen Computertomographie.

A total of 97 patients with an acute monoradicular lumbosacral compression syndrome and a herniated disc at the same level were reinvestigated an average of 25 months after the acute event. Assessment was based on CT investigation and "root score", which was compiled from reports of subjective complaints and neurological deficits. All patients had initially undergone conservative treatment as inpatients. At the time of reinvestigation CT examination of the herniated discs revealed that they were unchanged in 56.7%, some-what smaller in 34%, no longer visible in 4.1% and larger in 5.2%. Nevertheless, 53.6% of patients were free of complaints, while 23.7% had improved clinically by more then 75%. The remainder showed improvement by about 25-75%. In no patient was the score unchanged or worse. In 69% of the patients neurological deficits were no longer demonstrable, and the remaining patients were not aware of deficits or did not feel any impairment from deficits that were obvious on clinical example. In 22.7% impairment was caused solely by local radicular or pseudoradicular pain. From these results it can be concluded that herniation of the disc precipitates the acute event but is not the sole source of the pain. In the majority of cases, during the further course of the disease the herniated disc causes no pain. It appears, therefore, that the course of disease following a disc herniation can be influenced very favourably by non-operative treatment and that in more than 50% of cases the condition becomes clinically silent. It follows that in neuroradicular compression syndromes a neurological deficit associated with the acute event does not mean operative intervention is indicated.

[Hemorrhagic lesions of the spleen in chronic and chronic recurrent pancreatitis]. / Hämorrhagische Milzläsionen bei chronischer und chronisch-rezidivierender Pankreatitis.

Rupture of the spleen occurred in five patients (aged 44-59 years) in the course of chronic or chronic recurrent pancreatitis. In three patients the rupture was a consequence of perisplenic adhesions associated with subclinical chronic pancreatitis, in another there was direct enzymatic erosion of the splenic capsule via the phrenicosplenic ligament, and in the fifth patient haemorrhagic infarction followed splenic venous thrombosis. In four patient there was a history of chronic pancreatitis related to alcohol abuse. On admission all patients complained of breathing-related pains radiating into the shoulder. Three patients also had abnormal radiological signs in the left lower lung field (high diaphragm, effusion, infiltration). The findings can be explained pathogenetically by infiltration of the phrenicosplenic ligament which connects the tail of the pancreas with the splenic hilus and the diaphragm. The final diagnostic confirmation and indication for surgery was in all cases made by computed tomography. This is thus the imaging procedure of choice if splenic involvement is suspected in the course of chronic pancreatitis.

["Body packing" in Austria. Clinical and diagnostic aspects of gastrointestinal smuggling of intoxicating drugs based on 2 cases]. / "Body Packing" in Oberösterreich. Klinische und diagnostische Aspekte des gastrointestinalen Rauschgiftschmuggels an Hand von 2 Fällen.

The alimentary tract is frequently used as a hiding place for the transportation of drugs. We report on the cases of two smugglers with drug packages ("body packing") in the gastrointestinal tract. Radiological techniques provide the best method of diagnosis. The clinical problems and symptoms of acute drug intoxication are presented.

Alterations in electrolyte and trace-element concentrations during simulated extracorporeal blood circulation.

In our studies with simulated extracorporeal blood circulation we observed damaging effects on blood cells, especially under oxygenating conditions. In order to characterize these effects we also analysed electrolyte and trace-element concentrations in plasma during and after simulated extracorporeal blood circulation. Highest resorption effects for magnesium and highest desorption effects for calcium, copper and iron are found with oxygen gas flow in the system. Membrane permeability for electrolytes seems to be induced as well. Cellular damage due only to mechanical stress within the perfusion system can be neglected.

Reorientation rates and asymmetry of distribution of lysophospholipids between the inner and outer leaflet of the erythrocyte membrane.

Labelled lysophospholipids were inserted into the outer layer of the erythrocyte membrane and their reorientation (flip) to the inner layer quantified by following the increase of the fraction of lysophospholipids not extractable by albumin. Flip rate constants were calculated from the kinetics of equilibration of the lysophospholipids between two compartments, the outer and the inner leaf of the bilayer, in the early phase of the flip kinetics where correction for non-enzymatic hydrolysis and acylation could be omitted. The distribution of a lysophospholipid finally attained reflects its affinity for the two layers. Whereas lysophosphatidylcholine has a slight preference for the outer layer of the membrane, lysophosphatidylserine spontaneously concentrates in the inner layer up to a ratio of 4:1. This asymmetry mimics the distribution of phosphatidylserine in the native membrane. Flip rates depend on membrane lipid compositions. They are enhanced by cholesterol depletion. Comparison of various mammalian species demonstrates that erythrocytes with a higher phosphatidylcholine/sphingomyelin ratio and high content of polyunsaturated fatty acids (mouse and rat) have a high transbilayer mobility, in contrast to erythrocytes with a low phosphatidylcholine/sphingomyelin ratio and a low content of polyunsaturated fatty acids (ox). Molecular properties of lysophospholipids influence their transbilayer mobility. Flip rates of lysophospholipids are enhanced not only by unsaturation of their fatty acid, but also by a negative net charge on the headgroup. This indicates that the strongly asymmetric distribution of phosphatidylserine in the native erythrocyte membrane, which is maintained for the lifespan of the cell, does not result from a lack of transbilayer mobility.

Cross-linking of SH-groups in the erythrocyte membrane enhances transbilayer reorientation of phospholipids. Evidence for a limited access of phospholipids to the reorientation sites.

Oxidation of erythrocyte membrane SH-groups and concomitant cross-linking of spectrin, which induce a partial loss of phospholipid asymmetry (Haest, C.W.M., Plasa, G., Kamp, D. and Deuticke, B. (1978) Biochim. Biophys. Acta 509, 21-32) are now shown to result in a remarkable increase of the rates of transbilayer reorientation of exogenously incorporated lysophospholipids. Reorientation of both, neutral lysophosphatidylcholine and of negatively charged lysophosphatidylserine is enhanced. A decrease of the activation energy of the reorientation process as well as quantitative changes of the dependence of reorientation on the lysophosphatidylcholine and cholesterol content of the membrane indicate formation of new reorientation sites or modification of existing sites. A common mechanism may underly the formation of reorientation sites and the occurrence of leaks for small solutes (Deuticke, B., Poser, B., Lütkemeier, P. and Haest, C.W.M. (1983) Biochim. Biophys. Acta 731, 196-210) subsequent to oxidation of membrane SH-groups. Whereas exogenous lysophospholipids completely equilibrate between the two lipid layers regardless of the extent of oxidation of SH-groups, endogenous inner layer phospholipids become available for reorientation in a graded way. Native phospholipid asymmetry is therefore not the result of a low transbilayer mobility of phospholipids, but probably due to a lack of access of inner layer phospholipids to the reorientation sites.