Vagal stimulation exaggerates the inhibitory ghrelin response to oral fat in humans.

Ghrelin, the growth hormone secretagogue receptor ligand, is a key regulator of adiposity and food intake. However, the regulation of ghrelin in response to dietary fat intake remains largely unclear. Furthermore, cephalic elevation of ghrelin may influence fat absorption and postprandial lipaemia. Therefore, the aim of this study was to examine the effect of fat ingestion and vagal stimulation on the regulation of plasma ghrelin. Vagal stimulation was achieved by modified sham feeding (MSF). Eight healthy subjects (four male/four female) consumed a 50 g fat load on two separate occasions. On one occasion, the fat load was preceded by the MSF of a meal for 1 h. Blood, appetite and breath were analysed for 5 h postprandially.A 25% (S.E.M. 3.4) suppression in ghrelin concentration was observed after fat ingestion (P<0.001), without an increase in glucose or insulin. MSF in addition to oral fat enhanced ghrelin suppression further, as well as elevating plasma triacylglycerol (P<0.001) and reducing appetite (P<0.001). The fasting ghrelin concentration was inversely correlated with gastric half-emptying time (P=0.036). We conclude that ghrelin release may be influenced directly by both vagal stimulation and oral fat ingestion.

Surgical implantation and evaluation of heart rate transmitters in captive bighorn sheep.

A surgical approach was developed for implantation of transmitters to monitor heart rate of bighorn sheep (Ovis canadensis) with an objective of discrete long-term, long-range data collection. We surgically implanted Telonics model HR400 transmitters on the dorsolateral thorax of 15 captive adult bighorn sheep ewes in April-May and October-November 1995. No complications or marked impairment of function were associated with the surgery; however, a transmitter was passively expelled from one ewe 19.5 mo post-implantation. Twelve of 15 transmitters remained functional > or = 1 yr, while three failed 3.5 to 4.5 mo following implantation. Heart rate data collected from the transmitters using a Lotek SRX_400 telemetry receiver/datalogger equipped with W9 EVENT_LOG accurately reflected heart rate as measured with electrocardiogram tracings. Line of sight signal range was at least 800 m in 95% (37/39) of collections made from standing ewes, while data could be collected reliably (74%; 29/39) to 600 m from bedded ewes. When a reliable long-lasting inconspicuous telemetry system is required, we believe that this approach holds promise for success in free-ranging as well as captive ungulates.

Isoflurane anesthesia in free ranging sea lion pups.

California sea lion pups, Zalophus californianus, (n = 115), were captured and anesthetized for (mean +/- SD) 17.6 +/- 7.8 min on San Miguel Island, California (USA) in November of 1992. Mask isoflurane anesthesia allowed intubation in 7.1 +/- 2.74 min. Pups recovered and walked in 7.32 +/- 4.8 min. Mask anesthesia in pups resulted in relaxation in 45 +/- 14 sec. Safe, brief anesthesia was delivered in support of weighing, medical evaluation, and short surgical procedures. Recovery character of all pups was sufficient to permit release to the free ranging state immediately after surgery, saving labor, supervision personnel, and postoperative time.

Seroprevalence of antibodies to human herpesviruses in England and Hong Kong.

The age-related prevalence of antibodies to herpesviruses was compared in England and Hong Kong. Altogether 327 sera from England and 266 sera from Hong Kong were tested for antibodies to herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpesvirus 6 (HHV-6). Herpesvirus infections were common in both countries but generally were acquired earlier and were more prevalent in Hong Kong. Over 90% of children in Hong Kong were infected with VZV, EBV, and HHV-6 by 8 years of age. HSV and CMV were the least prevalent childhood infections in both countries, although, 30-40% of babies in Hong Kong became infected during the first year of life. CMV infections were rare throughout childhood in the English cohort. Overcrowding and early attendance at kindergarten may aid more efficient and earlier transmission of herpesvirus in Hong Kong. The high prevalence of CMV in particular may have implications for the management of young pregnant women and organ transplant recipients in Hong Kong.

Congenital infection by human cytomegalovirus with a 65bp deletion in the morphological transforming region II.

Human cytomegalovirus (HCMV) infection is an important cause of neonatal death. Using primers derived from sequences within the morphological transforming region II (mtrII), HCMV DNA was amplified by polymerase chain reaction (PCR) from fixed tissues of infants who had died of congenital HCMV infection. In one neonate, HCMV DNA with reduction in the expected size was detected in the liver, spleen, kidney, adrenal, und thyroid tissues by gel electrophoresis. Nucleotide sequencing of the PCR product revealed a 65bp frame-shift deletion within the 79 amino acid open reading frame (ORF) of the mtrII. Based upon this observation, it is likely that viral genomic rearrangement involving the mtrII may occur in some cases of congenital HCMV infection.

Hemodynamic function during neurectomy in halothane-anesthetized horses with or without constant dose detomidine infusion.

Nine horses were premediated with acepromazine, and anesthesia was induced with guaifenesin and thiamylal. Anesthesia was maintained in four horses with halothane in oxygen, and in five horses with halothane in oxygen plus a constant dose infusion of detomidine. Both maintenance regimens produced a MAC equivalent of 1.4 at the ambient barometric pressure. Hemodynamic and respiratory measurements were made after the horses were anesthetized, during surgical manipulations involving skin or tissues other than nerves, during manipulation and transection of digital nerves, and after surgery while the limbs were being bandaged. Heart rate was significantly higher in horses anesthetized with halothane only than in horses that also received detomidine; there were no other differences in hemodynamic function or recovery characteristics. Respiratory rate was significantly higher than baseline during soft tissue and nerve manipulations; arterial blood pressure was significantly higher after surgery began and highest during neurectomy; cardiac output and cardiac index were significantly decreased during surgery; systemic vascular resistance was significantly increased during neurectomy and bandaging and highest during neurectomy. The data suggest that the increase in blood pressure often associated with surgical stimulation is caused by increased vascular resistance and may be accompanied by a decrease in cardiac output.

Lumbosacral epidural management.

Spinal techniques (epidural and subarachnoid injection) are taught in veterinary curricula, but because they are less convenient they are not used widely in practice. Many animals undergoing routine (below the umbilicus level) surgical procedures can be anesthetized with mild sedation and caudal epidural analgesia. Ninety minutes of analgesia is provided by the shorter-acting agents, whereas bupivacaine provides 4 to 6 hours. Twelve percent of our attempts failed to produce analgesia. Sedation, surgeon acceptance, and patient temperament contributed to an additional few failures. High-risk cases are better handled on oxygen.

Clinical investigations of halothane and isoflurane for induction and maintenance of foal anesthesia.

Fifty-eight foals were divided into two groups for study of aspects of the clinical anesthetic management of foals and to characterize effects of halothane (n = 30) and isoflurane (n = 28) in foals. There were no significant differences (P greater than 0.05) in the demographics of the two groups. Results of hemograms and biochemical analysis of venous blood samples before and after anesthesia were either not influenced or only mildly (clinically unimportant) affected by either agent. Like adult horses, foals have an increased PaCO2 when anesthetized with inhaled anesthetics. We could detect no difference in the magnitude of increase in PaCO2 with either anesthetic. Anesthetic induction and recovery was most rapid with isoflurane. The quality of induction and recovery was similarly acceptable with either agent. Heart rate during isoflurane was not significantly different from conscious conditions but during halothane, heart rate was significantly less than control except at 91-120 min when statistical significance was not detected. These results support the clinical impression that foals can be safely and reliably anesthetized with either agent.

Inhibitory effects of urine on the polymerase chain reaction for cytomegalovirus DNA.

The inhibitory effects of urine samples taken from neonates and older children, some of which were known to be infected with cytomegalovirus, on the polymerase chain reaction (PCR) were investigated. Urea was the major inhibitory component of urine and inhibited the PCR at a concentration of more than 50 mM. Urine samples from older children were more inhibitory than those from neonates. This correlated with the higher concentration of urea generally found in urine samples from older children compared with neonatal urines. Two of 13 neonatal urine samples, however, were inhibitory despite low urea concentrations--presumably due to metabolites derived from parenteral nutrition. The inhibitory effects of urine were effectively removed by simple dialysis or ultrafiltration. The sensitivity and specificity of PCR for detecting cytomegalovirus DNA in urine were further improved by using "nested" primers and a modified PCR protocol entailing the use of reduced reactants in the first 20 cycles of a two-stage 50 cycle PCR.

A prospective study of viral and mycoplasma infections in chronic inflammatory bowel disease.

Seventy-two children with chronic inflammatory bowel disease were investigated for infections with various viruses and Mycoplasma pneumoniae, Chlamydia psittaci, and Coxiella burnetii to determine whether these pathogens are associated with acute onset exacerbations. Altogether 54 infections were identified serologically, of which 23 (42.6%) were associated with exacerbations. This corresponded to 24.2% of the recorded exacerbations during the study period. The respiratory pathogens accounted for 59.3% of the infections and 43.8% of these were associated with gastrointestinal symptoms. This is consistent with the observation that up to 40% of the exacerbations were associated with symptoms of antecedent or concurrent infection, most commonly involving the respiratory tract. Rubella virus, Epstein-Barr virus, and adenovirus were associated with acute exacerbations in 5 children. Thus, common pathogens were frequently associated with exacerbations and account for a large proportion of the commonly reported symptoms of a concurrent infection. The possible causal relationship between these pathogens and exacerbation of inflammatory bowel disease is discussed. Reactivation of latent herpesviruses was identified in 4 children with active disease and indicates that the converse relationship may also occur.

Antibody responses in recipients of varicella vaccine assayed by immunoblotting.

Sera taken from 35 children with cancer who had been vaccinated with live varicella vaccine were assayed using immunoblotting for the presence of IgG class antibodies to proteins present in varicella-zoster virus (VZV)-infected cells. Sera from 23 of these patients were also assayed for IgM class antibodies. The patterns of immunoreactivity observed for these patients following vaccination were substantially weaker and more variable than those detected following natural VZV infection in otherwise healthy individuals. The IgG responses detected following vaccination involved up to 10 protein bands between 28 and 188 kDa. Bands were particularly frequent in the 78-96 kDa region. IgM responses involved up to 10 bands between 28 and 114 kDa, with the bands in the 78-96 kDa region and at 32-36 kDa being detected most frequently. Repeated vaccination generally produced a stronger IgG antibody response than did single vaccination, and subsequent exposure of vaccinees to natural VZV infection resulted in an increased level of reactivity for IgG antibodies, but not for IgM. Similar reaction patterns were obtained with sera from vaccinees when the vaccine virus and wild-type VZV were used as antigens. Immunoblotting showed good correlation with indirect radioimmunoassay for the detection of a vaccine-induced IgG response.

Cardiopulmonary effects of ephedrine in halothane-anesthetized horses.

The cardiopulmonary effects of intravenous (i.v.) administration of the sympathomimetic drug ephedrine during two different levels of halothane anesthesia [end-tidal concentration of 1.37% (light anesthesia) and 2.1% (deep anesthesia)] were studied in eight horses. Anesthesia was induced and maintained using only halothane in O2. Ventilation was controlled to maintain a Paco2 of 38-42 mmHg. Following instrumentation and stabilization of the horse at the halothane concentration being studied, baseline measurements of cardiac output (Q), arterial blood pressure (AP), pulmonary artery pressure, heart rate, Pao2, Paco2 and pH were made. Ephedrine was then administered (0.06 mg/kg i.v.) and these measurements repeated at 10, 20, 30, 45 and 60 min after injection. At both doses of halothane there was a significant (P less than 0.05) increase in Q, stroke volume (SV), and systolic AP following ephedrine administration. In addition, at 2.1% halothane, ephedrine administration resulted in a significant (P less than 0.05) increase in mean AP and Pao2 and a decrease in total peripheral resistance. The increase in systolic AP, Q, and SV was significantly (P less than 0.05) greater at 2.1% halothane than at 1.37% halothane. Ephedrine administration to horses during both light and deep halothane anesthesia results in an increase in AP that is due to an increase in Q and SV.

Laryngotracheal lesions following routine orotracheal intubation in the horse.

Sequelae of routine orotracheal intubation under clinical conditions were characterised in 38 healthy horses presented at three veterinary medical teaching hospitals. Four of these were necropsied and their tissues studied histologically. To minimise variation, 30 mm id cuffed silicone endotracheal tubes or Cole cuffless tubes were used in all patients. Fibreoptic endoscopic examination of upper respiratory and tracheal areas was accomplished pre-intubation, immediately post extubation and after 24 h. Endoscopy revealed that intubation was associated with laryngeal and/or tracheal lesions in all horses. Observations included abundant tracheal mucus, epithelial ecchymoses, basement membrane haemorrhage and mucus covered diphtheritic membrane plaques. Histological examination of lesions from the upper respiratory system of the four necropsied horses confirmed that the damage was comparable to that associated with tracheal intubation and reported in other species.

Cardiopulmonary effects of halothane anesthesia in cats.

The cardiopulmonary effects of 2 planes of halothane anesthesia (halothane end-tidal concentrations of 1.78% [light anesthesia] and 2.75% [deep anesthesia]) and 2 ventilatory modes (spontaneous ventilation [SV] or mechanically controlled ventilation [CV]) were studied in 8 cats. Anesthesia was induced and maintained with halothane in O2 only, and each cat was administered each treatment according to a Latin square design. Cardiac output, arterial blood pressure, pulmonary arterial pressure, heart rate, respiratory frequency, and PaO2, PaCO2, and pH were measured during each treatment. Stroke volume, cardiac index, and total peripheral resistance were calculated. A probability value of less than 5% was accepted as significant. In the cats, cardiac output, cardiac index, and stroke volume were reduced by deep anesthesia and CV, although only the reduction attributable to CV was significant. Systemic arterial pressure was significantly reduced by use of deep anesthesia and CV. Respiratory frequency was significantly lower during CV than during SV. Arterial PO2 was significantly decreased at the deeper plan of anesthesia, compared with the lighter plane. At the deeper plane of anesthesia, arterial PCO2 and pulmonary arterial pressure were significantly lower during CV than during SV. The deeper plane of halothane anesthesia depressed cardiopulmonary function in these cats, resulting in hypotension and considerable hypercapnia. Compared with SV, CV significantly reduced circulatory variables and should be used with care in cats. Arterial blood pressure was judged to be more useful for assessing anesthetic depth than was heart rate or respiratory frequency.

Llama anesthetic programs.

Llamas are anesthetized conveniently with guaifenesin thiamylal mixes, or, for short periods of time, with xylazine/ketamine. Small individuals must be accurately weighed. Estimating weight without experience is dangerous in this species. The greatest levels of safety and control, especially for critical patients, is afforded by inhalation anesthesia techniques using small animal equipment. All neonates and juveniles can be masked readily but in adults intravenous induction is most satisfactory. Intubation is aided by a long blade laryngoscope. Blood pressure monitoring is best accomplished with an arterial line in the ear artery. However, doppler equipment on the tail or distal leg usually works well.

Serum alphafetoprotein levels in subjects infected with hepatitis B virus.

Serum alphafetoprotein (AFP) levels were measured using a sensitive radioimmunoassay in 108 hepatitis B surface antigen (HBsAg)-positive subjects and 695 controls. The concentrations were significantly higher in the HBsAg-positives. Within this group, the highest levels were found in those with active HBV infection. In those without evidence of acute infection, the levels were higher in the high-risk than in the low-risk subjects. It is concluded: 1) that measurement of serum AFP might be a useful additional index of infectivity and prognosis in HBsAg-positive subjects; and 2) that in the light of the association between chronic HBV infection, hepatocellular carcinoma, and raised AFP in non-European populations, consideration should be given to regular monitoring of AFP levels in HBsAg-positive subjects in the United Kingdom.

Detection of specific IgM in varicella and herpes zoster by antibody-capture radioimmunoassay.

A simple and sensitive M antibody-capture radioimmunoassay (MACRIA) is described which utilizes crude commercial VZV antigen and a single monoclonal anti-VZV antibody. This was compared to the immunofluorescence (IF) test for IgM antibody and was used to study IgM responses in sera from 261 patients with varicella and 220 patients with herpes zoster. With MACRIA, IgM antibodies were detected in all patients with varicella. The IgM antibodies appeared shortly after onset of rash, reached peak levels between 1 and 4 weeks after onset and then declined to low or undetectable levels in most, though not all, patients after 3 months. IgM antibodies were also detected in 98.2% of patients with herpes zoster, but the levels of IgM were significantly lower than after varicella and there was wider individual variation both in magnitude and duration of the IgM responses, in some cases only lasting 2-3 weeks. Comparison between MACRIA and IF showed good agreement in the detection of IgM antibodies following varicella. Discordant results were obtained with 13% of sera, of which 81% were taken either early or late after onset of rash and contained very low IgM levels. In contrast, 62 (28%) of the 220 sera from patients with zoster gave discordant results in the two tests, all except five being MACRIA-positive but IF-negative. The largest proportion of discordant results were obtained with sera taken more than 3 months after onset of rash, but 18 (29%) contained high IgM levels and were taken during the period of peak IgM responses. The diagnostic applications of the VZV MACRIA are discussed.