Embryo transfer and embryonic capsules in the bobcat (Lynx rufus).

Bobcats (Lynx rufus) (n=22) were used to test a surgical embryo transfer protocol for wild felines. Five blastocysts were collected 8-14 days post-initial copulation (PIC). Translucent capsule-like structures were recovered at 12 days PIC and are the first report of such a structure in a felid. Endometrial fibrosis was observed in one cat but, in general, post-surgical fibrosis of the uterus did not seem to impede ova or embryo transport. One embryo underwent cryopreservation and this embryo plus two other transferrable embryos were placed in recipient cats during the course of the study. No pregnancies were maintained; but one non-cryopreserved embryo was detected by ultrasound examination at 2 weeks post-transfer. This study provides valuable groundwork for future studies and warrants optimism for continued research in this area.

Blood parameters of clinically normal captive bobcats (Felis rufus).

Data on blood parameters were obtained from 56 (32 female, 24 male) clinically healthy, captive bobcats (Felis rufus). The animals were housed under ambient conditions at the Mississippi State University Captive Bobcat Facility. Samples were collected opportunistically between 1982 and 1995. Differences (P < or = 0.05) in blood parameters existed between sexes, among age classes (kitten, subadult, adult, and geriatric), and among stages in the reproductive cycle (breeding, parturition, recycling, and anestrus). Blood parameters for bobcats were similar to reported values for domestic cats (Felis catus). These results can be used as as reference to indicate when blood parameter aberrations exist in bobcats.

Comparing outcomes and charges for patients with acute myocardial infarction in three community hospitals: an approach for assessing "value".

OBJECTIVE: To assess the value of care (i.e. outcomes in relation to charges) for acute myocardial infarction (Acute MI) patients in three community hospitals after controlling for patient mix differences. DESIGN: An observational study of a cohort of acute MI patients admitted to hospital for care were studied based on medical record review and on patient-completed questionnaires at 8 weeks post-discharge. SETTING: Three community hospitals located in urban areas in the southeastern region of the United States. PATIENTS: A consecutive sample of 133 non-transfer Acute MI patients were entered into the study based on EKG results, enzyme tests and chest pain characteristics. Hospital medical record and charge data were available on all patients and patient-reports on 86% of survivors. MAIN OUTCOME MEASURES: Data were gathered on clinical outcomes (death, angina, dyspnea), functional outcomes (physical and psychosocial), satisfaction, and resource intensity (length of stay, total hospital charges, ancillary charges). Because of patient mix differences across hospitals, outcomes were adjusted for severity of Acute MI, comorbidity and demographics. RESULTS: There were important patient mix differences across hospitals. For example, Hospital C had more comorbidity than Hospital B (57.78% of Hospital C patients vs 15.00% of Hospital B patients were rated moderate or severe using a well tested index, p < 0.0001). After adjusting for patient mix differences, Hospital C scored significantly better on four of six outcome measures (i.e. angina, dyspnea, physical functioning, psychosocial functioning). For example, Hospital C's patients' mean scores on physical functioning at 8 week follow-up averaged 75.19 (on a 0-100 scale), while Hospital A's was 63.03 and Hospital B's was 48.57 (F-ratio = 4.95; p < 0.05). However, Hospital A scored significantly lower on all three resource intensity indicators (length of stay, ancillary charges, and total charges). For example, Hospital A's ancillary charges averaged $10,752 while Hospital B's and C's averaged $11,432 and $16,598 respectively. Between-hospital comparisons on adjusted mortality and satisfaction did not differ significantly. CONCLUSION: The "value" profiles (i.e. outcomes related to charges) produced by these three hospitals were substantially different. Studies that simultaneously measure outcomes, costs, patient mix and processes have potential to: (a) enable clinical teams to improve the measurable value of clinical care; and (b) enable purchasers to better evaluate which providers to select as preferred sources of care.

HMG CoA reductase inhibitors lower LDL cholesterol without reducing Lp(a) levels.

Lp(a) is a plasma lipoprotein particle consisting of a plasminogenlike protein [apo(a)] disulfide bonded to the apo B moiety of low-density lipoprotein (LDL). Increased plasma levels of Lp(a), either independently or interactively with LDL levels, have been shown to be a risk factor for atherosclerosis. Recently, a new class of lipid-lowering drugs, HMG CoA reductase inhibitors, have been introduced. These drugs act by decreasing liver cholesterol synthesis resulting in up-regulation of LDL receptors, increased clearance of LDL from plasma, and diminution of plasma LDL levels. In this study, we examined the effect of HMG CoA reductase inhibitors on Lp(a) levels in three groups of subjects, five volunteers and two groups of five and 14 patients. In all 24 subjects, mean decreases were observed in total cholesterol (43 +/- 5%), total triglyceride (35 +/- 8%), very low-density lipoprotein (45 +/- 9%), and LDL cholesterol (43 +/- 5%). The mean change in high-density lipoprotein cholesterol was an increase of 7 +/- 8%. Despite the very significant decrease in LDL cholesterol levels (p less than 0.001), Lp(a) levels increased by 33 +/- 12% (p less than 0.005). This was not associated with a measurable change in the chemical composition or size of the Lp(a) particle. This emphatically suggests that Lp(a) particles, despite consisting principally of LDL, are cleared from plasma differently than LDL. The surprising finding of an increase in Lp(a) levels suggests this class of drugs may have a direct effect on Lp(a) synthesis or clearance independent of its effect on LDL receptors.

Postprandial hyperlipemia inhibits platelet aggregation without affecting prostanoid metabolism.

The objective of this work was to characterize changes in platelet aggregability during postprandial hypertriglyceridemia with special emphasis on arachidonic acid metabolism. Ten healthy young men consumed 100 g fat after a fasting period of 12 hr. In-vitro platelet aggregation induced by ADP and collagen was measured at 0, 3, 5, and 9 hours after the fat intake. The major arachidonic acid metabolites, 12-hydroxyeicosatetraenoic acid (12-HETE), thromboxane A2 (TXA2), prostaglandin F2 alpha (PGF2a), and prostaglandin E2 (PGE2) produced during collagen-induced platelet activation were quantified by gas chromatography/mass spectrometry. A significant decrease in platelet aggregability induced by both ADP and collagen was detected during the postprandial hyperlipemia. No significant changes could be found in the prostanoid pattern of collagen activated platelets. There was no correlation between the degree of the inhibition of platelet aggregation and the relative or absolute increase of triglyceride-levels in the plasma during the postprandial hyperlipemia.

[Changes in zinc level in the serum, whole blood and erythrocytes in disorders of thyroid function]. / Veränderungen des Zinkspiegels im Serum, Vollblut und im Erythrozyten bei Schilddrüsen-Stoffwechselstörungen.

The zinc level in serum and whole blood was determined in a series of 121 patients, 20 suffering from overt hyperthyroidism, 34 with manifest hypothyroidism and a control group of 67 euthyroid subjects. The zinc content per deciliter of erythrocytes was calculated from the haematocrit. The hyperthyroid group revealed a highly significantly elevated serum zinc level (p less than 0.01), but a most significantly reduced zinc content in whole blood (p less than 0.001) in comparison with the euthyroid group. On the other hand, the reverse changes were observed in the hypothyroid group, i.e. a most significantly reduced serum zinc content (p less than 0.001) and a highly significantly increased zinc content in whole blood (p less than 0.01). These results suggest that the determination of zinc levels both in serum and in whole blood may be a useful additional parameter of peripheral thyroid hormone effect.

Radioelectrophoresis for determination of thyroid hormone binding abnormalities in human serum.

This paper describes a rapid and accurate method for determining binding abilities of thyroid hormones to their corresponding serum proteins: prealbumin, albumin and thyroxine binding globulin. A tube cell agarose gel electrophoresis is used with radioactive labelled triiodothyronine or thyroxine. The distribution curve shows characteristic peaks for prealbumin, albumin and thyroxine binding globulin. A collective of 60 euthyroid thyroid-healthy persons was examined, and the following reference values for the binding of thyroxine to its binding proteins were found: The percentage binding of thyroxine to the prealbumin fraction is 21 to 33%, to the albumin fraction 10 to 15% and to the thyroxine binding globulin fraction 54 to 66%. In a group of 220 patients with suspected thyroid hormone binding abnormalities there were 42 cases of albumin-associated hyperthyroxinaemia, 5 cases of prealbumin-associated hyperthyroxinaemia and 2 cases of thyroxine binding globulin deficiency. In another group of 35 patients with suspected antibodies against thyroid hormones one patient showed antibodies against triiodothyronine.

[Detection of thyroid hormone antibodies using a radial immunodiffusion method]. / Nachweis von Schilddrüsenhormonantikörpern mittels einer radialen Immundiffusionsmethode.

T3 and T4 autoantibodies just as protein binding anomalies are the cause of discrepancies of thyroid hormone assays as against actual thyroid function. Depending on the separation techniques used, autoantibodies lead to false low or high T3 or T4 values. A series of 105 preselected thyroid patients was investigated as to the presence of T3 and T4 autoantibodies. Only in one of these patients T3 autoantibodies could be documented as cause for elevated fT3 values in otherwise euthyroid function (clinically euthyroid, positive TRH/TSH response, euthyroid peripheral tissue parameters). The remaining 104 subjects showed neither T4 nor T3 autoantibodies. The method of investigation developed for final diagnosis of T4 and T3 autoantibodies was done by a radial immune diffusion technique. Here the serum sample was incubated for 12 hours at room temperature with radioactive labelled T3 or T4, then applied on to an antiIgG immune diffusion disc. The radioactivity of the punched precipitation area is measured. This method is quick and easily carried out and highly suitable as screening method.

[Prealbumin-associated hyperthyroxinemia]. / Präalbuminassoziierte Hyperthyroxinämie.

Prealbumin associated hyperthyroxinaemia represents a rare but important protein binding anomaly, causing difficulties in differential diagnostics. This anomaly is based on a variant prealbumin showing an increased affinity to T4 and rT3 and in some cases also when using T4 analogue tracers. The condition of the patient is clinically euthyroid which is confirmed by a normal bTSH level, a normal response to TRH, and peripheral parameters (BMR, ASR, STI, SHBG) in the euthyroid range. This paper describes the diagnostic difficulties in a 45-year-old male pointing out the significance of precise laboratory determination of prealbumin associated hyperthyroxinaemia in order to avoid misdiagnosis and wrong treatment.