Applications of ultrasonography in the reproductive management of Dux magnus gentis venteris saginati.

Dux magnus gentis venteris saginati is considered to be a Scottish delicacy; however, depleting wild stocks have resulted in attempts to farm them. Selective breeding has been successful in modifying behaviour, increasing body length, reducing hair coat and improving fank (litter) size. However, there are still significant problems associated with the terrain in which they are farmed. This article describes the use of ultrasonography in the reproductive management of this species and the introduction of new genetic material in an attempt to address these problems, with the aim of improving welfare and productivity.

Comparison of ultrasonography, radiography and a single computed tomography slice for the identification of fluid within the canine tympanic bulla.

Fluid accumulation within the tympanic bulla (TB) is an important diagnostic indicator in clinical cases of canine otitis media although its identification can be a challenge using currently available imaging techniques. The aim of this study was to compare ultrasound with radiography and a single computed tomography (CT) slice for the identification of fluid within the TB of canine cadavers. A random number of TB in 66 cadavers were filled with ultrasound gel. Rostrocaudal open mouth (RCdoM) radiographs and CT images were interpreted by 2 blinded radiologists and ultrasound examinations were performed by 2 blinded sonographers. The heads were then frozen and sectioned to confirm the contents of each TB. Although CT remained the most accurate method, comparable results were obtained by one of the sonographers and even the inexperienced sonographer produced results superior to radiography. Ultrasound has several advantages over the other imaging techniques and this study suggests that it may have an application in the investigation of canine otitis media although further work in live animals would be required to confirm this.

Ultrasound imaging of the canine tympanic bulla.

A procedure for imaging the canine tympanic bulla, external ear canal and adjacent structures using currently available ultrasound equipment was established. Lateral and ventral transducer positions were identified for this purpose and a 6.5 MHz curvilinear transducer was considered to be optimal. The sonographic appearance of these structures in cadavers and live dogs unaffected by ear disease is documented. Fluid was introduced into the tympanic bullae of the cadavers and its presence could be identified through the bony wall of the bulla. The ability of ultrasound to differentiate between gas and fluid within the bulla has important clinical implications as this is a common occurrence in dogs with middle ear disease. Ultrasound has several advantages over other imaging modalities and the examination procedure was well tolerated by unsedated dogs.

Changes in the Doppler waveform of the ovine femoral artery following infusion of vasoactive agents: a preliminary study.

The aim of this study was to investigate whether femoral artery pulsatility index (PI) can be used as an indicator of vasomotor tone in the digit of an ungulate species by measuring the change in PI induced by infusion of vasoactive agents in halothane-anaesthetised sheep. Intra-arterial infusion of the vasoconstrictor phenylephrine (9 microg min(-1)) tended to increase waveform PI (3.89-6.24, n=4, P=0.100). Infusion of a low dose (3 microg min(-1)) of the vasodilator sodium nitroprusside did not alter femoral artery PI, however infusion of a higher dose (30 microg min(-1)) tended to increase PI (5.39-6.70, n=5, P=0.059). During these studies heart rate, mean ABP and p(a)CO(2) did not change significantly. The tendency for PI to increase in response to vasodilation was unexpected and the mechanism involved is unclear. It appears that femoral artery PI cannot be used to predict vasomotor tone in the digit of the anaesthetised sheep.

Prophylactic antigen-matched donor blood for patients with warm autoantibodies: an algorithm for transfusion management.

BACKGROUND: Patients with warm autoantibodies are at high risk for delayed hemolytic transfusion reactions due to the presence of alloantibodies. To provide blood safe for transfusion and to avoid adsorption studies in some cases, the provision of prophylactic antigen-matched donor blood where feasible for patients with warm autoantibodies is advocated. STUDY DESIGN AND METHODS: Twenty consecutive adult patients with warm autoantibodies (January 1999 to February 2000) received chronic RBC transfusions by use of this protocol: the serology consistent with warm autoantibodies was confirmed; the alloantibodies were identified; the complete phenotype was determined (i.e., C, E, c, e, K, Jk(a), Jk(b), Fy(a), Fy(b), S, and s); and prophylactic antigen-matched (i.e., donor RBCs matched with the patient's phenotype), WBC-reduced donor RBCs were provided for transfusion. On subsequent admissions, samples were evaluated by panel studies and DATs. If the serology remained consistent with previous findings, prophylactic antigen-matched, WBC-reduced RBCs were transfused without further testing. RESULTS: Eight of 20 (40%) patients had existing, clinically significant alloantibodies. In 12 of 20 (60%) patients, a phenotype was determined and the patients received transfusion of a total of 149 prophylactic antigen-matched RBC units (mean, 15 units per patient) precluding adsorption studies on 51 pretransfusion samples. In 8 of 20 (40%) cases (2 with alloantibodies), phenotypes were indeterminant, necessitating differential allogeneic adsorption studies on 39 samples before transfusion of 144 RBC units (mean, 18 units per patient). CONCLUSIONS: Determining complete phenotypes should be a routine component of the serologic evaluation of patients with warm autoantibodies. Our algorithm for providing prophylactic antigen-matched RBCs to these patients when a complete phenotype can be determined provides flexibility in their transfusion management while maintaining safety and circumvents or simplifies pretransfusion adsorption studies.

Polyurethane: material for the next generation of heart valve prostheses?

OBJECTIVES: The prospects for a durable, athrombogenic, synthetic, flexible leaflet heart valve are enhanced by the recent availability of novel, biostable polyurethanes. As a forerunner to evaluation of such biostable valves, a prototype trileaflet polyurethane valve (utilising conventional material of known in vitro behaviour) was compared with mechanical and bioprosthetic valves for assessment of in vivo function, durability, thromboembolic potential and calcification. METHODS: Polyurethane (PU), ATS bileaflet mechanical, and Carpentier-Edwards porcine (CE) valves were implanted in the mitral position of growing sheep. Counting of high-intensity transient signals (HITS) in the carotid arteries, echocardiographic assessment of valve function, and examination of blood smears for platelet aggregates were undertaken during the 6-month anticoagulant-free survival period. Valve structure and hydrodynamic performance were assessed following elective sacrifice. RESULTS: Twenty-eight animals survived surgery (ten ATS; ten CE; eight PU). At 6 months the mechanical valve group (n=9) showed highest numbers of HITS (mean 40/h, P=0.01 cf. porcine valves), and platelet aggregates (mean 62.22/standard field), but no thromboembolism, and no structural or functional change. The bioprosthetic group (n=6) showed low HITS (1/h) and fewer aggregates (41.67, P=1.00, not significant), calcification and severe pannus overgrowth with progressive stenosis. The PU valves (n=8) showed a small degree of fibrin attachment to leaflet surfaces, no pannus overgrowth, little change in haemodynamic performance, low levels of HITS (5/h) and platelet aggregates (17.50, P<0.01 cf. mechanical valves, P=0.23 cf. porcine valves), and no evidence of thromboembolism. CONCLUSIONS: In the absence of valve-related death and morbidity, and retention of good haemodynamic function, the PU valve was superior to the bioprosthesis; lower HITS and aggregate counts in the PU valve imply lower thrombogenicity compared with the mechanical valve. A biostable polyurethane valve could offer clinical advantage with the promise of improved durability (cf. bioprostheses) and low thrombogenicity (cf. mechanical valves).

Formation of a secondary corpus luteum after ultrasound-guided follicular aspiration in cows.

This paper reports the observed formation of a secondary corpus luteum (CL) in the presence of the cyclic corpus luteum, on the ovaries of a cow after ultrasound-guided follicular aspiration for oocyte recovery. The secondary structure, although smaller and lighter (4.97 g vs. 6.02 g) than the natural one, had the typical macroscopic appearance of a corpus luteum. Histological examination of the structure using electron microscopy revealed typical structural features of a natural CL. Mean tissue progesterone concentration was significantly lower in the secondary CL (31.15 +/- 3.11 compared with 58.29 +/- 6.32 micrograms/g tissue of the cyclic CL) and oestradiol-17 beta significantly higher than in the natural CL (108 +/- 11.6 compared with 74.2 +/- 7.81 pg/g tissue). P450scc and P450(17 alpha) mRNA was detected in both structures while P450arom and full-length mRNA FSH receptor were detected only in the secondary structure.

Plasma estradiol FSH and LH concentration after dominant follicle aspiration in the cow.

This work investigates the estrogenic role of the dominant follicle with regard to regulation of plasma FSH and LH concentration. Eight Holstein-Friesian cows were used for aspiration of the dominant follicle using ultrasound guidance during the early, mid and late stages of the luteal phase. Blood samples were collected at 15-min intervals from 4 h before until 7 h after aspiration. Plasma progesterone concentration increased from 0.7 to 7.2 ng mL-1 from early to mid luteal phase and then fell slightly to 5.9 ng mL-1 in the late luteal phase, but remained unaffected by follicle puncture. The follicular aspirate contained a thousandfold higher estradiol, than plasma concentration but its estradiol:progesterone ratio remained at around 2 at each stage of the luteal phase. Aspiration caused plasma estradiol concentration to fall from 1.4 to 0.7, 1.8 to 1.0 and 1.7 to 0.8 pg mL-1 in the early, mid and late stages of the luteal phase, respectively (P < 0.05). At the same time, mean plasma FSH concentration was increased from 1.1 to 1.8, 1.7 to 2.9 and 0.8 to 1.9 ng mL-1 (P < 0.05), respectively. The results suggest that estradiol secreted from dominant follicles selectively regulates gonadotropin secretion, since aspiration of the dominant follicle at any stage of the cycle affected circulating FSH but did not appear to influence the mean LH concentration.

Determination of corpora lutea numbers in Booroola--Texel ewes using transrectal ultrasound.

Ovulation rates in Booroola--Texel ewes are currently determined by laparoscopic examination of the ovaries during the luteal phase allowing for carrier status of the ewe to be diagnosed. However, this is an invasive procedure and the aim of this work was to determine whether or not transrectal ultrasound would be an acceptable and accurate alternative to laparoscopy for this purpose in ewes. Transrectal ultrasound was performed using a 5.0 MHz transducer in 18 ewes restrained in the standing position. They were then euthanized and laparoscopy was performed, following which the reproductive tracts were recovered. An additional 22 ewes were subjected to scanning in dorsal recumbency, using a 7.5 MHz transducer, at various stages of the luteal phase before being euthanized and the reproductive tracts recovered. The ovarian structures identified using each method were then compared. The results demonstrated that laparoscopy is an accurate method of determining ovulation rates in ewes. Transrectal ultrasound examination appeared to be an acceptable and non-invasive procedure. The use of a 7.5 MHz transducer with the ewes in dorsal recumbency produced the best results and clearest images of the ovaries, which allowed for the determination of the number of corpora lutea (CL) and the presence of other structures. Accuracy improved with experience in the technique, the stage of the luteal phase at which the examination was performed, the number of CL present in the ovary and the age of the ewe. Further work is needed to confirm this finding due to the small numbers of animals in the present study. This ultrasound technique, however, has the potential to provide an alternative to laparoscopy for the determination of numbers of CL in ewes.

A comparison of a new affinity column system with a conventional tube LISS-antiglobulin test for antibody detection.

A recently introduced system for antibody detection (ReACT) consists of affinity columns (AFC) that contain protein A and protein G-coated agarose. We compared the ReACT system to a conventional tube low-ionic-strength saline antiglobulin test (LISS-AGT). We selected 100 LISS-AGT positive samples with clinically important and benign antibodies of varying strengths and 130 LISS-AGT negative samples to evaluate by the AFC method. AFC tests were positive with all 84 clinically important antibodies, including 36 antibodies that reacted <= 1+ at LISS-AGT (0% falsely negative). Eleven of 16 (69%) clinically benign antibodies reacted by AFC. Five samples (2 anti-Sda, 2 anti-I, and 1 inconclusive) were negative by AFC. AFC tests were negative with all 130 samples that were negative by LISS-AGT (0% falsely positive). The AFC method showed results comparable with results obtained with a conventional tube LISS-AGT for detection of clinically important antibodies. Some unwanted, clinically benign antibodies may not be detected by the AFC method.

Assessment of the clinical significance of anti-Dob.

BACKGROUND: Anti-Dob is an uncommon antibody, and there are few data regarding its clinical importance. In the present case, the patient's transfusion management was based on both in vivo and in vitro assay results. CASE REPORT: A delayed hemolytic transfusion reaction was suspected in a 64-year-old white woman awaiting cardiac surgery when the transfusion of 1 unit of red cells failed to raise her hematocrit. Although direct antiglobulin tests were negative, antibody screening tests on samples drawn 9 days after transfusion were positive, and anti-Dob was identified, reacting to a titer of 4. 51Cr in vivo survival studies with incompatible Do(b+) red cells showed poor survival: 83.2 percent at 1 hour, 43 percent at 24 hours, and 29.6 percent at 48 hours and t1/2 = 19 hours (normal t1/2 = 25-35 days). A monocyte monolayer assay performed with the same incompatible Do(b+) donor red cells also indicated poor survival: 22 percent and 30 percent reactive monocytes, respectively, with and without the addition of complement (normal, 0-3%). The patient was given 4 Do(b-) red cell units without clinical signs or symptoms of a reaction. CONCLUSIONS: This example of anti-Dob was implicated in a delayed hemolytic transfusion reaction. The 51Cr survival studies and monocyte monolayer assay results indicated that the anti-Dob was clinically significant, requiring the use of Do(b-) red cells for transfusion.

Gross and ultrasonographic anatomy of the carpal flexor tendon sheath in horses.

This study was undertaken to establish the gross anatomy and the ultrasonographic appearance of the carpal digital flexor tendon sheath (carpal sheath) and the palmar carpal region in normal horses. The isolated forelimbs from 15 horses were used to study the morphology of the sheath and associated structures, including a detailed study of the location of the main blood vessels and nerves in that region. These limbs and the forelimbs of five live, sound horses were also examined ultrasonographically. The examination yielded good soft tissue detail of the tendons and ligaments, synovial and perisynovial tissues and larger blood vessels. There was a good correlation between the ultrasonographic and gross anatomical appearance of the limbs. The sheath cavity was only identified after it had been distended with water, and the various synovial recesses at the level of the carpal canal were poorly imaged.

Endoscopic examination of the carpal flexor tendon sheath in horses.

This study was undertaken to design a safe technique to examine the carpal flexor tendon sheath (carpal sheath) of horses endoscopically, using an arthroscope. The limbs from 15 horses were used to study the normal anatomy of the carpal sheath and related structures, establish a safe approach and endoscopic technique, and determine the normal endoscopic appearance of the sheath. Major arteries, veins and nerves, present within and around the sheath, left few 'safe' areas to insert the endoscope. Several portals were assessed and a distal lateral approach was found to be safest and to allow adequate visualisation of most of the sheath. The surgical technique and normal endoscopic findings are described in detail and discussed.

Adherence to a strict specimen-labeling policy decreases the incidence of erroneous blood grouping of blood bank specimens.

BACKGROUND: To assess the effectiveness of a system of preventing incompatible blood transfusions resulting from the misidentification of patient specimens, a prospective analysis of all blood samples submitted to a laboratory was performed. STUDY DESIGN AND METHODS: Incorrectly labeled specimens (rejected samples) were tested for ABO and Rh type, and routine antibody screens were performed. Test results were compared to historic patient data or patient data obtained from subsequently submitted (correctly) labeled specimens. For comparison, all discrepant serologic results from appropriately labeled samples were also recorded. RESULTS: Specimens that failed to meet the criteria for specimen acceptance were 40 times more likely to have a blood grouping discrepancy. CONCLUSION: Strict adherence to the labeling requirements results in a significant decrease in erroneous blood grouping. This would accordingly diminish the likelihood of transfusing out-of-group blood components.

Use of the polymerase chain reaction to sex the bovine fetus using cells recovered by ultrasound-guided fetal fluid aspiration.

The aim of this study was to carry out first trimester fetal sex diagnosis using the polymerase chain reaction (PCR) to amplify DNA from bovine fetal cells recovered by transvaginal ultrasound-guided uterine puncture and fetal fluid aspiration. For sex determination, a nested, allele-specific, PCR amplification of the bovine zfx and zfy gene fragments was utilised. The PCR assay was validated using fetal fluids recovered from uteri post mortem. Cells were harvested from the fetal fluids, genomic DNA extracted and the PCR assay applied. A technique which was developed for transvaginal ultrasound-guided follicle aspiration was modified to recover fetal fluid from live animals. Small volumes of fetal fluid (0.5-5 ml) were recovered between days 61-97 of gestation and the PCR assay applied. The gender determined by PCR of fetal fluid cells was in all cases confirmed by visual inspection (n = 15 abattoir specimens) or ultrasound scanning (n = 7 live animals). Fetal death, attributed to the introduction of intrauterine infection, occurred in 4/4 cows in the first series of aspirations but in only 1/3 heifers in the second series of aspirations.

Ultrasonographic examination of the femorotibial articulation in horses: imaging of the cranial and caudal aspects.

The aim of this study was to determine the normal ultrasonographic features of the cranial and caudal aspects of the femorotibial articulation and, in particular, to establish a method of examining the menisci, cruciate and meniscal ligaments ultrasonographically. Twenty hindlimbs isolated post mortem from 10 horses were used to study the normal ultrasonographic and gross anatomy of the femorotibial joint. Five stifles from 3 normal, live horses were also examined with B-mode, real-time ultrasound imaging. The results of the anatomical study are presented. The joint surfaces, menisci, cruciate and meniscal ligaments could be imaged adequately in all the specimens. No obvious variations in shape or echotexture, that might impair visualisation of potential lesions, were observed. The authors suggest that ultrasonography is a potential, noninvasive means of diagnosing soft tissue lesions in the femorotibial joint.

Polyethylene glycol versus low-ionic-strength solution in pretransfusion testing: a blinded comparison study.

BACKGROUND: Polyethylene glycol (PEG) has been shown to potentiate antigen-antibody reactions. STUDY DESIGN AND METHODS: To investigate the utility of PEG in pretransfusion testing, a blinded comparison study of PEG and a low-ionic-strength additive solution (LISS) was conducted. A total of 500 patient samples were tested in parallel with reagent antibody-detection cells using blind-coded PEG and LISS potentiators. RESULTS: In 34 (34%) of 100 samples with known antibodies in the Rh, Kell, Duffy, Kidd, and MNS systems, PEG antiglobulin reactions were stronger (total score, 382) than LISS antiglobulin reactions (total score, 216), and in 66 cases (66%), they were equal to those of LISS. Of 400 samples without detectable antibodies, 384 were negative with PEG and LISS, and 16 were positive in PEG tests and negative in LISS. Seven of the 16 were clinically important antibodies (D, 1; E, 3; Fya, 1; Jka; 1; Jkb, 1), and four were clinically benign antibodies (Le(a), 2; McCc, 1; Sda, 1). Five of the 16 demonstrated inconclusive PEG reactions, for a false-positive rate of 5 in 400 (1.3%). Of the 500 samples, none was negative in PEG tests and positive in LISS (0% false-negative rate). CONCLUSION: Although PEG demonstrates a relatively high false-positive rate, PEG is more sensitive than LISS in detecting clinically significant antibodies.

Technical aspects of transvaginal ultrasound-guided follicular aspiration in cows.

A 7.5 MHz rectal transducer adapted for transvaginal use was compared with a human microcurvilinear 6 MHz transvaginal transducer for follicular aspiration in cows. Some of the problems encountered while developing an accurate and repeatable technique are discussed, including the preparation of the cow, and the selection of the needle and suction apparatus. Proficiency in the retrieval of oocytes was improved through practice. Four cows were aspirated on days 2 to 4, 9 to 12 and 15 to 16 after oestrus in two successive oestrous cycles. The initial recovery rates were poor (7 per cent) and the oocytes were of poor quality, being almost completely denuded. However, after five weeks' practice recovery rates of 41 per cent were achieved and the oocytes were suitable for in vitro maturation.

Factors affecting the clinical outcome of injuries to the superficial digital flexor tendon in National Hunt and point-to-point racehorses.

Ultrasonographic examination was used to define the severity of injuries to the superficial digital flexor tendon in 73 National Hunt or point-to-point racehorses and the factors influencing the outcome of the cases were examined. Thirty-four of the horses (46 per cent) returned to work with an average time out of training of 13.5 months. The rate of recurrence of the injury was 35 per cent. The severity of the lesions was related to the outcome; all the mildly affected horses returned to work, with 63 per cent of them racing and an average time out of training of 10.2 months; 50 per cent of the moderately affected horses returned to work, and 30 per cent raced with an average time out of training of 11.3 months; 30 per cent of the severely affected horses worked, and 23 per cent raced with an average time out of training of 18.3 months. The differences in outcome between unilateral and bilateral injuries within each severity group were not statistically significant. Seventy-six per cent of horses treated with polysulphated glycosaminoglycans returned to work, compared with 46 per cent of conservatively managed horses and 50 per cent of horses treated with laser therapy. However, these differences were not statistically significant and the rate of recurrence of the injury in the horses treated with polysulphated glycosaminoglycans was 50 per cent compared with only 31 per cent in the conservatively managed horses. Seventy per cent of the mares and 47 per cent of the geldings were retired from racing.

Ultrasonographic and histopathological findings in equine superficial digital flexor tendon injury.

The ultrasonographic and histopathological findings in 12 normal and 28 injured superficial digital flexor tendons, with lesions ranging in duration from 2 days to 15 months, were compared. A consistent relationship between the ultrasonographic and histological findings was demonstrated. The echogenicity of lesions, the distinctness of their delineation from the surrounding tissue, and the presence and arrangement of the linear echoes were useful features by which to assess the ultrasonograms. Acute lesions were anechoic, a complex mixture of anechoic and hypoechoic areas, or diffusely hypoechoic. These appearances represented haemorrhage, fibrolysis and early granulation tissue. Fibroplasia and granulation tissue produced well to moderately well defined hypoechoic lesions. Chronic fibrosis was characterised by heterogeneously echogenic areas which were poorly defined from the surrounding tissue and had irregularly-arranged linear echoes on longitudinal images. Intratendinous scar formation resulted in multiple hyperechoic foci. Extensive peritendinous lesions were readily apparent on ultrasonograms, but intertendinous adhesions were more difficult to assess, and produced ill-definition of the borders between the superficial and deep digital flexor tendons.