Medial canthopexy using transcaruncular barb and miniplate: technique and cadaver study.

Traditional medial canthopexy techniques require transnasal access, periorbital skin incision, and/or direct canthal suturing, often yielding unpredictable outcomes. The transcaruncular canthal barb and miniplate technique is a simplified method of canthopexy that avoids these manoeuvres. 10 transcaruncular medial canthopexies were performed on cadavers with simulated naso-orbito-ethmoid (NOE) injury. Differences in mean pre-injury and post-canthopexy intercanthal distance (ICD) and palpebral aperture width (PAW) measurements were compared using a matched paired t test. Reliability between pre-injury and post-injury intercanthal distance and PAW was compared with intraclass correlation coefficients. Canalicular distortion and final implant position were assessed with post-canthopexy computed tomography (CT). There was no difference in mean palpebral aperture width (32.32 and 32.43 mm) or mean intercanthal distance (29.18 and 29.06 mm) between pre-injury and post-canthopexy groups (both p>0.05). All intercanthal distance and PAW intraclass correlation coefficients were >0.97 (p<0.05). Post-canthopexy, CT scans showed canaliculus distortion in 4/10 of upper and 0/10 of lower canaliculi with all canthal barbs in the correct position relative to the plate. In a cadaver telecanthus model, medial canthopexy using the transcaruncular barb and miniplate technique reliably reduces the medial canthus and did not distort the lower lacrimal canaliculus, but may distort the upper canaliculus.

Vaccination and consumer perception of seafood quality.

Unlike other segments of international food production, finfish aquaculture has so far not been associated with major food scandals. However, because of increased focus on food safety, the seafood industry and associated businesses have to respond to and document all aspects related to their products and processes. Consumers have a right to know, and need knowledge and information to be able to make qualified choices. In aquaculture good management and environmental attention is essential for both product quality and economic sustainability. One of the main challenges in all farming activities is efficient fish health management, which is crucial for maintaining and further developing the industry. In all biological production, and also in aquaculture, diseases have been, are, and will continue to present a challenge. When dealing with disease incidents, environmental, ethical, biological and economic issues must be taken into account. In animal health management there is a common understanding that prevention is better than treatment, so also in aquaculture. In many segments of industrial fish farming, vaccines have proved a good management tool to control diseases and to reduce both mortality and the use of chemotherapeutics. As seen in a recent Norwegian consumer survey, this might unfortunately look somewhat different from a consumer point of view. The perception of vaccines as foreign substances, visible vaccine lesions or pigment, words about genetically produced vaccines, and a general lack of knowledge may fuel scepticism. Even when experts are giving good and well-documented information, consumers still stick to their original perception of food, including seafood. Given this background, this papers discusses the aquaculture industry's priorities regarding vaccines and vaccination strategies, and its information policy towards the customer.

Multiple site analytical evaluation of a portable blood gas/electrolyte analyzer for point of care testing.

OBJECTIVE: To evaluate the analytical performance of the SenDx 100 portable blood gas and electrolyte analyzer (SenDx Medical, Carlsbad, CA). DESIGN: Accuracy was evaluated by correlation of whole blood patient samples with the Nova Stat Profile 5 (Nova Biomedical, Waltham, MA) and the Ciba Corning 865 (Chiron Diagnostics, Medford, MA). Precision was evaluated using quality control materials (RNA Medical, Acton, MA). SETTING: Critical care laboratories and operating rooms in two institutions. MEASUREMENTS AND MAIN RESULTS: Precision studies performed at three different concentration levels for each analyte demonstrated intra-assay precision of < or =2.5% coefficient of variation and interassay precision of < or =4.0% coefficient of variation in all cases. Analysis of patient specimens in general showed good to excellent correlation to reference analyzers. Regression variables are tabulated. CONCLUSIONS: The SenDx 100 portable blood gas and electrolyte analyzer is a simple and easy to use analyzer demonstrating acceptable performance compared with reference methods.

Invited review: small versus large plate fixation of mandibular fractures.

BACKGROUND AND OBJECTIVES: Since the introduction of antibiotics in the late 1940s, open reduction and internal fixation (ORIF) gradually replaced various dental splints and devices as a means of providing additional reduction and fixation of mandibular fractures. Stainless steel wire has been recently replaced by plate-and-screw fixation. When properly utilized, this method provides convalescent function without maxillomandibular fixation (MMF). The purpose of this article is to review the evolution of small versus large plate fixation of mandibular fractures. METHODS AND MATERIALS: In the context of reports in the literature and 26 years of clinical experience, the authors review the types of mandibular rigid fixation, healing of fractures, morbidity of fracture repair, indications for rigid fixation, and evolution of techniques of treatment. RESULTS AND/OR CONCLUSIONS: Although numerous devices and techniques--bone clamps, intra- and extramedullary K-wires, metallic mesh, and other means--have been used and abandoned, modern plate and screw systems, if not the standard of care, have become widely accepted and used.

The vaccinia virus 42-kDa envelope protein is required for the envelopment and egress of extracellular virus and for virus virulence.

Vaccinia virus gene B5R encodes a M(r) 42K glycoprotein that is expressed throughout infection and forms part of the envelope of extracellular virus. In this paper deletion mutants (delta B5R) lacking the B5R open reading frame (ORF) from the Western Reserve (WR) and IHD-J strains of vaccinia virus have been constructed and shown to form very small plaques compared with the wild-type viruses. This phenotype was directly attributable to loss of the B5R gene since re-insertion of this gene from WR or IHD-J into the WR mutant lacking B5R (W-delta B5R) restored a normal plaque phenotype. In the latter case the failure of the revertant to form comets indicated that the nine amino acid differences in the B5R ORF between the IHD-J and WR strains of virus are not responsible for comet formation by IHD-J virus. Furthermore, the B5R deletion mutant of IHD-J (I-delta B5R) still formed small comets. Despite the small plaque phenotype of the deletion mutants, normal yields of intracellular naked virus (INV) were produced. In contrast, deletion of B5R had a profound affect on the formation of the extracellular enveloped virus (EEV). Transmission electron microscopy indicated that INV particles were not wrapped by a double layer of Golgi-derived membrane and enveloped particles were not detected within the cell or on the cell surface without expression of the B5R protein. Biochemical measurement of EEV formation, by labeling infected cells with [3H]thymidine followed by cesium chloride density gradient centrifugation of particles released from the cells 24 hr postinfection, showed that only 10% of WT levels of EEV were produced by I-delta B5R. The loss of the B5R ORF caused severe attenuation in intranasally infected mice. At doses between 10(4) and 3 x 10(7) plaque-forming units there were no signs of disease in animals infected with W-delta B5R, whereas at comparable doses the WR parent virus caused significant mortalities. Finally, an ORF with 93.4% amino acid identity to vaccinia WR B5R is present in variola major virus strain Harvey and the B5R protein was shown by Western blotting to be expressed by all orthopoxviruses tested.

A constitutively expressed vaccinia gene encodes a 42-kDa glycoprotein related to complement control factors that forms part of the extracellular virus envelope.

Nucleotide sequence analysis of a 42-kb region of the vaccinia virus (strain Western Reserve) genome identified a gene with the potential to encode a 35.1-kDa polypeptide with properties of a membrane glycoprotein (Smith et al., J. Gen. Virol. 72, 1349-1376, 1991). The 317 amino acid open reading frame (ORF) has similarity with complement control proteins and a secretory vaccinia virus protein (C28K) which interferes with complement function. The predicted B5R gene product differs from the latter protein in that it contains a C-terminal hydrophobic sequence and may be membrane-associated rather than secretory. Transcriptional mapping by Northern blotting and S1 nuclease protection showed that the gene is transcribed both early and late during infection, with the early RNA start site located 60 bp upstream of the late start site that is present at -9 to -5 bp relative to the ORF. Nevertheless, translation of early and late mRNAs are predicted to produce the same polypeptide. A rabbit antiserum was raised to the predicted external hydrophilic domain of B5R expressed in Escherichia coli and used to immunoprecipitate a M(r) 42 K protein from vaccinia-infected cells. This protein was synthesized throughout infection, with a peak from 6 to 7 hr, and its production was inhibited by tunicamycin but not monensin. Western blotting of proteins from purified extracellular enveloped virus (EEV) or intracellular naked virus with anti-B5R serum showed that this M(r) 42 K protein and two higher molecular weight forms (Mr82 and 87 K) were present only in EEV. Anti-B5R serum inhibited comet formation by the IHD-J strain of virus on RK13 cells. B5R is the third vaccinia gene shown to encode an EEV glycoprotein, the others being the virus hemagglutinin gene, and gene SalL4R which encodes a group of lectin-like glycoproteins of M(r) 22-24 K.

Prescribing of veterinary and human preparations for animals in Norway. Was the preparation approved for the animal species for which it was prescribed?

The prescribing of drugs for use in veterinary medicine in Norway was investigated through a cross-sectional survey. Of the 8741 prescriptions issued for animals included in this study 22% were for drug use in veterinarians' practices. Drugs from all but one therapeutic group were prescribed for use in animals. On average, 49% of the prescriptions were for veterinary preparations, 43% were for human preparations, and 8% were for formulations prepared by pharmacies. Of prescriptions for specific animal species, 27% of the preparations were not approved for the intended animal species. The corresponding figures for prescriptions of veterinary and human preparations were 7% and 41%, respectively. Of prescriptions for production animals 17% of the preparations were not approved for the intended animal species, and for pets this figure was 30%.

An evaluation of the information given on veterinary prescriptions in Norway. Compliance with the legal regulations.

Compliance with Norwegian legal regulations for veterinary prescriptions was investigated and evaluated. The study was designed as a cross-sectional prescription survey, and the prescriptions were recorded in Dbase III. Of the 6505 written and telephone prescriptions collected only about one in five fulfilled the legal requirements, namely, giving information about the animal species the drug was intended for, indication for the prescribed drug and directions for use. On average 86% contained information about the animal species, while 26% and 80%, respectively, contained formation about the indication for the prescribed drug and directions for use. The number of prescriptions on which indication and directions for use were given, was significantly higher for written prescriptions than for telephone prescriptions, and for prescriptions of human preparations compared with prescriptions of veterinary preparations. For pets, the number of prescriptions containing directions for use was significantly higher than for production animals. The proportion of prescriptions for pets giving a statement of the indication was not significantly different from prescriptions for production animals.

Utilization of dichlorvos and trichlorfon in salmonid farming in Norway during 1981-1988.

The main objectives of this investigation were to quantify the use of dichlorvos and trichlorfon in the treatment of salmon lice infestations, to evaluate the prescribing of these drugs, and to estimate possible changes in the salmon lice problem by use of drug statistics. This study has shown that the use of trichlorfon increased from 4.9 tons in 1981 to 28.3 tons in 1985. This figure declined to 3.2 tons in 1988. The use of dichlorvos increased from 0.3 tons in 1986 to 3.2 tons in 1988. The change in the prescribing from trichlorfon to dichlorvos has dramatically reduced the pollution caused by these substances in the marine environment. Moreover, if necessary safety rules are observed, this change reduces the exposure of the workers on fish farms to these drugs, and also reduces the possibilities of intoxications of the fish during the treatment procedure. The sales figures of dichlorvos and trichlorfon, related to the calculated biomass of farmed salmonids in the sea, indicate a dramatic increase in the salmon lice problem.

Clinical use of dichlorvos (Nuvan) and trichlorfon (Neguvon) in the treatment of salmon louse, Lepeophtheirus salmonis. Compliance with the recommended treatment procedures.

Veterinarians representing one third of the Norwegian fish farms were asked about the clinical use of dichlorvos and trichlorfon by use of a questionnaire. A total of 45 veterinarians had experience in treatment of salmon lice with these organophosphates. Fourty-nine percent of the veterinarians reported that the fish farmers in their region solely used the recommended treatment equipment when delousing the fish, of these 1/4 always oxygenated the treatment solution. Repeated treatment were always prescribed by 24% of the veterinarians, while 44% did this occasionally. Of the 45 veterinarians 7% were often present and 44% were occasionally present at the fish farms in connection with the treatment. The answers showed that compliance with the recommended treatment procedures was unsatisfactory.

Assay of factors of the kinin system in plasma from patients with specific exogenous allergies.

Factors of significance for the release of kinin were estimated in plasma from patients with specific, exogenous allergies and in that from healthy individuals. There was no evidence that the rapid initial kinin release in plasma from allergic patients caused by submaximum concentrations of hog pancreas kalikrein or by acetone-activated human plasma (2) was due to an increased level of prekallikrein activator (activated factor XII), to prekallikrein itself or to a factor possibly positioned between active factor XII and prekallikrein. In addition, the rapid halt in kinin release observed for the patient plasma could not be ascribed to an increased level of alpha2-macroglobulin, CI-inactivator or alpha1-antitrypsin. It is suggested that the differences in kinin release registered between the patient plasma and the normal plasma might reflect differences in the relative amounts of kininogen fractions present.