Assessment of leakage pressure following enterotomy closure reinforced by tissue adhesive in a caprine cadaver model.

AIMS: To compare the combination of suture and tissue adhesive with suture alone for closure of enterotomy incisions in an ex vivo caprine jejunal model, by measuring the intraluminal pressure at which leakage occurred and the proportion of closures that leaked at intraluminal pressures <40 mmHg. METHODS: Jejunal tissue was harvested from a goat following euthanasia, and enterotomy incisions (4 mm in length) were made in each of 24 isolated jejunal segments. The enterotomies were randomly assigned to be closed using a single interrupted suture alone (n=12) or in combination with biopolymer tissue adhesive (n=12). The jejunal segments were infused with saline containing fluorescent dye and leakage pressure was defined as the peak pressure attained when visible leakage of saline solution occurred. The number of enterotomies that did or did not exhibit leakage at <40 mmHg intraluminal pressure was also recorded. RESULTS: Enterotomies closed using a combination of suture and tissue adhesive leaked at higher intraluminal pressure (58.2 (SD 4.7) mmHg) than those closed with suture alone (29.8 (SD 4.2) mmHg; p<0.001). The proportion of enterotomy closures in which the intraluminal pressure failed to reach 40 mmHg before leakage occurred was higher in enterotomies closed using suture alone (9/12, 75%) compared to those closed using both suture and tissue adhesive (3/12, 25%; p=0.002). CONCLUSIONS AND CLINICAL RELEVANCE: Use of tissue adhesive in addition to sutures increased the intraluminal pressure achieved before leakage occurred, compared to sutures alone, following enterotomy closure in a caprine cadaver model. In vivo studies are indicated to further assess the value of supplementing intestinal suture lines with tissue adhesive.

Biomechanical strength of two laparoscopic herniorrhaphy techniques in a cadaveric diaphragm and in a neoprene model.

OBJECTIVES: Our objectives were to 1) Biomechanically compare two laparoscopic repair techniques; an automated suturing device and a stapling device to conventional open suturing, and 2) Evaluate a model for canine diaphragmatic tissue by comparisons to similar constructs in fresh diaphragms. We hypothesized that automated suturing is biomechanically superior to laparoscopic stapling in dogs, and that neoprene defect repair is an acceptable model for experimental cadaveric diaphragm herniorrhaphy. MATERIALS AND METHODS: Samples of diaphragm pars costalis were prepared with defects mimicking radial muscular tears. Defects were repaired using conventional open suturing, laparoscopic automated suturing, and laparoscopic stapling techniques. Similar defects were created in 6.35 mm thick single-sided neoprene. Samples were biomechanically tested across a biaxial loading machine. Site and mode of failure were noted for all samples. RESULTS: In both the diaphragm muscle and neoprene, the laparoscopic stapling technique was significantly weaker. The neoprene model showed a similar failure load as the diaphragm in both laparoscopic techniques, and a similar stiffness in an open-sutured and stapled diaphragm compared to the neoprene samples. Site and mode of failure in neoprene were similar to cadaveric diaphragmatic tissue, but the overall median load-to-failure was higher for the neoprene. CONCLUSION: The strength of laparoscopically repaired simulated diaphragmatic hernias was higher with an automated suture technique than with a stapling technique. Neoprene defect repair is an acceptable model of canine diaphragmatic herniorrhaphy for biomechanical testing.

Hormonal concentrations in bitches with primary uterine inertia.

Normal labor is accompanied by sequential changes in blood concentrations of prostaglandin F2alpha (measured as 15-ketodihydro-PGF2 alpha=PGFM), progesterone, estradiol, oxytocin, vasopressin, and of elevated cortisol levels. The aim of this study was to investigate hormone concentrations in dogs diagnosed with primary uterine inertia before and during treatment by cesarean section. The hypothesis was the dogs would have abnormally low plasma concentrations in one or several of the hormones involved in parturition. The study comprised seven bitches with total primary uterine inertia (dystocia group) treated with cesarean section and six healthy bitches (control group) subjected to planned cesarean section. Blood samples were taken before anesthesia, before surgery started, on delivery of the first puppy and on delivery of the last puppy. The progesterone:PGFM ratio in plasma was higher in the dystocia group than in the control group, but the serum estradiol concentration did not differ between groups. The plasma concentrations of oxytocin and vasopressin increased in both groups when the first puppies were delivered, but both hormones were more elevated in the control group than in the dystocia group on delivery of the last puppies. The plasma cortisol concentration increased to the same level in both groups. In conclusion, the ratio between progesterone and PGFM was higher and the oxytocin and vasopressin concentrations lower in the dystocia dogs than in the control dogs. The findings indicate that these hormones are involved in the pathophysiology of total primary uterine inertia in bitches.

Crescentic osteotomy for resection of oral tumours in four dogs.

Rim resection of mandibular tumours and a simplified technique using a biradial osteotomy blade for maxillary tumours in dogs has not previously been described. The medical records and radiographs of dogs with mandibular (n = 3) or maxillary (n = 1) tumours resected using crescentic osteotomies were reviewed. The owners of two of the dogs reported excellent outcomes without any long-term complications or tumour recurrence. The goal of this study was to describe the surgical technique for performing a crescentic osteotomy for resection of maxillary and mandibular tumours. This technique for resection of mandibular and maxillary tumours is clinically applicable in carefully selected cases.

Primary uterine inertia in 27 bitches: aetiology and treatment.

OBJECTIVES: To evaluate two treatment methods in bitches with primary uterine inertia in relation to blood concentrations of oxytocin, calcium and glucose. METHODS: A prospective study where 27 bitches with primary inertia were randomly allocated to treatment groups I and II. Blood samples were collected before and after treatment. Group I was treated with a combination of intravenous calcium solutions and oxytocin and group II with oxytocin only. If unsuccessful, caesarean sections or additional medical treatment was pursued. RESULTS: Plasma oxytocin concentrations were 35+/-15 pmol/l in group I and 30+/-15 pmol/l in group II. Before treatment, the total serum calcium concentrations were 2.1+/-0.2 mmol/l in both the groups, and blood glucose values were 7.0+/-0.5 mmol/l (group I) and 7.3+/-1.4 mmol/l (group II). The number of bitches subjected to caesarean sections and the number of puppies born did not differ between the two groups. CLINICAL SIGNIFICANCE: This study indicates that low plasma oxytocin levels is a cause of primary inertia in bitches with normal serum calcium concentrations and aggravates the condition in bitches with low calcium levels. Hypoglycaemia was not observed. The outcome of labour did not differ between groups I and II.

Differentiation between pyometra and cystic endometrial hyperplasia/mucometra in bitches by prostaglandin F2alpha metabolite analysis.

Bitches with pyometra are potential emergency cases which may be clinically difficult to differentiate from cases of cystic endometrial hyperplasia (CEH) in combination with mucometra. In the present study plasma prostaglandin F(2alpha), as measured by its main metabolite 15-keto-13,14-dihydro-PGF(2alpha) (PG-metabolite) concentrations, blood biochemical and hematological parameters were measured in 59 bitches with pyometra, 10 bitches with CEH and nine controls to determine if PG-metabolite could differentiate between the three uterine conditions. Bitches with pyometra had significantly higher plasma levels of PG-metabolite than bitches with CEH (P=0.002) and the controls (P=0.002). PG-metabolite analysis alone had a high sensitivity (98.3%) and a high specificity (80.0%) for the differentiation of pyometra versus CEH in bitches where fluid in the uterus was diagnosed. When a combination of PG-metabolite and percentage band neutrophils (PBN) was used for differentiation of the two diagnoses, a sensitivity of 100% and specificity of 90.0% was obtained. This means that the combination of PG-metabolite and PBN analysis allows for differentiation between cases of pyometra and CEH. If the PG-metabolite level in a bitch is >or=4,524 pmol l(-1), there is a 99% probability of the diagnosis pyometra versus CEH. Levels of PG-metabolite >or=3,054 pmol l(-1), >or=2,388 pmol l(-1) or>or=1,666 pmol l(-1) indicates a 95%, 90% or 80% probability of pyometra, respectively. At high PG-metabolite levels (above about 3,000 pmol l(-1)), PG-metabolite alone is enough for differentiation of pyometra versus CEH. The results of the present study showed that PG-metabolite analysis is valuable in the diagnosis and prediction of severity of uterine diseases.

Pneumonia after intracranial surgery in dogs.

OBJECTIVE: To determine factors associated with the occurrence of pneumonia after intracranial surgery in dogs. STUDY DESIGN: Retrospective cohort study. Animals-Forty-nine client-owned dogs. METHODS: The medical records of 49 dogs with space-occupying intracranial disease that underwent craniotomy were reviewed. Development of pneumonia after surgery was considered highly likely in 12 dogs (affected dogs) based on clinical signs, including acute dyspnea or coughing in association with typical radiographic findings or abnormal transtracheal wash results. Pneumonia was confirmed in 6 dogs based on necropsy findings. Affected dogs were compared with 37 dogs that did not develop pneumonia (unaffected dogs) subsequent to intracranial surgery. Based on the medical records of affected dogs, determinations were made regarding time between development of pneumonia and surgery, surgical procedure, intracranial lesion type, and intracranial lesion location. Risk factors examined for both affected and unaffected dogs included level of consciousness, body position during the postoperative recovery period, duration of anesthesia, occurrence of vomiting or regurgitation, presence of seizures, cranial nerve deficiencies, and the presence of megaesophagus before and after surgery. We also compared the feeding protocol after surgery for each group. RESULTS: Pneumonia typically occurred within the first week after surgery (median, 6.5 days); however, this was variable (range, 1-96 days). Of the factors that were present within 24 hours before the clinical signs of pneumonia, vomiting or regurgitation and megaesophagus were found to be significant risk factors. Dogs that vomited or regurgitated were 2.71 times more likely to develop pneumonia than dogs that did not. Vomiting or regurgitation occurred in 63% of the dogs that developed pneumonia in this cohort. Dogs with megaesophagus were 9.25 times more likely to develop pneumonia than dogs without megaesophagus. Seven dogs with pneumonia died. Five of these 7 dogs appeared to have died as a direct sequel to pneumonia. CONCLUSION: Dogs undergoing craniectomies for space-occupying intracranial disease may be at higher risk for development of pneumonia due to several factors, including vomiting, regurgitation, and megaesophagus.

Determination of the optical purity of threonine and hydroxyproline by capillary gas chromatography on a chiral stationary phase.

Experimental conditions for the derivatization and resolution by GLC of all stereoisomers of threonine and 4-hydroxyproline are reported. Threonine was in two steps converted to N,O-bisisobutoxycarbonyl 2,2,2-trifluoroethyl ester derivatives, the second of which was performed under anhydrous conditions. As such the enantiomers could pairwise be separated by capillary gas chromatography on a Chirasil-Val column. Since L- and D-threonine eluted much earlier than the corresponding allo forms, quantitative determination of the allothreonine content in D- or L-threonine down to the one percent level could be simply accomplished but also enantiomeric impurities could be determined. Unlike for threonine, the corresponding 4-hydroxyproline isomers could not all be resolved as N,O-bisisobutoxycarbonyl 2,2,2-trifluoroethyl esters on this column. Although diastereomers could still be separated, the allo pair cochromatographed and the resolution for the L- and D-isomers was low. Complete separation of the 4-hydroxyproline isomers could be accomplished as N,O-bisprotected isobutyl amides, the formation of which required three derivatization steps. These were used for the determination of allohydroxyproline.

A physiotherapy test package for assessing back and neck dysfunction--discriminative ability for patients versus healthy control subjects.

BACKGROUND AND PURPOSE: A physiotherapy test package of 10 tests designed for assessing dysfunction due to back or neck pain was tested for its ability to discriminate between back- or neck-pain sufferers and healthy control subjects. Twenty-seven patients and 26 healthy control subjects participated in the study. METHOD: Fifteen patients suffering from back or neck pain and 15 matched healthy control subjects were assessed using the package to compare the results between the groups. The results from a further 12 back- or neck-pain sufferers and 11 unmatched healthy control subjects were analysed with respect to sensitivity and specificity, cluster formation and correlation with ratings of pain and perceived exertion. RESULTS: The differences in the test results for the patients and the matched healthy control subjects were highly significant in all variables but one. High sensitivity for cut-off points of clinical relevance was found in all variables but one, whereas specificity was moderate in most variables. CONCLUSIONS: Despite the small sample size, the significant differences between patients and healthy control subjects, with the sensitivity and specificity figures, suggest that the content validity of the test package is satisfactory.

Bacteriological findings, blood chemistry profile and plasma endotoxin levels in bitches with pyometra or other uterine diseases.

Uteri from 60 bitches with a clinical diagnosis of pyometra, or with an enlarged uterus as revealed radiographically or ultrasonographically, underwent histopathological examination, at which a diagnosis of pyometra was established in 48 of the 60 (80%) cases. Escherichia coli was isolated from 43 (90%) of the 48 uteri with pyometra. In 8 of the 60 cases, other pathological uterine conditions, such as endometrial hyperplasia, adenomyosis, mucometra or hydrometra, were diagnosed histopathologically. No bacterial growth was observed in the uteri of these 8 cases. Four of the 60 bitches (6%) showed no pathological changes in the uterus, and in 3 of these no bacteriological growth was seen in the uterus, while in one case a sparse growth of mixed culture was found. Blood samples from bitches with uterine infection caused by gram-negative bacteria showed marked hematological changes. These included higher total WBC counts and a more marked left shift in the differential WBC count than among the other bitches. Toxic degeneration of neutrophils was present among the bitches with gram-negative uterine infection and the serum ALP level was slightly higher than in the other groups of bitches. The plasma endotoxin concentration was determined in 53 bitches before surgery, in 28 bitches after surgery and in 11 control dogs. Only in 7 of the samples was endotoxin detected. The general condition of the bitches included in the present study was only mildly to moderately affected, and in no case indicated severe endotoxemia.

Use of a dehydroalanine-containing peptide as an efficient inhibitor of tripeptidyl peptidase II.

Tripeptidyl peptidase II is an intracellular exopeptidase, which has been purified from rat liver and human erythrocytes. An efficient specific inhibitor was obtained through beta-elimination of phosphate from the phosphopeptide Arg-Ala-Ser(P)-Val-Ala. The dehydroalanine-containing peptide formed was a competitive inhibitor with a Ki of 0.02 +/- 0.01 microM. This study demonstrated that replacing a serine residue in a good inhibitor with a dehydroalanine residue reduced the Ki 45 times. It is proposed that dehydroalanine-containing peptides could be of interest in the development of inhibitors for other peptidases as well.

Synthesis and antiviral activity of three pyrazole analogues of distamycin A.

The synthesis of three new monopyrazole analogues of the antiviral compound distamycin A is reported. Suitably protected 4-amino-1-methylpyrrole-2-carboxylic acid and 3-amino-1-methylpyrazole-5-carboxylic acid derivatives were chosen as starting materials. The construction of the trimeric polyamide framework was accomplished by assembly of the monomeric precursors under condensing conditions by analogy with our previous methodology, although with significant improvements in some pivotal steps. After chromatographic purification and spectroscopic characterisation, the analogues were assayed for antiviral activity. Compounds 7a-c inhibited vaccinia virus at a concentration similar to or lower than distamycin A and the related antibiotic netropsin. Analogues 7b and 7c exhibited an antiviral effect comparable to those of distamycin A and netropsin against HSV-1 and HSV-2, whereas their antiviral activity against several other viruses including HIV-1 and HIV-2 was somewhat lower. The cellular toxicity of 7a-c toward different host cell types proved to be of similar magnitude or lower than those of distamycin A and netropsin.

Wear resistance of some prosthodontic materials in vivo.

The purpose of this study was to compare a gravimetric method and an impression technique in the evaluation of occlusal substance loss. The wear of gold, porcelain, and microfilled resin was studied in vivo. The gravimetric method showed lower substance loss for porcelain than for gold, whereas the microfilled resin had the highest substance loss. To obtain a higher accuracy for the measurement of occlusal substance loss of restorative materials with an impression technique, the test area has to be restricted, the antagonizing occlusal contacts carefully recorded before the test period, and the number of cuts increased. The observed structure of wear facets (SEM) corroborated with previous findings of the wear mechanism of these materials; that is, gold has mainly abrasive wear in contact with porcelain, whereas porcelain has a fatigue type and microfilled resin a tribochemical type of wear.

Separation of a complete set of basic, diastereomeric pentapeptides by reversed-phase ion-pair chromatography.

The resolving power of liquid chromatography systems containing 1-pentane sulfonate, previously used to analyze basic hydrophilic peptides related to substrates of cAMP-dependent protein kinase, has been studied with respect to diastereomeric peptides. A set of peptides comprising RRASV and its five diastereomers containing one D-amino acid were used as model compounds. Complete resolution of all the peptides could be accomplished both with ethanol and acetonitrile as organic modifiers. The separation of the various peptides within the set turned out to be only modestly changed under the conditions investigated. These new results clearly demonstrate the potential of the chromatography systems studied.