Endocrine measurements and calving performance of Swedish red and white and Swedish Holstein dairy cattle with special respect to stillbirth.

During 3 consecutive calving seasons, calving performance, placental characteristics and endocrine profiles of total 98 pregnancies of late pregnant Swedish Red and White (SRB) and Swedish Holstein (SLB) dairy heifers and cows, were investigated. Ninety-four singleton pregnancies and 4 sets of twins were recorded. In animals with singleton pregnancy, 8 stillbirths, 7 weak calves, 3 premature parturitions and 1 abortion were registered. In the SLB heifers, 19% of stillbirth (5/26) were observed, while 5% (2/42) were noted for the SRB heifers. One stillborn calf derived from the SRB cows and none was found from the SLB cows. In the heifers and cows delivering a normal living calf with unassisted parturition, the placentome thickness monitored by ultrasonography was constant towards the end of pregnancy. The numbers of foetal cotyledons varied individually between animals but in total, fewer cotyledons were found in the foetal membranes of the SRB animals than in the SLB animals (69 +/- 19) vs. (88 +/- 29) (p < 0.05). No morphological and numerical differences of the placentome thickness in animals delivering a stillborn or weak calf, compared to animals delivering a normal living calf, could be observed. In animals with unassisted parturition and without birth complications, the levels of progesterone (P4), PGF2alpha metabolite (PG-metabolite), cortisol, oestrone sulphate (E1SO4) and pregnancy associated glycoproteins (PAGs) were not different by breeds and parities. In animals carrying stillbirth, higher levels of E1SO4 were found in 3 SRB animals and 1 SLB heifer, whereas lower levels of E1SO4 were recorded in 3 SLB heifers during the last week of pregnancy, compared to the profiles found in animals with unassisted parturition. Additionally, the levels of PAGs remained low and constant in 1 SRB cow (delivering a stillborn calf), 1 SRB heifer (giving birth prematurely), 4 animals (carrying twins) and 1 aborting SRB cow. Our results show a very high rate of stillbirth in especially SLB heifers and deviating profiles of E1SO4 and PAGs in animals with impaired parturition were recorded.

DNA analysis of malignant salivary gland carcinomas: comparison of different tissue preparations and measuring techniques.

This study correlates static and flow-cytometric analysis on paraffin-embedded and fresh material of salivary gland carcinomas. Nuclear suspensions for DNA analysis were prepared from paraffin-embedded and fresh material. Comparison of the results of static and flow cytometry on paraffin-embedded material revealed no significant correlation between DNA ploidy and S-phase value. The coefficients of variation were significantly lower for static than for flow cytometry (p < 0.05). Flow-cytometric analysis on fresh and paraffin-embedded material correlated well concerning DNA ploidy, but not for the S-phase. The coefficients of variation were significantly lower for the fresh than for the paraffin-embedded material (p < 0.001). Cytometric analysis on paraffin-embedded material of malignant salivary gland carcinomas should be critically evaluated. There is a need for flow-cytometric investigations on fresh material to clarify further the prognostic value of this method.

Acoustic rhinometry in the evaluation of congenital choanal malformations.

Previous studies have shown that acoustic rhinometry (AR) is well suited to describe the nasal airway dimensions in healthy infants. The technique is quick to perform, non-invasive, without potential hazards and requires minimal cooperation. Due to the small dimensions of the infant nasal airways, the optimized miniprobe (Rhinometrics, Lynge, Denmark) provides abilities superior to those of adult probes. The equipment is portable and examinations can be performed in the maternity ward, out-patient department or at home. Measurements on models simulating the pre- and post-operative nasal geometry were performed to determine the accuracy and resolution of AR and to improve the interpretation of the curves obtained in vivo. Acoustic measurements in five infants with congenital respiratory distress caused by bilateral choanal atresia or stenosis have been compared with CT-scans and the results of the model simulations to evaluate the diagnostic value of the method. We conclude that AR represents a new and valuable tool in the diagnosis of congenital choanal malformations. Despite current technical limitations, it may also be of value in the post-operative evaluation, particularly if the posterior part of the septum is not resected.

Cost of bowel obstruction resulting from adhesions.

OBJECTIVE: To assess the direct costs associated with bowel obstruction resulting from adhesions. DESIGN: Prospective study. SETTING: University Hospital, Sweden. SUBJECTS: 57 patients aged 16 years or older who fulfilled the clinical and radiological criteria of bowel obstruction. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Course of, and direct costs associated with, the illness. RESULTS: In 34 of the 57 patients (60%) bowel obstruction was caused by adhesions, and in all 34 the small bowel was obstructed (85% of all cases of small bowel obstruction). 22 of the 42 patients who required a hospital stay of more than 24 hours (52%) had adhesive obstruction, and 10 of these (45%) had to be operated on, 2 of them twice. Major complications occurred in 6 (60%) and one died. In a national perspective, adhesive bowel obstruction may cause 2330 hospital admissions annually, which is associated with an estimated direct cost of about US$13 million. CONCLUSIONS: Adhesions are a serious, common, and costly complication of surgery. Efforts have to be undertaken to control their formation.

Prognostic significance of nucleolar organizer regions in adenoid cystic carcinomas of the head and neck.

OBJECTIVE: To determine the prognostic use of nucleolar organizing region (AgNOR) counts and clinical and histopathological features in adenoid cystic carcinoma. DESIGN: Argyrophilic staining was applied to ordinary formalin-fixed, paraffin-embedded specimens and evaluated to obtain the mean number of AgNORs and the percentage of nuclei with more than 1 (pAgNOR > 1), more than 2, more than 3, and more than 4 AgNORs. RESULTS: Using the log rank test, the mean AgNOR count showed no correlation with the disease-free period. All pAgNOR parameters exceeding the respective overall mean had poorer prognosis when compared with those below the mean (P = .02). The pAgNOR > 1 appeared as the best discriminator, singling out all treatment failures (P < or = .001). This parameter also showed a high degree of intraobserver and interobserver reproducibility. Stage of the disease, violated resection margins, and presence of the histopathological solid subtype were markers of an unfavorable prognosis. Multivariate analysis by the Cox model showed that pAgNOR > 1 (P < or = .001) and tumor stage (P = .03) were the only statistically significant parameters. CONCLUSIONS: Estimation of pAgNOR > 1 is easy, quick, and highly reproducible. It may become a useful prognostic parameter in adenoid cystic carcinoma, but larger studies should be performed to confirm the reliability of this method.

Ki-67 as a prognostic marker in adenoid cystic carcinoma assessed with the monoclonal antibody MIB1 in paraffin sections.

The monoclonal antibody MIB1 recognizing the Ki-67 antigen in formalin-fixed, paraffin-embedded tissue was used to study the proliferative activity in 44 adenoid cystic carcinomas of the salivary glands. The antigen expression was compared with clinical factors, histopathological grading, and prognosis. The Ki-67 value was significantly higher in tumors from patients suffering from treatment failure than in nonfailures (P<0.001). The Ki-67 expression was also higher in tumors exhibiting areas more than 30% of the solid growth pattern and higher in sinonasal tumors than in other locations. By Cox regression analysis, Ki-67 more than 4% was the strongest prognostic indicator (P<0.005). Clinical stage and violation of surgical margins were also found to be independent significant prognostic indicators. We conclude that Ki-67 expression estimated by the use of MIB1 is a powerful tool for predicting the short-term prognosis for patients with adenoid cystic carcinoma.

p53 protein expression in adenoid cystic carcinoma of the head and neck.

Forty-one adenoid cystic carcinomas were investigated retrospectively with the polyclonal antibody CM-1 against the p53 protein and the results compared with clinicopathological parameters and the proliferative activity estimated by Ki-67 expression. p53 acted as a significant explanation variable in simple linear regression with Ki-67 as the dependent variable (r=0.39, p<0.02). High p53 expression was observed in tumors with violated margins during primary surgery. No significant correlations were demonstrated with other clinicopathological parameters or treatment outcome. Alterations in the p53 gene may be responsible for increased proliferative activity in the tumors, but elevated antigen expression has little prognostic value.

[Allergic rhinitis. Epidemiology, pathogenesis, investigation and treatment]. / Allergisk rhinitt. Epidemiologi, patogenese, utredning og behandling.

The incidence of allergic rhinitis is increasing, as is our knowledge of its pathogenesis, epidemiologic factors and optimal therapeutic principles. This paper discusses various allergy promoting factors and gives a brief update on current immunological concepts of allergy. Recent achievements in the pathogenesis of allergic rhinitis are discussed, as well as pharmacological and non-pharmacological treatment.

[Chronic non-allergic rhinitis. Etiology, diagnosis and treatment]. / Kronisk ikke-allergisk rhinitt. Arsaker, utredning og behandling.

Chronic rhinitis can be defined as an inflammation of the nasal mucosa lasting for more than three months. The condition may be due to allergy or infection, or to a number of non-allergic and non-infectious causes, such as trauma, hormonal imbalance, toxic influence or locally applied drugs. The etiology, diagnostic procedures and treatment of non-allergic chronic rhinitis are discussed.

DNA content in adenoid cystic carcinomas.

BACKGROUND: A retrospective study was performed on 51 patients with adenoid cystic carcinomas to see whether DNA ploidy, tumor stage, and histopathologic grading correlated with prognosis. METHODS: Histopathologic grading was performed according to Szanto et al and DNA content was estimated from archived material using the technique by Hedley et al. RESULTS: Thirty-nine tumors were DNA diploid and 12 were DNA aneuploid. Histologic grade III was more often associated with DNA aneuploidy than the lower grades (p = 0.011). DNA ploidy also correlated with clinical stage (p = 0.011). Log-rank analysis and Cox regression analysis of treatment failures revealed significant findings for S-phase value and DNA ploidy. CONCLUSIONS: Our results indicate that DNA ploidy estimations, S-phase value, and histologic grading are prognostic factors in adenoid cystic carcinomas. These examinations should therefore be incorporated in the evaluation of patients with adenoid cystic carcinomas.

Proliferating cell nuclear antigen in adenoid cystic carcinomas of the head and neck.

This retrospective study was performed on formalin fixed, paraffin-embedded specimens from 50 patients with adenoid cystic carcinomas to investigate if proliferating cell nuclear antigen (PCNA) correlated with DNA ploidy and S-phase value. Moreover, we have analysed whether PCNA could be used in the prediction of treatment failures, i.e. inability to eradicate the disease or recurrences. The PCNA expression showed values ranging from 0-78%. The mean PCNA value for DNA aneuploid and DNA diploid tumours were 9.5% and 4.8% respectively. No correlation was found between PCNA expression and S-phase value. Nor did we find any relation between the PCNA expression and treatment failure. Our results indicate that PCNA expression of archival material from adenoid cystic carcinomas is not a reliable prognostic factor.

Post-operative evaluation of functional endoscopic sinus surgery with computed tomography.

Fifty consecutive patients underwent functional endoscopic sinus surgery (FES) for bilateral rhinosinusitis. Pre- and post-operative computerized tomographic scans were evaluated. Of 50 patients, 45 (90%) experienced improvement in symptoms. Post-operative scans gave less encouraging results, with a slightly improved score for the combined group of sinuses and for the ethmoidal and maxillary sinuses separately. The difference between the pre- and post-operative CT score for the ethmoidal sinuses was statistically significant. The frontal sinus showed similar pre- and post-operative radiological findings. For the inexperienced surgeon we recommend computer tomographic examination 4-6 months after surgery. This could prove helpful if recurrence of symptoms occurs. For the experienced surgeon, clinical and endoscopic follow-up for at least 3 years is appropriate.

[Hearing loss in autoimmune diseases]. / Hørselstap ved autoimmune sykdommer.

Several autoimmune disorders are associated with inner ear involvement. The resulting sensorineural loss of hearing may be improved by treatment with immunosuppressive agents. We describe a patient with oral ulcerations, systemic vasculitis, iridocyclitis and bilateral sudden deafness. After a course of systemic steroid treatment the hearing improved. Atypical Cogan's syndrome is the most likely diagnosis.

Aspects of stability of regional cerebral blood flow in chronic schizophrenia: an 18-year followup study.

Regional cerebral blood flow (rCBF) measurements and psychiatric ratings were performed on seven schizophrenic patients (mean age = 41.4 years) who had been examined 18 years previously in a study that used similar psychiatric ratings and a comparable rCBF technique. Neither the clinical symptomatology nor the rCBF level and distribution had changed appreciably between 1972 and 1990. The findings indicate that cerebral functional activity in chronic schizophrenia remains constant in spite of continuous neuroleptic medication.

Adenoid cystic carcinoma: DNA as a prognostic indicator.

A retrospective study was performed on 20 patients with adenoid cystic carcinomas of major salivary glands to see if DNA patterns correlated with their prognoses. Fourteen tumors were found to be DNA diploid; 6 were DNA aneuploid. Histologically, all DNA-aneuploid tumors had solid components, compared with only 5 of the DNA-diploid tumors. All of the DNA-aneuploid tumors recurred, in contrast to only 2 of the DNA-diploid tumors; the difference was highly significant (P less than 0.001). All of the patients with no recurrences had DNA-diploid tumors. In our study, DNA measurements of adenoid cystic carcinomas gave statistically significant information about prognosis and correlated to histological grading. We propose that evaluation of DNA content may be performed before planning the treatment of adenoid cystic carcinomas.

[Osteosynthesis with miniplates in unstable maxillo-zygomatic fractures]. / Osteosyntese med miniplater ved ustabile maxilla-zygomaticus-frakturer.

This article discusses the etiology and classification of zygomatic fractures, as well as indications and methods of surgery. Osteosynthesis with a miniplate is a new treatment modality for unstable zygomatic fractures. The operative procedure is relatively simple and gives good cosmetic and functional results. We describe the technique illustrated with pre- and postoperative x-rays of a patient.

Regional cerebral blood flow in schizophrenia: repeated studies during a psychotic episode.

Regional cerebral blood flow (rCBF) measurements and clinical ratings were performed on 17 schizophrenic patients and a subgroup of 10 medication-free patients before and after treatment. While clinically exacerbated patients had normal blood flow, patients in remission showed a redistribution of flow with lower values in frontal areas. Anteroposterior ratios correlated with the degree of behavioral disturbances, suggesting that the level of frontal lobe activity in schizophrenia may be a function of the patient's clinical state at the time of study.

Pharmacokinetics of remoxipride controlled release and immediate release capsules in schizophrenic patients.

Single dose and steady-state pharmacokinetics of remoxipride, a new antipsychotic drug, were compared after administration of a controlled release capsule (CR) and an immediate release capsule (IR), both 200 mg and administered b.i.d. Thirteen patients with chronic schizophrenia entered the double-blind 6-week crossover study. Seven were evaluable for investigation of steady-state pharmacokinetics. Fluctuations in plasma remoxipride concentrations decreased considerably after remoxipride CR compared with the IR formulation. The plasma peak concentrations were significantly decreased and the trough values were increased after the CR formulation, although the average concentrations at steady-state were similar. The two formulations were bioequivalent regarding the amount of remoxipride absorbed after repeated dosing. Five out of 13 patients withdrew prematurely from the study because of ineffectiveness or refusal of treatment. Both formulations were well tolerated.

Pharmacokinetics of remoxipride in elderly psychotic patients.

The pharmacokinetics of remoxipride when given as single doses of 50 mg and repeated doses of 50 mg, 100 mg, and 200 mg twice daily to 10 elderly psychotic patients (71-89 years) were compared with the findings of two other studies to reveal any age-related differences. The three studies comprised a total of 38 patients in three distinct age groups: elderly (71-89 years), middle-aged (46-69 years) and young (19-36 years). AUC, Cmax and Cmin of both total and unbound remoxipride increased with increasing age. The unbound fraction was similar in the three age groups. The half-life was prolonged in the elderly, most probably caused by a decrease in intrinsic clearance. A two-fold increase in AUC of both total and unbound concentrations was observed in the elderly group compared to the young, suggesting that patients over 70 years in general require half the dose needed by young adult patients. In general, the pharmacokinetics of remoxipride in the elderly are linear.

DNA ploidy in oral cavity carcinomas, with special reference to prognosis.

Single-cell DNA cytofluorometry was performed on paraffin-embedded tissue of 140 patients with squamous cell carcinomas of the oral cavity. Half of the tumors (71 of 140) were DNA nondiploid. Well-differentiated carcinomas were more often DNA diploid than moderately well-differentiated ones (P less than 0.001; chi-square). The aneuploid tumors responded better to preoperative radiotherapy than did the DNA diploid (P less than 0.001) and polyploid tumors (P less than 0.05; chi-square). Using the multivariate Cox's regression analysis multiploid type tumor, age of the patients and presence of lymph node metastases were the only significant factors influencing survival. DNA diploid tumors in stages I and II had a better prognosis than DNA nondiploid (P less than 0.01; Kaplan-Meier). The reverse was true for stages III and IV, where DNA nondiploid tumors had a better prognosis (P less than 0.05; Kaplan-Meier). Tumor stages (P less than 0.001; Kaplan-Meier) and especially lymph node metastases (P less than 0.0005; Kaplan-Meier) were major prognostic factors. Tumor DNA ploidy may be a complement to clinical and morphologic parameters as a prognostic predictor in squamous cell carcinoma of the oral cavity.