Comparative therapeutic efficacy and safety of type-II collagen (UC-II), glucosamine and chondroitin in arthritic dogs: pain evaluation by ground force plate.

The investigation was conducted on client-owned moderately arthritic dogs with two objectives: (i) to evaluate therapeutic efficacy of type-II collagen (UC-II) alone or in combination with glucosamine hydrochloride (GLU) and chondroitin sulphate (CHO), and (ii) to determine their tolerability and safety. Dogs in four groups (n = 7-10), were treated daily for a period of 150 days with placebo (Group-I), 10 mg active UC-II (Group-II), 2000 mg GLU + 1600 mg CHO (Group-III), and UC-II + GLU + CHO (Group-IV). On a monthly basis, dogs were evaluated for observational pain (overall pain, pain upon limb manipulation, and pain after physical exertion) using different numeric scales. Pain level was also measured objectively using piezoelectric sensor-based GFP for peak vertical force and impulse area. Dogs were also examined every month for physical, hepatic (ALP, ALT and bilirubin) and renal (BUN and creatinine) functions. Based on observations, significant (p < 0.05) reduction in pain was noted in Group-II, III, and IV dogs. Using GFP, significant increases in peak vertical force (N/kg body wt) and impulse area (N s/kg body wt), indicative of a decrease in arthritis associated pain, were observed in Group-II dogs only. None of the dogs in any group showed changes in physical, hepatic or renal functions. In conclusion, based on GFP data, moderately arthritic dogs treated with UC-II (10 mg) showed a marked reduction in arthritic pain with maximum improvement by day 150. UC-II, GLU and CHO operate through different mechanisms of action, and were well tolerated over a period of 150 days.

Computerized cranial tomography in cerebral diseases of white matter.

Computerized tomographic scans were performed on 31 patients with primary diseases of the white matter. Among 18 patients with multiple sclerosis, acute lesions were visualized in five, all with symptomatic cerebral hemisphere disease. Characteristic white matter lesions were also demonstrated in adrenoleukodystrophy, spongiform encephalopathy, progressive multifocal leukoencephalopathy, disseminated necrotizing leukoencephalopathy, and an undiagnosed leukoencephalopathy associated with malignancy. Besides identifying white matter abnormalities, the CT scan patterns were often specific enough to help distinguish among the various etiologic possibilities for the abnormalities. Useful diagnostic characteristics included the anatomic distribution of lesions, mass effect, atrophic changes, and enhancement after contrast infusion.

Hepatic ultrasonic tissue characterization of video image data.

A study measuring in vivo three quantitative parameters of human liver was performed to assess the feasibility of measuring these parameters using standard ultrasound equipment and technique and to evaluate their potential for diagnosing diffuse liver disease. The parameters measured were: (1) d-bar, the average scatter spacing between semiperiodic scatterer; (2) r, a measure of the relative scattering strength; and (3) sigma, a measure of the variability in the relative scattering strength. Using linear discriminant and multivariate analysis, the above parameters are able to significantly separate normal livers from those with cirrhosis. This technique shows promise in the clinical identification of diffuse liver disease.

A real-time adaptive ultrasonic imaging system.

The performance of an experimental, adaptive, phased array imaging system in improving the quality of abdominal organ images in healthy volunteers was assessed. Trials were conducted under usual clinical imaging conditions and when phase aberrators of known shape and magnitude were introduced into the imaging system. The system, which uses local target brightness as a quality factor, was able to improve clinical image quality when aberrators introduced externally were present and had a negligible effect on image quality when they were not. On several of the volunteers, the phase aberrations were measured directly across the abdomen. The implications of these results for the future clinical application of adaptive imaging systems and the future system modifications are reported.

The harmful effects of aqueous contrast agents on the gastrointestinal tract: a study of mechanism and means of counteraction.

The effect of mildly and strongly hypertonic solutions on intestinal tone and motility was tested with aqueous contrast solutions and with mannitol as a control in 15 dogs. These experiments were repeated in animals premedicated with atropine sulfate and/or methysergide maleate. Intestinal motility was recorded on serial x-ray films. Tone and motility were estimated by variations of intestinal caliber and rate of transit of contrast solution, respectively. The results obtained contradict the currently accepted mechanism of action of iodinated contrast media on the intestinal tract, which assumes that the effect is osmotic like that of a saline laxative. Solutions of different osmolarity produce hyperperistalsis of the same magnitude. This effect begins rapidly after the onset of gastric emptying and much sooner than a significant osmotic fluid shift occurs. Atropine sulfate and methysergide maleate (serotonin blocker), when given individually, are incapable of completely inhibiting hyperperistalsis induced by hypertonic solutions. However, when these agents are given in combination, motility is completely inhibited. The evidence supports a serotonin role in the hyperperistalsis induced by hypertonic solutions, partly by direct action of serotonin on the smooth muscle cells and partly by indirect action on the intramural cholinergic ganglion cells. This concept offers a possible means of eliminating one of the adverse effects of aqueous contrast media on the gastrointestinal tract.

Gelatin encapsulated nitrogen microbubbles as ultrasonic contrast agents.

Gelatin encapsulated nitrogen microbubbles were effective ultrasonic contrast agents in in vitro phantom and in vivo rabbit V2 carcinoma studies. Intra-arterial injection of 80-micrometer gelatin encapsulated nitrogen microbubbles appeared to improve tumor visualization by rim enhancement, which persisted for several minutes.

Effects of repeated administration of the monoamine oxidase inhibitor phenelzine on the discriminability of d-lysergic acid diethylamide (LSD) and 1-(m-trifluoromethylphenyl) piperazine (TFMPP).

Rats trained to discriminate d-lysergic acid diethylamide (LSD; 0.08 mg/kg) or 1-(m-trifluoromethylphenyl) piperazine (TFMPP; 0.8 mg/kg) were treated with the monoamine oxidase inhibitor (MAOI) phenelzine (10 mg/kg/day) for 7 days. After a 24 h "washout" period, they were challenged with the training drug (and dose) or saline, during extinction test sessions. Following 0.08 mg/kg LSD, LSD-trained rats responded primarily on the saline lever (29% drug-appropriate responding) while, after TFMPP (0.8 mg/kg), TFMPP-trained animals responded on the drug lever (75% drug-appropriate responding). These preliminary data suggest that, if serotonin receptors are involved in the behavioral effects of TFMPP, these receptors differ from those involved in the effects of LSD.

Duplex Doppler systems in obstetric ultrasound.

Doppler ultrasound applications in normal and complicated pregnancies are presented in this article. Anatomy and pathophysiology of fetal placental blood flow are described. Potential pitfalls in the evaluation of fetal placental blood flow are explored. Doppler flow velocity waveform analysis combined with other clinical and physiologic information is valuable in monitoring of the high-risk pregnancy. Duplex technology may also be useful in the first trimester.

Scrotal ultrasound.

Ultrasound has been shown to be a reliable and valuable tool in the diagnosis of scrotal abnormalities. In this article, a comprehensive discussion of scrotal abnormalities and their ultrasonographic appearance is presented, oriented toward common clinical presentations, and the present uses and indications of scrotal ultrasound are enumerated.

The diagnostic approach to deep venous thrombosis. Which technique?

Current approaches to the diagnosis of deep venous thrombosis are presented in the context of the clinician's perspective. The historical evolution of these current studies, accuracy of various diagnostic imaging modalities, and extensive references dealing with clinical research in the area of deep venous thrombosis are included. Diagnostic algorithms for the management of patients with suspected deep venous thrombosis are suggested.

Studies of blood flow employing duplex, pulsed Doppler real-time sonography.

The physics of pulsed Doppler techniques have been recently applied to clinical evaluation of superficial blood vessels and the flow within them. Essential physical principles of pulsed Doppler ultrasound are presented, including spectrum analysis and flow measurements. Duplex instrumentation combining high-resolution real-time imaging and a pulsed-Doppler system is described. Indications for duplex carotid sonography are outlined. Clinical applications are discussed and examples of normal and pathologic states are shown. Finally, the role of duplex sonography in the evaluation of carotid vascular disease is compared to traditional arteriographic and contemporary digital subtraction angiographic methods.

Carotid ultrasound.

Carotid ultrasonography has become the preferred imaging technique for screening patients with suspected atherosclerotic cerebrovascular disease. The principles underlying duplex Doppler sonography and color and power Doppler ultrasonography are discussed. A standard approach to the performance and interpretation of carotid ultrasonography is presented, together with a discussion of potential diagnostic pitfalls. Brief discussion of transcranial Doppler and vertebral sonography are included.

Strategic water planning for south east England: preparing for proposed development.

The South East of England has one of the fastest growing and economically active populations in Europe, with associated significant pressures from development, particularly housing and transport. Sustainable water management has been identified as a major issue for future development of the region. The South East England Regional Assembly and the Environment Agency have carried out a study to investigate the potential constraints that flood risk, water resources, and water quality may pose on development. The study aims to improve understanding in order to inform the revision of regional planning polices and suggest practical guidance for local authorities to implement such policies. Wide technical consultation was carried out with the Environment Agency, local planning authorities and development agencies. Threshold Assessment was investigated as a technique to assess the potential impacts on the environment of various levels of forecast growth within selected parts of the region. Initial results indicate the need for more strategic and better integrated planning which recognises environmental and development boundaries.

Duplex sonography in patients with hemispheric symptoms.

Many patients with hemispheric neurologic symptoms do not have operative stenoses of the extracranial carotid arteries. In order to assess the frequency of such atherosclerotic lesions, 154 patients with documented hemispheric events underwent duplex Doppler examinations of the extracranial carotid bifurcation to assess if operative stenosis (70% to 80% stenosis) was present. Seventy-two patients with transient ischemic attacks (TIA), 62 patients with cerebrovascular accidents (CVA), and 20 patients with amaurosis fugax (AF) were studied. Sixty-nine percent of patients with TIAs demonstrated a less than 50% stenosis, 52% of patients with CVAs demonstrated a less than 50% stenosis, and 65% of patients with AF demonstrated a less than 50% stenosis on duplex Doppler examination. Intra-arterial digital subtraction angiography (IADSA) was performed in 35 of 154 patients. In all of these 35 cases, ultrasound and angiographic studies agreed with respect to whether or not a greater than 50% stenosis was present. Our findings support the use of duplex Doppler sonography as a triage procedure in patients with hemispheric events in order to determine those patients who have significant carotid stenoses and who may be potential operative candidates.

Obstetric duplex sonography in patients with lupus anticoagulant syndrome.

The lupus anticoagulant (LAC) syndrome has recently been described as a potential cause of many cases of preeclampsia. This syndrome is associated with a maternal history of repeated first trimester abortions and second and third trimester demise in utero. Umbilical arterial duplex Doppler systolic/diastolic (S/D) ratios and uterine artery S/D ratios for 28 patients whose pregnancies were complicated by lupus anticoagulant syndrome are presented. Five of the six patients who subsequently delivered fetuses small for gestational age (SGA) demonstrated abnormal umbilical arterial S/D ratios, whereas only two of these patients demonstrated abnormally elevated uterine S/D ratios. Twenty three of 28 patients were treated with aspirin and prednisone throughout gestation; no cases of fetal demise in utero were noted.

Gallstones: in vitro comparison of physical, radiographic, and ultrasonic characteristics.

An in vitro study of 30 gallstones was undertaken in which radiographic, ultrasonic, and physical characteristics were compared. Stones greater than 1 mm in diameter were consistently visualized in vitro using higher frequency transducers, lower intensities, and simple sector scanning techniques in different planes. All stones greater than 3 mm demonstrated consistent posterior acoustic shadowing, similarly facilitated by use of these techniques. The demonstration of posterior acoustic shadowing does not relate to the calcium content, shape, surface characteristics, or specific gravity of the stone.

Biliary cystadenoma and cystadenocarcinoma: gray scale ultrasound appearance.

The gray scale echographic appearance of biliary cystadenoma/cystadenocarcinoma is described. The characteristic findings are a cystic, multiloculated intrahepatic mass with thick, highly echogenic internal septations. Findings are similar to those in pancreatic and ovarian cystadenomas/cystadenocarcinomas.

Gallbladder wall thickening secondary to focal lymphatic obstruction.

Gallbladder wall thickening (3 mm or greater) has been described as a sign of acute or chronic inflammatory disease of the gallbladder. However, gallbladder wall thickening is a nonspecific finding in contracted, postprandial gallbladders and in cases of hypoproteinemia, elevated portal venous pressure, congestive heart failure, multiple myeloma, and hepatitis. This report describes the case of a patient who had a markedly thickened gallbladder wall secondary to focal obstruction of gallbladder lymphatic drainage by malignant lymphoma in the portal lymph nodes.