Financial records: which to keep, which to toss.
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Biomedical subjects
Publications and source records attributed to B Rice.
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OBJECTIVES: To determine normal cecal emptying curves for liquid- and solid-phase radiolabeled markers and to further define myoelectric patterns of the ileum, cecum, and colon in healthy ponies. ANIMALS: 6 adult ponies. PROCEDURE: A cecal cannula and 12 bipolar Ag-AgCl recording electrodes were sutured to the ileum, cecum, and right ventral colon of the ponies. Radioisotopes, indium 111-labeled diethyltriaminepentaacetic acid (111In-DTPA) and technetium 99m (99mTc)-labeled sulfur colloid bound to egg albumen, were introduced through the cannula directly into the cecal body. Movement of these markers from the cecum was monitored by a gamma camera, and power exponential clearance curves were generated. Myoelectric data were collected before and after i.v. administration of isotonic saline (0.9% NaCl) solution, and were analyzed for spike burst (SB) rate, relative activity index, and mean burst duration. Myoelectric complexes were identified from observation of chart recordings or compressed, digitized data. RESULTS: Clearance curves were generated for liquid (111In-DTPA)- and solid (99mTc)-phase markers. Marker types were not different with respect to lag phase, but liquid markers emptied at a slightly faster rate than did solids. Baseline values were calculated after saline solution administration for each of the myoelectric variables investigated. A relation between ileal, cecal, and colonic myoelectric activity was identified. Activity consistent with the previously described colonic migrating myoelectric complex in the pelvic flexure was identified in the right ventral colon. CONCLUSIONS AND CLINICAL RELEVANCE: Baseline data on normal cecal emptying was obtained; this technique could be used to evaluate the effect of postulated motility-modifying treatments used in equine practice.
OBJECTIVE: To determine effect of xylazine hydrochloride (XYL), yohimbine hydrochloride (YOH), bethanechol chloride (BET), neostigmine methyl sulfate (NEO), or flunixin meglumine (FLU) on ileocecocolic myoelectric activity and passage of radiolabeled markers from the cecum. ANIMALS: 6 healthy adult ponies. PROCEDURE: A cecal cannula was surgically implanted, and 12 were sutured to the ileum, cecum, and right ventral colon. After a 12-hour nonfeeding period, 370 MBq of technetium 99m-labeled sulfur colloid in egg albumen and 37 MBq of indium 111-labeled diethyltriaminepentaacetic acid in 60 ml of water were injected into the cecal apex. All drugs were administered i.v. as a bolus, with the exception of NEO, which was given SC: XYL, 0.5 mg/kg of body weight; YOH, 0.075 mg/kg; BET, 0.025 mg/kg; NEO, 0.025 mg/kg; FLU, 1.1 mg/kg; and saline solution (SAL), 10 ml. Drugs were administered in a randomized complete block design, each treatment was administered twice to each pony, and dual-phase scintigraphic images were obtained. The time to 50% emptying (t50) and the slope of the emptying curve (beta) were derived from the calculated power exponential equation. RESULTS: The t50 after BET (184.8 +/- 16.5 minutes) and NEO (124.7 +/- 16.5 minutes) administration were significantly shorter than values after saline (230.2 +/- 17.1 minutes) administration. The t50 after XYL administration (250.5 +/- 18.6 minutes) was longer, and that after YOH administration (190.1 +/- 16.2 minutes) was shorter, than the t50 after saline administration, but neither difference was significant. The t50 and beta after FLU administration differed from those after saline administration. Myoelectric data appeared to be well correlated with drug-induced alterations in isotope clearance. CONCLUSIONS AND CLINICAL RELEVANCE: Cholinergic agonists, BET and NEO, have significant effects on the myoelectric activity of ileum, cecum, and right ventral colon, with the net effect of hastening cecal emptying.
OBJECTIVE: To determine the effect of erythromycin lactobionate (ERY) on ileocecocolic myoelectric activity and passage of radiolabeled markers from the cecum. ANIMALS: 6 healthy adult ponies. PROCEDURE: After a 12-hour nonfeeding period, 370 MBq of technetium 99m-labeled sulfur colloid in egg albumen and 37 MBq of indium 111-labeled diethyltriaminepentaacetic acid in 60 ml of water were administered directly into the cecal apex. The following drug concentrations were tested: ERY, 0.01, 0.10, 1.0, and 10.0 mg/kg of body weight; ERY, 0.10 mg/kg bolus; and saline (0.9% NaCl) solution, 10 ml. All treatments, with the exception of the 0.10-mg/kg bolus and saline solution, were infusions administered i.v. during a 60-minute period in a randomized complete block design. Each treatment was administered 2 times/pony. Dual-phase scintigraphic images were obtained, and the best-fit function was determined for each study, using data from the right side. Myoelectric data were collected before and after each treatment and analyzed for spike burst rate, relative activity, and burst duration. RESULTS: The time to 50% emptying (t50) after ERY administration was dose dependent, and all treatments, with the exception of the 0.01-mg/kg infusion, resulted in a significantly shorter t50 than that observed after saline administration (230.2 +/- 17.12 minutes). The shortest t50 was observed after the 1.0 mg/kg dosage of ERY (76.9 +/- 22.0 minutes). Although not significantly different, the t50 and beta were shorter (108.6 +/- 25.9 minutes) and steeper after a bolus dose of 0.10 mg/kg of ERY than after infusion at the same dosage (131.1 +/- 18.7 minutes). CONCLUSIONS AND CLINICAL RELEVANCE: ERY may be a useful prokinetic for prevention or treatment of cecal motility dysfunction. The ability of ERY to evoke a similar response during the early postanesthetic or postoperative period remains to be determined.
Can a good-sized, well-established group reinvent itself? Recognizing a need for greater efficiency and more satisfied patients, this multispecialty clinic did.
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