Biomedical subjects
Publications and source records attributed to F A Mann.
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Endorectal ileoanal pull-through offers an attractive alternative to proctocolectomy and ileostomy for patients with ulcerative colitis, Gardner syndrome, and familial polyposis. To our knowledge, a careful radiographic analysis of the ileum, ileal pouch, and ileoanal anastomosis after ileoanal pull-through has not been reported. Thirty-two patients with ulcerative colitis, Gardner syndrome, and familial polyposis underwent colectomy, mucosal proctectomy, and endorectal ileoanal pull-through of a 15-cm ileal "J" pouch and loop ileostomy. Twenty-five (78%) of 32 of all the pouches radiographically demonstrated spiral folds extending from the middle of the pouch to the pectinate line. Other radiographic features included a mesenteric mass effect, pseudopolyps, and a central lucency that indicated intrapouch sutures. Radiographs provide useful information in the postoperative management of the ileal pull-through.
Esophageal stricture and web are described in a 14-year-old girl who presented with a history of progressive dysphagia subsequent to an episode of Stevens-Johnson syndrome at the age of 4.
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To define the most cost-effective means of diagnosing and following gastric ulcers, both benign and malignant, the University of Utah Medical Center (UUMC) experience between September 1980 and October 1983 was reviewed. Endoscopy (EGD) was utilized in the initial evaluation process in 96% of patients. Follow-up was performed by either a combination of EGD and double contrast upper GI (DCUGI) or EGD alone. Diagnostic and follow-up modality had no effect on survival. It appears that the high-frequency use of EGD for gastric ulcer management is not cost-effective. We suggest an algorithm in which EGD would be used only following failure either to demonstrate characteristic benign appearance on DCUGI or inadequate healing following therapeutic trial. A theoretical net savings of 55% is calculated by retrospective application of the algorithm to the UUMC experience; 30% savings is realized for diagnosis and 81% for follow-up. If adopted on a national scale, the algorithm proposed may result in a significant savings in health-care cost.
Sixteen normal 20 to 30 kg dogs had standard femoral head and neck excision (8 dogs) or femoral head and neck excision with interposition of a biceps muscle flap (8 dogs). Lameness lessened at week 6, and did not differ between groups; neither group returned to a completely normal gait. Weightbearing decreased on the operated pelvic limb compared to controls (forceplate analysis). Weightbearing force of the muscle flap dogs was significantly less at weeks 6 and 16 than that of the standard femoral head and neck excision dogs. The operated limb of both groups was shortened; shortening was significantly greater for the muscle flap group. Hip extension was limited in both groups. Both groups had decreased (more acute) hip, stifle, and hock angles measured in standing position. Thigh muscle atrophy was more pronounced in the muscle flap group at week 6. More soft tissue was interposed in the muscle flap group at necropsy compared to the group with standard femoral head and neck excision, but the difference was not statistically significant. Skeletal muscle fibers were present in the interposed fibrous connective tissue of the muscle flap group, and the healed surfaces were smoother than those of the standard femoral head and neck excision group.
Percutaneous nephrostomy catheters modified by cutting off the tubing connectors were implanted in three dogs with prostatic neoplasia to relieve or prevent stranguria. One catheter was implanted with a guide wire through a perineal urethrotomy, and two catheters were implanted via celiotomy and cystotomy. Morbidity and complications were minimal. Inflammation of the abdominal incision was present from day 4 to day 8 in the dogs with celiotomy. Urinary incontinence was continuous in one dog and intermittent in two dogs. Hematuria occurred in two dogs. The retained urethral catheter was a suitable palliative treatment for urethral obstruction in three dogs with prostatic neoplasia.
Three different pin types (Ellis, enhanced threaded, and nonthreaded) were used in type 1 external skeletal fixation after transverse osteotomy of the radius and ulna in 12 skeletally mature dogs. Dogs were placed into three groups of four dogs based on the pin type used. Axial extraction forces were determined for each of the pin types after 8 weeks of weight bearing (chronic study). Nine contralateral radii were used to determine axial extraction forces for nine of each pin type not subjected to weight bearing forces (acute study). The force required for extraction of the enhanced threaded and Ellis pins in the chronic and acute studies was not significantly different. The force required to extract the nonthreaded pins was significantly less than that required for the other two pin types. Ground reaction forces had returned to levels measured before surgery by 2 weeks after surgery in the enhanced threaded and Ellis pin groups, however, dogs in the nonthreaded pin group required 4 weeks until normal ground reaction forces were measured. Radiographic evaluations 1, 2, 4, 6, and 8 weeks after surgery showed no difference among groups in the number of pin tract radiolucencies, however, the enhanced threaded pins had caused more trans-cortical chip fractures than the other two pin types. None of the pins broke during the eight-week chronic study.
OBJECTIVES: (1) To determine the usefulness of one specific oscillometric monitor for making indirect measurements of arterial pressure in cats. (2) To determine the difference between two specific cuff placement sites. (3) To determine if clipping the hair beneath the cuff has an affect on the accuracy of oscillometric blood pressure determination. STUDY DESIGN: Prospective study comparing the accuracy of the Datascope Passport (Datascope Corp, Paramus, NJ) with concurrent invasive measurements. ANIMALS: Six anesthetized domestic felines weighing 4.5 to 5 kg. METHODS: The direct arterial pressure was measured using a cannula placed in the right common carotid artery. Oscillometric cuffs of appropriate size were placed on both thoracic limbs distal to the elbow and both pelvic limbs distal to the stifle. The hair in the areas of cuff placement on the right limbs was clipped circumferentially. Measurements of systolic, diastolic, and mean arterial pressure (MAP) were taken for each site during normotension, hypotension, and hypertension. Comparisons between indirect and direct measurements were made using a parametric analysis of method comparison. RESULTS: No significant differences were noted when the clipped limbs were compared with the corresponding limbs which were left unclipped (P > .378) or when the thoracic limb measurements were compared with those of the pelvic limb (P > .088). There were significant differences (P < or = .002) between the two pressure measurement methods for the systolic, diastolic, and mean arterial pressures over all three pressure ranges. CONCLUSIONS: The Datascope Passport did not accurately estimate the invasively measured arterial pressure. CLINICAL RELEVANCE: Use of noninvasive blood pressure monitoring equipment is increasing in use in veterinary medicine, and the accuracy of one specific monitor is reported.
Elbow dysplasia is osteoarthrosis/degenerative joint disease due to abnormal development of the elbow joint. The abnormal development is the result of specific inherited etiologies alone or in combination. This paper attempts to clarify the diagnosis of elbow dysplasia based on the presence of degenerative joint disease by correlating radiographic, necropsy, and histopathologic results using elbows from 8 German Shepherd dogs. All elbows had radiographic changes consistent with osteoarthrosis/degenerative joint disease which were identified best on the flexed medial-lateral projection. Radiographically, a specific diagnosis was made in seven elbows; ununited anconeal process (6) and osteochondrosis (1). At necropsy these lesions were confirmed plus 14 elbows were identified that had fragmented medial coronoid process (6), abnormally shaped medial coronoid processes or fissures in the articular cartilage of the medial coronoid process (8). Additionally, histopathologically there was proliferative synovitis at the radial notch of the ulna and degenerative changes on the proximal, nonarticular surface of the anconeal process at the site of insertion of the olecranon ligament and joint capsule. Therefore, for screening the elbow joint to identify elbow dysplasia, the recognition of osteoarthrosis/degenerative joint disease on an extreme flexed mediolateral radiograph appears to be sufficient.
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A carbon dioxide laser was used to incise around, dissect, and remove a 2-cm intradermal mass from the left carpus of an 8-year-old, spayed female wheaten terrier. The wound was partially closed, resulting in a 3-cm diameter circular defect with extensor tendons exposed. A swine intestinal submucosa graft was utilized to cover the remaining defect. The graft was removed 5 days later, revealing a healthy granulation tissue bed covering previously exposed tendons with minimal wound margin retraction. The remaining wound was allowed to heal by contraction and epithelialization that was complete by 5 weeks postoperatively. The mass, a pilomatricoma, had not recurred at the last follow-up contact 18 months after surgery. Pilomatricoma, laser application, swine intestinal submucosa grafting, and postoperative wound management are discussed.
Placement of two different pulse oximeter probes, a finger (f) probe and a multisite (s) probe, was evaluated in six healthy, anesthetized beagles. Concurrent arterial blood gas values were compared to determine the most consistent (repeatable) and accurate (compared to calculated hemoglobin saturations) pulse oximeter probe and probe placement sites for subsequent use in awake dogs. Hemoglobin oxygen saturation was determined from arterial blood gas analysis (SaO2) and by pulse oximetry (SpO2) at full hemoglobin saturation (mean, 99.5% SaO2) and at moderate desaturation (mean, 92.9% SaO2). Each probe was evaluated with three independent readings at seven different body sites (Achilles, ear, flank, lip, tail, toe, and tongue). Values for SpO2 obtained with the s probe demonstrated a significant correlation with SaO2 values (p = 0.014, R = 0.712) compared to the SpO2 values obtained with the f probe (p = 0.108). The best probe placement sites for the clip-on probes in this study were on the lip and tongue using the s probe; however, the ear, tail, and toe may be acceptable sites in awake dogs using a probe which maintains good contact across these vascular beds.
The medical records of 34 dogs (median age, eight years) with colorectal mucosal lesions were reviewed. Hematochezia was the most common (82%) presenting sign. Most dogs (79%) presented with solitary masses located in the rectum. After histological review, 12 masses were classified as adenomatous polyps and 22 as carcinoma in situ. Recurrence of clinical signs were common (41%), and malignant transformation of the tumor was documented in 18% of the cases. A higher recurrence rate and malignant transformation occurred in dogs presented with multiple masses or diffuse disease and in dogs initially diagnosed with carcinoma in situ.
Metatarsophalangeal (MTP) arthrodesis was done in each of three dogs with end-stage degenerative joint disease resulting from trauma and osteomyelitis (n = 2) and immune-mediated disease (n = 1). In two cases, MTP arthrodesis proved to be a useful method of eliminating pain and salvaging limb function. In one case, concurrent injuries and obesity prevented full return to function. Arthrodesis was accomplished with autogenous cancellous bone grafts and bone plates (n = 2) and with transarticular K-wires (n = 1). External coaptation was a necessary adjunct to internal fixation in all cases.
A latissimus dorsi muscle flap was used to reconstruct a proximal scapular defect in a cat after excision of a fibrosarcoma that had recurred after eight surgeries, radiation therapy, and chemotherapy. To obtain appropriate surgical margins, infraspinatus and supraspinatus myectomy and scapular spinous ostectomy were performed. The latissimus dorsi muscle flap was rotated into the defect and anchored to four holes placed in the cranial border of the scapula. The cat showed no lameness at 6, 21, 42, and 147 days after surgery. The latissimus dorsi muscle flap was successful for proximal scapular reconstruction in this cat.
An in vitro comparison of centrifugal pumping systems manufactured by Sarns-3M and St. Jude Medical revealed a difference in blood cell derangement. The purpose of this study was to compare in vivo the effects of 96 hr of left ventricular assist (LVA) on indexes of coagulopathy, hemolysis, and complement activation. Two groups of calves (each: n = 5) were instrumented with identical left atrial to thoracic aorta centrifugal pumping circuits using either Sarns-3M or St. Jude centrifugal pumps. Laboratory evaluations were performed pre-assist and at 1, 4, 24, 48, 72, and 96 hr during LVA. Platelet counts dropped significantly by 24 hr (Sarns-3M: 28%; St. Jude: 30%); no significant change in function was noted. Activated clotting time increased slightly (p > 0.05). Prothrombin time increased at 4 and 24 hr of LVA, returning to baseline by 96 hr (p < 0.05). Activated partial thromboplastin time increased with the St. Jude device from 24 to 96 hr on LVA (p < 0.05); the increase with the Sarns-3M device never reached significance. No significant changes in lactate dehydrogenase or plasma free hemoglobin were detected. Complement fraction C5a rose by 1 hr of LVA (p < 0.05), peaking at 4 hr and returning to baseline by 96 hr with both pumps. No significant difference was detected between pump groups for any of the parameters. It was concluded that 1) 96 hr Sarns-3M and St. Jude LVA caused coagulation derangement in calves, 2) neither pump demonstrated an advantage regarding coagulation and complement parameters, 3) hemolysis observed with the Sarns-3M pump in vitro was not evidenced in vivo, and 4) in vitro evidenced centrifugal pump differences may not be realized in vivo.