Biomedical subjects
Publications and source records attributed to J P Held.
Aspermia was diagnosed in a 12-year-old Thoroughbred stallion with generalized lymphosarcoma. Invasion of the epididymus by neoplastic cells caused thickening and enlargement of both epididymes. The testes were not affected. The nodular ultrasonographic architecture was similar to that in previously reported cases of infectious epididymitis.
Comparison of standard and radionuclide methods for measuring glomerular filtration rate (GFR) and effective renal blood flow (ERBF) was performed in 8 healthy female horses. Inulin and p-aminohippurate solutions were administered IV as a bolus, followed by sustained administration. Urine and plasma inulin and p-aminohippurate concentrations and urine volume were measured. Glomerular filtration rate and ERBF were calculated on the basis of these measurements. Glomerular filtration rate and ERBF were measured on the basis of plasma clearance of the radiopharmaceuticals, 99mTc-labeled diethylene-triaminepentaacetic acid (99mTc-DTPA) and [131I]-o-iodohippuric acid (131I-OIH), respectively. Mean +/- SEM GFR, using inulin, was 1.83 +/- 0.21 ml/min/kg of body weight. Mean GFR, using 99mTc-DTPA was 1.79 +/- 0.18 ml/min/kg. Mean ERBF, using p-aminohippurate, was 15.13 +/- 1.28 ml/min/kg. Mean ERBF, using 131I-OIH, was 18.42 +/- 1.57 ml/min/kg. Analysis of variance indicated no significant difference between mean values for GFR and ERBF. Radionuclide measurement of GFR and ERBF compared well with standard methods and is an alternative technique to the cumbersome standard methods for determination of GFR and ERBF in horses.
A 9-year-old Arabian stallion with a 3-year history of infertility was evaluated for breeding soundness. Both testes were small. Ultrasonography revealed a small amount of free fluid between the tunics of both testes. Results of cytologic examination of the fluid were unremarkable. On semen examination, progressive motility was 10%, and total number of spermatozoa in the ejaculate was 6.6 x 10(9), of which 92% were abnormal. Predominant abnormalities were head defects (75%): 57% of the heads had single or multiple vacuoles, and 60% also had midpiece swelling or bending.
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This study was concluded on paraplegic and tetraplegic patients of all aetiologies except neoplasic, where paralysis developed within 48 hours. All patients were admitted to the rehabilitation department within 90 days after the onset of paralysis. In a preliminary review of 328 files, there were 27 cases of clinical deep vein thrombosis (DVT) and 10 with pulmonary embolism (PE), 6 of which were fatal. A prospective study was conducted, based on systematic detection of asymptomatic DVT with phlebography. Among the 147 patients, 20 previously presented with DVT. The 127 others underwent phlebography which showed 39 DVT in 29 patients. Eighty seven patients with negative phlebography underwent a second study a month later which showed 14 DVT in 12 patients. Only one minor pulmonary embolism occurred in these 147 patients. The incidence of DVT after acute spinal cord injury and the frequent absence of clinical manifestations were confirmed. Prophylactic anticoagulant therapy is useful but insufficient. This study demonstrates that systematic and repeated detection of DVT by phlebography may reduce the incidence of PE.
The effect of flunixin meglumine on renal function was studied in 6 healthy horses by use of nonimaging nuclear medicine techniques. Effective renal plasma flow (ERPF) and effective renal blood flow (ERBF) were determined by plasma clearance of 131I-orthoiodohippuric acid before and after administration of flunixin meglumine. Mean ERPF and ERBF was 6.03 ml/min/kg and 10.7 ml/min/kg, respectively, before treatment and was 5.7 ml/min/kg and 9.7 ml/min/kg, respectively, after treatment. Although ERPF and ERBF decreased after flunixin meglumine administration, the difference was not statistically significant.
Two stallions had unilateral bacterial epididymitis attributable to S zooepidemicus infection. Diagnosis was based on bacterial isolation, WBC in the semen, higher than normal blood fibrinogen concentration, and leukocytosis with regenerative left shift. One horse had high seminal pH. Ultrasonography of the involved epididymides revealed changes consistent with the appearance of abnormal accumulation of exudate in the tail of the epididymis. Treatment included unilateral orchiectomy and antibiotic administration. In stallion 1, the infection persisted despite treatment. Treatment result was not available for stallion 2.
Ultrasonography and nuclear imaging were used in the diagnosis of scrotal hernia in a dog. Both techniques were useful as aids in the differential diagnosis of scrotal enlargement. Nuclear imaging was useful in ruling out testicular torsion; ultrasonography revealed a normal-appearing testis amid fluid and portions of omentum.
Severe multiple trauma raises difficult problems of rehabilitation. In the most usual cases, other injuries are associated with head injuries and coma, and they must be systematically screened by a very complete radiological assessment and a thorough clinical examination. Rehabilitation will be passive as long as the injured person is comatose; however, it is very important as it allows preventing bedsores and the reduction of joint amplitude that may have serious consequences later on. The associated fracture of the limbs require orthopedic or surgical solutions. External fixation devices, which are sometimes used, complicate the rest of rehabilitation. Fractures of the spine are fortunately rare, even more so when associated with lesions of the cord causing paraplegia and tetraplegia. Thoracic complications are frequent and sometime produce a complicated postoperative period so that the removal of the tracheal tube, and sometimes the suppression of feeding through a nasogastric tube or gastrostomy, will be delayed. The management of head injuries is complex. First of all the injured person, whose consciousness often is fluctuant for some times, must be reassured, pampered, then progressively helped to cooperate and to take care of himself again. The disorders, including disorders of speech, of vision, deficiencies, disorders of balance, of coordination, will be as completely assessed as possible through a complete examination. The existence of frequent orthopedic disorders will hinder the progress towards self-reliance. Simultaneously, the cognitive functions will be restored: the memory is often severely disturbed, and disorders of attentiveness and reasoning must also be dealt with. As far as possible, attempts will be made to treat the very
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Pleural effusion, secondary to a metastasis from a malignant hepatoblastoma, was diagnosed in a 3-year-old Appaloosa gelding. Severe hemorrhagic transudate in both pleural cavities resulted in acute onset of labored breathing, tachypnea, tachycardia, and jugular vein pulsation. Results of ultrasonography and radiography of the ventral lung field and cranial portion of the abdomen initially were nondiagnostic, as were results of cytologic examination of peritoneal fluid and tracheal wash specimens. Moderately high serum gamma-glutamyl transferase and alkaline phosphatase activities, despite normal hepatocyte-specific enzyme (sorbital dehydrogenase) activity, were indicative of biliary stasis without hepatocyte destruction. The horse was euthanatized. Necropsy revealed a 47-kg hepatoblastoma, with metastases in the lungs and intestines.
A 7-year-old stallion with a history of abdominal pain after it fell was examined and found to have a swelling of the right testis and epididymis. Semen evaluation revealed an increase in secondary sperm abnormalities. The stallion was unilaterally castrated. The histologic diagnosis was sperm granuloma, with no evidence of infection. Periductal fibrosis was observed and appeared to have developed before the trauma occurred. The changes seen could be compatible with chronic blockade of efferent ductules, resulting in extravasation of spermatozoa.
Research in muscle physiology has progressed in both the volume and complexity of data examined. Dependence on manual methods to analyze and condense this amount of information can present a narrow bottleneck to the efficient completion of a study, and can compromise the reliability of the results. We designed a general purpose computerized system for data acquisition in experiments in our cardiovascular physiology laboratory. In addition, we developed a software program specifically for the analysis of data from studies of isolated, isometrically contracting myocardium. This system has reduced the time for analysis of such data by approximately 50-fold over that of manual techniques, and has contributed significantly to our confidence in the measured results.
A 62 year old man suddenly presented with a pure left sensory deficit involving only pain and temperature sensations. CT scan and MRI showed a small haemorrhage in the dorsolateral part of the right midbrain. This suggested a lesion limited to the right dorsal spinothalamic tract.
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Osteochondroma of the distal portion of the radius was diagnosed in 3 horses with a history of lameness and distention of the common tendon sheath of the superficial and deep digital flexor tendons at the level of the carpal canal. In 2 horses, the exostosis was removed through an incision at the caudal border of the lateral digital extensor muscle above the carpal ligament.
A patient with clinically complete cervical spinal cord transection developed rhythmic myoclonic movements of the trunk and lower limbs, demonstrating that, in man, such movements can be generated within the spinal cord itself when deprived of supraspinal control. Electromyographic (EMG) recordings used to define the features of the myoclonus, which had a frequency of 0.3-0.6 Hz, was bilaterally symmetric, and involved extensor muscles. The EMG bursts always appeared in phase in all muscles involved. Peripheral stimulation of flexor reflex afferents (FRA) could induce, slow or interrupt the rhythmic activity. When FRA stimulation induced a flexion reflex, it occurred between extensor EMG bursts and induced alternating flexion-extension activity which could be sustained for several cycles. Soleus and quadriceps monosynaptic reflexes were depressed during the silent period of the rhythmic activity. Several arguments, mainly the great sensitivity of the myoclonus to flexor reflex afferent stimulation, suggest that the myoclonus observed in this patient was due to partial release of a spinal stepping generator.