Lysis of basilar artery occlusion with tissue plasminogen activator.
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Biomedical subjects
Publications and source records attributed to J Romatowski.
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For a variety of reasons--both medical and medicolegal--a more aggressive approach is taken in canine than in human rheumatoid arthritis. While cytotoxic agents are probably the drugs of choice in the dog, they are normally the last resort of the rheumatologist. On the other hand, the nonsteroidal anti-inflammatory drugs, which are the cornerstone of treatment in man, are of questionable safety--if not absolutely contraindicated--in the dog. Canine rheumatoid arthritis is an uncommon diagnosis, and it is not the intent of this discussion to encourage either the use of cytotoxic drugs or the experimentation with unproven agents in dogs with vaguely defined forms of arthritis.
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A 9-year-old male German Shepherd had marked stumbling, staggering and weakness in both rear limbs. Pelvic radiographs revealed only mild hip dysplasia, while survey spinal radiographs and a myelogram revealed only areas of possible pachymeningitis. Results of CSF analysis were normal. Degenerative myelopathy was suspected, but a mitogen response assay failed to confirm this diagnosis. Another mitogen response assay, performed several months later, again failed to indicate degenerative myelopathy as the cause of clinical signs. The dog's condition worsened and the animal was euthanized. At necropsy, classic histopathologic lesions of degenerative myelopathy were noted in the thoracic spinal cord.
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Structural changes in both biliary tract and pancreas have been assessed with endoscopic retrograde cholangiopancreatography in 100 diabetic patients divided into subgroups depending on the type of diabetes mellitus, i.e. type I, type II and III-pancreatic. Control group included 100 randomly selected patients without diabetes mellitus in whom endoscopic retrograde cholangiopancreatography has been performed for various indications. Structural changes in the biliary tract and pancreas have been more frequent in diabetic patients than in the control group (47 and 75% vs 32 and 30%, respectively). Cholelithiasis has been noted in 27.8% of patients with type II diabetes mellitus and in 11.3% of patients with type I diabetes mellitus; obesity has been found in 57 and 12% of patients, respectively. Other biliary tract disorders, mainly in the form of segmental stenosis or dilatation of the common bile duct, have been more frequent in patients with type II diabetes mellitus. Pancreatic disorders, assessed with the aid of Cambridge classification, have been noted in all patients with pancreatic diabetes and in 80.7% of patients with diabetes mellitus type I. Incidence of so-called doubtful and mild disorders has been more frequent (22.2 and 24.1%, respectively) in patients with diabetes mellitus type II whereas "moderate" and "severe" disorders have been significantly less frequent (7.4 and 1.9% of patients). The results indicate, that endoscopic retrograde cholangiopancreatography is useful in the assessment of bile ducts structure and pancreatic exocrine activity in diabetic patients in whom disorders are more frequent.
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