Infantile hypertrophic pyloric stenosis: where should it be treated?
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Biomedical subjects
Publications and source records attributed to H W Taylor.
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An analysis of breastfeeding and ovulation data from 72 nursing mothers is presented. A proportional hazards model of the data strengthens the hypothesis that a pattern of short, frequent bouts of nursing defines a risk-set of women less susceptible to post-partum ovulation than those who choose to nurse on a schedule of relatively lengthy and infrequent bouts. In contrast, no effect of maternal weight-for-height on the month-specific rate of post-partum ovulation could be detected in the study population comprised of American mothers trained in self-observation of fertility signs.
The long-term efficacy of an irradiation attenuated larval (L3) vaccine against Strongylus vulgaris was tested in ponies which were reared on pasture. Prior to foaling, mares were divided into two groups. One group of mares and foals received regular (eight weekly) treatment with ivermectin and the second group remained untreated. Half the foals in each pasture group were vaccinated at eight to ten weeks of age. Foals were weaned at three to four months of age and maintained on separate pastures. At eight to ten months of age, ponies were placed in box stalls and half of each treatment group were challenged with S. vulgaris (5 x 1000 L3). Clinical signs and lesions typical of acute verminous arteritis were found at necropsy in the ivermectin treated non-vaccinated challenged yearlings. Ivermectin treated vaccinated challenged yearlings did not show these clinical signs, had markedly reduced to absent arterial lesions and showed an 89 per cent reduction in arterial larval burdens post mortem. Significant differences in clinical signs, arterial lesions or arterial larval burdens were not seen between vaccinated and non-vaccinated foals reared without benefit of ivermectin treatment.
To study testicular ultrasonographic features, unilateral testicular artery ligation was performed in 12 bucks to induce predictable ischemic necrosis of the testis. Both scrotal testes then were scanned subsequently on days 1, 3, 5, 7, 15, and 30. On each of the designated days, 2 bucks each were castrated and the excised testes were rescanned outside the scrotum before gross and histologic examinations. In each goat, the testis without the ligated artery served as a control. Gross and histopathologic findings in the testis were compared with ultrasonographic observations. As the study progressed from day 0 to day 15, visually and microscopically, the testis involved in the testicular artery ligation had edema that changed to areas of peripheral necrosis with thickening of the testicular capsule. On day 30, the affected testis had granulation tissue in the areas that previously had been necrotic. Ultrasonographically, the testicular changes were consistent with the gross and histopathologic findings. There were areas of decreased echogenicity that corresponded to the necrotic areas and foci of high echogenicity that corresponded to areas of tubular mineralization. On day 30, the granulation tissue was difficult to differentiate ultrasonographically from normal testicular parenchyma. Between days 3 and 15, hydrocele was seen ultrasonographically in several goats. The excellent association between ultrasonographic findings and gross and histologic changes suggested that testicular ultrasonography might be a valuable diagnostic tool for assessing testicular disease in domestic animals.
Twenty-one mixed-breed pony foals, reared and maintained under parasite-free conditions, were used to test the efficacy of ivermectin in oral drench and paste formulations (200 micrograms/kg) against 11-day-old migrating larvae of Parascaris equorum. Three replicates of 4 foals and 3 replicates of 3 foals were formed on the basis of age. Foals in replicates of 4 were randomly allocated to be indicators, or to receive vehicle (control) or ivermectin paste or ivermectin liquid. Foals in replicates of 3 were randomly allocated to receive vehicle or ivermectin paste or ivermectin liquid. The recovery of larvae from the lungs, liver, and small intestines of the indicator foals showed that 99.9% of the larvae were in the lungs 11 days after inoculation (day 0 of treatment). The recoveries of larvae from lungs and small intestines of controls at 25 days after inoculation indicated that all larvae had migrated to the small intestine by this time. The mean length of larvae recovered from the lungs (11 days after inoculation) was 0.87 mm the mean length of those recovered from the small intestine (25 days after inoculation) was 3.65 mm. Using larvae recovered from small intestinal contents for calculations, ivermectin in both formulations was 100% effective against 11-day P equorum (P less than 0.01, compared with control group geometric mean of 1498.4).
Primary pulmonary adenocarcinoma with metastatic spread to the brain stem was diagnosed at necropsy in an aged Bulldog. Initial clinical signs included coughing, decreased exercise tolerance, and personality changes. Primary differential diagnoses after thoracic radiography were multicentric metastatic neoplasia or fungal disease. Later clinical signs (inappetence, unilateral facial paralysis and decreased sensation, and hemiparesis) were referable to the effect of the tumor on cranial nerves V and VII and other brain stem structures. Primary lung tumors are uncommon, as are metastatic tumors within the CNS. Radiographic appearance alone of lung lesions is insufficient for accurate diagnosis.
Cryptosporidiosis, giardiasis, trichomoniasis, and distemper were diagnosed in a 6-month-old female Siberian Husky pup. Poor growth rate, mucopurulent ocular and nasal discharges, and diarrhea were observed. Results of immunologic studies revealed decreased serum IgG concentration and undetectable serum IgA concentration. Cultured lymphocytes yielded a less-than-adequate response to mitogen stimulation. The serum also contained a factor that suppressed mitogen stimulation in control cultured lymphocytes.
An adult female American alligator (Alligator mississippiensis) had diffuse, yellow, granular serosal thickening at necropsy. Light microscopic examination of affected stomach, small intestine and spleen revealed a chronic proliferative serositis associated with 3 to 15 micron eosinophilic extracellular globules identified histochemically and morphologically as egg yolk. The intracoelomic egg yolk was considered to be the cause of the serosal reaction.
The efficacy of ivermectin in oral paste formulation at a dosage of 200 micrograms/kg of body weight was tested against naturally acquired larval and adult stages of Parascaris equorum, in a controlled study. Twenty infected pony foals 18 to 27 weeks of age were randomly allocated to 2 groups of 10 each and were placed in dry lots. Foals in 1 group were given ivermectin on day 0. Necropsies and parasite recoveries from small intestines and lung tissues were performed on 5 foals in each group at 2 weeks after treatment (WAT) and on the remaining foals at 5 WAT. Ivermectin was 100% effective against adult P equorum. At 2 WAT, ivermectin was 100% effective against lung larval stages and 91% effective against intestinal larvae of P equorum. Efficacy of ivermectin against all intestinal stages was 93%. Intestinal and lung larval populations were similar in ivermectin-treated and nontreated foals at 5 WAT, indicating that the foals had become reinfected from the contaminated drylots, with larvae repopulating in the tissues 2 to 5 WAT. Apparent increases in severity of lymphoproliferative and inflammatory tissue reactions were observed histologically in lung and liver tissues of treated foals. Clear differences in clinical conditions between foals in treated and nontreated groups were not observed. However, weight gains in foals were greatest after treatment.
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Blind-end atresia coli was observed in two genetically unrelated foals at about the same time and location. The two foals, one an Appaloosa and the other a Quarterhorse, were born 4 days apart on nearby but separate farms. The Appaloosa foal died after surgical anastomosis of the affected segments of the colon. The Quarterhorse foal was euthanized after the defect was found at laparotomy. Both foals were necropsied and representative tissues were examined histopathologically. Histopathologic results were unremarkable. No cause of the defects could be determined and the timing and geographical location of the two events were considered coincidental.
The effect of handling mice by the tail or by the body on serum alanine transaminase (ALT) activity was investigated in normal mice and in mice pretreated with a known hepatotoxin. In normal mice, the mean ALT activity 1 h after grasping the body was almost four times greater than in the control (not-handled) and tail-handled groups. However, when ALT analyses were repeated 1 week later, all groups were equivalent. In mice given a hepatotoxic dose of 30 mg kg-1 carbon tetrachloride, the mean ALT activity was approximately three times greater in mice handled by the body than in mice grasped by the tail only. Handling mice by the body may reduce the usefulness of ALT activity as a measure of hepatotoxicity.
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Data was generated for 828 clinical stage 1 melanoma patients, divided into groups according to sex, tumor location, and tumor level for each of the 56 groups. Summary data, including the number of patients, number of patients dying as a result of melanoma, range of tumor thickness, mean and median tumor thickness, and mean length of follow-up of the surviving patients, are shown. Patients with melanoma of the palms and soles, subungual melanomas, and mucosal melanomas were excluded. A physician with a new melanoma patient could select the appropriate group for his or her patient, matched with respect to sex, location, and level, and then make a judgment regarding the prognosis, based on the survival experience of the group. In a few groups, the small numbers of patients provides only a rough impression of survival, but with many groups, a fair estimate can be made. The effectiveness of elective lymph node dissection was examined by creating 111 pairs of patients, matched by sex, level, location, and tumor thickness (to within +/- 12%), in which one member of the pair had an elective node dissection (ELND) and the other did not. There was no statistically significant difference between the survival of the two groups.
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