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Biomedical subjects

J Auer

Publications and source records attributed to J Auer.

118 records · Page 7Linked to original sources

Diseases of the carpus.

Degenerative joint disease is the most frequently diagnosed problem of the carpus. Horses afflicted with this disease should not be injected with corticosteroids, but should be rested for several months. Swimming exercise and intra-articular injections of hyaluronic acid during this time help to restore the integrity of the involved joints. Chip fractures of the various carpal bones and the distal radius are commonly diagnosed as the cause of the lameness. Not all horses with carpal fractures are candidates for surgery. It is important that the severity of the problem be realized and that the best treatment for the specific case be selected accordingly. Other less commonly diagnosed diseases of the carpus, such fractures of the accessory carpal bone, hygromas, luxations, and ganglions, were discussed. Many horses that have been retired from racing prior to complete ruination of their joints by multiple corticosteroid injections may be used for other purposes. It is therefore important in evaluating a lameness to keep in mind the type of work the patient is supposed to do. A race horse with a small carpal chip fracture may not make it back to the racetrack successfully, but may fulfill perfectly the requirements for a pleasure or timber horse.

Animals↗

Spermatozoa as potential carriers of HIV.

In order to investigate the role of germ cells in the sexual transmission of immunodeficiency virus (HIV), spermatozoa from healthy HIV-seronegative men were incubated in vitro with HIV1. After washing, they were cocultured with peripheral blood leukocytes from seronegative blood donors. Reverse transcriptase assays and p24 antigen tests were performed in culture supernatants. Electron microscopy examination of these HIV-incubated spermatozoa was carried out, as well as the search for CD4 molecules on their surface. Although virus bound to and seemed to enter spermatozoa despite the absence of detectable CD4 epitopes on their surface, no replication of HIV was apparent. However, HIV particles on the surface of spermatozoa were capable of infecting CD4 T lymphocytes. Present results would seem to preclude artificial insemination between an HIV-seropositive man and an HIV-seronegative woman.

Adult↗

Screw fixation in lag fashion of equine cadaveric metacarpal and metatarsal condylar bone specimens: a biomechanical comparison of shaft and cortex screws.

OBJECTIVE: To compare acute fixation stability and insertion effort of cortex bone screws with and without a shaft inserted in lag fashion in equine metacarpal (metatarsal, MC(T)III) bone. METHODS: Screw types with independent variables of screw diameter (4.5 or 5.5 mm) and shaft type (without shaft, with 20-mm shaft, or with 25-mm shaft) were studied. Bone specimens cut from distal equine MC(T)III condyles were used. After screw insertion in lag fashion into 2 bone blocks with an instrumented device, shear tests were conducted in a mechanical testing machine. Outcome variables of peak insertion torque, insertion energy, stiffness. yield strength, and displacement at 3 kN of load were compared. RESULTS: The effects of screw design were substantial. Screws with shaft were 30% to 40% stiffer and 60% to 70% stronger than screws without shaft. Screws with shaft could tolerate 80 to 95 kg more force than screws without shaft before yielding. At 3 kN load, the displacement with screws with shaft was 55% to 60% of that with screws without shaft. Screws with a long shaft tended to perform better than those with a short shaft. There was no difference in the shear stiffness, shear yield strength, or shear displacement between the 2 screw diameters. Although larger diameter screws required more insertion effort, and screws with a short shaft required the most insertion energy, these differences were small. CONCLUSIONS: Cortex screws with a long shaft of 4.5- or 5.5-mm diameter provide better stability in equine MC(T)III condyle bone with less insertion effort compared with those with a short shaft or no shaft. CLINICAL SIGNIFICANCE: Cortex bone screws with a shaft inserted in lag fashion should be considered for the fixation of equine MC(T)III condylar fractures.

Animals↗

Serum neopterin and activity of coronary artery disease.

Inflammation plays a key role in the pathogenesis of atherosclerosis. In coronary artery disease (CAD), the release of different cytokines activates cellular defense. Infiltration of neutrophils and monocytes/macrophages is detected in the vessel wall in patients with CAD. Macrophages activated by interferon gamma synthesize metalloproteinases and neopterin, a pteridin derivative that has been used as an immune marker. To determine neopterin levels in patients with chronic CAD and acute coronary syndromes, the authors studied 116 subjects: 1) 25 consecutive patients (18 men, 7 women; mean age 68.5 +/- 14.3, range 40 to 86 years) with unstable angina or acute myocardial infarction (AMI); 2) 31 consecutive patients (25 men, 6 women; mean age 64 +/- 12.7, range 47 to 83 years) with signs and symptoms of clinically stable CAD; and 3) 60 consecutive healthy blood donors (38 men, 22 women; mean age 54.4 +/- 6.23, range 44 to 66 years). Neopterin levels were determined with a commercially available enzyme-linked immunosorbent assay method. In patients with unstable angina and AMI before thrombolytic therapy, neopterin levels were not significantly different from levels in patients with stable CAD (5.97 +/- 1.4 versus 7.84 +/- 3.56 nmol/L; P = 0.15). Neopterin levels in both patient groups did not significantly differ from levels in control subjects (P > 0.1). Neopterin levels in patients with unstable angina and AMI were measured four times during a 72-hour period. The lowest value was observed at baseline and differed significantly from values after 72 hours (P < 0.001; 5.97 +/- 1.4 versus 9.25 +/- 2.36). Neopterin levels after 72 hours were also significantly different from initial values in patients with stable CAD (P < 0.001). There was no correlation between neopterin and creatine kinase (CK) levels, CK-MB isoenzyme, or troponin I as markers for the extent of the myocardial injury during the observation period. These data do not support previous reports of higher baseline levels of serum neopterin in patients with unstable angina or AMI compared with patients with chronic, stable CAD and healthy controls. Neopterin as a marker of macrophage activation is significantly increased in patients with AMI and unstable angina shortly after the onset of symptoms (after a period of 72 hours), supporting the hypothesis of monocyte and macrophage activation in patients with an acute coronary syndrome or AMI.

Adult↗

Dialysis--a family matter. A personal tribute to the relatives of kidney patients.

The patient and his or her treatment is the main focus of the multidisciplinary team in the Renal Unit, yet the most important part of the patient's life is that spent at home, outside the hospital. It is important to recognise the contribution to care of the patient's family, especially the spouse. It is also important to understand the carer's needs. Carers experience many of the stresses associated with End Stage Renal Failure, while being relatively unsupported and unappreciated by hospital staff. This paper focuses on the need for imagination and understanding of the carer's predicament, and suggests ways in which carer's needs can be met.

Adaptation, Psychological↗

Relation of C-reactive protein levels to presence, extent, and severity of angiographic coronary artery disease.

BACKGROUND: C-reactive protein is a valid marker of cardiovascular risk. It is not known whether C-reactive protein is a marker of atherosclerotic burden or whether it reflects a process (e.g. inflammatory fibrous cap degradation) leading to acute coronary events. This study was performed to determine whetherthe concentration of C-reactive protein is associated with coronary atherosclerosis assessed by coronary angiography. METHODS AND RESULTS: We studied a total of 100 men and women (41 women, 59 men, mean age 63.7 +/- 11.0 years) who were referred for coronary angiography. Baseline data collection comprised clinical characteristics and conventional risk factors for coronary artery disease, levels of serum lipids and fasting total homocysteine levels. The relation between serum C-reactive protein levels and the severity and extension of coronary lesions was studied. The coronary angiograms were evaluated in a blinded manner according to three scores: vessel score (0-3 points for 0-3 vessels with coronary artery disease), stenosis score (0-3 points: number and severity of coronary stenoses or lesions; 0 for no, 1 for coronary lesion with diameter stenosis less than 50%, 2 for 50%-75%, and 3 for more than 75% diameter stenosis), and extent score (0-3 points; segment-extension of all coronary lesions within the total coronary vessel length). According to the total score values obtained, groups for coronary artery disease risk were defined and analyzed forcorrelations with age and levels of total cholesterol. high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting total homocysteine. and C-reactive protein in serum. From the 100 patients, 40 were found to have no or minimal coronary artery disease (group A; score 0-3), 33 had moderate (group B; score 4-8) and 27 had severe (group C: score more than 8) coronary artery disease assessed by coronary angiography. Estimates of the relative risk of coronary heart disease for the third quintile of serum C-reactive protein as compared with the first quintile were 1.79 (95 percent confidence interval 1.23-2.39). Serum C-reactive protein levels were 3.54 (+/- 7.07) mg/L, 11.41 (+/- 13.5) mg/L and 5.66 (+/- 8.32) mg/L in groups A, B and C and represented an independent risk factor for the presence of coronary artery disease assessed by coronary angiography (p<0.01). With step-wise logistic regression analyses, use of C-reactive protein values maintained the ability to predict the probability of coronary artery disease. Moreover, the presence of angiographic coronary artery disease was associated with patient age (p=0.048), male sex (p<0.01), high LDL-cholesterol levels (p=0.02), low HDL-cholesterol levels (p=0.02), high plasma fibrinogen levels (p<0.01) and high fasting total homocysteine levels (p=0.04). CONCLUSIONS: These results suggest that the serum concentration of C-reactive protein is associated with presence, but not severity, of coronary artery disease in patients referred for coronary angiography.

Adult↗