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[Main results of the Biorisk experiment on the International Space Station].

To get better appreciation of the margins of phenotypic adaptation and genotypic changes in bacteria-fungi associations within the typical microbiota residing on structural materials of space-flown equipment, developed were a program and hardware for a series of experiments under the general name BIORISK. Protocol of each experimental cycle is based on the well-proven method of exposure of "passive" samples of materials (Biorisk-KM), microorganisms-materials systems inside the ISS service module (Biorisk-MSV), and microorganisms-materials systems on the outside of the ISS SM (Biorisk-MSN). Each six months the samples are returned to the laboratory in conjunction with crew rotation. Already the first in-hand data from the experiment point to the dramatic effect of space flight on growth, reproduction, and biological properties of test microbes and fungi. Thus, the activity of enzymes that characterize the pathogenic potential (RNA-ase and DNA-ase), and resistance of microorganisms to aseptic agents were found increased.

Adaptation, Physiological↗

Arbuscular mycorrhizal fungi associated with sedges on the Tibetan plateau.

The arbuscular mycorrhizal (AM) status of nine dominant sedge species and the diversity of AM fungi in Tibetan grassland were surveyed in the autumn of 2003 and 2004. Most of the sedge species and ecotypes examined were mycorrhizal, but Carex moorcroftii and Kobresia pusilla were of doubtful AM status, and Kobresia humilis was facultatively mycorrhizal. This is the first report of the mycorrhizal status of eight of the nine sedge species examined. Intraradical vesicles and aseptate hyphae were the structures most frequently observed. Appressoria, coils, and arbuscules were found in the roots of a few sedge species. A strong negative correlation was found between soil organic matter content and the extent of mycorrhizal colonization. Using trap cultures, 26 species of AM fungi belonging to six genera, Glomus, Acaulospora, Paraglomus, Archaeospora, Pacispora, and Scutellospora, were isolated from the soil samples collected. The frequency of occurrence of different taxa of AM fungi varied greatly. Glomus and Acaulospora were the dominant genera, and Acaulospora scrobiculata was the most frequent and abundant species. The species richness of AM fungi was 2.73 in the study area. Species richness and diversity index differed among the sedge species but were not correlated with soil factors such as pH, available P, or organic matter content.

Colony Count, Microbial↗

Simultaneous assay of prostaglandins and thromboxane in the cerebrospinal fluid by gas chromatography-mass spectrometry-selected ion monitoring.

A method of simultaneous analysis of prostaglandins (PGs) and thromboxane (TX) B2 in cerebrospinal fluid (CSF) with GC-MS-SIM was established. Deuterated PGs and TXB2 were used as internal standards: tetra-deuterated PGE2 (d4-PGE2) for PGE2, PGE1 and PGD2; d5-PGF2alpha for PGF2alpha and 9alpha,11beta-PGF2 and 8-epi PGF2alpha; d4-TXB2 for TXB2; and d4-6-keto PGF1alpha for 6-keto PGF1alpha. The PGs and TXB2 were derivatized to the methyl ester of the methoxim dimethyisopropylsilyl (DMiPSi) ether form or the methyl ester of the DMiPSi ether form with simultaneous preparation. Samples were extracted with octadecyl silica gel and purified in two steps with silisic acid gel chromatography between derivatization steps. The calibration curve of each PG and TXB2 was linear from 10 pg to 10 ng with the isotope dilution method. The levels of the seven types of PG and of TXB2 were assayed simultaneously in the cerebrospinal fluid (CSF) from patients with aseptic meningitis. The CSF pattern of the PG and TXB2 concentrations in mumps meningitis differed from those in other types of aseptic meningitis and in disease controls.

Calibration↗

Outbreak of aseptic meningitis in Taipei in spring 1993.

An outbreak of aseptic meningitis in the Taipei area occurred from January to August 1993. A total of 114 cases were identified by cerebrospinal fluid (CSF) examination at National Taiwan University Hospital. Most of the cases were found from February to May 1993. The peak of age distribution was 3 to 11 years. The male-to-female ratio was 2.1 to 1. Most patients had fever, headache, and vomiting and nausea. On initial CSF examination, protein concentrations > 400 mg/L were noted in 38 of 93 CSF samples, while 19 of 70 initial samples had hypoglycorrhachia (CSF/serum glucose ratio < 0.5). CSF white cell counts of the initial lumbar puncture were 0-9 x 10(6) cells/L in 4 patients, 10-99 x 10(6) cells/L in 42 patients, 100-199 x 10(6) cells/L in 27 patients, 200-499 x 10(6) cells/L in 24 patients, 500-999 x 10(6) cells/L in 12 patients and > or = 1,000 x 10(6) cells/L in 5 patients. Polymorphonuclear cells predominated in 73 of 114 cases. Viral cultures from CSF, throat swabs and rectal swabs were done with a majority yielding enteroviruses. Enterovirus as a definite etiology was found in 58 of 114 cases and was the presumptive etiology in 15 of 114 cases. The serotypes of the enteroviruses isolated were mostly echovirus type 30. All patients recovered without obvious sequelae.

Adolescent↗

[Laparoscopic treatment of ovarian tumors in menopausal women].

OBJECTIVE: The authors report their experiences in the laparoscopical therapy of ovarian tumours with 94 postmenopausal women. STUDY DESIGN: The patients were treated in the Department of Gynecology at Göppingen Medical Center from March 1, 1992 until December 31, 1993. Tumour marker CA 125 was not within normal limits (< 35 U/ml) in all patients. Preoperatively all findings were verified by ultrasound examination. In some cases, cysts were single-chambered, smooth-bounded or without endovegetations. Choice therapy has been bilateral adnectomy without opening the ovarian cyst and without trauma to the ovary capsula. Adnectomy was performed by bipolar coagulation and sharp preparation. In every case the specimen was positioned intact in a "Lap-Sac" and then removed via second puncture. In case of ultrasonographic or laparoscopic-macroscopic conspicuous findings an obligatory fast microscopic random sample was performed. RESULTS: In one case the microscopic test sample revealed carcinoma of the ovary--the operation was terminated by standard laparotomy. No other cases showed signs of malignancy. There were no peri- or postoperative complications. The average operation lasted 35 min (20-80 min), all operations were performed without significant blood-loss. Usually the patients were discharged at the 4th to 6th postoperative day. CONCLUSION: This operation-technique guaranteed "oncological aseptic" results at any time of operation. Therefore you can waive the standard laparotomy for the benefit of laparoscopy in many elderly patients even with suspicious findings.

Adenoma↗

Bacterial contamination of propofol in the operating theatre.

There have been several reports of propofol becoming extrinsically contaminated with bacteria. These reports have usually related to infusions or delays in administration after the ampoule has been opened. This observational study was performed to examine bacterial contamination of propofol during usual practice in the operating theatres of a single large hospital group. One hundred samples of propofol were collected and cultured. Samples were taken immediately after administration in cases where the delay between opening the ampoule and administration was at least 15 minutes. The samples were classified according to whether the propofol was kept in the ampoule or a syringe after opening the ampoule and whether the intended use was for a single patient or multiple patients. The time between opening the ampoule and administration was recorded. There were three positive bacterial cultures. These samples all came from ampoules used for more than one patient, without the later dose (does) being drawn into a syringe at the time the ampoule was opened. This common clinical practice, especially in paediatric anaesthesia, does not comply with the manufacturer's recommendations. The clinical significance of the bacterial contamination detected is not clear. It is recommended that propofol should be handled in an aseptic fashion and measures taken to minimize the risk of bacterial contamination.

Bacteria↗

[Total hip arthroplasty and femoral head osteonecrosis in renal transplant recipients].

PURPOSE OF THE STUDY: Osteonecrosis of the femoral head is reported in a very variable proportion of renal transplant recipients. When these patients require total hip arthroplasty (THA), immunosuppression and poor bone quality increase the risk of aseptic loosening and infection. In the literature, functional outcome has been satisfactory although rates of early and late complications have varied greatly. The purpose of our work was to determine the long-term outcome in a series of renal graft recipients who underwent THA for osteonecrosis of the femoral head. MATERIAL AND METHODS: Forty-eight THA were implanted for aseptic osteonecrosis of the femoral head (Ficat grade III and IV) in 32 renal transplant recipients between 1974 and 1995 (21 men and 11 women). Mean age was 30 years at transplantation and 39 years at THA surgery. Thirty patients had been on hemodialysis for a mean 1 year prior to transplantation. Joint disease concerned 2 or more joints in 23 of the 32 patients. Fifteen hips had a surgical history: 8 drillings and 3 head arthroplasties. The THA was implanted under general anesthesia via the posterolateral approach. All implants were fixed with a gentamycin cement. A cephalosporin was used for the antibiotic prophylaxis in 20 cases and a cephalosporin/vancomycin combination in 24. Functional outcome was assessed with the Postel-Merle-d'Aubigné (PMA) score. Functional gain was [(PMAreview-PMApreop)/PMApreop]. General or local complications were recorded at last follow-up. The complete or incomplete nature of lucent lines seen on the last follow-up x-rays and their evolution were also recorded. Reasons for second procedures were noted. RESULTS: Early complications were: phlebitis (n=1), hematoma (n=7), dislocation (n=1), deep infection (n=2). At last follow-up (mean=5 years 7 months), four patients (6 THA) had died and six (7 THA) were lost to follow-up. Preoperatively, function was scored fair or poor in 91% of the patients. At last follow-up function was scored good, very good, or excellent in 75%. Mean functional gain was 38%. A second operation was necessary for seven THA due to aseptic loosening (mean delay 9 years 10 months), for five others for septic loosening (mean delay 6 years 8 months), and finally for two for instability (one early and the other after more than 2 years). In all, 29% of the THA were reoperated. Two deaths were related to late THA infection. Active lucent lines were observed in 11% of the THA (excepting patients reperated for loosening). DISCUSSION: The functional gain provided by THA in renal transplant recipients with aseptic osteonecrosis of the femoral head is clearly established. Implant survival remains a problem. The rate of early local complications was high in our series, mainly related to hematoma formation and infection. The infections observed were particularly severe requiring early comprehensive management at onset of clinical signs. For patients with suspected deep infection, we propose an aspiration biopsy of the joint to obtain a bacteriological sample. CONCLUSION: THA enables good functional outcome for renal transplant recipients suffering from osteonecrosis of the femoral head, but at the cost of a high risk of early and long-term complications not always reported in the literature.

Activities of Daily Living↗

Increased nucleotide catabolism after cerebral convulsions.

Cardiazol induced seizures in rabbits showed that the highest oxypurine concentrations can be detected in the CSF 1 hour after the convulsions. There is a sharp decline continuing until the third hour. After that the CSF values remain nearly constant until the 24th hour being about ten times higher than in the controls. There is a good correlation of these results obtained through the densitometric thin-layer, enzymatic-oxymetric, and HPLC-methods. Creatinine and potassium were raised only during the first two hours postconvulsively. Uracil appeared in the CSF slightly higher at the 1 hour and at the 12 and 24 hour values. A parallel increase of the oxypurine and creatinine concentrations was found in the serum between 30 to 120 minutes postconvulsively. After that the raised serum values decreased slowly to the initial values. CSF samples were examined in 31 children postconvulsively: Hypoxanthine was found to be raised in 8 of 12 patients with severe grand mal seizures, 1 of 6 patients with hypsarrhythmia, 1 of 8 patients with short seizures (less than 2 min) and in all 5 patients with petit mal status. In contrast to these groups the hypoxanthine concentrations was raised only in 2 of 20 children with aseptic meningitis. The difference between the group of children with convulsions and the group of children with aseptic meningitis is significant (p less than 0.005). Also, the frequency of raised uric acid concentration is higher in the group of children with convulsions (70%) than in the group of children with aseptic meningitis (40%); (p less than 0.05).

Animals↗

Chemokines in acute anterior uveitis.

PURPOSE: The aim of this study was to define the expression of chemoattractant cytokines (chemokines) in human aqueous humor, obtained from patients with idiopathic acute anterior uveitis (AU). The chemokines assayed included macrophage inflammatory proteins-1 alpha and -1 beta (MIP-1 alpha and -1 beta), monocyte chemoattractant protein-1 (MCP-1), interleukin-8 (IL-8), interferon-inducible protein-10 (IP-10), and regulated on activation, normal T-expressed and secreted (RANTES). METHODS: We studied fifteen patients (7 females) with idiopathic acute AU, at various stages of disease activity, and two control subjects undergoing elective cataract extraction. Aqueous humor was collected under aseptic conditions, after obtaining informed consent. Chemokine concentrations were measured using specific ELISA. Correlation was sought between chemokine concentrations and disease activity, evaluated by slit lamp biomicroscopy and graded using a standardized scale of disease severity. RESULTS: IL-8 was detected (35.9 +/- 13.6, mean +/- SE) in three of seven subjects in active, untreated stages of AU (clinical score 2-4), and it was undetectable in subjects sampled in the quiescent phase of the disease. IP-10 had a mean concentration of 40.6 ng/ml +/- 20.9 in the active group (N = 7), declining to 0.8 ng/ml +/- 0.3 in the samples from patients with inactive disease (N = 7, P = 0.001). Similarly, substantial expression of MCP-1 was noted, with a maximum concentration of 145 ng/ml, in acute (active) AU (N = 6), (26.7 +/- 19.7), falling to undetectable levels in those with inactive disease, and in control subjects (P = 0.001). MIP-1 beta (N = 7), (3.4 +/- 1.5, P = 0.001) and RANTES (N = 7, 8.8 +/- 4.2) levels were significantly increased in acute disease (P = 0.001) and related to the activity of the disease, although the concentrations were not as high as MCP-1, IP-10 and IL-8. IP-10, RANTES and MIP-1 beta were detected at low concentrations in the aqueous humor of the control subjects. CONCLUSIONS: This is the first study of chemokine concentrations in the aqueous humor of patients with acute anterior uveitis. The concentration of chemokines: IL-8, IP-10, MCP-1, RANTES and MIP-1 beta were significantly increased during the active stages of AU, and correlated with the clinical severity of the disease. These chemoattractant cytokines probably play a critical role in leucocyte recruitment in acute AU.

Acute Disease↗

Pustular psoriasis and aseptic purulent arthritis: possible role of leukotrienes B4 and C4 in a flare of synovitis.

BACKGROUND: Arthritis is a frequent complication of pustular psoriasis. However, the mechanism of onset of this arthritis still remains unclear. OBJECTIVES: The present study was conducted to determine whether leukotriene (LT) B4 or LTC4 is one of the proinflammatory mediators that possibly enhance exacerbation of the arthritis lesions. METHODS: We investigated the condition of the arthritis and autopsy findings of two cases of generalized pustular psoriasis with the severe complication of aseptic purulent arthritis. We also measured the synovial fluid levels of LTB4 and LTC4 by radioimmunoassay. RESULTS: The collected synovial fluid was purulent, but nonbacterial, and the synovium of the knee joint showed histopathologic evidence of polymorphonuclear leukocyte (PMN) invasion, edema and dilatation of small vessels showing similarity to a histologic reaction in the skin lesions. The immunoreactive (i-) LTB4 and i-LTC4 in the samples significantly exceeded the amount measured in osteoarthritis patients used as the controls. CONCLUSION: Thus, i-LTB4 and i-LTC4 appear to be generated in the arthritis lesions of pustular psoriasis, the former attracting PMNs to the joints and the latter causing exudation of synovial fluid.

Aged↗

[Cerebrospinal fluid abnormalities in 170 cases of AIDS].

Cerebrospinal fluid (CSF) was analysed in 170 AIDS patients. All of them showed HIV positive serological tests. All of them showed neurologic syndromes related to AIDS. The time period of the investigation was July 1984-April 1989. In 8 cases (4.7%) CSF composition was normal. Lymphoma cells were observed in three cases. Aseptic meningities occurred in 34 cases (20.1%). Aetiological diagnosis of associated infection was established in 88 cases: cryptococcosis in 28 (35.9%); toxoplasmosis in 20 (25.6%); syphilis in 10; candidiasis in 3; Chagas disease in 2; tuberculosis in 1; nocardiosis in 1; schistosomiasis in 1. Antibodies for other virus were detected in 7. Bacteria were isolated in 5 cases. Anti-HIV antibodies were tested in CSF samples of 55 cases: they were found in 48 (87.3%). Two or more associated infections were observed in 15 cases. Changes of CSF composition in AIDS are discussed taking into account changes reported.

AIDS-Related Complex↗

Perioperative infections in Nigerians: a seven-year prospective study.

The introduction of simple, measures in addition to usual aseptic and antiseptic measures at the University of Ilorin Teaching Hospital theatre in Ilorin, Nigeria, led to a significant decrease in perioperative infection rate in a pilot study. These measures were applied to 440 operative procedures in a unit over a 7-year period in an old as well as new theatre. Sterility tests on sterilizing packs, nasal and throat swabs and bacteria-carrying particle samplings were done to document and limit the sources of wound contamination. Mortality and infection rates were significantly higher among patients undergoing thoracic than extrathoracic surgical operation (P less than 0.05; p less than 0.005) including post-tube thoracostomy empyema. Clean and clean-contaminated cases survived operations significantly more frequently and were significantly less infected than the contaminated and dirty cases (less than 0.001; p less than 0.005). Although there was significantly higher mortality (p less than 0.05) in patients older than 31 years, there was no significantly higher infection rate. Neither the mortality rate nor infection rate was significantly affected by seasonal and patients' sex. Overall infection rate was 7.5% (32 out of 428 fully evaluated patients) while wound and non-wound infection rate in this study is an improvement over those previously reported in this country.

Female↗

[UHT--behandeling van melk (author's transl)].

Pasteurisation of milk provides protection for the consumer against pathogens which may be present in the raw milk, and improves its keeping quality. Sterilisation provides indefinite keeping quality but has an undesirable effect on the flavour and nutritive value of the milk. Ultra high temperature (UHT) treatment produces a milk with prolonged shelf life at ambient temperatures yet has practically the same effect on colour, falvour and nutritive value as pasteurisation. UHT treatment of milk involves preheating to 80 degrees C and then quickly raising the temperature, either by indirect heating in a tubular heater or by direct steam injection, to 130 degrees-- to 150 degrees C at which temperature it is kept for 3 to 5 sec. Cooling follows immediately. Systems in operation in South Africa use steam injection for heating to sterilising temperatures. Evaporation cooling is obtained by subjecting milk to a partial vacuum. This removes any water added during heating by condensing steam and also removes steam-volatile off-flavours. UHT-treated milk is packed aseptically, usually into heat-sealed paperboard laminated cartons. Intact packages can be kept for up to three months. Absolute sterility cannot be obtained by UHT processing. The term "sterilising effect", introduced by Galesloot, means the log10 of the ratio of initial spore count to surviving spore count. A spoilage rate of not more than one litre package per 1000 is considered satisfactory. For laboratory control samples of the sterilized milk are incubated at temperatures favourable to germination of mesophilic and thermophilic spores respectively. After incubation the milk is examined for flavour and physical appearance, subjected to the standard plate count and tested for increase in acidity and decrease in stability towards the alcohol test. Milk for UHT treatment must possess protein stability in the alcohol test, be of good bacteriological quality, and a low spore count in particular.

Animals↗

Relative rates and features of musculoskeletal complications in adult sicklers.

The purpose of this study was to prospectively look for the relative rates and features of musculoskeletal complications in a sample of adult homozygous SS sicklers in Yaoundé. During a 3-year period, known homozygous SS sicklers aged sixteen years or more, with suspicion or evidence of locomotor system disease, including leg ulcer, were consecutively investigated through complete medical history, clinical examination, full blood count, C-reactive protein, standard radiographs of the area of complaint, and, when necessary, CT scan and pus analysis. Those patients with no definite diagnosis were excluded. The study group comprised 84 patients aged 16 to 51 years (mean age: 22 years), with a male/female ratio of 0.75. Four of them (4.5%) were older than 40 years. Thirty five (41.6%) presented a total of 50 lesions of aseptic osteonecrosis, which were located in the hips in 25 cases (50%), in the lumbar spine in 20 cases (40%), in the humeral head in four cases (10%) and in the talar body in one case. The hip necrosis was grade I in 6 cases, grade II in four, grade III in 11 and terminal in four. Multiple sites of necrosis were observed in six patients. Nineteen (22.6%) of the sicklers came on with 36 malleolar ulcers, more frequently in males (sex ratio: 5/1) and 28 (78%) located on the medial side. Fifteen sites of osteomyelitis were noted in 14 patients (17.8%) and septic arthritis in six (7%). Less frequent complications were impingement syndrome, gout osteoarthropathy, stress fracture, subtalar fusion, knee osteoarthritis, tendonitis of the anterior tibialis, and recurrent dislocation of the patella. All patients were managed conventionally, except for advanced aseptic necrosis in which the indication for arthroplasty was delayed till the terminal stage. As suggested by another recent report from Senegal, efforts should be made to improve the life expectancy of sicklers in Sub-Saharan African countries, by acting on education, social and medical care. Orthopaedic surgery should focus on reducing the failure rate of joint replacement in terminal stages of osteonecrosis and designing core decompression trials in early stages.

Adolescent↗

Molecular epidemiology of microbial contamination in the operating room environment: Is there a risk for infection?

BACKGROUND: Modern operating rooms are considered to be aseptic environments. The use of surgical mask, frequent air exchanges, and architectural barriers are used to reduce airborne microbial populations. Breaks in surgical technique, host contamination, or hematogenous seeding are suggested as causal factors in these infections. This study implicates contamination of the operating room air as an additional etiology of infection. METHODS: To investigate the potential sources of perioperative contamination, an innovative in situ air-sampling analysis was conducted during an 18-month period involving 70 separate vascular surgical procedures. Air-sample cultures were obtained from multiple points within the operating room, ranging from 0.5 to 4 m from the surgical wound. Selected microbial clonality was determined by pulse-field gel electrophoresis. In a separate series of studies microbial nasopharyngeal shedding was evaluated under controlled environmental conditions in the presence and absence of a surgical mask. RESULTS: Coagulase-negative staphylococci were recovered from 86% of air samples, 51% from within 0.5 m of the surgical wound, whereas Staphylococcus aureus was recovered from 64% of air samples, 39% within 0.5 m from the wound. Anterior nares swabs were obtained from 11 members of the vascular team, clonality was observed between 8 strains of S epidermidis, and 2 strains of S aureus were recovered from selected team members and air-samples collected throughout the operating room environment. Miscellaneous Gram-negative isolates were recovered less frequently (<33%); however, 7 isolates expressed multiple patterns of antimicrobial resistance. The traditional surgical mask demonstrated limited effectiveness at curtailing microbial shedding, especially during symptomatic periods of rhinorrhea. CONCLUSIONS: Gram-positive staphylococcal isolates were frequently isolated from air samples obtained throughout the operating room, including areas adjacent to the operative field. Nasopharyngeal shedding from person participating in the operation was identified as the source of many of these airborne contaminants. Failure of the traditional surgical mask to prevent microbial shedding is likely associated with an increased risk of perioperative contamination of biomedical implants, especially in procedures lasting longer than 90 minutes.

Air Microbiology↗

Prevalence and numbers of bacteria in broiler crop and gizzard contents.

Crops or gizzards in broiler carcasses are frequently damaged during processing. The contents from either organ, defined by the USDA Food Safety and Inspection Service as ingesta, may contaminate the carcass. Previous research has shown crop contents are a source of Salmonella contamination on processed carcasses, although less information is available on gizzard contents. The purpose of this study was to determine the prevalence and numbers of total aerobic bacteria, coliforms, Escherichia coli, and Campylobacter in ingesta collected from the crop and gizzard. In each of 3 replicate trials, 10 uneviscerated broiler carcasses were obtained from a processor at the shackle transfer point just prior to evisceration. Liquid crop contents and solid gizzard contents were aseptically collected from each carcass and quantitatively cultured. Total aerobic bacteria, coliforms, E. coli, and Campylobacter were determined for contents from both organs. Crop contents (log cfu/mL), compared with gizzard contents (log cfu/g), contained significantly (P < 0.05) higher numbers of total aerobic bacteria (5.6 vs. 2.9), coliforms (4.2 vs. 2.3), E. coli (3.9 vs. 2.2), and Campylobacter (4.6 vs. 2.2). Escherichia coli prevalence was higher in crop samples (28 of 29) than gizzard samples (19 of 30). Campylobacter prevalence was also higher for crop vs. gizzard samples (29 of 29 vs. 12 of 30). An average of 2.4 g of crop contents and 8.4 g of gizzard contents were recovered. Crop contents contain more bacteria than gizzard contents and contained a higher incidence of E. coli and Campylobacter contamination. However, because of the numbers of bacteria and amount of material in the crop and gizzard, it is unlikely that ingesta contamination would increase overall bacterial counts of prechill broiler carcasses.

Animals↗

Vascular access port (VAP) usage in large animal species.

Intravascular catheterization access for injection and sampling is one of the most common experimental surgical procedures. The vascular access port (VAP) was developed as an alternative to externalization of catheters. A VAP typically is implanted subcutaneously, with an attached catheter that is tunneled to a blood vessel for chronic catheterization. Catheters and ports have been designed to reduce the problems of occlusion, venous thrombosis, and infection. Key issues involve the use of meticulous aseptic technique for implantation of the devices and a "locking" solution that prevents clotting and retention of residues within the catheter. There are species-specific differences to be considered when planning the surgical implantation and maintenance of these devices. This manuscript reviews the procedures that have been used in the implantation of VAPs in large animal species and makes recommendations for procedures that will decrease complication rates associated with long-term catheterization.

Animals↗

Effects of intra-articular administration of dimethylsulfoxide on chemically induced synovitis in immature horses.

The effects of intra-articular administration of dimethylsulfoxide (DMSO) on chemically induced synovitis in the middle carpal joint of 6 weanling horses were evaluated. Following aseptic collection of synovial fluid, the middle carpal joint of each forelimb was injected with 50 mg of Na-monoiodoacetate to induce synovitis. Eight days after injection, synovial fluid was obtained and the right middle carpal joints were injected with 2 ml of 40% DMSO in lactated Ringer solution. The corresponding joints of the left limb (control) were injected with 2 ml of lactated Ringer solution. Sampling and treatments were repeated on post-injection days 11 and 14, for a total of 3 treatments. Horses were visually evaluated daily for lameness and joint effusion. Synovial fluid was evaluated for color and clarity, differential and total WBC count, total protein content, and hyaluronic acid concentration. The Kaegi gait analysis system provided an objective assessment of lameness prior to inducing synovitis, again on day 7, and on day 17. At necropsy (day 17), synovial fluid, synovial membrane, and articular cartilage specimens were collected. Joint effusion was evident 12 hours after injection of Na-monoiodoacetate in all joints. Mild lameness was evident at 24 hours; however, the lameness resolved by 72 hours. Objective assessment of lameness did not reveal significant differences between treatment or control limbs. Hyaluronic acid concentrations increased significantly (P = 0.023) above baseline values in most joints over the study period. Synovial fluid WBC counts increased significantly (P = 0.002) following Na-monoiodoacetate injection and remained significantly (P = 0.002) above baseline values throughout the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗