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There are several non-steroidal intra-articular therapeutics (NSIATs) available for use by equine practitioners for the treatment of performance-limiting joint-related pathology. Information is limited on perceived clinical efficacy, recommended treatment protocols, and associated complications. Our objective with this cross-sectional survey was to investigate the current clinical usage of NSIATs by equine practitioners. An electronic cross-sectional convenience survey inquiring about the use of steroidal and NSIATS (platelet-rich plasma, autologous conditioned serum, autologous protein solution, cellular therapies, and polyacrylamide hydrogel) was distributed internationally to equine practitioners. A total of 353 surveys were completed. NSIATs were used by 87.5% of the participants. Corticosteroids and hyaluronic acid remain the intra-articular therapeutic of choice among practitioners, followed by autologous conditioned serum, and platelet-rich plasma and autologous conditioned protein. Polyacrylamide hydrogel was the least used. Practitioners were more likely to use NSIATs if their caseload was greater than 50% equine (P

Mass spectrometry (MS)-based quantitative proteomics experiments typically assay a subset of up to 60% of the ≈20 000 human protein coding genes. Computational methods for imputing the missing values using RNA expression data usually allow only for imputations of proteins measured in at least some of the samples. In silico methods for comprehensively estimating abundances across all proteins are still missing. Here, a novel method is proposed using deep learning to extrapolate the observed protein expression values in label-free MS experiments to all proteins, leveraging gene functional annotations and RNA measurements as key predictive attributes. This method is tested on four datasets, including human cell lines and human and mouse tissues. This method predicts the protein expression values with average R 2 scores between 0.46 and 0.54, which is significantly better than predictions based on correlations using the RNA expression data alone. Moreover, it is demonstrated that the derived models can be "transferred" across experiments and species. For instance, the model derived from human tissues gave a R 2 = 0.51 when applied to mouse tissue data. It is concluded that protein abundances generated in label-free MS experiments can be computationally predicted using functional annotated attributes and can be used to highlight aberrant protein abundance values.

Degenerative joint disease (DJD) or osteoarthritis in the equine is largely a result of biomechanical stressors that result in inflammation within the joint, which with continual exposure, leads to progressive degeneration. A myriad of therapies are available for treatment of horses with DJD including nonsteroidal anti-inflammatory drugs, corticosteroids, physiological modifiers, and biological therapies. C-phycocyanin, a protein-bound pigment found in blue-green algae, has been shown to have anti-inflammatory and antioxidant properties and is available as a diet supplement in people, dogs, and horses. Forty-one horses with naturally occurring lameness as a result of DJD were selected for this study. In a blinded study, horses were randomly assigned to either the commercial or placebo product that was fed once daily for 12 months. At selected time points, lameness evaluation was performed through objective gait analysis. Previous medical records for management of lameness were reviewed for all enrolled horses. No statistically significant differences existed within or between the two groups when gait was evaluated objectively nor within individual horses between time points. Review of medical records found that five treated horses had a decreased in frequency of intra-articular injection of corticosteroids. Although this study did not find statistically significant improvement of lameness with oral daily supplementation of C-phycocyanin in equine athletes, there appeared to be a trend of improvement in lameness during the loading period and a decrease in frequency of administration of intra-articular corticosteroids. Further investigations using a higher dose seem warranted.

Background Birth outcome disparities are particularly evident in Alabama and evidence has shown that including doulas in an interprofessional birth care team (IBCT) may improve these outcomes. Purpose The purpose of this study is to assess whether including doulas in the birth care team was associated with improved birth outcomes among low resource mothers in Alabama. Methods Doula supported birth outcomes in 2013–2014 (n = 120) were restrospectively compared to all 2014 Medicaid funded births in Jefferson County, Alabama (n = 3782). Results Doula supported births were associate with lower rates of epidural anesthesia and birth by cesarean as compared to the reference population (OR 3.0, 95% CI 2.1–4.4 and OR 1.8, 95% CI 1.1–2.9, respectively, for reference population). Doulas were also associated with a ten-fold increase in breastfeeding initiation (OR 10.5, 95% CI 5.4–23.2). Conclusions Doula support is associated with increased breastfeeding initiation and reduced rates of epidurals and cesareans among low resource mothers in Alabama.

Identification and quantification of proteins by shotgun proteomics experiments is underpinned by the use of accurate masses and fragmentation patterns generated by tandem mass spectrometry. Assigning peptide sequences to tandem MS data is supported by a plethora of informatics tools. The majority of spectral identification software report arbitrary fitness scores reflecting the quality of a match, however, valid statistical metrics must be used to make sense of these scores and attribute a confidence to the peptide identifications. Accurately estimating the error and devising filtering routines to minimise incorrect and random identifications is essential for making valid and reproducible conclusions about the biology of the sample being analysed. This chapter discusses the statistical approaches used to evaluate and validate shotgun proteomics peptide to spectrum matches and provides a summary of software available for this purpose.

The original PRIDE Converter tool greatly simplified the process of submitting mass spectrometry (MS)-based proteomics data to the PRIDE database. However, after much user feedback, it was noted that the tool had some limitations and could not handle several user requirements that were now becoming commonplace. This prompted us to design and implement a whole new suite of tools that would build on the successes of the original PRIDE Converter and allow users to generate submission-ready, well-annotated PRIDE XML files. The PRIDE Converter 2 tool suite allows users to convert search result files into PRIDE XML (the format needed for performing submissions to the PRIDE database), generate mzTab skeleton files that can be used as a basis to submit quantitative and gel-based MS data, and post-process PRIDE XML files by filtering out contaminants and empty spectra, or by merging several PRIDE XML files together. All the tools have both a graphical user interface that provides a dialog-based, user-friendly way to convert and prepare files for submission, as well as a command-line interface that can be used to integrate the tools into existing or novel pipelines, for batch processing and power users. The PRIDE Converter 2 tool suite will thus become a cornerstone in the submission process to PRIDE and, by extension, to the ProteomeXchange consortium of MS-proteomics data repositories. publishedVersion

Objective—To establish a protocol to collect temporal-spatial gait analysis variables by use of a portable walkway system in Labrador Retrievers at a walk and to determine reference values. Animals—56 healthy Labrador Retrievers. Procedures—6 passes across the walkway (3 passes in each direction) were recorded. Inclusion criteria for a pass were that the dog was at a walk (velocity, 60.0 to 90.0 cm/s) and had minimal head turning. The first 3 passes that met the inclusion criteria were analyzed for each dog. Results—Mean stride length was 88.4 cm. Mean stance time (ST) of forelimbs and hind limbs was 0.62 and 0.56 seconds, respectively. Mean stance time percentage (ST%; proportion of stance time to total gait cycle time) for forelimbs and hind limbs was 55.6% and 50.2%, respectively. Mean total pressure index (TPI) of forelimbs and hind limbs was 27.1 and 17.4, respectively. Mean number of sensors (NS) activated by each paw strike of forelimbs and hind limbs was 17 and 13, respectively. Mean forelimb-to-hind limb symmetry ratios were 1.11 (ST), 1.10 (ST%), 1.62 (TPI), and 1.37 (NS). Symmetry ratios for left limbs to right limbs, left forelimb to right forelimb, and left hind limb to right hind limb were 1.00. Conclusions and Clinical Relevance—A protocol for collection of temporal-spatial gait analysis variables with a portable walkway system in Labrador Retrievers at a walk was developed, and reference values for variables and symmetry ratios were reported. Further research will determine the extent to which symmetry ratios differ in dogs with orthopedic disorders. (Am J Vet Res 2010;71:997–1002)

Objective: To evaluate the effects of low-dosage (3 μg/kg/min) dopamine on urine output, renal blood flow, creatinine clearance, sodium excretion, heart rate, and mean arterial pressure (MAP) in healthy anesthetized cats. Design: Controlled experimental study. Setting: University experimental laboratory. Animals: Twelve random-bred 2–4-year-old cats. Interventions: Anesthesia, laparotomy for renal artery blood flow measurement, and arterial and venous catheterization. Measurements: Heart rate (HR), MAP, renal blood flow, urine output, sodium excretion, fractional sodium excretion, and creatinine clearance. Main results: No significant difference in urine output, sodium excretion, HR, or creatinine clearance occurred in cats receiving low-dosage dopamine. A transient decrease in the mean arterial blood pressure occurred in cats receiving dopamine. Conclusions: Low-dosage dopamine cannot be expected to induce diuresis in healthy cats. Low-dosage dopamine may cause vasodilation in non-renal vascular beds.

Background Urine protein: urine creatinine (UP:UC) ratio determined from the quantitative measurement of protein and creatinine in a single urine sample is the best feasible assessment of clinically significant proteinuria in dogs and cats. A dipstick that measures urine protein, urine creatinine, and UP:UC ratio has been used in human medicine and could have application for veterinary practice. Objective The objective of this study was to compare the Multistix PRO dipstick (Bayer Corporation, Elkhart, IN, USA) to other biochemical methods for determination of urine protein and creatinine, and UP:UC ratio in canine and feline urine. Methods A complete urinalysis, including sulfosalicylic acid (SSA) precipitation, was performed on urine samples submitted to our laboratory between February and April 2003 from 100 dogs and 49 cats. Urine protein and creatinine concentrations were determined by the Multistix PRO dipstick using a Clinitek 50 analyzer (Bayer) and compared with the results of SSA precipitation and quantitative biochemical analysis. The UP:UC ratios from the dipstick results (calculated by the Clinitek 50 and also manually) were compared with those calculated from quantitative values. Pearson product-moment correlation analysis and diagnostic sensitivity and specificity (using quantitative results as the gold standard) were determined. Results For both canine and feline urine, protein and creatinine concentrations determined by the Multistix PRO correlated closely with quantitative concentrations for protein (dogs r = .78, P = .0001; cats r = .87, P = .0001) and creatinine (dogs r = .78, P = .0001; cats r = .76, P = .0001). The Multistix PRO was more sensitive and less specific than SSA precipitation for diagnosing clinically significant proteinuria. UP:UC ratios obtained by manual calculation of dipstick results correlated best with quantitative UP:UC ratios in dogs, and had higher specificity but lower sensitivity for the diagnosis of proteinuria. In cats, UP:UC ratios determined by the dipstick method did not correlate (r = -.24, P = .0974) with quantitative values. Conclusions The Multistix PRO, with manual calculation of UP:UC, may be a good alternative for the diagnosis of clinically significant proteinuria in dogs, but not cats. Dipstick creatinine concentration should be considered as an estimate.

Objective— To describe the macroscopic features of first and second intention cutaneous wound healing in the cat and compare with the dog. Study Design— Experimental study. Animals— Domestic shorthaired cats (6) and beagle dogs (6). Methods— Square, open cutaneous wounds created on the dorsal aspect of the thorax were evaluated for 21 days for temporal and spatial development of granulation tissue, wound contraction, epithelialization, and total healing. To evaluate first intention healing, breaking strength of sutured linear cutaneous wounds was measured at 7 days post-wounding. Laser-Doppler perfusion imaging was used to measure cutaneous perfusion. Results— First intention healing: sutured wounds in cats were only half as strong as those in dogs at day 7 (0.406 versus 0.818 kg breaking strength). Second intention healing: cats produced significantly less granulation tissue than dogs, with a peripheral, rather than central distribution. Wound epithelialization and total wound healing (total reduction in open wound area from contraction and epithelialization) were greater for dogs than for cats over 21 days. Wound contraction on day 7 was greater for dogs, but not on day 14 or 21. Cutaneous perfusion was initially greater for dogs than for cats, but no differences were detected after day 7. Conclusions— Significant, previously unreported differences in cutaneous wound healing exist between cats and dogs. In general, cutaneous wounds in cats are slower to heal. Cats and dogs also appear to use different mechanisms of second intention healing. In cats wounds close mainly by contraction of the wound edges, whereas in dogs wounds close more from central pull, and epithelialization. Clinical Relevance— Surgeons should view the cat as a unique species, which presents its own special challenges in wound healing, and should take this into account when planning treatment of feline wounds, either by primary closure, or by second intention healing.

Objective: To perform blood gas analysis of the respiratory response to transdermal fentanyl in dogs which have experienced an open-chest surgical procedure. Design: Prospective trial. Setting: Veterinary Teaching Hospital Surgical Research and Student Laboratory. Intervention: Dogs were purchased for a surgical laboratory. Students performed a cranial abdominal exploratory and diaphragmatic hernia repair. Sixteen dogs were divided into 2 groups. Dogs received transdermal fentanyl (group F), using an average dose of 4.8 µg/kg/hr, applied to the caudal-lateral abdomen 22 hours before surgery, or intravenous buprenorphine (group B; 0.02 mg/kg) given 1 hour prior to anesthetic induction and every 6 hours postoperatively. All dogs received intravenous acepromazine (0.05 mg/kg) preoperatively and every 6 hours postoperatively. Dogs were instrumented with carotid artery catheters. Measurements and main results: Arterial blood gas values were analyzed every 2 hours postoperatively. Plasma fentanyl levels were analyzed every 4 hours postoperatively. The mean carbon dioxide tension (PCO2) did not exceed 45 mmHg in either group. The range in mean PCO2 levels was 32.9 (± 3.4)−38.1 (± 3.9) in group B and 34.7 (± 3.25)−43.6 (± 5.5) in group F. At 2 time points, the mean PCO2 was significantly lower in group B compared with normal levels in group F. Hypoxemia occurred in both the groups. The range in mean oxygen tension (PO2) was 76.5 (± 18.3)−91.1 (± 16.3) in group B and 76.0 (± 10.8)−96.6 (± 7.6) in group F. There was no significant difference in PO2 between groups. Levels of fentanyl considered to be analgesic were maintained for the postoperative period. Conclusions: The use of a relatively high dose of transdermal fentanyl did not induce postoperative hypoventilation as evidenced by serial arterial blood gas analysis in this model.

Objective—To evaluate responses of cats with vaccine- associated sarcomas to treatment with surgery and radiotherapy, with or without adjunctive chemotherapy. Design—Retrospective study. Animals—76 cats (78 tumors). Procedure—Medical records were reviewed. Factors potentially associated with survival time, time to recurrence, and time to development of metastases were evaluated. Results—Following excision, electron beam radiation, and, in some cases, chemotherapy, 32 (41%) cats experienced recurrence, and 9 (12%) cats developed metastases. One- and 2-year survival rates were 86 and 44%, respectively. Median survival time from onset of disease was 730 days (range, 30 to 2,014 days). Median disease-free interval was 405 days (range, 30 to 925 days). Cats that underwent only 1 surgery prior to radiotherapy had a lower recurrence rate than did cats that underwent > 1 surgery and had a significantly longer disease-free interval. Survival time and disease-free interval decreased as time between surgery and the start of radiotherapy increased. Cats that developed metastases had significantly shorter survival times and disease-free intervals than did cats that did not develop metastases. Castrated male cats had a significantly shorter survival time than did spayed female cats. Cats with larger tumors prior to the first surgery had shorter survival times. Twenty-six cats received chemotherapy in addition to surgery and radiotherapy. Whether cats received chemotherapy was not associated with recurrence rate, metastasis rate, or survival time. Conclusions and Clinical Relevance—Results suggest that excision followed by electron beam irradiation may be beneficial for treatment of cats with vaccine- associated sarcomas. Extent of excision prior to radiotherapy did not seem to be associated with recurrence rate. (J Am Vet Med Assoc 2001;219:1582–1589)

A retrospective study was performed of 17 dogs and seven cats with various stages of thymoma treated with radiation alone or as an adjunctive therapy. Analysis revealed an overall response rate of 75% (15/20 evaluable cases). Partial (i.e., >50% reduction in tumor size) and complete (i.e., no detectable tumor) responses were included. Complete responses were rare (4/20). Three of five animals with stable disease (i.e.

A condition colloquially referred to as “limber tail” and “cold tail” is familiar to people working with hunting dogs, primarily Pointers and Labrador Retrievers. The typical case consists of an adult dog that suddenly develops a flaccid tail. The tail either hangs down from the tail base or is held out horizontally for several inches from the tail base and then hangs straight down or at some degree below horizontal. Initially, the hair on the dorsal aspect of the proximal tail may be raised and dogs may resent palpation of the area 3–4 inches (8–10 cm) from the tail base. Most dogs recover spontaneously within a few days to weeks. Anecdotal reports suggest that anti-inflammatory drugs administered within 24 hours after onset hasten recovery. Less than one half of affected dogs experience a recurrence. Affected Pointers almost always have a history of prolonged cage transport, a hard workout the previous day, or exposure to cold or wet weather. Most owners and trainers familiar with the condition do not seek veterinary assistance. In cases where people are not familiar with this disease, other conditions such as a fracture, spinal cord disease, impacted anal glands, or prostatic disease have been incorrectly diagnosed. We examined 4 affected Pointers and found evidence of coccygeal muscle damage, which included mild elevation of creatine kinase early after onset of clinical signs, needle electromyographic examination showing abnormal spontaneous discharges restricted to the coccygeal muscles several days after onset, and histopathologic evidence of muscle fiber damage. Specific muscle groups, namely the laterally positioned intertransver-sarius ventralis caudalis muscles, were affected most severely. Abnormal findings on thermography and scintigraphy further supported the diagnosis.

Human fibrin sealant (HFS) and bovine fibrin sealant (BFS) were delivered as preformulated fibrinogen-thrombin mixtures that are light activated. These formulations were evaluated in the healing of incised cutaneous wounds in beagle dogs. Four groups were differentiated by sealant type and study duration with group: BFS for 10 days, HFS for 10 days, BFS for 30 days, and HFS for 30 days. Healing was evaluated by noting incidences of open wounds, laser Doppler perfusion imaging (LDPI), planimetry, breaking strength, and histopathology. In the absence of tension, both sealants tended to hold wound edges together; however, HFS tended to be better than its controls and BFS. Both sealants augmented suture closure, necessitating fewer sutures for wound closure. At 5 and 30 days BFS wounds had more perfusion than HFS wounds, indicating more inflammation. At 10 and 30 days BFS wounds had larger scar areas than their controls, while scar areas of HFS wounds were smaller than either BFS wounds or controls. Breaking strengths indicated that HFS wounds were stronger than their controls and BFS wounds. Histologically, mild to moderate chronic-active inflammation was observed in wounds receiving either sealant, and this persisted longer in BFS wounds. Overall, HFS had positive qualities, thus showing potential for functional and cosmetic wound closure.

Objective—To determine the lowest ACTH dose that would induce a significant increase in serum cortisol concentration and identify the time to peak cortisol concentration in healthy neonatal foals. Design—Prospective randomized crossover study. Animals—11 healthy neonatal foals. Procedures—Saline (0.9% NaCl) solution or 1 of 4 doses (0.02, 0.1, 0.25, and 0.5 μg/kg [0.009, 0.045, 0.114, and 0.227 μg/lb]) of cosyntropin (synthetic ACTH) was administered IV. Serum cortisol concentrations were measured before and 10, 20, 30, 60, 90, 120, 180, and 240 minutes after administration of cosyntropin or saline solution; CBCs were performed before and 30, 60, 120, and 240 minutes after administration. Results—Serum cortisol concentration was significantly increased, compared with baseline, by 10 minutes after cosyntropin administration at doses of 0.1, 0.25, and 0.5 μg/kg. Serum cortisol concentration peaked 20 minutes after administration of cosyntropin at doses of 0.02, 0.1, and 0.25 μg/kg, with peak concentrations 1.7, 2.0, and 1.9 times the baseline concentration, respectively. Serum cortisol concentration peaked 30 minutes after cosyntropin administration at a dose of 0.5 μg/kg, with peak concentration 2.2 times the baseline concentration. No significant differences were detected among peak serum cortisol concentrations obtained with cosyntropin administration at doses of 0.25 and 0.5 μg/kg. Cosyntropin administration significantly affected the lymphocyte count and the neutrophil-to-lymphocyte ratio. Conclusions and Clinical Relevance—Results suggested that in healthy neonatal foals, the lowest dose of cosyntropin to result in significant adrenal gland stimulation was 0.25 μg/kg, with peak cortisol concentration 20 minutes after cosyntropin administration.

The progression of hip dysplasia was investigated in 116 military working dogs. Medical records were reviewed for any clinical history of hind-limb lameness. Pelvic radiographs were studied for evidence and degree of hip dysplasia, degenerative joint disease, or both. The number of months each dog worked was determined. Each dog's age at termination from service and cause of death (or euthanasia) were recorded. The mean months of work for normal and dysplastic dogs were evaluated using the Student's t-test. No significant difference was found in the total number of months worked between normal and dysplastic dogs (p greater than 0.05).

An indirect fluorescent antibody (IFA) test was developed using a novel format of Borrelia burgdorferi organisms adhered to a monolayer of cultured endothelial cells derived from an equine tumor. Sensitivity and specificity of the new IFA test for detecting anti- B. burgdorferi antibodies were evaluated using sera from dogs inoculated with live B. burgdorferi or vaccinated with B. burgdorferi bacterin or leptobacterins and from unvaccinated specific-pathogen-free (SPF) dogs. To compare the new IFA test with existing tests, serum samples were submitted to independent laboratories to be tested by enzyme-linked immunosorbent assay (ELISA) and a traditional IFA test. Samples were also tested with 2 commercially available membrane-bound ELISA kits. Both Borrelia-inoculated dogs and dogs vaccinated with B. burgdorferi bacterin developed levels of antibody detectable by the new IFA test. Dogs vaccinated with a combination canine vaccine or leptobacterin for food animal use developed detectable levels of antibody against Leptospira but remained seronegative for Borrelia by the new IFA test, as did the unvaccinated SPF dogs. The new IFA test was sensitive, detecting antibodies against B. burgdorferi as early as 7 days postinoculation. It was also specific, showing no cross-reactivity with anti- Leptospira antibodies induced by vaccination with leptobacterins. The new IFA test compared favorably with both the standardized traditional IFA test and ELISA. Results from both membrane-bound ELISA kits were not consistent when compared with each other or with the new IFA test. The new IFA test had low nonspecific fluorescence, which made it easier to evaluate and reduced the human error and variability of test results.

Intraoperative Doppler ultrasonography was used to measure the effects of four experimental nerve root compression treatments (central compression, central-plus-lateral compression, lateral compression, and compression release) on arterial blood flow velocities in the seventh lumbar spinal ganglion of three dogs. Graphed blood flow velocity changes (change = treatment value − pretreatment value) were below baseline during the first three compression treatments and above baseline following compression release. Mean blood flow velocity changes for both central-plus-lateral compression and lateral compression differed (p ≤ 0.05) from changes for central compression. Changes for central-plus-lateral compression did not differ (p > 0.05) from changes for lateral compression. Changes among the first three compression treatments differed (p ≤ 0.05) from changes for compression release. No histologic abnormalities were identified in compressed nerve tissues, compared to contralateral controls. These findings indicate that stenosis within the L7-S1 intervertebral foramen may cause ischemia of the L7 spinal ganglion in dogs.

Doppler ultrasonography of the spinal cord was performed in 34 normal, anesthetized dogs following hemilaminectomy. This study was part of an investigation to evaluate the efficacy of a 21-aminosteroid compound and high dose methylprednisolone for the treatment of spinal cord trauma. Grey-scale images of the canine spinal cord were similar to those described for the spinal cord of people. Doppler waveforms of intraparenchymal spinal arteries exhibited high end diastolic blood flow velocities, indicating low resistance to flow. Doppler values (mean ± SD) for arteries immediately ventrolateral to the central canal were: Peak Systolic Velocity = 5.78 ± 2.5 cm/sec, Minimum Diastolic Velocity = 3.5 ± 1.62 cm/sec, Mean Velocity = 4.45 ± 1.96 cm/sec, Minimum Diastolic Velocity = 3.5 ± 1.62 cm/sec, Mean Velocity = 4.45 ± 1.96 cm/sec, Systolic/Diastolic ratio = 169 ± 0.19, Pulsatility Index = 0.53 ± 0.09, and Resistance Index = 0.4 ± 0.06.

Prior to trauma, intraoperative ultrasound of the spinal canal in 31 normal dogs was performed through a hemilaminectomy in the left pedicle of L2. A ventral compressive model of spinal cord injury was performed as part of a clinical drug trial. Maximum ultrasonographic spinal cord diameter ranged from 4.9–7.2 mm (5.7 × 0.6). Significant positive correlation (p = 0.023, r = 0.49) was found between age and spinal cord diameter. The dura mater was a separate, well-defined, echogenic horizontal line in 28 (90%) dogs, dorsally, and in 29 (94%) dogs, ventrally. Cerebrospinal fluid was anechoic. Eighteen (58%) dogs had a well-defined anechoic dorsal subarachnoid space, whereas 22 (71%) had a well-defined ventral space. Pia mater was thin but strongly echogenic and covered spinal cord. Central canal was a double hyperechoic line in 17 (55%) dogs and a single-line in 14 (45%) dogs. A difference in the ultrasonographic appearance between gray and white matter was not seen. Epidural fat and connective tissue was a lobular echogenic material in the ventral epidural space. The periosteal-vertebral body interface was seen as a bright curvilinear echo with distal acoustic shadowing. Spinal cord parenchyma could be classified subjectively into four groups based upon ultrasonographic appearance. Spinal cord parenchyma had a uniform hypoechogenicity in 8 (27%) dogs (Group 1), subtle low level echoes in 7 (23%) dogs (Group 2), multiple clusters of defined echogenic foci in 12 (37%) dogs (Group 3), and multiple sharply-defined linear echoes in 4 (13%) dogs (Group 4). There was a significant relationship between pre-trauma ultrasonographic appearance of the spinal cord and histopathology 21 days after trauma. One (13%) dog in Group 1, 4 (57%) dogs in Group 2,10 (91%) dogs in Group 3, and 3 (75%) dogs in Group 4 had malacia on histological evaluation. Therefore, dogs with echogenic spinal cords or linear echoes within cord parenchyma were significantly more likely to develop malacia rather than Wallerian degeneration after induced spinal cord trauma (p = 0.002). Spinal cord echogenicity may indicate vascularity in a segment of spinal cord and might be prognostic following spinal cord trauma. No complications were found related to intraoperative ultrasound. Hematoma or fibrous tissue formation appeared to impede percutaneous ultrasound of the spinal cord in dogs re-evaluated forty-eight hours and one week after surgery.

Objective—To determine whether seasonal variations exist in endogenous plasma ACTH, plasma α-melanocyte—stimulating hormone (α-MSH), serum cortisol, and serum insulin concentrations and in the results of a dexamethasone suppression test for older, clinically normal geldings in Alabama. Design—Cohort study. Animals—15 healthy mixed-breed geldings (median age, 14 years). Procedures—Sample collection was repeated monthly for 12 months. Dexamethasone (0.04 mg/kg [0.02 mg/lb], IM) was administered and cortisol concentrations were determined at 15 and 19 hours. Radioimmunoassays were used to measure ACTH, α-MSH, cortisol, and insulin concentrations at each testing time. Hormone concentrations were compared between months via repeated-measures ANOVA and correlated with age within each month. Results—A significant time effect was found between months for α-MSH and insulin concentrations. Endogenous cortisol and ACTH concentrations remained within existing reference ranges. Significant correlations were detected between age and ACTH concentration for several fall and winter months and between age and insulin concentration for September. Conclusions and Clinical Relevance—Older horses have higher ACTH concentrations in several fall and winter months and higher insulin concentrations in September than do younger horses. Seasonally specific reference ranges are required for α-MSH and insulin concentrations, with significantly higher concentrations detected in the fall. Practitioners should be advised to submit samples only to local laboratories that can provide such reference ranges for their local geographic region.

Objective—To determine the lowest ACTH dose that would induce a maximum increase in serum cortisol concentration in healthy adult horses and identify the time to peak cortisol concentration. Design—Evaluation study. Animals—8 healthy adult horses. Procedures—Saline (0.9% NaCl) solution or 1 of 4 doses (0.02, 0.1, 0.25, and 0.5 μg/kg [0.009, 0.045, 0.114, and 0.227 μg/lb]) of cosyntropin (synthetic ACTH) were administered IV (5 treatments/horse). Serum cortisol concentrations were measured before and 30, 60, 90, 120, 180, and 240 minutes after injection of cosyntropin or saline solution; CBCs were performed before and 30, 60, 120, and 240 minutes after injection. Results—For all 4 doses, serum cortisol concentration was significantly increased, compared with the baseline value, by 30 minutes after administration of cosyntropin; no significant differences were detected among maximum serum cortisol concentrations obtained in response to administration of doses of 0.1, 0.25, and 0.5 μg/kg. Serum cortisol concentration peaked 30 minutes after administration of cosyntropin at a dose of 0.02 or 0.1 μg/kg, with peak concentrations 1.5 and 1.9 times, respectively, the baseline concentration. Serum cortisol concentration peaked 90 minutes after administration of cosyntropin at a dose of 0.25 or 0.5 μg/kg, with peak concentrations 2.0 and 2.3 times, respectively, the baseline concentration. Cosyntropin administration significantly affected WBC, neutrophil, and eosinophil counts and the neutrophil-to-lymphocyte ratio. Conclusions and Clinical Relevance—Results suggested that in healthy horses, administration of cosyntropin at a dose of 0.1 μg/kg resulted in maximum adrenal stimulation, with peak cortisol concentration 30 minutes after cosyntropin administration.

To meet long-term needs, many veterinary colleges and schools are participating in dual-degree DVM/MPH programs. Auburn University's College of Veterinary Medicine and the School of Public Health at the University of Alabama at Birmingham have developed a coordinated-degree curriculum in which the DVM and the MPH are not necessarily awarded simultaneously. Other opportunities at Auburn include Public Health Careers Day, trips to the Centers for Disease Control and Prevention, several elective courses related to veterinary epidemiology, and online access to the Emerging and Exotic Diseases of Animals course available from the Veterinary Information Network. We have been able to increase our students’ exposure to the role of the veterinarian in public health and to develop a program to augment their training in public practice.

Objective— To describe and compare the contribution of the subcutaneous tissues to 1st and 2nd intention cutaneous wound healing in the dog and cat. Study Design— Experimental study. Animals— Domestic shorthaired cats (n=6) and 6 beagle dogs. Methods— Paired wounds were created on either side of the dorsal midline; the subcutaneous tissue was removed on 1 side and left intact on the other. Square, open wounds of the dorsal aspect of the thorax were observed for 21 days to monitor granulation tissue formation, wound contraction, epithelialization, and total healing (contraction+epithelialization). Breaking strength of sutured linear wounds was measured 7 days after wounding. Laser-Doppler perfusion imaging (LDPI) was used to measure cutaneous perfusion. Results— First intention healing: subcutaneous tissue removal had no consistent effect on sutured wound strength at 7 days in dogs or cats. Second intention healing: removal of subcutaneous tissue reduced wound perfusion, granulation, contraction, epithelialization, and total healing. Granulation tissue formation and wound contraction were delayed to a significantly greater degree in cats than in dogs (P

Cases diagnosed with portosystemic shunting between the years 1993 and 2001 were reviewed. Sensitivities of screening tests and abdominal ultrasonographic evaluation for the detection of portosystemic shunting were evaluated. Prognosis for surgically treated shunts was also evaluated. Results indicated that both paired serum bile acids and blood ammonia levels were useful screening tests for portosystemic shunting. However, paired bile acid tests were significantly more sensitive than blood ammonia levels. Overall postoperative mortality rates for extrahepatic shunts and intrahepatic shunts were 8.7% and 20%, respectively. Postoperative mortality rates were slightly higher for animals treated with partial ligation when compared to those treated with ameroid ring placement, although this did not reach statistical significance. Long-term complication rates for animals with single extrahepatic portosystemic shunts treated with complete ligation, ameroid ring placement, and partial ligation alone were 9%, 15.4%, and 42%, respectively. Animals >2 years of age with extrahepatic shunts had almost identical postoperative mortality and long-term complication rates as animals ≤2 years of age. No animal in this study had paired bile acid samples within the reference range postoperatively, indicating continued abnormal liver function after surgery.

Objective: To investigate adult heights attained by patients with 21-hydroxylase deficiency and to perform a meta-analysis of height outcomes reported in this population. Study design: A retrospective chart review of our patients >5 years of age (n = 65) who were followed up from 1978 to 1998 for 21-hydroxylase deficiency was conducted. Final height (FH) SD scores and target height (TH) SD scores were determined. The impact of sex, time of diagnosis, and compliance was assessed. Meta-analysis of results from 18 studies was performed; TH was available for 204 of 561 patients. Results: Mean FH SD score–TH SD score for our 65 patients was –1.03. For the meta-analysis, mean weighted FH SD score for all 561 patients was –1.37, whereas weighted mean FH SD score–TH SD score for the 204 patients for whom TH was available was –1.21. No difference in outcome was seen for males compared with females, although a statistically significant difference was seen for patients identified early versus late. Conclusions: Adult height in patients with 21-hydroxylase deficiency is often within 1 SD of TH. Early diagnosis and good compliance appear to improve the outcome. Rather than pursuing alternate therapies for congenital adrenal hyperplasia, efforts may instead be focused on early detection and improved compliance with traditional medical therapy. (J Pediatr 2001;138:26-32)

Objective—To evaluate the seasonal influence, signalment, type of hay consumed, clinical examination findings, and outcome after surgery for horses with ileal impaction. Study Design—A retrospective study. Results—Between 1988 and 1993, 28 horses had surgical correction of ileal impaction. There was a significantly higher rate of ileal impaction during the Fall (September-November, P= .0041). Mean duration of clinical signs of abdominal pain before referral was 15 hours. Transrectal palpation was used to localize the impaction in 11 horses. The ileal impaction was reduced by extraluminal massage aided by admixing of intestinal fluid oral to the impaction or injection of fluids intraluminally and then movement of the ingesta into the cecum alone in 24 horses. A total of 26 horses recovered from surgery; 24 horses were discharged from the hospital and eventually returned to previous use. Two horses had fatal postoperative complications: jejunocec-ostomy dehiscence and development of extensive small intestine adhesions after manual reduction of the impaction. One horse initially treated by manual reduction required jejunocecostomy twice for management of recurrent ileal impaction. Follow-up information was obtained for 21 horses, of which 20 were alive 1 year or longer after surgery. A total of 27 of 28 horses were fed Coastal Bermudagrass hay as the primary type of hay consumed. A total of 9 horses continued to be fed Coastal Bermudagrass hay as the only roughage source, whereas 6 horses were fed Coastal Bermudagrass with at least 50% other hay, and in 6 horses, Coastal Bermudagrass hay was entirely eliminated from the diet. Conclusion and Clinical Relevance—Ileal impactions can be successfully reduced by celiotomy and extraluminal massage and injection techniques to soften the ingesta for passage into the cecum without enterotomy or bypass techniques in most horses. Changes in weather and feeding practices in the Fall may account for an increased risk of ileal impaction in horses in the southeastern United States at that time of year.

Doppler ultrasonography was performed on the cerebral arteries of 19 neonatal dogs. Vascular structures were identified using anatomic preparations of brains pre-injected with a radiopaque silicone rubber product and cleared using a modified tissue clearing technique. Brain sections were subsequently radiographed or examined under a stereomicroscope. Color flow Doppler imaging was used to facilitate positioning of the Doppler calipers for measurement of peak systolic velocity, minimum diastolic velocity, and resistance index. Blood flow velocities in the internal carotid and middle cerebral arteries were lower when measured in transverse images than in sagittal images. The rostral cerebral arteries could be measured using either plane but values obtained from different locations or using different methods of measurement were statistically different. Blood flow velocities generally increased during the first month after birth. Arterial signals were diphasic with flow throughout diastole. Resistance indices most often were between 0.6 and 0.7 and did not exceed 0.86.

The progression of hip dysplasia was investigated in 116 military working dogs. Serial pelvic radiographs were graded for degree of dysplasia and degenerative joint disease (DJD). Norberg angles, angles of inclination, and joint space widths were measured. There was a significant correlation between the Norberg angle and the degree of dysplasia (p less than 0.0001). Angles of inclination and joint space width measurements did not demonstrate a correlation to canine hip dysplasia. Dysplastic dogs had a significant estimated risk for development of DJD compared to normal dogs (p less than 0.0001; odds ratio of 70.2). Dogs with normal hip conformation at 24 months of age or older did not develop moderate nor severe DJD.

A simplified technique for laparoscopic gastropexy (group 1) was compared to belt-loop gastropexy (group 2) in eight adult male dogs randomly divided into two groups of four dogs each. Our hypothesis was that a satisfactory laparoscopic gastropexy would approximate the strength and operative time required for belt-loop gastropexy. Operative time, surgical complications, postoperative morbidity, gross and histological appearance, radiographic microvascularization, and maximal tensile strength were measured and compared between the two groups. All dogs recovered from surgery. No morbidity was associated with either procedure. The mean (+/- SD) duration of surgery was 69.75 +/- 7.23 minutes for group 1 and 58.75 +/- 7.63 minutes for group 2. Fifty days after surgery, the microvascular appearance of the gastropexy site was similar for both groups. Blood vessels were observed within each seromuscular flap but vascular ingrowth to the abdominal musculature was observed in only two dogs, one from each group. The maximum tensile strength at 50 days was 76.55 +/- 22.78 for group 1 and 109.21 +/- 22.29 N for group 2. Differences between surgical duration and maximum tensile strength were not statistically significant (P > .05). Histologically, all gastropexies consisted of an adhesion composed of dense fibrous connective tissue. The results of this study indicate that laparoscopic gastropexy provides a minimally invasive alternative to open abdominal prophylactic gastropexy in dogs.

The purpose of this study was to evaluate the effrcacy of using a telecommunication system to assist in the outpatient management of pediatric patients with insulin- dependent diabetes. Metabolic control, patients' psychosocial status, family functioning, perceived quality of life, patterns of parental/child responsibility for daily diabetes maintenance, and nursing time-on-task were evaluated. One hundred six pediatric patients (mean age= 13.3 years) were randomly assigned to an experimental or control outpatient clinic for 1 year. Experimental subjects transmitted self-monitoring blood glucose data by modem to the hospital every 2 weeks. Transmitted data were reviewed by nurse practitioners who telephoned subjects to discuss regimen adjustments. Control subjects received standard care with regimen adjustments made by physicians. There were no significant between-group differences for metabolic control, rates of hospitalization or emergency-room visits, psychological status, general family functioning, quality of life, or parent-child responsibility. A significant decrease was noted in nursing time-on-task for experimental subjects.

This study evaluated the effect of notchplasty (enlargement of the intercondylar fossa) in stable and unstable canine stifles. Bilateral notchplasty and unilateral cranial cruciate ligament (CrCL) transection were performed in 6 dogs. Exercise, consisting of walking 1.5 miles three times a week, began 1 month after surgery and continued until euthanasia 6 months after surgery. Evaluation methods included orthopedic examination, serial radiographs, thin section radiography, histopathology, and gross pathology. Notchplasty in the stable stifle did not cause lameness beyond 3 weeks, joint instability, or degenerative joint disease. In the stable stifle, smooth resurfacing of the notchplasty site with fibrous and osseous tissue occurred. Stifles with notchplasty and CrCL transection exhibited persistent lameness, instability, and degenerative joint disease. In CrCL deficient stifles osteophytes formed within the notchplasty site, resulting in a rough surface. Our observations indicated significant refilling in notchplasties of both stable and unstable stifles (P < .05). However, the intercondylar fossa (ICF) width 6 months after notchplasty was significantly smaller in unstable stifles compared with stable stifles (P < .05) indicating that greater refilling of the notchplasties occurred in the unstable stifles. In clinical cases, notchplasty should be larger than the desired final result to accomodate the partial refilling that occurs even in stable stifles.

The intercondylar fossa (ICF) in dogs consists of a cranial outlet, intercondylar shelf, caudal arch, caudal outlet, a medial wall, and a lateral wall. The normal cranial outlet is bell-shape and, in mixed-breed dogs (mean body weight 19.2 kg, N = 21), measured 5.8 mm cranially, 8.1 mm centrally, and 10.3 mm caudally. The ICF is oriented 12 degrees from the dorsal plane of the femoral diaphysis and obliqued 7 degrees, proximolateral to distomedial, in the sagittal plane. To adjust for dog size, a fossa width index (FWI) was calculated by dividing the cranial outlet width by the distance between epicondyles. The normal FWI as determined in this study was 0.18 cranially, 0.25 centrally, and 0.32 caudally. The fossa height index 0.31. Contact between the ICF and the cranial cruciate ligament began at about 115 degrees of extension. The contact area moved cranially in the intercondylar fossa as the stifle was extended. Evaluation of the ICF can be performed radiographically but positioning is critical.

A model simulating acute-compressive spinal cord trauma at the second lumbar spinal cord segment (100 g, 300 seconds) was used to evaluate the efficacy of a vehicle control, methylprednisolone sodium succinate (MPSS), and a 21-aminosteroid compound (U74389G). Dogs were allocated into one of five treatment groups (A to E) using ultrasonographic determination of spinal cord diameters to ensure even distribution of spinal cord diameters among the treatment groups. Initial dosages of the vehicle control (A), methylprednisolone (30 mg/kg of body weight) (B), or U74389G (30 mg/kg, 3 mg/kg, or 10 mg/kg of body weight) (C, D, or E, respectively) were administered intravenously 30 minutes after trauma. Dosages were reduced by one-half for 2 and 6 hour treatments. Then every 4 hours for 42 hours, dosages were reduced one-third and one-sixth from the original dose of methylprednisolone and U74389G, respectively. Neurological examinations were performed daily for 21 days. Histopathological examination of the traumatized spinal cord showed malacic and degenerative lesions. Although significant differences in some portions of the neurological and histopathologic examinations were observed, clinical efficacy for MPSS and U74389G could not be established in this model.

Plasma alpha-tocopherol (alpha-T) concentrations, erythrocyte osmotic fragility and detergent sensitivity were measured at 8 week intervals in two 1-year-old male beagle dogs fed a vitamin E-deficient diet (0.08 mg per kg alpha-T) and in two control beagles fed the same diet supplemented with vitamin E (90 mg per kg alpha-T). Beginning at 24 weeks, dialuric acid haemolysis and spontaneous haemolysis were evaluated also. In the vitamin E-deficient dogs, plasma alpha-T concentrations declined progressively from baseline values of 20.5 and 31.3 micrograms per ml to 0.11 and 0.07 micrograms per ml, respectively, by 90 weeks. The supplemented dogs maintained alpha-T concentrations between 18.3 and 38.4 micrograms per ml. Both dialuric acid haemolysis (R = -0.89) and spontaneous haemolysis (R = -0.91) increased with declining plasma alpha-T concentration. In the dialuric acid haemolysis assay, 50 per cent haemolysis occurred when plasma alpha-T declined to 1.7 micrograms per ml, compared with spontaneous haemolysis in which 50 per cent haemolysis occurred when plasma alpha-T declined to 0.5 micrograms per ml. Osmotic fragility and detergent sensitivity remained unchanged in the vitamin E-deficient dogs throughout the study. Of the four tests, dialuric acid haemolysis was the most sensitive in-vitro assay for vitamin E deficiency in adult dogs.

The Prospect for a Reasonable Adult Height in Patients with 21-hydroxylase Deficiency Is Dismal...or Is it?

Extract: Pseudohypoaldosteronism is an uncommon disorder characterized by urinary sodium wasting and is attributed to a defect in distal renal tubular sodium handling with failure to respond to endogenous aldosterone. Sweat electrolyte values in other reported patients, when measured, have been normal. A 3.5-year-old girl developed repeated episodes of dehydration, hyponatremia, and hyperkalemia during the first 19 months of life. Serum sodium was as low as 113 mEq/liter and potassium as high as 11.1 mEq/liter. Her plasma and urinary aldosterone levels were persistently elevated (Figs. 1–4). Unlike patients with classic pseudohypoaldosteronism she demonstrated no urinary sodium wasting (Figs. 2 and 3). During episodes of hyponatremia and reduced sodium intake her urinary sodium was less than 5 mEq/liter. In addition, her sweat sodium concentration was consistently above 125 mEq/liter and salivary sodium concentration above 58 mEq/liter. Her chest x-ray, 72-hr fecal fat excretion, serum and urinary pancreatic amylase (amy-2) were normal, providing no evidence for cystic fibrosis. It is proposed that this patient represents a new variant of pseudohypoaldosteronism with excessive loss of sodium from the sweat and salivary glands instead of the kidneys. Spectulation: Aldosterone is known to control sodium and potassium excretion by kidneys, sweat glands, and salivary glands. In patients with classic pseudohypoaldosteronism there is a defect in renal tubular response to aldosterone action. Studies in the present patient suggest that there may be variants of this syndrome in which the end organ defect is in the sweat and salivary glands instead of the renal tubule. In addition, it is possible that new variants will be found in which end organ defect is in still other organs concerned with electrolyte transport.

1. 1. An analysis is presented of 175 consecutive patients with supraventricular paroxysmal tachycardia seen in a teaching hospital practice over a period of 15 years. 2. 2. Underlying organic heart disease was found in 131 patients (75 per cent), all of whom represented, in general, an older age group than the patients with normal hearts. Arteriosclerosis and hypertension were the most frequent etiologies, being found in 88 (67 per cent) of the cases with diseased hearts. 3. 3. Of the supraventricular tachycardias in patients with organic heart disease, 45 (35 per cent) were complicated by second and third degree atrioventricular block, which usually could be attributed to complicating digitalis intoxication. 4. 4. Serious clinical symptoms were only rarely observed in patients with normal hearts. In contrast, chest pain, heart failure, and shock were frequent manifestations of the disorder in organic heart disease. 5. 5. Aberration of the QRS complexes during tachycardia was as frequent in normal hearts as in diseased hearts. Atrial rates were noted to be higher in the group with atrioventricular block, resulting in confusion of the electrocardiographic diagnosis with slow atrial flutter. The diagnostic criteria are outlined. 6. 6. The usual methods of termination, utilizing carotid sinus pressure mechanical reflex increase in vagus tone, were much less effective in the patients with organic heart disease than in normal patients. If such measures failed, digitalis therapy was found to be the most effective method if it was not a factor in the production of the rhythm disorder. 7. 7. Paroxysmal supraventricular tachycardia with atrioventricular block presents a special problem in therapy. There is usually gratifying restoration to sinus rhythm upon discontinuation of digitalis and administration of potassium salts. 8. 8. The prognosis of these disorders depends upon the underlying etiology. In myocardial infarction it is uniformly poor, but a few cases can be salvaged by proper therapy. 9. 9. Methods of management in other unusual situations, and prevention of recurrences are discussed.

Seventy-five cases of hypopituitarism were reviewed; forty-five were examples of idiopathic somatotropin deficiency, alone or in combination with other tropin defects, eleven were idiopathic cases of isolated gonadotropin deficiency, and nineteen were cases of central nervous system lesions within or above the pituitary. The presenting complaints for each group, respectively, were growth failure, sexual immaturity, and either neurologic symptoms or diabetes insipidus. Because of characteristic symptoms and almost uniform abnormalities on skull films, the last group was easily separated from the other two. The second group did not show retarded growth, and results of tests of pituitary function were normal except for the persistent absence of gonadotropins. Contrary to previous reports, growth failure was noted by one year of age in 35.9 per cent of patients with idiopathic hypopituitarism. Carbohydrate metabolism abnormalities were common, and two thirds of a small group tested were insulin-sensitive. Serum nonprotein or urea nitrogen levels were frequently elevated; serum calcium, phosphorus and alkaline phosphatase were within normal limits, and serum cholesterol usually varied as expected on the basis of intact or absent TSH in any one patient. In order of decreasing frequency, deficiencies of gonadotropin, ACTH and TSH were noted. A decreased sulfation factor, a diminished metapirone response, and hypoglycemic unresponsiveness accompanying growth failure, are the most characteristic laboratory abnormalities of idiopathic hypopituitarism and are considered the most helpful tools in arriving at a diagnosis in the child.

The Glucometer M Diabetes Management System includes a glucose-reflectance meter with memory that can interface with a microcomputer for data manipulation and analysis. We evaluated the system in a short-term randomized control trial to determine its impact on metabolic control, self-monitoring of blood glucose (SMBG) testing behaviors, regimen selfadjustment, understanding of insulin-dependent diabetes mellitus (IDDM) treatment, attitudes about SMBG, and perceived quality of patient-physician interaction. Twenty-nine adolescent subjects (experimental) with IDDM were randomly assigned the Glucometer M system for 4 mo. Twenty-eight control subjects used meters without memory. All subjects returned twice to the clinic at 2-mo intervals during the study. At clinic visits, both groups reviewed their SMBG data with their physician. Reviews on experimental subjects were conducted with computer-generated data formats. Control subject reviews used traditional logbooks. Both groups showed a significant drop in glycosylated hemoglobin during the study period (P < .001); however, there were no between-group differences. There were also no differences in SMBG testing behavior or self-reported regimen selfadjustment between groups or within groups compared with baseline. Compared with control subjects, experimental subjects indicated a significant increase in self-reported understanding of IDDM treatment (P = .002), perceived importance of testing (P = .006), and the quality of interaction with their physician (P < .001). These data suggest that use of computer-assisted SMBG systems in the outpatient setting does not improve metabolic control over 4 mo. It may, however, contribute to improving communication between the patient and health-care providers.

A case is presented of a child with signs of recurrent acute thyroid infection which was found to result from rupture of an infected branchial cleft cyst abscess. This association has not previously been reported. A review of the bacterial etiol ogies of suppurative thyroiditis in childhood is presented.

IN recent years there have been many references to angioid streaks of the retina found in association with pseudoxanthoma elasticum and Paget's disease of bones (Elwyn, 1953; Cowper, 1954; Bedrossian, 1958; Hogan and Zinmerman, 1962). A review of the current literature on angioid streaks and on brain tumours revealed no cases of angioid streaks in patients who presented with ocular manifestations of brain tumour. This case is therefore reported because of the rarity of this combination.

Four patients had insufficiency of hGH, TSH, ACTH, and ADH following surgery for craniopharyngiomas. Despite hypopituitarism, and without hGH therapy, all showed “catch-up” growth during post-operative follow up. Prolactin, determined by RAI was normal in every patient, and therefore cannot be responsible for the increase in post-operative growth rate. Their prolactin values were similar to those of a large series of children with idiopathic hypopituitarism. In determined by bioassay and was normal. An additional patient who showed a normal growth rate (without “catch-up”) postoperatively also had normal somatomedin in the absence of growth hormone response to provocative tests. While the mechanism for catch-up growth in the patients remains enigmatic, the possibility cannot be excluded that hyperinsulinism could play a role, inasmuch as these patients are generally obese secondary to voracious appetites.