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Sixty patients undergoing elective coronary artery bypass grafting were randomly allocated into two groups, each of 30 patients and similar as regards age, sex, number of coronary artery bypasses and left ventricular ejection fraction. In group A the proximal anastomoses of vein grafts were sutured after aortic declamping during partial occlusion of the aorta, and in group B these anastomoses were done during aortic cross-clamping. The aortic cross-clamp time was significantly longer in group B than in group A (72 vs 57 min, p < 0.0001). Myocardial cooling and rewarming and the number of sustained or possible perioperative myocardial infarctions were equal in both groups. Central haemodynamics showed no intergroup difference, before or after induction of anaesthesia or at the end of surgery. Conduction disturbances were more common in group A than in group B (12 vs 3, p = 0.0246), and transient external pacing was more often required in group A (9 vs 2, p = 0.0534). Myocardial reperfusion via native coronary arteries and bypass grafts gives better protection against conduction disturbances than does reperfusion via only native arteries, despite longer aortic cross-clamping time.

The first case of cholangitis in which Stomatococcus mucilaginosus was cultured from bile is reported. A 64-year-old male became icteric and was shown to have gallstones in the gallbladder and a common bile duct stone which was removed endoscopically. As the patient remained icteric for a month thereafter the gallbladder with stones was removed. No common bile duct stone was shown by cholangiography perioperatively. The liver biopsy revealed cholangitis and Stomatococcus mucilaginosus was grown from the bile. The patient was cured by cholecystectomy without any antimicrobial therapy.

The effects of antegrade and of combined antegrade and retrograde cardioplegia were compared in 101 patients undergoing elective coronary artery surgery. The patients were randomly allocated to two groups: antegrade cardioplegia was administered in 53 patients and combined cardioplegia in 43 patients. The patients of the two groups were similar in age, sex and left ventricular ejection fraction. Aortic clamping time and the number of coronary bypasses were equal in the groups. The ventricular septal temperature was measured continuously during cardioplegia administration, after each distal anastomosis accomplished, and continuously after aortic declamping. Serum CK-MB activities were serially measured for up to 3 days postoperatively. Electrocardiograms (ECG) were taken preoperatively, as well as on the first, second and eighth postoperative days. The left ventricular function was evaluated with a volume load test preoperatively and on the first postoperative morning. The two groups were similar with respect to myocardial cooling, response to volume loading, the number of patients with perioperative myocardial infarctions, cardiac arrhythmias or atrioventricular conduction blocks and clinical outcome. However, the CK-MB activities were lower in the antegrade group suggesting better myocardial protection in an unselected group of patients undergoing coronary artery bypass grafting.

Diurnal variation in blood melatonin levels and renal melatonin excretion was monitored in five ewes by blood sampling and quantitative urine collection at 2-h intervals. A typical secretory pattern of melatonin was seen both in blood and urine levels and in the renal excretion of melatonin. Serum melatonin levels increased from daytime values of approximately 200 pmol/l to a mean of 800 pmol/l during darkness. Urine flow rate and urine osmolality did not show any clear diurnal rhythm. To examine whether urine flow rate affects renal melatonin excretion at night, urine was collected in three consecutive 30-min fractions, and blood was sampled in the middle of each urine collection period when the sheep were in normal water balance or after hydration. Hydration increased urine flow rate over sixfold and decreased urine osmolality well below plasma osmolality. Glomerular filtration rate, measured as creatinine clearance, did not change. Serum melatonin concentrations did not differ between hydrated and non-hydrated sheep. However, urinary melatonin excretion was 1.1 +/- 0.3 (S.E.M.) pmol/min at midnight in normal water balance, and significantly higher (2.6 +/- 0.4 pmol/min) in the hydrated state. In this study, the validity of urinary melatonin determinations as an indicator of pineal function was confirmed in normal water balance. In addition, our results suggest that a high tubular fluid load during diuresis increases urinary melatonin excretion because of decreased tubular reabsorption.(ABSTRACT TRUNCATED AT 250 WORDS)

The reproductive physiology of taxonomically closely related species is usually very similar. The main difference in the reproduction of the dog and fox is the length of the different phases of the oestrous cycle. Pro-oestrus and oestrus are longest in the dog: oestrus lasts 3-5 days in the blue fox and 1-3 days in the silver fox, compared with about 1 week in the dog. The profiles of sex steroid concentrations in plasma during oestrus and pregnancy are similar and the luteal phase in non-pregnant animals is prolonged, progesterone concentrations reaching a maximum by 15-30 days after the luteinizing hormone (LH) peak in the dog, by 10-20 days in the blue fox and by 5-15 days in the silver fox. The duration from LH surge to ovulation is about the same in the dog and fox, but thereafter the oocytes and early embryos develop faster in foxes than in the dog. The tubal transport time is 4-6 days in the silver fox, embryos entering the uterus at the 4-16-cell stage. In the blue fox the oocytes remain in the oviducts for 8-10 days, developing into the morula stage, whereas in the dog a still longer oviductal phase results in embryos that are at the compact morula or blastocyst stage when entering the uterus. The preimplantation period is about 1 week in the dog and the blue fox, but 9-10 days in the silver fox.(ABSTRACT TRUNCATED AT 250 WORDS)

An infusion of propofol (2,6-diisopropylphenol) was compared with isoflurane to induce hypotension for middle ear surgery. Forty patients (ASA physical status I-II, 16-55 years) scheduled for elective surgery were included in an open randomized study. The pharmacokinetics of propofol infusion were also studied in 6 patients. Both agents produced controlled hypotension (MAP reduction of 30% from the baseline values) with an acceptable visibility of the surgical field. No major complications occurred. The mean total dose of propofol infusion was 6.4 +/- 2.7 mg/kg and the mean concentration of isoflurane was 0.9 +/- 0.4%. Considerable interindividual pharmacokinetic variability was found and propofol was extensively distributed and rapidly cleared from the body after the infusion. Propofol infusion may be a new alternative as a hypotensive agent in middle ear surgery.

A continuous infusion of propofol following an induction dose of 2 mg/kg was compared with thiopental/isoflurane for the induction and maintenance of anesthesia in 20 mentally retarded outpatients undergoing routine dental procedures. The infusion rate of propofol and the concentration of isoflurane were adjusted to maintain the heart rate and blood pressure within +/- 25% of the baseline values. Postoperative wakefulness was assessed using a 100-mm visual analogue scale at the time of extubation and at 5, 10, 15, 30, 60, 90, and 120 min after extubation. Both agents provided adequate anesthesia for the treatment, and no major adverse reactions occurred. Recovery was more complete during the first hour after extubation in the propofol group, and these patients were discharged earlier.

Severe watery diarrhea and eosinophilic colitis induced by carbamazepine (CBZ) has not been described previously. We report the first known case of CBZ-induced watery diarrhea and eosinophilic colitis in a 57-year-old man receiving CBZ for secondarily generalized tonic-clonic seizures that developed after a cerebral infarction.

A cluster of seven febrile and severely neutropenic patients who developed Clostridium tertium septicemia during a 13-month period is described. The patients had received third generation cephalosporins for 7 to 13 days (mean 9 days) at the time Clostridium tertium was isolated from blood cultures. Two patients had perirectal and one patient pericaecal cellulitis. The organism was also isolated from bronchial secretions in one patient. No patient had diarrhea. Five of six strains tested were resistant to clindamycin (MIC 2-8 micrograms/ml), and six of seven strains moderately resistant to penicillin (MIC 1-4 micrograms/ml). In one patient Clostridium tertium grew from blood cultures although metronidazole had been administered for two days. Six patients recovered on antibiotic therapy. In view of the unusual susceptibility pattern of Clostridium tertium, an accurate diagnosis of infection with this organism is important for the choice of an appropriate antimicrobial treatment.

Propofol (2,6-di-isopropylphenol) 1.5-2.0 mg/kg i.v. was compared with thiopentone 3.0-4.0 mg/kg i.v. as an induction agent in anaesthesia for computerised tomography (CT) of the brain in children. Both induction agents were combined with diazepam 0.2 mg/kg i.v. Thirty children (ASA physical status I-II) aged 3 to 10 years and scheduled for elective examination were included in the randomized study. The haemodynamic response to propofol and thiopentone did not differ between the groups. Spontaneous respiration was retained in all patients and no ventilatory support was required during anaesthesia. The incidence of side-effects did not differ between the groups. Pain on injection with propofol was rare (n = 1) after mixing 1 ml lignocaine (1%) with propofol prior to induction. The recovery times were significantly shorter in the propofol than in the thiopentone group. Propofol appears to be a promising alternative for use in short day-case anaesthesia for CT scanning in children.

Embryos from vixens at different stages of gestation were measured and photographed. Implantation was observed 16-18 days after breeding. Differentiation and the development of characteristic features were described and embryonic loss was studied in relation to number of corpora lutea.

The clinical features of testicular feminization in the racoon dog (Nyctereutes procyonoides) are reported. The condition is characterized by a normal male karyotype, but a mixed phenotype consisting of vulva, enlarged clitoris and scrotal testes. Partial spermatogenesis with a relative arrest at the first meiotic division was observed. The likely underlying genetic defect and mode of inheritance are discussed, together with implications for breeding programmes.

Four female goats first were fed a high protein diet and later a low protein diet. Renal urea handling was studied during feeding of both diets. Glomerular filtration rate was measured with [hydroxymethyl-carbon-14] inulin. Glomerular filtration rate dropped about 60% when nitrogen intake was restricted. Urea concentration of plasma fell from 6 mM on high protein diet to .6mM on low protein diet. On low protein diet the rate of urea filtration at the glomeruli was only 4% of that on high protein diet, 22 versus 519 mumol/min. In addition, tubular urea reabsorption in percentage of filtered urea rose up to 92% on low protein diet. As a result of all these renal changes following dietary nitrogen restriction, urinary urea excretion was only .6% of urinary urea excretion on high protein diet. In goats as in other ruminants, renal mechanisms effectively contribute to urea conservation during protein deprivation.

Intestinal and lung parasites of 85 mountain hares (Lepus timidus) and 24 European hares (L. europaeus) were examined. The species of parasites found in both hare species were Trichostrongylus retortaeformis Zeder, 1800; Mosgovoyia pectinata Goeze, 1782 and Protostrongylus pulmonalis Froelich, 1802. Eimeria semisculpta Madsen, 1938 and E. townsendi Carvalho, 1943 were found only in the European hares and Eimeria leporis Nieschulz, 1923 and Dicrocoelium dendriticum Rudolphi, 1819 only in the mountain hares. Ninety-five percent of the mountain hares and 88% of the European hares were infected with parasites. Mountain hares were more commonly infected with P. pulmonalis and D. dendriticum while European hares were more commonly infected with Eimeria spp. and T. retortaeformis. Young mountain hares were more often infected with M. pectinata and adult mountain hares with P. pulmonalis. The management technique of winter-feeding did not increase significantly the percentage of infected animals. Dicrocoelium dendriticum was found only in hares from islands where sheep had grazed during the summers. The absence of cysticerci of Taenia pisiformis Bloch, 1780 in this survey may be a reflection of improved hygiene practices instituted by hunters.

The effect of a ten-day dietary sodium load on the fluid balance of mink was studied by adding to the food NaCl 0.5, 1 or 2% of the wet weight. The basic diet without salt addition contained sodium corresponding to 0.5% NaCl of the wet weight. The animals showed no signs of discomfort, eating well in all test groups. Adding of 0.5% salt to the food did not increase drinking of water, whereas 1 and 2% salt addition doubled and quadrupled water consumption, respectively. Urine excretion was slightly higher than consumption of drinking water, and both increased parallelly to increasing salt intake. The dietary salt excess was mainly excreted in urine, whereas the alimentary canal played only a minor role. Urine sodium concentration rose with increasing salt intake, peak concentration 350 mM being reached in the diet with 1% salt addition. On higher sodium load any further increase in renal sodium excretion was achieved only by increasing the volume of urine. Urine osmolality was slightly above 2000 mOsm/kg on the control diet and on the diet with 0.5% salt addition. More diluted urine was excreted on higher salt loads, urine osmolality being 1500 mOsm/kg on the diet with 2% salt addition. Healthy minks appear to tolerate considerably high concentrations of salt in the feed. However, a sufficient supply of drinking water is of critical importance, because increased water intake and renal sodium excretion are the main means of eliminating excess salt.

Porin (outer membrane protein) preparations extracted from a rough (Rb2) mutant of Salmonella typhimurium proved to be good immunogens in mice and rabbits. The antibody response achieved was measured by using enzyme-linked immunosorbent assay techniques. High titers of both antiporin and antilipopolysaccharide were detected in both species. The rabbit antiserum raised against the porins and the porin preparations themselves had a highly significant protective capacity against intraperitoneal Salmonella infection of mice. Absorption of the rabbit antiporin serum with lipopolysaccharide immunosorbent did not change its protective capacity in a passive immunization experiment, suggesting that the antiporin antibody preparations were the active components.

Young American male mink born in Finland from imported pregnant females showed a clear delay (p less than 0.05) in testicular development as compared with local male mink in late February and produced semen of unsatisfactory quality during the breeding season in March. Better sperm quality (p less than 0.05) and better testicular development (p less than 0.1-0.05) was obtained in older American male mink born in Finland as compared with younger American male mink and the local breeding stock. Serum testosterone concentrations during six successive months in American males indicated a clear delay in sexual maturity and it could also be established that testosterone development reached normal levels in American males after 2 generations born in Finland. There were no differences in the serum thyroxine concentrations between American and local male mink.

Propofol 2.5 mg/kg was compared with thiopentone 5 mg/kg in a randomised open study, as an induction agent in paediatric anaesthesia. One hundred and twenty children who were to undergo elective surgery were included in the study. Both propofol and thiopentone produced a rapid and smooth induction with a low incidence of side effects. A similar decrease (10%) in mean arterial pressure was observed with both agents, but propofol showed better suppression of the haemodynamic response to tracheal intubation. Respiratory upsets occurred less frequently with propofol than with thiopentone, but propofol frequently induced discomfort on injection. Both agents provided satisfactory and controllable induction of anesthesia and no major adverse reactions occurred during or after anaesthesia. We conclude that propofol is a useful alternative as an induction agent in children.

During 7 successive months in 1982 and 1983 blood and semen samples were taken from male mink. The patterns of testosterone development in sterile and fertile males were readily distinguishable from each other. Testosterone concentrations showed a clear correlation (r = 0.73) with sperm quality of mink males. High testosterone levels (16.0-24.5 ng/ml) in early February were associated with defective sperm quality in March and low testosterone levels (2.0-13.3 ng/ml) with good sperm quality.

The efficacy of lignocaine (1%) mixed with propofol in reducing pain on injection with propofol was studied in 40 children undergoing elective surgery in a double-blind, randomized comparison with glucose (5%). The pharmacokinetics of propofol in a single dose of 2.5 mg/kg was also studied in eight children participating in the same study. Lignocaine (1 mg) significantly reduced pain on injection compared to the control group (P less than 0.001). The induction characteristics of propofol were not affected by the lignocaine, and no undesirable interaction was found between the two drugs. The first-stage elimination half-life (t1/2 beta) of propofol in children was shorter (mean 9.3 +/- 3.8 (s.d.) min) than the values found in adults. This pharmacokinetic alteration may have clinical significance following repeated administration or continuous infusion of propofol.

An infusion of propofol was compared with intravenous boluses of diazepam as sedation for minor oral surgery under local anaesthesia in 12 healthy patients who had elective bilateral surgical extraction of lower third molars; the patients served as their own controls. Plasma catecholamine, vasopressin and cortisol concentrations were determined from repeated blood samples. The total administered dose of propofol was 3.93 (SD 1.34) mg/kg and of diazepam 0.28 (SD 0.07) mg/kg. No cardiovascular depression or airway problems occurred. Other side effects were also rare but some discomfort on injection was frequent with propofol. Recovery times were faster after propofol than after diazepam as assessed by the Maddox wing and visual analogue scales. Propofol also provided better amnesia compared to diazepam at the time of the extraction of the teeth. Eight of the 12 patients subjectively preferred propofol sedation. There was no hormonal stress response in either group.

The structure of the polysaccharide chains that constitute the O antigen on the surface of Salmonella bacteria determines the rate of complement activation and C3b deposition on the bacteria. A fast-activating O antigen causes rapid C3-dependent opsonization of the bacteria injected intraperitoneally; as a consequence, the bacteria are taken up and killed by the resident peritoneal macrophages, and their virulence is low. A slow-activating O antigen protects the bacteria from opsonization in the peritoneal cavity, and is associated with higher virulence. However, if injected intravenously bacteria with either O-antigenic type are equally virulent; in the high complement concentration of the blood they become opsonized and taken up by macrophages in the liver and spleen, which are unable to kill them but instead provide a protected site for multiplication.

Two female reindeer were hydrated by administration of (10% of b.wt.) water into the rumen. The diuretic response was very fast and strong but the urea and electrolyte excretion were little affected. Dehydration was carried out by not giving the reindeer water for 48 h. This water deprivation caused a loss of up to 20% of their body weight. The urine osmolality did not exceed 840 mosm/kg H2O, although the plasma osmolality rose from 300 to 346 and 368 mosm/kg H2O respectively. The plasma and urine urea concentrations were elevated during dehydration, while the urine urea excretion did not increase. Urine sodium concentration did not increase. When the urine flow rate, after two days of water deprivation, decreased to half of the original, the urine Na+ concentrations, instead of increasing, went down to half of the original. So did the potassium excretion. When ADH was injected intravenously into hydrated animals a dose of 30 mU of ADH was needed to induce antidiuresis or increased excretion of potassium. The resistance to ADH and the low relative thickness of the medulla confirm the limited capacity of reindeer kidney to concentrate urine or to excrete a solute load. On the other hand, reindeer is able rapidly to excrete surplus water without affecting the electrolyte or nitrogen balance.

Propofol 2.5 mg/kg was compared with thiopentone 5 mg/kg as an induction agent for elective Caesarean section. Thirty-two healthy women with cephalopelvic disproportion were included in an open randomised study. The placental transfer of propofol was also studied in 10 other mothers given a single dose of 2.5 mg/kg. The induction characteristics and haemodynamic response to propofol and thiopentone were similar. Side effects were rare with both agents, but propofol caused more discomfort on injection compared to thiopentone. Recovery times were shorter after propofol as evaluated by time to orientation, recovery scoring after anaesthesia and measurements with the Maddox wing. Rapid placental transfer and significant fetal uptake were detected for propofol. There was no significant neonatal depression as assessed by Apgar scores and blood gas analyses. Propofol appears to be a suitable alternative to thiopentone as an induction agent for anaesthesia in elective Caesarean section.

To evaluate the use of ultra low-field (0.02 T) magnetic resonance (MR) imaging in the diagnosis of musculoskeletal infection, MR examinations with T2 weighted sequences were performed in 61 patients thought to be suffering from one of four major diagnostic categories: Soft-tissue abscesses (n = 22), osteomyelitis (n = 21), septic arthritis (n = 9) and spondylitis (n = 9). Infection was confirmed for 37 of these 61 patients. The verified abscesses, arthritis, spondylitis and acute osteomyelitis could be detected by 0.02 T MR. The sensitivity was poor in cases of chronic osteomyelitis. There was one false positive finding in a patient with a possible soft tissue infection. The 0.02 T MR examination failed four times. Two patients were too heavy and another 2 patients had magnetic material in or near the scanning field. Compared with computed tomography and isotope scanning, 0.02 T MR proved a little more informative, but without any statistical significance.

The present study compares the clinical efficacy and side-effects of amoxycillin in two groups of children at the age of six years or less randomly assigned to amoxycillin therapy 40 mg/kg/day either two or three times daily for the clinical diagnosis of acute respiratory tract infections. Both treatment groups were comparable according to age, sex, weight and additional treatment. Acute otitis media occurred in 152 out of 187 (81%) patients receiving amoxycillin three times daily, and in 153 out of 180 (85%) patients with a twice daily dosage schedule. A clinical diagnosis of acute bronchitis was made in 55 cases (29%) in the former group and in 59 cases (33%) in the latter group. In the patient group with twice daily dosage schedule, 82% of the patients with otitis media were cured. The corresponding figure in the thrice daily group was 86%. On the basis of the disappearance of the symptoms and the improvement of the signs the overall results are equally good in both treatment groups. The number of side-effects of amoxycillin was equal in both groups, 6.4% and 6.7% respectively. Exanthem was the most frequent side-effect. No serious side-effects occurred. Our results indicate that the same total daily dose of amoxycillin given either three times daily or two times daily is comparably effective and tolerated in children with acute respiratory infections, e.g. acute otitis media and acute bronchitis.

Propofol (2,6-diisopropylphenol) 2.5 mg.kg-1 IV was compared with thiopentone 5 mg.kg-1 IV as an induction agent in anaesthesia for elective cardioversion. Thirty-five patients (ASA physical status II-III) with atrial fibrillation were included. Thirty patients were randomized to receive propofol or thiopentone. Five patients were treated twice during the study period and anaesthetized with both agents (the first treatment according to the random order and the second with the agent not used on the first occasion). The induction characteristics and the haemodynamic response for propofol and thiopentone were similar. The success rate of cardioversion did not differ between the groups. Recovery times were shorter after propofol than after thiopentone with respect to ocular muscle balance, central integration and subjective sedation of patients. The incidence of side-effects did not differ between the groups. None of the patients reported any awareness during the procedure. All five patients treated twice (with both agents) assessed the anaesthetic procedure with propofol as being more pleasant than that with thiopentone.