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BackgroundLimited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations.MethodsThis is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity.Results1,383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32 – 1.67]); Black patients (aOR 1.74; 95 CI 1.24-2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70 – 6.79) and Other (aOR 2.97; 95 CI 1.71-5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83 – 12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63 – 3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20 – 2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66 – 3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89 – 22.6]). Hispanic ethnicity, timing and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status.ConclusionsUsing one of the largest registries on cancer and COVID-19, we identified patient and BC related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to Non-Hispanic White patients.FundingThis study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L. Warner; P30-CA046592 to Christopher R. Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K. Shah and Dimpy P. Shah; and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01-CCE) and P30-CA054174 for Dimpy P. Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication.Clinical Trial NumberCCC19 registry is registered on ClinicalTrials.gov,NCT04354701.

Background The SARS-CoV-2 pandemic has caused over 400,000 deaths worldwide thus far, and poses therapeutic challenges for millions of patients. There is currently no treatment for SARS-CoV-2 infection approved by the United States Food and Drug Administration. Multiple agents have been used off-label to treat SARS-CoV-2 infection based on small observational cohorts and in vitro data. Here we present the experience of a large academic medical center in treating SARS-CoV-2 infection. Methods We performed a retrospective cohort study of patients admitted for greater than 24 hours with a nasopharyngeal, oropharyngeal, and/or bronchoalveolar lavage sample positive for SARS-CoV-2 by polymerase chain reaction (PCR). Demographic data, comorbidities, clinical data, and treatment data were collected from the electronic medical record. Off-label therapies were used at the discretion of the treating providers guided by regularly updated treatment guidelines assembled by infectious diseases physicians and antimicrobial stewardship pharmacists. The primary outcome assessed was in-hospital mortality. Secondary outcomes included admission to the intensive care unit (ICU), endotracheal intubation, initiation of vasopressors, and drug-related adverse events. Results Data collection was completed for 448 patients admitted between March 18, 2020 and May 8, 2020. All-cause in-hospital mortality was 13.4% (60/448) during this time. Mortality rates increased with age, up to 45% for patients over 80 years old. Male sex, hypertension, chronic pulmonary disease, end-stage renal disease, chronic liver disease were also risk factors for increased mortality. QTc interval prolongation occurred significantly more frequently in patients who received hydroxychloroquine (HCQ) with or without azithromycin(AZM) than those who did not (HCQ 6%, HCQ+AZM 7.8% vs all other patients, 0%, p< .0001). Review of treatment trends showed close adherence to the treatment recommendations at that time (Figure 1). Patient Characteristics Admission Laboratory Data by Disease Severity QTc Prolongation Conclusion SARS-CoV-2 infection is associated with significant inpatient mortality, and use of off-label treatments was associated with significant drug-related adverse events. Treatment regimens changed rapidly, and providers adhered closely to institutional guidelines as they evolved. Treatment Trends by Week QTC pre/post Treatment by Hydroxychloroquine Use vs. No Hydroxychloroquine Use Disclosures Samir Gupta, MD, Gilead Sciences (Consultant, Scientific Research Study Investigator, Advisor or Review Panel member)ViiV (Consultant, Grant/Research Support, Scientific Research Study Investigator, Advisor or Review Panel member, Research Grant or Support)

Anchialine habitats in the Hawaiian Islands, characterized as coastal bodies of land-locked salt or brackish water that fluctuate with the tides due to subterranean connections, are the only ecosystems of this type found within the United States. These habitats are currently subject to anthropogenic impacts tha t threaten their future existence. Previous research has shown strong genetic population structure of an endemic atyid shrimp, Halocaridina rubra, in these habitats. The native alpheid shrimp, Metabetaeus lohena, whose known range entirely overlaps that of H. rubra, has feeding and reproductive behaviors that are biologically distinct from H. rubra. Its historic scarcity and status as a candidate for the US Fish and Wildlife Department’s Endangered Species List, make M. lohena an ideal species to compare against the known genetic structure of H. rubra. We investigated the population structure of this native anchialine shrimp to test the hypothesis that genetic population structure differs between the two shrimp species and that M. lohena is genetically unstructured across its range. A survey of 605 bp of the mitochondrial cytochrome c oxidase subunit I (COI) gene from 127 individuals collected at 7 sites spanning the islands of O’ahu, Maui and Hawaii revealed 43 haplotypes. The most common haplotype was represented in similar proportions from all sites sampled, accounting for 44% of the surveyed sequences. Analyses of molecular variation (AMOVA), pairwise ΦST values, Bayesian estimates of migration (M), Mantel tests and Nested Clade Analyses (NCAs) all failed to reveal evidence of major barriers to gene flow among most populations separated by inter-island channels. This lack of genetic structure in M. lohena is found to be in stark contrast with the highly structured population of H. rubra, and may be attributed to oceanic dispersal strategies and/or a recent introduction to the Hawaiian Islands. Rev. Biol. Trop. 58 (1): 159-170. Epub 2010 March 01.Los hábitats de los alfeidos de las islas de Hawaii, se caracterizan por ser zonas cerradas de aguas saladas o salobres, que fluctúan con las mareas, debido a las conexiones subterráneas, son los únicos ecosistemas de este tipo que se encuentran en Estados Unidos. Estos hábitats actualmente están sujetos a impactos antropogénicos que amenazan su existencia futura. La investigación anterior ha demostrado una fuerte estructura genética de una población de camarones atíidos endémicos, Halocaridina rubra, en estos hábitats. El camarón alfeido nativo, Metabetaeus lohena, cuya área de distribución conocida se superpone totalmente con la de H. rubra, tiene comportamientos alimenticios y reproductivos que son biológicamente diferentes a los de H. rubra. Su escasez histórica y su condición de candidato para aparecer en la Lista de Especies en Peligro del Departamento de Pesca y Vida Silvestre de Estados Unidos, hace de M. lohena una especie ideal para comparar su estructura genética con la de H. rubra. Se investigó la estructura de la población de este camarón alfeido nativo para probar la hipótesis que la estructura genética de la población difiere entre las dos especies y que la de M. lohena está genéticamente no estructurada en todo su ámbito. El análisis de 605 pb de la oxidasa mitocondrial citocromo c subunidad I (COI) de genes de 127 individuos recolectados en 7 sitios que abarcan las islas de Oahu, Maui y Hawaii reveló 43 haplotipos. El haplotipo más común fue representado en proporciones similares en todos los sitios incluidos en la muestra, de acuerdo al 44% de las secuencias estudiadas. El análisis de variación molecular (AMOVA), los valores de ΦST pareados, la estimación bayesiana de la migración (M), las pruebas de Mantel y los Análisis Cladísticos no pudieron revelar la existencia de importantes barreras al flujo genético entre las poblaciones más separadas por los canales entre las islas. La falta de estructura genética en M. lohena contrasta con la muy estructurada población de H. rubra, y puede ser atribuida a las estrategias de dispersión oceánica y/o una introducción reciente en las islas hawaianas.

The genetic structure and evolutionary history of an endemic anchialine species, the shrimp Halocaridina rubra Holthuis, 1963 (Crustacean: Decapoda: Atyidae), was investigated across its range in the Hawaiian archipelago using mitochondrial (e.g., cytochrome oxidase subunit I and large subunit ribosomal) gene sequences. A survey of 573 individuals collected from 34 sites on the islands of Hawai‘i, Maui, and Oahu revealed 13 distinct genetic groups belonging to eight divergent lineages. In general, a Halocaridina genetic group or lineage was restricted to a particular region of a single Hawaiian Island, with no individuals being exchanged between them. This pattern

Gonadotropins, steroids and growth factors stimulate or inhibit cumulus expansion, nuclear maturation, or both, of most mammalian oocytes in vitro. The objective was to evaluate the effects of epidermal growth factor (EGF) and various hormone combinations on in vitro granulosa/cumulus (G-C) expansion and nuclear maturation of domestic dog oocytes derived from advanced preantral and early antral follicles. Follicles were collected after enzymatic digestion of ovarian tissue and cultured for 66 h in F-12/DME with 20% fetal bovine serum, 2mM glutamine and 1% antibiotic-antimycotic (Control). Treatments comprised the following groups; each was cultured both with and without EGF (5 ng/mL): Control, FSH (0.5 microg/mL), LH (5 microg/mL), estradiol-17beta (E2, 1 microg/mL), FSH+LH, and FSH+LH+E2. Granulosa/cumulus expansion was scored on a scale of 0 (no expansion) to +3 (maximum expansion). The interaction between EGF and hormone treatment affected (P=0.011) maximum G-C expansion. With the exception of the E2 group, EGF increased (P0.05) the proportion of oocytes exhibiting +3 expansion. The synergism of E2 with FSH+LH enhanced maximum G-C expansion; compared to all other treatments, the greatest expansion was observed in the FSH+LH+E2+EGF group (83.5+/-3.5%). When cultured in EGF alone, oocytes failed to reach metaphase I-II (MI-MII) stages. The interaction between EGF and hormone treatment tended (P=0.089) to increase the proportion of oocytes resuming or completing nuclear maturation (GVBD-MII). In addition, supplementing culture media with hormones increased (P=0.010) the GVBD-MII rate. Therefore, EGF in combination with FSH and LH enhanced G-C expansion of cultured canine oocytes, with no significant effect on the proportion of oocytes derived from advanced preantral and early antral follicles that reached MI-MII.

BACKGROUND: We have performed an in-vitro examination of the morphology of flap thickness and stromal bed after LASIK in porcine eyes. MATERIALS AND METHODS: Freshly enucleated porcine eyes and synthetic eye models were used for cutting flaps with the microkeratomes Hansatome-Excellus (Bausch&Lomb), M2 single use (Moria), Amadeus (AMO), MK-2000 (Nidek) and Carriazo-Pendular (Schwind). The flap thickness of porcine eyes was determined using a non-contact, confocal optical distance measuring device (CHR 150N, Jurca), in the eye models a mechanical thickness measuring device (Kafler) was used. The morphology of the stromal bed was examined by photography, histology, scanning electron microscopy and confocal optical distance measurements. RESULTS: The optical/mechanical flap thickness measurements showed an average difference compared to the adjusted thickness of - 3/+ 90 microm (Hansatome-Excellus), + 7/+ 100 microm (M2 single use), - 35/+ 40 microm (Amadeus), - 4/+ 80 microm (MK-2000) and + 11/+ 0 microm (Carriazo-Pendular). Histology showed no mechanical damage and smooth, slightly undulating surfaces with all microkeratomes. In the scanning electron microscopic examination, the stromal surface was found to be homogeneous and smooth for all of the microkeratomes. Average roughness of the ablation surface was 0.27 microm (Hansatome-Excellus), 0.23 microm (M2 single use), 0.21 microm (Amadeus), 0.23 microm (MK-2000) and 0.29 microm (Carriazo-Pendular). CONCLUSION: The stromal bed showed in all cases only a slightly roughness, which seems to be acceptable for the clinical outcome. However, the more critical point is the large variations in flap thickness compared to the intended thickness.

Use of the Harmonic Scalpel has recently been described in thyroid surgery, in which it appears to result in decreased operative time and blood loss without increasing the incidence of nerve injury when compared to conventional techniques of vessel ligation and tissue division. We sought to determine whether the use of the Harmonic Scalpel in superficial parotidectomy was associated with a difference in operative time, blood loss, or facial nerve injury compared with conventional techniques.The medical records of all patients who underwent superficial parotidectomy for benign parotid pathology at the Medical College of Georgia and Veterans Affairs Hospital of Augusta, Georgia, from 1999 to 2002 were retrospectively reviewed. Patients were excluded if they had a history of a bleeding disorder, prior facial nerve weakness, prior parotid surgery, malignant pathology, or required total parotidectomy.Forty-two patients were eligible for inclusion. Nineteen patients underwent Harmonic Scalpel parotidectomy (HS) and 21 patients underwent conventional parotidectomy (control group). There were no significant differences between the 2 groups with respect to demographic data, pathology, or tumor size. Use of the Harmonic Scalpel was associated with a significant reduction in length of surgery (167.5 +/- 42.6 min vs. 195.5 +/- 37.4 min for controls, P = 0.03) and intraoperative blood loss (37.5 +/- 25.8 mL vs. 60.0 +/- 37.1 mL for controls, P = 0.03). There were no significant differences between the HS or control groups with respect to postoperative drain output (48.7 +/- 33.8 mL vs. 48.0 +/- 22.9 mL, respectively, P0.05) or facial nerve function.Use of the Harmonic Scalpel for superficial parotidectomy is safe and may result in reduced operative time and blood loss compared with conventional techniques. Significance A safe alternative to cold knife superficial parotidectomy is presented with the potential benefits of reduced operative time and blood loss demonstrated.

Objectives: The introduction of percutaneous tracheostomy (PercTrach) has resulted in tension over the scope of practice between otolaryngologists and pulmonary/critical care (PCC) specialists. We sought to determine the value of a collaborative approach to the performance of PercTrach at the bedside in the intensive care unit setting. Study Design and Methods: A retrospective study of consecutive patients who underwent bedside PercTrach at the Medical College of Georgia between May of 2003 and November of 2003. All cases were performed in conjunction with the PCC team, which typically provided bronchoscopic guidance during the performance of the procedure, whereas the PercTrach was performed by the otolaryngology team, although these roles were occasionally reversed. In all cases, the PercTrach was performed using the Ciaglia Blue Rhino introducer set. Results: Twenty-three patients (12 males, 11 females) with a mean age of 47.6 ± 14.3 (range 23-65) years underwent PercTrach. The procedural times ranged from 7 to 21 minutes, with a mean of 13.9 ± 4.4 minutes; this represented 9.6 minutes on average to insert the tracheostomy tube and an additional 4.3 minutes to completely secure the tracheostomy tube. The time interval from consultation to PercTrach was less than 24 hours in 16 of 23 cases (overall mean time to PercTrach = 41.7 ± 37.1 hours), with delays beyond 24 hours related in most instances to patient stability. Conclusion: A multidisciplinary approach to PercTrach results in a number of clinical and educational benefits. Chief among these benefits is a rapid, cost-effective response to requests for elective tracheostomy. Practicing otolaryngologists with a prior bias against this approach (as we had) should reconsider adopting this revised procedure.

Tissue restoration is the process whereby multiple damaged cell types are replaced to restore the histoarchitecture and function to the tissue. Several theories have been proposed to explain the phenomenon of tissue restoration in amphibians and in animals belonging to higher orders. These theories include dedifferentiation of damaged tissues, transdifferentiation of lineage-committed progenitor cells, and activation of reserve precursor cells. Studies by Young et al. and others demonstrated that connective tissue compartments throughout postnatal individuals contain reserve precursor cells. Subsequent repetitive single cell-cloning and cell-sorting studies revealed that these reserve precursor cells consisted of multiple populations of cells, including tissue-specific progenitor cells, germ-layer lineage stem cells, and pluripotent stem cells. Tissue-specific progenitor cells display various capacities for differentiation, ranging from unipotency (forming a single cell type) to multipotency (forming multiple cell types). However, all progenitor cells demonstrate a finite life span of 50 to 70 population doublings before programmed cell senescence and cell death occurs. Germ-layer lineage stem cells can form a wider range of cell types than a progenitor cell. An individual germ-layer lineage stem cell can form all cells types within its respective germ-layer lineage (i.e., ectoderm, mesoderm, or endoderm). Pluripotent stem cells can form a wider range of cell types than a single germ-layer lineage stem cell. A single pluripotent stem cell can form cells belonging to all three germ layer lineages. Both germ-layer lineage stem cells and pluripotent stem cells exhibit extended capabilities for self-renewal, far surpassing the limited life span of progenitor cells (50-70 population doublings). The authors propose that the activation of quiescent tissue-specific progenitor cells, germ-layer lineage stem cells, and/or pluripotent stem cells may be a potential explanation, along with dedifferentiation and transdifferentiation, for the process of tissue restoration. Several model systems are currently being investigated to determine the possibilities of using these adult quiescent reserve precursor cells for tissue engineering.

Hintergrund. In der Mittelohrchirurgie kamen wahrend der letzten Jahre unterschiedliche Lasersysteme zum Einsatz. In der vorliegenden Studie wurden die technischen Parameter fur eine Gehorknochelchenteilresektion mit dem CO2-Laser bestimmt und die histologischen Befunde am Knochenpraparat analysiert.

The ability of oocytes from preantral follicles to mature in vitro was assessed using a synthetic oviduct fluid (SOF) medium. Advanced preantral follicles (approximately 210 microm diameter) were isolated from the ovaries of domestic bitches and assigned to one of four treatment groups: (1) SOF (n = 230); (2) SOF + 3 mg/ml bovine serum albumin (+BSA, n = 220); (3) SOF + 20% fetal bovine serum (+FBS, n = 227); or (4) SOF + 3 mg/ml BSA + 20% FBS (+BSA+FBS, n = 232), then cultured for up to 72 h. A group of control follicles was not cultured (n = 103). The percentages of oocytes reaching metaphase I to metaphase II stages (MI to MII) did not differ between treatments at each culture period. Within treatments, the percentages of oocytes at MI to MII stages did not differ with duration of culture. However, when compared to the control group (0.97%) the percentages of oocytes at MI to MII increased (P0.05) in the SOF group after 48 h (10.0%) and 72 h (12.2%) of culture. In the +BSA (10.1%) and +FBS (9.7%) groups, the percentages of oocytes at MI to MII increased (P0.05) above control values only after 72 h of culture. The percentage of oocytes at MI to MII did not significantly increase in the +BSA+FBS group (3.9,6.6 and 7.6% at 24,48 and 72 h of culture, respectively) compared to the control group. These results indicate that under the described conditions supplementation of culture medium with BSA or FBS is not essential, and the simple medium SOF can support nuclear maturation of a small proportion of bitch oocytes in vitro.

We report results on the ratio of mid-rapidity anti-proton to proton yields in Au+Au collisions at $\rts = 130$ GeV per nucleon pair as measured by the STAR experiment at RHIC. Within the rapidity and transverse momentum range of $|y

Elliptic flow from nuclear collisions is a hadronic observable sensitive to the early stages of system evolution. We report first results on elliptic flow of charged particles at midrapidity in Au+Au collisions at √(sNN) = 130 GeV using the STAR Time Projection Chamber at the Relativistic Heavy Ion Collider. The elliptic flow signal, v₂, averaged over transverse momentum, reaches values of about 6% for relatively peripheral collisions and decreases for the more central collisions. This can be interpreted as the observation of a higher degree of thermalization than at lower collision energies. Pseudorapidity and transverse momentum dependence of elliptic flow are also presented.

Experiments E866 and E917 at the AGS have measured the differential invariant yields of positive and negative charged kaons from Au+Au collisions at beam kinetic energies in the laboratory of 2, 4, 6, 8, and 10.8 A·GeV. At each beam energy, a multiplicity array is used to select on the centrality of the collision.

The effects of baryon stopping and its resulting energy deposition on the dynamics of Au + Au collisions at 6, 8 and 10.8 GeV/nucleon are explored with recent results from the AGS experiment E917. Current analyses of stopping, collective flow signals and HBT parameters are presented. Strangeness and anti-baryon production is examined using the yields of anti-lambdas and anti-protons.

Particle yields and spectra for kaons, pions and protons have been measured as a function of beam energy in Au Au collisions at the AGS. The energy dependence of the yields indicates that increased beam energy leads primarily to an increase in particle production with a slight increase in transverse momentum. The measured 〈 m T 〉 distributions have been fit to a simple model which assumes a thermal distribution with an additional term proportional to the particle mass. This additional term can be attributed to collective expansion.

We examined the effects of long-term streptozotocin (STZ) diabetes andits treatment by intensive insulin therapy (IIT) or pancreatic islet transplantation on pulmonarypressor and depressor responses and segmental resistance profiles in female Wistar–Furth rats.Pulmonary vascular reactivity was examined using isolated, salt-perfused lungs at a constantflow rate of 30 mL·min–1·kg–1 body weight. Baseline perfusion pressurewas significantly (p < 0.05) lower in lungs obtained from IIT animals compared with allother treatment groups. Following STZ administration, pressor responsiveness to 1.0 µg ofU-46619(9,11-dideoxy-9 alpha,11 alpha-methanoepoxy prostaglandinF2 alpha) was decreased in diabetic compared with IIT animals (9.33 ± 0.54 vs. 11.94 ±0.29 mmHg (1 mmHg = 133.3 Pa)). Diabetes caused a similar decrease in thevasodilatory response to arginine vasopressin when compared with IIT animals (39.25 ± 7.54vs. 68.24 ± 4.75%). Diabetes was also associated with a shift in the primary site of resistancefrom the pulmonary arterial to the pulmonary venous bed. This shift was restored to normalfollowing pancreatic islet transplantation, but not IIT. IIT was also associated with significantalterations in the pattern of constrictor and dilator responses to U-46619 and argininevasopressin. Pulmonary venous vasoconstrictor responses to U-46619 were augmented whencompared with either control or diabetic animals, but not transplant. In addition, pulmonaryvenous vasoconstrictor responses in IIT animals were significantly greater than pulmonaryarterial responses in the same group, a finding that was unique to IIT animals. Finally, IITsignificantly augmented the pulmonary venous vasodilatory response to arginine vasopressinwhen compared with all other treatment groups. These data demonstrate significant alterations inpulmonary hemodynamic status of STZ diabetic female animals and suggest that pancreatic islettransplantation may be more beneficial than intensive insulin therapy in ameliorating thesechanges.Key words: segmental vascular resistance,insulin-dependent diabetes mellitus, lungs, U-46619, pressor responsiveness, gender effects.

This study was designed to develop preantral follicle isolation and classification protocols for the domestic dog as a model for endangered canids. Ovary donors were grouped by age, size, breed purity, ovary weight and ovary status. Ovaries were randomly assigned to 1 of 3 digestion protocols: A) digestion and follicle isolation on the day of spaying; B) storage at 4 degrees C for 18 to 24 h prior to digestion and follicle isolation; C) digestion on the day of spaying, then incubation at 4 degrees C for 18 h prior to follicle isolation. Minced tissue was placed in a collagenase/DNase solution at 37 degrees C for 1 h. Follicles were classified by oocyte size and opaqueness and by size and appearance of the granulosa cell layers. Preantral follicles contained small, pale oocytes. Preantral follicles containing grown oocytes with dense cytoplasmic lipid were designated as advanced preantral. Only advanced preantral and early antral follicles were examined and classified further. Group 1 follicles had incomplete or absent granulosa layers, Group 2 follicles had several intact granulosa layers, while Group 3 were vesicular (early antral) follicles. Misshapen or pale grown oocytes were classified as degenerated. The percentage of intact germinal vesicles (GV) was recorded for each Group. Digestion Protocol B produced the lowest percentage of degenerated follicles (P0.01). Prepubertal donors had fewer (P0.01) follicles in each Group and more (P0.001) degenerated follicles than older bitches. Larger ovaries yielded the highest total number of follicles (P0.05). Ovary status did not affect follicle yield. Oocytes from Group 1 follicles had fewer intact GVs than those from Group 2 or Group 3 (P0.0001). These findings provide an opportunity for quantitative studies of the factors regulating folliculogenesis in the domestic dog as a model for endangered canids.

Since the passage of the Goldwater-Nichols Act in 1986, the U.S. armed forces have faced daunting challenges to operate effectively in dynamic, ever-changing, and complex security environments and to maintain lethality. Fiscally challenging times in addition to increasing diversity throughout the globe show that interdependence, interoperability, and integration are vital to success on the battlefield, no matter what its form. To view the shape of the future joint task force (or U.S. armed force for that matter) through today's lens will inevitably result in paradigm paralysis. Recent history has shown that a U.S. armed force that is completely reliant on interdependent, interoperable, and integrative mechanisms will quickly off balance and paralyze its enemies, and accomplish the missions tasked by the nation (military or non-military). Are we ready to fully commit to this and avoid paradigm paralysis?

Although arterial complications after Total Knee Arthroplasty (TKA) are rare, results can be devastating for patients, because infection and possibility of amputation are common. Not only can pre-existing peripheral artery disease (PAD) lead to poor healing and increased risk of infection, use of the tourniquet during surgery has been implicated in subsequent arterial complications. Because many of the patients who develop these complications have pre-existing PAD, identifying those at risk should be an integral part of the initial orthopedic patient assessment. Nurses are in a unique position to assess risk factors for PAD in potential candidates for TKA and to decrease risk of postoperative complications by performing the Ankle-Brachial Index (ABI). The test is quick and simple, can be performed in the office and results can be shared immediately with the orthopedic surgeon if follow-up with a vascular surgeon is necessitated. PAD affects at least 10% of adults older than 70 years and will become an increasingly important factor affecting their health care. Although the disease goes unrecognized in about 75% of cases, the clinical presentation of early onset occlusive disease generally manifests itself asymptomatically or in the lower extremities in the form of intermittent claudication (IC). Intermittent claudication is a common and disabling symptom that affects between 3% and 7% of the population and up to 1 in 5 individuals over the age of 75, an age group common to have TKA. Although the symptoms are easy to detect, they are frequently overlooked be

Experiments were performed on isolated salt-perfused rat lungs to determine the receptor type(s) responsible for the pulmonary vascular effects of the neurohypophyseal peptides arginine vasopressin (AVP) and oxytocin. Bolus administration of AVP to lungs preconstricted with the thromboxane mimetic U-46619 resulted in a dose-dependent vasodilatory response (approximately 65% reversal of U-46619-induced vasoconstriction at the highest dose tested) that was blocked by pretreatment with a selective V1- but not by a selective V2-vasopressinergic receptor antagonist. Administration of a selective V1-agonist to the preconstricted pulmonary vasculature resulted in a vasodilatory response similar to that observed with AVP (approximately 55% reversal of U-46619 vasoconstriction), which was blocked by prior administration of the selective V1-receptor antagonist. Administration of the selective V2-receptor agonist desmopressin to the preconstricted pulmonary vasculature resulted in a small (approximately 8% reversal of U-46619 vasoconstriction) vasodilatory response that was, nevertheless, greater than that produced by addition of vehicle alone and was attenuated by pretreatment with a selective V2-receptor antagonist. Finally, oxytocin also caused vasodilation in the preconstricted pulmonary vasculature; however, the potency of oxytocin was approximately 1% of AVP, and the vasodilation produced by oxytocin was blocked by prior administration of a selective V1-receptor antagonist, suggesting that oxytocin acts via V1-vasopressinergic receptor stimulation. We conclude from these experiments that AVP and oxytocin dilate the preconstricted pulmonary vasculature primarily via stimulation of V1-vasopressinergic receptors. V2-receptor stimulation results in a minor vasodilatory response, although its physiological significance is unclear.

The present study investigated the role of the sympathetic nervous system in the development of ethanol-induced hypertension (EIH) in the rat. Sympathetic nerve activity (SNA) as an index of central sympathetic tone was measured directly from the preganglionic fibers of the greater splanchnic nerve. Four weeks after starting ethanol feeding, and prior to the development of hypertension, SNA of the ethanol-fed rats was significantly greater than that of controls. The increase in SNA was also evident at the early stages of EIH, at 8 weeks, and in fully developed EIH, after 12 weeks of ethanol consumption. Baroreceptor reflex control of heart rate (HR) but not SNA was impaired prior to the development of EIH at 4 weeks. However, at 8 and 12 weeks, baroreflex control of HR and SNA was normal or slightly greater than that of control rats. Because arterial pressure of ethanol-fed rats was significantly higher than that of controls at 8 and 12 weeks, the data suggest that ethanol feeding caused baroreceptor resetting. Pressor responsiveness to phenylephrine was depressed before the development of EIH but was similar to that of control rats following the development of EIH. The data also shows that blood and plasma volumes of ethanol-fed rats at the times that coincided with the pre- and posthypertensive states were similar to those of control rats which suggests that the development of EIH does not involve an increase in plasma volume. It is concluded that an increase in SNA contributes to the development of EIH and that baroreceptor resetting evoked by ethanol feeding plays a permissive role in maintaining an elevated blood pressure in ethanol-fed rats.

Aim of this study was to evaluate the potential of denaturation of hormone active tissue in the thyroid gland by laser induced interstitial thermotherapy (LITT) as a treatment of autonomous hyperthyroidism.An interstitial thyroid laser application (Nd:YAG 1064 nm, 5W, 2 min) was performed in 5 pigs. During laser application, the laryngeal recurrent nerve was controlled electro-physiologically. Postoperatively, TSH, total T(3) (TT(3)) and free T(4) (FT(4)) were measured regularly. After a follow-up period of up to 6 weeks, pigs were sacrificed and the thyroid glands were evaluated histological.A malfunction of the nerve due to laser treatment was not detected. During the first postoperative week there was a decrease of both FT(4) and TSH whereas TT(3) showed an extreme decline of its plasma levels reaching nearly the detection limit. All values showed a recovery to their initial levels during an interval of 10 days and than increased to levels sometimes higher than baseline. The coagulation zones were demarcated clearly towards normal tissue with increasing fibrosis of the treated areas.Interstitial thyroid ablation using a Nd:YAG laser is a minimal invasive, safe and effective procedure. Further evaluation including long term follow-up in humans is needed to confirm these results.

We have performed an in-vitro examination of the morphology of flap thickness and stromal bed after LASIK in porcine eyes.Freshly enucleated porcine eyes and synthetic eye models were used for cutting flaps with the microkeratomes Hansatome-Excellus (BauschLomb), M2 single use (Moria), Amadeus (AMO), MK-2000 (Nidek) and Carriazo-Pendular (Schwind). The flap thickness of porcine eyes was determined using a non-contact, confocal optical distance measuring device (CHR 150N, Jurca), in the eye models a mechanical thickness measuring device (Käfler) was used. The morphology of the stromal bed was examined by photography, histology, scanning electron microscopy and confocal optical distance measurements.The optical/mechanical flap thickness measurements showed an average difference compared to the adjusted thickness of - 3/+ 90 microm (Hansatome-Excellus), + 7/+ 100 microm (M2 single use), - 35/+ 40 microm (Amadeus), - 4/+ 80 microm (MK-2000) and + 11/+ 0 microm (Carriazo-Pendular). Histology showed no mechanical damage and smooth, slightly undulating surfaces with all microkeratomes. In the scanning electron microscopic examination, the stromal surface was found to be homogeneous and smooth for all of the microkeratomes. Average roughness of the ablation surface was 0.27 microm (Hansatome-Excellus), 0.23 microm (M2 single use), 0.21 microm (Amadeus), 0.23 microm (MK-2000) and 0.29 microm (Carriazo-Pendular).The stromal bed showed in all cases only a slightly roughness, which seems to be acceptable for the clinical outcome. However, the more critical point is the large variations in flap thickness compared to the intended thickness.

Objectives: Modifications of the percutaneous tracheostomy (PercTrach) technique have made this a straightforward and safe procedure in appropriately selected patients. We sought to determine its value in high-risk patients. Study Design/Methods: A retrospective study of high-risk and low-risk patients on whom bedside PercTrach was performed between May 2003 and October 2004 at the Medical College of Georgia. The patients were prospectively stratified into groups based on their comorbidities (morbid obesity or coagulopathy). The Ciaglia Blue Rhino introducer set was used in all cases. Results: Fifty-four consecutive patients were included in the study; the high-risk patients (n = 16) were younger than the low-risk (n = 38) patients (48.2 vs. 53.6 years, respectively), but had significantly higher Acute Physiology and Chronic Health Evaluation II scores (10.1 vs. 5.4, P = .0001). There were seven morbidly obese patients with a mean body mass index of 64.4 and a mean weight of 184.9 kg. There were 9 patients with a total of 10 coagulopathic conditions (7 = International Normalized Ratio [INR] of >1.5, 2 = heparin drip, 1 = platelet count < 20,000). One patient included in the study met requirements for two categories with a platelet count of 17,000 and an INR of 1.7. The procedural times ranged from 5 to 30 minutes. The high-risk PercTrachs took 14.4 ± 5.0 minutes on average, compared with 12.2 ± 4.8 minutes in the low-risk group (P =.115). One patient in the low-risk group bled from an anterior jugular communicating vein injury, requiring wound exploration and vein ligation. There were no other significant complications. Conclusions: There were no statistically significant differences in intraoperative or perioperative outcomes between the PercTrachs performed in high-risk versus low-risk patients. PercTrachs may be performed safely even in high-risk patients such as those with morbid obesity and coagulopathy.