Search

Objective: To compare results obtained by use of laparoscopyassisted abomasopexy versus omentopexy via right flank laparotomy for the treatment of dairy cows with left displaced abomasum (LDA)., Animals: 120 dairy cows with an LDA., Procedure: In a prospective clinical trial, cows were randomly allocated to the abomasopexy group (laparoscopy-assisted abomasopexy) or to the control group (omentopexy via right flank). Data were obtained during the first 5 days after surgery and 6 weeks and 6 months after surgery., Results: 59 of 60 cows in the abomasopexy group and all 60 cows in the control group were treated successfully. Median duration was shorter for the laparoscopic procedure (27.5 minutes), compared with that for the control group (38 minutes). Five cows in the abomasopexy group had wound complications and 2 had LDA relapses, compared with 2 wound complications and no relapses in the control group. During the 5 days after surgery, the abomasopexy group had a significantly higher increase in rate of energy intake and milk yield and a more rapid return to reference range for serum glutamic dehydrogenase activity and total bilirubin concentration, compared with results for the control group., Conclusions and Clinical Relevance: Success rates were almost equal for both methods. Advantages of the laparoscopic abomasopexy procedure include practicality, low risk of complications, and rapid postoperative recovery. Contraindications are cardiopulmonary diseases. Other disadvantages include the cost of the instruments and inability to perform the procedure in cows with abomasal adhesions.

Aim of the study was to investigate the correlation between the occurrence of abomasal displacement and the weather situations. Data were collected for the years 2000 and 2001 in the area around Lisbon at 26 farms keeping about 6500 Holstein-Friesian milk cows; the analysis of 372 cases of abomasal displacement were included in the study. The weather situation was assessed on daily basis: atmospheric pressure, relative humidity, precipitation, daily insolation, maximum air temperature, minimum air temperature and average wind velocity. These original parameters were modified for the statistical analyses according to atmospheric pressure, water vapour pressure, relative humidity, temperature, temperature range, precipitation, insolation and wind speed. The change of the weather situation was described by the mean absolute deviation (deviation of the meteorological parameters from the running mean over a period of 5 and 10 days) and by a method which was based on the principal component analysis of the entire data set. A weak influence of water vapour pressure, relative humidity, temperature, temperature range, precipitation, and insolation on the occurrence of abomasal displacements was found by linear correlation- and regression analysis. A higher probability for abomasal displacement was verified for low water vapour pressure, high relative humidity, low air temperature, low temperature range, high precipitation and low insolation. No statistically significant relations were found between occurrence of abomasal displacement and either wind velocity or atmospheric pressure. A time series analysis exhibited a higher prevalence for abomasal displacement for periods with a change from sunny, warm and dry days to cool, overcast and humid days. From the present work it can be concluded that the meteorological situation has an influence on the occurrence of abomasal displacement. Therefore, the weather situation should be included among the predisposing causes of the occurrence of abomasal displacements.

In cattle liquid and gas in the abdominal cavity can be detected from the outside by use of simultaneous auscultation and percussion or by auscultation with simultaneous shaking of the abdominal wall. Size, area and the quality of the "ping" and splashing sounds are helpful to determine which organs are involved in the disease. Nine possible reasons for intraabdominal gas- and liquid accumulation are discussed. In 12 schematic figures the areas of externally detectable "ping" and splashing sounds are compared with the topographic anatomical situation inside the abdomen.

In view of the wide range of liability claims, expert medical reports constitute part of the basis of the work of liability insurers. However, the very different qualifications of experts often present the so-called "corporate physician" with great problems, since some expert reports are hardly acceptable, as the author discovered during many years of study of a large number of liability files. In addition, the most striking and frequently occurring criteria are discussed.

A dilated and dorsally displaced abomasum usually performs an additional counterclockwise rotation (1989-1994: 403 of 462 cases). A report is given about a repositioning technique that enables to correct nearly all cases of this counterclockwise rotation without removal of abomasal fluid. After the reposition the congested abomasal content flows to the intestine where it is resorbed, so that cases of right displaced abomasum (RDA, n = 275) recover without any parenteral fluid therapy within 24 to 48 hours. In cases of abomasal volvulus (AV, n = 187) the blood supply of the abomasum is disturbed, and after surgery the abomasal emptying is often delayed, due to a malfunction of the pylorus. This cases must be treated intravenously with large amounts of 0.9% NaCl-solution (20 to 30 liters) to correct volume deficit and hypochloremic blood alcalosis.

A report is given about 462 cases (1989-1994) of abomasal displacement (RDA, n = 275) and abomasal volvulus (AV, n = 187) in cattle. The pathogenesis and the functional disturbances of abomasal hypotony, displacement, and volvulus are described. A right and dorsally displaced abomasum easily performs an additional rotation around a vertical axis. In 99% of all cases this rotation is performed to the left (counter-clockwise, seen from rear) and the duodenum twines round the abomasal fundus, where it is compressed and trapped between the abomasum and the omasum. The intestinal passage becomes obstructed. As long as the abomasal twist does not exceed 180 degrees, functional disturbances are caused mainly by a reduced abomasal outflow, resulting in dehydration and in disturbances of blood acid-base-balance (hypochloremic alcalosis). These cases have a very good prognosis (success of treatment 91.3%), when surgery is performed immediately. When the twist of the abomasum exceeds 180 degrees (abomasal volvulus), the twine gets more contracted, strangulating the abomasal nerves and blood vessels. Serious cases like this (n = 136) were treated successfully in 64.7%. When the abomasal volvulus is complicated by an omasal (RDAO, n = 31) or an omasal and reticular involvement (RDAOR, n = 20) the success of therapy decreases to about 40%.

A report is given about the course of urolithiasis in 34 rams and 18 castrated billy-goats. Different therapeutic procedures of this disease are discussed. Concrements in the processus urethrae (n = 27) were removed by amputation of this organ. In animals with a further proximal situated urethral obstruction an ischiourethrostomy was done (n = 7). 21 animals were healed and 9 animals were sent home in an improved condition, but with urine leaking from an artificial opening. Complications as: hyperdistended and ruptured bladder (n = 9) or hydronephrosis caused by severe urine pressure were mostly seen when the diagnosis urolithiasis had been urine pressure were mostly seen when the diagnosis urolithiasis had been confirmed too late, or when the animals had been treated for several days only with analgetics or spasmolytics. Urine cellulitis of the ventral abdomen (n = 11) had not always a bad prognosis. 7 of 11 cases were healed.

The first cases of scrapie in the Federal Republic of Germany since 1945 occurred in 1990 and 1991. The disease was found in three flocks of Suffolk sheep and it was probably brought to Germany by breeding sheep from France. Scrapie is a transmissible degenerative disease of the central nervous system with a slowly progressing but always fatal course. The scrapie agent is highly resistant against environmental influences as well as against disinfectants. Incubation period and clinical signs of scrapie vary from flock to flock, depending on genetical factors of infected sheep and depending on the involved scrapie strain. In infected flocks normally not more than 1% of the sheep show clinical symptoms. Affected sheep are usually more than two years old (maximum incidence at three years of age). First signs of the disease may be changes in behaviour or pruritus or locomotor symptoms. When the disease progresses, all sheep loose flesh and within some weeks up to some months they get weaker and weaker until they finally die in recumbency. Scrapie cannot be detected in living animals and the disease may be overlooked during autopsy, because in the final stage of the disease many sheep die from non-specific secondary infections. In suspected cases of scrapie, the practicing veterinarian must give a precise history to the pathologist and he must ask for histopathological examination of the brain.

Abomasal bloat in calves can be a rapidly progressing, life-threatening disease. Gas must be removed from the tympanic abomasum as fast as possible, to prevent the calf from choking. It is very difficult to reach the abomasum with a stomach tube and in most cases it is also not possible to remove all gas from the abomasum by a single puncture in the distended right flank. A report is given about a method of abomasal puncture that can remove all abomasal gas by one single puncture. The calf is turned upside down and a puncture is performed with a 1.4 x 50 mm needle median on the highest point of the distended abdominal wall just between the umbilicus and xiphoid. Between 1985 and 1992 twenty of twenty-one calves that were suffering from abomasal tympany could be healed without further complications by one single puncture. When the state of health is getting worse or when the calf is bloating again within 2 or 3 hours after the puncture, a diagnostic laparotomy must be done, in order to detect and to treat a possibly twisted abomasum.

Between 1986 and 1989 there were 9 cases of idiopathic congestive heart failure at this clinic. Normally heifers in the last 1/3 of pregnancy and young cows aged between 2.5 and 3.5 years were affected, but the disease also occurred in one younger (1.5 years), one older (6 years) and in one male animal. In contrast to other reports, myocardial fibrosis in the State of Hesse was only seen in the Rotbunte breed. The animals suffered from a severe heart failure with venous congestion and congestive edema of the brisket, the submandibular area and the ventral abdomen. In most cases there is no precise difference in history, clinical findings and laboratory findings between myocardial fibrosis, traumatic pericarditis and endocarditis valvularis. Only pathological and histological examinations of the heart confirm a suspected myocardial fibrosis: The heart is enlarged and dilatated and seems to be non-elastic. Microscopically a scattered interstitial fibrosis and signs of myocardial degeneration are visible.

Twenty-two sheep and 4 goats suffering from central nervous listeriosis were treated with a therapy that had proved to be successful in cattle. For one week they received daily subcutaneous injections of 50,000 IU Procaine Penicillin G per kg live weight and 5 to 10 mg Vitamin B1 per kg body weight. The base excess was tested by blood gas analysis, and it was compensated by intravenous infusion of Na-bicarbonate. Animals that could not eat or swallow received water and rumen liquid by stomach tube. Eight of 26 patients (31%) were healed. The prognosis of central nervous listeriosis depends mainly on the time of initial treatment and on the degree of general disturbances: More than 90% of the animals that were recumbent (16 of 17) or showed dysphagia (12 of 13) at the beginning of treatment died or had to be euthanized because of persistent central nervous disturbances. The correction of blood-pH was of no therapeutic benefit when the disease was already in progress. Treatment of central nervous listeriosis seems to be effective as long as the patients can stand and swallow. When patients received care at this early stage of disease, 77% (7 of 9) were healed and returned to the flock.

The possibility of maintaining preload reduction and enhancement of exercise tolerance during an interval treatment with 50 mg/day of sustained-release isosorbide-5-nitrate (IS-5-N) was investigated in 13 patients (aged 54.4 +/- 7.9 years [mean +/- standard deviation]) with angiographically confirmed coronary artery disease and chronic stable angina pectoris. The effects of a single dose (acute test) were compared with those following an 8-day (chronic) regimen of mononitrate administration. Two hours after administration of 50-mg sustained-release IS-5-N, mean resting pulmonary arterial pressure (PAP), measured with a Swan-Ganz catheter, was reduced by 27% (p less than 0.01), and at submaximal exercise level (50 W, 3 minutes) by 34% (p less than 0.001). At individually highest comparable work loads mean PAP was reduced by 28% (p less than 0.01), and at maximal work load the PAP reduction was 21% (p less than 0.05). At the end of 1 week of therapy with sustained-release IS-5-N a slight, clinically irrelevant reduction of hemodynamic effects was recorded. Work capacity increased after 1 hour by 60% (408 +/- 104 vs 653 +/- 147 W x min, p less than 0.001)--still significantly above baseline 10 hours after nitrate administration. No difference from baseline was demonstrable 24 hours after medication. During interval therapy the improved work capacity was fully maintained (chronic, 1 hour: 417 +/- 93 vs 679 +/- 160 W x min, p less than 0.001). During interval therapy with sustained-release IS-5-N, hemodynamics and exercise tolerance were durably improved.(ABSTRACT TRUNCATED AT 250 WORDS)

The specificity of commercially available hCG and hCG-beta antibodies (anti-hCG-beta from N.I.A.M.D.D. (SB6), Serono (S), Biosigma (B), Union Carbide (UC) (I.R.E.) and anti-hCG from Union Carbide) were compared. Using 125I-hCG (CR 115), the crossreactivity with LH (LER 960) was 5.5% for SB6, 0.25% for S and 0.3% for B. In the homologous hCG system UC, crossreactivity was 0.06% with hCG-beta and 1.2% with LH, in the hCG-beta system UC, it was 2.2% with hCG and 0.01% with LH. Parallel standard curves for hCG, the 2nd I.R.P. hCG and hCG-beta were found exclusively with the 125I-hCG, anti-hCG-beta system S. Consequently accurate estimates of the total hCG or hCG-beta content in serum and standardization with the 2nd I.R.P. is possible. This system is the most useful for clinical purposes. The serum half-life of hCG was calculated in 10 pregnant women after delivery and was found to be 10 to 34 h. AFP half-life time, determined by the double antibody radioimmunoassay was 4.0 +/- 1.8 (+/- SD) days in pregnant women after delivery (n = 60) and 3.8 +/- 0.9 days in neonates during the first 16 days of life (n = 26). Altogether, apparent half-life determinations were carried out in 29 patients with nonseminomatous germ cell tumors. The results indicate that half-life determinations of hCG and AFP may have a predictive value with respect to the monitoring of therapy.

In connection with gynaecological diseases and/or their therapy, genital fistulas constitute a grave complication. Accurate representation of these fistulas in conjunction with the adjacent hollow organs is of curcial importance for their successful removal. A modified kind of wick urethrocystocolporectography, which is a method that has proved efficient in cases of a dislocation in the female genital tract and also in cases of insufficiency of locking of the urinary bladder, provides these preconditions for an efficient therapy. That is, through the difference in the course of motion during holding and pressing in comparison with rest there are detected not only any valve mechanisms present but also dislocations, if any. Moreover, the method, easy to apply as it is and involving only little strain, provides an advantage which cannot be overlooked.

A report about a case of St. John's wort poisoning in German Blackface sheep is given. After the ingestion of St. John's wort (Hypericum perforatum) all slightly pigmented parts of the skin, that were rarely covered with hair, were photosensitized. In summer many sheep suffered from inflammatory skin alterations at the ears, the bridge of the nose and at the surroundings of the eyes. A literature review informs about etiology and treatment of photosensitivity disease and the St. John's wort is exactly described to facilitate recognition.

Fluctuating mononitrate plasma levels in the course of 24 h are a prerequisite for prevention of nitrate tolerance in patients with angina pectoris undergoing longterm treatment. In 12 patients with angiographically proven coronary artery disease (54 +/- 7 years) effects of 50 mg Isosorbide-5-mononitrate (IS-5-MN) in a slow-release (SR) formulation on hemodynamics and exercise tolerance were evaluated after a first dose and at the end of a 1-week treatment period with 50 mg given once-daily. 1 and 2 h after medication mean pulmonary artery pressure (PAP) at rest was reduced by 30% (p less than 0.001) and 25% (p less than 0.01 respectively. During submaximal bicycle exercise (50 W, 3 min) PAP was significantly reduced by IS-5-MN by 35% (1 and 2 h after medication). At the end of exercise (discontinuation), drug-induced reductions of PAP were 19% (1 h) and 21% (2 h) (p less than 0.05), respectively. IS-5-MN led to a marked increase of exercise capacity (base-line: 396 +/- 119 W x min); 1 h: 646 +/- 153 W x min (p less than 0.01). At stress testing 2, 4 and 10 h post medication improvements were 67% (p less than 0.01), 49% (p less than 0.01) and 28% (p less than 0.01), respectively. 24 h after medication baseline values were reached again. After a 1-week treatment with 50 mg IS-5-MN SR daily, beneficial effects of the drug on hemodynamics and working capacity could be demonstrated. Again, significant effects could be shown up to 10 h after drug administration. Thus, IS-5-MN SR administered once daily proved effective in intermediate-term treatment of patients with coronary artery disease with regard to hemodynamics and exercise capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

With wick urethrocystocolporectography, an improved type of colpocystorectography, the form and undisturbed function of the urethra at rest, and during holding and pressing, may be optimally observed. The simultaneous picture of the female pelvic organs allows conclusions to be drawn as to the statics and dynamics of the viscera, as well as the functional strength of the pelvic floor. Illustrations show the behavior of the female urethra accompanying vertical and rotatory descensus, and prolapse.

In addition to the known surgical risks in the treatment of incontinence or prolapse there exists a functional risk inherent in the surgical methods, which can even cause a deterioration in the functional condition if the surgical aim is not achieved. The vaginal bladderneck sutures are only worth as much as the tissues they hold together. The surgical treatment of certain cases of prolapse can eliminate the stopcock mechanism of the urethra and lead to the manifestation of a preoperatively-existent incontinence. With the sling operations success depends, among other factors, on the degree of restraint and the correct placement of the sling. The outcome of hysterectomy is endangered by failure to recognize a coexistent prolapse or enterocoele. With Ward's manipulation, high peritonization and adequate treatment of the overextened posterior vaginal vault, the involved functional risks can be minimized. Typical examples are mentioned in the text. Particular emphasis is placed on the necessity of exact knowledge of the circumstances threatending the functional success and their recognition by means of wick-urethrocystocolporectography. For the maintenance of a good doctor-patient relationship, the patient may receive prior to surgery an understandable explanation of the limitations of the methods used in achieving a functional cure.

This study presents the cystotonometric checks of trends in 102 patients with irradiated carcinoma of the cervix up to the time of the so-called five year survival recovery. As compared with a standard control group concerning the function of the urinary bladder a distinct tendency to hypertonia is realized and attributed as inevitable to radiotherapy. The moderate load being present before the onset of irradiation is mentioned, resulting from diagnostic operations and from the primary disease. Based on these observations, functional findings which allow objectivation appear to be indicated, the aim being to recognize, as early as possible, the increase of vesical reactions with regard to gynecologic radiotherapy and later follow-up care.