Steroid-responsive meningitis-arteritis in dogs with noninfectious, nonerosive, idiopathic, immune-mediated polyarthritis

Signs related to spinal pain are commonly reported in dogs with noninfectious, nonerosive, idiopathic immune-mediated polyarthritis (IMPA). This study examined the prevalence and etiology of spinal pain in these dogs through a retrospective review of 62 case records of dogs with IMPA. All dogs with IMPA and signs suggestive of spinal pain were described with regard to age, gender, breed, physical stature, location of vertebral pain, rectal temperature, and clinical laboratory findings. The prevalence of spinal pain in these dogs was 29% (18 of 62). Fourteen of the 18 dogs with spinal pain and IMPA were male. Cerebrospinal fluid (CSF) from 11 dogs with signs of spinal pain was analyzed. Five of these (46%) had concurrent steroid-responsive meningitis-arteritis (SRMA). We concluded that SRMA does occur concurrently in some dogs having IMPA. Meningeal involvement may explain the origin of spinal pain observed in some of these dogs.

Compensatory locomotor adjustments of rats with cervical or thoracic spinal cord hemisections

The accurate measurement of behavioral compensation after CNS trauma, such as spinal cord injury, is important when assessing the functional effects of injury and treatment in animal models. We investigated the locomotor abilities of rats with unilateral thoracic or cervical spinal cord injuries using a locomotor rating (BBB) scale, reflex tests, and quantitative kinetic measurements. The BBB rating scale indicated that thoracic spinal hemisected (TH) rats had more severely affected hindlimbs compared to cervical spinal hemisected (CH) and sham-operated animals. Kinetic measurements revealed that CH and TH animals moved with different ground reaction force patterns, which nevertheless shared some similarities with each other and with the gait patterns of rats with different unilateral CNS lesions. Uninjured rats typically had an equal distribution of their body weight over the forelimbs and hind limbs, and used their forelimbs predominantly for braking while using their hind limbs mostly for propulsion. CH rats bore more weight on their hind limbs than their forelimbs, while TH animals bore more weight on their forelimbs than their hind limbs. Neither CH nor TH rats used the forelimb ipsilateral to the spinal hemisection for net braking or propulsion. The hindlimb contralateral to the hemisection was placed on the ground prematurely during the stride cycle for both CH and TH animals. The altered kinetics of the locomotor pattern in hemisected animals resulted in changes in the oscillations of total body potential and kinetic energies. These two forms of energy oscillate synchronously in intact locomoting rats, but were asynchronous during parts of the stride cycle in spinal hemisected animals. We conclude that rats develop a general compensatory response for unilateral CNS lesions, which may help stabilize the animal during locomotion.

Audit of a multidisciplinary approach to the care of children with unilateral and bilateral cleft lip and palate

Cleft lip and palate affects the child in many ways, particularly appearance, dental arch relationships, growth of the face, and speech development. The key to successful care is management in a multidisciplinary team adhering to a well-designed protocol, and careful audit of results. We present the intermediate outcome audit of 15 patients with complete bilateral and unilateral cleft lip and palate whose condition was managed in a multidisciplinary team according to a strict protocol. We give the results observations of operations of a single surgeon's functional primary surgery over a 6-year period in terms of dental arch relationships, cephalometric analyses, aesthetic assessments, and speech analysis. The results show good early facial growth, with dental arch relationships appropriate for the age and group; we found only minor speech discrepancies, with no patients requiring pharyngoplasty. The results show the importance of multidisciplinary management, the value of keeping to sound surgical protocols, and functional techniques in cleft lip and palate surgery. Our study includes the neglected group of children who have bilateral cleft lip and palate, and it conforms to the style of pan-European projects.

The role of calcium in ABA-induced gene expression and stomatal movements

There is much interest in the transduction pathways by which abscisic acid (ABA) regulates stomatal movements (ABA-turgor signalling) and by which this phytohormone regulates the pattern of gene expression in plant cells (ABA-nuclear signalling). A number of second messengers have been identified in both the ABA-turgor and ABA-nuclear signalling pathways. A major challenge is to understand the architecture of ABA-signalling pathways and to determine how the ABA signal is coupled to the appropriate response. We have investigated whether separate Ca2+-dependent and -independent ABA-signalling pathways are present in guard cells. Our data suggest that increases in [Ca2+]i are a common component of the guard cell ABA-turgor and ABA-nuclear signalling pathways. The effects of Ca2+ antagonists on ABA-induced stomatal closure and the ABA-responsive CDeT6-19 gene promoter suggest that Ca2+ is involved in both ABA-turgor signalling and ABA-nuclear signalling in guard cells. However, the sensitivity of these pathways to alterations in the external calcium concentration differ, suggesting that the ABA-nuclear and ABA-turgor signalling pathways are not completely convergent. Our data suggest that whilst Ca2+-independent signalling elements are present in the guard cell, they do not form a completely separate Ca2+-independent ABA-signalling pathway.

Surgical management of cutaneous squamous cell carcinoma of the head and neck

A retrospective audit was made of histological records and hospital case notes of patients who had cutaneous squamous cell carcinomas excised from the head and neck region at the Maxillofacial Units at St Richard's Hospital, Chichester and Southlands Hospital, Shoreham-By-Sea, UK. A total of 227 lesions were excised from 183 patients over a 5-year period between 1990 and 1995. The local recurrence rate was 4% (9/227) and 12 (7%) of the patients presented with or developed regional nodal metastases. Of the 183 patients, 177 (97%) were cured. These rates compare favourably with those of other published series of cutaneous squamous cell carcinoma managed by surgical techniques that did not follow the micrographical technique of Mohs. Certain characteristics may aid in the prediction of those cancers that may be more aggressive. It is important to evaluate each case in terms of histological grade and site and to design management plans to deal with each lesion in the most appropriate way.

MR imaging findings in a dog with lumbar ganglion cysts

Intraspinal cysts of the L6-L7 and L7-S1 articular process joints in a six-year-old neutered female German Shepherd Dog were diagnosed using magnetic resonance (MR) imaging. Histopathology provided a diagnosis of ganglion cysts. Clinical, laboratory, radiographic and MR imaging findings are described. Briefly, radiographic findings revealed lumbarization of the first sacral vertebra, and fusion of the first caudal vertebra to the sacrum. In addition, spondylosis and articular process osteoarthrosis occurred at L6-L7 and L7-S1. MR imaging revealed multiple, well encapsulated structures ranging in size from 3-10 mm in diameter which were found to arise from the L6-L7 and L7-S1 articular process joints. These cysts had signal intensities that varied from hyperintense to the cerebrospinal fluid (CSF) on T1 weighted images to isointense to CSF on T2 weighted images. Decompressive surgery in conjunction with arthrodesis of these joints resulted in resolution of clinical signs. The dog remained pain-free 1 1/2 years following surgical therapy.

Mini-review: assessment of behavioural recovery following spinal cord injury in rats

Behavioural recovery is one of the primary goals of therapeutic intervention in animal models of disease. It is necessary, therefore, to have the means with which to quantify pertinent behavioural changes in experimental animals. Nevertheless, the number and diversity of behavioural measures which have been used to assess recovery after experimental interventions often makes it difficult to compare results between studies. The present review attempts to integrate and categorize the wide variety of behavioural assessments used to measure recovery in spinal-injured rats. These categories include endpoint measures, kinematic measures, kinetic measurements, and electrophysiological measurements. Within this categorization, we discuss the advantages and disadvantages of each type of measurement. Finally, we make some recommendations regarding the principles for a comprehensive behavioural analysis after experimental spinal cord injury in rats.

The blood-brain barrier and its role in inflammation

The unique microenvironment within the central nervous system (CNS) relies upon the integrity of the blood-brain barrier (BBB). This selectively permeable barrier comprises interendothelial tight junctions located at the capillaries and postcapillary venules. Cells and structures in the local environment are required to maintain normal BBB function. When inflammation is present, the BBB itself plays an integral role in the inflammatory response by either producing or expressing a variety of cytokines, adhesion molecules, metalloproteinases, serine proteases, products of arachidonic acid metabolism, and nitric oxide. Understanding the role of the BBB during inflammation is essential when creating and employing a therapeutic regime for animals with CNS disease. This review focusses on recent discoveries about the BBB and its role in inflammation, and applies this knowledge to our current understanding of inflammatory CNS disease in dogs and cats.

ABI1 protein phosphatase 2C is a negative regulator of abscisic acid signaling

The plant hormone abscisic acid (ABA) is a key regulator of seed maturation and germination and mediates adaptive responses to environmental stress. In Arabidopsis, the ABI1 gene encodes a member of the 2C class of protein serine/threonine phosphatases (PP2C), and the abi1-1 mutation markedly reduces ABA responsiveness in both seeds and vegetative tissues. However, this mutation is dominant and has been the only mutant allele available for the ABI1 gene. Hence, it remained unclear whether ABI1 contributes to ABA signaling, and in case ABI1 does regulate ABA responsiveness, whether it is a positive or negative regulator of ABA action. In this study, we isolated seven novel alleles of the ABI1 gene as intragenic revertants of the abi1-1 mutant. In contrast to the ABA-resistant abi1-1 mutant, these revertants were more sensitive than the wild type to the inhibition of seed germination and seedling root growth by applied ABA. They also displayed increases in seed dormancy and drought adaptive responses that are indicative of a higher responsiveness to endogenous ABA. The revertant alleles were recessive to the wild-type ABI1 allele in enhancing ABA sensitivity, indicating that this ABA-supersensitive phenotype results from a loss of function in ABI1. The seven suppressor mutations are missense mutations in conserved regions of the PP2C domain of ABI1, and each of the corresponding revertant alleles encodes an ABI1 protein that lacked any detectable PP2C activity in an in vitro enzymatic assay. These results indicate that a loss of ABI1 PP2C activity leads to an enhanced responsiveness to ABA. Thus, the wild-type ABI1 phosphatase is a negative regulator of ABA responses.

ABI1 protein phosphatase 2C is a negative regulator of abscisic acid signaling

The plant hormone abscisic acid (ABA) is a key regulator of seed maturation and germination and mediates adaptive responses to environmental stress. In Arabidopsis, the ABI1 gene encodes a member of the 2C class of protein serine/threonine phosphatases (PP2C), and the abi1-1 mutation markedly reduces ABA responsiveness in both seeds and vegetative tissues. However, this mutation is dominant and has been the only mutant allele available for the ABI1 gene. Hence, it remained unclear whether ABI1 contributes to ABA signaling, and in case ABI1 does regulate ABA responsiveness, whether it is a positive or negative regulator of ABA action. In this study, we isolated seven novel alleles of the ABI1 gene as intragenic revertants of the abi1-1 mutant. In contrast to the ABA-resistant abi1-1 mutant, these revertants were more sensitive than the wild type to the inhibition of seed germination and seedling root growth by applied ABA. They also displayed increases in seed dormancy and drought adaptive responses that are indicative of a higher responsiveness to endogenous ABA. The revertant alleles were recessive to the wild-type ABI1 allele in enhancing ABA sensitivity, indicating that this ABA-supersensitive phenotype results from a loss of function in ABI1. The seven suppressor mutations are missense mutations in conserved regions of the PP2C domain of ABI1, and each of the corresponding revertant alleles encodes an ABI1 protein that lacked any detectable PP2C activity in an in vitro enzymatic assay. These results indicate that a loss of ABI1 PP2C activity leads to an enhanced responsiveness to ABA. Thus, the wild-type ABI1 phosphatase is a negative regulator of ABA responses.

Intradural spinal arachnoid cyst in a dog

An 8-month-old, spayed female dog was presented with signs localizing a neurologic lesion between the 3rd thoracic and 3rd lumbar vertebrae. An arachnoid cyst was diagnosed by myelography, and a dorsal laminectomy with durotomy was performed. The dog continues to do well 1-1/2 year after surgery.

A descriptive study of missed appointments: families' perceptions of barriers to care

INTRODUCTION

When clinic appointments are missed, families deprive their child of health care opportunities and contribute to rising health care costs. The purpose of this study was to determine families' perceptions of barriers to attending clinic appointments.

METHOD

Two hundred participants with a history of missed appointments were randomly selected to participate in a telephone survey. Ninety-five of the families selected did not have telephones. Of the 105 families contacted by telephone, 101 consented to participate in a survey. For the group without phones (n = 95), demographic information was collected to use as comparison data with families that were reached. Patterns of missed appointments were also analyzed.

RESULTS

The majority of families were headed by young single mothers. The families identified transportation problems, wait times, and not knowing the reason for the appointment as barriers.

DISCUSSION

Clearly, many issues have an impact on decisions related to attending clinic appointments. In the interest of health, interventions to decrease barriers and increase attendance should be a priority for health care professionals. Further research of the effectiveness of these interventions will delineate the appropriate focus of health care professional's efforts.

Intravenous regional anesthesia (Bier block) in a dog

Intravenous regional anesthesia was used in an adult dog as part of a balanced approach to general anesthesia for amputation of the 4th digit of its right hind limb. It allowed the concentration of isoflurane to be reduced to 0.5%.

Skin care of the pediatric patient

Several factors influence the chronically ill child's susceptibility for skin breakdown. Nurses are an integral part of the care team that has the responsibility for identification of these factors, as well as pressure ulcer prevention and early intervention. An important aspect of this responsibility is identification of individuals at risk. This article provides a guide for assessment and early intervention for skin breakdown in chronically ill children. A care plan and consultation recommendations are included.

Re-evaluation of i.m. ephedrine as prophylaxis against hypotension associated with spinal anaesthesia for Caesarean section

PURPOSE

To assess the safety and efficacy of 37.5 mg ephedrine i.m. in preventing hypotension associated with spinal anaesthesia for Caesarean section.

METHODS

In a double-blind randomised controlled study, 40 patients (20 in each group) were given either 37.5 mg ephedrine or placebo i.m. The following parameters were recorded: (i) blood pressure; (ii) heart rate; (iii) ephedrine i.v. supplementation; (iv) umbilical venous blood gases and neonatal Apgar scores.

RESULTS

The incidence of hypertension in the study group was 30% compared with 20% for the control group (P:NS). There was no difference in mean highest blood pressure or mean highest heart rate between the groups. The incidence of hypotension was lower but not significantly lower in the study group (50%) than in the control group (80%) (P:NS). However, the incidence of delayed hypotension was only 10% in the study group patients compared with 50% in the control group patients (P < 0.05).

CONCLUSION

Giving 37.5 mg ephedrine i.m. prior to spinal anaesthesia was not associated with reactive hypertension or tachycardia. Intramuscular ephedrine provided more sustained cardiovascular support than intravenous ephedrine.

The short-period mutant, toc1-1, alters circadian clock regulation of multiple outputs throughout development in Arabidopsis thaliana

The coordination of developmental and physiological events with environmental signals is facilitated by the action of the circadian clock. Here we report a new set of circadian clock-controlled phenotypes for Arabidopsis thaliana. We use these markers together with the short-period mutant, toc1-1, and the clock-controlled cab2::luciferase reporter gene to assess the nature of the circadian clock throughout development and to suggest the position of TOC1 within the circadian clock system. In dark-grown seedlings, the toc1-1 lesion conferred a short period to the cycling of cab2::luciferase luminescence, as previously found in light-grown plants, indicating that the circadian clocks in these two divergent developmental states share at least one component. Stomatal conductance rhythms were similarly approximately 3 hours shorter than wild type in toc1-1, suggesting that a cell-autonomous clockwork may be active in guard cells in 5- to 6-week-old leaves. The effect of daylength on flowering time in the C24 ecotype was diminished by toc1-1, and was nearly eliminated in the Landsberg erecta background where the plants flowered equally early in both short and long days. Throughout a 500-fold range of red light intensities, both the wild type and the mutant showed an inverse log-linear relationship of fluence rate to period, with a 2–3 hour shorter period for the mutant at all intensities. These results indicate that TOC1 acts on or within the clock independently of light input. Temperature entrainment appears normal in toc1-1, and the period-shortening effects of the mutant remain unchanged over a 20 degrees C temperature range. Taken together our results are consistent with the likelihood that TOC1 codes for an oscillator component rather than for an element of an input signaling pathway. In addition, the pervasive effect of toc1-1 on a variety of clock-controlled processes throughout development suggests that a single circadian system is primarily responsible for controlling most, if not all, circadian rhythms in the plant.

Focal myasthenia gravis in a dog

A 10-month-old American cocker spaniel was evaluated for megaesophagus, aspiration pneumonia, but no appendicular muscle weakness. During hospitalization, weakness of the facial muscles developed, this resolved with anticholinesterase administration. Serum antibodies against acetylcholine receptors were documented, confirming the diagnosis of focal myasthenia gravis. Diagnosis, management, and medical treatment are discussed.

Convergence of the abscisic acid, CO2, and extracellular calcium signal transduction pathways in stomatal guard cells

We show that guard cells from Arabidopsis thaliana plants carrying the abscisic acid-insensitive mutations abi1 and abi2 fail to respond to CO2 and extracellular calcium. This demonstrates that the signal transduction pathways for all three stimuli converge on, or close to, the ABI1 and ABI2 gene products.

Satisfaction with nursing care: a comparison of patients with HIV/AIDS, non-HIV/AIDS infectious diseases, and medical diagnoses

The purpose of this study was to describe patients' perceptions of nursing care and compare those perceptions based on patients' diagnoses (HIV/AIDS, non-HIV/AIDS infectious diseases, and medical diagnoses). One hundred forty-two patients on five units in a major medical center were surveyed using the Patient Satisfaction Instrument. In addition, 126 staff nurses completed the AIDS Vulnerability Survey. Results of data analysis indicated a statistically significant difference in patient satisfaction with nursing care among patients in the medical group compared to patients in the HIV/AIDS group, with the medical group being more satisfied with their nursing care. Further, there was a statistically significant difference across units between nurses' knowledge, attitude, and fear. In spite of their knowledge base related to HIV/AIDS, nurses felt vulnerable when providing care to this population, thus perpetuating fear and negative attitudes. Additional research into the dynamics of these relationships is imperative as we continue to see increases in the number of patients with HIV/AIDS.

Family health and mental health six years after economic stress and unemployment

This study is a follow-up of 39 working class couples who were interviewed after suffering economic stress or unemployment and again six years later. Repeated measures related to economics, stress, family functioning, anxiety, and depression were collected and analyzed for couples and for husbands and wives separately. A model of long-term coping was suggested for future testing. Initially stressed families appeared to grow stronger. Mental health correlated negatively to family problems. Depressed wives seemed to maintain their depression over time if they perceived family life as stressful. Irrespective of marital problems, husbands were less likely to stay depressed.

ABA-regulated promoter activity in stomatal guard cells

CDeT6-19 is an ABA-regulated gene which has been isolated from Craterostigma plantagineum. The CDeT6-19 gene promoter has been fused to the beta-glucuronidase reporter gene (GUS) and used to stably transform Arabidopsis thaliana and Nicotiana tabacum. This construct has been shown to be expressed in stomatal guard cells and often in the adjacent epidermal cells of both species in response to both exogenous ABA and drought stress. These results indicate that the stomatal guard cell is competent to relay an ABA signal to the nucleus. In contrast GUS expression directed by the promoter from a predominantly seed-specific, ABA-regulated gene, Em, or the promoter from the ABA-regulated CDeT27-45 gene is not detectable in the epidermal or guard cells of tobacco or Arabidopsis in response to ABA. The fact that not all ABA-regulated gene promoters are active in stomatal guard cells suggests that effective transduction of the signal is dependent upon particular regions within the gene promoter or that guard cells lack all or part of the specific transduction apparatus required to couple the ABA signal to these promoters. This suggests that there are multiple ABA stimulus response coupling pathways. The identification of a regulatory sequence from an ABA-induced gene which is expressed in stomatal guard cells creates the possibility of examining the role of Ca2+ and other second messengers in ABA-induced gene expression.

Nursing Students' Knowledge and Anxiety About AIDS: An Experiential Workshop

The purpose of this quasiexperimental study was to examine the effectiveness of an experiential workshop on nursing students' anxiety and knowledge about AIDS. This study was based on Peplau's interpersonal theory in nursing practice. The sample included 67 senior nursing students and was designed as a three-group pre/post quasiexperiment. All groups received a pretest, posttest, and 6-week follow-up posttest. The experimental intervention was a 6-hour workshop that included anxiety awareness exercises in an experiential format and information about AIDS. Knowledge and anxiety scores were significantly higher for the group that attended the didactic portion of the workshop before the experiential portion. The control group showed no change in knowledge or anxiety. Results indicated that recognition of anxiety through experiential exercises contributed to learning about AIDS.