Infiltrative urethral disease in female dogs: 41 cases (1980-1987)

Forty-one cases of infiltrative urethral disease in female dogs were reviewed. The cause was epithelial neoplasia in 29 dogs, granulomatous (chronic active) urethritis in 10 dogs, and leiomyoma in 2 dogs. Clinical signs of disease were similar in dogs with neoplastic and inflammatory disease and included strangury (36/41), hematuria (30/41), pollakiuria (20/41), vaginal discharge (16/41), and complete urinary obstruction (7/41). Results of aspiration biopsy of the urethra correlated with those of surgical biopsy in 11 of 15 dogs. In 4 of 15 dogs, results of cytologic and histologic examinations differed. Granulomatous (chronic active) urethritis is an infiltrative urethral disease in female dogs. Clinical findings are similar, but the prognosis is more favorable than that in dogs with urethral epithelial neoplasia.

The influence of skin structure on permeability: an intersite and interspecies comparison with hydrophilic penetrants

For reasons that are unclear, skin from various body sites has different permeability properties. We have used hydrophilic penetrants (water, ethanol, mannitol, and paraquat) to study the in vitro permeability of skin from marmoset (eight body sites), man, and rat. Skin structure (stratum corneum thickness and number of cell layers; epidermal and dermal thickness; number and area of hair follicle openings per mm2) was compared with permeability. There was no apparent relationship between skin structure and permeability to the most rapid penetrants, water and ethanol. Follicle area opening was the structural feature that varied most between species and between body sites. Different marmoset body sites showed a threefold range in follicle area but this did not appear to influence the absorption rates of the test penetrants. However, among the species there was an 80-times range in follicle area, which correlated with the observed differences in rate of mannitol and paraquat absorption. Thus, permeability could be related to inter-species differences in skin structure, but only with the relatively slowly absorbed test penetrants, mannitol and paraquat.

In vitro absorption of some chlorinated paraffins through human skin

The in vitro absorption of chlorinated paraffins, Cereclor S52 and Cereclor 56L (present in a cutting fluid), has been measured through human skin. During 56 h continuous skin contact no Cereclor S52 was detected to have been absorbed and only a very slow rate of Cereclor 56L absorption (mean rate, 0.04 micrograms/cm/h) was measured. This rate was only apparent after more than 7 h continuous skin contact. These chlorinated paraffins were very poorly absorbed through human skin and human dermal exposure should not cause significant systemic levels.

Prediction of coronary artery disease in a population of insulin-requiring diabetic patients: results of an 8-year follow-up study

To identify predictors of clinical coronary artery disease, 110 insulin-requiring diabetic patients with no symptoms suggestive of cardiac disease and with a normal resting ECG underwent metabolic and noninvasive cardiovascular screening including a history and physical examination, exercise ECG, M-mode echocardiography, and chemical laboratory testing. During a median follow-up interval of 100 months, 14 of these patients had clinical evidence of coronary artery disease consisting of acute myocardial infarction, sudden cardiac death, or anginal chest pain with angiographic documentation of occlusive coronary artery disease. Baseline variables that were univariately predictive of subsequent clinical coronary disease included age, peak treadmill heart rate, and retinal neovascularization. According to multivariate analysis the peak treadmill heart rate was the single most important predictor of subsequent development of clinical coronary disease. A treadmill ECG result that was either abnormal or inconclusive because of failure to achieve 90% of predicted maximal heart rate identified each patient in whom clinical coronary artery disease developed within 50 months after entry testing. Thus the entry treadmill ECG provided prognostic information not available from the history and physical examination results, but little further prognostic information was provided after the first 50 months of follow-up, suggesting the need for serial testing.

The permeability of grafted human transplant skin in athymic mice

Human skin has been transplanted onto athymic mice and its permeability properties assessed to see if this in-vivo model would be of benefit in predicting accurately absorption of drugs or toxic chemicals through human skin. The permeability properties of the skin alone, and grafted and athymic mouse skin were assessed by measuring in-vitro absorption of tritiated water and a permanently charged cationic penetrant, paraquat. The grafted skin and athymic mouse skin had similar permeability to the tritiated water. However, the grafted skin was less permeable to paraquat but was more permeable to it than normal human skin, indicating that although histologically, the transplanted skin appeared normal, its barrier properties were impaired. The model was not, therefore, useful for assessing human percutaneous absorption.

In vitro absorption of some o-phthalate diesters through human and rat skin

The absorption of undiluted phthalate diesters [dimethyl phthalate (DMP), diethylphthalate (DEP), dibutyl phthalate (DBP) and di-(2-ethylhexyl)phthalate (DEHP)] has been measured in vitro through human and rat epidermal membranes. Epidermal membranes were set up in glass diffusion cells and their permeability to tritiated water measured to establish the integrity of the skin before the phthalate esters were applied to the epidermal surface. Absorption rates for each phthalate ester were determined and a second tritiated water permeability assessment made to quantify any irreversible alterations in barrier function due to contact with the esters. Rat skin was consistently more permeable to phthalate esters than the human skin. As the esters became more lipophilic and less hydrophilic, the rate of absorption was reduced. Contact with the esters caused little change in the barrier properties of human skin, but caused marked increases in the permeability to water of rat skin. Although differences were noted between species, the absolute rates of absorption measured indicate that the phthalate esters are slowly absorbed through both human and rat skin.

Comparison of the in vivo and in vitro percutaneous absorption of a lipophilic molecule (cypermethrin, a pyrethroid insecticide)

The absorption of a pyrethroid insecticide, cypermethrin, through rat skin has been measured both in vitro and in vivo. Cypermethrin did not penetrate in vitro through whole skin but did penetrate epidermal membranes. The in vitro absorption was influenced by the choice of receptor fluid in the glass diffusion cell. There was good agreement between in vivo and in vitro data using 50% aqueous ethanol, 6% Volpo 20, or total calf serum receptor fluids. Rat epidermal membranes in vitro were more than 20 times more permeable to cypermethrin than human epidermal membranes, indicating that cypermethrin would be less readily absorbed in humans than in the rat. The percutaneous absorption in vitro technique using epidermal membranes was successfully used with this lipophilic chemical to predict the in vivo absorption in the rat.

A model for quantifying absorption through abnormal skin

Techniques are available for quantitatively studying factors governing absorption through normal skin (in vivo and in vitro) but relatively little is known about the permeability of abnormal skin. We have designed and evaluated an in vivo model for quantifying absorption through abnormal skin. Absorption of [3H]mannitol and [14C]octyl benzoate was studied through altered rat skin. [3H]Mannitol penetrated normal skin much more slowly than did [14C]octyl benzoate. Abnormal skin was more permeable to [3H]mannitol and [14C]octyl benzoate, absorption was greater than 100X and greater than 2X greater, respectively, than normal. The in vivo model has been successfully used to quantify absorption through abnormal skin.

Permeability of abnormal rat skin

We have measured the permeability (to water in vivo and in vitro) and examined the histology of rat skin after mild, superficial epidermal alterations: scalpel blade (Cat I) and sandpaper abrasion (Cat II), adhesive tape stripping (Cat III), and suction blister top removal (Cat IV). After each alteration the permeability was increased (Cat IV greater than Cat III greater than Cat II greater than Cat I) and the epidermis regenerated in a distinct, biphasic manner, as indicated by the permeability and histology data. The rapid first phase corresponded with a decrease in permeability and the development of a scab (the greater the increased permeability, the slower the rate of regeneration). The second phase was more gradual (with a similar rate of regeneration after each alteration) and corresponded with a return to normal permeability and gradual thickening of the stratum corneum (return to normal corresponded with degree of initial stratum corneum removal). A similar, though slower biphasic regeneration has been reported to occur in human skin following similar types of alterations. It is concluded that abnormal rat skin is suitable for quantifying absorption through abnormal epidermis.

Absorption of some glycol ethers through human skin in vitro

To assist evaluation of the hazards of skin contact with selected undiluted glycol ethers, their absorption across isolated human abdominal epidermis was measured in vitro. Epidermal membranes were set up in glass diffusion cells and, following an initial determination of permeability to tritiated water, excess undiluted glycol ether was applied to the outer surface for 8 hr. The appearance of glycol ether in an aqueous "receptor" phase bathing the underside of the epidermis was quantified by a gas chromatographic technique. A final determination of tritiated water permeability was compared with initial values to establish any irreversible alterations in epidermal barrier function induced by contact with the glycol ethers. 2-methoxyethanol (EM) was most readily absorbed (mean steady rate 2.82 mg/cm2/hr), and a relatively high absorption rate (1.17 mg/cm2/hr) was also apparent for 1-methoxypropan-2-ol (PM). There was a trend of reducing absorption rate with increasing molecular weight or reducing volatility for monoethylene glycol ethers (EM, 2.82 mg/cm2/hr; 2-ethoxyethanol, EE, 0.796 mg/cm2/hr; 2-butoxyethanol, EB, 0.198 mg/cm2/hr) and also within the diethylene glycol series: 2-(2-methoxyethoxy) ethanol (DM, 0.206 mg/cm2/hr); 2-(2-ethoxyethoxy) ethanol (DE, 0.125 mg/cm2/hr) and 2-(2-butoxyethoxy) ethanol (DB, 0.035 mg/cm2/hr). The rate of absorption of 2-ethoxyethyl acetate (EEAc) was similar to that of the parent alcohol, EE. Absorption rates of diethylene glycol ethers were slower than their corresponding monoethylene glycol equivalents. Combination of intrinsic toxicity and ability to pass across skin contribute to assessment of hazards of contact with undiluted glycol ethers.

Effects of sodium intake on steady-state potassium excretion

The effects of changes in sodium intake on the steady-state relationship between plasma potassium concentration and potassium excretion were studied in 15 chronically adrenalectomized dogs. Throughout the experiments the dogs received aldosterone at a rate of 50 micrograms/day and methylprednisolone at 1 mg/day. The relationship between plasma potassium and steady-state potassium excretion was obtained by changing potassium intake from 10 to 30 to 100 meq/day, each level being maintained for 7-10 days. At the conclusion of each period at a given level of potassium intake, plasma potassium and excretion were measured and plotted, plasma potassium being the independent variable. Such a relationship was obtained while the dogs were on three different levels of sodium intake: 10, 100, and 200 meq/day. The curves from the data obtained at 100 and 200 meq/day sodium intake both were shifted to the left of the curve obtained at 10 meq/day (P less than 0.05), although the 100 and 200 meq/day curves were not different from each other. On the basis of these data one could predict that, at a plasma potassium concentration of 4.0 meq/liter, the animals would excrete potassium at a rate of 17 meq/day on a 10 meq/day sodium intake, 37 meq/day on a 100 meq/day sodium intake, and 47 meq/day on a 200 meq/day sodium intake. Urine flow and electrolyte concentration data are consistent with the hypothesis that the sodium intake effect on potassium excretion was mediated through increases in distal nephron flow rate and decreases in distal nephron potassium concentration.

Plasmapheresis-immunoadsorption for treatment of systemic lupus erythematosus in a dog

Systemic lupus erythematosus was diagnosed in a 3-year-old, male German Shepherd Dog. Clinical signs included lethargy, partial anorexia, fever, joint swelling, and skin and oral ulceration. The diagnosis was confirmed on the basis of an antinuclear antibody titer of 1:640 and immunofluorescence for immunoglobulin G at the dermal-epidermal junction in skin biopsy specimens. Treatment with prednisone and cyclophosphamide failed to induce remission. Intensive plasmapheresis-immunoadsorption, using purified Staphylococcus protein A in combination with low-dose prednisone therapy, resulted in sustained remission.

A comparison of techniques for the measurement of transepidermal water loss

An Evaporimeter and a ventilated chamber technique have been compared in their ability to measure transepidermal water loss (TEWL) through rat skin. These techniques measure TEWL under very different conditions; the Evaporimeter measures the net TEWL under ambient relative humidity (RH) whereas the ventilated chamber employs a constant atmosphere, usually of low RH and thus measured the uni-directional diffusion of water. Paired Evaporimeter and ventilated chamber measurements were made of TEWL through normal skin and through skin whose barrier properties had been altered by tape-stripping (15 applications) or single applications of n-hexadecane (28.4 mumol cm-2). Both measuring techniques indicated the same level of TEWL through normal skin (mean 0.3 mg cm-2 h-1) and during increases in TEWL induced by n-hexadecane (max TEWL c 3.5 mg cm-2 h-1). However, the Evaporimeter was found to underestimate the higher rates of TEWL induced by tape-stripping, ie above TEWL raters of 7.5 mg cm-2 h-1. The Evaporimeter is portable, easy to use and suitable for measurements of net water loss up to 7.5 mg cm-2 h-1; it can only be used for comparative assessment of epidermal barrier function if used at a particular ambient RH. The more cumbersome ventilated chamber is to be preferred for accurate assessments of barrier function where high rates of TEWL occur.

Lesch-Nyhan syndrome: rapid detection of heterozygotes by use of hair follicles

A method is described which permits rapid phenotypic diagnosis of the Lesch-Nyhan heterozygote by direct assay of hypoxanthine guanine phosphori-bosyltransferase activity in single hair follicles obtained from the scalp.

A critical appraisal of the electrocardiographic criteria for the diagnosis of left ventricular hypertrophy

Thirty-three different electrocardiographic criteria for left ventricular hypertrophy have been evaluated in 360 autopsied hearts utilizing a chamber dissection technic. One hundred and sixty hearts had left ventricular hypertrophy, and 200 hearts did not (146 of these were normal, and 54 had right ventricular hypertrophy).

The following five electrocardiographic criteria had a sensitivity of 56% but 10.5% to 14.5% false positives: S v1 or S v2 +R v5 ≥35 mm, S v1 +R v5 or R v6 >30 mm, S v1 , or S v2 + R v5 or R v6 >35 mm, S v2 +R v4 or R v5 >35 mm, R+S>40 mm. A point-score system employing a combination of criteria had a sensitivity of 54%, but lowered the false positives to 3%. The best limb-lead criterion was R aV L >7.5 which had a sensitivity of 22.5% with only 3.5% false positives. The following criteria had no false positives, but the highest sensitivity was 19%: S v1 ≥24 mm, R aV L >11 mm, R I +S III >25 mm, R I >13 mm, R aV L >12 mm, R I >15 mm, R aV L >13 mm, and S aV R >14 mm. Overall the precordial lead criteria were considerably more sensitive but less specific than the limb lead criteria. Since only six of the 200 hearts without left ventricular hypertrophy were in persons less than 30 years of age, this is not the major explanation for the high incidence of false positives in the more sensitive voltage criteria. The problems of using voltage criteria alone and the need for new criteria and approaches to the electrocardiographic diagnosis of left ventricular hypertrophy are discussed.

Observations on the assessment of cardiac hypertrophy utilizing a chamber partition technique

Three hundred fifty-four adult human hearts were dissected utilizing a technique similar to those previously described by Müller 1 and Lewis. 2 A classification was synthesized on the basis of anatomic characteristics of 100 normal hearts. Presumptive evidence of either left or right ventricular overload, provided by clinical and autopsy observation, served as essential corollary data in establishing normal limits. The existence of hypertrophy was readily recognized in hearts in which one or both ventricles increased in mass sufficiently to surpass the defined upper limit. Isolated ventricular hypertrophy of mild degree was recognized as a consequence of an abnormal LV+S/RV ratio in 58 hearts in which ventricular weights were within the normal range. Factors which would be expected to result in left or right ventricular overload were demonstrable in 42 of these cases. Atrial hypertrophy correlated well with hypertrophy of the corresponding ventricle and served as an invaluable aid in recognition of mild degrees of combined ventricular hypertrophy. This classification constitutes the basis for a subsequent correlative electrocardiographic study.