Effect of sodium bicarbonate and sodium bentonite on digestion, solid and liquid flow, and ruminal fermentation characteristics of forage sorghum silage-based diets fed to steers

Six ruminally cannulated steers, five Holsteins and one Hereford (250 to 295 kg), were fed 84% forage sorghum silage plus 16% supplement or 50% forage sorghum silage plus concentrate and supplement diets containing either no addition (controls), 1% sodium bicarbonate (NaHCO3) or 2% sodium bentonite in a 2 X 3 factorial arrangement of treatments in a 6 X 6 Latin-square experiment with 3-wk periods. Sodium bicarbonate increased dry matter (DM) intake when concentrate was included, but neither compound affected intake of the 84% silage diet. Bentonite lowered DM, neutral detergent fiber (NDF), and acid detergent fiber (ADF) digestibilities, but NDF disappearance from nylon bags was unchanged. Ruminal pH, osmolality and L(+) and D(-) lactate were not affected by treatment. Both NaHCO3 and bentonite tended to lower ruminal NH3-N concentrations. Bentonite lowered the molar proportion of isobutyrate in ruminal fluid relative to controls, but proportions of other volatile fatty acids (VFA) and total VFA concentrations were unchanged. Neither NaHCO3 nor bentonite affected ruminal liquid or solid volumes, dilution rate constants or ruminal outflow rates. Markers overestimated volumes, but correction with measured volumes did not change interpretation of treatment effects. It was concluded that control diets had sufficiently high baseline values of pH, dilution rate and acetate proportion to preclude changes induced by either compound, especially at 1 or 2% of DM intake. An effect on palatibility through neutralization of silage acids may have been responsible for the intake response to NaHCO3.

Intensive care for high-risk infants in Calcutta. Efficacy and cost

The efficacy and cost of implementing an intermediate level of newborn intensive care (INIC) was retrospectively evaluated over a four-year period in Calcutta to see if survival could be improved at low cost using indigenous human and material resources. The patient population (94.7% less than or equal to 2500 g) included all infants admitted to the facilities operated by the International Mission of Hope (India) Society. Survival was compared within 250-g increments in 1980 and 1981, when infants with major medical problems were hospitalized in outside facilities (mortality, 100%) and 1982 and 1983, when INIC was provided completely within the facility. Overall survival increased from 37.9% (n = 504) in 1980 and 1981 to 70.5% (n = 581) in 1982 and 1983. Infants weighing 1251 to 2000 g benefited greatly (34.4% [n = 279], 74.8% [n = 322]) from INIC. Survival of infants weighing 1250 g or less, although improved, remained low (5.6% [n = 89] to 23.1% [n = 108]). The average daily cost for the entire period of hospitalization was $7.75. These data indicate that survival in infants of low birth weight can be improved with INIC at modest cost using resources already available within the community. However, the application of this type of program must still be considered in relation to strategies designed to reduce the number of infants of low birth weight as well as to the long-term goals and available financial resources in non-industrialized countries.

Intrauterine aspiration of a large fetal ovarian cyst

Most large series of neonatal ovarian cysts are limited to those diagnosed in the newborn period. Eight cases of fetal ovarian cysts diagnosed prenatally by ultrasound have been reported, only one of which was aspirated in utero. Reported is the youngest fetus to undergo in utero aspiration of an ovarian cyst to reduce the risk of secondary pulmonary hypoplasia.

The effect of high dietary cation concentration on methanogenesis by steers fed diets with and without ionophores

Nine steers (300 to 350 kg body weight) were divided into three groups and received either no ionophore, monensin or lasalocid in a 70% cracked corn basal diet for the entire experiment. Within each group, a 3 X 3 Latin-square design was used to evaluate the effect of a high cation concentration added to the diets on in vivo methanogenesis. The three cation treatments consisted of NaCl or KCl addition (Na or K increased to 2.5% of diet dry matter) or no cation addition. Sodium addition decreased methane production in the monensin group 19% when compared with control (P less than .05). Sodium also tended to decrease methane in the lasalocid group (P less than .1) but had no effect on the no-ionophore group. There was no significant effect of K addition on methane production when compared to no added cation. However, K tended to increase methane in both the lasalocid and no-ionophore groups and decrease methane in the monensin group. Results of this experiment support in vitro evidence that cation levels may modulate ionophore effects on methane production.

Monotherapy for empiric treatment of fever in granulocytopenic cancer patients

Infection remains a major complication of severe granulocytopenia. The administration of empiric antibiotic therapy at the first sign of infection or fever has significantly reduced the sequelae of infection in such compromised patients. Yet, the appropriate composition of the empiric antibiotic regimen continues to be debated. Antibiotic combinations have been the standard approach; multiple studies have confirmed the importance of antibiotic combinations in patients who are profoundly granulocytopenic and have gram-negative rod bacteremia. The presence of a synergistic antibacterial effect and high serum bactericidal activity of the antimicrobial regimen improves the response rate in such severe infectious episodes. However, the occurrence of such infections at certain centers is declining, and the introduction of new, highly active, broad-spectrum beta-lactam antibiotics has raised the question of using a single agent, or monotherapy, as empiric treatment of febrile granulocytopenic cancer patients. Approximately 20 studies have been completed, and although these trials have demonstrated support for this approach, caution must be exercised because of the inconsistent study designs, wide range of response definitions, small patient numbers, and limited frequency of treated documented infections. Therefore, at present, a broad-spectrum antibiotic combination still remains the treatment of choice for empiric therapy of febrile granulocytopenic cancer patients. Carefully designed, prospective, randomized, double-blind trials investigating new approaches, such as monotherapy, must continue.

Efficacy of single-agent therapy with azlocillin, ticarcillin, and amikacin and beta-lactam/amikacin combinations for treatment of Pseudomonas aeruginosa bacteremia in granulocytopenic rats

The efficacy of azlocillin, ticarcillin, and amikacin as single agents and the penicillin/amikacin combinations for treatment of Pseudomonas aeruginosa bacteremia during cyclophosphamide-induced severe neutropenia in a rat model were assessed. Equivalent antibiotic dosing was based on the time rat serum antibiotic levels were above the minimal bactericidal concentration for the challenge organism. Antibiotic therapy was administered for 62 hours after bacterial challenge. Antimicrobial efficacy was based on the rate of bacteremia, the emergence of resistant organisms during therapy, life-table survival analysis, and rat survival seventy-two hours after bacterial challenge. For infection with a P. aeruginosa strain susceptible to all study antibiotics, therapy with azlocillin and ticarcillin (given so as to be equipotent) were equivalent, as judged by bacteremia rates or rat survival. However, combination therapy prevented the emergence of organisms resistant to azlocillin, but not to ticarcillin. Amikacin-containing combinations were more effective than single-agent regimens.

Hydrops fetalis and chromosomal trisomies

Three patients with trisomy 21 and one with trisomy 13 associated with nonimmunologic hydrops fetalis are presented. Analysis of previous nonimmunologic hydrops fetalis, which included chromosomal trisomies, and the present study yields an overall incidence of 7% for chromosomal trisomy disorders in live-born infants with nonimmunologic hydrops fetalis. Our data emphasize the need for chromosomal analysis of neonates with nonimmunologic hydrops fetalis.

Tumor size: effect on monoclonal antibody uptake in tumor models

Studies were performed to determine the effect of tumor size on the incorporation of radiolabeled monoclonal antitumor antibodies (MoAbs) into human tumors growing in nude mice. The colon tumors ranged in size from 0.03-1.6 g, the melanoma from 0.1 to 6.7 g, and the lymphoma from 0.06 to 10.2 g. Indium-111 was primarily used as the radiolabel, however, both 125I and 111In were used as tracers for the MoAb in one experiment. The per g radiopharmaceutical uptake by tumors was inversely proportional to tumor size when tumor specific MoAb was administered. This finding was independent of the radiolabel and was demonstrable when the mice bore two tumors of differing size. When the MoAb was not specific for the tumor, the data were less well defined and a statistically significant correlation with size did not occur. These data are strong evidence for a decrease in per g uptake of labeled tumor specific antibodies as tumors increase in size.

Immune interferon modulation of in vitro murine anti-human T cell monoclonal antibody-mediated cytotoxicity

Limited antitumor effects have been achieved in clinical trials with murine monoclonal antibody T101, perhaps because of its limited ability to effect complement-mediated or cell-mediated cytotoxicity. We explored the effects of recombinant immune interferon on T101-mediated cytotoxicity in vitro. Interferon failed to enhance expression of the antigen detected by T101 on target cells, but it did increase Fc receptor binding of T101 and other IgG2A and IgG3 murine proteins, but not IgG1 or IgG2B. Preincubation of U937, HL60, and human mononuclear cells with 100 U of immune interferon for 48 hr, while T101 was preincubated with various T cell line targets or human CLL cells at 4 degrees C for 30 min before combining effectors and targets for 4 hr at 37 degrees C, resulted in cytotoxicity of 18 to 44% of maximum. Cytotoxicity in the absence of interferon or T101 was less than 5%. Unfortunately, rapid modulation of antigen-antibody when T101 was preincubated with targets at 37 degrees C prevented any increase in cytotoxicity under those conditions. We conclude that immune interferon can augment T101-mediated cytotoxicity in vitro, but it is unlikely that it would enhance T101-mediated cytotoxicity via complement or cell-mediated mechanisms in vivo.

Immune interferon modulation of in vitro murine anti-human T cell monoclonal antibody-mediated cytotoxicity

Limited antitumor effects have been achieved in clinical trials with murine monoclonal antibody T101, perhaps because of its limited ability to effect complement-mediated or cell-mediated cytotoxicity. We explored the effects of recombinant immune interferon on T101-mediated cytotoxicity in vitro. Interferon failed to enhance expression of the antigen detected by T101 on target cells, but it did increase Fc receptor binding of T101 and other IgG2A and IgG3 murine proteins, but not IgG1 or IgG2B. Preincubation of U937, HL60, and human mononuclear cells with 100 U of immune interferon for 48 hr, while T101 was preincubated with various T cell line targets or human CLL cells at 4 degrees C for 30 min before combining effectors and targets for 4 hr at 37 degrees C, resulted in cytotoxicity of 18 to 44% of maximum. Cytotoxicity in the absence of interferon or T101 was less than 5%. Unfortunately, rapid modulation of antigen-antibody when T101 was preincubated with targets at 37 degrees C prevented any increase in cytotoxicity under those conditions. We conclude that immune interferon can augment T101-mediated cytotoxicity in vitro, but it is unlikely that it would enhance T101-mediated cytotoxicity via complement or cell-mediated mechanisms in vivo.

Retrovesical leiomyoma

Primary tumors arising in the retrovesical area are rare. We recently treated by primary excision a large retrovesical leiomyoma in a forty-five-year-old man. The smooth muscle nature of the tumor was confirmed by electron microscopy. Recognizing this entity is important, since treatment consists only of surgical removal, and the prognosis should be excellent.

Comparative activities of piperacillin, ceftazidime, and amikacin, alone and in all possible combinations, against experimental Pseudomonas aeruginosa infections in neutropenic rats

This study compared the efficacy of therapy with the double beta-lactam combination of ceftazidime plus piperacillin with that of single-agent therapy with ceftazidime, piperacillin, or amikacin alone and with that of two aminoglycoside-beta-lactam combinations against Pseudomonas aeruginosa peritonitis and bacteremia in neutropenic rats. Rats made severely granulocytopenic with cyclophosphamide became bacteremic secondary to peritonitis which was induced by intraperitoneal challenge with P. aeruginosa. Antibiotic therapy with single agents (amikacin, 20 mg/kg of body weight, intramuscularly; ceftazidime, 20 mg/kg of body weight, subcutaneously; piperacillin, 200 mg/kg of body weight, intramuscularly) or with the various combinations of agents was begun 2 h after bacterial challenge and was continued every 6 to 8 h for 62 h. Therapeutic efficacy was judged on the basis of survival 72 h after bacterial challenge, rate of mortality, incidence of bacteremia, and the emergence of resistant organisms. Based on these criteria, therapy with the double beta-lactam combination had no advantage over single-agent therapy and was in all cases clearly inferior to beta-lactam-aminoglycoside combinations.

Primary chemotherapy followed by a selective retroperitoneal lymphadenectomy in the management of clinical stage II testicular carcinoma: a preliminary report

In 28 patients with primary clinical stage II testicular carcinoma (retroperitoneal mass of less than 10 cm. in diameter) or persistently elevated levels of serum biomarkers after orchiectomy primary chemotherapy was administered followed by selective lymphadenectomy for patients with a persistent retroperitoneal mass. Of the patients 21 were treated with cyclophosphamide, doxorubicin, cisplatin/vinblastine and bleomycin, and 7 who were not candidates for this regimen received less aggressive chemotherapy. All 28 patients were free of disease after a mean followup of 93.6 weeks and a median of 89 weeks (range 28 to 199.5 weeks). No patient who achieved complete remission has had relapse. Of the 28 patients 1 had a seminoma and an elevated alpha-fetoprotein level, 15 had embryonal carcinoma (Dixon-Moore category II) and 12 had teratocarcinomas (Dixon-Moore category IV). Only 1 of the 15 patients with embryonal carcinoma required surgical exploration for a persistent radiographic abnormality, whereas 6 of the 12 patients with Dixon-Moore category IV tumors required surgical exploration (p less than 0.0147). This delayed approach did not increase surgical complications. Our experience with primary chemotherapy followed by selective lymphadenectomy for stage II testicular carcinoma resulted in universal survival. Only 8 of the 28 patients (29 per cent) required lymphadenectomy.

Ileal conduit calculi from stapler anastomosis: a long-term complication?

A long-term review of 24 patients in whom ileal conduit diversions were constructed using surgical staples has shown calculi developing as a result of the staples in only 1 patient (4.2%). Experience suggests that calculi usually form within fourteen months of surgery, pass spontaneously, and produce minimal symptoms.

Athymic mouse model of a human T-cell tumor

Because of the large number of different immunoconjugates which can be produced from monoclonal antibody-directed anti-cancer therapy, it would be useful to have in vivo tumor models to compare such preparations. Although historically human leukemias-lymphomas have been difficult to establish in athymic mice we have succeeded in establishing human T-cell tumors from primary MOLT-4 cultures in 290 of 353 animals and have successfully transferred tumors in 42 of 45 animals during ten serial passages. The potential utility of this model for testing immunoconjugates of murine monoclonal antibody T101 have been confirmed by: (a) in all 148 tumors sampled including all passaged tumors the human T-cell antigen, T65, was expressed in a manner identical to that of cultured cells; (b) 111In-T101 was concentrated preferentially in the tumor; and (c) T101 injected by both the i.p. and i.v. routes bound to tumor and induced antigenic modulation to the same extent as that observed previously in vitro and in human studies.

Relation between frequency selectivity and speech perception following glycerol-induced cochlear changes

Changes in auditory threshold, psychophysical tuning curves, and speech perception (in both quiet and noise) were monitored over a 3-hr period following the ingestion of glycerol. All listeners had sensorineural hearing loss secondary to Menière's disease. Findings were characterized by large intersubject variability and in general did not show a clear relation between changes in threshold, frequency resolution, and speech perception.

Value of routine radionuclide bone scans in renal cell carcinoma

Radionuclide bone scans were obtained as part of the routine evaluation of 85 patients with renal cell carcinoma. Twenty-nine patients (34%) were found to have metastatic disease at presentation. Bone scans were abnormal in 27 of these 29 patients for a sensitivity of 93 per cent; of the remaining 56 without metastatic disease, 48 had normal bone scans for a specificity of 86 per cent. In all patients whose abnormal bone scans indicated metastatic disease, there were either clinical signs (bone pain), laboratory findings (elevated alkaline phosphatase), or routine radiographic procedures (chest roentgenogram, intravenous pyelogram, or angiogram) suggesting disease metastatic to bone. Although bone scanning was useful for confirming clinically or radiographically suspected metastatic disease, it did not influence the staging of the renal cell carcinoma in any patient. We therefore conclude that bone scans should be used to confirm the presence and to determine the extent of osseous metastases in patients with renal cell carcinoma but are unnecessary as a routine staging procedure.