Influence of postpartum weight and body condition change on duration of anestrus by undernourished suckled beef heifers

Two experiments were conducted to determine the relationship between change in weight and body condition on postpartum interval of thin first-calf beef heifers. Twenty-nine (Exp. I) and 36 (Exp. II) Angus and Angus-sired crossbred heifers were limit-fed to reduce their condition score (BCS) to 4 (scale of 1 to 9) at calving. After calving, heifers were assigned to one of four daily ME intakes (range of 198 to 305 kcal ME/kg BW.75) designed to create a range of BCS changes. Each unit change in BCS was associated (R2 = .72; P < .0001) with a 33-kg weight change. Mean postpartum interval (PPI) from calving to initiation of luteal activity was 121 +/- 6.0 d. As dietary energy density increased, PPI decreased (P < .01). Condition score at calving (CCS) accounted for a greater proportion of the variation (R2 = .37) associated with PPI than did condition score change from calving to d 90 postpartum (CSCH90; R2 = .27) or weight change from calving to d 90 postpartum (WTCH90; R2 = .17). The "best fit" equation (R2 = .56) for predicting PPI included CCS and CSCH90: PPI = 244.5 - 28.28(CCS) - 23.07(CSCH90) + 6.36(CSCH90(2)). Maximum reduction in PPI occurred when heifers gained 1.8 units of BCS during the first 90 d of lactation. Gaining BCS at a faster rate was of no additional benefit.

Intravascular contrast media: can we justify the continued use of ionic contrast agents?

Cost has been the major factor preventing the universal conversion to non-ionic contrast agents. We assessed the costs and potential benefits of making this change in our department. During a 10-month-period the use of all intravascular contrast agents and reaction rates were audited prospectively. One thousand three hundred and ninety-four examinations were included. A local protocol for the use of ionic and non-ionic contrast media was already in place, based on the Royal College of Radiologists Guidelines. For each patient the contrast agent used, risk factors, and presence or absence of a contrast reaction were recorded. Non-ionic contrast agent usage exceeded ionic by a factor of 10. Patients receiving ionic agents intravenously had a reaction rate of 16.8% compared with 2.7% for non-ionic contrast media. The use of ionic contrast media was subsequently suspended and the effect of this on overall costs assessed by retrospectively and prospectively analysing hospital expenditure on contrast agents. No increase in costs was found. The reasons for this are two-fold. Firstly in our institution the protocol in place and the nature of the workload resulted in relatively small volumes of ionic contrast media being used compared with non-ionic agents. Secondly, since our department is a bulk purchaser of non-ionic agents, substantial discounts could be negotiated. The benefits of non-ionic contrast media are well recognized and our experience suggests that cost may no longer be a barrier to conversion to these lower risk agents.

Effect of a cancer screening intervention conducted by lay health workers among inner-city women

INTRODUCTION

We conducted a randomized controlled trial to determine if an in-home educational intervention conducted by lay health workers (LHWs) could increase adherence among low-income, inner-city, African-American women to breast and cervical cancer screening schedules.

METHODS

We recruited 321 African-American women from diverse inner-city sources. After baseline interviews, they were randomly assigned to either the intervention (n = 163) or the control (n = 158) group. Those in the intervention group were visited in their homes up to three times by LHWs who provided a culturally sensitive educational program that emphasized the need for screening.

RESULTS

Ninety-three (93) women in the intervention group and 102 in the control group completed the postintervention interview. For Pap smears, the increase in screening was similar in both groups. For clinical breast exams (CBEs), however, there was a modest increase in the intervention group. The improvement was greatest for mammography, for which there was a 10% to 12% increase. Among women who were not on recommended schedules at baseline, the improvement was substantial and greater in the intervention group.

CONCLUSIONS

LHWs' intervention appeared to improve the rate at which inner-city women obtained CBEs and mammograms, but had no effect on Pap smears. A high attrition rate weakened our ability to make conclusive statements about the exact impact of the intervention.

[Myositis caused by Pleistophora in a patient with AIDS]

The third case in the literature is reported of an infection produced by Pleistophora. The clinical detail of the three cases are discussed. Two of the patients-including the reported one-were infected by HIV. All patients suffered from myositis with fever, resting and at palpation myalgia, and progressive weakness. Blood tests showed anaemia and high levels of muscle enzymes. Necrotic muscle fibrosis induced disabling contractures. Diagnosis was obtained by detecting the protozoon in a muscle biopsy. The spores may be detectable by means of different staining methods at light microscopy although electron microscopy remains the most reliable technique. Since this is such a rare condition there is no known treatment. Whether the albendazole could be as useful as occurs in patients infected by other genera of microsporidia in still uncertain.

The effect of postruminal amino acid flow on muscle cell proliferation and protein turnover

An experiment was conducted to characterize the effects of postruminal administration of casein, glutamine, cornstarch, and water on protein turnover and in vitro muscle cell proliferation. Four MARC III steers (205 kg) were fed a protein-restricted bromegrass hay-based diet (2.86 Mcal of DE/kg and 13.6 g of N/kg). Using a 4 x 5 Latin square arrangement balanced for residual effects, casein and glutamine, equal to 50% of basal dietary nitrogen intake, cornstarch, isocaloric with casein infusion, or an equal volume of water was continuously infused into the abomasum of steers. Blood samples, collected every 2 h for 24 h after 7 d of infusion, were tested for the effect on cell cycle kinetics and myotube protein turnover. Urine and feces were also collected for 4 d after blood sampling for nitrogen balance and fractional skeletal muscle degradation. The mitogenic activity and ability of serum to influence rate of myoblast proliferation in a dose-dependent manner was influenced (P < .05) by infusate: casein > cornstarch > glutamine = water. Abomasal infusion of casein and cornstarch increased (P < .05) in vitro muscle protein synthesis and decreased (P < .05) in vitro muscle protein degradation, whereas abomasal glutamine infusion only increased (P < .05) in vitro muscle protein synthesis. Abomasal glutamine infusion decreased (P < .05) fractional skeletal muscle protein degradation and synthesis; however, fractional muscle protein accretion tended to increase due to a greater decline in fractional muscle protein degradation. In contrast, abomasal casein infusion increased (P < .05) fractional skeletal muscle protein synthesis, breakdown, and accretion. These results suggest that muscle hypertrophy may be regulated by serum constituents whose activity is affected by postruminal amino acid flow.

ACP Broadsheet no 148. July 1996. Laboratory diagnosis of malaria

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The differentiation of snoring mechanisms using sound analysis

Ten subjects known to suffer from heavy snoring but not obstructive sleep apnoea were studied using the technique of sleep nasendoscopy. The mechanism of snoring was noted for each and sound recordings of the snoring noise were made. Six subjects were observed to snore using their soft palate only, three snored using only their tongue base and one snored using a combination of palate and tongue base. The sound recordings were subjected to computer analysis of waveform and frequency. Palatal flutter snoring and tongue base snoring appear to have distinct waveform and frequency patterns which allows them to be differentiated from each other.

Effects of feeding wash-water solids on health and performance of ewes and lambs

Diets containing 0, 10, or 20% dried wash-water solids (WWS) from a milk processing plant were fed to 48 Hampshire crossbred wews (average weight 58.1 kg) for 3 yr. Data were obtained on BW gains, hematology, tissue elements, and survival for ewes and BW gains, tissue elements and survival for their lambs. Ewes fed 20% WWS gained less (P < .05 ) BW during gestation and lactation in yr 1 and had lower BW (P < .05) in yr 2 and 3 than those fed 0 or 10% WWS. Lambs from ewes fed 20% WWS gained less (P < .05) BW in yr 2 and 3. Hematology variables of ewes, survival of ewes and survival of lambs were not effected by diet. Although WWS-containing diets contained high concentrations of Ca, P, Mn, and Fe and moderate concentrations of Mo, Mg, and Zn, diets had few effects on tissue elements in ewes and lambs. Concentrations of some tissue elements were less (P < .05) in lambs in yr 2 and 3 than in yr 1. Wash-water solids can be incorporated into ruminant diets, providing a disposal alternative that recycles and conserves nutrients. Long-term feeding posed only minor or negligible health of safety problems. Because fo low energy and N availability and high ash content, WWS probably should be limited to 10% or less of conventional diets.

Oxygen transport and cardiovascular effects of resuscitation from severe hemorrhagic shock using hemoglobin solutions

OBJECTIVE

To test the short-term efficacy of three hemoglobin solutions in restoring cardiac output, intravascular pressures, oxygen transport (DO2), and oxygen consumption (VO2) after resuscitation from severe hemorrhagic shock.

DESIGN

Prospective study.

SETTING

Research laboratory.

SUBJECTS

Beagle dogs.

INTERVENTIONS

After anesthesia and instrumentation, hemorrhagic shock was induced for 2 hrs by blood withdrawal to maintain systolic blood pressure at 50 mm Hg. Resuscitation then occurred with one of four different resuscitation fluids. One group of dogs was not resuscitated. Survival rate was monitored for 8 days.

MEASUREMENTS AND MAIN RESULTS

In 33 beagle dogs, cardiovascular variables (DO2 and VO2) were compared after resuscitation with 8% stroma-free hemoglobin, 4% or 8% pyridoxalated-hemoglobin-polyoxyethylene conjugate (PHP44 and PHP88, respectively), or autologous whole blood. The dogs were anesthetized, paralyzed, mechanically ventilated (FIO2 of 0.21), and instrumented with arterial and pulmonary artery catheters. An average of 63% of estimated blood volume was removed to maintain systolic blood pressure at 50 mm Hg for 2 hrs. The dogs then were either not resuscitated (n = 4) or resuscitated with 8% stroma-free hemoglobin (n = 7), PHP44 (n = 6), PHP88 (n = 8), or whole blood (n = 8), with a volume equivalent to the withdrawn blood. Cardiovascular variables, DO2, VO2, oxygen extraction ratios, and blood concentrations of lactic acid and catecholamines were determined before, and for < or = 6 hrs after, resuscitation from hemorrhagic shock. Blood smears were microscopically examined. In addition, the survival rate was monitored for 8 days after resuscitation. By 2 hrs of hemorrhagic shock, there was a large decrease in DO2 (p < .05) and an increase in oxygen extraction ratio from 0.27 to 0.70 (p < .05). There was a 3.5-fold increase in lactate concentrations and a 25-fold increase in catecholamine concentrations as compared with preshock values. All dogs not resuscitated died within 1.75 hrs after 2 hrs of shock. After resuscitation with whole blood, all cardiovascular and oxygen transport variables returned to approximately prehemorrhage values and remained so throughout the measurement period. After resuscitation with any hemoglobin solution, DO2 returned transiently to control values. However, recovery of DO2 was short-lived in all hemoglobin solution groups, and, by 4 hrs postresuscitation in all groups, DO2 was less than the DO2 of the dogs receiving whole blood (p < .05). These changes were associated with decreases in total hemoglobin concentrations compared with the values immediately before resuscitation (p < .05). In addition, with resuscitation using the PHP solutions, blood smears demonstrated aggregation of red blood cells and platelets. On day 8 after hemorrhagic shock, the survival rate was 100% for whole blood and PHP44, 86% for 8% stroma-free hemoglobin, and 33% for PHP88.

CONCLUSIONS

Resuscitation from severe hemorrhagic shock with 8% stroma-free hemoglobin, PHP44, or PHP88 is equally effective in restoring cardiac index and vascular pressures as using whole blood. However, resuscitation with the three hemoglobin solutions only transiently restored DO2 after hemorrhagic shock. The subsequent reduction of DO2 compared with the DO2 value using whole blood was due mostly to hemodilution. With the two PHP solutions, formation of red blood cell aggregates probably resulted in sequestration of red cell mass and additional loss of oxygen carrying capacity.

A 'Big Five' Scoring System for the Item Pool of the Adjective Check List

The item pool of the Adjective Check List (ACL; Gough & Heilbrun, 1980) is widely used as a means of capturing the personal characteristics associated with various target groups (e.g., women vs. men, young adults vs. old adults). The purpose of this research was to develop a system for scoring the ACL items in terms of the five-factor model of personality. In Study 1, five groups of introductory psychology students served as judges, with each group of approximately 100 persons rating the 300 ACL items for one of the five factors. The ratings of each factor were highly reliable. When corrected for favorability, the intercorrelations among the five factors were quite low, as expected, except for the positive correlation of Openness and Extraversion. Good convergence was found between our ratings and the indicative and counterindicative items identified by John's (1989) graduate student judges. In Study 2, convergent validity was demonstrated between the five-factor scores obtained from self-descriptive ACLs and corresponding factor scores obtained from Costa and McCrae's NEO-PI-R and NEO-FFI instruments (Costa & McCrae, 1992). Data from earlier cross-cultural studies of gender and age stereotypes were rescored using the new ACL-FF system to illustrate its potential utility as a research tool.

Parametric analysis of the effects of cocaine and cocaine pretreatment on dopamine release in the nucleus accumbens measured by fast cyclic voltammetry

Fast cyclic voltammetry was used to measure dopamine (DA) release in the nucleus accumbens of anaesthetized rats, in response to electrical sine-wave stimulation of the ventral tegmental area. Voltammetric signals followed increases in either frequency (50-100 Hz), intensity (50-100 microA) or duration (0.5-5.0 s) of the stimulus. Cocaine administration (10 mg/kg) preferentially increased DA release by weak electrical stimuli. Cocaine pretreatment (3 x 10 mg/kg, two weeks earlier) preferentially increased DA release by stronger stimuli, and the effects of acute cocaine were potentiated in these animals. The effects of increasing stimulus duration conformed to first order kinetics. Cocaine pretreatment selectively increased the kinetic parameter representing maximal release, while acute cocaine administration preferentially decreased the parameter representing the stimulus duration eliciting half maximal release. The lack of statistical interaction between these two effects suggests that sensitization of the response to acute cocaine by cocaine pretreatment may simply reflect an increase in the size of the releasable pool of DA.

Health behavior segmentation and campaign planning to reduce cardiovascular disease risk among Hispanics

Using the social marketing principle of audience segmentation, a Hispanic audience was disaggregated to examine heterogeneous behaviors and lifestyles that could guide planning for public information campaigns designed to reduce cardiovascular disease (CVD) risk. Signal detection analysis resulted in six mutually exclusive subgroups, based on self-reported behavioral changes to improve health. Subgroups differed significantly in communication, behavioral, psychological, and demographic dimensions, indicating they may require unique campaign planning strategies. To determine whether subgroups were meaningful relative to external health-related criteria, they were compared as to health knowledge and status on cardiovascular disease risk factors. The results showed significant differences among audience subgroups in plasma high-density lipoprotein levels and hypertensive status. Results are discussed in terms of their implications for campaign planning and the need for public health campaigns to diversify strategies when targeting Hispanic audiences.

Biomechanics of snoring

A large proportion of the population either snores or suffers the snoring of others. Recent advances with the use of fibre-optic endoscopes have enabled surgeons to observe the inside of the pharynx while a patient is asleep and snoring. In this article we look at the underlying structure of the upper airway and explain, with the use of simple mechanical models, the aerodynamic events occurring inside the upper airway during snoring.

Effect of injectate temperature and thermistor position on reproducibility of thermodilution cardiac output determinations

STUDY OBJECTIVE

The purpose of this study was to evaluate the effect of thermistor position with varying injectate temperatures on the reproducibility of thermodilution cardiac output determination. The key hypothesis to be tested was that the positioning of the proximal thermistor at the right atrial port would improve the reproducibility of thermodilution cardiac output determination, independent of injectate temperature.

DESIGN

Prospective randomized trial.

SETTING

The study was performed in the cardiac catheterization laboratory of the West Haven Veterans Affairs Medical Center.

PARTICIPANTS

Twenty consecutive patients undergoing right and left heart catheterizations were enrolled in the study.

INTERVENTIONS

Each patient underwent triplicate determination of thermodilution cardiac output measurements under four experimental conditions: (1) ambient or room temperature injectate using an external thermistor in the injectate reservoir; (2) iced injectate using an external thermistor; (3) room temperature injectate using an internal right atrium (RA) thermistor; and (4) iced injectate using an RA thermistor. Reproducibility was assessed by the coefficient of variation (CV) and standard error of the mean percent (SEM%), of the triplicate measurements.

MEASUREMENTS AND RESULTS

Using an internal RA thermistor improved the reproducibility of cardiac output determinations independent of injectate temperature. Using room temperature injectate, the CV was 12.8 percent using an external thermistor and 7.9 percent using an internal RA thermistor (p < 0.05). Using iced injectate, the CV was 10.2 percent using an external thermistor and 5.5 percent using an internal RA thermistor (p < 0.05).

CONCLUSIONS

Reproducibility of thermodilution cardiac output determinations is improved when injectate temperature is measured internally, at the RA, as opposed to externally in the reservoir. This has clinical implications for determining significant changes in serial cardiac output determinations.

Randomized controlled trial of the effect of the Royal College of Radiologists' guidelines on general practitioners' referrals for radiographic examination

BACKGROUND

The Royal College of Radiologists' guidelines aim to encourage more appropriate use of diagnostic radiology and so reduce the use of clinically unhelpful x-ray examinations.

AIM

The object of this study was to conduct a randomized controlled trial of the introduction of the guidelines into general practice.

METHOD

A total of 62 practices (170 general practitioners) referring patients to St George's Hospital, London for diagnostic radiology were randomly allocated into two groups. Guidelines were sent to the 30 practices in the intervention group. Radiological referral patterns were compared in both groups before and after the introduction of guidelines.

RESULTS

Practices which had received guidelines requested significantly fewer examinations of the spine, and made a significantly higher proportion of requests which conformed to the guidelines compared with practices which had not received the guidelines. There were no significant differences in the proportion of forms giving physical findings or in the proportion of positive findings at radiology.

CONCLUSION

Introduction of guidelines can influence general practitioners' radiological referrals in the short term. Wider use of guidelines might help to reduce unnecessary irradiation of patients.

Clozapine attenuates the discriminative stimulus properties of (-)-nicotine

Rats were trained to discriminate 1.9 mumol/kg (-)-nicotine (0.3 mg/kg) from saline in a standard two-bar operant conditioning paradigm with food reinforcement. The effect of neuronal nicotinic acetylcholine receptor (nAChR) agonists and antagonists were verified, and the participation of dopaminergic receptors subtypes in the expression of the (-)-nicotine cue was investigated with cis-flupentixol (D1-D2 antagonist), haloperidol (D2 antagonist) and clozapine (D4 antagonist). The stereoselectivity of the behavioral response was indicated by the 10-fold less sensitivity to (+)-nicotine in (-)-nicotine-trained rats. (+/-)-Anabasine and (-)-cytisine exhibited partial agonist profiles at the 1.9 mumol/kg dose while (-)-lobeline was devoid of any effect in doses up to 19 mumol/kg. (-)-Lobeline did not show antagonist properties in this paradigm. The nicotinic channel blockers mecamylamine, chlorisondamine and hexamethonium were inactive on their own but mecamylamine and chlorisondamine were able to block the effect of (-)-nicotine. Clozapine attenuated the (-)-nicotine cue while cis-flupentixol and haloperidol were ineffective. Similar doses of cis-flupentixol significantly blocked the locomotor stimulant effect of (-)-nicotine in rats indicating that blockade of dopaminergic receptors was achieved at the doses used in the drug discrimination studies. These data suggest that the discriminative stimulus properties of (-)-nicotine are mediated through neuronal nAChRs and involves the activation of dopaminergic receptors of the D4 subtype.

The implementation of a quality management system in a department of diagnostic radiology

The quality management systems of the Departments of Diagnostic Radiology of St George's Hospital, London, and Bristol Royal Infirmary (BRI) have been certified with the British Standard 5750. These were the first clinical departments in the UK to be certified to this internationally recognized quality assurance (QA) standard. Quality is a much used term; in this context it is defined as 'fitness for purpose', and quality assurance is the mechanism by which quality is achieved. The paper describes the features of the quality system which have been implemented at St George's Hospital, and how a management concept for manufacturing industries has been adapted successfully to a National Health Service Department. The paper also demonstrates how the quality system has led to the setting and achieving of departmental objectives.

Continence in patients with spina bifida: long term results

One hundred and forty four questionnaires relating to bladder and bowel control were sent to a random selection of patients with spina bifida throughout the United Kingdom. One hundred and seventeen questionnaires were returned, of which 109 were usable. Twenty eight out of 109 responders had undergone some form of urinary diversion, of whom 20 (71%) were reliably dry. The remaining 81 responders emptied their bladders by a variety of techniques including normal voiding, straining, expression, clean intermittent catheterisation, indwelling catheters, or they dribbled urine continuously. Only 31 (38%) of this group were reliably dry. Ninety four of 109 (86%) responders regularly sat on the toilet to evacuate their bowels and most used some aid such as manual evacuation, laxatives, suppositories, or enemas. Fifty five of 104 (53%) responders soiled regularly, 31 (56%) of whom were also wet. Forty seven per cent of dry patients (24/51) were faecally incontinent. Only 25 of 104 (24%) patients responding to all questions were reliably clean and dry.

Development of pulmonary infection in mice inoculated with Blastomyces dermatitidis conidia

Intratracheal injection of Balb/cByJ mice with 10(4) Blastomyces dermatitidis conida produces chronic pulmonary and disseminated blastomycosis characterized by pyogranulomatous inflammation. To study the evolution of the pulmonary infection, mice were killed at varying intervals after inoculation, their lungs cultured and examined histologically. Nodular intraalveolar infiltrates of macrophages (M phi) were seen on Day 1 with occasional admixed polymorphonuclear leukocytes (PMN). Phagocytized yeast forms within M phi were evident by Day 5. By Day 28 pyogranulomas, which developed first as central microabscesses associated with a peripheral zone of M phi and giant cells containing internalized yeast, were a prominent feature of the infection. Lymphocytic and plasmacytic infiltrates, accumulating next to granulomas, formed the major peripheral component of the granuloma by Day 35. Formation of pyogranulomas was coincident with the host's failure to contain fungal growth measured by the sharp rise in colony-forming units recovered from lungs. Antibody against B. dermatitidis was first detected at Day 35 by enzyme immunoassay, but not until Day 63 by double immunodiffusion. During the 4 wk after inoculation, pulmonary lavage fluid contained > 90% M phi and < 3% PMN. On day 28, PMN rose to 17%, reaching 40% on Day 42. These data contribute to our knowledge of this model and help form the basis for investigations into the roles of fungal pathogenic and host defense mechanisms in blastomycosis.

Abomasal casein infusion enhances the mitogenic activity of serum from protein-restricted steers

Holstein steers fed protein-restricted diets were used to evaluate protein realimentation and site of serum collection on the ability of calf serum to affect proliferation, protein synthesis and degradation in L6 myoblast cell culture bioassay. In Experiment 1, five steers (average weight 227 kg) received continuous abomasal infusion of 4 L of water or casein (50% of basal dietary nitrogen intake) in a switchback design. Serum was collected 2 d before and after 1, 3, 5, 7 and 9 d of infusion. Abomasal casein infusion increased serum mitogenic activity, nitrogen retention (119%) and total post-ruminal amino acid flow (78%). In Experiment 2, serum was collected from the jugular and femoral veins and the carotid artery before and after 7 d of abomasal casein infusion. Serum from calves abomasally infused with casein increased myoblast proliferation (jugular > femoral > carotid) and protein synthesis and decreased protein degradation in cultured myotubes. The addition of test calf serum inhibited the mitogenic activity of control calf serum. Results suggest that post-ruminal amino acid flow and site of serum collection alter the ability of serum to influence cell culture bioassays.

Plasma growth hormone, insulin-like growth factor, insulin, and thyroid hormone association with body protein and fat accretion in steers undergoing compensatory gain after dietary energy restriction

Eighteen Chianina crossbred steers were used to examine the interrelationship between hormonal status and empty body protein (EBPRT) and fat (EBFAT) accretion during an 88-d controlled realimentation (REAL; DMI was adjusted weekly on an individual BW basis) period. Body composition was determined by monitoring endogenous whole-body 40[K]. At the end of restriction (REST) and on d 31 and 59 of REAL blood samples were taken and analyzed for concentrations of growth hormone (GH), IGF-I, IGF-II, insulin (INS), thyroxine (T4), triiodothyronine (T3), reverse triiodothyronine (rT3), nonesterified fatty acids (NEFA), glucose, and urea nitrogen. Depositions of EBPRT and EBFAT were decreased (P < .001) in REST (92 d) animals compared with nonrestricted (NR) controls. During REST, plasma levels of glucose, IGF-I, INS, T4, T3, and rT3 were decreased (P < .05); plasma urea nitrogen (PUN), NEFA, and GH levels were increased (P < .05), and IGF-II concentrations were similar between REST and NR steers. A transient compensatory response in BW gain and protein deposition occurred in repleted steers between d 35 and 62 of REAL. During this period, PUN levels markedly declined (P < .01) in REAL steers and glucose concentration increased (P < .01) to levels similar to those in NR controls. This response prevailed even though apparent digestible nutrients were decreased in repleted animals. During energy repletion, plasma levels of T4, T3, rT3, IGF-I, and INS were positively, and of GH was negatively, correlated with EBPRT and EBFAT gain in repleted animals. Unlike IGF-I, IGF-II was not correlated with compensatory body growth. These results suggest that compensating steers are more metabolically efficient; rapid body tissue gain occurs during a period of reduced nutrient digestibility. Additionally, plasma levels of IGF-I, GH, INS, and thyroid hormones, but not of IGF-II, are markedly affected by alteration of energy intake and are highly correlated with empty body gain and protein deposition in compensating late-maturing steers.

Supplemental protein influences on carbohydrate degradation and bacterial 16S ribosomal ribonucleic acid

This research examined the mechanism by which soybean protein stimulates growth of mixed ruminal anaerobes and degrades structural polysaccharides in vitro. Soybean meal, isolated soy protein, or branched-chain VFA was added to orchardgrass hay substrate in Experiment 1. Cell-wall degradation increased 14.5% over that of the control by protein addition. Protein addition resulted in 1.3- to 1.5-fold increases in bacterial growth. Hybridization with a 16S probe specific for Fibrobacter succinogenes indicated that protein addition did not influence the proportion of this species. For in vitro Experiment 2, optimal protein for cell-wall degradation was 2 g/L in cultures containing tall fescue hay. To determine whether protein stimulated microbial colonization of plant cell wall (Experiment 3), orchardgrass hay was placed in 14-L fermentors; treatments were control, NH3 N (2 g of N/L), or isolated soy protein (2 g of N/L). Addition of protein and NH3 N increased the extent of cell-wall disappearance 9.7% above control. Protein and ammonia improved cell-wall digestion, but protein had the greatest stimulatory effect on prokaryote growth with no preferential effect of F. succinogenes.

Surgical relief of snoring due to palatal flutter: a preliminary report

We describe our experience in the surgical treatment of 32 patients with severe snoring. In the first 16 patients we used the standard surgical procedure of uvulopalatopharyngoplasty (UPP) but found this unsatisfactory because of its radical nature, complications and uncertain outcome. We therefore investigated the mechanics of snoring in the laboratory as a help in devising a more effective operation. These studies have shown that there are several methods by which snoring can be generated but that palatal flutter is probably the most important. The dominant parameters in the generation of flutter of the palate are its length and stiffness. Any removal of tissue to shorten the palate as in UPP inevitably risks impairing its function, so we chose the stiffening alternative. Using the laser, a central longitudinal strip of mucosa was removed from the surface of the soft palate which healed by fibrosis, producing the required stiffening. The early results of this new procedure show that snoring has been eliminated or greatly reduced in 14 of 16 patients and that apart from local pain there have been no complications.

Marrow B-cell precursors are increased in lymphomas or systemic diseases associated with B-cell dysfunction

Marrow regeneration is known to be associated with an increase in immature B cells, including CD10+ cells. A similar phenotype has been seen in some children with unusual cytopenias. This article describes 21 adult patients not recovering from chemotherapy, who had increased CD10+ cells in their marrows. These cells had the relatively uniform scatter properties of small lymphocytes by flow cytometry, and by multiparameter analysis were found to have a distinct phenotype in that they were CD19+, lacked surface immunoglobulin, and heterogeneity expressed CD20. In two of three patients tested, some but not all of these early B cells were TdT+. CD10+ cells accounted for 10-76% of total mononuclear cells. All 21 patients had some systemic illness. Thirteen patients had a diagnosis of lymphoma (three Hodgkin's, ten non-Hodgkin's); all ten of the latter were extranodal and seven of seven phenotyped cases were B-cell lymphomas. Seven patients had autoimmune disease (one also had lymphoma) and one had the acquired immunodeficiency syndrome with mycobacterial infection of the marrow. One patient with a history of a "viral illness" had a lymph node showing atypical lymphoid hyperplasia with progressive transformation of germinal centers. Examination of marrow core biopsies in these patients showed a proliferation of small lymphocytes ranging from a barely perceptible diffuse increase to numerous lymphoid aggregates. The extensive lymphocytosis seen in two marrows suggested a diagnosis of lymphoma on morphologic grounds alone, but neither these patients nor any others had B-cell clonal excess. The presence of this phenotype suggests nonspecific stimulation of marrow B-cell precursors associated with systemic B-cell activation in either an immunologic or neoplastic disorder. Presence of this unusual phenotype does not imply involvement of marrow by B-cell neoplasia.