[Description and determination of the diameter of arteries and veins in the hindlimb of cattle using B-mode ultrasonography]

The large arteries and veins of both metatarsal and digital regions of 14 healthy, non-pregnant cows with a mean age of 6.1 +/- 1.7 years were examined sonographically (real-time B-mode system with a 7.5 MHz linear-transducer). The ultrasonographic imaging of the larger vessels was investigated, diameters were measured, especially of the digital veins, in which intravenous regional anaesthesia and antibiosis is usually applied. Three measurements per cow on each distal hindlimb were noted over a period of 3 weeks using defined anatomical locations. The mean diameter of the vessels were as follows: Arteria (A.) dorsalis pedis 4.1 +/- 0.4 mm, Vena (V.) dorsalis pedis 5.2 +/- 0.5 mm, A. metatarsea dorsalis III 3.3 +/- 0.4 mm, A. digitalis dorsalis communis III 3.9 +/- 0.4 mm, V. digitalis dorsalis communis III 2.7 +/- 0.4 mm, V. digitalis plantaris communis IV 2.1 +/- 0.4 mm, V. digitalis plantaris communis II 2.1 +/- 0.3 mm, V. metatarsea plantaris lateralis 4.5 +/- 0.8 mm, V. metatarsea plantaris medialis 4.4 +/- 0.6 mm. The Ramus cranialis of the V. saphena lateralis, the A. and V. digitalis plantaris communis III and the A. digitalis plantaris communis II and IV could only be imaged in a few cases. Except for V. digitalis dorsalis communis III, statistical analysis of the mean diameters of the examined vessels of the right and the left distal hindlimb in 14 cows revealed no significant differences (P < 0.05). B-mode ultrasonography proved a suitable method for imaging and examination of the vessels larger than 1 mm in the distal bovine hindlimb and can be recommended as the non-invasive method of choice for the examination of blood vessels in cattle.

[New possibilities for the diagnosis of septic tenosynovitis of the digital flexor tendon sheath in cattle using sonography--therapy and long-term results]

Sonographic examination is a new and very effective method in diagnosing of septic tenosynovitis in cattle and may be regarded as an valuable help to the classic diagnostic methods. Among 563 patients, 22 animals suffered exclusively from a serofibrinous, purulent or necrotising tenosynovitis of the digital flexor tendon sheath. In 11 cases, a resection of both flexor tendons, in 2 cases a resection of the deep flexor tendon only were performed, and in 4 cases the tendon sheath was surgically opened and irrigated. 5 animals were slaughtered after diagnosing, because both tendon sheaths of the same limb suffered from a purulent or necrotising tenosynovitis. Surgery was performed using intravenous regional anesthesia and antibiosis. Clinical, radiographic, sonographic and centesis findings are presented. Sonography enabled an accurate assessment of the extent of the inflammation and an assessment of eventual adhesions. It was therefore possible to obtain a comprehensive preoperative image about the condition of the diseased tendon sheath. Intraoperative findings are compared with sonographic diagnosis. After an average hospitalisation of 26.5 days, the patients returned to their owners. Postoperative long term follow-up from 8 months to a maximum of 8 years was evaluated in 17 animals. The minimum duration of economic use of all animals averaged 29.2 months with a range of 1 to 69 months. At the time of survey 9 cows (52.9%) were still alive. 15 cows (88.2%) produced a total of 34 calves with a maximum of 6 calves in one cow. Details on the status of the operated limb, the postoperative milk yield and reasons for culling are discussed.

[Cauda equina syndrome in a Fleckvieh bull after a pathological fracture of the first sacral vertebra caused by a spindle cell sarcoma]

A 9 month old Simmental fattening bull was presented with signs of a cauda equina syndrome. An epidurographic examination was made after thorough clinical, neurological and routine radiographic examination. The cause of the cauda equina compression--a spindle cell sarcoma--was revealed by the pathologic-histologic examination. This tumor caused the compression of the cauda equina and pathologic transverse fracture of the body of the first sacral vertebra and cranial epiphyseal fracture of the 1st and the 3rd sacral vertebra as well as the separation of the arcus from the first and second sacral vertebral bodies. Some other diseases which can cause cauda equina syndrome are mentioned.

[Laminitis with a high degree of osteitis rarefaciens of the distal phalanx in a Fleckvieh bull]

Chronic laminitis with severe rarefactive osteitis was diagnosed in a nine month old Simmental fattening bull. The condition was observed in all eight weight bearing digits. Clinical, radiological and pathomorphological examinations revealed osteolysis and downward rotation of all the distal phalanges. The condition appears to resemble the several cases of laminitis in Jersey cattle, which have been attributed to hereditary factors. In this case, however, the genetic background was unavailable for evaluation.

[Acute tonsillitis: clinical symptoms; bacteriologic culture and rapid test as deciding criteria for the use of antibiotics]

In order to prevent late sequelae from an untreated streptococcal pharyngitis all patients with streptococcal tonsillitis/pharyngitis have to be treated with antibiotics, preferably penicillin. A correct diagnosis by clinical criteria is only achievable in 72% of patients with streptococcal pharyngitis. Additional criteria such as diagnosis by culture are, therefore, mandatory. Time is a major disadvantage of traditional culture methods. Slide agglutination tests show an acceptable sensitivity of 92% and a specificity of 93%. Due to the possibility of false negative test results, with consequent withholding of adequate antimicrobial chemotherapy, these test results should be used only as a valuable guide. Decision to administer an antibiotic should still be based on clinical criteria.

[Studies of the penetrating ability of fosfomycin into the aqueous humor and vitreous body of the eye]

Fosfomycin is an antibiotic with a new simple chemical structure and a broad spectrum of antibacterial activity, especially against staphylococci. In the study reported here, the penetration of fosfomycin into the aqueous humor and vitreous body was investigated after intravenous infusion of 4 and 8 g. The highest average concentration approximately 2 hours after administration was 28.3 micrograms/ml after the 4 g dose and 52 micrograms/ml after the 8 g dose. Both the 4 g and 8 g doses thus produced aqueous humor levels exceeding the minimum inhibitory concentrations required for most gram-positive and gram-negative organisms commonly responsible for bacterial endophthalmitis, including strains of pseudomonas aeruginosa. Extremely high aqueous humor levels of fosfomycin were observed in two patients with inflamed eyes because of a change in the blood-aqueous barrier.

[Demonstration of a species specific determinant of Bacteroides fragilis lipopolysaccharides using monoclonal antibodies]

The reactivity of two monoclonal antibodies to Bacteroides fragilis was tested (ELISA) with 37 strains of B. fragilis, 1 strain each of B. thetaiotaomicron, B. ovatus, B. vulgatus and B. eggerthii, 1 strain of Fusobacterium, as well as Pseudomonas aeruginosa (6 strains), E coli (8 strains), Klebsiella (2 strains), Yersinia enterocolitica (1 strain) and LPS from Salmonella minnesota. Both monoclonal antibodies proved to be specific for B. fragilis. The determinants recognized by these antibodies are localized in the LPS of this gram-negative anaerobe.

The influence of third-generation cephalosporins on the aerobic intestinal flora

The influence of three third-generation cephalosporins with varying degrees of biliary excretion on the aerobic flora was investigated. The faecal flora prior to therapy with one of these substances consisted mainly of anaerobic bacilli. Escherichia coli was present in concentrations of 10(9) organisms/g stool. Candida albicans and enterococci were observed in concentrations of 10(5) - 10(6) organisms/g stool. Within 24 hours after the administration of ceftriaxone and cefoperazone, the gram-negative aerobic flora was completely eradicated. C. albicans and enterococci increased to 10(9) organisms/g stool. Between the third and tenth days (mean 6.7 days) of therapy Pseudomonas aeruginosa, Enterobacter and Citrobacter in this order of frequency reappeared in the faecal flora with complete resistance to all betalactam antibiotics. C. albicans and enterococci decreased to 10(7) organisms/g stool. The anaerobic flora was largely unaltered. In contrast, cefotaxime had only a moderate influence on the aerobic faecal flora. Concentrations of gram-negative organisms decreased to 5 X 10(7) organisms/g stool during the first five days of therapy; the concomitant increase in C. albicans and enterococci was approximately 1 log 10. No alterations in the susceptibility pattern were observed. We would like to emphasize that substantial alterations of the faecal flora and the susceptibility pattern of antibiotics may accompany the use of antimicrobial agents, particularly those with a high degree of biliary elimination.

Influence of third-generation cephalosporins on aerobic intestinal flora

Excretion of an antibiotic in bile may result in high intra-intestinal concentrations and thus alteration in the faecal flora. We investigated the effects of cefoperazone (75% biliary excretion), ceftriaxone (45%) and cefotaxime (5%) on the aerobic faecal flora. Cefoperazone reduced numbers of normal Gram-negative bacilli and selected resistant Pseudomonas, Serratia and Klebsiella-Enterobacter. Ceftriaxone was similar. However, cefotaxime had little effect on the normal Gram-negative flora, and did not promote the emergence of resistant organisms.

Familial occurrence of syngnathia congenita syndrome

A case of familial occurrence of syngnathia congenita in mother and child is described; this syndrome has been seen only sporadically until now. Due to the distinct appearance of the intraoral chords--they were situated on both sides between the ridges of the jaw and also between the left half of the bifid uvula and the retrolingual region--a relationship to the autosomal-dominantly transmitted Cleft Palate Lateral Synechiae Syndrome (CPLS-Syndrome) is suspected. Complete penetrance with different expressivity may explain the different clinical manifestations of the cases seen up to now and the absence of bifid uvula in the mother of our patient. The probable pathogenesis during embryological development is discussed.

[Bird-headed-dwarfism. A case report (author's transl)]

The case history and symptoms of a girl aged 12 months are reported suffering from bird-headed-dwarfism or Seckel-Syndrom: low birth weight in spite of prolonged pregnancy, typical "bird-headed-face", mikrocephaly, dwarfism, dystrophy, mental-motoric retardation.

[Complete parenteral nutrition in childhood]

Complete parenteral nutrition by means of continuous intravenous drip into large veins, over a long period, has already shown itself to be of therapeutic use in the field of pediatrics. While the nutritional-physiological aspect of this therapeutic method is clear -- it depends on an accurate and sufficient supply of water, salts, glucose, amino-acids, triglycerides and essential fatty acids, vitamins and trace elements -- in practice it presents difficulties which though often serious are not insurmountable. Especially are to cite the septic complications, which are nearly imperceptible during their development. They are only to accept in view of the often almost hopeless condition of the child, who would be lost without complete parenteral feeding. Similar problems arise through metabolic complications which are caused non rarely only by insufficient dosages and lack of careful supervision but it is generally possible to correct these at an early stage. Complete parenteral nutrition must be exactly indicated. It is indeed a great therapeutic help, particularly when over a longer period -- at least a week or longer -- oral nutrition is impossible or insufficient. Practicall experiences will be reported. A retrospective assessment of 50 cases has shown the tendency (through taking too much care?) to hold the quantity of liquids and supply of calories too short and to administer too much carbohydrates and too little fat.