Prediction and Evaluation of Urine and Urinary Nitrogen and Mineral Excretion from Dairy Cattle

Urine excretion is a substantial factor in the amount of manure that needs to be managed, and urinary N can contribute to ammonia volatilization. Development and validation of prediction equations focusing on dietary factors to decrease urine and urinary nutrient excretion will provide information for managing urine and feces separately or for other future technologies. The objective of this study was to develop equations for prediction of urine excretion and excretion of urinary N, Na, and K and to evaluate both new and previously published prediction equations for estimation of urine and urinary nutrient excretion from lactating dairy cows. Data sets from metabolism studies conducted at Washington State University were compiled and evaluated for excretion of minerals. Urine excretion averaged 24.1 kg/d and urinary nitrogen excretion ranged from 63 to 499 g/d in the calibration data set. Regression equations were developed to predict urine excretion, urinary N excretion, and urinary Na and K excretion. Predictors used in the regression equations included milk yield, body weight, dietary crude protein percentage, milk urea nitrogen, and nutrient intakes. Previously published prediction equations were evaluated using data sets from Washington State University and the University of Wisconsin. Mean and linear biases were evaluated by determining the regression of residuals on predicted values. Evaluation and validation of prediction equations are important to develop equations that will more accurately estimate urine and urinary nitrogen excretion from lactating dairy cows.

Prediction of Manure and Nutrient Excretion from Dairy Cattle

Accurate estimates of manure excretion are needed for planning manure storage facilities and for nutrient management. Data sets from metabolism studies conducted at several universities were compiled and evaluated for excretion of total manure, N, P, and K. Animal groups included calves weighing up to 204 kg, heifers weighing between 274 and 613 kg, nonlactating cows, and lactating cows. Regression equations were developed to predict excretion of total manure, total dry matter, N, P, and K. Predictors used in the regression equations for lactating cows included milk yield, percentages of protein and fat in milk, dietary concentrations of crude protein and neutral detergent fiber, and intakes of nutrients. The regression equations provide improved predictions of excretion and enable more accurate planning of manure storage and nutrients to be managed at the farm level.

Repeated daily cocaine alters subsequent cocaine-induced increase of extracellular dopamine in the medial prefrontal cortex

Male Sprague-Dawley rats that were naive or that had been treated with five daily saline or cocaine injections (15 mg/kg i.p.) were subsequently challenged with an injection of cocaine, and extracellular dopamine content in the medial prefrontal cortex (mPFC) was measured using in vivo microdialysis. Cocaine challenge increased extracellular dopamine levels from base line in all three groups of rats, but the augmentation was significantly reduced in the cocaine-pretreated group, compared with the saline-pretreated group. In contrast, mPFC dopamine levels were not different among groups after challenge with systemic d-amphetamine. To test whether repeated cocaine treatment led to altered releasability of dopamine from mPFC terminals, challenge with KCI (10, 30 or 100 mM) or d-amphetamine (3, 30 or 300 microM) was made via infusion through the dialysis probe into the mPFC. No differences in dopamine levels were found between treatment groups for either drug at any dose. To determine whether the effects of cocaine were mediated by local actions within mPFC dopamine terminals, a cocaine challenge was administered through the microdialysis probe (1, 10 or 100 microM). In contrast to the systemic cocaine challenge, local infusion of cocaine elicited a significant increase in daily cocaine-pretreated rats, compared with saline-pretreated controls, at the lowest dose tested, with no differences at the higher two doses. In summary, daily cocaine-pretreated rats demonstrated a suppressed mPFC dopamine response to subsequent systemic, but not local, cocaine challenge. The results suggest that this apparent tolerance is not due to altered releasability of dopamine from mPFC terminals and may rely on altered afferent regulation of mesocortical dopamine neurons.

A multicentre comparative trial of sodium valproate and carbamazepine in adult onset epilepsy. Adult EPITEG Collaborative Group

The long-term efficacy and safety of sodium valproate and carbamazepine in adult outpatients with newly diagnosed primary generalised or partial and secondarily generalised seizures were compared in a randomised, open, multicentre study at 22 neurology outpatient clinics. Patients were randomised to oral sodium valproate (Epilim EC enteric coated 200 mg tablets twice daily, n = 149) or oral carbamazepine (100 mg twice daily increasing to 200 mg twice daily in week 2, n = 151) and followed up for three years. If clinically necessary, dosages were regularly increased until seizures were controlled or toxicity developed. Sodium valproate and carbamazepine controlled both primary generalised and partial seizures equally effectively overall. Significantly more patients on sodium valproate than carbamazepine (126/140 (90%) v 105/141 (75%), p = 0.001) remained on randomised treatment for at least six months. Skin rashes occurred significantly more often in carbamazepine recipients than in sodium valproate recipients (11.2% v 1.7%, p < 0.05) and carbamazepine was associated with a higher withdrawal rate because of adverse events (15% v 5% on sodium valproate) in the first six months of treatment. There was no difference between the drugs in the rate of withdrawal because of poor seizure control at any stage, regardless of seizure type. At the end of the three year trial period, over 70% of the available patients were still on randomised treatment or had recently stopped treatment after achieving full seizure control. Sodium valproate and carbamazepine were both associated with a high degree of overall seizure control regardless of seizure type and both have good long-term tolerability in adult patients with newly diagnosed epilepsy. Recommendations are made for a higher initial dosage regime for sodium valproate in partial seizures.

The cost of epilepsy in patients attending a specialist epilepsy service

Epilepsy is a common disability, especially in young adults, and, as the costs to the community are likely to be high, estimates are required to plan health and community care. The neurological unit of Dundee Royal Infirmary provides an epilepsy clinic for the Tayside region (population 300,000) and in 1991 the records of over 303 patients were computerized using the Epicare system developed by Sanofi-Winthrop. It was calculated that the total state expenditure on care was 662,919 pounds (2188 pounds/head) in 1991. The direct health costs were obtained by reviewing database entries and medical records and were estimated to be 159,192 pounds (24%), including 77,171 pounds for drugs, 64,750 pounds for hospital care and 17,271 pounds for general practice consultations. The cost of welfare payments was 503,728 pounds/year (76%) (4419 pounds/recipient). The transfer payments to patients with epilepsy greatly exceed the costs of health care and any management strategy which improves the prospects for employment and independence of people with epilepsy is likely to produce significant fiscal benefits for both the individual and the state.

Western blotting analysis in patients with MS using human brain vessels as antigen

Serum samples from patients suffering from multiple sclerosis, other neurological diseases and normal controls were screened by "western blotting" for antibody directed against proteins of human brain vessels purified from a post mortem brain. A small number of sera contained autoantibodies against some of the proteins of the brain vessels, particularly in patients suffering from MS, epilepsy and migraine. The significance of these results is discussed.

Parathyroid hyperplasia associated with thymoma

The case of a 65 year old female with myasthenia gravis and hypercalcaemia is presented. Failure of medical control of the myasthenia necessitated thymectomy at which time parathyroid exploration was also carried out. This revealed parathyroid hyperplasia and a thymoma. This association has not been previously documented in the literature.

Reduced ouabain binding to erythrocytes in epilepsy--evidence for a membrane abnormality

The number of sodium pump sites on erythrocytes was measured using tritiated ouabain in 20 untreated fasted patients with recent-onset untreated primary generalised or partial seizures and in 22 age- and sex-matched controls. The ouabain binding was significantly lower at 1393 +/- 392 molecules ouabain/pl cells compared to 1677 +/- 366 molecules ouabain/pl cells in the group with epilepsy (P less than 0.02). The differences between ouabain binding in patient and control groups were greater for males than for females. There were no significant differences between patients with generalised and those with partial seizures. These results are consistent with a generalised membrane abnormality in epilepsy which, if present in the brain, might predispose to seizures.

Abnormal aluminium, cobalt, manganese, strontium and zinc concentrations in untreated epilepsy

The concentration of 38 trace and bulk elements in the serum from 19 patients with recent onset of epilepsy and 20 age- and sex-matched controls was estimated by neutron activation analysis or inductively coupled plasma source by mass spectrometry. The concentrations of aluminium, strontium and zinc were significantly higher and the concentrations of cobalt and manganese were significantly lower than controls. Low concentrations of manganese and high concentrations of zinc in epilepsy have been previously reported but the abnormalities of aluminium, cobalt and strontium are new findings. The possible significance of these results in the pathogenesis of epilepsy is discussed.

Adoptive immunotherapy of human cancer using low-dose recombinant interleukin 2 and lymphokine-activated killer cells

The adoptive transfer of recombinant-methionyl human interleukin 2 (rIL-2)-activated autologous peripheral blood mononuclear lymphokine-activated killer (LAK) cells to cancer patients is being evaluated as an alternative to conventional cancer therapy. We have independently developed an alternative regimen to previously reported adoptive immunotherapy protocols using rIL-2 and LAK cells which features the prolonged administration of low-dose rIL-2 (30,000 units/kg) and an automated, entirely enclosed system of peripheral blood cell procurement, culture, harvest, and reinfusion of activated cells. The cell culture system was tested with a murine tumor model in which LAK cells generated in plastic culture bags were reinfused into tumor-bearing mice. Tumor regression was as effective with cells activated in the bags as in conventional culture flasks. Twenty-eight cancer patients were treated for 5 consecutive days with low-dose rIL-2, followed by leukapheresis, infusion of LAK cells, and prolonged IL-2 administration. At least 50% tumor regression was observed in 46% of all patients treated. These data imply that human peripheral blood mononuclear cells retain fully their capacity for rIL-2-induced activation and effector cell function under this alternative approach, and further, that a low-dose rIL-2 regimen with markedly reduced toxicities can be as effective as high-dose rIL-2 regimens if low-dose rIL-2 is given for a prolonged period of time following LAK cell infusion.

The effective evaluation of thyroid status in patients on phenytoin, carbamazepine or sodium valproate attending an epilepsy clinic

To assess the most efficient means of monitoring thyroid status in an epilepsy clinic, total thyroxine (T4), free thyroxine stimulating hormone (TSH) were measured in 71 adult patients treated long-term with either phenytoin (DPH), carbamazepine (CBZ) or sodium valproate (VAL). Twenty-seven patients with one or more abnormal thyroid hormone results were further investigated by a thyrotrophin releasing hormone (TRH) test and clinical assessment. T4 was found to be normal in 85% on VAL, 40% on CBZ and 39% on DPH. FT4 was normal in more patients, namely 95% on VAL, 70% on CBZ and 65% on DPH. The TRH tests indicated that FT4 was the most efficient screening test for hypothyroidism in this epileptic population. We estimate that the use of FT4 alone as a screening test would have reduced by 60% the number of TRH tests required.

The effects of age on carbamazepine pharmacokinetics and adverse effects

The pharmacokinetics and effect of single oral doses of carbamazepine (400 mg) were compared in a group of six young volunteers aged between 20 and 25 years, and a second group of five elderly volunteers aged between 66 and 84 years. No age related changes in salivary or plasma pharmacokinetics or in psychomotor function were detected.

Lipid peroxidation products and antioxidant proteins in plasma and cerebrospinal fluid from multiple sclerosis patients

Lipid peroxidation (LPx) products were measured as thiobarbituric acid-reactive substances (TS) and lipid-soluble fluorescent pigments (FP) in both plasma and CSF from MS patients and controls. Although no significant changes were found in MS plasma, we report here for the first time increases in both TS and FP in MS CSF (p less than 0.05 and p less than 0.01, respectively, compared with patients with other neurological diseases), indicating that increased LPx in CNS may be a feature of MS. Levels of transferrin were normal but caeruloplasmin (CP), a major antioxidant plasma protein, was significantly raised in MS patients (p less than 0.01) and this may represent an adaptive response to increased oxidative challenge. Neither of these proteins was detectable in CSF using radial immunodiffusion. There was no significant correlation between the severity or duration of the disease nor the period since the last relapse and either LPx products or CP suggesting that the changes observed in this work are not simply the direct result of demyelination and tissue damage.

Erythrocyte antioxidant enzymes in multiple sclerosis and the effect of hyperbaric oxygen

The activities of catalase, glutathione peroxidase, and glutathione reductase, were not significantly different from normal whereas that of superoxide dismutase was decreased (P less than 0.05) in erythrocytes from patients with multiple sclerosis. Assay of the lipid peroxidation product, malondialdehyde, after incubation of erythrocytes with 10 mM H2O2 under carefully controlled conditions (peroxide stress test) demonstrated that MS erythrocytes are significantly (P less than 0.001) less susceptible to H2O2-induced lipid peroxidation in vitro. This finding suggests that the level of an endogenous antioxidant, possibly vitamin E, may be elevated in MS red cells. After treatment with hyperbaric O2, the activity of MS erythrocyte catalase is significantly (P less than 0.01) elevated by 2-6-fold.

Erythrocyte membrane glycerophospholipid organization is normal in multiple sclerosis

The phospholipid composition of erythrocyte membranes from patients with multiple sclerosis (MS) was found to be normal, in agreement with previous reports. The transbilayer asymmetry of the glycerophospholipids in MS red cells was probed using bee venom phospholipase A2 and was also found not to be significantly different from normal. Abnormal membrane glycerophospholipid organisation is therefore not involved in the increased red cell size, osmotic fragility, and electrophoretic mobility associated with MS.

Brain biopsy in the diagnosis of cerebral mycosis fungoides

A case of cerebral mycosis fungoides co-existing with progressive multifocal leucoencephalopathy presented with dementia. Brain biopsy established the diagnosis of mycosis fungoides after cerebrospinal fluid examinations and computerised tomographic scanning of the brain produced non-specific abnormalities.

Serum prolactin and cortisol concentrations after grand mal seizures

Serial serum prolactin and cortisol levels were measured in five patients after a grand mal seizure and in four volunteers with simulated seizures. Single levels were measured after a witnessed seizure in 26 patients and in a matched control group. Significant increase in both prolactin and cortisol levels occurred after seizures. The change in cortisol level may reflect a non-specific stress response, but the increase in prolactin levels could not be accounted for on this basis, and probably indicates an alteration in hypothalamic neurotransmitter activity during the seizure. These findings may have clinical value in the diagnosis of epilepsy.