Current concepts in imaging the adult hip

Diagnostic imaging plays a key role in the evaluation of adult hip pain. Cornerstone to the initial assessment of hip pain is the plain radiograph. The need for secondary imaging of the hip and choice of imaging modality depends on the clinical presentation, results of the plain radiograph series, and clinical question to be answered. CT is primarily used in acute trauma, particularly in cases of an acetabular fracture or hip dislocation to detect intraarticular fragments and associated articular surface fractures and to better depict fracture patterns for surgical planning. In the setting of normal plain radiographs and unexplained hip pain, MR imaging is particularly helpful in detecting marrow-based abnormalities and demonstrating intra- and extraarticular pathology. MR athrography is useful in the detection of labral injuries and potentially may demonstrate additional intraarticular pathology, including chondral damage, loose bodies, and injuries of the ligamentum teres.

Traumatic anterior dislocation of the hip: spectrum of plain film and CT findings

Traumatic anterior dislocation of the hip represents 11% of all hip dislocations and is classified into superior and inferior types [1]. Whereas inferior anterior hip dislocation is easily recognized on an anteroposterior radiograph of the pelvis, the radiographic appearance of superior anterior hip dislocation is less straightforward, often leading to an initial misdiagnosis of posterior hip dislocation. Misdiagnosis of the direction (anterior versus posterior) of a hip dislocation can result in failed closed reduction or an improper surgical approach to open reduction. In addition, recognition of associated impaction fractures is important, as patients with this finding have a greater tendency to develop traumatic arthritis [2, 3]. This pictorial essay, which is based on our experience with 20 cases of anterior hip dislocation, including five of the rare superior type, illustrates the spectrum of radiographic findings and distinguishing features associated with anterior hip dislocation.

Gallbladder injury secondary to blunt trauma: CT findings

OBJECTIVE

Our objective was to determine CT findings of gallbladder injury secondary to blunt trauma.

MATERIALS AND METHODS

Computed tomography scans and medical records of seven patients diagnosed with gallbladder injury secondary to blunt trauma, including six surgically confirmed cases and one presumptive diagnosis based on CT findings, were reviewed retrospectively to delineate CT findings associated with gallbladder injury. Evaluation of CT scans included assessment of gallbladder distention, wall thickness and contour, intraluminal contents, presence of pericholecystic fluid, and associated injuries. Data obtained included age, gender, mechanism of injury, surgical and pathologic findings when available, treatment, morbidity, and mortality.

RESULTS

Four patients had gallbladder contusions and three had either gallbladder laceration, partial avulsion, or intraluminal hemorrhage. The spectrum of CT findings included pericholecystic fluid (seven), ill defined contour of the gallbladder wall (four), high density intraluminal hemorrhage (four), mass effect on the duodenum (three), and gallbladder collapse (one). No combination of findings was specific for the type of injury. The most common associated injuries were pericholecystic liver lacerations and duodenal hematoma or perforation.

CONCLUSION

The CT finding of an ill defined contour of the gallbladder wall, a collapsed lumen, or high density intraluminal hemorrhage, especially in the presence of pericholecystic fluid, strongly suggests primary gallbladder injury.

Magnetic resonance imaging of Carney's triad

Carney's triad, a rare disorder affecting young females, is characterized by the presence of at least two of the three following neoplasms: gastric epithelioid leiomyosarcoma, extra-adrenal paraganglioma, and pulmonary chondroma. Diagnosis and follow-up evaluation of cases of Carney's triad may require an approach that uses a combination of modalities, including magnetic resonance imaging (MRI), metaiodobenzyl-guanidine (MIBG) I 131 scintigraphy, and computed tomography. MRI is as effective as MIBG scintigraphy in detecting functioning paragangliomas. In the evaluation of suspected cases of Carney's triad in which there is clinical and biochemical evidence of a paraganglioma, MRI is the modality of choice for screening and follow-up. We report a case of gastric leiomyosarcoma and extra-adrenal paraganglioma in a young woman whose initial presentation was at 7 years of age. To our knowledge, this is the earliest presentation of this disorder.

Early detection of acute myocardial infarction in patients presenting with chest pain and nondiagnostic ECGs: serial CK-MB sampling in the emergency department

STUDY OBJECTIVES

Patients presenting to the emergency department with chest discomfort are a difficult problem for emergency physicians. Nearly 50% of patients with acute myocardial infarction (AMI) will initially have nondiagnostic ECGs on ED presentation. The purpose of this study was to determine if patients with AMI having nondiagnostic ECGs could be identified using new immunochemical assays for serial CK-MB sampling in the ED.

DESIGN

Chest pain patients, more than 30 years old, with pain not caused by trauma or explained by radiographic findings, were eligible for the study. Serial serum samples were drawn on ED presentation (zero hours) and three hours after presentation, then analyzed for CK-MB using four immunochemical methods and electrophoresis. Standard World Health Organization criteria were used to establish the diagnosis of AMI, including new Q-wave formation or elevation of standard in-hospital serum cardiac enzyme markers.

SETTING

A tertiary cardiac care community hospital.

MEASUREMENTS AND MAIN RESULTS

The serum from 183 patients hospitalized for possible ischemic chest pain was collected and analyzed. Thirty-one of 183 patients (17%) were found to have AMI by standard in-hospital criteria. Sixteen of the 31 patients (52%) with AMI had nondiagnostic ECGs on presentation. Immunochemical determination of serial CK-MB levels provided a sensitive and specific method for detecting AMI in patients within three hours after ED presentation compared with standard electrophoresis. The four immunochemical methods demonstrated a range in sensitivity from 50% to 62.1% on ED presentation versus 92% to 96.7% three hours later. The immunochemical tests demonstrated specificities ranging from 83.0% to 96.4% at three hours, with three of the four tests having specificities of 92% or greater. Electrophoresis had a sensitivity of 34.5% on ED presentation, increasing to 76.9% at three hours, with a specificity of 98.6%.

CONCLUSIONS

Immunochemical CK-MB methods allowed rapid, sensitive detection of AMI in the ED. Early detection of AMI offers many potential advantages to the emergency physician. Early detection of AMI, while the patient is in the ED, could direct disposition of this potentially unstable patient to an intensive care setting. Such information may prevent the ED discharge of patients with AMI having nondiagnostic ECGs. The diagnosis of AMI within a six-hour period after symptom onset may allow thrombolytic therapy to be given to patients with AMI not having diagnostic ECGs. This study served as a pilot trial for a multicenter study of the Emergency Medicine Cardiac Research Group, which is currently ongoing.

Adenocarcinoma in a sigmoid conduit: case report

The increased risk of developing adenocarcinoma in the sigmoid colon after ureterosigmoidostomy has been acknowledged for some time. Development of adenocarcinoma in colonic conduits isolated from the fecal stream is rare. We report a case of adenocarcinoma arising in a sigmoid conduit that probably represents a metachronous adenocarcinoma of the colon.

Massive hemoperitoneum following rupture of hepatic metastases from unsuspected choriocarcinoma

Spontaneous massive hemoperitoneum in a reproductive-aged woman is usually associated with ectopic pregnancy. An unusual cause of intraperitoneal hemorrhage is presented: spontaneous rupture of hepatic metastases from unsuspected choriocarcinoma in a 29-year-old woman 4 weeks postpartum. Although choriocarcinoma is known to have the potential for subsequent hemorrhage of secondary sites, massive hemoperitoneum due to rupture of hepatic metastases is rare. In this case report, the presentation, prognosis groups, and treatment modalities are presented.

Factors associated with edema of the mammary gland in primigravid dairy heifers

The severity and anatomical extent of mammary edema (edema) of 73 primigravid Holstein heifers was scored, and certain hormones in peripheral blood plasma were quantified. The objective was to obtain by least-squares analysis of covariance independent estimates of the association of each hormone and other factors with edema scores around first calving. Mammary edema prepartum increased with age of heifer and gestation length, decreased as calf birthweight increased, but was unrelated to seasonal fluctuations in temperature and photoperiod. The increase in edema during the last week of pregnancy was accounted for by associations with prepartum concentrations of hormones in plasma. The independent estimates of hormonal relationships to edema score prepartum were positive for plasma estrone and estradiol-17 alpha and were negative for plasma estradiol-17 beta and progesterone. Plasma prolactin was not related to edema score. After parturition, estradiol-17 beta was the only independent variable associated (negatively) with edema. The results indicate a complicated interaction among the sex steroids of late pregnancy wherein some steroids may promote edema and other steroids may inhibit edema in heifers.

Relationships of hormones, temperature, photoperiod, and other factors to voluntary intake of dry matter in pregnant dairy cows prior to parturition

Voluntary intake of dry matter per 100 kg body weight (defined as intake) was quantified in 86 pluriparous Holstein cows which calved during 19 consecutive mo. Least squares techniques were used to examine the association of intake during the last 8 days before calving with numerous independent variables representing seasonal and physiological factors. The data were summarized as prepartum days 7, 4, and 1 (means of days 8 to 6, 5 to 3, and 2 to 0, respectively). Intake was lowest on prepartum day 1. Main effects of diet-group, health status, and month were not related significantly to intake when covariates were included in the statistical model. Intake decreased with increasing age of cows, but it was not related independently to body condition score. There were seasonal variations in intake which could be accounted for statistically by either month as a main effect or by quantitative indices of seasonality (temperature, photoperiod, plasma prolactin). Intake was lowest in February, June, and July and highest in October. Calf birthweight was related to intake in an unexpected manner. Intake was lowest in dams carrying either small or large calves. Prolactin of plasma was associated independently with intake, but this hormone may be just another measure of seasonal variation. All variables accounted for 58% of the total variance in intake. When seasonal variations in intake were accounted for statistically by other variables, none of the steroid hormones (progesterone, estrone, estradiol-17 beta, and estradiol-17 alpha) were associated independently with variation in voluntary intake. Associations of cow age and of climatic indices with intake were greater during days 7, 4, and 1 prepartum as compared to day 250 of gestation, days .5 to 2.5 postpartum, and days 3 to 30 of lactation.

Variables associated with peripartum traits in dairy cows. IX. Relationship of season and other factors to blood plasma concentrations of progesterone and the estrogens

Least-squares associations of month, average daily temperature, photoperiod (h daylight/24 h) and other factors with plasma concentrations of hormones during the prepartum period were examined in 172 Holstein cows and heifers. The data were summarized and expressed as values for prepartum d 7, 4 and 1, which represented the means for d 8 to 6, 5 to 3, and 2 to 0. respectively. All animals calved during a period of 19 consecutive months. Across days, least-squares means for plasma hormones were 4.0 ng/ml for progesterone (P4), 232 pg/ml for estradiol-17 beta (E beta), 478 pg/ml for estradiol-17 alpha (E alpha), 1,970 pg/ml for estrone (E1) and 2,680 pg/ml for total estrogen (TE; sum of E beta, E alpha and E1). Variations in plasma concentrations of certain steroids were associated (P less than .05 to P less than .01) with diet group (E beta), calf sex (TE), prepartum day (all hormones), month (E beta, E alpha) and linear covariates of cow weight (E beta, E alpha) calf birth weight (E beta, E alpha, E 1, TE), temperature (P4, E beta) and photoperiod (P4, E beta). The independent linear regressions for temperature and for photoperiod in prediction equations for each plasma hormone were always inversely related. The combined use of these regressions only partially accounted for fluctuations in the least-squares monthly means for hormones. Changes in least-squares monthly means for P4, E beta and E alpha tended to be only partially paralleled during the year. Nonparallel trends among hormones were most apparent during May to July (decreasing P4 but increasing E beta and E alpha), September to November (decreasing P4 and E beta but increasing E alpha) and January and February (only E alpha elevated). We hypothesize that seasonal differences in parturient traits reported for cows may be explained in part by the seasonally associated nonparallel changes in plasma concentrations of P4, E beta and E alpha.

Artificial induction of lactation in cattle: Effect of modified treatments on milk yield, fertility, and hormones in blood plasma and milk

Holsteins were divided into groups CON and IL, each with six dry cows and six heifers. Group CON calved in mid-summer when group IL was treated (kg body weight per day) with (a) progesterone (P; .25 mg) and estradiol-17beta (Ebeta), either .05 mg or .10 mg, for 7 days; (b) continued Ebeta at one-third the initial rate until udders were engorged; (c) then 12 injections (8-hr intervals) of TRH (each 200 mug) or saline; and (d) GnRH during lactation. Milk yield was not affected by Ebeta dose rate, TRH or GnRH. GnRH luteinized the persistent ovarian follicles in group IL, and pregnancy rates were 80% and 83% in groups IL and CON, respectively. Large differences (P < .01) between groups IL and CON were observed in plasma prolactin (IL-low), insulin (IL-high) and growth hormone (IL-low) wherein insulin was correlated (P < .01) negatively with milk yield between days 7 to 49 of lactation. Milk concentrations of P, Ebeta, estrone and estradiol-17alpha in group IL were no higher (P > .10) 14 days after the last injection of P or Ebeta than in group CON or in milk from the herd's bulk tank. The steroids were lowest in milk and plasma from ovariectomized cows. It was hypothesized that high insulin, as well as low prolactin and growth hormone, may contribute to inferior induced lactations.

Variables associated with peripartum traits in dairy cows. VII. Hormones, calf traits and subsequent milk yield

Independent effects of certain partum and peripartum traits on subsequent milk yields (Y) during days 1 to 27 (Y27), 28 to 60 (Y60) and 1 to 200 (Y200) of lactation were estimated from data on 167 Holstein cows and first-calf heifers. The variables were health status, calf sex and covariates (linear, quadratic and cubic) of calf birth weight (CBW), cow age (CA), month of calving code (season) and the peripartum blood plasma concentrations (means of three samples taken from 48 hr prepartum to within 2 hr postpartum) of prolactin (PRL), progesterone (P4), estrone (E1), estradiol-17 beta (E beta) and estradiol-17 alpha (E alpha). Except for Y200 values, the measures of milk yield were positively correlated (P < .01) with each other and with CA, CBW, plasma PRL and plasma E beta. Plasma PRL, E beta and E1 were positively correlated with each other and with CA (PRL and E beta) and CBW (E1 and E beta). Covariates prominently and independently related to increases in Y were CA, CBW and plasma PRL (P < .01). Predicted Y27, Y60 and Y200, calculated with equations of the cubic model, increased by 12.4, 6.5 and 3.7%, respectively, between CBW of 37 and 50 kg, and by 16.6, 15.9 and 14.8% between plasma PRL concentrations of 50 and 195 ng/ml. Season of calving, calf sex and health status were associated with changes in Y27 but not Y60 or Y200. Within the health status group, only infectious disorders (metritis or mastitis) decreased (P < .025) milk yield adjusted for CA and cow weight (adjusted Y60 and Y200). Among all other cows, including those with dystocia alone, adjusted yields were increased by heavier calves (P < .07, Y60), high plasma PRL (P < .025, Y60) and below average plasma E1 (P < .025, Y200). It may be practical to increase milk yield by providing supplemental light prepartum to increase plasma PRL and by selecting sires to maintain CBW above average.

Variables associated with peripartum traits in dairy cows. IV. Seasonal relationships among temperature, photoperiod, and blood plasma prolactin

Concentrations of prolactin in plasma were measured in 176 dairy cows and heifers from 13 days before calving to 2.5 days after calving over 21 mo. Prolactin averaged 35.1, 115.0, and 34.4 ng/ml prepartum (days -13 to -2), peripartum (days -1.0 to +.5), and postpartum (days +1.5 and +2.5). Season of the year affected prolactin in all periods. The linear covariate of daily photoperiod (hours of daylight per 24 h) accounted for as much variation in prolactin prepartum and postpartum as did linear covariates of both photoperiod and average daily temperature. However, it was possible to account for additional seasonal variation in prolactin peripartum by addition of the temperature covariate to the photoperiod covariate. Although photoperiod was related either directly or indirectly more than temperature to factors affecting prolactin seasonally, these statistical inferences cannot prove that prolactin is more dependent on photoperiod than on temperature because the two metereorological measures were correlated (r = .84). When the data were grouped for correlation analysis by months, correlations between temperature and prolactin among prepartum samples collected in the spring and in the fall were positive, small but significant.

Variables associated with peripartum traits in dairy cows. I. Effect of dietary forages and disorders on voluntary intake of feed, body weight and milk yield

Daily voluntary intakes of feed by each of 89 Holstein cows were compared between day 220 of gestation and day 30 postpartum over a 21-month period. Diets designed to meet NRC requirements and which contained either chopped hay (29 cows), hay crop silage (HCS; 30 cows) or corn silage (CS; 30 cows) were compared prepartum (27 to 0 days), peripartum (1 day before to 3 days after calving) and postpartum (days 4 to 30 postpartum). Mixed rations, fed during lactation, were 60% forage and 40% concentrate dry matter (DM). Cow management was similar to commercial operations. The experimental hypothesis was that pre-disposition for partum and postpartum disorders (abnormal) could be related either to voluntary intake of different diets or to physical traits. Intakes (DM or estimated net energy) across diets decreased 30% between days 7 and 1 prepartum and averaged 18% and 20% lower peripartum and postpartum, respectively, in abnormal cows than in control cows. Seasonal effects on intakes were significant. In general, changes in body weight and condition and differences in udder edema and milk yield reflected intakes. The results support the original hypothesis.

Variables associated with peripartum traits in dairy cows. III. Effect of diets and disorders on certain blood traits

BLood samples were collected from 89 Holstein cows on days 220 and 250 of gestation, within 24 hr prepartum and postpartum and on day 30 postpartum. Balanced diets which contained either chopped hay (29 cows), hay crop silage (HCS; 30 cows) or corn silage (CS; 30 cows) were fed from day 220 of gestation to day 30 postpartum. The purpose was to determine if variations in certain blood traits were indicative of peripartum and postpartum disorders. The blood traits evaluated were concentrations of plasma total protein, whole blood hemoglobin, packed cell volume, and white blood cells, and serum glutamic oxalacetic transaminase (SGOT), glucose, urea nitrogen, calcium, inorganic phosphorus, magnesium, potassium and sodium. No blood trait was useful to predict a disorder prior to its visual signs with one possible exception. Serum glucose and calcium were lower and SGOT and magnesium were higher peripartum which was prior to death of three cows from fat cow syndrome.

Variables associated with peripartum traits in dairy cows. II. Interrelationships among disorders and their effects on intake of feed and on reproductive efficiency

Daily individual voluntary intakes of dry matter (DM % of body weight) and estimated net energy (ENE, Mcal/100 kg) by 89 Holstein cows were compared between day 220 of gestation and day 30 postpartum over a 21-month period. The purpose was to compare effects of diet and health status (control vs. abnormal) on intakes of DM and ENE. The cows were fed either chopped hay, hay crop silage (HCS) or corn silage (CS). Compared to controls, voluntary intakes of DM and ENE were decreased (most to least) in cows with fat cow syndrome (FCS), parturient paresis (PP), mastitis (MST), retained fetal membranes-metritis (RFM-M), and displaced abomasum (DA) prepartum and FCS, DA, PP, RFM-M and MST peripartum. Cows fed hay had a lower incidence of RFM-M (28%) than cows fed HCS (57%) and CS (47%) as well as superior reproductive efficiency subsequently (89% conceived vs. 72% and 78%, respectively).

Effect of sexual experience, location, malnutrition, and repeated sampling on concentrations of testosterone in blood plasma of Gallus domesticus roosters

Five studies were conducted with mature White Leghorn roosters to study variables associated with concentrations of testosterone in blood sampled from a wing vein. Testosterone in blood plasma was unchanged 15, 30, or 45 min after collection of semen artificially whether or not roosters were trained for collection of semen. Likewise, cohabitation with hens for 7 to 8 hr was without effect. However, trained roosters had higher (P less than .05) plasma testosterone concentrations after 7 to 8 hr in a new location than untrained roosters. Furthermore, both groups in the new location had higher testosterone concentrations than the controls not translocated. Plasma testosterone was decreased (P less than .01) about 50% within 2 weeks by feeding a diet low in crude protein (2%) which decreased feed intake 33% and caused weight loss; those fed 12% crude proteins were unchanged. Variations in concentrations of testosterone among sequential samples of blood collected at 45 min intervals for 3 hr indicated random pulsatile releases of testosterone as reported for mammals. Sequential sampling at 15 min intervals for 1 to 2 hr revealed that the testosterone increases (up to 10 ng/ml) lasted for about 1 hr and that the returns to basal concentrations required about 1 to 1.5 hr. The interval between pulsatile releases may be as long as 3 hr in some roosters. These results indicate that roosters have spontaneous and pulsatile releases of testosterone as expected, because roosters release luteinizing hormone episodically during both light and dark cycles of the day.

Urinary creatinine as an index of urinary excretion of estrogen in cows prepartum and postpartum

Urine was collected from 55 cows via indwelling urinary catheters for periods of 12 h on different days (28 days prepartum to 60 days postpartum). Excretion of urinary creatinine (mg/h per kg bodyweight) among Holsteins increased from .94 on day 28 prepartum to 1.14 on day .5 postpartum and then decreased to .82 on days 30 to 45 of lactation. Excretion of creatinine among 12-h collections of urine on different days did not differ for groups of cows within periods prepartum and postpartum, and coefficients of variation within cows were 12 to 13%. Ratio of urinary estradiol (-17 alpha) to urinary creatinine was correlated (.93) more highly with its excretion based on volume of urine excreted than was its urinary concentration (.79) within periods prepartum and postpartum. Ratios of urinary metabolites to urinary creatinine rather than their concentrations should be used to express rates of excretion in cows' urine when urine excreted per hour is unknown. Moreover, daily rates of excretion of estradiol in urine can be estimated [ng estradiol/day = A X ng/mg urinary creatinine x kg bodyweight x 24 h, where A is average excretion of urinary creatinine (mg/h per kg bodyweight)] for respective days prepartum and postpartum.

Assay of prolactin after freezing cow's milk

Concentrations of prolactin were similar in aliquots of the same milk sample stored for 2 days at 4 C or --23 C but averaged lower if prepared for assay at 30 C than if prepared at 40 or 50 C. Average deviations in prolactin between duplicate measurements relative to respective treatment averages were lowest generally when technique of mixing included vortexing for 5 s immediately prior to pipetting volumes of milk for assay. The average deviation of differences in prolactin among duplicate measurements relative to average concentrations of prolactin were about the same for colostrum, milk, and blood plasma (11, 17, and 14%) stored frozen. Prolactin can be measured reliably in frozen cow's milk provided samples are warmed to 40 C to 50 C and mixed thoroughly when prepared for assay.

Blood plasma and milk prolactin, and effects of sampling technique on composition of milk from suckled ewes

Relations of techniques of sampling milk to its composition and concentrations of prolactin in blood plasma and milk from 59 suckled ewes were compared; Prolactin in milk and blood samples 0 to 2 h (hour 0) after removal of lambs did not differ significantly within autumn or summer, but both were doubled in summer. After the hour 0 sampling (summer only), one side of the udder of each of 12 ewes (group 1) was milked hourly for 4 h, and the opposite side was milked only at 0 and 4 h. Group 2 ewes were milked only at 0 and 4 h and blood was collected from both groups at 0 h and 4 h. Concentrations of prolactin were correlated in pairs of milk or blood samples from the same ewe and in plasma and milk of ewes in group 2 but not in group 1. Prolactin in milk increased between 0 h and 4 h in groups 1 and 2. Although milk lactose and prolactin concentrations differed among hourly samples, their average was similar to that of milk accumulated in the contralateral side for 4 h (group 1). Variations among ewes in progesterone of plasma indicated luteal activity during autumn and none during summer. Prolactin was unchanged in milk stored at -23 C for 30 days. The hour-0 milk-sampling technique was satisfactory to compare among individuals the concentrations of prolactin, total protein, or somatic cells in milk but not percentage fat and lactose, or milk yield due to variable time from last suckling to milking at hour 0.

Hormonal control of mammogenesis and onset of lactation in cows--a review

Estrogen stimulates development of mammary ducts, and progesterone and estrogen stimulate proliferation of secretory tissues. In vivo, sequential addition of insulin (step 1), glucocorticoid (step 2), and prolcatin (step 3) leads to biosynthesis of casein and lactose. In cows, mammogenesis continues until termination of pregnancy and overlaps onset of lactation. Progesterone probably inhibits differentiation of secretory cells at step 2 or step 3. Sensitivity of individual cells to progestational inhibition may decrease variably which may be interdependent upon relative increases in estrogen, prolactin, corticoids, and growth hormone to cause asynchronies among them at calving. Since prolactin in plasma is not correlated with progesterone or the estrogens, factors other than feed-back effects of ovarian steroids may be responsible for its sustained increase periparturiently. Also, elevated prolactin periparturiently may be unrelated to subsequent rates of lactation because its "basal" concentrations may meet requirements when inhibiting effects of progesterone are removed. This concept is attractive because mammary cells neither are synchronized highly for biosynthesis nor secrete normal milk for several days after calving. At the latter time, concentrations in plasma are low for progesterone and estrogen, similar to 3 days before calving for glucocoiticoids and prolactin, and increasing for insulin. Evidence of lactation under unusual circumstances was discussed.

Hormone induced lactation in the cow. IV. Relationships between lactational performance and hormone concentrations in blood plasma

Concentrations of progesterone, estrogen, and prolactin in plasma were compared among lactations induced in 29 cows by daily subcutaneous injections of .25 mg progesterone and .1 mg estradiol-17beta per kg body weight for 7 days. Superior, median, and inferior lactations were identified by ranking both weightage adjusted maximum milk yields in 7 consecutive days (average 144 +/- 9 kg) and days for milk yield to increase from 5 to 10 kg/day (15 +/- 3 days). Superior and inferior of the former averaged 189 and 101 kg, and their latter averaged 2 and 42 days. Plasma hormones were measured on day 0 before first treatment (day 1), and on days 7, 14, 17, 21, 24, 28, and 35. Superior lactations were associated with below-average progesterone and estrogen in plasma on day 0, rapid decreases in progesterone after day 7 and in estrogen after day 14, and increased prolactin after 7. In comparison, median lactations were associated with elevated progesterone and estrogen after day 17, but prolactin was similar to that of superior lactations. Inferior lactations were associated with decreased prolactin in plasma from days 21 to 35. We hypothesized that (a) first treatment should start 3 to 8 days after estrus, (b) daily doses of estradiol-17beta should be decreased with progesterone unchanged for the 7 days, and (c) estradiol-17beta alone should be continued for 7 days to improve hormonally induced lactations.

Equine granulosa cell tumors

Unilateral ovariectomy was performed on 3 mares affected with granulosa cell tumors. Tumor fluid in each mare was found to contain estrogen, testosterone, and progesterone. In 2 mares, preoperative blood plasma concentrations of these hormones were comparable to those of a series of clinically normal mares. The other mare, which had a history of aggressive, masculine behavior, had higher testosterone content in the tumor fluid and in the preoperative blood sample. After surgical removal of the tumors, each mare developed follicles and ovulated with the remaining ovary. Each was eventually bred and 2 conceived. The probability of metastasis of these tumors in mares appears uncertain. Data from other species suggests a guarded long-term prognosis may be justified.

Environmental and lactational variables affecting prolactin concentrations in bovine milk

Relationships were examined between prolactin concentrations in bovine milk and various environmental and lactational variables. Prolactin was quantified by radioimmunoassay in 1.316 milk samples from two experiments. Environmental temperatures preceding milking, stage of lactation, daily miik yield, and dominance rank of the cow were correlated significantly with milk prolactin concentration. Stepwise multiple regression analysis was used to determine, in order of importance, the variables having significant independent effects on milk prolactin. Ambient temperature extremes, high and low, exerted the greatest effects and were each associated with elevated concentrations of prolactin. In Experiment I,conducted throughout the year, the variable representing maximum temperature preceding milking accounted for 14.3% of the variation in milk prolactin. In Experiment II, conducted during late fall and early winter, the minimum temperature preceding milking accounted for 21.1% of the variation. Although earlier stages of lactation and larger daily milk yields were associated with higher prolactin concentrations, inclusion of lactation stage in the stepwise regression model tended to eliminate almost all the variance of prolactinpreviously associated with daily yield. Dominance measurements indicated that more submissive cows had higher milk prolactin. Individual cows tended to have characteristic prolactin, but this tendency was eliminated by statistical adjustment of the data for environmental and lactational variables.

Relationships between immunoreactive estrone and estradiol in milk, blood, and urine of dairy cows

Quantities of immunoreactive estrone and estradiol in blood plasma, urine, and milk were measured during the estrous cycle and pregnancy of cows. The objectives were to develop a radioimmunoassay procedure for quantifying estrogen in milk and urine and to compare changes in milk estrogen with those in blood plasma and urine. Concentrations of estrone and estradiol in milk varied during the estrous cycle. Relative concentrations of estradiol in blood plasma and milk were not different, but average estrone concentrations in milk were four times greater than those in blood plasma. Concentration of total estrogen (estradiol plus estrone) exceeded 1 ng/ml in colostrum and milk from cows milked prepartum, and was correlated with total estrogen in blood plasma and urine before and after calving. Blood plasma estrone was correlated only with milk estrone whereas blood plasma estradiol was correlated with urinary estradiol, milk estrone, and milk estradiol during the estrous cycle. These results raise possibilities that mammary gland of the lactating cow may concentrate preferentially estrone or convert estradiol to estrone. However, estimated excretion of estrogen through the milk represents no more than a fraction of 1% of the total excreted during the estrous cycle, and the proportion becomes less as gestation progresses up to at least 7 mo.

Characterization of metabolites in domestic sow urine after intravenous administration of radioactive estrogen and corticosteroids

We measured distribution of radioactivity among urinary metabolites excreted in nonpregnant and ovariectomized sows after intravenous injection of radionuclides (14carbon) labeled estrone, estradiol-17beta, cortisol, and corticosterone. Treatment with an enzyme preparation (Glusulase) containing both beta-glucuronidase and sulfatase activity, rendered extractable over 95% of the radioactivity recovered from urine with diethyl ether (estrogens) and ethyl acetate (corticoids). Only an additional 1 to 4% of the radioactivity was extracted following solvolysis of the aqueous residue remaining after enzyme hydrolysis and extraction. Radioactivity in nonpregnant sow urine was predominantly in the estrone fraction following injection of either estrone or estradiol-17beta. Moreover, the principal metabolite was estrone monoglucuronide. Only traces of estradiol-17beta and an estriol-like compound were detected. Two other isolates contained radioactivity. One compound probably was 2-methoxyestrone, but structure of the other compound (X1) could not be established. The principal urinary metabolites from injection of cortisol corresponded to chromatographic properties of tetrahydrocortisol and tetrahydrocortisone. Both metabolites were low in urine following injection of corticosterone. The major urinary metabolites from corticosterone injection corresponded to chromatographic properties of tetrahydrocorticosterone and corticosterone. Considerable radioactivity from injection of both corticoids was isolated in the cortol, cortolone, and 11-ketoetiocholanolone - 11beta-hydroxyetiocholanolone areas of chromatograms. The data for corticoids agree with similar data for the human being and cow.