Cardiac Output during Total Hip Replacement in Dogs

Trans-oesophageal pulsed-wave Doppler echocardiography was evaluated as a noninvasive method of determining cardiac output during total hip replacement in 10 dogs. Cardiac output was estimated by determining the crosssectional area of the aorta via caudal transverse echocardiography and the outflow velocity of the ascending aorta via cranial transverse Doppler echocardiography. Thermodilution was used as the reference method. In addition, cardiopulmonary changes, at the time of femoral prosthesis insertion, were determined. Comparison of 160 measurements yielded a correlation coefficient of 0.48. Linear regression analysis revealed the equation, cardiac outputDoppler echocardiography = 0.45 cardiac outputthermodilution + 3.3. In comparison to thermodilution, trans-oesophageal pulsedwave Doppler echocardiography overestimated cardiac output at flow rates less than 61/min and underestimated the cardiac output at flow rates greater than 61/min. There was a significant decrease in the partial pressure of carbon dioxide at end-expiration (PETCO2), the systolic arterial blood pressure (mmHg) and the invasive stroke volume (ml/beat/m2) and a significant increase in the pulmonary vascular resistance (dynes/sec/cm5) immediately after insertion of the femoral prosthesis.

The purpose of this study was to evaluate the trans-oesophageal pulsed-wave Doppler echocardiography as a noninvasive method of determining cardiac output in dogs during total hip replacement. Thermodilution was used as the reference method. The correlation coefficient was r = 0.48. In conclusion, this study confirms that the trans-oesophageal Doppler echocardiography is not suitable for measuring the absolute CO-value. This ultrasound technique only allows an approximate estimation of the CO-trend.

Schmerztherapie mit Metamizol

Gegenstand und Ziel: Die vorliegende Arbeit soll den derzeitigen Wissensstand über die pharmakologische und klinische Wirkung von Metamizol bei Hund, Katze Maus und Ratte vorstellen. Metamizol erlebt in den letzten Jahren eine Renaissance, vor allem in der Humanmedizin. Lange Zeit wurde Metamizol als schwaches Analgetikum mit vorwiegend antipyretischer Wirkung eingestuft und die pharmakologische Wirkung war lange Zeit unbekannt. Heute ist wissenschaftlich nachgewiesen, dass zentrale und periphere Wirkmechanismen für die potente analgetische Wirkung von Metamizol verantwortlich sind. Opioiderge Mechanismen und Hemmung der Zyklooxygenasen gelten heute als gesicherte Wirkmechanismen von Metamizol. Metamizol wirkt aber auch antipyretisch, gering antiphlogistisch, spasmolytisch und antikonvulsiv. Die analgetische Wirkung ist mit der von Opioiden vergleichbar. Die hypotensive Nebenwirkung bei intravenöser Injektion lässt sich durch langsame Applikation weitestgehend vermeiden. Eine Agranulozytose wurde bisher in der Veterinärmedizin nicht beobachtet und auch in der Humanmedizin liegt die Inzidenz unter 0,008%. Die Magen-Darm-Trakt-Verträglichkeit von Metamizol ist als gut einzustufen. Schlussfolgerung und klinische Relevanz: Der vorliegende Artikel zeigt, dass Metamizol auch in der Veterinärmedizin potent analgetisch wirkt und die Verträglichkeit als sehr gut zu bewerten ist.

Comparison of dipyrone/propofol versus fentanyl/propofol anaesthesia during surgery in rabbits

In this study, the investigation of the intraoperative effects of dipyrone (metamizol) on heart rate (HR), mean arterial pressure (MAP) and analgesic efficacy in rabbits is described for the first time. This was carried out to evaluate the cardiovascular stability achieved using dipyrone compared with fentanyl. In this prospective study, 17 female New Zealand White rabbits were randomly allocated to either one of two groups: dipyrone/propofol (DP) or fentanyl/propofol (FP). Anaesthesia was induced in both groups using propofol to effect (4.0–8.0 mg/kg intravenously) until the swallowing reflex was lost for intubation. After induction, anaesthesia was maintained with continuous infusion of propofol 1.5–1.7 mg/kg/min intravenously. Analgesics were then injected in defined boluses of either dipyrone 65 mg/kg or fentanyl 0.0053 mg/kg. After surgical tolerance, defined as loss of the ear pinch reflex and loss of the anterior and posterior pedal withdrawal reflex, was achieved, two surgical procedures were performed. The surgical procedures (implantation of either a pacemaker or an electrocardiogram transmitter), both require a comparable level of analgesic depth. During and after surgery, clinical variables, such as MAP, HR, peripheral arterial oxygen saturation (SpO2) and end-tidal CO2 (Pe′CO2) were recorded simultaneously every 2 min. Eight time points were chosen for comparison: baseline, surgical tolerance (ST), values at 10, 20 and 30 min after reaching ST, values at the end of propofol infusion (EI) and data at 10 and 20 min after EI. Both FP and DP combinations provided effective anaesthesia and analgesia in rabbits. In both groups a significant decrease of HR and MAP was measured. The results of this study indicate that the non-opioid drug dipyrone produces similar analgesic and even better cardiovascular effects by trend in rabbits. Therefore we conclude that dipyrone in combination with propofol can be used as an alternative to FP for intraoperative analgesia.

A Comparative Clinical Study of Three Different Dosages of Intramuscular Midazolam?Medetomidine?Ketamine Immobilization in Cats

A low dose of midazolam-medetomidine-ketamine (MMK) combination was evaluated in three increasing dosages. Each of the 18 cats was randomly allocated for several times to one of four groups. Five minutes after premedication with intramuscular (IM) 0.04 mg/kg atropine, group A (n = 43), B (n = 40) and C (n = 28) all were anaesthetized with 0.5 mg/kg midazolam, combined with 10, 20 or 30 microg/kg medetomidine, and 1.0, 2.0 or 3.0 mg/kg ketamine, respectively, IM in one syringe. Group D (n = 11) received the established combination of 50 microg/kg medetomidine and 10.0 mg/kg ketamine for comparison. Because this study was in cooperation with a project on dental prophylaxis, cats had to be immobilized for approximately 1 h. Therefore, anaesthesia was prolonged with propofol to effect, if necessary. Duration of MMK anaesthesia was between 30 +/- 15, 45 +/- 19 and 68 +/- 28 min in groups A, B and C respectively. A significant decrease of respiratory rate was observed with increasing dosage, but venous carbon dioxide (pCO(2)) and pH values in combination with arterial oxygen saturation (SpO(2)) values were not alarming. The diastolic blood pressure particularly showed an increase. MMK combination A showed the best cardiovascular results, but it cannot be recommended due to disadvantages like a long induction time sometimes accompanied by excitations and the short duration of surgical immobilization. Dosage C in contrast had fewer side effects but less favourable cardiovascular results and a longer recovery period. However, either dosage B or C was suitable as a repeatable IM immobilization method for non-invasive procedures in healthy cats.

Biomechanical and histomorphometric comparison between zirconia implants with varying surface textures and a titanium implant in the maxilla of miniature pigs

BACKGROUND

Mechanical properties and biocompatibility make zirconia ceramics suitable implant material. The characteristics of tooth-color like, the ability to be machined and the low plaque affinity make zirconia especially suitable as a dental implant material. The influence of surface modification on the osseointegration of this material has not been extensively investigated.

PURPOSE

Long-term investigations with titanium implants have shown superior biomechanical results with the sandblasted acid-etched (SLA) surface, demonstrating a high bone-implant interaction. The objective of this study was to compare two different zirconia surface topographies biomechanically and histologically with the well-documented titanium SLA surface.

MATERIAL AND METHODS

Zirconia implants with either a machined (ZrO2m) or a sandblasted (rough, ZrO2r) surface were manufactured with the exact same cylindrical shape with a standard ITI thread configuration as the SLA titanium implants. The incisors 2 and 3 were removed from both sides of the maxillae of 13 adult miniature pigs and the tissues left to heal for 6 months. After this time period the animals received a total of 78 implants using a randomized scheme, with the titanium SLA implant used as an only individual reference. After healing periods of 4, 8, and 12 weeks 20, 24, and 25 implants, respectively, were subjected to removal torque tests (RTQ) as the main biomechanical analysis of the of the study. A fewer number was resected on bloc, embedded in methylmethacrylat and analyzed for their direct bone apposition under a light microscope.

RESULTS

Surface analysis revealed the highest surface roughness for the SLA-implant, followed by ZrO2r and ZrO2m. The turned ZrO2m implants showed statistically significant lower RTQ values than the other two implants types after 8 and 12 weeks, while the SLA implant showed significantly higher RTQs values than ZrO2r surface after 8 weeks. Differences in the bone apposition were observed in the histomorphometric analysis using light microscopy for all surfaces at any time point.

CONCLUSION

The findings suggest that ZrO2r implants can achieve a higher stability in bone than ZrO2m implants. Roughening the turned zirconia implants enhances bone apposition and has a beneficial effect on the interfacial shear strength.

Nerve Replacement Strategies for Cavernous Nerves

OBJECTIVE

This article reviews novel restorative therapies for cavernous nerves that may be used to replace resected cavernous nerves at the time of pelvic surgery.

METHODS

A literature-based presentation (Medline search) on current nerve replacement strategies was conducted with emphasis on neurobiological factors contributing to the restoration of erectile function after cavernous nerve injuries.

RESULTS

A promising alternative to autologous nerve grafts for extending the length of successful nerve regeneration are artificial nerve guides. The addition of neurotrophic factors, extracellular matrix components and Schwann cells has been shown to promote cavernous nerve regeneration. Neurotrophic factors can be incorporated in the scaffold or can be supplied by cells seeded into the stroma. The regenerative capacity of these cells can be further enhanced by genetic modification with neurotrophic factor encoding genes.

CONCLUSIONS

Artificial nerve guides, especially biodegradable ones containing growth-promoting factors or cells, are a promising option for the repair of cavernous nerve lesions.

Magnetisches Drug Targeting—ein neuer Ansatz in der lokoregionären Tumortherapie mit Chemotherapeutika

BACKGROUND

Advanced squamous cell carcinomas of the head and neck region were often treated with combined radio-chemotherapy. Radiotherapy allows a focused treatment of the tumor, and healthy tissue can be protected from radiation. Chemotherapy, however, is mostly given systemically and the unwanted negative side effects also develop in many other organs.

AIM OF THE STUDY

Locoregional application of chemotherapeutic agents with Magnetic Drug Targeting on an animal experimental study.

METHODS AND RESULTS

Magnetic Drug Targeting is a new approach to the locoregional treatment of tumors. Ferrofluids (colloidal dispersion of magnetic nanoparticles) were reversibly bound to chemotherapeutic agents and injected intra-arterially, while focused with an external magnetic field to a certain body compartment (i.e. the tumor). With only 20% or 50% percent of the regular systemic chemotherapeutic dose, we achieved an up to 26 times higher concentration in the tumor region with this application compared to the usual systemic administration.

CONCLUSION

Magnetic Drug Targeting offers an unique opportunity to treat tumors locoregionally with chemotherapeutic agents.

[Nerve repair strategies for restoration of erectile function after radical pelvic surgery]

Iatrogenic cavernous nerve lesions occurring during radical pelvic surgery often lead to irreversible erectile dysfunction. The nerve defects after excision of the neurovascular bundles must be reconstructed by interposition grafting to supply a permissive scaffold for oriented axonal regrowth. The use of autologous nerve grafts for the repair of human cavernous nerves during radical prostatectomy has been controversial regarding the limited success achieved with bilateral nerve grafting. Artificial nerve guides consisting of natural or synthetic materials have been successfully used for bridging peripheral nerve defects. The combination with Schwann cells, neurotrophic factors and extracellular matrix components has been shown to promote cavernous nerve regeneration.

Investigation on the precaecal and faecal digestibility of lactulose and inulin and their influence on nutrient digestibility and microbial characteristics

This study was conducted to determine the pre-caecal and faecal digestibility of lactulose and inulin and the influence of these substances on nutrient digestibility and microbial characteristics. In metabolic trials three of six male growing pigs (German Landrace x Pietrain) were fitted with an ileo-rectal anastomosis (IRA) in end-to-end technique with preserved ileo-caeco-colic valve. The metabolic trials were conducted from day 21-63 after surgery. The remaining pigs were used as intact partners (IN) for the IRA pigs. The experimental diets, based on corn, wheat, barley and soybean meal, were supplemented with either 1.5% lactulose or 2% inulin in replacement of diatomaceous earth (control). Pre-caecal digestibility of lactulose and inulin was assessed to be 79 and 98%, respectively. faecal digestibility was determined as 100%. The supplementation of lactulose and inulin had only minor effects on the pre-caecal and faecal digestibility of nutrients. Significant differences in nutrient digestibility were obvious between IRA and IN pigs, whereas the IRA pigs showed lower digestibility values with the exception of ether extracts (EE). Bacterial population in the digesta of IRA and IN pigs were not affected by the experimental diets except the concentration of gram-negative anaerobes, which inclined when the IRA pigs received the lactulose diet. The pH of chyme was significantly lower than the pH of faeces, however the pH was unaffected by the different supplemented diets. The concentration of volatile fatty acids (VFA) in pre-caecal chyme decreased significantly when IRA pigs received the lactulose supplemented diet whereas VFA in faeces were unaffected by the supplementation. IRA pigs administered with lactulose excreted more N via the urine, but the nitrogen balance remained unaffected. From the present investigation it can be concluded that lactulose and inulin did only partly or scarcely fulfill the expectation of acting as prebiotics in pigs.

Tissue Engineering erektiler Nerven

Dissection of the cavernous nerves eliminates spontaneous erections and may lead to irreversible erectile dysfunction due to degeneration of cavernous tissue. Novel procedures to reconstruct penile innervation include cavernous nerve interposition grafting and neurotrophic treatments to revitalize penile neural input, evaluated thus far in various preclinical models of cavernous nerve injury. Schwann cells crucially contribute to successful axonal regeneration by mechanical and paracrine mechanisms in the injured nerve, and Schwann cells seeded into guidance channels have been successfully employed to support regeneration in animal models of cavernous nerve injury. Gene therapy, tissue engineering, and reconstructive techniques have been combined to deliver neurotrophic factors and recover erectile function.

Schwann cell seeded guidance tubes restore erectile function after ablation of cavernous nerves in rats

PURPOSE

Dissection of the cavernous nerves eliminates spontaneous erections. We evaluated the ability of Schwann cell seeded nerve guidance tubes to restore erections after bilateral cavernous nerve resection in rats.

MATERIALS AND METHODS

Sections (5 mm) of the cavernous nerve were excised bilaterally, followed by immediate bilateral microsurgical reconstruction. In 10 animals per group (20 study nerves) reconstruction was performed by genitofemoral nerve interposition, interposition of silicone tubes or interposition of silicone tubes seeded with homologous Schwann cells. As the control 10 animals (20 study nerves) underwent sham operation (positive control) and bilateral nerve ablation (without reconstruction) was performed in a further 10 (negative control). Erectile function was evaluated 3 months postoperatively by relaparotomy, electrical nerve stimulation and intracavernous pressure recording.

RESULTS

After 3 months neurostimulation resulted in an intact erectile response in 90% (18 of 20) of Schwann cell grafts, while treatment with autologous nerves (30% or 6 of 20) or tubes only (50% or 10 of 20) was less successful (p <0.01). Whereas untreated ablated rats showed no inducible erections (0% or 0 of 20), all sham operated animals had an intact erectile response (100% or 20 of 20). Maximum intracavernous pressure upon electrostimulation was significantly elevated using Schwann cell grafts compared to results in the other treatment groups (p <0.001). Morphological evaluation revealed advanced regeneration within Schwann cell grafts.

CONCLUSIONS

Schwann cell seeded guidance tubes restore erectile function after the ablation of cavernous nerves in rats and they are superior to autologous nerve grafts.

Anaesthesia with Midazolam/Medetomidine/Fentanyl in Chinchillas (Chinchilla lanigera) Compared to Anaesthesia with Xylazine/Ketamine and Medetomidine/Ketamine

We studied four different drug regimes for anaesthetic management in chinchillas and evaluated and compared their cardiovascular and respiratory effects. In this randomized, cross-over experimental study, seven adult chinchillas, five females, two males [515 +/- 70 (SD) g] were randomly assigned to one of the following groups: group 1 [midazolam, medetomidine and fentanyl (MMF), flumazenil, atipamezole and naloxone (FAN); MMF-FAN] received 1.0 mg/kg midazolam, 0.05 mg/kg medetomidine and 0.02 mg/kg fentanyl i.m., and for reversal 0.1 mg/kg flumazenil, 0.5 mg/kg atipamezole and 0.05 mg/kg naloxone s.c. after 45 min; group 2 (MMF) 1.0 mg/kg midazolam, 0.05 mg/kg medetomidine and 0.02 mg/kg fentanyl i.m.; group 3 [xylazine/ketamine (X/K)] 2.0 mg/kg xylazine and 40.0 mg/kg ketamine i.m.; and group 4 [medetomidine/ketamine (M/K)] 0.06 mg/kg medetomidine and 5.0 mg/kg ketamine i.m. Reflexes were judged to determine anaesthetic stages and planes. Anaesthesia with X/K and M/K was associated with a prolonged surgical tolerance and recovery period. By reversing MMF, recovery period was significantly shortened (5 +/- 1.3 min versus 40 +/- 10.3 min in MMF without FAN, 73 +/- 15.0 min in X/K, and 31 +/- 8.5 min in M/K). Without reversal, MMF produced anaesthesia lasting 109 +/- 16.3 min. All combinations decreased respiratory and heart rate but compared with X/K and M/K, respiratory and cardiovascular complications were less in the MMF groups. Focussing on the clinical relevance of the tested combinations, completely reversible anaesthesia showed two major advantages: anaesthesia can be antagonized in case of emergency and routinely shortens recovery. In small animals particularly these advantages lead to less complications and discomfort and thus often can be lifesaving. As all analgesic components (medetomidine and fentanyl) are reversed, postoperative analgesia should be provided before reversal of anaesthesia.

Periarterial application of papaverine during laparoscopic donor nephrectomy improves early graft function after kidney transplantation in pigs

BACKGROUND

Laparoscopic donor nephrectomy (LDN) increases incentives to donation by subjects who might refuse an open operation. However, the incidence of delayed graft function is higher after LDN than after open operation. This may be caused by the reduction of renal perfusion as a result of the raised intraabdominal pressure and mechanically induced renal angiospasm during the operation. We conducted experiments to find out whether the application of papaverine around the renal artery during LDN could improve early graft function after transplantation.

METHODS

Renal function was studied in 10 male pigs (weight approximately 25 kg). The left kidney was harvested laparoscopically (intraabdominal pressure 8 mmHg). Five animals were randomly selected to have perivascular application of 50 mg papaverine (treatment group) before preparation of the vessels. In controls no papaverine was used. After LDN and open right nephrectomy the left kidney was autotransplanted. The main outcome measures were volume of urine produced and creatinine clearance during the first 20 h after the transplant.

RESULTS

The groups were comparable in respect of body weight, hemodynamic values, amount of infusions, warm and cold ischemia time, and duration of anastomosis. Urine output and creatinine clearance were significantly higher in pigs treated with papaverine than in controls.

CONCLUSIONS

Papaverine substantially improved early graft function in pigs when applied around the renal artery during LDN. Whether this is applicable to procurement of human kidneys remains to be evaluated.

The influence of periarterial papaverine application on intraoperative renal function and blood flow during laparoscopic donor nephrectomy in a pig model

BACKGROUND

The transplantation of live donor kidneys harvested laparoscopically is associated with a higher incidence of delayed graft function than the transplantation of grafts harvested via the open technique. The delay is believed to be due to a decrease in renal blood flow during laparoscopic donor nephrectomy (LDN). The aim of this study was to evaluate whether renal function and blood perfusion can be enhanced by the periarterial application of papaverine during LDN.

METHODS

Renal function and blood flow were studied in a porcine model that included a total of 24 pigs (20-30 kg). In 12 of the pigs, urine output and creatinine clearance were determined as measures of renal function. In the other 12 pigs, renal blood flow was determined using fluorescent-labeled microspheres. In each group, the pigs were randomized into two subgroups, one with and one without a perivascular injection of 50 mg papaverine.

RESULTS

As compared to the controls, the animals receiving papaverine had a significantly higher urine output (3.1 +/- 1.6 vs 0.9 +/- 0.45 ml/h/kg; p = 0.02), superior creatinine clearance (2.22 +/- 0.5 vs 0.95 +/- 0.1 ml/min/kg; p = 0.038), and enhanced renal blood flow (4.9 +/- 2.2 vs 2.1 +/- 0.8 ml/min/g; p = 0.008).

CONCLUSIONS

When applied to the tissue surrounding the renal artery, papaverine substantially improves renal function and blood flow during laparoscopic live kidney donation. Whether graft optimization during kidney procurement also translates into improved posttransplantation function remains to be established.

Plasma epinephrine levels after epinephrine administration using different tracheal administration techniques in an adult CPR porcine model

The aim of the study was to compare arterial plasma epinephrine levels after tracheal epinephrine application using three different tracheal instillation techniques at different tracheal levels in a porcine adult cardiopulmonary resuscitation model. In the prospective, randomized study, electrically-induced cardiopulmonary arrest was applied to 32 anaesthetized and paralyzed domestic pigs. After 3 min of cardiopulmonary arrest and 2 min of external chest compressions using a pneumatic compression device and mechanical ventilation, epinephrine was administered intravenously (20 microg/kg) or tracheally (50 microg/kg): using either direct injection into the upper end of the tracheal tube, via a catheter placed into the bronchial system and using a special tracheal application tube. In each group, there were eight pigs. Arterial blood samples were taken before and up to 10 min after epinephrine administration. Regression analysis was performed of the correlated data. The values of mean arterial blood pressure and end-tidal CO(2) during the time of observation did not differ between groups. Total plasma epinephrine concentrations showed a significant increase in all groups, but with no difference between the tracheal groups. However, peak epinephrine levels in the intravenous group were significantly higher than in tracheal groups. We conclude that administration using three different tracheal instillation levels result in similar onset and peak plasma epinephrine levels in this setting and therefore the preferred method of tracheal epinephrine application for cardiopulmonary resuscitation may be selected by other criteria.

Locoregional cancer treatment with magnetic drug targeting

The specific delivery of chemotherapeutic agents to their desired targets with a minimum of systemic side effects is an important, ongoing challenge of chemotherapy. One approach, developed in the past to address this problem, is the i.v. injection of magnetic particles [ferrofluids (FFs)] bound to anticancer agents that are then concentrated in the desired area (e.g., the tumor) by an external magnetic field. In the present study, we treated squamous cell carcinoma in rabbits with FFs bound to mitoxantrone (FF-MTX) that was concentrated with a magnetic field. Experimental VX-2 squamous cell carcinoma was implanted in the median portion of the hind limb of New Zealand White rabbits (n = 26). When the tumor had reached a volume of approximately 3500 mm3, FF-MTX was injected intraarterially (i.a.; femoral artery) or i.v. (ear vein), whereas an external magnetic field was focused on the tumor. FF-MTX i.a. application with the external magnetic field resulted in a significant (P < 0.05), complete, and permanent remission of the squamous cell carcinoma compared with the control group (no treatment) and the i.v. FF-MTX group, with no signs of toxicity. The intratumoral accumulation of FFs was visualized both histologically and by magnetic resonance imaging. Thus, our data show that i.a. application of FF-MTX is successful in treating experimental squamous cell carcinoma. This "magnetic drug targeting" offers a unique opportunity to treat malignant tumors locoregionally without systemic toxicity. Furthermore, it may be possible to use these magnetic particles as a "carrier system" for a variety of anticancer agents, e.g., radionuclides, cancer-specific antibodies, and genes.

Endohyperthermia--experimental evaluation of a new therapeutic approach for treatment of biliary carcinoma

BACKGROUND AND STUDY AIMS

To improve the prognosis of patients with unresectable, locally advanced bile duct carcinoma, new treatment strategies need to be evaluated. Hyperthermia has been successfully applied as part of multimodal therapy in esophageal and rectal carcinoma. We performed in-vitro and in-vivo experiments with a new intraluminal hyperthermia system in the biliary tract.

METHODS

A radiofrequency system (13.56 MHz, Endoradiotherm XERT-200A; Olympus Optical Co., Tokyo, Japan) was used with a special intraluminal microelectrode (diameter 4.5 mm, length 40 mm) covered by a silicone balloon with cooling water and a large counter electrode for focusing the electromagnetic field around the electrode. The heating capacity of the endohyperthermia unit was examined in vitro in a muscle-equivalent phantom (agar 4 %), in isolated livers of pigs and cows, as well as in vivo in anesthetized sheep. Continuous thermometry was done with thermosensors at the applicator surface, and with multichannel thermocouple probes in the environment of the applicator.

RESULTS

Endohyperthermia induced a homogeneous heating of the phantom and the isolated liver bile duct preparation to a temperature > or = 40 degrees C in an area at least 10 mm in depth. After placement of the applicator into the common bile duct of anesthetized sheep, endohyperthermia led to a consistent and repeatable heating of the surrounding tissue to 40.5 +/- 0.5 degrees C at 1 cm distance, and 39.9 +/- 0.7 degrees C at 2 cm distance. Blood pressure, heart rate, and systemic temperature did not change in vivo. Histological examination of the bile duct showed superficial mucosal necrosis (depth 100-200 microm), microvascular damage with petechiae, congestion and edema of the bile duct wall and adventitia after hyperthermia treatment in vivo.

CONCLUSIONS

The intraluminal endohyperthermia system produces consistent and repeatable heating of the surrounding tissue. Since effective thermal power can reach a depth of up to 2 cm, tumors may also be heated adequately.

Inhibition of neointima formation after experimental coronary artery stenting: a new biodegradable stent coating releasing hirudin and the prostacyclin analogue iloprost

BACKGROUND

To minimize acute stent thrombosis and development of restenosis, stents coated with biodegradable and nonbiodegradable polymers have been proposed to serve as sustained-release drug carriers.

METHODS AND RESULTS

In both a sheep and a pig model, we examined the vascular response to standard and high-pressure implantation of coronary Palmaz-Schatz stents coated with a 10-microm layer of polylactic acid (MW 30 kDa) releasing recombinant polyethylene glycol (r-PEG)-hirudin and the prostacyclin analogue iloprost, both drugs with antithrombotic and potentially antiproliferative effects. Study observation time was 28 days. Between the corresponding stent groups, no differences were observed with regard to preplacement and postplacement implantation parameters. The morphometric analysis demonstrated that the coating was associated with a greater lumen diameter through a reduction in the mean restenosis area by 22.9% (P<0.02) in the standard-pressure model (sheep) and by 24.8% (P<0.02) in the overstretch pig model compared with uncoated control stents without inducing a local inflammatory response.

CONCLUSIONS

The results from this study demonstrate beneficial effects of a polymeric stent coating with polylactic acid releasing r-PEG-hirudin and iloprost on the development of restenosis after coronary stent placement at 4 weeks, independent of the extent of vascular injury. Future studies are proposed to investigate the integration of other substances to further enhance the potential of the stent coating on reducing neointimal formation.

Investigations on the intestinal availability of native thiamin in selected foods and feedstuffs

The aim of the present study was to investigate the precaecal digestibility as a quantitative measure for the intestinal availability of naturally occurring thiamin from selected foods and feedstuffs. Therefore, three experiments were conducted to examine the following foods and feedstuffs: Eggs, bananas, white cabbage, corn, milk, fish, barley, soybeans, rice, wheat bran, brewer's yeast, rye and soybean meal. The foods and food processing procedures were made with regard to their relevance in human and animal nutrition. For all experiments male pigs with an initial live weight between 33 and 40 kg were fitted with an end-to-end ileo-rectal anastomosis with preserved ileo-caeco-colicvalve. Three weeks after surgery, the digestibility trials were carried out from week 4 to week 9 and week 12 to week 17 after surgery. The animals were fed the individual experimental diets for a period of 12 days while digesta were collected twice a day quantitatively during the final 5 days of this period. Precaecal digestibility for thiamin from all tested foods and feedstuffs was within a range from 73% to 94% with the highest values from boiled soybeans, boiled rice and barley, and the lowest value from steamed fish. In comparison with the animal products the plant products show on average a nearly equal precaecal digestibility for thiamin (87.3% versus 83.5%). Moreover, all tested foods and feedstuffs exhibit a relatively good intestinal availability of thiamin.

Phase-related changes in right ventricular cardiac output under volume-controlled mechanical ventilation with positive end-expiratory pressure

OBJECTIVE

To examine determinants of right ventricular function throughout the ventilatory cycle under volume-controlled mechanical ventilation with various positive end-expiratory pressure (PEEP) stages.

DESIGN

Prospective observational animal pilot study.

SETTING

Animal research laboratory at a university hospital.

SUBJECTS

Eight healthy swine under volume- controlled mechanical ventilation.

INTERVENTIONS

Flow probes were implanted in eight swine in order to continuously measure blood flow in the pulmonary artery and inferior vena cava. After a recovery phase of 14 days, the swine were subjected to various PEEP stages (0, 5, 10 cm H2O) during volume-controlled positive pressure ventilation.

MEASUREMENTS AND MAIN RESULTS

Continuous flow measurement took place in the pulmonary artery and inferior vena cava. Data on standard hemodynamic parameters were additionally acquired. Respiration-phase-specific analysis of right ventricular cardiac output and of additional hemodynamic function parameters followed, after calculation of mean values throughout five respiration cycles. PEEP at 5 cm H2O led to significant decreases in inferior vena cava flow (4.1%), and in right ventricular cardiac output (5.2%); the respective decreases at PEEP 10 cm H2O were 13.9% and 18.3%. In the inspiration phase at PEEP 10 cm H2O, results revealed an overproportionally pronounced decrease in comparison with the expiration phase in inferior vena cava flow (-24.6% vs. -10%) and right ventricular cardiac output (-35% vs. -13.5%). This phenomenon is presumably caused by a PEEP-related increase in mean airway pressure by the amount of 10.7 cm H2O in inspiration.

CONCLUSIONS

Increases in PEEP during volume-controlled mechanical ventilation leads to respiration-phase-specific reduction of right ventricular cardiac output, with a significantly pronounced decrease during the inspiration phase. This decrease in cardiac output should be taken into particular consideration for patients with already critically reduced cardiac output.

[Salivary cortisol as a stress parameter in piglets]

The relationship between salivary and plasma levels of total and free cortisol was monitored in 97 male piglets, aged two to four weeks, subjected to castration. Samples were taken 10 minutes before (basal value) as well as one, two, three, four and 24 hours post castration and at the same time intervals from a control group of 17 animals which did not undergo surgery. Simultaneously to blood (indwelling catheter) withdrawing saliva was collected by two cotton swabs. Cortisol levels were measured by radioimmunoassay (RIA). A highly significant increase in total, free and salivary cortisol was found within the first four hours after castration compared to the control group. The percentage increase one hour after castration above basal values was highest in free plasma cortisol (21.08 +/- 2.03 nmol/l vs. 61.26 +/- 4.16 nmol/l; 290.6%), and lowest in total plasma cortisol (177.33 +/- 9.69 nmol/l vs. 374.09 +/- 18.21 nmol/l; 211.0%), whereas salivary cortisol showed an 255.7% increase (10.46 +/- 1.03 nmol/l vs. 26.75 +/- 1.93 nmol/l). Total cortisol included 11.9-16.4% free cortisol. Salivary cortisol concentration was between 5.9% and 7.5% of the total plasma cortisol concentration. The highest correlation between total plasma cortisol and salivary cortisol occurred one hour after castration (r = 0.57; p < 0.01). The correlation between free and salivary cortisol was lowest for basal values (r = 0.27; p < 0.05), whereas correlations for the remaining time points were highly significant (0.41 < or = r < or = 0.61; p < 0.01). For the control group significant correlations were found between salivary and total plasma cortisol (0.58 < or = r < or = 0.89; p < 0.05) and between free and salivary cortisol (0.63 < or = r < or = 0.92; p < 0.05). The present work indicates that the measurement of salivary levels of cortisol reflects the concentration of this hormone in plasma samples of piglets.

Reduced CO2-elimination during combined high-frequency ventilation compared to conventional pressure-controlled ventilation in surfactant-deficient piglets

BACKGROUND

Combined high-frequency ventilation (CHFV) combines a conventional low-frequency component with super-imposed high-frequency jet pulses. The intention is to overcome the limited CO2-elimination of high-frequency ventilation, and to decrease airway pressures and enhance hemodynamic performance by reducing the conventional component. The present study was performed to compare the effects of conventional continuous positive-pressure ventilation (CPPV) on gas exchange, airway pressures and cardiac output to those of CHFV at matched minute volume (MV) and mean airway pressure (MPAW).

METHODS

Sixteen anaesthetised piglets with lavage-induced surfactant deficiency were ventilated with CPPV, with positive end-expiratory pressure (PEEP) set to obliterate the lower inflection point of the inspiratory pressure-volume loop. This setting was compared to CHFV during which 50% of the total MV was applied as superimposed jet pulses of 20 Hz at otherwise unchanged settings, and to CPPV at a PEEP level which was reduced (CPPVred) until MPAW matched MPAW during CHFV. Gas exchange, airway pressures and hemodynamics were measured after the ventilatory setting had been applied for 20 min.

RESULTS

MPAW decreased from (median) 2.7 kPa with CPPV to 2.4 kPa with CHFV (P < or = 0.05). Peak inspiratory pressure was 3.6 kPa with CPPV, 3.2 kPa with CHFV, and 3.2 kPa with CPPVred (P < or = 0.05 for differences to CPPV), respectively. PaCO2 was comparable during CPPV (5.9 kPa), CPPVred and CHFVCO2, while it increased during CHFV (6.8 kPa, (P < or = 0.05)). Cardiac output did not differ significantly between the settings.

CONCLUSION

In the porcine lavage model, CO2-elimination is reduced during CHFV compared to CPPV at matched minute volume. At matched mean airway pressure, CHFV fails to reduce peak inspiratory airway pressure and to improve hemodynamic performance compared to CPPV.

Doppler energy: a new acquisition technique for the transthoracic detection of myocardial perfusion defects with the use of a venous contrast agent

AIMS

This animal experiment was designed to study whether the new technique of Doppler energy imaging could display myocardial perfusion abnormalities with the use of a combination of transthoracic imaging and right atrial injection of a myocardial contrast agent.

METHODS AND RESULTS

A series of 11 pigs were studied during (1) normal perfusion, (2) dipyridamole-induced coronary dilatation, and (3) during and after temporary occlusion of the left anterior descending or circumflex artery after a right atrial injection of 8 ml Levovist, 400 mg/ml. Short-axis views were obtained with the four following imaging modes: gray scale imaging (two-dimensional and M-mode), Doppler energy imaging (two-dimensional and M-mode). Visual inspection and off-line video densitometry (results expressed in arbitrary videointensity units 0 to 255) with digital background subtraction were performed. Doppler energy was significantly more sensitive in detecting the presence of contrast than gray scale imaging (background subtracted peak videointensity 32 +/- 17 versus 17 +/- 12, p < 0.001). Mean background-subtracted videointensity increased during dipyridamole-induced coronary hyperemia (40 +/- 14 versus 31 +/- 9, p < 0.003) using Doppler energy technique. Doppler energy imaging consistently detected absent perfusion (background subtracted videointensity -6 +/- 6) and immediate reperfusion (background subtracted peak videointensity 29 +/- 15, p < 0.001).

CONCLUSIONS

With the use of a galactose-based contrast agent, Doppler energy data acquisition was superior to standard gray scale imaging in transthoracic evaluation of regional myocardial perfusion, absence of perfusion, and reperfusion.

[Ban of the use of metomidate (Hypnodil) in swine. Background, consequences and alternatives]

Since the beginning of 1997 the use of the hypnotic drug metomidate (Hypnodil) in swine is not longer allowed. This ban caused a substantial therapeutic deficit for anesthesia in swine. The ban is based on provisions of the European Council Directive 2377/90 for fixing maximum residue limits (MRL) of veterinary drugs in animal-derived food and due to the fact that the pharmaceutical industry has not submitted any application for determining an MRL for metomidate. According to the regulations of the German drug law only those substances can be used as alternatives which are authorized for use in swine or another food-producing animal species. Registrations for use in swine exist for the barbiturates thiamylal and narcobarbital, for ketamine and for the neuroleptics azaperone, acepromazine and propionylpromazine. In the exceptional case of therapeutic emergency levomethadone or xylazine can be used. The administration of propofol, thiopentone, opioids (except levomethadone) or benzodiazepines (except brotizolam) to swine is not allowed since these drugs are authorized only for use in humans or companion animals. At present the most appropriate alternative for anesthesia in swine is thiamylal after premedication of azaperone and ketamine inducing general anesthesia with sufficient tolerance at low risks. In current studies general anesthesia with tolerance could further be produced by combinations of levomethadone, ketamine and azaperone or xylazine. Combined use of levomethadone with benzodiazepines appeared to be not suitable in swine.

[Problems of laparoscopy using captoperitoneum: controlled ventilation, circulation, blood gas and body temperature]

More and more veterinarians are going to perform laparoscopic diagnosis and surgery those days. But the technique using capnoperitoneum implicates several alterations of different physiological parameters, which, without proper monitoring, are often realized to late. Pathophysiology under CO2 insufflated abdomen as well as counter measures to keep or reestablish physiological situations are described. Within experimental studies, 27 pigs received partial colon resection using the laparoscopic technique, another six after laparotomy. They were compared concerning controlled ventilation, cardiovascular and blood gas parameters as well as the body temperature. Monitoring of the end-exspiratory CO2-gas tension as well as controlled ventilation seems to be essential. Blood gas analyses are proposed additionally. Under the described laparoscopic conditions blood circulation and body temperature seem to be influenced positively.

[Isoflurane anesthesia in rabbits in a closed anesthetic system]

Using the Stephens anaesthetic apparatus-which is a closed system with an in-circuit, nonprecision vaporizer-and isoflurane as anaesthetic gas, 18 rabbits were anaesthetized and showed sufficient hypnosis, analgesia, and muscle relaxation during bone surgery. Induction of anaesthesia was achieved with intravenous propofol and all rabbits were intubated afterwards. During the following isoflurane inhalation anaesthesia the mean arterial blood pressure decreased considerably (compared to control measures before induction), the heart rate remained the same or showed a slight increase, and the respiratory rate decreased. The arterial pO2 decreased corresponding to the respiratory depression after propofol induction and increased again during spontaneous ventilation with 100% oxygen. The changes in arterial pCO2 and pH were representative for a rise in the CO2-stimulation threshold. A moderate metabolic acidosis could be seen due to preanaesthetic excitement of the animals. Recovery time was short (between one and 11 minutes) and no signs of excitation could be detected. The consumed volume of isoflurane was 0.80 ml/kg BW/h.

Quantitative evaluation of manganese-52m as a myocardial perfusion tracer in pigs using positron emission tomography

There is a need for a quantitative myocardial perfusion agent that does not require an on-site cyclotron. Early studies with manganese demonstrated that this trace metal is of potential use for myocardial imaging. 52mMn can be produced in a 52Fe-52mMn generator and is suitable for positron emission tomographic (PET) imaging. The purpose of this study was to evaluate 52mMn with regard to its potential to quantitatively assess myocardial perfusion. Dynamic PET imaging was performed in six pigs with various doses of dipyridamole to increase blood flow. Retention (R) and model-based K1 values were correlated with microsphere blood flow. The models consisted of one (K1, k2) and two (K1, k2, k3) tissue compartments. Anterior, lateral and septal regions showed a good myocardium-to-background ratio; the evaluation of the inferior wall was impaired by high liver uptake. Linear regression yielded the following equations: K1=1.152 flow+0.059 (r=0.92), R=0.069 flow+0.034 (r=0.84). Based on these regressions, K1 increased 2.7-fold and R 2.6-fold in the examined flow range of 0.5-2 ml/min/g (fourfold increase), demonstrating an underestimation of higher flow rates by both measures. It is concluded that 52mMn allows the qualitative assessment of myocardial perfusion but does not meet the requirements of a quantitative myocardial perfusion agent.

Calmodulin sensitivity of the sarcoplasmic reticulum ryanodine receptor from normal and malignant-hyperthermia-susceptible muscle

Ca2+ release from sarcoplasmic reticulum (SR) of malignant-hyperthermia-susceptible (MHS) muscle is hypersensitive to Ca2+ and caffeine. To determine if an abnormal calmodulin (CaM) regulation of the SR Ca(2+)-release-channel-ryanodine-receptor complex (RYR1) contributes to this hypersensitivity, we investigated the effect of CaM on high-affinity [3H]ryanodine binding to isolated SR vesicles from normal and MHS pig skeletal muscle. CaM modulated [3H]ryanodine binding in a Ca(2+)-dependent manner. In the presence of maximally activating Ca2+ concentrations, CaM inhibited [3H]ryanodine binding with no differences between normal and MHS vesicles. In the absence of Ca2+, however, CaM activated [3H]ryanodine binding with a 2-fold-higher potency in MHS vesicles. Significant differences between normal and MHS tissue were observed for CaM concentrations between 50 nM and 10 microM. A polyclonal antibody raised against the central region of RYR1 specifically inhibited this activating effect of CaM without affecting the inhibition by CaM. This indicates that the central region of RYR1 is a potential binding domain for CaM in the absence of Ca2+. It is suggested that in vivo an enhanced CaM sensitivity of RYR1 might contribute to the abnormal high release of Ca2+ from the SR of MHS muscle.

[Carbon dioxide stunning for the slaughter of turkeys]

In an experimental study on stunning of 460 turkeys in a CO2 enriched atmosphere (60-70% CO2 in air), as a more animal protecting and more economic alternative to conventional electrical stunning, the following results are obtained: all animals show respiratory arrest within 100 seconds. After being dipped in a CO2 enriched atmosphere for a few seconds the turkeys show head shaking and forced respiration which has to be considered as a strain the animals are conscious of. The meat hygienic results after CO2 stunning are much better than after electrical stunning.

[Percutaneous cystoscopy in dogs and cats]

Cystoscopy enables a reliable diagnosis of urinary bladder diseases. The use of transurethral or perineal endoscopic technique is limited by anatomical features. Therefore it was examined, if the prepubic percutaneous access shows advantages referring to diagnosis and treatment. Using this technique three dogs and two cats were examined. The endoscopic instrumentarium and the technical procedure are described.

[Clinical investigations of an i.m. combination anesthesia with fentanylclimazolam/xylazine and postoperative i.v. antagonism with naloxone/sarmazenil/yohimbine in guinea pigs]

Aim of the study was the clinical use of a completely antagonisable anaesthesia in guinea pigs. The dosage based on experimental studies. Fentanyl, climazolam and xylazine (0.05/2.0/2.0 mg/kg) were injected i.m. for combination anaesthesia and naloxone, sarmazenil and yohimbine (0.03/0.3/2.0 mg/kg) i.v. were used for antagonisation. 18 guinea pigs (17 female, one male) with an average body weight of 1177 g aged between eight months and five years were anaesthetised for various surgical procedures. The following clinical parameters were measured: body temperature, muscle relaxation, analgesia, hyperacusia, righting-, interdigital- and palpebral reflex. After antagonisation the return of righting reflex, the appearance of muscle trembling, the first walking without ataxia and the first food uptake were observed. The investigations showed that this kind of anaesthesia is suitable for surgical procedures in the guinea pig and is very safe because of the complete antagonisation of the depressing respiratory and circulatory effects of anaesthesia.

Recording of unexpectedly high frequency vibrations of blood vessel walls in experimental arteriovenous fistulae of rabbits using a laser vibrometer

Because arteriovenous fistulae are associated with a palpable thrill and an audible murmur, the vibrational activity of the blood vessel walls about experimental arteriovenous fistulae in rabbits was investigated using, for the first time, a high-resolution laser vibrometer. Frequencies of mural vibrations up to 2200 Hz were recorded at different sites about the fistulae. The relationship of this vibratory activity of blood vessel walls to physiological and pathological conditions warrants further investigation.

[Fulminating malignant hyperthermia in swine--an alternative therapy concept]

An inexpensive therapeutic concept compared to the dantrolene-therapy to counter the malignant hyperthermia (MH) is to be discussed, using a case-study from swine-anaesthesia. Hyperventilating the animals (with O2), administering metamizol, beta-blocker, bicarbonate and sufficiently cooling the patient can, if the symptoms are recognized early enough, arrest the hypermetabolic cascade in its track. All the animals that were treated according to this scheme survived the (MH) crisis without any lasting post operative damage.