[A comparison of the Proseal laryngeal mask to the standard laryngeal mask on anesthesized, non-relaxed patients]

It was our goal to compare the Proseal-laryngeal mask airway (PLMA) with the classical laryngeal mask airway (LMA) in a german multicenter trial. Handling of the instruments and application criteria were to be tested. 7 anaesthesia departments were able to take part in this study. 280 patients could be investigated after approval of the ethics committee of the medical faculty of the university of Goettingen. 145 patients received the PLMA and 135 the LMA. The surgical interventions were small to moderate procedures with a duration of at least 20 minutes in the sections general surgery, trauma/orthopedic surgery, urology, vascular surgery, gynecology, ENT-surgery and ophthalmology. There was equivalence of the two instruments PLMA and LMA concerning duration and ease of insertion, endoscopic position check, observations on emergence, potential for injury and some postoperative complaints. This equivalence could be confirmed statistically. Laryngospasm was observed in three, Bronchospasm in two patients with the PLMA, in no one with the LMA. In one case of laryngospasm and another of bronchospasm a mechanism of supraglottic laryngeal stenosis has been involved which may occur in rare instances with the PLMA. This mechanism is due to the double cuff of the PLMA with the instruments proximity to the laryngeal inlet. The seal pressure in both groups differs significantly (p = 0.001). The mean value for the seal pressure was 29,3 +/- 0,21 mbar for the PLMA and 20,9 +/- 0,21 mbar for the LMA. In the PLMA the gastric tube could be positioned with the first attempt in 118 patients, with the second attempt in 17 cases. In 10 patients the gastric tube could not be placed. Contrary to the LMA the tip of the PLMA cuff may be bent in some cases with loss of airway safety and positioning of the gastric tube. The symptoms sore throat and painful swallowing on the first postoperative day were more frequent with LMA application. These differences could be confirmed statistically (sore throat p = 0.01, painful swallowing p = 0.04). They may be explained by the more rigid LMA compared to the PLMA and by the fact that the LMA in this study was older than the PLMA, loosing plasticizer. The drainage tube within the PLMA offers safety from aspiration in patients with no primary aspiration risk, additional reassurance for a correct position and a better stability of the airway. Our data may support a wider indication range for the PLMA compared with the LMA. The PLMA may be applied in laparoscopies and lower abdominal surgical interventions. Careful clinical observation will show, if the minimal invasiveness of the PLMA offers an advantage for these patients. The PLMA should not be applied in patients with increased aspiration risk.

[Clinical signs and diagnosis of BSE]

Bovine spongiform encephalopathy (BSE) in cattle is characterised by typical signs and an insidious course. There is gradual weight loss and decreased milk production, and the disease is distinguished by disturbances in behaviour, sensitivity and locomotion. The most common behavioural changes are apprehension and abnormal temperament. The most common changes in sensitivity are hypersensitivity to tactile, auditory and optical stimuli, kicking during milking and excessive licking of the muzzle. The most important disturbances in locomotion include ataxia, falling down and inability to get up. Diagnostic procedures include a thorough clinical and neurological examination followed by a more detailed examination to assess behaviour, locomotion and sensitivity to touch, sound and light stimuli. Other causes of central nervous system disease may be ruled out by a complete blood count, biochemical profile, urinalysis and examination of cerebrospinal fluid. Disturbances in behaviour, locomotion and sensitivity that occur singly, rather than in combination with each other, should be interpreted with caution. However, in cattle with disturbances in two or more of these categories, a tentative diagnosis of BSE can be made, and the veterinary authorities must be notified.

Effect of a treatment with eprinomectin or trichlorfon on the yield and quality of milk produced by multiparous dairy cows

The effects of a strategic antiparasitic treatment against Hypoderma species and other parasites on the milk yield, composition, and somatic cell counts of 742 multiparous dairy cattle were investigated on 79 farms in a Hypoderma species-endemic area in western Switzerland; 357 of the cows were treated with eprinomectin, 252 with trichlorfon, and 133 were left untreated. The treatments were given between October and early December 1998, on average 53 days before calving. Milk yield, fat, protein and somatic cell counts were measured once a month until the end of lactation. Eprinomectin and trichlorfon significantly increased milk yield during the first month after treatment compared with the control cows by 2.14 (P < 0.001) and 2.50 kg per day (P < 0.001), respectively. Initially, the difference between the eprinomectin- and trichlorfon-treated animals was not significant, but the effect of eprinomectin on milk yield was persistent, whereas the effect of trichlorfon decreased significantly by 0.12 kg per day per month (P < 0.05). The somatic cell counts increased significantly slower in the treated cows than in the control cows (P < 0.05). Milk composition was not affected by the treatments.

Comparison of forced-air warming systems with upper body blankets using a copper manikin of the human body

BACKGROUND

Forced-air warming with upper body blankets has gained high acceptance as a measure for the prevention of intraoperative hypothermia. However, data on heat transfer with upper body blankets are not yet available. This study was conducted to determine the heat transfer efficacy of eight complete upper body warming systems and to gain more insight into the principles of forced-air warming.

METHODS

Heat transfer of forced-air warmers can be described as follows: Qdot;=h. DeltaT. A, where Qdot;= heat flux [W], h=heat exchange coefficient [W m-2 degrees C-1], DeltaT=temperature gradient between the blanket and surface [ degrees C], and A=covered area [m2]. We tested eight different forced-air warming systems: (1) Bair Hugger and upper body blanket (Augustine Medical Inc. Eden Prairie, MN); (2) Thermacare and upper body blanket (Gaymar Industries, Orchard Park, NY); (3) Thermacare (Gaymar Industries) with reusable Optisan upper body blanket (Willy Rüsch AG, Kernen, Germany); (4) WarmAir and upper body blanket (Cincinnati Sub-Zero Products, Cincinnati, OH); (5) Warm-Gard and single use upper body blanket (Luis Gibeck AB, Upplands Väsby, Sweden); (6) Warm-Gard and reusable upper body blanket (Luis Gibeck AB); (7) WarmTouch and CareDrape upper body blanket (Mallinckrodt Medical Inc., St. Luis, MO); and (8) WarmTouch and reusable MultiCover trade mark upper body blanket (Mallinckrodt Medical Inc.) on a previously validated copper manikin of the human body. Heat flux and surface temperature were measured with 11 calibrated heat flux transducers. Blanket temperature was measured using 11 thermocouples. The temperature gradient between the blanket and surface (DeltaT) was varied between -8 and +8 degrees C, and h was determined by linear regression analysis as the slope of DeltaT vs. heat flux. Mean DeltaT was determined for surface temperatures between 36 and 38 degrees C, as similar mean skin surface temperatures have been found in volunteers. The covered area was estimated to be 0.35 m2.

RESULTS

Total heat flow from the blanket to the manikin was different for surface temperatures between 36 and 38 degrees C. At a surface temperature of 36 degrees C the heat flows were higher (4-26.6 W) than at surface temperatures of 38 degrees C (2.6-18.1 W). The highest total heat flow was delivered by the WarmTouch trade mark system with the CareDrape trade mark upper body blanket (18.1-26.6 W). The lowest total heat flow was delivered by the Warm-Gard system with the single use upper body blanket (2.6-4 W). The heat exchange coefficient varied between 15.1 and 36.2 W m-2 degrees C-1, and mean DeltaT varied between 0.5 and 3.3 degrees C.

CONCLUSION

We found total heat flows of 2.6-26.6 W by forced-air warming systems with upper body blankets. However, the changes in heat balance by forced-air warming systems with upper body blankets are larger, as these systems are not only transferring heat to the body but are also reducing heat losses from the covered area to zero. Converting heat losses of approximately 37.8 W to heat gain, results in a 40.4-64.4 W change in heat balance. The differences between the systems result from different heat exchange coefficients and different mean temperature gradients. However, the combination of a high heat exchange coefficient with a high mean temperature gradient is rare. This fact offers some possibility to improve these systems.

Ultrasonographic evaluation of reticular motility in cows after administration of atropine, scopolamine and xylazine

The goal of this study was to evaluate the effect of various dosages and routes of administration of atropine, scopolamine and xylazine on reticular motility in cows. Groups of five cows received atropine, scopolamine or xylazine at dosages varying from 0.01 to 0.20 mg/kg. The drugs were administered intramuscularly and intravenously; atropine was also given subcutaneously. A total of 17 trials, each using five cows, were carried out. Reticular motility was assessed for 3 min immediately prior to the administration of a drug and for 21 min after administration, and the latter period was divided into seven 3-min intervals. The motility was further assessed during 3-min periods every 10 min starting 28 min and ending 141 min after administration of a drug. During each 3-min interval, the number of reticular contractions or the occurrence of reticular atony was determined. Onset and duration of reticular atony were assessed. All three drugs inhibited reticular motility but onset varied with route of administration and dosage. As expected, the onset of reticular atony occurred most rapidly after intravenous administration of each drug, followed by intramuscular and subcutaneous administration. Reticular atony occurred 0-3.0 min after the intravenous administration of each drug and at all dosages except the lowest dosage of atropine. Atony lasted for 3-111 min. Reticular atony occurred 3-18 min and 9-15 min after intramuscular and subcutaneous administration, respectively. It lasted 32-108 min and 39-122 min for the intramuscular and subcutaneous routes, respectively. For each drug, higher dosages resulted in a more rapid onset and longer duration of reticular atony than did lower dosages. This study demonstrated that administration of atropine, scopolamine and xylazine results in reticular atony. Whether this has clinical relevance requires further investigation.

[Border disease in a flock of sheep]

This report describes border disease in a flock of sheep in Switzerland. In April 2001, three ewes in a flock of 41 sheep gave birth to lambs that had generalized tremors and excessively hairy fleece. One of these, a three-week-old female lamb, was referred to our clinic for further diagnostic work-up. The lamb was very nervous, bleated constantly and had generalized muscle tremors, which were more pronounced in the head region. Hind end ataxia was observed, and the lamb was slow to correct its posture when the hind limbs were abducted, adducted or crossed. Blood samples were collected every six weeks to determine antibody titres to pestivirus and for virus isolation via cell culture. A skin biopsy sample was also collected and examined immunohistochemically for pestivirus antigen. Antibody titres in the first tests were suspicious and those of the second were negative. Pestivirus was identified in cell culture, and the skin biopsy sample was positive for pestivirus antigen. Blood samples were collected from all of the ewes and lambs and the buck for virus isolation via cell culture and determination of pestivirus antibody titres. Thirty-one animals were seropositive, six had borderline antibody titres and four were seronegative. Pestivirus was isolated from eight animals, which included the lamb described in this report. Of the virus-positive animals, three were seronegative, three others had borderline titres and two were seropositive. Six of the eight viruses isolated from cell culture were further characterized genetically via retrotranscription and polymerase chain reaction and subsequent sequencing. The phylogenetic analysis revealed that the causative agent was border disease virus. This is the first time that border disease virus has been isolated in Switzerland. The lamb referred to our clinic was observed for three months; it was then euthanatised and a postmortem examination was performed. Immunohistochemical examination of numerous organs revealed pestivirus antigen. The source of infection was though to be infected sheep from another flock, which shared a pasture. All antigen-positive animals were slaughtered.

Diagnosis by ultrasonography of congestion of the caudal vena cava secondary to thrombosis in 12 cows

This paper describes the clinical, ultrasonographic, radiographic and postmortem findings in 12 cows with thrombosis of the caudal vena cava. The principal clinical signs were chronic bronchopneumonia and fever in 11 cows; one cow had epistaxis and one cow bled from the mouth; eight cows had anaemia and leucocytosis, and the clotting time for the glutaraldehyde test was markedly decreased in all the cows; in nine of the cows the activity of gamma-glutamyltransferase was high, suggesting chronic hepatic congestion. The most important ultrasonographic finding was congestion of the caudal vena cava attributable to thrombosis of the vein. In all the cows the caudal vena cava was round to oval on cross-section, rather than the normal triangular shape. The hepatic, splenic and portal veins were dilated in five, three and one cow, respectively. The results of radiography and endoscopy supported a diagnosis of bronchopneumonia, but there were radiographic changes in the diaphragmatic lung lobes that supported a diagnosis of vena caval disease in only four cows. Postmortem there was a thrombosis of the caudal vena cava in all the cows, and the thrombi were located in the thoracic, subphrenic and abdominal part of the caudal vena cava at the level of the liver in four, one and seven cows, respectively. In three cows, the thrombus was situated where a hepatic abscess had broken into the caudal vena cava, and in one cow it was at the site of a diaphragmatic abscess. In another cow, there was a fistula between the major bronchus of the right diaphragmatic lung lobe and the caudal vena cava where the thrombus was situated. Three cows had liver abscesses that had not broken into the caudal vena cava. There was severe bronchopneumonia in 11 of the cows, some of which also had multiple pulmonary abscesses.

Ultrasonographic findings in cows with dilatation, torsion and retroflexion of the caecum

Thirty cows with caecal dilatation underwent clinical and ultrasonographic examinations, followed by a right flank laparotomy and surgical correction. The intraoperative findings were compared with the results of the ultrasonographic examination. The appearance, position, dimensions, diameter and nature of the contents of the caecum and proximal and spiral ansa of the colon were determined with a 3.5 MHz linear transducer. The wall of the proximal ansa of the colon and of the dilated caecum closest to the abdominal wall was visible in all the cows and appeared as an echogenic semicircular line immediately adjacent to the peritoneum. The contents of the caecum and of the proximal and spiral ansa of the colon were not visible in 21, 25 and 25 cows, respectively, owing to gas. In the remaining cows, the contents were hypoechogenic to echogenic in appearance. In all of the cows, the dilated caecum was imaged from the right abdominal wall at the level of the tuber coxae. The caecum was imaged from the 12th, 11th and 10th intercostal spaces in 11, five and three cows, respectively. The caecum and proximal ansa of the colon were situated immediately adjacent to the right abdominal wall in 28 cows, but in the other two cows parts of these structures were pushed away from the abdominal wall by the liver or gall bladder. The diameter of the caecum, measured at various sites varied from 7.0 to 25.0 cm. Caecal dilatation was diagnosed on the basis of the results of rectal examinations in 28 of the cows, but in all 30 cows on the basis of the results of the ultrasonographic examinations. Dilatation and caudal displacement of the caecum were diagnosed in 18 cows; dilatation and cranioventral retroflexion of the caecum were diagnosed in six cows, and dilatation and craniodorsal retroflexion of the caecum were diagnosed in two cows. In the four other cows, the direction of the retroflexed caecum could not be determined. The diagnosis of caecal dilatation based on the ultrasonographic findings was confirmed in all the cows during exploratory laparotomy. The results of ultrasonography and exploratory surgery with regard to the position of the dilated and sometimes retroflexed or twisted caecum were in complete agreement in 18 cases, in partial agreement in eight cases, but in four cases did not agree.

Clinical findings and treatment of listeriosis in 67 sheep and goats

This paper describes the clinical findings and treatment of 67 sheep and goats with listeriosis. In 55 of them the diagnosis was made on the basis of the typical signs, which included vestibular ataxia, circling, head tilt and unilateral cranial nerve deficits, but in 12 animals a definitive diagnosis was made only after postmortem examination. The most significant haematological and biochemical findings were a high haematocrit in 16 animals, a high concentration of total protein in 33, a high concentration of bilirubin in 39 and a high concentration of urea nitrogen in 28 animals. Twenty-eight of the animals had a metabolic acidosis. Thirty-nine animals were treated with antibiotics, intravenous sodium chloride and glucose solutions and sodium bicarbonate. Ten of them survived and the others were euthanased because their condition deteriorated. Of the 10 that survived, nine were able to stand when they were first examined and one was in lateral recumbency. Of 15 animals treated with chloramphenicol, one survived; of 11 animals treated with oxytetracycline, two survived; and of nine animals treated with gentamicin and ampicillin, six survived.

Construction and evaluation of a manikin for perioperative heat exchange

BACKGROUND

During surgery hypothermia can be avoided only if the heat exchange between the body surface and the environment can be controlled. To allow a systematic analysis of this heat exchange, we constructed and evaluated a copper manikin of the human body.

METHODS

The manikin consists of six tubes (head, trunk, two arms and two legs) painted matt-black to simulate the emissivity of the human skin. Hot-water mattresses are bonded to the inner surface of the copper tubes to set the surface temperature. Calibrated heat flux transducers were placed on the following points to determine the heat exchange coefficient for radiation and convection (hRC) of the manikin: Forehead, chest, abdomen, upper arm, forearm, dorsal hand, anterior thigh, anterior leg and foot. Room temperature was set to 22 degrees C. Surface temperature of the manikin was set between 22 degrees C and 38 degrees C. The hRC was determined by linear regression analysis as the slope of the temperature gradient between the manikin and the room versus the measured heat flux. Subsequently we studied five minimally clothed volunteers in a climate chamber. Initial chamber temperature was set to 29 degrees C and was lowered slowly to 12 degrees C. The hRC was determined as described above for each volunteer.

RESULTS

The hRC of the manikin was 11.0 W m(-2) degrees C(-1) and hRC of the volunteers was 10.8 W m(-2) degrees C(-1).

CONCLUSION

The excellent correlation of hRC between the volunteers and the manikin will allow the manikin to be used for standardised studies of perioperative heat exchange.

[Long-term results after surgical tracheotomy and percutaneous dilatation tracheostomy. A comparative retrospective analysis]

Besides surgical tracheostoma for treatment of long-term intubation, percutaneous dilatational tracheostomy (PDT) has become available during the last few years. Long-term results of the PDT are rare in the medical literature. This paper reports a retrospective analysis comparing the results after PDT with those after surgical tracheostomy. The methods include subjective evaluation of both techniques by the patients using a standardized questionnaire. It also includes the objective cosmetic result of the outside scar, as well as endoscopic inspection of the larynx and trachea. The patients own evaluation showed a higher content in the PDT group mainly due to the cosmetic result. The objective data confirmed those results. Patients with surgical tracheostomy had an average scar length of 5 cm (2 inches), compared to 1,2 cm (5 inch) in the PDT group. The endoscopic examination showed minor stenosis of the trachea in both groups that were not functionally relevant. The average stenosis of 14% for the PDT was similar to that observed after surgical tracheostomy which was 19%. The choice of the best technique should be made in close cooperation between head- and neck surgeons and anesthesiologists.

[Malignant catarrhal fever in Switzerland: 2. Evaluation of the diagnosis]

Malignant catarrhal fever (MCF) is a mostly fatal lymphoproliferative disease of cattle. In 1995 a PCR based method was introduced for the detection of the ovine herpesvirus 2 (OvHV-2), which is regarded as the causative agent of the sheep-associated form of the disease. This PCR can be regarded as a gold standard for the in vivo diagnosis of sheep-associated MCF in cattle (Müller-Doblies et al., 1998). This semi-nested PCR was now used as a reference test for the reassessment of diagnostic criteria in the clinical and post mortem diagnosis that could previously not be quantitated. Based on 83 suspected cases with a complete clinical record the clinical signs were weighted and grouped according to their sensitivity and specificity into lead signs indicative of MCF and frequently accompanying signs supportive for the diagnosis of MCF and general clinical signs that were less reliable for the diagnosis. Differential diagnoses are discussed, which are of particular significance due to their status as OIE list A diseases e.g. foot-and-mouth disease or rinderpest. 38 PCR confirmed cattle with MCF served for the quantitative analysis of organ lesions. For the post mortem diagnosis an essential set of organ samples is defined to permit a reliable histological diagnosis, as the gross pathology often did not give any indication for the diagnosis. These criteria should help to improve the diagnostic efficiency and to select the appropriate laboratory diagnostic procedures for MCF-suspected cattle.

Exacerbated vein graft arteriosclerosis in protein kinase Cdelta-null mice

Smooth muscle cell (SMC) accumulation is a key event in the development of atherosclerosis, including vein bypass graft arteriosclerosis. Because members of the protein kinase C (PKC) family signal cells to undergo proliferation, differentiation, or apoptosis, we generated PKCdelta knockout mice and performed vein bypass grafts on these animals. PKCdelta(-/-) mice developed normally and were fertile. Vein segments from PKCdelta(-/-) mice isografted to carotid arteries of recipient mice of either genotype led to a more severe arteriosclerosis than was seen with PKCdelta(+/+) vein grafts. Arteriosclerotic lesions in PKCdelta(-/-) mice showed a significantly higher number of SMCs than were found in wild-type animals; this was correlated with decreased SMC death in lesions of PKCdelta(-/-) mice. SMCs derived from PKCdelta(-/-) aortae were resistant to cell death induced by any of several stimuli, but they were similar to wild-type SMCs with respect to mitogen-stimulated cell proliferation in vitro. Furthermore, pro-apoptotic treatments led to diminished caspase-3 activation, poly(ADP-ribose) polymerase cleavage, and cytochrome c release in PKCdelta(-/-) relative to wild-type SMCs, suggesting that their apoptotic resistance involves the loss of free radical generation and mitochondrial dysfunction in response to stress stimuli. Our data indicate that PKCdelta maintains SMC homeostasis and that its function in the vessel wall per se is crucial in the development of vein graft arteriosclerosis.

[Clinical findings and diagnostic procedure in a dairy sheep with visna]

The goal of this report was to describe the clinical signs and diagnosis of Visna in a seven-year-old East Friesian milk sheep. A striking feature was that the ewe's behaviour changed frequently. At one time, the ewe was somnolent. A few minutes later, the sheep was alert and eating hay. The ewe was thin. It had a slight head tilt and a severe generalised ataxia. Based on the neurological symptoms and chronic weight loss, a tentative diagnosis of visna was made. Serological testing for maedi-visna was positive, and the ewe was euthanised. A postmortem examination was performed, and lung and brain samples were collected aseptically. Cell cultures from these organs were positive for viral enzymatic reverse transcriptase and for maedi-visna RNA.

Targeted disruption of the zetaPKC gene results in the impairment of the NF-kappaB pathway

Here we have addressed the role that zetaPKC plays in NF-kappaB activation using mice in which this kinase was inactivated by homologous recombination. These mice, although grossly normal, showed phenotypic alterations in secondary lymphoid organs reminiscent of those of the TNF receptor-1 and of the lymphotoxin-beta receptor gene-deficient mice. The lack of zetaPKC in embryonic fibroblasts (EFs) severely impairs kappaB-dependent transcriptional activity as well as cytokine-induced phosphorylation of p65. Also, a cytokine-inducible interaction of zetaPKC with p65 was detected which requires the previous degradation of IkappaB. Although in zetaPKC-/- EFs this kinase is not necessary for IKK activation, in lung, which abundantly expresses zetaPKC, IKK activation is inhibited.

Ultrasonographic examination of the caecum and the proximal and spiral ansa of the colon of cattle

The large intestine of 10 cows was examined from the right abdominal wall with a 3.5 MHz linear transducer. The cows were then slaughtered, and the organs were re-examined in a water bath. The caecum was visualised from the middle region of the abdominal wall. It ran caudo-cranially, varied in diameter from 5.2 to 18.0 cm and was situated immediately adjacent to the abdominal wall. The lateral wall of the caecum appeared as a thick, echogenic, crescent-shaped line. It could be visualised as far cranially as the 12th intercostal space. Although its junction could not be identified, the proximal ansa of the colon was recognised on the basis of its anatomical position and its diameter, which was smaller than that of the caecum. The spiral ansa of the colon and the descending colon were situated dorsal to the caecum and could be identified by moving the transducer horizontally along the abdominal wall to the last rib. The spiral ansa of the colon was situated ventral to the descending colon, and its walls appeared as thick echogenic lines. In a contracted state, the spiral colon had the appearance of a garland.

Strangulation of the duodenum by the uterus during late pregnancy in two cows

Two Swiss Braunvieh cows in late pregnancy underwent surgery because of a rare form of ileus due to strangulation of the duodenum at its caudal flexure by the gravid uterus. The whole uterus had passed through a gap between the mesoduodenum and duodenum and with increasing weight had led to strangulation of the duodenum. This was possible since the mesoduodenum and both walls of the greater omentum adjacent to its caudal edge were not connected with the duodenum, probably due to a congenital inhibitory malformation. A transsection and an end-to-end anastomosis of the duodenum were necessary in both cases since it was impossible to retract the gravid uterus through the defect. Postoperative recovering was uneventful in both cows, which were discharged after seven and five days respectively and calved normally about two months later.

Lack of dystrophin is associated with altered integration of the mitochondria and ATPases in slow-twitch muscle cells of MDX mice

The potential role of dystrophin-mediated control of systems integrating mitochondria with ATPases was assessed in muscle cells. Mitochondrial distribution and function in skinned cardiac and skeletal muscle fibers from dystrophin-deficient (MDX) and wild-type mice were compared. Laser confocal microscopy revealed disorganized mitochondrial arrays in m. gastrocnemius in MDX mice, whereas the other muscles appeared normal in this group. Irrespective of muscle type, the absence of dystrophin had no effect on the maximal capacity of oxidative phosphorylation, nor on coupling between oxidation and phosphorylation. However, in the myocardium and m. soleus, the coupling of mitochondrial creatine kinase to adenine nucleotide translocase was attenuated as evidenced by the decreased effect of creatine on the Km for ADP in the reactions of oxidative phosphorylation. In m. soleus, a low Km for ADP compared to the wild-type counterpart was found, which implies increased permeability for that nucleotide across the mitochondrial outer membrane. In normal cardiac fibers 35% of the ADP flux generated by ATPases was not accessible to the external pyruvate kinase-phosphoenolpyruvate system, which suggests the compartmentalized (direct) channeling of that fraction of ADP to mitochondria. Compared to control, the direct ADP transfer was increased in MDX ventricles. In conclusion, our data indicate that in slow-twitch muscle cells, the absence of dystrophin is associated with the rearrangement of the intracellular energy and feedback signal transfer systems between mitochondria and ATPases. As the mechanisms mediated by creatine kinases become ineffective, the role of diffusion of adenine nucleotides increases due to the higher permeability of the mitochondrial outer membrane for ADP and enhanced compartmentalization of ADP flux.

One session cognitive behavioural therapy for elderly patients with chronic obstructive pulmonary disease

BACKGROUND

We hypothesized that compared to an educational intervention, a single 2 h session of cognitive behavioural therapy (CBT), with 6-week follow-up, would reduce anxiety and depression, improve physical and mental functioning, and lead to a better quality of life and greater satisfaction with treatment in older patients with chronic obstructive pulmonary disease (COPD).

METHODS

Fifty-six subjects were recruited from a large, urban, academically affiliated Veterans Affairs (VA) Hospital, a non-profit private hospital, and a local newspaper, for a single blind randomized controlled clinical trial. One 2 h session of group CBT was designed to reduce symptoms of anxiety, with specific components including relaxation training, cognitive interventions, and graduated practice, followed by homework and weekly calls for 6 weeks. This was compared to a group that received 2 h of COPD education, followed by weekly calls. Pre- and post-intervention subjects in both groups were administered SF-36, Geriatric Depression Scale, Beck Anxiety Inventory, 6 min walk test, and the FEV-1. Following the intervention, both groups completed the Client Satisfaction Questionnaire.

RESULTS

When compared with a group that received education about COPD, 2 h CBT group showed decreased depression and anxiety. Contrary to our hypothesis, despite the decrease in depression and anxiety, there was no change in the physical functioning of the patients.

CONCLUSIONS

Twenty to 40% of patients with COPD have high levels of anxiety and depression. Our study finds that as little as 2 h of CBT administered in a group setting is able to reduce these anxious and depressive symptoms.

Functional complexes of mitochondria with Ca,MgATPases of myofibrils and sarcoplasmic reticulum in muscle cells

Regulation of mitochondrial respiration in situ in the muscle cells was studied by using fully permeabilized muscle fibers and cardiomyocytes. The results show that the kinetics of regulation of mitochondrial respiration in situ by exogenous ADP are very different from the kinetics of its regulation by endogenous ADP. In cardiac and m. soleus fibers apparent K(m) for exogenous ADP in regulation of respiration was equal to 300-400 microM. However, when ADP production was initiated by intracellular ATPase reactions, the ADP concentration in the medium leveled off at about 40 microM when about 70% of maximal rate of respiration was achieved. Respiration rate maintained by intracellular ATPases was suppressed about 20-30% during exogenous trapping of ADP with excess pyruvate kinase (PK, 20 IU/ml) and phosphoenolpyruvate (PEP, 5 mM). ADP flux via the external PK+PEP system was decreased by half by activation of mitochondrial oxidative phosphorylation. Creatine (20 mM) further activated the respiration in the presence of PK+PEP. It is concluded that in oxidative muscle cells mitochondria behave as if they were incorporated into functional complexes with adjacent ADP producing systems - with the MgATPases in myofibrils and Ca,MgATPases of sarcoplasmic reticulum.

[Malignant catarrhal fever in Switzerland. 1.Epidemiology]

Malignant catarrhal fever (MCF) is a usually fatal infectious disease of cattle with global distribution. Based on the recent introduction of a diagnostic PCR assay and a competitive inhibition ELISA (ciELISA) epidemiological data were collected on field cases in Switzerland. Throughout a three-year period, an MCF incidence of 0.6@1000 was observed, with a gradient of cases from Eastern to Western Switzerland. While the cantons Wallis, Vaud and Geneva reported no and the remaining western cantons only reported a few cases, the highest incidence was observed in the cantons Appenzell Innerrhoden, Lucern, Glarus, Grison, St. Gallen, Schwyz, and Thurgau. MCF occurred seasonally and an age-related clustering was also observed. About 50% of all cases and all outbreaks with more than one animal in a single herd occurred between April and June. Animals between six months and two years were strongly over represented. Observations on four surviving cattle showed that the outcome of the disease is not invariably fatal and that these persistently infected cows can produce healthy negative calves. Investigations on the aetiology indicate that the main reservoir for OvHV-2 is in sheep and possibly goats, while cattle do not normally harbor the virus. An OvHV-2 negative sheep herd was raised from lambs, which were reared colostrum-free and in isolation from their mothers. The success rate clearly indicated that vertical intrauterine infection is not the main mode of transmission among sheep. Therefore, horizontal, seasonally occurring transmission of OvHV-2 among sheep has to be assumed.