Dietary fats alter the activity and expression of glucose-6-phosphate dehydrogenase in rat lymphoid cells and tissues

The effect of diets enriched with fat containing different fatty acids on the activity and expression of the glucose-6-phosphate dehydrogenase (EC 1.1.1.49) of mesenteric lymph nodes lymphocytes and intraperitoneal macrophages was examined. Measurements of the enzyme were also performed using spleen, thymus and liver for comparison. The following fat rich diets containing a variety of fatty acids were used: 1-standard chow (CC); 2-medium chain saturated fatty acids (MS)-coconut fat-oil; 3-long chain saturated fatty acids (LS)-cocoa butter; 4-monounsaturated fatty acids (MU)-canola oil (n-9); 5-polyunsaturated fatty acids (PU)-soybean oil (n-6). Of the fat-rich diets tested, MS had the least effect. The G6PDH activity of lymphocytes was reduced by all the fat-rich diets; 16% for MS, 38% for LS, and 54% for MU. Similarly, the enzyme activity was reduced in macrophages; 35%, 86%, and 73%, for LS, MU, and PU, respectively. In contrast, the fat-rich diets elevated G6PDH activity in the lymphoid organs; by 42% in the spleen due to LS and by 131%, 35%, and 56% in the thymus due to LS, MU, and PU, respectively. Fat-rich diets decreased the activity of G6PDH in liver; 42%, 68%, and 39% for MS, MU, and PU, respectively. Some of the changes in G6PDH activity induced by the fat-rich diets occur through the mechanisms of mRNA abundance.

Glutathione metabolism and glutathione S-conjugate export ATPase (MRP1/GS-X pump) activity in cancer. II. Cell-to-cell variability, relation with cellular activation state and functional absence of GS-X pump in lymphocytes

A severe complication in late-stage cancer patients is host immunosuppression. It is suggested that overproduction of the highly cytostatic and cytotoxic antiproliferative cyclopentenone prostaglandins (CP-PGs) within the plasma of cancer-bearing subjects may contribute to immunosuppression. Lymphoid tissues of Walker 256 tumor-bearing rats accumulate large amounts of CP-PGs while the tumor tissue itself does not. Moreover, tumor cells may present differential sensitivity to CP-PGs due to the expression of the multidrug resistance-associated protein (MRP1) gene product which shows a Mg(2+)-dependent vanadate-sensitive glutathione S-conjugate export ATPase (GS-X pump) activity that extrudes CP-PGs from cells as glutathione S-conjugates. In this study, the possibility that deficient GS-X pump activity in immune cells that may be involved in the accumulation of CP-PGs is investigated. Rat lymph node lymphocytes do not exhibit any notable activity even when mitogen-stimulated. Conversely, although rat peritoneal resident (quiescent) or thioglycollate-stimulated (inflammatory) macrophages exhibit low GS-X pump activity, Bacillus Calmette-Guérin (BCG)-activated macrophages show a notable rise in the activity of the ATPase, suggesting that the cellular activation state may modulate GS-X pump activity/expression and that, under appropriate stimuli (e.g., during immune response) macrophages may provide a self-defense against electrophilic CP-PGs by forming GS-conjugates that can be extruded from cells through the GS-X pump. ras oncogene expression may be linked with MRP1/GS-X pump expression/activity, since C2C12 promyoblasts transformed by v-H-ras transfection doubled GS-X pump activity. These results support the proposition that the accumulation of CP-PGs and the immunosuppression of tumor-bearing subjects may be attributed to a lack of GS-X pump activity/expression in lymphocytes.

Effects of the antiproliferative cyclopentenone prostaglandin A1 on glutathione metabolism in human cancer cells in culture

Homeostatic mechanisms for the maintenance of glutathione (GSH) are fundamental in the provision of a cellular defense against electrophilic/oxidant challenges. Cyclopentenone prostaglandins (CP-PGs) are powerful antiproliferative endogenous substances that may act as electrophilic regulating compounds, by virtue of the presence of an alpha,beta-unsaturated carbonyl group in the cyclopentane ring. Nevertheless, differential resistance to CP-PG cytotoxic/cytostatic effect has been reported in different cell types. It is reported that the activity/expression of gamma-glutamylcysteine synthetase (gamma-GCS, the rate-limiting enzyme in GSH biosynthesis) can be inducibly activated by electrophiles, including CP-PGs. The response of the human cancer strains HEp-2 (larynx carcinoma) and HL-60 (promyelocytic leukemia) cells to treatment with the CP-PG PGA1 in culture was investigated by evaluating the time-course of GSH synthesis and activity of enzymes of GSH metabolism, other than gamma-GCS, after PGA1 addition. HEp-2 cells, being more resistant to PGA1 cytotoxic and cytostatic effects, have basal GSH levels that were 2.4-fold higher than that of HL-60 cells. The activities of GSH S-transferase (GST), glutathione reductase (GSRd) and glutathione peroxidase (GSPx) are constitutively higher in HL-60 cells than in HEp-2 cells (respectively, 17.0-, 28.5- and 12.3-fold). When challenged with PGA1, both cell types exhibited a dose-dependent rise in GSH content that was maximal 18 h after PGA1 addition and was preceded by a rise in GST and GSRd activities in both cell types (at 12 h). GSPx activity increased only in HEp-2 (PGA1 evoked a 93.4%-inhibition in HL-60 cells). Moreover only HEp-2 cells exhibited early capacity to enhance GSH content (1-2 h just after PGA1 addition). These results and earlier data showing that leukemia cells are sensitive to CP-PG treatment suggest that deficiencies in GSH metabolism may be strategically in therapeutic approaches to the treatment of human leukemias.

Glutathione metabolism and glutathione S-conjugate export ATPase (MRP1/GS-X pump) activity in cancer. I. Differential expression in human cancer cell lines

Mg(2+)-dependent vanadate-sensitive glutathione S-conjugate ATPase (GS-X pump) activity is a common feature of some ATP-binding cassette (ABC) transporters, such as the multidrug resistance-associated protein (MRP1) gene product, that exports biologically active electrophiles after their conjugation with intracellular glutathione (GSH) from normal and cancer cells. Antitumor electrophiles (e.g. naturally occurring cyclopentenone prostaglandins and anticancer chemicals) can be intracellularly conjugated with GSH via a glutathione S-transferase catalyzed reaction and be eliminated through GS-X pumps thus threatening cancer chemotherapeutics. Since different sensitivities to antitumor electrophiles are shown by different cell types, the ability of several human cancer cell lines to produce and export S-(2,4-dinitrophenyl)-glutathione (DNP-SG) conjugate through the GS-X pump, using whole cells and inside-out membrane vesicle preparations, is investigated. Different cancer cell lines exhibited characteristically different GS-X pump activity. In particular, HEp-2 larynx carcinoma cells possess an elevated DNP-SG export rate through the GS-X pump compared with HeLa, K562, U937 or HL-60 cells, which exhibit the lowest activity. The differences in DNP-SG export rates are not due to decreased glutathione S-transferase activity or impaired de novo synthesis of GSH. The findings suggest that the GS-X pump may be involved in the modulation of the biological activity of both naturally occurring electrophiles and anticancer drugs. The differential expression of GS-X pumps may lead to an improved understanding of multidrug resistance and may be exploited in the development of new therapeutic strategies for the treatment of cancer patients.

Dirofilaria immitis: heartworm infection converts histamine-induced constriction to endothelium-dependent relaxation in canine pulmonary artery

Heartworm (Dirofilaria immitis) infection alters the behavior of vascular endothelial cells in vivo and in vitro, with the potential, therefore, to influence vascular function. Histamine, an autocoid implicated in the pathogenesis of parasitic and inflammatory diseases, is vasoactive, and causes endothelium-dependent relaxation in some vascular beds. Experiments were designed to determine if histamine is an endothelium-dependent vasodilator in in vitro rings of canine pulmonary artery from heartworm and control dogs; to elucidate the mechanisms involved in histamine vasoactivity; and to measure circulating levels of histamine. Dose-response relationships to histamine were done in rings of canine pulmonary artery from heartworm and control dogs, in the presence and absence of endothelial cells, the H1 receptor blocker tripelennamine, or the H2 receptor blocker cimetidine. Histamine caused a dose-dependent constriction in control, that was not influenced by endothelial cell removal. However, histamine caused an endothelium-dependent relaxation in heartworm pulmonary artery that was converted to constriction by endothelial cell removal. In heartworm, histamine relaxation was mediated by H2 receptors, but did not appear to involve nitric oxide or cyclooxygenase products. While diseases cause depression of endothelium-dependent relaxation, this is the first report of a disease that changes a constriction response to an endothelium-dependent relaxation.

Carnitine palmitoyltransferase II activity is decreased in liver mitochondria of cachectic rats bearing the Walker 256 carcinosarcoma: effect of indomethacin treatment

The syndrome of cancer cachexia is accompanied by several alterations of lipid metabolism, especially that in the liver. In this study we have investigated a possible mechanism whereby the presence of the Walker 256 carcinosarcoma affects hepatic fatty acid oxidative capacity in tumour-bearing rats. Hepatic mitochondrial outer membrane carnitine palmitoyltransferase I (CPT I), generally accepted as the main site of regulation of fatty acid oxidation, was unaffected by the presence of the extra-hepatic tumour. However, mitochondrial inner-membrane carnitine palmitoyltransferase II (CPT II) activity was markedly decreased in mitochondria isolated from the liver of tumour-bearing rats. Immuno-detection by Western blotting using a CPT II-specific antibody identified two bands (corresponding to M(r) 69,000 and 54,000) in tumour-bearing rats whereas only the normal-sized CPT II was present (at the expected M(r) 69,000) in mitochondria from control rats. It is suggested that the emergence of the second, smaller protein may represent a catalytically less active protein that arises in vivo, since its appearance was not affected by the inclusion of proteolysis inhibitors in the mitochondrial preparation buffers. Treatment of the tumour-bearing rats with indomethacin, a prostaglandin (including PGE2) synthesis inhibitor, increased CPT II activity to levels even higher than those found in the control animals. It is suggested that PGE2 may play a role in the control of CPT II expression in the liver of tumour-bearing rats. Indomethacin treatment did not affect either of the two CPT activities of the mitochondria isolated from tumour tissue.

Evidence for the transfer in culture of [14C]-labelled fatty acids from macrophages to lymphocytes

[14C]-labelled palmitic acid (PA), oleic acid (OA), linoleic (LA) and arachidonic (AA) acids were transferred from macrophages (M phi) to lymphocytes (LY) when equal numbers of the two cell types were co-cultured. The relative degree and amounts of the fatty acids transferred from M phi to LY are as follow: AA (368.57 +/- 21.62) = OA (274.52 +/- 15.41) > LA (42.11 +/- 8.31) = PA (36.53 +/- 2.45). The transfer units are nmol/10(10) M phi/10(10) LY and the values are mean +/- SEM for 7 experiments. The [14C]-radioactivity transferred was mainly directed to the phospholipid fraction of the lymphocytes (85% by PA, 86% by LA, 83% by OA and 79% by AA). In the same order as above, phosphatidylcholine was the phospholipid moiety most heavily labelled (82% by PA, 71% by LA, 66% by OA and 47% by AA). The amount of [14C]-radioactivity transferred to stimulated lymphocytes of thioglycollate treated animals remained unchanged for LA, PA and AA but reduced for OA (71%). The significance of these observations for the immune functions of the cells and resolution of the question of whether some of the [14C]-isotope transfer involves a component of exchange or is unequivocally net fatty acid mass transfer are still being investigated.

Effect of arsenical drugs on in vitro vascular responses of pulmonary artery from heartworm-infected dogs

OBJECTIVE

To test the effect of thiacetarsamide and melarsomine on vascular responses in isolated rings of pulmonary artery from heartworm-infected dogs.

ANIMALS

18 heartworm-infected dogs.

PROCEDURE

Isolated rings of pulmonary artery from heartworm-infected dogs were randomly treated with thiacetarsamide (30 micrograms/ml) or melarsomine dihydrochloride (30 micrograms/ml) for 30 minutes; untreated rings from the same dog served as control. Cumulative dose-response relations to norepinephrine, nitroglycerin, and methacholine were determined.

RESULTS

Norepinephrine-induced constriction was not altered by treatment with either thiacetarsamide or melarsomine. Treatment with thiacetarsamide depressed nitroglycerin-induced relaxation, compared with values for untreated control rings and rings treated with melarsomine. Treatment of rings with thiacetarsamide or melarsomine depressed methacholine-induced relaxation, compared with values for untreated rings. Histologic examination of rings indicated that treatment with thiacetarsamide or melarsomine resulted in loss of endothelial cells.

CONCLUSION

Endothelial cell loss as a direct drug effect may be responsible for impaired endothelium-dependent relaxation in pulmonary artery from heartworm-infected dogs. Thiacetarsamide appears to have additional effects on vascular smooth muscle, which may explain why fewer complications are observed in dogs treated with melarsomine.

CLINICAL RELEVANCE

Melarsomine may be a safer drug than thiacetarsamide and could be a better treatment for dogs with heartworm infection.

Effect of heartworm infection on in vitro contractile responses of canine pulmonary artery and vein

OBJECTIVE

To test the effect of heartworm infection on agonist-induced constriction of canine pulmonary artery and vein in vitro.

PROCEDURE

Cumulative concentration-response relations to norepinephrine, serotonin, histamine, prostaglandin F2 alpha, and the thromboxane A2 analog U-44069 were determined, using isolated rings of pulmonary artery and vein from control and heartworm-infected dogs. To determine the role of endothelial cells in histamine constriction, some rings were denuded of endothelial cells in both artery and vein.

ANIMALS

Noninfected control and heartworm-infected dogs.

RESULTS

There was no difference in constriction response to norepinephrine, serotonin, prostaglandin F2 alpha, or U44069 of pulmonary artery or vein from control or heartworm-infected dogs. Histamine-induced constriction of pulmonary artery from heartworm-infected dogs was not different from control values, however, when endothelial cells were removed from control, but not heartworm-infected pulmonary artery, histamine-induced constriction was enhanced. Histamine-induced constriction of pulmonary vein from heartworm-infected dogs was significantly depressed, compared with that of control pulmonary vein. However, removal of endothelial cells in pulmonary vein from heartworm-infected, but not control dogs significantly increased constriction.

CONCLUSION

Heartworm infection alters histamine-induced constriction responses of pulmonary artery and vein. These changes may reflect high circulating histamine concentrations in heartworm-infected dogs, compared with that in controls. Increased circulating histamine concentrations in vivo could bring about decreased sensitivity of histamine receptors o decreases in the number of receptors expressed.

CLINICAL RELEVANCE

Mast cells and histamine may be important factors in altered endothelium-mediated responses associated with heartworm disease.

Dirofilaria immitis: heartworm infection alters pulmonary artery endothelial cell behavior

The pathogenesis of filariasis has generally been attributed to either physical presence of the adult parasites or the host's immune response to the parasites. However, the spectrum of filariasis cannot be entirely explained by these causes, and other mechanisms must be operative. It is now evident that factors released by filarial parasites likely contribute to the pathogenesis of filarial diseases. Adult heartworms (Dirofilaria immitis) reside in the right heart and pulmonary artery, so the pulmonary artery should be exposed to the highest concentration of filarial factors. We tested the hypothesis that endothelium-dependent relaxation is altered in the in vitro pulmonary artery from heartworm-infected dogs. Relaxation responses to endothelium-dependent vasodilators (methacholine, bradykinin, substance P, and A-23187) and the nonendothelium-dependent vasodilator nitroglycerin and contractile responses were measured in rings of pulmonary artery from control and heartworm-infected dogs. Endothelium-dependent relaxation was assessed in the presence and absence of inhibitors of nitric oxide synthase, cyclooxygenase, and guanylate cyclase. Responses to methacholine, substance P, and A-23187, but not to bradykinin, nitroglycerin, norepinephrine, or KCl, were depressed in pulmonary artery from heartworm-infected dogs when compared with control, suggesting that changes in endothelial cell and not vascular smooth muscle behavior are involved in altered relaxation. The mechanism of endothelium-dependent relaxation in control pulmonary artery appears to involve nitric oxide in the case of methacholine and both nitric oxide and a cyclooxygenase product in the case of bradykinin and A-23187. The mechanism of endothelium-dependent relaxation in pulmonary artery from heartworm-infected dogs was not clearly elucidated. These data provide no evidence that heartworm infection globally influences either endothelial cell receptor function or the vascular smooth muscle guanylate cyclase guanosine 3',5'-cyclic monophosphate system, making it likely that changes in intracellular signaling are primarily responsible for the observed alteration of endothelium-mediated relaxation. Alteration of endothelial cell function by filarial parasites may be an important component in the pathology associated with filariasis.

A prospective study of the impact of patient preferences on life-sustaining treatment and hospital cost

OBJECTIVES

Ethicists advise that life-sustaining treatment decisions should be made in keeping with patient preferences. Until recently, there has been little systematic study of the impact of patient preferences on the use of various life-sustaining treatments or the consequent cost of hospital care. This prospective study was designed to answer the following questions: a) Do patient treatment preferences about the use of life-sustaining treatment influence the treatments they receive? and b) Do patient treatment preferences influence the total cost of their hospitalization?

DESIGN

A prospective, cohort study.

SETTING

A university teaching hospital.

PATIENTS

Hospitalized patients, at least 50 yrs of age, with short life expectancy due to end-stage heart, lung, or liver disease, metastatic cancer, or lymphoma.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Patients were interviewed to determine their desire for life-sustaining treatment and other characteristics and then were followed for 6 months to determine life-sustaining treatment use and costs during hospitalization. Two hundred forty-four patients were interviewed. Fifty-eight percent of patients expressed a desire for life-sustaining treatments to prolong life for 1 wk. During 245 subsequent hospitalizations, there were 20 episodes of mechanical ventilation, 63 episodes of intensive care, and 66 cancer treatments given. Bivariate and multivariate analyses showed no significant association between patient desire to receive treatment to prolong life and either life-sustaining treatment use (p = .59) or hospital costs (p = .20).

CONCLUSION

In a university teaching hospital setting, there is no systematic evidence that patient preferences determine life-sustaining treatment use or hospital costs.

Thiacetarsamide depresses relaxation of canine pulmonary artery in vitro

Little information is available on the primary pharmacological effects of thiacetarsamide on mammalian systems, particularly on blood vessels. The effects of thiacetarsamide on arterial responses was studied in isolated rings from canine pulmonary artery. Vessels were exposed to thiacetarsamide and dose-response relationships were applied to methacholine and nitroglycerin. To rule out non-specific effects of antihelmintics, the effects of two other antifilarial drugs, diethylcarbamazine and ivermectin, were also tested. Thiacetarsamide significantly depressed relaxation of canine pulmonary artery to both methacholine and nitroglycerin, and significantly enhanced constriction to norepinephrine. Neither diethylcarbamazine nor ivermectin altered vascular response. These direct effects of thiacetarsamide on arterial responsiveness may be responsible, in part, for acute pulmonary complications observed in dogs infected with Dirofilaria immitis after adulticide treatment.

Studies on the lipid metabolism of Walker 256 tumour-bearing rats during the development of cancer cachexia

Aspects of the lipid metabolism of Walker 256 carcinosarcoma-bearing cachectic rats (TB) were investigated during a 14 day interval of tumour growth. Food intake and body weight of the TB rats were reduced by 18% and 13%, respectively, on day 14, as compared with non-tumour-bearing animals. The tumour burden then, corresponded to 19% of total body weight. The total fat content was not different in the liver, heart, carcass, epididymal (EAT) and retroperitoneal (RPAT) adipose tissues of the two groups. The brown adipose tissue (BAT) and skeletal muscle (gastrocnemius-SM) of the TB rats had increased levels of fat (23% and 200%, respectively). Enteral absorption of 14C-triolein was decreased in the TB rats, but the liver, heart, and SM of these animals incorporated more radiolabelled lipid than the control animals, while the adipose tissues exhibited a decreased incorporation of radioactivity in relation to controls. More lipid was incorporated into the VLDL fraction secreted by the liver of TB rats, which exhibited a different distribution of the incorporated 14C-oleate in the various lipid subfractions. Ultrastructural studies showed that the hepatocytes of the TB rats had a greater incidence of lipid droplets in the cytoplasm.

Microbial contamination of dental unit waterlines: current preventive measures and emerging options

Various approaches to prevention and control of microbial contamination of dental unit water are evolving. Currently available methods and emerging technologies are reviewed here in the context of contemporary federal regulatory and advisory agency positions on water quality in the dental operatory. Clean water systems, fully autoclavable systems, and a variety of devices designed to provide physical barriers to the influx and accumulation of microbial contaminants can all be used to assure satisfactory quality for coolant and irrigant water. There is one important proviso: all require a commitment to maintenance if they are to be deployed successfully. Stricter adherence to American Dental Association/American National Standards Institute standards in manufacturing and production and compliance with federal regulatory marketing procedures for equipment and devices would do much to advance the cause of dental unit water quality control.

Ivermectin distribution in the plasma and tissues of patients infected with Onchocerca volvulus

OBJECTIVE

To determine the distribution of ivermectin in plasma and tissues of onchocerciasis patients following a single oral dose of 150 micrograms kg-1.

SETTING

Medical Department at Soba University Hospital, Khartoum.

PATIENTS

Twenty five patients and fourteen healthy volunteers.

METHODS

Serial blood samples were obtained from both groups. Tissue samples were removed from various patients as full thickness skin punch biopsies or during nodulectomy. Ivermectin concentration was determined by radioimmunoassay.

RESULTS

The plasma pharmacokinetic variables for patients were; maximum plasma concentration 52.0 ng ml-1; time to achieve maximum concentration, 5.2 h.; elimination half life, 35.0 h; and the area under the plasma concentration curve versus time, 2852 ng.h.ml-1. In healthy volunteers, the plasma ivermectin distribution was similar to that in patients, and both groups showed a tendency for a second rise in plasma concentration of the drug suggestive of enterohepatic recirculation. Ivermectin was detected in tissues obtained from patients. Fat showed the highest and most persistent levels, whilst values for skin, nodular tissues, and worms were comparable. Subcutaneous fascia contained the lowest concentrations.

CONCLUSIONS

Infection with O. volvulus does not affect the pharmacokinetics of ivermectin, and filarial infected tissues and parasites themselves do take up the drug. There may be prolonged retention of ivermectin because of depot formation in fat tissue.

Microbial contamination of dental unit waterlines: origins and characteristics

Microbial adherence to the internal surface of dental tubing and the formation of a highly protective biofilm layer is predictable, given the ideal growth conditions in the tubing. The slime layer is the most common cause of dental water contamination. Various environmental and human-derived potential pathogens have been reported worldwide. Dental equipment such as retracting shut-off valves, antiretracting valves that tend to fail, or waterlines that are inaccessible contribute to a situation in which virtually every standard dental unit contains contaminated water. While exposure to Pseudomonas, Moraxella, Staphylococcus, and Legionella has been linked to dental water, the medical risk of dental unit waterline contamination is most significant to immune-deficient individuals. Regulations and technological devices are emerging to manage dental water quality.

Brugia pahangi-induced contractility of bovine mesenteric lymphatics studied in vitro: a role for filarial factors in the development of lymphedema?

Products generated by filarial nematodes depress vascular reactivity by mechanisms involving endothelial cells. We hypothesized that comparable filarial-induced alterations might occur in lymph vessels. Experiments were designed to test the hypothesis that spontaneous contractions of bovine mesenteric lymphatics studied in vitro are altered by the filarial parasite Brugia pahangi. Rings of bovine mesenteric lymphatics were suspended in tissue baths and spontaneous contractions were evaluated for rate, rhythm, and amplitude. Rings that met inclusion criteria (rate > 1.8/min, regular rhythm, and an amplitude > 500 mg) were randomly exposed to B. pahangi or used as controls. Parasites were added to the bath at time zero. Changes in rate, rhythm, and magnitude of spontaneous contractions were evaluated every 10 min. Comparisons were made within control or Brugia-infected groups over time and between groups (B. pahangi versus controls). The presence of B. pahangi significantly depressed the frequency of spontaneous contractions when compared with controls. Control rings were stable over time, without changes in rate, rhythm, or amplitude. However, B. pahangi alter both the rate and rhythm of spontaneous contractions. Since spontaneous contractile activity is likely to be important in the propulsion of lymph, alterations of contractile activity could result in lymphedema. Thus, filarial factors may be responsible, in part, for altered lymphatic function seen in lymphedema. Pharmacologic intervention aimed toward influencing host-parasite metabolic interactions may, in this complicated scenario, prove useful.

Legionella contamination of dental-unit waters

Volume 61, no. 4, p. 1211, column 2, line 40: this sentence should read as follows. "The viable-culture methods for Legionella sp. detection, however, often fail, and the Centers for Disease Control and Prevention has turned, when necessary, to PCR for epidemiological investigations of Legionnaires' disease and Pontiac fever (19)." Line 46: "(6)" should read "(11)." [This corrects the article on p. 1208 in vol. 61.].

Ultrasonographic renal changes associated with phenylbutazone administration in three foals

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