Cost of achieving HbA1c and weight loss treatment targets with IDegLira vs insulin glargine U100 plus insulin aspart in the USA

Background

Compared with basal-bolus insulin therapy (insulin glargine U100 plus insulin aspart), IDegLira has been shown to be associated with similar improvements in HbA1c, with superior weight loss and reduced hypoglycemia in patients with type 2 diabetes. The present analysis evaluated the cost per patient with type 2 diabetes achieving HbA1c-focused and composite treatment targets with IDegLira and insulin glargine U100 plus insulin aspart (≤4 times daily).

Methods

The proportions of patients achieving treatment targets were obtained from the treat-to-target, non-inferiority DUAL VII study (NCT02420262). The annual cost per patient achieving target (cost of control) was analyzed from a US healthcare payer perspective. The annual cost of control was assessed for eight prespecified endpoints and four post-hoc endpoints.

Results

The number needed to treat to bring one patient to targets of HbA1c <7.0% and HbA1c ≤6.5% was similar with IDegLira and insulin glargine U100 plus insulin aspart. However, when weight gain and/or hypoglycemia were included, the number needed to treat was lower with IDegLira. IDegLira and insulin glargine U100 plus insulin aspart had similar costs of control for HbA1c <7.0%. However, cost of control values were substantially lower with IDegLira when the more stringent target of HbA1c ≤6.5% was used, and when patient-centered outcomes of hypoglycemia risk and impact on weight were included.

Conclusion

IDegLira was shown to be a cost-effective treatment vs insulin glargine U100 plus insulin aspart for patients with type 2 diabetes not achieving glycemic targets on basal insulin in the USA.

RhoA controls retinoid signaling by ROCK dependent regulation of retinol metabolism

The ubiquitously expressed small GTPase RhoA is essential for embryonic development and mutated in different cancers. Functionally, it is well described as a regulator of the actin cytoskeleton, but its role in gene regulation is less understood. Using primary mouse keratinocytes with a deletion of the RhoA gene, we have now been exploring how the loss of RhoA affects gene expression. Performing transcription factor reporter assays, we found a significantly decreased activity of a RAR luciferase reporter in RhoA-null keratinocytes. Inhibition of the RhoA effector ROCK in control cells reproduced this phenotype. ATRA and retinal, but not retinol increased RAR reporter activity of keratinocytes with impaired RhoA/ROCK signaling, suggesting that retinol metabolism is regulated by RhoA/ROCK signaling. Furthermore a significant percentage of known ATRA target genes displayed altered expression in RhoA-null keratinocytes. These data reveal an unexpected link between the cytoskeletal regulator RhoA and retinoid signaling and uncover a novel pathway by which RhoA regulates gene expression.

Stroke and periodontal disease in Senegal: case-control study

OBJECTIVE

To determine the periodontal factors associated with stroke in melanodermic subjects in Senegal.

STUDY DESIGN

Case-control study.

METHODS

One hundred and twenty cases and 120 controls were included in this study. Cases had been diagnosed with stroke by a neurologist, with the diagnosis confirmed by scanner. Controls had never had any type of stroke. Data were collected regarding sociodemographic characteristics, lifestyle behaviours, general history, type of stroke (ischaemic or haemorrhagic) and periodontal parameters [plaque index, papillary bleeding index, pocket depth, clinical attachment loss, Community Periodontal Index of Treatment Needs and periodontitis (defined by clinical attachment loss >2 mm and pocket depth >3 mm)]. Logistic regression analysis was performed using R software to isolate a final model after adjustment for the 5% threshold.

RESULTS

All periodontal characteristics were more common among cases than among controls. Periodontitis (odds ratio 1.58, 95% confidence interval 1.1-3.022) and periodontal parameters were significantly associated with stroke, adjusted for hypertension, sedentary lifestyle, and the interaction between periodontitis and age.

CONCLUSIONS

Periodontal disease is associated with stroke in the Senegalese population. Prospective longitudinal studies should be undertaken to improve understanding.

[Management of neurological emergencies in developing country: example of Senegal]

Senegal, like many African countries is facing the so-called demographic and epidemiological transition leading to the development of neurological diseases. These diseases dominated by stroke and status epilepticus are public health priorities with a high prevalence, high lethality and high cost of care. These diseases are managed at the department of neurology, Fann Teaching Hospital, Dakar-Senegal (the only one) with a 65 beds capacity. Unfortunately, access care to the clinic is lately associated with human and material resource scarcity. To improve the management of patients at the clinic, it is important to increase resources (human and material), sensitize the population on early access to health services and prevention of risk factors.

Rho GTPase knockout induction in primary keratinocytes from adult mice

Primary keratinocytes are an important tool to investigate the molecular mechanism underlying the skin phenotype of mice with null mutations in Rho GTPase genes. If the RhoA gene deletion is conditional, the knockout can be induced in vitro by transfection with cre-IRES-GFP and sorting for GFP positive cells by flow cytometry. Such in vitro knockout will allow determining the cell autonomous functions of the Rho GTPase, independent of any in vivo interactions. Using the same method, also other expression vectors or knockdown constructs can be introduced into primary mouse keratinocytes.

RhoA is dispensable for skin development, but crucial for contraction and directed migration of keratinocytes

RhoA is a small GTPase shown to be crucial for cytokinesis, stress fiber formation, and epithelial cell–cell contacts. Analyzing mice with a keratinocyte-restricted deletion of the RhoA gene, we find that RhoA is not required for skin development and maintenance but has specific functions in vitro.

RhoA is a small guanosine-5’-triphosphatase (GTPase) suggested to be essential for cytokinesis, stress fiber formation, and epithelial cell–cell contacts. In skin, loss of RhoA was suggested to underlie pemphigus skin blistering. To analyze RhoA function in vivo, we generated mice with a keratinocyte-restricted deletion of the RhoA gene. Despite a severe reduction of cofilin and myosin light chain (MLC) phosphorylation, these mice showed normal skin development. Primary RhoA-null keratinocytes, however, displayed an increased percentage of multinucleated cells, defective maturation of cell–cell contacts. Furthermore we observed increased cell spreading due to impaired RhoA-ROCK (Rho-associated protein kinase)-MLC phosphatase-MLC–mediated cell contraction, independent of Rac1. Rho-inhibiting toxins further increased multinucleation of RhoA-null cells but had no significant effect on spreading, suggesting that RhoB and RhoC have partially overlapping functions with RhoA. Loss of RhoA decreased directed cell migration in vitro caused by reduced migration speed and directional persistence. These defects were not related to the decreased cell contraction and were independent of ROCK, as ROCK inhibition by Y27632 increased directed migration of both control and RhoA-null keratinocytes. Our data indicate a crucial role for RhoA and contraction in regulating cell spreading and a contraction-independent function of RhoA in keratinocyte migration. In addition, our data show that RhoA is dispensable for skin development.

N-WASP is a novel regulator of hair-follicle cycling that controls antiproliferative TGF{beta} pathways

N-WASP is a cytoplasmic molecule mediating Arp2/3 nucleated actin polymerization. Mice with a keratinocyte-specific deletion of the gene encoding N-WASP showed normal interfollicular epidermis, but delayed hair-follicle morphogenesis and abnormal hair-follicle cycling, associated with cyclic alopecia and prolonged catagen and telogen phases. The delayed anagen onset correlated with an increased expression of the cell-cycle inhibitor p21CIP, and increased activity of the TGFbeta pathway, a known inducer of p21CIP expression. Primary N-WASP-null keratinocytes showed reduced growth compared with control cells and enhanced expression of the gene encoding the cell-cycle inhibitor p15INK4B, a TGFbeta target gene. Inhibition of TGFbeta signaling blocked overexpression of p15INK4B and restored proliferation of N-WASP-deficient keratinocytes in vitro. However, induction of N-WASP gene deletion in vitro did not result in obvious changes in TGFbeta signaling or growth of keratinocytes, indicating that the in vivo environment is required for the phenotype development. These data identify the actin nucleation regulator N-WASP as a novel element of hair-cycle control that modulates the antiproliferative and pro-apoptotic TGFbeta pathway in keratinocytes in vivo and in vitro.

Rac1 is crucial for Ras-dependent skin tumor formation by controlling Pak1-Mek-Erk hyperactivation and hyperproliferation in vivo

Rac1 has a role in proliferation and survival of tumor cells in vitro. The exact effects of Rac1 on growth, apoptosis and corresponding signaling pathways during tumorigenesis in vivo, however, have not been explored yet. Using mice with a keratinocyte-restricted deletion of the Rac1 gene, we found that Rac1 is essential for DMBA/TPA-induced skin tumor formation. This corresponded to a decreased keratinocyte hyperproliferation, although apoptosis was not detectably altered. Activated Rac1 promoted Erk-dependent hyperproliferation by Pak1-mediated Mek activation independent of Mek1 phosporylation at serine 298. Rac1 was furthermore required for Pak2-dependent hyperactivation of Akt, which under in vivo condition was restricted to the suprabasal cell layers corresponding to a suprabasal-specific expression of Pak2. It is surprising that none of these signaling pathways was altered in untreated Rac1-deficient skin, indicating a hyperproliferation-specific function of Rac1 in vivo. These data suggest that blocking of Rac1 function might allow tumor-specific growth repression, as Rac1 is not required for normal growth and growth signaling controlling pathways in skin in vivo.

Typing of Pasteurella multocida from haemorrhagic septicaemia in Danish fallow deer (Dama dama)

Isolates of Pasteurella multocida ssp. multocida (n = 31) from a Danish population of fallow deer which succumbed to haemorrhagic septicaemia during 1992 1993 and isolates from the palatine tonsils of apparently healthy fallow deer from the same area (n=6) were typed and compared with P. multocida from other sources. Plasmids were net observed in the fallow deer strains and one unique pattern was observed by ribotyping using HindIII and by pulsed-field gel electrophoresis using SanlI as restriction endonuclease. All Danish fallow deer isolates belonged to serotype B:3,4. On restriction endonuclease analysis using HhaI as restriction endonuclease, all had a profile identical to that of a fallow deer isolate from the United Kingdom: profile 0033 of Wilson et al. On restriction endonuclease analysis using HpaII as restriction endonuclease, the Danish fallow deer isolates had a unique profile, designated 0062, which differed slightly from that of a fallow deer isolate from the United Kingdom. P. multocida from other animal species were genotypically different from the fallow deer isolates. It is concluded that a specific clone of P. multocida was responsible for the outbreak of haemorrhagic septicaemia among Danish fallow deer. A carrier rate of 27% was demonstrated among apparently normal animals from the same population.

Hemorrhagic septicemia in fallow deer (Dama dama) caused by Pasteurella multocida multocida

Four outbreaks of hemorrhagic septicemia caused by Pasteurella multocida multocida occurred in a population of 1,800 fallow deer (Dama dama) during 1992-1996. A total of 340 fallow deer were submitted for postmortem examination. Pasteurellosis was diagnosed in 273 of 312 deer suspected of having septicemia. Pasteurella multocida was isolated from 257 animals, and the diagnosis was based on typical pathologic changes alone in the other 16 animals. Pasteurella multocida was isolated in pure culture from 219 of 248 samples of cerebrospinal fluid. Eighteen animals were observed moribund with severe depression, foamy nasal discharge, and respiratory distress, and 257 were found dead. Major clinical signs and pathologic changes included extensive swelling of the head and the neck and peracute or acute septic pneumonia, petechial and ecchymotic hemorrhages on serous membranes, and severely hemorrhagic adrenal glands and abomasum. Rhinitis and necrotic pharyngeal mucosae were common. Histologically, the most advanced lesions were in the nasal mucosa and pharynx. The swelling of the head and the neck arose from a diffuse cellulitis in the subcutaneous and intermuscular tissues. The earliest lesions in the lungs included large numbers of bacteria in the pulmonary capillaries, but various degrees of fibrinous exudation to the alveoli and infiltration with heterophils usually were observed.

Gross and histopathological findings in synovial membranes of pigs with experimentally induced Mycoplasma hyosynoviae arthritis

The aim of this investigation was to describe the gross and histopathological findings in synovial membranes of pigs with experimentally induced Mycoplasma hyosynoviae arthritis and in synovial membranes of non-infected pigs of the same age. Experimental intravenous or intranasal inoculation or contact exposure with M. hyosynoviae induced arthritis in 13- to 17-week-old pigs. The acute to subacute arthritis was characterized by increased amounts of serohaemorrhagic, serofibrinous or mahogany coloured synovial fluid combined with edema and hyperaemia, followed by yellow to brownish discoloration and moderate villous proliferation of the synovial membrane. In the chronic phase moderate fibrosis was seen, but no periarticular or articular cartilage involvement. The acute to subacute histopathological characteristics were edema, hyperaemia, variable hyperplasia of synovial lining cells, increased density of subsynovial cell populations, diffuse and perivascular infiltration with lymphocytes, plasma cells and macrophage-like cells, fibrinous material, mild to moderate villous hypertrophy and mild to moderate fibrosis in chronic cases. The morphogenetic changes during the course of the infection may be described as follows: An acute preimmune phase with inflammatory changes and synovial membrane reactions dominates the first week of the infection. By the second and third week, the peak of the immune phase with masses of plasma cells and lymphocytes is seen. By 7 weeks, there is healing with moderate fibrosis. Mild ongoing reactions or recurrence of arthritis, perhaps related to persistence of mycoplasma antigens, may be seen in later phases and local antibody production may be important in this infection.

Feed-induced changes in transport across the rumen epithelium

The effect of feeding strategy on rumen epithelial growth and transport capacity were studied in sixteen dairy cows. There was a significant effect of feeding strategy on transport of butyrate, sodium and chloride ions, which could not be explained by changes in epithelial surface area, structure or resistance.

Pulmonary intravascular macrophages in the pathogenesis of bovine pulmonary lesions caused by Actinomyces pyogenes

Rabbit antisera raised against somatic antigens from two strains of Actinomyces pyogenes reacted specifically in a peroxidase anti-peroxidase technique which was developed for the location of the bacteria in formalin-fixed tissues. The technique was applied on experimental murine and spontaneous bovine lesions caused by A. pyogenes. By electron microscopy and immunohistochemistry it was demonstrated that pulmonary intravascular macrophages play a role in the uptake of A. pyogenes from the blood, and in the production of pyaemic pulmonary lesions.

Induced acute ruminal acidosis in goats treated with yeast (Saccharomyces cerevisiae) and bicarbonate

Ruminal acidosis was induced in twenty-one 10-month-old West African Dwarf Goats by feeding a suspension of 80 g wheat flour per kg bodyweight (day 0) through a stomach tube. Ruminal and systemic acidosis was diagnosed on day 1 in all goats. Clinical signs included loss of rumination and appetite, trembling, and watery diarrhoea. The detection of acidic faeces during the first 24h was considered of diagnostic importance. Subgroups were treated orally on days 1, 2, and 3 either with 1 g of sodium bicarbonate per kg bodyweight, with 1 g of baking yeast per kg, or with a combination of these treatments at 0.5 g of each per kg. A fourth group served as untreated controls. Peroral bicarbonate neutralization was highly effective in the treatment of rumen acidosis, whereas the use of yeast was found ineffective. The combined treatment had a moderate effect probably due to the bicarbonate. Three fatal cases (60%) occurred in the untreated group compared with none in the bicarbonate group, and 2 in each of the remaining groups. This corresponded to 33% of the yeast treated group and 40% of the combined treated group. Details were given on post mortem examinations performed on all survivors on day 11. Lesions included subacute rumenitis and abomasal ulcers. No lesions were found in 3 of the bicarbonate treated goats and in 2 of the animals receiving combined treatment.

Induced acute ruminal acidosis in goats treated with yeast (Saccharomyces cerevisiae) and bicarbonate

Ruminal acidosis was induced in twenty-one 10-month-old West African Dwarf Goats by feeding a suspension of 80 g wheat flour per kg bodyweight (day 0) through a stomach tube. Ruminal and systemic acidosis was diagnosed on day 1 in all goats. Clinical signs included loss of rumination and appetite, trembling, and watery diarrhoea. The detection of acidic faeces during the first 24h was considered of diagnostic importance. Subgroups were treated orally on days 1, 2, and 3 either with 1 g of sodium bicarbonate per kg bodyweight, with 1 g of baking yeast per kg, or with a combination of these treatments at 0.5 g of each per kg. A fourth group served as untreated controls. Peroral bicarbonate neutralization was highly effective in the treatment of rumen acidosis, whereas the use of yeast was found ineffective. The combined treatment had a moderate effect probably due to the bicarbonate. Three fatal cases (60%) occurred in the untreated group compared with none in the bicarbonate group, and 2 in each of the remaining groups. This corresponded to 33% of the yeast treated group and 40% of the combined treated group. Details were given on post mortem examinations performed on all survivors on day 11. Lesions included subacute rumenitis and abomasal ulcers. No lesions were found in 3 of the bicarbonate treated goats and in 2 of the animals receiving combined treatment.

Abortion and calf mortality in Danish cattle herds

The aetiology of abortions and calf mortality in 65 Danish cattle herds consisting of both dairy and beef breeds during a 1-year period is described. All observed aborted foetuses, still-born calves, and calves dying before 6 months of age were necropsied, and relevant microbiological examinations were performed. A total of 240 calves and 66 abortions were submitted corresponding to a calf mortality rate of 7%. The abortion frequency could not be calculated. 43% of the calves died at day 0, while 22% were aborted, 15% died during the first week of life, 9% died from 1 to 4 weeks of age, and 11% died at the age of 1 to 6 months. The most common cause was neonatal pulmonic atelectasis (stillbirth) followed by foetal infections, pneumonia, and septicaemia.

Investigations on the occurrence of hereditary diseases in the Danish cattle population 1989-1991

The methods of the Danish Bovine Genetic Disease Programme are outlined, and the results obtained during the first 3 years in function are described. The most common disease reported was spinal muscular atrophy in calves of the Red Danish Dairy breed with 312 reports. Necropsy was performed on 162 cases, and spinal muscular atrophy was diagnosed in 82 of these. Bovine progressive degenerative myeloencephalopathy, rectovaginal constriction, syndrome of arthrogryposis and palatoschisis, hereditary chondrodysplasia (2 different types), syndactylism, epitheliogenesis imperfecta, and osteogenesis imperfecta was diagnosed with 1 case each. Lethal trait A46 was diagnosed in 4 calves. Some of these diseases have not previously been described in Denmark, and epitheliogenesis imperfecta was for the first time diagnosed in the Hereford breed. Chromosome translocation 1/29 was detected in the Blonde d'Aquitaine (BAQ), Limousine, and Red Danish Dairy breed. The aberration occurred frequently in BAQ. Furthermore, a complex chromosome translocation t(1;8;9)(q45;q13;q26) was detected in the Red Danish Dairy breed.

Spinal muscular atrophy in calves of the Red Danish dairy breed

Pathological and genetic aspects of spinal muscular atrophy in Red Danish dairy cattle are described. A total of 312 calves suspected of having the condition was reported in the Danish Bovine Genetic Disease Programme, 162 of them were examined post mortem and spinal muscular atrophy was diagnosed in 82 of these. Seventy-five per cent of the affected calves had bronchopneumonia. The diagnosis of spinal muscular atrophy was based on histopathological examinations of the spinal cord and musculature. The lesions were primarily characterised by degeneration of the spinal cord motor neurons with neuronophagia and denervation muscular atrophy. The ages of the affected calves varied from those recumbent from birth to a 21-week-old calf. All the necropsied cases appeared in a clearly familial pattern and could be traced back to American Brown Swiss bulls.

Osteogenesis imperfecta in Holstein-Friesian calves

Eight calves with osteogenesis imperfecta were born in a Danish Holstein-Friesian herd during a two-year period. In total 92 calves were born (84 normal), and all were sired by a clinically normal Holstein-Friesian bull. The defect was probably due to a de novo dominant mutation present as a gonadal mosaicism in the bull. Affected calves were characterised by multiple fractures, congenital bone deformations, general joint laxity, dentinogenesis imperfecta, and light blue sclerae. The skin seemed normal. Electron microscopical studies revealed slightly decreased average diameter of cutaneous collagen fibrils, while the diameter of collagen fibrils in tendons and ligaments was severely reduced. Abnormalities of collagen type I from skin and compact bone were not detected by biochemical analyses.

Bovine leukocyte adhesion deficiency in Danish Holstein-Friesian cattle. II. Patho-anatomical description of affected calves

The patho-anatomical findings in 3 Danish Holstein-Friesian calves affected with bovine leukocyte adhesion deficiency (BLAD) are described. The diagnosis was confirmed by genotyping for the BLAD mutagene by polymerase chain reaction technique. The main clinical symptoms were general unthriftyness and leukocytosis with a high proportion of neutrophils. None of the calves suffered from severe infections and the major pathological changes were different from those described in previously published cases. One calf had a fibro-granulomatous perilienitis and calcification of splenic stroma and pulmonic arteries. In the other cases only minor pathological changes were present.

Investigations on the occurrence of hereditary diseases in the Danish cattle population 1989-1991

The methods of the Danish Bovine Genetic Disease Programme are outlined, and the results obtained during the first 3 years in function are described. The most common disease reported was spinal muscular atrophy in calves of the Red Danish Dairy breed with 312 reports. Necropsy was performed on 162 cases, and spinal muscular atrophy was diagnosed in 82 of these. Bovine progressive degenerative myeloencephalopathy, rectovaginal constriction, syndrome of arthrogryposis and palatoschisis, hereditary chondrodysplasia (2 different types), syndactylism, epitheliogenesis imperfecta, and osteogenesis imperfecta was diagnosed with 1 case each. Lethal trait A46 was diagnosed in 4 calves. Some of these diseases have not previously been described in Denmark, and epitheliogenesis imperfecta was for the first time diagnosed in the Hereford breed. Chromosome translocation 1/29 was detected in the Blonde d'Aquitaine (BAQ), Limousine, and Red Danish Dairy breed. The aberration occurred frequently in BAQ. Furthermore, a complex chromosome translocation t(1;8;9)(q45;q13;q26) was detected in the Red Danish Dairy breed.

Vertebral fractures in newborn calves

A prospective study on vertebral fractures in newborn calves is described. Vertebral fractures were found in 7.0% of necropsied calves of the Danish Holstein-Friesian (SDM) and Red Danish Dairy (RDM) breeds. Cases were not found in submitted calves of the Jersey breed or beef breeds. At least in beef breeds this was probably due to the low number necropsied. The rate of vertebral fractures in SDM and RDM breeds and between males and females were similar. Most cases occurred in calves born by heifers, and manual traction force had been applied in all cases. All fractures which in most cases consisted of a simple epiphysiolysis were located at the thoraco-lumbar area, and especially the posterior epiphysis of T13 was afflicted.

Bovine leukocyte adhesion deficiency in Danish Holstein-Friesian cattle. II. Patho-anatomical description of affected calves

The patho-anatomical findings in 3 Danish Holstein-Friesian calves affected with bovine leukocyte adhesion deficiency (BLAD) are described. The diagnosis was confirmed by genotyping for the BLAD mutagene by polymerase chain reaction technique. The main clinical symptoms were general unthriftyness and leukocytosis with a high proportion of neutrophils. None of the calves suffered from severe infections and the major pathological changes were different from those described in previously published cases. One calf had a fibro-granulomatous perilienitis and calcification of splenic stroma and pulmonic arteries. In the other cases only minor pathological changes were present.

Abortion and calf mortality in Danish cattle herds

The aetiology of abortions and calf mortality in 65 Danish cattle herds consisting of both dairy and beef breeds during a 1-year period is described. All observed aborted foetuses, still-born calves, and calves dying before 6 months of age were necropsied, and relevant microbiological examinations were performed. A total of 240 calves and 66 abortions were submitted corresponding to a calf mortality rate of 7%. The abortion frequency could not be calculated. 43% of the calves died at day 0, while 22% were aborted, 15% died during the first week of life, 9% died from 1 to 4 weeks of age, and 11% died at the age of 1 to 6 months. The most common cause was neonatal pulmonic atelectasis (stillbirth) followed by foetal infections, pneumonia, and septicaemia.

The occurrence of fungi in bovine tissues in relation to portals of entry and environmental factors

The occurrence of fungi in tissue specimens from 72 cattle was examined by culture, histopathology and indirect immunofluorescence staining (IIF). Groups of 12 animals each had been fed either concentrate or roughage and had been housed either in tie stalls, on slatted floors or on deep bedding. Specimens were obtained from the lung, omasum and Peyer's patches of the ileum and corresponding lymph nodes. Both hyphae and spores were made visible by IIF and by combination of IIF, morphology and conventional staining it was possible to differentiate between aspergilli and zygomycetes. In the lungs, aspergilli were detected at the same rate by morphology and IIF, whereas zygomycetes were found nearly twice as often by IIF than by culture. Fungi in pulmonary tissue were most frequent in cattle tied or kept on deep bedding (P < 0.01) as assessed by IIF. Within lymph nodes only spores were found, and Aspergillus fumigatus was the predominant species. Lesions devoid of fungi, especially ulcerations, were observed on the edges of the largest omasal laminae with a notable preference for the aboral third. The localization and histopathology suggested a reflux of acid abomasal contents to be the pathogenic principle. Granulomas with centrally located plant material were found more frequently in cattle fed roughage than in cattle fed concentrate (P = 0.01) and were differentiated from mycotic granulomas.

Acute disseminated Aspergillosis in a cow with special reference to penetration and spread

Acute disseminated aspergillosis caused by Aspergillus fumigatus is reported in a 4-year-old cow given broad spectrum antibiotics and anti-inflammatory therapy. All stomach compartments were infected and hyphal invasion of gastric blood vessels was the probable source of generalization to the liver, lung and kidneys. Throughout the Peyer's patches of the jejunum there were acute necrotic foci with Aspergillus hyphae and similar foci occurred in the corresponding mesenteric lymph nodes. This points to the Peyer's patches being a portal of entry for A. fumigatus to the lymphatic system of the intestine.

Comparison of intestinal anaphylactic reactions in sensitized mice challenged with untreated bovine milk and homogenized bovine milk

Outbred NMRI mice were sensitized for high IgE production either by subcutaneous injections of low doses of untreated bovine milk or homogenized bovine milk in combination with intraperitoneal injections of Freund's Complete Adjuvant or by oral administration of untreated or homogenized bovine milk without adjuvant. When analysed in murine passive cutaneous anaphylaxis test both types of milk resulted in production of reaginic antibodies against bovine milk proteins when given subcutaneously. When given orally, homogenized milk resulted in reagin production in 10 out of 14 mice, whereas untreated milk resulted in reagin production in only one out of 12 mice. The sensitized mice, and control mice, were orally challenged with either untreated milk, homogenized milk or 0.9% NaCl. Examination of the intestines 40 min after oral administration revealed that homogenized milk, contrary to untreated milk or 0.9% NaCl, resulted in a large increase in the mass of the proximal gut segment of mice sensitized orally with homogenized milk compared with control mice orally challenged with saline (P less than 0.001), and only mice both sensitized and challenged orally with homogenized milk showed degranulation of mast cells in the intestinal wall. By contrast, subcutaneously sensitized mice or mice sensitized orally with untreated bovine milk showed no significant intestinal reaction upon oral challenge with either homogenized or untreated bovine milk. These observations may indicate that the route of sensitization is of great importance when intestinal reactions are to be studied, and that homogenization of bovine milk may render the milk more aggressive with respect to its ability to induce intestinal reactions. The study indicates that mice may be an attractive experimental animal model for mimicking the intestinal anaphylactic reactions of cow milk-allergic humans.

Mycosis in the stomach compartments of cattle

During a period of 22 months, 9.7% (23 out of 238) of the cattle necropsied at the Department of Veterinary Pathology had mycotic affections in the stomach compartments. The various stomach compartments were affected in the following pattern: omasum: 15 cases, rumen: 10 cases, reticulum: 8 cases and abomasum: 6 cases. In 5 of the animals mycotic affection was also found in other organs of which the liver was most often involved. Out of the 23 cases described, a primary diagnosis of mycosis was only established in 5 cases. In the remaining 18 cases the mycotic infection was regarded as being of a minor importance in the total necropsy result. Macroscopically and histologically the mycotic processes could be grouped into acute, subacute or chronic affections. In 20 cases only one type of inflammation was present, in the remaining cases combinations were found. Identification of the infective agent was performed by immunological staining of hyphal structures in tissue sections. Members of the Zygomycetes were found to predominate as causative fungi. Aspergillus fumigatus was found to have a propensity for infecting the terminal gastric compartments, whereas the Zygomycetes were found regularly in all compartments. Candida spp. were only found in 1 case. Predisposing factors for developing systemic mycosis are discussed. Among these especially the use of antimicrobial drugs, other diseases, metabolic disturbances and stressors in the post parturient period seem to be important.

Fertility in two cats with X-chromosome mosaicism and unilateral ovarian dysgenesis

Two pregnant cats showed unilateral ovarian dysgenesis at surgery. Cytogenetic examination revealed a 37,X/39,XXX karyotype in Cat 1, a 37,X/38,XX karyotype in Cat 2 and a marked difference in frequency of mosaicism between fibroblasts and lymphocytes in both cats. Histologically the ovarian morphology ranged from normal to complete dysgenesis in both cats. Three fetuses examined showed a normal feline karyotype.

A murine model for the assessment of placental and fetal development in teratogenicity studies

During normal pregnancy in the mouse, maternal serum levels of the analogues to human schwangerschaftsprotein-1 and alpha-fetoprotein correlate significantly with the growth of the placenta and fetus respectively. This relationship has been utilized in the analysis of the effect of sodium selenite on placental and fetal growth in mice. Moderate doses of sodium selenite did not affect the growth of the placenta and fetus significantly, whereas high doses of selenite resulted in a large percentage of abortions. The protein markers were found to be useful in the prediction of placental and fetal growth, and they are suggested to be of general use in the study of the impact of teratogenic substances, since they reflect the status of the fetoplacental mass during gestation.

Two cases of male pseudohermaphroditism in the dog. Clinical, macroscopic, karyotypic and therapeutic features

Two cases of male pseudohermaphroditism in the dog are described, including clinical, macroscopic, microscopic, karyotypic and therapeutic features. The external appearance of both dogs was that of an otherwise normal bilateral cryptorchid. Both dogs developed signs of male feminizing syndrome at 7 and 5 years of age respectively. This prompted exploratory laparotomy, disclosing an uterus, testes at the ovarian sites and Sertoli cell tumours. It is emphasized to include malformations of the genital apparatus in the differential diagnosis of canine urological and endocrine disease.

Interdigitating cells in the lymphoid tissues of bovine fetuses and calves. An electron-microscopic study

Electron-microscopic studies of lymphoid tissues from bovine fetuses and from calves disclosed a non-lymphoid cell type in the thymus-dependent zones of secondary lymphoid tissues and in the thymus that is distinguishable from reticulum cells, epithelial and endothelial cells, and macrophages. Based on morphological and topographical criteria, the cell is identified as the interdigitating cell. In addition, studies of the tissues of normal and virus-challenged fetuses, and of conventionally reared calves, indicated that the interdigitating cells originate from monocytoid cells, which undergo differentiation in the thymus-dependent zones during an immune response.

Congenital ascorbic acid deficiency in pigs

In a swine production herd, spontaneous scurvy was observed among piglets 2–3 weeks after weaning. All affected pigs had the same boar as both maternal and paternal grandfather. The affected pigs had only traces of ascorbic acid in blood and tissues as compared to litter mates and other normal pigs. The ratio between the total numbers of normal and affected pigs in the 4 litters concerned was in agreement with a 3:1 segregation, which is characteristic of simple autosomal recessive inheritance in matings between non-affected carriers.

Two affected pigs were restored to normal when given ascorbic acid in the diet. Without vitamin C supplement affected pigs died or had to be euthanized.

Liver microsomes from an affected pig were unable to synthesize ascorbic acid in vitro with 1-gulonolactone as a substrate, unlike microsomes from normal control pigs.

Congenital tremor type AI: light and electron microscopical observations on the spinal cords of affected piglets

The histology and ultrastructure of the spinal white matter from the dorsolateral funiculus of the third cervical segment was studied in normal control pigs and pigs whose dams were inoculated with the Weybridge congenital tremor strain of swine fever virus in early pregnancy. Only inoculated sows produced abnormal piglets. These showed congenital tremors and ataxia. The severity of clinical signs was related to the degree of spinal myelin deficiency. Morphologically this was quantified by determination of the thickness of myelin investing axons classed according to their diameter. In clinically affected pigs fewer axons were myelinated than normal. Though the myelin sheath thickness increased with increasing axon diameter in all pigs whether clinically normal or not, the increase was less in moderately affected and much less in severely affected pigs. The deficiency of spinal myelin was probably due to delayed or sub-normal myelination accompanied by paranodal myelin abnormalities, myelin degeneration and remyelination.

Clinico-pathologic findings in young pigs fed different levels of selenium, vitamin E and antioxidant

A randomized, blocked 2³ factorial experiment was conducted with 48 young pigs. The treatment factors were: 2 levels of selenium (55 and 115 µg/kg), 2 levels of vitamin E (3 and 53 mg/kg) and 2 levels of the antioxidant feed additive Ethoxyquin (0 and 150 mg/kg). All pigs were kept in single pens and fed ad libitum throughout the experimental period of 9 weeks, i.e. from 3 to 12 weeks of age.

Plasma, heart, liver and muscle Se levels as well as whole blood glutathione peroxidase activity (EC 1.11.1.9 GSH-Px) were significantly higher in pigs given a dietary supplement of Se than in pigs given no supplement of Se (P ≤ 0.001). The Se-supplemented pigs showed a tendency to lower mean serum transaminase activity (ASAT and ALAT) than unsupplemented pigs, but the influence was significant (P ≤ 0.05) only for the ALAT activity.

Blood vit. E levels were higher for pigs receiving a supplement of vit. E than for unsupplemented pigs (P ≤ 0.001), and so was the resistance of red blood cells against lipid peroxidation (ELP), as expressed by lower ELP values.

There were no effects of Ethoxyquin supplementation on the biochemical variables included in the study.

The histological examination of heart muscle showed that the score for changes was negatively influenced by both Se and vit. E supplement (P ≤ 0.001) and to some extent also by Ethoxyquin supplement (P ≤ 0.05). The histological picture of m. long dorsi was influenced only by the vit. E supplement (P ≤ 0.01). No histological changes were found in the liver in this study. There were inverse relationships between whole blood GSH-Px defluorescence time and blood Se, and between ELP and whole blood vit. E (P ≤ 0.001).

Bovine mastitis induced by a common intestinal Chlamydia psittaci strain. A pathogenetic and serological investigation

Cattle are frequently infected with a persisting intestinal Chlamydia psittaci strain, which through the manure deposit will contaminate their surroundings. The potential of such a strain (ROS) for inducing mastitis was demonstrated in 7 cows, inoculated in 1 udder-quarter through the teat canal, and the pathogenetic events provoked were compared with those of more virulent and infrequently isolated strains, viz. the EAE and the SBE strains. The chlamydial agent caused during a 2–3 weeks period a local, self-limiting exudative mastitis with a fibrinous secretion, leading to a state of reduced milk production. Increasing titres of complement fixing and agglutinating antibodies were demonstrated in whey and serum. The results from the 2 serological methods did not substitute each other entirely, so that both tests had to be employed in order to demonstrate the presence of the agent in all cases. Demonstration in 1 animal showed that the infection left the gland with resistance to reinfection.