Equine retained placenta: technique for and tolerance to umbilical artery injections of collagenase

Under laboratory conditions and in clinical experiments, bacterial collagenase has proven to be effective in hydrolyzing placenta and detaching cotyledon from caruncle in the bovine species. Laboratory studies in which placental samples were incubated with collagenase have also demonstrated that collagenase is 3.7 times more effective in hydrolyzing equine placenta than bovine placenta. This led to the hypothesis that collagenase may be a potential treatment for mares with retained placenta. However, that collagenase may hydrolyze the uterine wall and perforate the uterus was a concern. It was the purpose of this study thus to determine any adverse effects of collagenase on the equine uterus and to develop a method for intraplacental injection of collagenase. Three normally expelled intact placentas from Arabian mares, 10 cyclic mixed-breed mares, and 4 mares of various breeds with retained placenta were used. Fluoroscein dye and latex were used to study the placental vasculature and to determine a suitable dose of collagenase; placentas were hydrolyzed by collagenase solution in vitro. Bacterial collagenase solution (40,000 units, 200 ml) was infused into the uterine lumen of each cyclic mare. Uterine biopsies were obtained from the mares before collagenase infusion and again at 16 h and 26 d after infusion. In the mares with retained placenta, each placenta was infused via its umbilical cord vessels with 200,000 units of bacterial collagenase in 1 L of saline. Results showed that none of the uteri from cyclic mares were damaged by collagenase treatment. During a 4-wk period of monitoring (including endoscopy) mares with retained placenta did not show any abnormalities. Retained placentas were expelled in less than 6 h after collagenase treatment. It was concluded that intraplacental injections of collagenase are a safe and potentially effective treatment for retained placenta in mares.

[Socio-professional and judicial aspects of traumatic paraplegia and tetraplegia]

Social integration in competitive employment reminds the main laws, the practical aspects with difficulties encountered, and insufficient results. Juridical aspects mean study of different parts of torts, physiological and economic.

[Integration and quality of life of disabled people]

The return to home and integration in family are the main goals for disabled people. But there are many difficulties to resolve. School insertion is necessary for children, and nearly always possible. Return to work is often difficult, it has done some progress. Conveyance and accessibility in towns are necessary for a social integration, but it causes many problems. Driving is not allowed for disabled with mental or sensory impairments; it is easier for motor handicapped people, with appropriate equipment. Assessment quality of life is now evaluated, the validation of scales is not yet done.

French survey of postpolio sequelae. Risk factors study and medical social outcome

For 10 yr, numerous studies have been conducted to try to explain the further deterioration of the sequelae from a previous, acute poliomyelitis. The different etiologic hypotheses, which have been put forward, have not been confirmed yet. A retrospective study has been completed by mailed questionnaires sent to 360 patients previously affected by acute polio; 248 polio survivors replied. Deterioration, as functional loss especially during walking and exertion, was reported by 77% of our respondents. Among the newly affected cases, 60% have given up or slowed down their socio-professional activities because of these new problems with their health. These functional losses, reported by patients, have been statistically related to several factors: the aging process, weight gain, female predominance and the involvement of abdominal muscles at a previously acute polio stage. The recently affected population has the same degree of disability (measured through the "Functional Independence Measure" (translated in French and self-administered)) as the nonaffected one. This fact suggests that the problems that are being experienced may be partly subjective.

Slowly progressive apraxia: two case studies

Two patients with a slowly progressive and severe motor apraxia are presented. In one case, there was only apraxia; in the other there was moderate memory disturbance and a mild decline of global intellectual ability, suggesting a more widespread cognitive dysfunction. In this second case, recognition of the correct use of objects was also severely impaired, suggesting a disturbance of motor knowledge. In both cases, apraxia was asymmetrical, and associated with a contralateral atrophy of the upper parietal cortex, suggesting a differential involvement of separate action systems for each hand.

Epididymal swelling attributable to generalized lymphosarcoma in a stallion

Aspermia was diagnosed in a 12-year-old Thoroughbred stallion with generalized lymphosarcoma. Invasion of the epididymus by neoplastic cells caused thickening and enlargement of both epididymes. The testes were not affected. The nodular ultrasonographic architecture was similar to that in previously reported cases of infectious epididymitis.

Comparison of standard and radionuclide methods for measurement of glomerular filtration rate and effective renal blood flow in female horses

Comparison of standard and radionuclide methods for measuring glomerular filtration rate (GFR) and effective renal blood flow (ERBF) was performed in 8 healthy female horses. Inulin and p-aminohippurate solutions were administered IV as a bolus, followed by sustained administration. Urine and plasma inulin and p-aminohippurate concentrations and urine volume were measured. Glomerular filtration rate and ERBF were calculated on the basis of these measurements. Glomerular filtration rate and ERBF were measured on the basis of plasma clearance of the radiopharmaceuticals, 99mTc-labeled diethylene-triaminepentaacetic acid (99mTc-DTPA) and [131I]-o-iodohippuric acid (131I-OIH), respectively. Mean +/- SEM GFR, using inulin, was 1.83 +/- 0.21 ml/min/kg of body weight. Mean GFR, using 99mTc-DTPA was 1.79 +/- 0.18 ml/min/kg. Mean ERBF, using p-aminohippurate, was 15.13 +/- 1.28 ml/min/kg. Mean ERBF, using 131I-OIH, was 18.42 +/- 1.57 ml/min/kg. Analysis of variance indicated no significant difference between mean values for GFR and ERBF. Radionuclide measurement of GFR and ERBF compared well with standard methods and is an alternative technique to the cumbersome standard methods for determination of GFR and ERBF in horses.

Spermatozoal head defect as a cause of infertility in a stallion

A 9-year-old Arabian stallion with a 3-year history of infertility was evaluated for breeding soundness. Both testes were small. Ultrasonography revealed a small amount of free fluid between the tunics of both testes. Results of cytologic examination of the fluid were unremarkable. On semen examination, progressive motility was 10%, and total number of spermatozoa in the ejaculate was 6.6 x 10(9), of which 92% were abnormal. Predominant abnormalities were head defects (75%): 57% of the heads had single or multiple vacuoles, and 60% also had midpiece swelling or bending.

Use of nonimaging nuclear medicine techniques to assess the effect of flunixin meglumine on effective renal plasma flow and effective renal blood flow in healthy horses

The effect of flunixin meglumine on renal function was studied in 6 healthy horses by use of nonimaging nuclear medicine techniques. Effective renal plasma flow (ERPF) and effective renal blood flow (ERBF) were determined by plasma clearance of 131I-orthoiodohippuric acid before and after administration of flunixin meglumine. Mean ERPF and ERBF was 6.03 ml/min/kg and 10.7 ml/min/kg, respectively, before treatment and was 5.7 ml/min/kg and 9.7 ml/min/kg, respectively, after treatment. Although ERPF and ERBF decreased after flunixin meglumine administration, the difference was not statistically significant.

Systematic lower limb phlebography in acute spinal cord injury in 147 patients

This study was concluded on paraplegic and tetraplegic patients of all aetiologies except neoplasic, where paralysis developed within 48 hours. All patients were admitted to the rehabilitation department within 90 days after the onset of paralysis. In a preliminary review of 328 files, there were 27 cases of clinical deep vein thrombosis (DVT) and 10 with pulmonary embolism (PE), 6 of which were fatal. A prospective study was conducted, based on systematic detection of asymptomatic DVT with phlebography. Among the 147 patients, 20 previously presented with DVT. The 127 others underwent phlebography which showed 39 DVT in 29 patients. Eighty seven patients with negative phlebography underwent a second study a month later which showed 14 DVT in 12 patients. Only one minor pulmonary embolism occurred in these 147 patients. The incidence of DVT after acute spinal cord injury and the frequent absence of clinical manifestations were confirmed. Prophylactic anticoagulant therapy is useful but insufficient. This study demonstrates that systematic and repeated detection of DVT by phlebography may reduce the incidence of PE.

Bacterial epididymitis in two stallions

Two stallions had unilateral bacterial epididymitis attributable to S zooepidemicus infection. Diagnosis was based on bacterial isolation, WBC in the semen, higher than normal blood fibrinogen concentration, and leukocytosis with regenerative left shift. One horse had high seminal pH. Ultrasonography of the involved epididymides revealed changes consistent with the appearance of abnormal accumulation of exudate in the tail of the epididymis. Treatment included unilateral orchiectomy and antibiotic administration. In stallion 1, the infection persisted despite treatment. Treatment result was not available for stallion 2.

Use of ultrasonographic and nuclear imaging to diagnose scrotal hernia in a dog

Ultrasonography and nuclear imaging were used in the diagnosis of scrotal hernia in a dog. Both techniques were useful as aids in the differential diagnosis of scrotal enlargement. Nuclear imaging was useful in ruling out testicular torsion; ultrasonography revealed a normal-appearing testis amid fluid and portions of omentum.

Pure sensory stroke due to midbrain haemorrhage limited to the spinothalamic pathway

A 62 year old man suddenly presented with a pure left sensory deficit involving only pain and temperature sensations. CT scan and MRI showed a small haemorrhage in the dorsolateral part of the right midbrain. This suggested a lesion limited to the right dorsal spinothalamic tract.

Pleural effusion resulting from malignant hepatoblastoma in a horse

Pleural effusion, secondary to a metastasis from a malignant hepatoblastoma, was diagnosed in a 3-year-old Appaloosa gelding. Severe hemorrhagic transudate in both pleural cavities resulted in acute onset of labored breathing, tachypnea, tachycardia, and jugular vein pulsation. Results of ultrasonography and radiography of the ventral lung field and cranial portion of the abdomen initially were nondiagnostic, as were results of cytologic examination of peritoneal fluid and tracheal wash specimens. Moderately high serum gamma-glutamyl transferase and alkaline phosphatase activities, despite normal hepatocyte-specific enzyme (sorbital dehydrogenase) activity, were indicative of biliary stasis without hepatocyte destruction. The horse was euthanatized. Necropsy revealed a 47-kg hepatoblastoma, with metastases in the lungs and intestines.

Sperm granuloma in a stallion

A 7-year-old stallion with a history of abdominal pain after it fell was examined and found to have a swelling of the right testis and epididymis. Semen evaluation revealed an increase in secondary sperm abnormalities. The stallion was unilaterally castrated. The histologic diagnosis was sperm granuloma, with no evidence of infection. Periductal fibrosis was observed and appeared to have developed before the trauma occurred. The changes seen could be compatible with chronic blockade of efferent ductules, resulting in extravasation of spermatozoa.

Myoclonus in a patient with spinal cord transection. Possible involvement of the spinal stepping generator

A patient with clinically complete cervical spinal cord transection developed rhythmic myoclonic movements of the trunk and lower limbs, demonstrating that, in man, such movements can be generated within the spinal cord itself when deprived of supraspinal control. Electromyographic (EMG) recordings used to define the features of the myoclonus, which had a frequency of 0.3-0.6 Hz, was bilaterally symmetric, and involved extensor muscles. The EMG bursts always appeared in phase in all muscles involved. Peripheral stimulation of flexor reflex afferents (FRA) could induce, slow or interrupt the rhythmic activity. When FRA stimulation induced a flexion reflex, it occurred between extensor EMG bursts and induced alternating flexion-extension activity which could be sustained for several cycles. Soleus and quadriceps monosynaptic reflexes were depressed during the silent period of the rhythmic activity. Several arguments, mainly the great sensitivity of the myoclonus to flexor reflex afferent stimulation, suggest that the myoclonus observed in this patient was due to partial release of a spinal stepping generator.

Solitary osteochondroma of the radius in three horses

Osteochondroma of the distal portion of the radius was diagnosed in 3 horses with a history of lameness and distention of the common tendon sheath of the superficial and deep digital flexor tendons at the level of the carpal canal. In 2 horses, the exostosis was removed through an incision at the caudal border of the lateral digital extensor muscle above the carpal ligament.

Pyelonephritis associated with renal failure in a horse

A 20-year-old gelding with weight loss and generalized weakness that progressed gradually over a 3-month period was diagnosed as having pyelonephritis caused by Staphylococcus aureus infection. Abnormal laboratory findings included high values for BUN, creatinine, potassium, and calcium, and depletion of sodium. Determination of glomerular filtration rate and effective renal plasma flow indicated a severe decrease in renal filtration and perfusion.

Work intolerance in a horse with thyroid carcinoma

A thyroid carcinoma was diagnosed in a 14-year-old competitive trail horse with a 3-month history of work intolerance. Abnormal findings included low base-line triiodothyronine (T3) and thyroxine (T4) values, a large thyroid gland and decreased work tolerance. Nuclear medicine scanning revealed displacement of the right thyroid gland by a mass. Needle biopsy of the mass revealed neoplastic changes compatible with thyroid carcinoma. After removing the tumor surgically, T3 and T4 values returned to normal. Subsequently, the horse was able to compete successfully. Horses with work intolerance combined with a large thyroid gland may develop a thyroid carcinoma. In such horses, T3 and T4 values should be determined; if abnormal values are detected, needle biopsy and scintigraphic evaluation should be considered.

Thyrotropin stimulation test--new perspective on value of monitoring triiodothyronine

Thyrotropin (thyroid stimulating hormone; TSH) stimulus to thyroid cells of horses and dogs resulted in increased serum triiodothyronine (T3) concentrations that were detected earlier than those of thyroxine (T4). Doubling of the base-line T3 values in horses was detected 0.5 hours after injection of 5 IU of TSH IV, with peak response of 5 times base-line value detected 2 hours after injection. Doubling of T4 values in horses was noticed between 2 and 3 hours, with the peak response of 2.4 times base-line value at 4 hours after injection of TSH. Doubling of base-line T3 values in dogs in response to 0.2 IU TSH/kg of body weight (IV-5 IU maximum dose) was noticed at 1 hour, whereas T4 response doubled between 1.5 and 2 hours. Peak release of T3 and T4 in response to TSH in dogs had not developed by 4 hours; however, the percentage increase over base-line values was greater for T3 than T4 at early sampling time points, and this response has resulted in an increased T3/T4 ratio in hypothyroid dogs. Thus, in both dogs and horses, these studies indicated that T3 response to TSH could be used as a measure of thyroid function at earlier time intervals after TSH administration than one measures T4 response.

Pelvic limb lameness due to malignant melanoma in a horse

Malignant melanoma in a 21-year-old, gray, Arabian gelding was manifested by rapidly deteriorating lameness of the right pelvic limb. A melanotic, cutaneous mass of small dimensions was identified in the left jugular furrow. Exploratory laparoscopy revealed widespread infiltration of melanotic masses into the structures of the abdominal cavity. Necropsy indicated the lameness to have resulted from infiltration of neoplastic cells into the sacral nerves, dorsal root ganglia, proximal ischiatic nerve, and gluteal muscle fibers. The primary tumor could not be identified.

Heart rate, rate-pressure product, and oxygen uptake during four sexual activities

Heart rate, rate-pressure product, and VO2 were measured in ten healthy men during four specified sexual activities: coitus with husband on top, coitus with wife on top, noncoital stimulation of husband by wife, and self-stimulation by husband. Foreplay generated slight, but statistically significant, increases above resting baseline in cardiac and metabolic variables. From stimulation through orgasm, average effort was modest for relatively short spans. Maximum exercise values occurred during the brief spans of orgasm, then returned quickly to near baseline levels. The two noncoital activities required lower expenditures than the two coital positions, with man-on-top coitus rating the highest. Large variations among subjects and among activities discourage use of a general equivalent activity for comparison, such as "two flights of stairs," to represent "sexual activity."

Vaginal perforation after coitus in three mares

Three cases of vaginal perforation after coitus are discussed. The most consistent clinical sign is a small amount of blood escaping from the vulvar lips immediately after breeding. Secondary infection and posttraumatic swelling may cause abdominal pain due to rectal impaction. Treatment with high levels of an appropriate antibiotic is important to reduce the risk of a severe infectious peritonitis. The use of artificial insemination or a breeding roll to prevent full intromission is recommended.

A sampling protocol for the thyrotropin-stimulation test in the horse

A study was designed to assess the secretory response of thyroid glands in horses to an economically feasible dose (5 IU) of thyrotropin injected IV, and to establish valid blood sampling periods in cases in which thyroxine concentrations were different from base-line values. Significant (P less than 0.001) response (doubling or near-doubling of base line) occurred as early as 3 hours after thyrotropin administration, with peak response at 4 to 5 hours. It was concluded that administration of 5 IU of thyrotropin is economical and effective in the horse, with collection of a second blood sample possible as early as 3 hours after administration.

Treatment of anejaculation in the total paraplegic by subcutaneous injection of Physostigmine

The authors describe a new therapy for paraplegic anejaculation. Sub-cutaneous injection of Physostigmine with certain precautions and with selected methods of application can be used for patients where there is the same indication for the use of an intrathecal injection of Neostigmine. The T12-L2 myelomeres must be intact. The new treatment is easier to perform, and when the patient has experimented with three tests in our hospital without any problems, he is granted permission to apply this treatment at home, without any medical supervision.

The female orgasm: pelvic contractions

Eleven nulliparous women manually self-stimulated to orgasm, each on three separate occasions. Pelvic contraction pressure was measured by an anal probe and a vaginal probe simultaneously. Near the perceived start of orgasm, a series of regular contractions began in nine of the women. Anal and vaginal contraction waveforms were synchronized with each other, and the same number of orgasmic contractions occurred in each lumen. Anal pressure had a higher resting baseline and greater amplitude contractions than vaginal pressure. The perceived start of orgasm did not correspond precisely with the onset of regular contractions. Mean intercontraction intervals increased linearly at an increment of about 0.1 second through the series of regular contractions. Amplitudes of contraction pressure waveforms, representing pelvic muscular force, were initially low, increased through the first half of the regular series, and then decreased. Area and net area of the pressure waveforms, reflecting pelvic muscular exertion (force x time), increased during the regular orgasmic contractions. Three of the women's orgasms consistently included only a series of regular contractions (orgasm type I). For six other women, orgasms consistently continued beyond the regular series with additional irregular contractions (orgasm type II). Types I and II had been identified previously in men. Two women had no regular contractions during reported orgasms. This pattern, type IV, had not been recorded in men. Women of different types showed marked differences in orgasm duration and number of contractions. Identification of these types in subjects is important for meaningful comparison of contraction parameters in different studies.

Medical sex education: dogmatism and students' performance

Data are reported for performance on the problem of management of patients by 149 volunteer medical students from a class of 240 students enrolled in a required second-year course on human sexuality. The Patient-Management Problem has been used in a controlled setting to evaluate students' clinical judgment in treating a patient. The performance data are correlated with the volunteer students' dogmatism scores (Rokeach E form). The results indicate that performance on the problem is inversely related to high levels of dogmatism measured for these students.

A preliminary report on an attempt to modify behavior of untamed ponies by acupuncture

A preliminary study using various acupuncture techniques to modify behavior of untamed ponies was attempted. In five of the seven tested parameters, the animals's behavioral responses were unaffected by acupuncture treatments. However, substantial improvement of general behavior of the nervous ponies was observed in animals treated with jaw and scutiform points. The results are not conclusive and further testing of acupuncture as a mean of modifying animal behavior is desirable.

The male orgasm: pelvic contractions measured by anal probe

Pelvic muscle contractions during sexual response can be monitored conveniently by the anal probe method described. Eleven young adult male subjects were each recorded for three sessions of masturbation to orgasm. Electrical signals from an anal pressure probe were automatically digitized by computer. Orgasmic contractions were easily distinguished from voluntary contractions by the steadily increasing intervals and complete muscle relaxation between orgasmic contractions. At orgasm each subject produced a characteristic series of contractions starting abruptly at an intercontraction interval of about 0.6 seconds, and continued for 10 to 15 contractions at an increasing increment of about 0.1 second per contraction. Pressure amplitude, representing the force of contractions, increased from the beginning of the regular series to a maximum at the seventh or eighth contraction. Area under the pressure curve, reflecting muscular exertion during contraction, generally increased throughout the regular series. Each man's pattern of contractions was very similar from one session to the next and distinguished his records from others'. Individuals' patterns could be grouped into three types, based chiefly on the location of the regular contraction series within the subjective span of orgasm. The most common type was a simple series of regular contractions. It had the shortest duration and fewest contractions. The next most common pattern began with the regular series, followed by a number of irregular contractions. This type was longest in duration. One man with a third type of intermediate duration, had a number of preliminary contractions before the series of regular contractions began in midorgasm.

[Frequency and symptomatology of disorders of micturition during cerebrovascular accidents. Interest of complementary examinations (author's transl)]

A total of 228 patients with cerebrovascular accidents have been studied since 1975. Micturition disorders were present in 124 cases (54 p. 100), including total incontinence in 45 p. 100, imperative micturition in 37 p. 100, and complete retention in 18 p. 100 of the patients. They are associated in a significant manner with severe psycho-intellectual disorders, an extensive hemiplegia, bilateral pyramidal signs, and ruological abnormalities. Useful complementary examinations and some therapeutic modalities are briefly reviewed.

[The role of vestibular and proprioceptive afferent pathways in the reaction to pushing (author's transl)]

The reaction to pushing was studied in 6 normal subjects and 3 patients with bilateral peripheral vestibular lesions. The reaction to pushing was tested on the anterior tibial and soleus, by modifying the proprioceptive afferent impulses. The respective parts of the vestibular, proprioceptive, visual components, and of a sudden, start are analyzed; the afferent impulses obtain information from the initial posture and modulate the relative importance of these different factors at a supra-segmentary level.

[Change in recurrent inhibition when standing in normal subjects and spastics (author's transl)]

In normal subjects and patients with diseases of the upper motor neurone, recurrent inhibition directed to soleus motoneurones was studied in three different postures: sitting (control situation), standing when leaning backward on a wall, standing independently without the support of a wall. In normal subjects, this recurrent inhibition was not modified when standing with the support of a wall, while it was enhanced when standing without such a support.

[Peripheral and central factors controlling reciprocal Ia inhibition in man]

Variations of the soleus H reflex were studied during voluntary contractions of the tibialis anterior in man. At the onset of contraction there was a weak inhibition of the soleus H-reflex which was not related to the force of the tibialis anterior contraction. 110 msec after the onset of the EMG activity the inhibition became secondarily more marked and was then related to the force of the contraction. This secondary potentation of the H-reflex inhibition is brought about by group I fibres activity, since it was markedly reduced during ischemia of the leg. It is concluded that the early inhibition is only due to suprasegmental activity whereas during the secondary part of the inhibition, there is a supplementary inhibitory action likely brought about by Ia fibres tibialis anterior. The secondary potentiation of the inhibition is therefore likely to be produced via the gamma loop.

[Paralysis following Dimer X radiculography]

The authors report four cases of cauda equina syndrome following Dimer X radiculography. The cases are described and commented upon. The conclusion is that Dimer X is a substrate associated with a certain degree of toxicity. Indications for and technique in sacroradiculography should be rigorous.

Excitability of human motoneurones after discharge in a conditioning reflex

A new method of exploring the H reflex excitability cycle is proposed which permits the exploration of motoneurones that discharged in response to the conditioning shock. This is made possible by using a test stimulus supramaximal for the alpha motor fibres of the nerve, which causes a collision in the alpha fibres between the orthodromic conditioning reflex volley and the antidromic motor volley. As a result of this collision, a test reflex contraction appears in the EMG, due to motoneurones that have already discharged in the conditioning response. This method permits studies in human subjects of the poststimulus refractory period of motoneurones as well as the early inhibitory phenomena related to the conditioning stimulus and response. It is shown that during the initial period of the classical H reflex excitability cycle, the test shock explores only alpha motoneurones corresponding to a fringe of cells subliminally excited by the conditioning stimulus. The difference between the populations of motoneurones tested by the two methods explains the differences between the features of the cycles obtained.