Strategies to improve the ovarian response to equine pituitary extract in cyclic mares

Equine pituitary extract (EPE) has been reported to induce heightened follicular development in mares, but the response is inconsistent and lower than results obtained in ruminants undergoing standard superovulatory protocols. Three separate experiments were conducted to improve the ovarian response to EPE by evaluating: (1) effect of increasing the frequency or dose of EPE treatment; (2) use of a potent gonadotropin-releasing hormone agonist (GnRH-a) prior to EPE stimulation; (3) administration of EPE twice daily in successively decreasing doses. In the first experiment, 50 mares were randomly assigned to one of four treatment groups. Mares received (1) 25 mg EPE once daily; (2) 50 mg EPE once daily; (3) 12.5 mg EPE twice daily; or (4) 25 mg EPE twice daily. All mares began EPE treatment 5 days after detection of ovulation and received a single dose of cloprostenol sodium 7 days postovulation. EPE was discontinued once half of a cohort of follicles reached a diameter of >35 mm and hCG was administered. Mares receiving 50 mg of EPE once daily developed a greater number (P = 0.008) of preovulatory follicles than the remaining groups of EPE-treated mares, and more (P = 0.06) ovulations were detected for mares receiving 25 mg EPE twice daily compared to those receiving either 25 mg EPE once daily and 12.5 mg EPE twice daily. Embryo recovery per mare was greater (P = 0.05) in the mares that received 12.5 mg EPE twice daily than those that received 25 mg EPE once daily. In Experiment 2, 20 randomly selected mares received either 25 mg EPE twice daily beginning 5 days after a spontaneous ovulation, or two doses of a GnRH-a agonist upon detection of a follicle >35 mm and 25 mg EPE twice daily beginning 5 days after ovulation. Twenty-four hours after administration of hCG, oocytes were recovered by transvaginal aspiration from all follicles >35 mm. No differences were observed between groups in the numbers of preovulatory follicles generated (P = 0.54) and oocytes recovered (P = 0.40) per mare. In Experiment 3, 18 mares were randomly assigned to one of two treatment groups. Then, 6-11 days after ovulation, mares were administered a dose of PGF2, and concomitantly began twice-daily treatments with EPE given in successively declining doses, or a dose of PGF2alpha, but no EPE treatment. Mares administered EPE developed a higher (P = 0.0004) number of follicles > or = 35 mm, experienced more (P = 0.02) ovulations, and yielded a greater (P = 0.0006) number of embryos than untreated mares. In summary, doubling the dose of EPE generated a greater ovarian response, while increasing the frequency of treatment, but not necessarily the dose, improved embryo collection. Additionally, pretreatment with a GnRH-a prior to ovarian stimulation did not enhance the response to EPE or oocyte recovery rates.     

An experimental study on prednisolone-induced interstitial pneumonia caused by Pneumocystis carinii

This study was performed to observe the role of Pneumocystis carinii as an etiologic agent of interstitial pneumonia in immunocompromised hosts. Total 90 male Sprague-Dawley rats, approximately 150-180 g, were used. Fifteen of them were used as control group and remaining 75 (5 groups) were as immunosuppression groups; group 1 received prednisolone (25 mg/kg twice weekly) only; group 2 prednisolone and tetracycline (75 mk/kg/day); group 3 prednisolone, tetracycline and trimethoprim-sulfamethoxazole (50-250 mg/kg/day); group 4 prednisolone and trimethoprimsulfamethoxazole; and group 5 prednisolone and griseofulvin (300 mg/kg/day) until death. The survival days of each group rat were calculated, and upon death their lungs were removed immediately and then stamp smears were prepared and stained by Giemsa or toluidine blue O. For histopathologic observation, lungs were fixed in 10% formalin, cut into sections and stained with Gomori's methenamine silver, hematoxylin-eosin, and Brown & Brenn stain. The results obtained were as follows: 1. The mean survival time of each group rat was 19.3 +/- 5.2 days (group 1), 41.1 +/- 14.0 days (group 2), 50.5 +/- 18.4 days (group 3), 43.0 +/- 22.9 days (group 4) or 21.8 +/- 5.1 days (group 5). Significant differences were noted between group 1 and group 2(p less than 0.01), group 1 and group 3 (p less than 0.01), and group 1 and group 4 (p less than 0.01), which represented bacterial infections were most fatal in immunocompromised rats.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of Corticotrophin and Prednisolone in Treatment of Idiopathic Facial Paralysis (Bell's Palsy)

In a controlled trial of the effects of intramuscular corticotrophin and oral prednisolone in the treatment of acute Bell''s palsy 186 successive patients with idiopathic facial palsy were grouped for age and duration of palsy. They were then allocated at random to either corticotrophin or prednisolone therapy in pairs. The results were:(1) 94 received corticotrophin and 32 developed some degree of denervation and 92 received prednisolone and 13 developed some degree of denervation (P <0·005); (2) six of the corticotrophin group became severely denervated (less than 50% recovery) compared with none of the prednisolone group (P <0·02); (3) the best results were obtained in the younger patients (less than 45 years old) treated on the first or second day of palsy; and (4) side effects were minimal.It is concluded that oral prednisolone is the treatment of choice for idiopathic facial (Bell''s) palsy.     

Mecillinam in enteric fever.

Twelve consecutive patients with enteric fever entered a trial of 14 days'' treatment with mecillinam. Only three patients became afebrile within three days; four continued unimproved with fever and toxaemia for seven to nine days, when treatment was changed to chloramphenicol with good results. In one case the fever did not settle until the 13th day, and five days later the patient had a clinical relapse. Although all organisms recovered were fully sensitive to mecillinam, this drug is not an effective or consistent treatment for enteric fever.     

Trimethoprim-sulphamethoxazole in Acute Brucellosis

Eight patients with proved brucella infection were treated with trimethoprim-sulphamethoxazole. The dose varied from two to four tablets given twice daily for three weeks. Clinical response was rapid and all patients were asymptomatic and afebrile within two to seven days of starting therapy. Three patients relapsed clinically and bacteriologically within three weeks of ending treatment. There were no side effects of the treatment. It is suggested that the treatment be continued for at least six weeks to prevent relapses.     

咬合运动与注射醋酸泼尼松龙治疗滑膜炎的疗效比较

目的:比较咬合运动和关节下腔注射醋酸泼尼松龙治疗颞下颌关节滑膜炎的临床效果。方法:选择牙列完整、无第三磨牙阻生、符合颞下颌关节滑膜炎诊断标准的120例患者,随机分为实验组和对照组,每组60例。实验组行咬合运动,每次3-4个循环,每日3-4次,治疗周期为12个月;对照组给予醋酸泼尼松龙0.0125g+0.5ml2%利多卡因关节下腔注射一次,比较两种方法的治疗效果。结果:实验组的60例患者均在治疗后1-2w疼痛消失,追踪3-12个月无复发。对照组的60例患者,2个周后有18例无效,无效率为30%,两组比较其结果有显著性差异(P<0.001);3个月后有22例无效,无效率为36.67%,两组比较其结果有显著性差异(P<0.001)。结论:咬合运动组的治疗效果显著高于醋酸泼尼松龙注射组,咬合运动能有效的治疗滑膜炎并减少患者的治疗痛苦。     

Development of tolerance to ethanol-induced suppression of breathing movements and brain activity in the near-term fetal sheep during short-term maternal administration of ethanol

The effect of short-term maternal ethanol administration on the ethanol-induced suppression of fetal breathing movements, electrocortical (ECoG) activity, and electroocular (EOG) activity was determined in the near-term fetal sheep. Twelve conscious instrumented pregnant ewes (between 125 and 139 days of gestation; term, 147 days) received 1-h intravenous infusion of 1 g ethanol/kg total body weight daily for six days (n = 6) or an equivalent volume of normal saline daily for six days (n = 6). On the seventh day, the ethanol- and saline-pretreated animals were administered 1 g ethanol/kg total body weight. A further six ewes received 1-h intravenous infusion of 1 g ethanol/kg total body weight (n = 3) or an equivalent volume of normal saline (n = 3) daily for thirteen days with both groups receiving 1 g ethanol/kg total body weight on day fourteen. Fetal ECoG and EOG activities, and fetal breathing movements were monitored continuously over the post- operative and experimental periods. Saline infusion had no significant effect on the parameters studied. Fetal breathing movements were suppressed for 8 h after the first ethanol dose, and were not significantly suppressed after fourteen days of once-daily, maternal ethanol administration. Low-voltage ECoG and EOG activities were suppressed for 3 h after the first ethanol dose, and were not significantly suppressed after seven days of repeated ethanol administration. Maternal and fetal blood gases and acid-base balance were not significantly affected by maternal ethanol administration. These data demonstrate that short-term maternal administration of ethanol results in the development of tolerance to ethanol in the mature fetus.     

Pneumococcal bacteraemia: 325 episodes diagnosed at St Thomas's Hospital.

Three hundred and twenty five episodes of pneumococcal bacteraemia occurred at St Thomas''s Hospital during 1970-84, accounting for 13.3% of all episodes of bacteraemia. Twice as many cases occurred in male as in female patients, and common predisposing factors included chronic chest disease, alcoholism, haematological malignancies, cirrhosis, and sickle cell anaemia. Mortality was 28.6% overall but only 11.8% among patients who received antibiotic treatment for at least 24 hours. Most patients (261) had pneumonia, 26 had meningitis, and eight were children with occult bacteraemia. The commonest serotype of pneumococcus in adults was type 3 (39 episodes), and these strains were associated with a high mortality. Other factors determining a fatal outcome included underlying disease (such as cirrhosis, malignancy, and chronic chest disease) and extrapulmonary infection. Almost half the survivors were treated for 10 days or less and became afebrile within 48 hours.     

Comparison of ampicillin with clindamycin plus gentamicin in the treatment of postpartum uterine infection.

A prospective randomized study of the treatment of postpartum endometritis was conducted with 43 patients. The bacterial origin of the infection was determined by uterine aspiration. Treatment was successful in 17 of the 19 patients receiving ampicillin (12 g/d) and in 21 of the 24 patients receiving clindamycin (2.4 g/d) plus gentamicin (5.1 mg/kg daily).     

Impact of Chisan (ADAPT-232) on the quality-of-life and its efficacy as an adjuvant in the treatment of acute non-specific pneumonia

A double-blind, placebo-controlled, randomized (simple randomisation), pilot (phase III) study of Chisan^® (ADAPT-232; a standardised fixed combination of extracts of Rhodiola rosea L., Schisandra chinensis Turcz. Baill., and Eleutherococcus senticosus Maxim) was carried out on two parallel groups of patients suffering from acute non-specific pneumonia. Sixty patients (males and females; 18–65 years old) received a standard treatment with cephazoline, bromhexine, and theophylline: in addition, one group of 30 patients was given Chisan mixture, whilst the second group of 30 patients received a placebo, each medication being taken twice daily from the beginning of the study for 10–15 days. The primary outcome measurements were the duration of antibiotic therapy associated with the clinical manifestations of the acute phase of the disease, together with an evaluation of mental performance in a psychometric test and the self-evaluation of quality-of-life (QOL) (WHOQOL-Bref questionnaires) before treatment and on the first and fifth days after clinical convalescence. The mean duration of treatment with antibiotics required to bring about recovery from the acute phase of the disease was 2 days shorter in patients treated with Chisan compared with those in the placebo group. With respect to all QOL domains (physical, psychological, social and ecological), patients in the Chisan group scored higher at the beginning of the rehabilitation period, and significantly higher on the fifth day after clinical convalescence, than patients in the control group. Clearly, adjuvant therapy with ADAPT-232 has a positive effect on the recovery of patients by decreasing the duration of the acute phase of the illness, by increasing mental performance of patients in the rehabilitation period, and by improving their QOL. Both the clinical and laboratory results of the present study suggest that Chisan (ADAPT-232) can be recommended in the standard treatment of patients with acute non-specific pneumonia as an adjuvant to increase the QOL and to expedite the recovery of patients.     

Hypothalamic-pituitary-adrenal axis following glucocorticoid prophylaxis against acute mountain sickness.

The pituitary-adrenocortical and adrenomedullary response to high altitude (HA) stress was studied following daily single dose administration of prednisolone as a prophylaxis against altitude-induced acute mountain sickness (AMS). Forty healthy men, randomly divided into two groups of twenty, received placebo or prednisolone 20 mg once a day at 08.00 h for two days prior to induction to HA and during an initial three days stay at an altitude of 3450 m. The AMS score and circulatory levels of ACTH, cortisol, epinephrine and norepinephrine were measured at sea level (SL) and during residency at HA. The sensitivity of the hypothalamic-pituitary-adrenal axis in subjects receiving prednisolone therapy was evaluated at SL and on day four of stay at HA. Administration of prednisolone significantly (p < 0.01) decreased the severity of AMS in all the subjects. The steroid dose used did not inhibit endogenous secretion of ACTH, cortisol, epinephrine or norepinephrine, as HA response to adrenocortical and adrenomedullary hormones was identical in placebo and prednisolone treated subjects. The integrity of the hypothalamic-pituitary-adrenal axis was maintained well in subjects receiving low dose prednisolone therapy. These observations suggest that short-term administration of prednisolone is able to curtail AMS without causing suppression of the hypothalamic-pituitary-adrenal axis.     

Efficacy of monotherapy by meropenem in ventilator-associated pneumonia]

We performed a prospective, open label, randomized study in intensive care unit patients with ventilator-associated pneumonia (VAP) to determine the efficacy and safety of empiric intravenous (i.v.) meropenem monotherapy compared with the combination of ceftazidime plus amikacin. A total of 140 patients receiving mechanical ventilation and diagnosed with pneumonia were included in the study. Patients were randomized to receive either 1 g meropenem i.v. every 8 hours or 2 g ceftazidime i.v. every 8 hours plus 15 mg/kg amikacin daily, administered to patients with normal renal function as two daily doses. Satisfactory clinical responses (cure or improvement) were achieved at the end of treatment in 68.1% of meropenem-treated patients and 54.9% in the ceftazidime/amikacin treated group (relative risk 1.25; 95% confidence interval > 1.00, 1.55). When non-evaluable patients were excluded from the analysis, the satisfactory clinical response was 82.5% and 66.1% for the meropenem and ceftazidime/amikacin patients, respectively (p = 0.044). Logistic regression demonstrated that treatment with meropenem and both the basic traumatic and medical pathologies were significantly associated with a satisfactory response. Adverse events judged to be possible or probably related to treatment were reported by seven (10.1%) patients in the meropenem group and by eight patients (11.3%) in the ceftazidime/amikacin group. The results of this study confirm that monotherapy with meropenem is well tolerated and provides superior efficacy to the conventional combination of ceftazidime and amikacin in combating VAP.     

Ampicillin treatment trial in gonorrhea recurrences]

The results of using ampicillin in treatment of 54 gonorrhea patients (41 males and 13 females) previously treated with other antibiotics without success are presented. Ampicillin was used in a daily dose of 500 mg administered 5 times a day at equal intervals and an 8-hour interval during the night time. The course dose was 6--10 g. Patients with chronic and fresh gonorrhea with insignificantly pronounced symptoms were subjected to immunotherapy before the treatment with ampicillin. Pure gonococcal strains sensitive to ampicillin were isolated from 16 patients before the ampicillin use. Clinical improvement after the treatment with ampicillin in most of the patients was observed by the end of the 1st day and was evident from elimination of the urethral discharges, absence of urination colics and urea clarification. Etiological recovery was recorded in all the gonorrhea patients due to the treatment with ampicillin. All the patients were crossed off the register. The clinical and laboratory investigations showed high efficiency of ampicillin in treatment of gonorrhea relapses. The antibiotic is rapidly absorbed into the blood. Its therapeutic blood levels are maintained during 24 hours. It is well tolerated by the patients.     

Treatment of chronic drug-resistant pulmonary tuberculosis with rifampin and ethambutol

Twenty patients with chronic pulmonary tuberculosis completed eight months of rifampin-ethambutol treatment. Half the patients received daily 600 mg. rifampin and 25 mg./kg. ethambutol for the first two months and subsequently 15 mg./kg. The others received the same dosage of ethambutol and 450 mg. rifampin daily. The average time of sputum conversion was seven weeks and 11 weeks in the two groups respectively. The patients tolerated these drug regimens well.Rifampin blood levels and urinary excretion were studied monthly during the therapy. They indicated that after a short period of treatment the elimination of this drug became faster owing to increased excretion of rifampin, and particularly of its desacetyl metabolite, in the bile. Liver damage resulted in a slower excretion rate. Rifampin should be taken on an empty stomach because simultaneous food intake reduces the peak blood concentration.     

Results of Treatment of Thyrotoxicosis following Relapse after Antithyroid Drug Therapy

One hundred and thirty patients who relapsed after a full course of treatment with antithyroid drugs have been reviewed. Of 22 patients receiving a second course of antithyroid drugs, 17 (77%) relapsed. In contrast, only 2 out of 44 patients treated by surgery relapsed and seven became hypothyroid. Nevertheless, local complications, in particular parathyroid insufficiency, were especially common in this group. Eighty patients received radioiodine, 11 (14%) requiring more than three doses before finally being rendered euthyroid. Postradiation hypothyroidism developed in 39 (49%) patients.     

Therapy of bronchopulmonary infection in smokers]

The efficacy and safety of Cifran OD, a new dosage form of ciprofloxacin with prolonged action were studied in the treatment of patients with bronchopulmonary infection (n=23). The drug was used orally in a dose of 1 g once a day. The patients were divided into 2 groups: group 1 included patients with aggravation of chronic bronchitis and group 2 included patients with bacterial pneumonia. The recovery was stated in 77.7% of the patients in group 1, the other 26.3% of the patients showed clinical improvement. In the patients with pneumonia (group 2) the recovery was recorded in 100% of the cases. No significant side effects were observed.     

Immunosuppressive properties of sera and urine dialysates from kidney-graft recipients treated with azathioprine,prednisolone, and niridazole

Niridazole, an antischistosomal agent, was given to renal transplant recipients in addition to azathioprine and prednisolone, as there is experimental evidence that this combination of drugs is highly immunosuppressive. Sera obtained from kidney-graft recipients during the first two weeks after transplantation were examined for their ability to inhibit the one-way mixed lymphocyte reaction (MLR). Sera from seven patients receiving azathioprine, prednisolone, and niridazole (triple-drug treatment), five patients receiving azathioprine and prednisolone, and two other patients treated with niridazole alone for schistosomiasis produced MLR inhibition by comparison with pretreatment (control) sera.A mean of 78% inhibition was observed with sera taken after one day''s treatment with the three-drug combination, whereas this level of in-vitro immunosuppression occurred only after eight days of treatment with azathioprine and prednisolone. Niridazole alone produced an effect similar to azathioprine and prednisolone. Concentrated dialysate of urine from a patient receiving triple-drug treatment not only inhibited the MLR but also significantly prolonged the survival of heterotopic heart allografts in rats, whereas dialysate from the same patient after niridazole had been stopped gave less MLR inhibition and failed to prolong heart allograft survival.Since niridazole thus increased the in-vitro and in-vivo immunosuppressive action of azathioprine and prednisolone, we suggest that this triple-drug combination might be useful for preventing early acute kidney graft rejection.     

Prednisolone-induced Ca2+ malabsorption is caused by diminished expression of the epithelial Ca2+ channel TRPV6

Glucocorticoids, such as prednisolone, are often used in clinic because of their anti-inflammatory and immunosuppressive properties. However, glucocorticoids reduce bone mineral density (BMD) as a side effect. Malabsorption of Ca2+ in the intestine is supposed to play an important role in the etiology of low BMD. To elucidate the mechanism of glucocorticoid-induced Ca2+ malabsorption, the present study investigated the effect of prednisolone on the expression and activity of proteins responsible for active intestinal Ca2+ absorption including the epithelial Ca2+ channel TRPV6, calbindin-D(9K), and the plasma membrane ATPase PMCA1b. Therefore, C57BL/6 mice received 10 mg/kg body wt prednisolone daily by oral gavage for 7 days and were compared with control mice receiving vehicle only. An in vivo 45Ca2+ absorption assay indicated that intestinal Ca2+ absorption was diminished after prednisolone treatment. We showed decreased duodenal TRPV6 and calbindin-D(9K) mRNA and protein abundance in prednisolone-treated compared with control mice, whereas PMCA1b mRNA levels were not altered. Importantly, detailed expression studies demonstrated that in mice these Ca2+ transport proteins are predominantly localized in the first 2 cm of the duodenum. Furthermore, serum Ca2+ and 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] concentrations remained unchanged by prednisolone treatment. In conclusion, these data suggest that prednisolone reduces the intestinal Ca2+ absorption capacity through diminished duodenal expression of the active Ca2+ transporters TRPV6 and calbindin-D(9K) independent of systemic 1,25(OH)2D3.     

Comparison of two protocols for the treatment of retained fetal membranes in dairy cattle

Two protocols for the treatment of retained fetal membranes in dairy cattle were evaluated in a field trial. Cows that retained the fetal membranes for more than 12h were assigned to two treatment groups in an alternating order. In both groups rectal temperature was measured daily for 10 days after enrollment. In Group 1 (n=35) cows with a rectal temperature >or=39.5 degrees C received a systemic antibiotic treatment with 600mg ceftiofur intramuscularly on three consecutive days. No manual removal of the fetal membranes or intrauterine treatment was conducted. In case of elevated temperature of >or=39.5 degrees C on Day 3 treatment was conducted for another 2 days. In Group 2 (n=35) cows received a local antibiotic treatment (2500 mg ampicillin, 2500 mg cloxacillin) and an attempt was made to remove the fetal membranes manually. In case of a rectal temperature >or=39.5 degrees C 6000 mg of ampicillin were administered intramuscularly. Treatment was repeated on three consecutive days. If temperature did not decrease below 39.5 degrees C systemic treatment was extended for another 2 days.During 10 days of observation 33 and 34 cows showed fever, i.e. a body temperature >or=39.5 degrees C in Groups 1 and 2, respectively (94.3 versus 97.1%). The proportion of cows considered as cured (temperature <39.5 degrees C on Day 10 after enrollment) was 65.7 and 68.6% in Groups 1 and 2, respectively. All cows showed signs of chronic inflammation of the genital tract on Day 14 after calving. Within 4 weeks postpartum three (8.6%) and four (11.4%) cows were culled in Groups 1 and 2, respectively. Days to first service and days open did not differ significantly between the groups. Proportion of cows pregnant on Day 200 postpartum was 71.4 and 54.3% for Groups 1 and 2, respectively (P>0.05). Results indicate that treatment of retained fetal membranes without intrauterine manipulation and treatment can be as effective as conventional treatment including detachment and local antibiotic treatment.     

咬合运动与注射醋酸泼尼松龙治疗滑膜炎的疗效比较

目的：比较咬合运动和关节下腔注射醋酸泼尼松龙治疗颞下颌关节滑膜炎的临床效果。方法：选择牙列完整、无第三磨牙阻生、符合颞下颌关节滑膜炎诊断标准的120例患者,随机分为实验组和对照组,每组60例。实验组行咬合运动,每次34个循环,每日3-4次,治疗周期为12个月;对照组给予醋酸泼尼松龙0．0125g＋0．5m12％利多卡因关节下腔注射一次,比较两种方法谛治爿效果。结果：实验组的60例患者均在治疗后1-2W疼痛消失,追踪3．12个月无复发。对照组的60例患者,2个周后有18。例无效,无效率为30％,两组比较其结果有显著性差异（P〈O．001）;3个月后有22例无效,无效率为36．67％,两组比较其结果有显著性差异（P〈0．001）。结论：咬合运动组的治疗效果显著高于醋酸泼尼松龙注射组,咬合运动能有效的治疗滑腱炎并减少患者的治疗痛苦。