Early phase of acute pancreatitis: Assessment and management

Acute pancreatitis(AP) is a potentially life-threatening disease with a wide spectrum of severity. The overall mortality of AP is approximately 5%. According to the revised Atlanta classification system, AP can be classified as mild, moderate, or severe. Severe AP often takes a clinical course with two phases, an early and a late phase, which should both be considered separately. In this review article, we first discuss general aspects of AP, including incidence, pathophysiology, etiology, and grading of severity, then focus on the assessment of patients with suspected AP, including diagnosis and risk stratification, followed by the management of AP during the early phase, with special emphasis on fluid therapy, pain management, nutrition, and antibiotic prophylaxis.

Aldehyde dehydrogenase activity helps identify a subpopulation of murine adipose-derived stem cells with enhanced adipogenic and osteogenic differentiation potential

AIMTo identify and characterize functionally distinct subpopulation of adipose-derived stem cells (ADSCs). METHODSADSCs cultured from mouse subcutaneous adipose tissue were sorted fluorescence-activated cell sorter based on aldehyde dehydrogenase (ALDH) activity, a widely used stem cell marker. Differentiation potentials were analyzed by utilizing immunocytofluorescece and its quantitative analysis. RESULTSApproximately 15% of bulk ADSCs showed high ALDH activity in flow cytometric analysis. Although significant difference was not seen in proliferation capacity, the adipogenic and osteogenic differentiation capacity was higher in ALDHHi subpopulations than in ALDHLo. Gene set enrichment analysis revealed that ribosome-related gene sets were enriched in the ALDHHi subpopulation. CONCLUSIONHigh ALDH activity is a useful marker for identifying functionally different subpopulations in murine ADSCs. Additionally, we suggested the importance of ribosome for differentiation of ADSCs by gene set enrichment analysis.

Association between Presence of Urovirulence Factors, Phylogenetic Class, and Antimicrobial Resistance Patterns in 159 Uropathogenic <i>Escherichia coli</i>Samples Isolated from Dogs

The purpose of this study was to examine four urovirulence factors (UVFs) and their phylogenetic classes and compare their levels of resistance to antimicrobial drug classes in 159 canine uropathogenic E. coli (UPEC) isolates submitted to the Clinical bacteriology and Mycology Laboratory of The University of Tennessee Veterinary Medical Center in 2007. Multiplex polymerase chain reaction was used to detect the following UVFs: cytotoxic necrotizing factor (cnf), hemolysin (hly), S-fimbrial adhesion gene (sfa), and Pilus associated with pyelonephritis gene G allele III (pap);polymerase chain reaction was used to determine phylogenetic group. In vitro susceptibility to antimicrobial classes was evaluated, and resistance was compared to UVF presence as well as phylogenetic class. UVFs were presented in 48% of UPEC and were negatively correlated with antimicrobial resistance. Of the 159 samples, the number of UVFs expressed per isolate was 0 = 82 (52%), 1 = 24 (15%), 2 = 2 (1%), 3 = 18 (11%), and 4 = 33 (21%). The following UVFs were expressed: sfa (33%), hly (24%), cnf (25%), and pap (18%). Presence of all four UVFs, hly, cnf, and sfa together, and sfa alone, was associated with less resistance (P < 0.0001). Class B2 was the most common phylogenetic class and contained the highest number of UVFs (P < 0.001). Mean antimicrobial resistance was the highest in class A (P < 0.001) and the lowest in B2 (P < 0.001). Phylogenetic class A contained the lowest number of UVFs.

Prevalence and phylogenetic characterization of canine coronavirus from diseased pet dogs in Beijing,China

Dear Editor,Canine coronavirus including canine coronavirus(CCoV)and canine respiratory coronavirus(CRCoV)have been recognized as pathogenic viruses to dogs worldwide,causing enteric and respiratory issues(Buonavoglia et al.,2006).Zoonotic transfer of the viruses from the animal kingdom to humans has been repeatedly observed over the past decade,

Effects of controlled ventilation and positioning on cardiopulmonary function in horses anesthetized with total intravenous anesthesia using a drug combination of medetomidine,lidocaine,butorphanol and propofol (MLBP-TIVA)

The purpose of this study was to evaluate effects of controlled ventilation and positioning on cardiopulmonary function in horses anesthetized with total intravenous anesthesia using a drug combination of medetomidine,lidocaine,butorphanol and propofol (MLBP-TIVA).Five healthy adult horses were anesthetized with MLBP-TIVA for 2-hours on 3-occasions at 4-week interval. In each occasion,horses were anesthetized in lateral recumbency with (CV-LR-group) or without controlled ventilation (SB-LRgroup) or in dorsal recumbency with controlled ventilation (CV-DR-group). Anesthesia was induced with lidocaine (1mg/kg: IV) and propofol (3 mg/kg: IV) following premedications with medetomidine (0. 005 mg/kg: IV) and butorphanol (0. 02 mg/kg: IV),and then maintained by constant rate infusions of propofol (6 mg/kg/hr),medetomidine (0. 0035 mg/kg/h),lidocaine (3 mg/kg/h) and butorphanol (0. 024 mg/kg/h). All horses breathed 100% oxygen during anesthesia. In the CV-groups,horses were mechanically ventilated to maintain arterial CO2pressure (PaCO2)within 40 ~ 50 mmHg. Cardiopulmonary parameters were compared between groups using repeated-measures ANOVA.The level of significance was set at P 【 0. 05.In the SB-LR group,cardiovascular parameters were maintained within acceptable ranges (heart rate: 37 ~ 39beats/min,mean arterial blood pressure: 109 ~ 115 mmHg,mean pulmonary arterial pressure [MPAP]: 28 ~ 29 mmHg,mean right atrial pressure [MRAP]: 19 ~ 21 mmHg,cardiac output: 27 ~ 30 L/min) but severe hypercapnia with insufficient oxygenation (PaCO283 ~ 103 mmHg,arterial O2pressure [PaO2]155 ~171 mmHg) was observed. Cardiopulmonary parameters were maintained with acceptable ranges in the both CV groups. In the CV-LR group,significant decreases in heart rate (29 ~ 31 beats/min,P = 0. 020),cardiac output (17 ~ 21 L/min,P = 0. 005) and PaCO2 (42 ~50 mmHg,P =0. 001) and a significant increase in PaO2 (395 ~419 mmHg,P =0. 005) were observed compared to the SB-group. In the CV-DR group,MPAP (18 ~ 20 mmHg,P = 0. 001),MRAP (15 ~ 17 mmHg,P =0. 003) and PaO2 (171 ~301 mmHg,P =0. 043) were significantly decreased compared to the CV-LR-group.Cardiovascular functions were well maintained in horses during MLBP-TIVA. Controlled ventilation was useful for improving hypercapnia and oxygenation. It is thought that MLBP-TIVA preserves cardiovascular function and provides compensation for decreased preload in horses positioned in dorsal recumbency.

Sparing effect of robenacoxib on the minimum alveolar concentration for blunting adrenergic response( MAC-BAR) of sevoflurane in dogs.

Robenacoxib is a newer non-steroidal anti-inflammatory drug (NSAID) and effective for the management of perioperative pain and inflammation. A preoperative administration of robenacoxib is approved in many countries. The preoperative administration of NSAIDs (carprofen or meloxicam) reduces the minimum alveolar concentration (MAC) of sevoflurane during noxious stimulation in dogs (Yamashita et al. 2008). The purpose of this study was to evaluate the effect of robenacoxib on the MAC for blunting adrenergic response (MAC-BAR) of sevoflurane in dogs.Six adult healthy beagle dogs were anesthetized to determine the MAC-BAR of sevoflurane on 2-ocassions at least 1-week intervals. In each occasion,the dogs received a subcutaneous injection (SC) of saline (0. 1 ml/kg) or robenacoxib (2 mg/kg) before the MAC-BAR determination. MAC-BAR determination started at 60 minutes after the administration of saline or robenacoxib. MAC-BAR was determined in duplicate for each dog using electrical stimulus applied to the gingival (50 V,50 Hz,10 ms). During the MAC determination,all dogs were mechanically ventilated to maintain the end-tidal CO2within 35 to 40 mmHg and kept warm to maintain esophageal temperature within 37. 5 to 38. 5 ℃. Data were compared between groups using a paired t-test. The level of significance was set at P < 0. 05.The baseline MAC-BAR for sevoflurane was 3. 44 ± 0. 53%. Subcutaneous robenacoxib significantly decreased the sevoflurane MAC-BAR by 17% (2. 84 ± 0. 77%,P = 0. 039).Robenacoxib decreased the sevoflurane MAC-BAR when it was administered at the approved preoperative dose (2mg/kg: SC) to dogs. It is expected that the use of robenscoxib as premedication may provide a clinically relevant anesthetic sparing effect similar to carprofen and meloxicam in dogs (Yamashita et al. 2008).

Sparing effect of an antiemetic dose of maropitant on the minimum alveolar concentration for blunting adrenergic response (MAC-BAR) of sevoflurane in dogs.

Maropitant a neurokinin-1 (NK-1) receptor antagonist used as an antiemetic drug in dogs by blockade of substance P/NK-1 receptor binding in the vomiting center and chemoreceptor trigger zone in the central nervous system. In addition,substance P and NK-1 receptors have been isolated in nociceptive pathways. Therefore,it is expected that maropitant provides analgesic effect and its sparing effect of minimum alveolar concentration (MAC) has been reported in dogs. The purpose of this study was to evaluate the sparing effect of an approved antiemetic dose of maropitant on the MAC for blunting adrenergic response (MAC-BAR) of sevoflurane in dogs.Six adult healthy beagle dogs were anesthetized to determine the MAC-BAR of sevoflurane on 2-ocassions at least 1-week intervals. In each occasion,the dogs received a subcutaneous injection (SC) of saline (0. 1 ml/kg) or maropitant (1 mg/kg) before the MAC-BAR determination. MAC-BAR determination started at 60 min after the administration of saline or maropitant. MAC-BAR was determined in duplicate for each dog using electrical stimulus applied to the gingival (50 V,50 Hz,10 ms). During the MAC determination,all dogs were mechanically ventilated to maintain the endtidal CO2within 35 to 40 mmHg and kept warm to maintain esophageal temperature within 37. 5 to 38. 5 ℃. Data were compared between groups using a paired t-test. The level of significance was set at P < 0. 05.The baseline MAC-BAR for sevoflurane was 3. 44 ± 0. 53%. Subcutaneous maropitant significantly decreased the sevoflurane MAC-BAR by 17% (2. 88 ± 0. 74%,P = 0. 037).Maropitant decreased the sevoflurane MAC-BAR when administered at the approved antiemetic dose (1 mg/kg:SC) to dogs. It is expected that a preoperative administration of maropitant may produce anesthetic sparing effect in addition to antiemetic effect in dogs.

Effects of a Single Bolus Intravenous Dose of Tramadol on Minimum Alveolar Concentration( MAC) of Sevoflurane in Dogs

Tramadol is an atypical opioid analgesic widely used in small animal practice.This study was designed to determine the effect of a single intravenous (IV) dose of tramadol on the minimum alveolar concentration (MAC) of sevoflurane in dogs.Six beagle dogs were anesthetized twice to determine the sevoflurane MAC with or without an administration of tramadol (4 mg/kg,IV) at 7-days interval.The sevoflurane MAC was determined using a tail clamp method in each dog ventilated with positive pressure ventilation.The tramadol administration produced a significant reduction in the sevoflurane MAC by 22.3 ± 12.2% (1.44 ± 0.28% with tramadol versus 1.86 ± 0.29% without tramadol,P =0.010).This MAC reduction had been determined from 122 ± 19 to 180 ± 41 min following the tramadol administration.During this period,the plasma concentrations of tramadol and its metabolite,O-desmethyltramadol (M1),decreased from 429 ± 64 to 332 ± 55 ng/mL and from 136 ± 24 to 114 ± 68 ng/mL,respectively,but these changes were not statistically significant (P = 0.070 for tramadol and P = 0.716 for M1).There was no significant difference in heart rate,mean arterial blood pressure and SpO2between the control and tramadol treatment.The dogs that received tramadol treatment sometimes breathed spontaneously.Therefore,their respiratory rates significantly increased and PETCO2decreased during the MAC determination.In conclusion,the single IV dose of tramadol produced a significant reduction in the sevoflurane MAC in dog.