Diabetes mellitus in cats.

Feline diabetes is a multifactorial disease with genetic and environmental factors, including diet, excess body weight, and physical inactivity, involved in its pathogenesis. Although type 2 diabetes is most common in cats, most cats are insulin-dependent at the time of diagnosis. If good glycemic control can be achieved early after diagnosis, a substantial proportion of diabetic cats go into clinical remission.

Antibody-mediated interference with annexins in the antiphospholipid syndrome.

Targeting of the annexin A5 anticoagulant shield may be a significant mechanism for thrombosis and pregnancy losses in APS. This may occur via high affinity antibodies that recognize phospholipid-binding proteins that are capable of interfering with the assembly of the annexin A5 shield on phospholipid surfaces or via direct recognition of annexin A5 by autoantibodies. In addition, antibodies against other members of the annexin family of proteins may also have pathogenic roles in APS.

Reoperations after 3200 revision TKAs: rates, etiology, and lessons learned.

The purpose of this study was to evaluate the prevalence, etiology, and evolution with time of reoperations done after index revision total knee arthroplasties. After exclusion criteria were met, 1814 index knee revisions in 1627 patients were included in the final cohort with more than 50% of the revisions done for loosening and extensor mechanism problems and more than 80% of the revisions involving the femoral, tibial, or both components. Three hundred seventy-three knees subsequently have been reoperated on one or more times.

Canine and feline diabetes mellitus: nature or nurture?

There is evidence for the role of genetic and environmental factors in feline and canine diabetes. Type 2 diabetes is the most common form of diabetes in cats. Evidence for genetic factors in feline diabetes includes the overrepresentation of Burmese cats with diabetes.

Detection of antibody-mediated reduction of annexin A5 anticoagulant activity in plasmas of patients with the antiphospholipid syndrome.

Annexin A5 (A5) forms 2-dimensional crystals over phospholipid bilayers, blocking their availability for coagulation reactions. Recently, human antiphospholipid (aPL) monoclonal antibodies (mAbs) have been demonstrated by atomic force microscopy (AFM) to disrupt this crystallization and accelerate coagulation. We therefore performed a study with small, well-defined groups of patients to investigate whether these effects on A5 binding and activity are also detectable in plasmas from patients with the aPL syndrome.

Acquired von Willebrand syndrome 2004: International Registry--diagnosis and management from online to bedside.

The acquired von Willebrand syndrome (AVWS) is a rare bleeding disorder with laboratory findings similar to those for congenital von Willebrand disease. Unlike the congenital form, AVWS usually occurs in individuals with no personal or family history of bleeding. Large studies on AVWS are not available, diagnosis remains difficult and treatment empirical.

Treatment of the patella at reimplantation for septic total knee arthroplasty.

The results of treatment of the patella at the time of aseptic revision of a total knee arthroplasty (TKA) have been better with resurfacing of the patella than other modes of treatment such as leaving a bony shell. Treatment of the patella at the time of reimplantation of a TKA has not been addressed in prior studies. The ability to resurface the patella will be determined by the amount of bone remaining, integrity of the patella, vascularity, the location of the joint line, and soft tissue coverage for wound closure.

Platelet-endothelial interactions: sepsis, HIT, and antiphospholipid syndrome.

Acquired abnormalities in platelets, endothelium, and their interaction occur in sepsis, immune heparin-induced thrombocytopenia (HIT), and the antiphospholipid syndrome. Although of distinct pathogeneses, these three disorders have several clinical features in common, including thrombocytopenia and the potential for life- and limb-threatening thrombotic events, ranging from microvascular (sepsis > antiphospholipid > HIT) to macrovascular (HIT > antiphospholipid > sepsis) thrombosis, both venous and arterial. In Section I, Dr.

Controversies in differentiating thrombotic thrombocytopenic purpura and hemolytic uremic syndrome.

The diagnoses of thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) often remain questionable, forcing the clinician to make the difficult decision of initiating therapy based on symptomatology and clinical judgment and, sometimes, instinct. An increased awareness of characteristic symptoms and early diagnoses of TTP and HUS are of utmost importance, given the excellent results obtained with prompt plasma exchange therapy. Tremendous progress has been made in understanding TTP and HUS since TTP was first described more than 75 years ago at Mount Sinai.

Extensor mechanism complications following total knee arthroplasty.

Patellofemoral complications are avoided by careful patient selection, proper implant design, and correct surgical technique. The patient with an extensor mechanism complication should be carefully evaluated for femoral and tibial component positioning, especially rotational alignment. Management of the extensor mechanism complication should be directed at its cause and may necessitate revision of the entire arthroplasty.

Revision total knee arthroplasty with cemented components and uncemented intramedullary stems.

Sixty-three failed total knee arthroplasties in 60 patients (27 females, 33 males; average age, 66 years) were treated consecutively with revision using cemented component fixation and an uncemented stem. Patients were followed for a mean of 5.75 years (range, 2-10 years); none were lost to follow-up.

Human monoclonal antiphospholipid antibodies disrupt the annexin A5 anticoagulant crystal shield on phospholipid bilayers: evidence from atomic force microscopy and functional assay.

The antiphospholipid (aPL) syndrome is an autoimmune condition that is marked by recurrent pregnancy losses and/or systemic vascular thrombosis in patients who have antibodies against phospholipid/co-factor complexes. The mechanism(s) for pregnancy losses and thrombosis in this condition is (are) not known. Annexin A5 is a potent anticoagulant protein, expressed by placental trophoblasts and endothelial cells, that crystallizes over anionic phospholipids, shielding them from availability for coagulation reactions.

Cemented long-stem revision total knee arthroplasty.

From 1981 to 1989, 38 cemented, posterior, stabilized, revision, total knee arthroplasties (TKAs) were performed at the authors' institution using the stemmed kinematic stabilizer prosthesis of a single design. The mean clinical follow-up after the index procedure was 10.1 years.

Two neuronal, nuclear-localized RNA binding proteins involved in synaptic transmission.

While there is evidence that distinct protein isoforms resulting from alternative pre-mRNA splicing play critical roles in neuronal development and function, little is known about molecules regulating alternative splicing in the nervous system. Using Caenorhabditis elegans as a model for studying neuron/target communication, we report that unc-75 mutant animals display neuroanatomical and behavioral defects indicative of a role in modulating GABAergic and cholinergic neurotransmission but not neuronal development. We show that unc-75 encodes an RRM domain-containing RNA binding protein that is exclusively expressed in the nervous system and neurosecretory gland cells.

Non-stroke neurological syndromes associated with antiphospholipid antibodies: evaluation of clinical and experimental studies.

Although many types of neurological disorders and events have been described in association with antiphospholipid antibodies (aPL) and the antiphospholipid syndrome (APS), only ischaemic stroke is reasonably well established and accepted as a diagnostic criterion for the syndrome. We propose to evaluate, classify and rank the association of other neurological manifestations as possible, probable, or definite according to the data available from clinical studies and animal models. By these criteria, none of the neurological disorders or events such as epilepsy, psychiatric disease, dementia, transverse myelitis, multiple sclerosis-like disease, chorea, migraine, Guillian-Barrè syndrome, and sensory-neural hearing loss, can be definitely associated with aPL or APS.

Factors affecting the durability of primary total knee prostheses.

Background: Failure of total knee arthroplasty is problematic. The purpose of this study was to evaluate the factors that influence the durability of a primary total knee prosthesis.

Methods: A survivorship analysis of 11,606 primary total knee arthroplasties carried out between January 1, 1978, and December 31, 2000, was performed.

Evaluation of day-to-day variability of serial blood glucose concentration curves in diabetic dogs.

Objective: To evaluate day-to-day variability of serial blood glucose concentration curves in dogs with diabetes mellitus.

Design: Prospective clinical study.

Animals: 10 dogs with diabetes mellitus.

The antiphospholipid syndrome.

The antiphospholipid (aPL) antibody syndrome is an autoimmune condition in which vascular thrombosis and/or recurrent pregnancy losses occur in patients with laboratory evidence for antibodies that bind to phospholipids. There have been significant advances in the recognition of the role of phospholipid-binding cofactors, primarily beta2GPI, as the true immunologic targets of the antibodies. Recent evidence suggests that the antibodies disrupt phospholipid-dependent anticoagulant mechanisms and/or that aPL antibodies induce the expression of procoagulant and proadhesive molecules on endothelial cells.

Double level osteotomy of the knee: a method to retain joint-line obliquity. Clinical results.

Background: Although general guidelines have been proposed for proximal tibial and supracondylar osteotomies, double level osteotomy provides the advantage of maintaining neutral joint-line obliquity in addition to correcting limb malalignment around the knee. The goal of this prospective study was to determine the outcome of double level osteotomy of the knee performed after analysis with computer-aided preoperative planning software in patients with varus malalignment.

Methods: Twenty-nine double level osteotomies of the knee were performed in twenty-four patients.

Plasma leptin concentrations are independently associated with insulin sensitivity in lean and overweight cats.

This study investigated relationships between plasma leptin, insulin concentrations, insulin sensitivity and glucose tolerance in lean and overweight cats. Leptin concentrations were measured in 16 cats during glucose tolerance tests before and after gaining weight, and after feeding a test meal in overweight cats. An important finding of this study is that in both lean (r=-0.