Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

No description available.

Computed tomography (CT) is gaining popularity as a minimally invasive diagnostic modality in veterinary science. The use of contrast agents is well described and used with increasing frequency, having marked benefits over the invasive angiographic procedures used previously. Methods to perform CT angiographic (CTA) studies include bolus tracking, test bolus and empirical scan delay techniques. In human medicine, empirical scan delays have been extensively investigated but due to the marked patient variability encountered in veterinary medicine, this technique cannot, at this stage, be confidently used. This then poses the question that if both techniques can be used, is one significantly better than the other one when performing, in particular thoracic CTA? CTA studies were performed on 6 adult beagles, using the bolus tracking (BT) technique and the test bolus (TB) technique on two separate occasions, at least 2 weeks apart. Each beagle acted as its own control. The patients were placed under general anaesthesia. Two ml/kg of 300mgI/ml iodinated contrast agent was injected through a 20 gauge catheter place in the cephalic vein for the BT technique. Scans were initiated when the contrast in the aorta reached 150 Hounsfield units (HU). For the TB technique, the dogs received a test dose of 15% of 2ml/kg of 300mgI/ml iodinated contrast agent injected manually into the cephalic catheter, followed by a series of low dose sequential scans. Time attenuation curves were generated using dynamic evaluation software programs (DYNAEVA®). The full dose of 2ml/kg of the 300mgI/ml iodinated contrast agent was then administered and the scans were conducted at optimal times as identified from the time attenuation curves. The full dose of contrast administration was administered using a pressure injector operated at 3ml/sec and was followed by a manual saline flush for all studies. Mean attenuation in HU was taken at three consecutive levels in the aorta (Ao), caudal vena cava (CVC) and right caudal pulmonary artery (rCPA) by placing a region of interest (ROI) in the vessel of interest. These observations were done for both arterial and venous phases using the BT and TB studies in five of the six dogs. Additional observations included the visualisation of the smaller thoracic vessels, in particular the arteries, the study duration, milliampere (mA), computed tomography dose index volume (CTDI(vol)), dose length product (DLP) and the pressure and the duration of the contrast injection. These observations were done in all six dogs. Statistical analysis included the comparison of the attenuation achieved in the major vessels (Ao, CVC and rCPA) for the two techniques. The test bolus technique was deemed to be the gold standard, as this is adapted for each individual patient. In one beagle the study was considered non diagnostic with a later time to peak enhancement noted in the Ao than the CVC. No statistical analysis was done on the dynamic and attenuation data obtained in this dog. In all the other studies, the attenuation achieved in the vessels evaluated was deemed to be of diagnostic quality except for the attenuation achieved in the CVC during the arterial phase. The attenuation in the Ao during the arterial phase for the BT technique was not significantly different (660.52 HU ± 138.49) than the TB technique (469.82 HU ± 199.52)(p = 0.13). The attenuation in the Ao during the venous phase for the BT and TB techniques was also not significantly different (BT = 190.6 HU ± 28.29 and TB = 188.8 HU ± 21.9, p = 0.92). The attenuation in the CVC during the arterial phase and venous phases for the BT techniques were not significantly different (arterial phase BT = 37.84 HU ± 20.8, arterial phase TB = 91.48 HU ± 66.54, p = 0.069; venous phase BT = 171.3 HU ± 32.36, venous phase TB = 191.08 HU ± 19.59, p = 0.087). The attenuation in the rCPA during the arterial phase was not statistically different between the two techniques (BT= 606.34 HU ± 143.37 and TB = 413.72 HU ± 174.99, p = 0.28), nor was the attenuation in the rCPA during the venous phase (BT = 174.34 HU ± 27.25 and TB = 164.46 HU ± 18.51, p = 0.51). The mean mA for the BT technique (3538.5 ± 171.27) was significantly lower than the TB technique (3929.6 ± 312.3) with p = 0.024. The mean CTDI(vol) for the BT technique (24.42 ± 11.89) was significantly lower than the TB CTDI(vol) (45.32 ± 0.94) with a p-value of 0.013. The mean DLP did not differ significantly between the two techniques (BT = 139.1 ± 7.65, TB = 162.8 ± 33.1) (p = 0.12). The BT technique resulted in a significantly shorter procedural duration and utilised less contrast material than the TB technique. The injection duration and injection pressures did not differ significantly between the two techniques (p = 0.23 and p = 0.62 respectively). This study identifies that there is no preference for either technique when evaluating the Ao, CVC or rCPA, however, the BT technique is shown to be shorter in procedural duration, utilises less contrast material and results in less radiation dose to the patient when compared to the TB technique. Copyright / Dissertation (MMedVet)--University of Pretoria, 2011. / Companion Animal Clinical Studies / unrestricted

No description available.

Die Kombination einer geringen Kontrastmittelmenge (Prä-Bolus) zur Ermittlung und Konstruktion einer Arteriellen Input Funktion, kombiniert mit der Verabreichung eines höher dosierten Kontrastmittel-Bolus zur Darstellung der morphologischen Herzstrukturen bewirkt eine deutliche Verbesserung des Kontrast-Rausch-Verhältnisses bei gleichzeitigem Vermeiden von Sättigungseffekten. Durch die Möglichkeit der Anwendung dieser Technik in Multi Slice MR Imaging Sequenzen empfiehlt sich die neue Prä-Bolustechnik für weitere, zukünftige klinische Studien auf diesem Gebiet. / The combination of a low dose mri contrast agent (pre-bolus) for the determination and construction of the arterial input function with a second high dose contrast agent bolus results in a significant better contrast to noise ratio und simultaneously avoids known saturation effects in magnetic resonance perfusion imaging of the human heart. The possibility to use this new pre-bolus technique in multi slice mr imaging sequences seems to be a promising tool for future cardiac diagnostics in mri.

In this thesis, the relationships among oesophageal motility, bolus clearance and sensory perception of oesophageal stimuli in patients with several dysphagia syndromes were investigated. The work is divided into the following major sections: 1) Current advances in the application of impedance and its utility in distinguishing clearance characteristics between primary and secondary peristalsis; 2) The advances in our understanding of peristaltic motor characteristics, oesophageal bolus clearance and symptom perception in dysphagia syndromes; 3) Peristaltic dysfunction, impaired bolus clearance and symptom perception in gastro-oesophageal reflux disease (GORD) and in patients with globus; 4) TRPV1 expression in oesophageal mucosa in patients with GORD. The main findings from this work are: 1) Secondary peristalsis is less effective as primary peristalsis regarding esophageal transit and clearance of a liquid bolus. 2) In patients with non-obstructive dysphagia (NOD), bolus clearance by both morphologically normal and aberrant secondary peristaltic sequences is impaired. 3) Although, when compared with healthy controls, patients with NOD have a higher prevalence of non-specifically abnormal motor patterns, there is a poor correlation between dysphagia and oesophageal dysmotility. 4) Whereas manometry identified motility abnormalities in one quarter of patients with GORD, impedance demonstrated that the majority of these patients, as well as some patients with normal manometry, had defective bolus clearance. 5) Although patients with erosive GORD have delayed oesophageal bolus clearance, manometric characteristics in these patients are comparable to those seen in non-erosive reflux disease (NERD). These findings are compatible with the hypothesis that abnormal oesophageal bolus clearance may reflect a continuum of dysfunction secondary to increasing oesophageal mucosal damage. 6) Patients with globus are characterized by oesophageal visceral hypersensitivity and aberrant viscerosomatic referral of mechanical and electrical stimuli to the oesophagus. These findings support the hypothesis that oesophageal hypersensitivity with associated viscerosomatic referral patterns are an important pathogenetic mechanism for globus. 7) Patients with erosive GORD exhibit greater gene expression of TRPV1 in oesophageal mucosa when compared with NERD or healthy controls. These findings support the hypothesis that chronic inflammation may lead to the release of mediators which may modulate function of primary sensory neurons.

In this thesis, the relationships among oesophageal motility, bolus clearance and sensory perception of oesophageal stimuli in patients with several dysphagia syndromes were investigated. The work is divided into the following major sections: 1) Current advances in the application of impedance and its utility in distinguishing clearance characteristics between primary and secondary peristalsis; 2) The advances in our understanding of peristaltic motor characteristics, oesophageal bolus clearance and symptom perception in dysphagia syndromes; 3) Peristaltic dysfunction, impaired bolus clearance and symptom perception in gastro-oesophageal reflux disease (GORD) and in patients with globus; 4) TRPV1 expression in oesophageal mucosa in patients with GORD. The main findings from this work are: 1) Secondary peristalsis is less effective as primary peristalsis regarding esophageal transit and clearance of a liquid bolus. 2) In patients with non-obstructive dysphagia (NOD), bolus clearance by both morphologically normal and aberrant secondary peristaltic sequences is impaired. 3) Although, when compared with healthy controls, patients with NOD have a higher prevalence of non-specifically abnormal motor patterns, there is a poor correlation between dysphagia and oesophageal dysmotility. 4) Whereas manometry identified motility abnormalities in one quarter of patients with GORD, impedance demonstrated that the majority of these patients, as well as some patients with normal manometry, had defective bolus clearance. 5) Although patients with erosive GORD have delayed oesophageal bolus clearance, manometric characteristics in these patients are comparable to those seen in non-erosive reflux disease (NERD). These findings are compatible with the hypothesis that abnormal oesophageal bolus clearance may reflect a continuum of dysfunction secondary to increasing oesophageal mucosal damage. 6) Patients with globus are characterized by oesophageal visceral hypersensitivity and aberrant viscerosomatic referral of mechanical and electrical stimuli to the oesophagus. These findings support the hypothesis that oesophageal hypersensitivity with associated viscerosomatic referral patterns are an important pathogenetic mechanism for globus. 7) Patients with erosive GORD exhibit greater gene expression of TRPV1 in oesophageal mucosa when compared with NERD or healthy controls. These findings support the hypothesis that chronic inflammation may lead to the release of mediators which may modulate function of primary sensory neurons.

The work presented in this thesis is concerned with the chemotherapy of parasite infestations in the ruminant with the anthelmintic thiophanate [diethyl 4,4'-o-phenylene bis (3-thioallophanate)]. A new concept of administration was investigated, namely continuous low-level anthelmintic medication. Two aspects were studied which divide conveniently into two sections. In Section 1, following preliminary trials undertaken to assess the low-level anthelmintic activity of thiophanate, the effects are assessed when this drug is administered continually directly into the rumen of parasitised sheep. Thiophanate was infused at dosages between 3.0 and 5.0 mg per kg bodyweight over various periods of medication against various developmental stages of gastro-intestinal parasites. The daily drug release rate. required to inhibit egg hatch and eliminate the worm burden is established. A minimum daily release rate of 3.0 mg per kg bodyweight was shown to be required to completely inhibit egg hatch and 4.5 mg per kg for effective vermicidal activity. In similar experiments, the anthelmintic activities of levamisole (s-(-)-2,3,5,6-tetrahydro-6-phenylimidazo (2,1-b) thiazole), febantel (N-(2-(2,3-bis-(methoxycarbonyl)-guanidino)-5-(phenyl-thio)-phenyl)-2-methoxy-acetamide) and briefly oxfendazole (5-(phenylsulfinyl)-IH-benzimidazol-2yl) carbamate) were also examined. In Section 2, the development of an intra-ruminal bolus incorporating thiophanate and designed to release drug at a predetermined rate over an extended period of time is described. Experiments were carried out in sheep to assess the bolus density required for retention within the reticulo-rumen (monitored by direct bolus recovery), to compare various density factors (iron powder, iron bar core, iron shot and sand) and to assess the average drug release rate from different matrix formulations (based on fatty acids, palmitic acid and paraffin wax) when the boluses were dosed singly or in pairs. The development of a stable "carrier" on which to load a suitable matrix is also described, the majority of the experiments undertaken utilising this "carrier". The effect on the drug release rate of incorporating various "leaching aids" (digestible materials, wetting and soluble agents) into the matrix is examined and preliminary anthelmintic trials undertaken in experimentally infected lambs. The required drug release is achieved when the boluses are administered in pairs. The anthelmintic activity is confirmed. Possible matrices suitable for use as a single bolus administration were produced. The advantages of this form of anthelmintic medication over the single therapeutic dose are discussed along with some indications for further studies that emerged.

No description available.

No description available.