The laboratory as an aid to clinical diagnosis

The clinician may use the clinical pathology laboratory as a valuable aid to diagnosis and management, for the assessment of response to treatment, and in preventive medicine programs. Each "link in the chain," that is, sample selection, collection, handling, analysis, result reporting, and interpretation must be carefully and efficiently managed, using an informed combination of art and science, to provide a useful endpoint. This general introduction precedes more specific and detailed articles.     

Determination of bacterial N portions in feces and differently collected ileum chymus from swine]

In faeces and ileal digesta samples of 31 intact (INT) as well as 73 surgically differently prepared pigs bacterial fractionations and 2.6-diaminopimelic acid (DAP) estimations were carried out in order to calculate the bacterial N proportion in faeces N and digesta N after feeding various diets. Because of a high individual variability and the analytical variation width of the DAP/N-ratios no distinct influences of the fed diets could be found. The average DAP/N-values in the faeces (0.224) of INT pigs ranged in the same magnitude as in the digesta (0.0272) of ileorectostomized (IRA) pigs with open colon descendens (IRAo), where a digesta backflow is possible. Distinct lower DAP/N-ratios (0.0125 resp. 0.0043), however, were found in the digesta of pigs with ileo-caecal cannulae (IZB) or IRA pigs with closed colon (IRAg). On the base of various premises (N of the "bacterial fraction" C is only bacterial N; the DAP found in fraction A originates from intestinal bacteria adhering to feed particles) conducted calculations of the bacterial N proportions (in per cent of total N) led to the following data: Faeces of INT pigs: 43.0 ... 68.2 vs. 69.6 ... 89.0; digesta of operated pigs (except protein free diet) IRAo: 22.3 ... 57.0 vs. 46.2 ... 73.8; IZB: 17.0 ... 35.7 vs. 25.2 ... 53.6; IRAg (only 3 pigs): 23.6 vs. 24.2. The proportion of bacterial N in the digesta N of protein free fed IRAo pigs was 22.0 vs. 22.6%.     

Covalently protein-bound bilirubin conjugates in cholestatic disease of dogs

We investigated the occurrence of covalently protein-bound bilirubins in the plasma of dogs with hyperbilirubinemia attributable to hepatobiliary diseases or Coombs test-positive hemolysis. The bilirubins in plasma were measured with the conventional Van den Bergh reaction, by treatment with diazotized p-iodoaniline, and by high-performance liquid chromatography of bilirubin and its methylesters after alkaline methanolysis. All but one dog had covalently protein-bound bilirubin conjugates. The concentration and the fraction of total bilirubins varied in all diseases investigated, but they tended to be low in primary hemolysis. The "biliprotein" complex accounted for 2 to 94% of total plasma bilirubins. Because biliprotein usually is not cleared by the liver, but has a half-life comparable with that of albumin, it prevents the evaluation of the actual state of the underlying disease. Measurement of the total bilirubin concentration exclusively with the Van den Bergh reaction, therefore, is clinically useless. Other methods should be introduced for routine bilirubin assays, permitting the measurement of noncovalently bound pigment as a meaningful estimate of the course of the disease.     

A study of periodontal disease in sheep over a twelve month period

Sheep affected by broken mouth periodontal disease (P.D.) were examined over a twelve month period for different clinical parameters. It is suggested that P.D. in sheep is an episodic phenomenon similar to human P.D., and that only a few animals with signs of P.D. may undergo clinically significant destruction over a yearly period. No single parameter could reliably predict future deterioration in other parameters.