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Topic:Veterinary Medicine

Veterinary medicine for horses encompasses the study and application of medical practices to diagnose, treat, and prevent diseases in equine species. This field involves a comprehensive understanding of equine anatomy, physiology, pathology, and pharmacology. Veterinary practitioners employ a range of diagnostic tools and therapeutic interventions to address health issues in horses, including lameness, gastrointestinal disorders, respiratory conditions, and infectious diseases. Preventative care, such as vaccination and deworming programs, is also a significant aspect of equine veterinary medicine. This page gathers peer-reviewed research studies and scholarly articles that explore various aspects of veterinary medicine as it pertains to horses, including advancements in diagnostic techniques, treatment protocols, and preventive health strategies.
Influence of girth strap tensions on athletic performance of racehorses.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 52-56 doi: 10.1111/j.2042-3306.1999.tb05188.x
Bowers JR, Slocombe RF.Eight horses were exercised at speeds to produce 80% of maximal heart rates, on 4 occasions using a randomised block design, and girthed at tensions of approximately 5, 10, 15 or 20 kg using a standard canvas girth attached to a racing saddle. Tension was recorded continuously using an in-line load cell connected to a physiograph. Horses ran until fatigued on a treadmill inclined at 10% slope. Tensions were measured at peak inhalation (T/inh) and exhalation (T/exh), recorded at rest (rest) and during exercise (ex). Data were analysed by ANOVA and, in addition, least squares linear regression w...
Maximal exercise transiently disrupts hormonal secretory patterns in standardbred geldings.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 581-585 doi: 10.1111/j.2042-3306.1999.tb05288.x
Golland LC, Evans DL, Stone GM, Tyler-McGowan CM, Hodgson DR, Rose RJ.Basal concentrations of cortisol (CORT), beta-endorphin (beta EP), growth hormone (GH) and testosterone (T) and their disruption during 32 h of recovery after treadmill exercise were investigated in 4 geldings. Blood samples were collected from resting horses every 20 min between 0600-1000 and 1500-1900 h, and hourly between 1000-1500 h on 3 consecutive days. Treadmill exercise tests comprising 2 min intervals at 30, 50, and 70% VO2max then to fatigue at 100% VO2max were conducted between 1020-1130 h on Day 2. Blood was collected before, during and 15, 30, 60 and 90 min after exercise. Mean (C...
Exertional rhabdomyolysis in quarter horses and thoroughbreds: one syndrome, multiple aetiologies.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 533-538 doi: 10.1111/j.2042-3306.1999.tb05279.x
Valberg SJ, Mickelson JR, Gallant EM, MacLeay JM, Lentz L, de la Corte F.The purpose of this study was to determine if chronic exertional rhabdomyolysis (ER) in Quarter Horses and Thoroughbreds represents one or several distinct myopathies. Eighteen Quarter Horses and 18 Thoroughbreds with ER were selected from cases presented to the Veterinary Hospital on the basis of a history of ER, assessment of muscle histopathology, and serum CK activity before and 4 h post exercise. In addition, 2 of 3 of the following parameters were evaluated: muscle glycogen concentrations, thyroid hormones (T3, T4), fractional excretion (FE) of sodium, potassium and chloride. The CK resp...
Effect of a post exercise fat-supplemented diet on muscle glycogen repletion.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 493-498 doi: 10.1111/j.2042-3306.1999.tb05272.x
Hyyppä S, Saastamoinen M, Reeta Pösö A.Low muscle glycogen at the beginning of exercise may adversely affect performance, increase protein degradation and contribute to the onset of fatigue. As horses are sometimes required to compete on consecutive days both in racing and endurance types of competition, optimal muscle glycogen repletion may improve performance on the day following a race day. The purpose of this experiment was to study the effects of fat supplementation on repletion of muscle glycogen. Twelve Finnhorses performed an exercise test on a treadmill, and 2 and 4 h later they received hay and concentrate (Trial A). Two ...
The effects of training on ventilation and blood gases in exercising thoroughbreds.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 57-61 doi: 10.1111/j.2042-3306.1999.tb05189.x
Roberts CA, Marlin DJ, Lekeux P.The effects of training on ventilation and blood gases during exercise were investigated in 6 clinically normal, detrained Thoroughbred horses. They underwent a 16 week training programme similar to the type frequently used for Thoroughbred racehorses in Great Britain. Standardized treadmill exercise tests (2 min canter at 8 and 10 m/s C8 and C10[ and 2 min gallop at 12 m/s [G12], on a level surface) were performed prior to and after 16 weeks of training. Respiratory flow rates were measured using ultrasound flow transducers. Blood samples were drawn from a transverse facial artery and the rig...
In vitro transmission and attenuation of impact vibrations in the distal forelimb.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 245-248 doi: 10.1111/j.2042-3306.1999.tb05227.x
Willemen MA, Jacobs MW, Schamhardt HC.An in vitro model was developed and validated in vivo to quantify the attenuation of impact vibrations, transmitted through the lower equine forelimb and to assess the effects of horseshoeing on this attenuation. The transsected forelimbs of 13 horses were equipped with custom-made hollow bone screws in the 4 distal bones, on each of which a tri-axial accelerometer could be mounted. The limbs were then preloaded while the impact was simulated by dropping a weight on the steel plate on which the hoof was resting. At the hoof wall, the distal, middle and proximal phalanx and at the metacarpal bo...
Influence of training on autonomic nervous function in horses: evaluation by power spectral analysis of heart rate variability.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 178-180 doi: 10.1111/j.2042-3306.1999.tb05213.x
Kuwahara M, Hiraga A, Kai M, Tsubone H, Sugano S.We studied the influence of training on autonomic nervous function in the horse. For this purpose, Holter electrocardiogram (ECG) was recorded before and after training from 24 Thoroughbred horses (2-year-olds) and autonomic nervous function was evaluated by the power spectral analysis of heart rate (HR) variability. We obtained HR, low-frequency (LF) power, high-frequency (HF) power, and LF/HF ratio from recording. We set LF at 0.01-0.07 Hz and HF at 0.07-0.6 Hz. The HF power is thought to reflect primarily parasympathetic nervous function. Both the sympathetic and parasympathetic nervous sys...
Cardiac output measurements using sonomicrometer crystals on the left ventricle at rest and exercise.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 148-152 doi: 10.1111/j.2042-3306.1999.tb05206.x
Pascoe JR, Hiraga A, Hobo S, Birks EK, Yarbrough TB, Takahashi T, Hada T, Aida H, Steffey EP, Jones JH.Eight horses were fitted surgically with 8 ultrasonic sonomicrometer crystals each attached to their left ventricular pericardia and a left atrial catheter. Three horses returned to treadmill performance with a maximum rate of oxygen consumption similar to their presurgical values. These horses were evaluated to determine how well sonomicrometer estimates of cardiac output agreed with those obtained by a steady-state method, the Fick principle. Variance between the 2 was similar to the coefficient of variation (approximately 12.5%) of the Fick estimates. We conclude that left ventricular sonom...
Comparison of exercise variables measured during intensity of simulated training to variables at maximal effort in standardbreds.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 166-169 doi: 10.1111/j.2042-3306.1999.tb05210.x
Pringle J, MacMillan K, Briand H, Stämpfli H.The heart rate changes during routine training in a group of 8 actively racing Standardbreds were used to simulate the training work on a treadmill (ST) and indices of exercise compared to maximal effort (MAX) on the treadmill. The following parameters were recorded during treadmill work: heart rate, velocity, O2 consumption, respiratory and stride frequency, and stride length. Blood lactate concentrations were measured before and after each work test. Heart rate during simulated training was mean +/- s.d. 87.8 +/- 5.5% heart rate in MAX, one of the 8 horses working 0.05), being higher during...
Chronological changes in superoxide-scavenging ability and lipid peroxide concentration of equine serum due to stress from exercise and transport.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 430-433 doi: 10.1111/j.2042-3306.1999.tb05260.x
Ishida N, Hobo S, Takahashi T, Nanbo Y, Sato F, Hasegawa T, Mukoyama H.It has been suggested that a variety of stresses on animals may accelerate their production of superoxide. Racehorses are considered to be exposed to substantial oxide stress due to transport and exercise for training and racing. To determine the effect of exercise and transport on racehorses in terms of superoxide and antioxidative ability, changes in the superoxide-scavenging ability of equine serum were observed using electron spin resonance (ESR). Changes in the concentration of lipid peroxide, which is produced in equine serum by superoxide, were also examined. The analysis revealed that ...
Radiographic measures of bone shape in young thoroughbreds during training for racing.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 262-265 doi: 10.1111/j.2042-3306.1999.tb05231.x
Davies HM, Gale SM, Baker ID.The aim of this study was to determine if changes in the shape of the third metacarpal bone (MC3) during the first preparation for racing in young Thoroughbred racehorses could be measured radiographically. Lateral radiographs of each MC3 were taken when the horses commenced training, every 2 weeks for 10 weeks, and again at 6 months after the start of training. The width of the dorsal cortex (DC), palmar cortex (PC), and medulla (M) were measured at a position 2.5 cm distal to the nutrient foramen before the subject of each radiograph was identified. The following ratios were calculated: z = ...
Comparison of bone mineral content and biochemical markers of bone metabolism in stall- vs. pasture-reared horses.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 601-604 doi: 10.1111/j.2042-3306.1999.tb05292.x
Hoekstra KE, Nielsen BD, Orth MW, Rosenstein DS, Schott HC, Shelle JE.Sixteen Arabian yearlings were assigned randomly to 2 groups, confined to stall and pastured, to investigate the effects of confinement vs. pasture-rearing on bone mineral content and biochemical markers of bone metabolism over a 140 day period. Following an 84 day pretraining period, 6 horses from each group were selected randomly to complete a 56 day training period. Serum osteocalcin concentrations were determined from blood samples collected every 14 days. Urinary deoxypyridinoline concentrations and mineral content of the third metacarpus, as determined by lateral and medial radiographic ...
Effect of breathing frequency and airflow on pulmonary function in high-intensity equine exercise.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 19-23 doi: 10.1111/j.2042-3306.1999.tb05181.x
Bayly WM, Redman MJ, Sides RH.It has been postulated that the hypoxaemia and hypercapnoea that characterize strenuous equine exercise are partly due to flow limitations imposed by high breathing frequencies (fb), and that gas exchange would be improved if fb could be lowered. To evaluate this possibility, 6 Thoroughbred horses underwent 4 incremental treadmill exercise tests at inclines of 0, 5, 10 and 25%, respectively. In the test, horses were given a warm-up for 2 min, then ran sequentially for 1 min each at 60, 100 and 115% VO2max. Oxygen consumption (VO2), blood gas tensions (PaO2, PaCO2), fb, tidal volume (VT), minut...
High-altitude effects on respiratory gases, acid-base balance and pulmonary artery pressures in equids.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 71-76 doi: 10.1111/j.2042-3306.1999.tb05192.x
Greene HM, Wickler SJ, Anderson TP, Cogger EA, Lewis CC, Wyle A.Arterial and venous blood were analysed at rest and post exercise for pH, PCO2, and PO2, and bicarbonate ([HCO3-]), base excess (BE), and strong ion difference (SID) were calculated in response to a 10 day sojourn to 3800 m. Pulmonary artery pressures (PAP) were measured at rest. Post exercise samples were restricted to venous blood. The equids (n = 6) experienced a profound hypoxia-hypocapnia and a respiratory alkalosis. PaO2 decreased 42% and PaCO2 41%. PaCO2 increased to 80% of initial values after 8 days at altitude. Arterial [HCO3-] decreased by 34%; however, it returned to normal by Day ...
Electrolyte and glycerol supplementation improve water intake by horses performing a simulated 60 km endurance ride.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 418-424 doi: 10.1111/j.2042-3306.1999.tb05258.x
Düsterdieck KF, Schott HC, Eberhart SW, Woody KA, Coenen M.To replace electrolytes lost in sweat during endurance competitions, riders frequently supplement horses with hypertonic oral electrolyte pastes. To determine whether this practice and concurrent administration of the so-called hyperhydrating substance glycerol are of benefit, weight loss, voluntary water intake, plasma osmolality, and plasma protein and electrolyte concentrations were measured in 6 Arabian horses supplemented with a total of 2.4 ml/kg bwt of water (W); 0.2 g/kg bwt KCl and 0.4 g/kg bwt NaCl in 2.4 ml/kg bwt of water (E); or 0.2 g/kg bwt KCl and 0.4 g/kg bwt NaCl in 2.4 ml/kg ...
Effect of frusemide and hypertonic saline on electrolytes during post exercise anaesthesia.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 434-437 doi: 10.1111/j.2042-3306.1999.tb05261.x
Greene S, Keegan R, Brown J, Kingston J, Bayly WM.This study evaluated the effects of pre-exercise frusemide administration and hypertonic saline (H) infusion during anaesthesia on arterial pH, blood gases and electrolytes in 6 Thoroughbred horses anaesthetised immediately post exercise. Horses received either frusemide (F) (0.5 mg/kg, i.v.) or a saline placebo (P) injection 4 h prior to treadmill exercise. Exercise consisted of a 3 min warm-up at 40% VO2max followed by exercise to fatigue. Detomidine (40 micrograms/kg, i.v.) was given within 5 min of stopping and followed 5 min later by zolazepam-tiletamine (1.25 mg/kg, i.v.) to induce anaes...
Pre- and post exercise echocardiography in horses performing treadmill exercise in cool and hot/humid conditions.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 131-136 doi: 10.1111/j.2042-3306.1999.tb05203.x
Marr CM, Bright JM, Marlin DJ, Harris PA, Roberts CA.We hypothesised that exercise in a hot and humid environment would affect echocardiographic indices of cardiac dimensions and function more than exercise in a cool environment. M-mode echocardiograms were obtained in 5 clinically normal horses before, and at 0, 10, 30 and 60 min after a treadmill exercise test. The test was performed in a controlled environment at 20 degrees C/40% relative humidity (RH) and again at 30 degrees C/80% RH. All the horses completed the exercise test in cool conditions, but only one horse completed the exercise test in the hot/humid environment. The relaxation time...
The effect of shoeing on kinetics and kinematics during the stance phase.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 279-285 doi: 10.1111/j.2042-3306.1999.tb05235.x
Roepstorff L, Johnston C, Drevemo S.The increasing range of of horseshoes and hoofpads makes it important to be able to evaluate their influence on performance and stress in the locomotor apparatus. The aim of this study was to describe the changes in ground reaction forces and locomotion pattern during the stance phase due to the application of a standard iron shoe. Six Swedish Warmblood horses were evaluated kinetically and kinematically before and after they were shod with an 8 mm iron shoe. Data were used to calculate ground reaction forces in the vertical and craniocaudal directions, point of application of the force, hoof ...
Effects of flunixin on movement and performance of standardbred trotters on the track.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 270-273 doi: 10.1111/j.2042-3306.1999.tb05233.x
Kallings P, Johnston C, Drevemo S.An often discussed and controversial issue is the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on performance. The purpose of this study was to investigate the effect of the NSAID flunixin on the movement pattern and performance capacity of Standardbred trotters using a standardised track model. Five adult Standardbred horses in training trotted at 2 occasions with a 2 week interval on the same oval dirt track. Before each occasion the horses were either injected with flunixin meglumine (Finadyne) or normal saline solution i.m. 4 h before the performance test (double blind crossover...
Skeletal myosin heavy chain composition and carriage training.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 318-323 doi: 10.1111/j.2042-3306.1999.tb05241.x
Rivero JL, Serrano AL.Three different myosin heavy chain (MHC) isoforms have been identified in the equine gluteus medius muscle: the slow or MHC-I and the 2 fast MHC-IIA and MHC-IIX isoforms. They are distributed in 3 fibre types containing a single MHC (I, IIA, IIX) and 2 hybrid types co-expressing 2 isoforms (I + IIA, IIA + IIX). The aim of this study was to determine if heavy carriage training alters skeletal MHC composition in horses. Fourteen Andalusian mares age 42-46 months were used. Seven horses were used as controls to estimate the effects of growth on muscle. The remaining 7 horses underwent a training ...
Frusemide and weight carriage alter the acid:base responses of horses to incremental and to brief intense exertion.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 375-379 doi: 10.1111/j.2042-3306.1999.tb05251.x
Hinchcliff KW, McKeever KH.We speculated that frusemide would attenuate the acidosis associated with intense exertion, and that weight carriage would mitigate this effect. Therefore, in each of 2 experiments we measured pulmonary artery and systemic arterial blood pH, PCO2, PO2 and pulmonary artery temperature in 9 horses during exertion on a treadmill after each of 3 treatments. The treatments were: 1) injection of saline solution (C), 2) injection of frusemide (1 mg/kg bwt, i.v. 4 h before running) (FU) and 3) injection of frusemide (F) as for FU and the horses carried weight equal to that lost in the 4 h after frusem...
Changes in left ventricular dynamics during graded exercise.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 122-125 doi: 10.1111/j.2042-3306.1999.tb05201.x
Hiraga A, Hobo S, Birks EK, Takahashi T, Hada T, Smith BL, Carr EA, Pascoe JR, Jones JH.Three mature Thoroughbred horses were prepared surgically with ultrasonic sonomicrometer crystals affixed to their ventricular pericardia. Signals from crystals recorded dimensions of axes across the left ventricle. Cubic algorithms were fitted to dimensional data to generate volume estimates that matched stroke volumes simultaneously measured using the Fick principle. As horses stood at rest or exercised at various intensities (approx 7, 12, 24, 47 and 100% maximal rate of O2 consumption VO2max[), left ventricular dimensions were recorded and 20 consecutive diastolic and systolic volumes calc...
Environmental stress and 3-day eventing: effects of altitude.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 394-397 doi: 10.1111/j.2042-3306.1999.tb05254.x
Foreman JH, Waldsmith JK, Lalum RB.Three-day event horses are subject to various external environmental stresses including changes in ambient temperature, humidity, altitude, and test severity. Considerable research on the adverse effects of increased heat and humidity preceded the 1996 Olympic Summer Games in Atlanta, Georgia USA, but no research has been done previously on the effects of altitude on 3-day eventing. Physical and venous blood gas data were collected on horses (n = 24) competing in the High Prairie Preliminary (CCN*) and Intermediate (CCN**) 3-day events and Preliminary Horse Trials in Parker, Colorado (1900 m a...
Effect of inhaled beta 2 adrenoceptor agonist, albuterol sulphate, on performance of horses.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 575-580 doi: 10.1111/j.2042-3306.1999.tb05287.x
Bailey J, Colahan P, Kubilis P, Pablo L.This study was designed to test the hypothesis that a specific beta 2 adrenergic receptor agonist, albuterol sulphate, when delivered by metered-dose inhaler (MDI) would affect the performance of Thoroughbred horses during incremental exercise testing. Six conditioned Thoroughbred horses were randomly assigned to one of 2 treatment groups: Group 1 horses received placebo and Group 2 received albuterol. Each horse received both treatments in a crossover design with a 3 week interval between trials. Horses inspired albuterol (900 micrograms) or placebo over a 5 min period followed by an incremen...
Effect of exercise and COPD crisis on isoprostane concentration in plasma and bronchoalveolar lavage fluid in horses.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 88-91 doi: 10.1111/j.2042-3306.1999.tb05195.x
Kirschvink N, Art T, Smith N, Lekeux P.To test whether isoprostanes could be used as markers of oxidative stress in horses, their concentration was determined in plasma and in pulmonary epithelial lining fluid (PELF) in 3 models of oxidative stress: (1) strenuous exercise, (2) acute COPD crisis and (3) exercise combined with COPD crisis. Four horses were investigated twice, once in crisis and once in remission. The animals underwent a standardised treadmill exercise test. Isoprostane assessment was performed in plasma and bronchoalveolar lavage fluid 24 h before and 1 h after exercise and in plasma also immediately after exercise. ...
An MRI study of the effect of treadmill training on bone morphology of the central and third tarsal bones of young thoroughbred horses.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 258-261 doi: 10.1111/j.2042-3306.1999.tb05230.x
Whitton RC, Murray RC, Buckley C, Goodship AE, Lekeux P.Training results in marked modelling of the subchondral bone of the carpus, but the effect of training on the subchondral bone of the distal tarsal joints is unknown. The aim of this study was to determine whether training influenced modelling of the third and central tarsal bones in Thoroughbred horses. Twelve untrained Thoroughbred horses were divided into 2 groups. Group 1 underwent a 19 week progressive training regimen on a high speed treadmill. Group 2 were walked for 40 min daily. Images of left tarsi were obtained by magnetic resonance imaging (MRI) with a 0.5 Tesla superconducting mag...
Haematological and biochemical responses to training and overtraining.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 621-625 doi: 10.1111/j.2042-3306.1999.tb05297.x
Tyler-McGowan CM, Golland LC, Evans DL, Hodgson DR, Rose RJ.We sought a physiological marker of overtraining in horses, using commonly practised field and laboratory tests to allow early prediction and treatment of the syndrome. Thirteen Standardbred horses were trained as follows: phase 1 (endurance, 7 weeks), phase 2 (high intensity, 9 weeks) and phase 3 (overload, 18 weeks). In phase 3 the horses were divided into 2 groups: overload training (OLT) and control (C). The OLT group exercised at greater intensities, frequencies and durations than the C group. Overtraining occurred after 31 weeks and was defined as a significant decrease in treadmill run ...
The effects of a rider’s mass on ground reaction forces and fetlock kinematics at the trot.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 218-221 doi: 10.1111/j.2042-3306.1999.tb05221.x
Clayton HM, Lanovaz JL, Schamhardt HC, van Wessum R.Ground reaction force (GRF) measurements are often normalised to body mass to facilitate inter-individual comparisons. The objective of this study was to explore the effect of a rider on the GRFs and fetlock joint kinematics of trotting horses. The subjects were 5 dressage-trained horses and 3 experienced dressage riders. Ground reaction force measurements and sagittal view videotapes were recorded as the horses trotted at the same velocity in hand (3.49 +/- 0.52 m/s) and with a rider (3.49 +/- 0.46 m/s). Data were time-normalised to stance duration. Ground reaction force measurements were exp...
A preliminary study of the effect of inhaled nitric oxide on lung mechanics in the standing horse with histamine-induced bronchoconstriction.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 67-70 doi: 10.1111/j.2042-3306.1999.tb05191.x
Sweeney CR, Tomasic M, Russell GE.The effect of inhaled nitric oxide on pulmonary mechanics was studied in normal standing horses with histamine-induced bronchoconstriction. The respiratory health status of 6 normal horses was established on the basis of history, clinical and bronchoalveolar lavage examination. Intrathoracic pressures were estimated using distal oesophageal pressures. Respiratory gas flows were measured using a heated pneumotachograph. Pulmonary mechanics variables were determined from these measurements on a breath by breath basis. Bronchoconstriction was induced by nebulizing a 0.75% w/v solution of histamin...
Advantages and disadvantages of track vs. treadmill tests.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 645-647 doi: 10.1111/j.2042-3306.1999.tb05305.x
Sloet van Oldruitenborgh-Oosterbaan MM, Clayton HM.No abstract available