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Massive pleural effusions in cirrhotic patients with ascites.

A method is described based on the passage of air across the diaphragm to detect pathological diaphragmatic orifices in autopsies. This method was used in 65 post-mortem studies; orifices were detected in 7 cases. Only one of these appears histologically to be a real spontaneous orifice. This was found in the post-mortem study of a cirrhotic patient with ascites and massive and recurrent hydrothorax. In eight patients with cirrhotic ascites and pleural effusions, radioisotopes were introduced into the ascites fluid, and only in two of them, both with right massive and recurrent pleural effusion, was radioactivity detected in the pleural cavity within the 1st h after injection. The radioisotopic method for detecting in vivo these orifices avoids the repeated taps that are necessary when dyes are used.

Ascites↗

Relationship between ingestion of the locoweed Oxytropis sericea and congestive right-sided heart failure in cattle.

In field observations of young cattle grazing on certain high-altitude ranges infested with the locoweed Oxytropis sericea, a high frequency of clinical congestive right ventricular failure was identified. At necropsy of affected calves, there were right ventricular hypertrophy and dilation, subcutaneous edema, hydrothorax, diarrhea, and chronic passive congestion of liver. Microscopically, there was neurovisceral foamy cytoplasmic vacuolation, characteristic of locoism. An experiment was set up to test the relationship of O sericea to congestive right-ventricular failure. Preliminary investigation supports the field observation.

Altitude↗

Spontaneous cor pulmonale in laboratory beagles.

Right heart failure associated with postmortem evidence of pulmonary hypertension (cor pulmonale) was observed in nearly 1% of the young beagles of a large research colony. During the past 18 years, 176 dogs with cor pulmonale were observed. Most cases occurred between September and April of each year. Nearly equal numbers of males and females were involved, and some siblings were affected. Ninety-six percent of known affected dogs died, and 85% of the deaths occurred by 5 weeks of age. Clinically, most dogs were stunted and exhibited ascites, subcutaneous edema, hypothermia, dyspnea, cyanosis, and systolic murmur. Radiography revealed cardiomegaly, and electrocardiography revealed right axis deviation and an enlarged right atrium. Postmortem evidence of cor pulmonale included subcutaneous edema, ascites, hydrothorax, mediastinal and mesenteric edema, splenomegaly, centrolobular hepatic congestion and necrosis, right ventricular hypertrophy, interstitial pneumonia, and medial hypertrophy of pulmonary arteries and arterioles. The specific cause of the disease was not determined.

Age Factors↗

Pathologic alterations in hypertrophic and congestive cardiomyopathy of cats.

Pathologic alterations were studied in 15 cats with cardiomyopathy. Ten of these had hypertrophic cardiomyopathy, characterized by cardiomegaly, diffuse myocardial hypertrophy, small left ventricular cavities, and dilated left atria; the ventricular septum and left ventricular free walls were thick, but asymmetric septal hypertrophy was not present. Aortic thromboembolism, renal infarction, and pulmonary congestion and edema were frequent. Histopathologic and ultrastructural study revealed hypertrophy and disarray of cardiac muscle cells (most severe in left ventricle and ventricular septum), interstitial fibrosis, and fibromuscular hyperplasia of small intramural coronary arteries. The hypertrophied fibers had large nuclei, prominent Golgi complexes, and numerous polysomes; some fibers had crisscrossing myofibrils. Degenerative alterations in hypertrophied myocytes were: perinuclear distension of elements of sarcoplasmic reticulum, focal myofibrillar lysis, numerous thick clumps of Z-band material, and abundant lipofuscin granules. The interstitium showed accumulations of collagen fibrils, increased numbers of fibroblasts, and scattered remnants of external lamina. One cat had dilated chambers, but also had typical histologic and ultrastructural alterations of hypertrophic cardiomyopathy and was considered to have a late stage of this disorder. Four cats had congestive cardiomyopathy, with cardiomegaly and dilatation of all chambers. Hydrothorax and pulmonary congestion and edema were generally present. Cardiac histopathologic and ultrastructural alterations consisted only of mild interstitital edema and fibrosis. Detailed comparisons reveal many similarities in the spectrum of morphologic features of hypertrophic cardiomyopathy in human beings and cats; there are not marked differences in the morphologic features of congestive cardiomyopathy in human beings and cats. Thus, cardiomyopathies in the cat constitute useful models for the study of these diseases in human beings.

Animals↗

[Our experiences during cannulation of the subclavian vein in children (author's transl)].

With 260 children under 12 years of age we tried to cannulate the subclavian vein during 3 years 455 times, and were successful 391 times (85.9%). 43.8% of the patients were younger than 1 year. The success rate correlated to the childrens' bodyweight and was less with lower weight of the patients. - In 68.8% of the cases we found the tip of the cannula in the upper caval vein, 19.9% were in the internal jugular vein, and 6.1% were in the opposite subclavian vein. - In this study participated 7 members of the staff and 8 specializing doctors; catheterizations per participant, mean = 30,2, SD 21,49, minimum 6, maximum 65. - Cannulas functioned for 5 +/- 2, max. 19 days. - The most serious complications were 2 pneumo- and one pneumo-hydrothorax, 2 times suspicion of thrombosis and 1 hemorrhage due to a not known hemophilia. None of the complications caused therapeutical problems.

Body Weight↗

Fatal poisoning of sheep by Galega officinalis (French honeysuckle).

Three cases of rare acute poisonings due to Galega officinalis L. (French honeysuckle) have been recorded in France. This plant poisoning, which generally occurs in summer, is characterized by an asphyxic syndrome which leads to death within hours. A voluminous hydrothorax is observed during post mortem examination. The toxic mechanism is yet to be established.

Animals↗

An outbreak of African horsesickness in dogs.

Several dogs died from African horsesickness which was contracted by the consumption of uncooked meat from the carcase of a horse that had died from the disease. Respiratory embarrassment was the main clinical sign, while marked hydrothorax and pulmonary congestion and oedema were the major post mortem findings. Serotype 6 horsesickness virus was isolated from 2 of these dogs.

African Horse Sickness↗

A study of the toxicity of imidocarb dipropionate in cattle.

The toxic effects of imidocarb dipropionate (3,3'-bis[2-imidazolin-2-yl] carbanilide dipropionate) were studied in calves injected twice intramuscularly with 0, 5, 10 or 20 mg/kg dosages. Transient, dosage dependent signs of toxicosis consisted of excessive salivation, serous nasal discharge, diarrhoea and dyspnoea. Elevations in blood urea nitrogen concentrations and serum glutamic oxalacetic transaminase activities were related to dosage and markedly increased at the high dosage. Renal hyperaemia, hepatomegaly, pulmonary congestion and oedema, hydrothorax, hydroperitoneum, hydropericardium and mortality occurred at the 20 mg/kg dosage. Microscopic lesions observed at the high dosage included acute severe renal tubular necrosis and focal hepatocellular necrosis. Injection site reactions varied from microscopic areas of necrotising myositis at the 5 mg/kg dosage to focal grossly visible areas of necrosis, encapsulated by granulation tissue and surrounded by fascial oedema at the 20 mg/kg dosage.

Animals↗

Radiographic diagnosis of bovine thoracic disorders.

Various thoracic disorders were radiographically diagnosed in 362 cattle and buffaloes, which accounted for 18.7% of total cases involving these 2 species. Of these 362 cases, diaphragmatic hernia accounted for about 42%, tuberculosis 18% and bronchopneumonia 15%. Other disorders included metastatic neoplasia, pericarditis with or without foreign-body involvement, hydrothorax and foreign bodies.

Animals↗

Echocardiographic diagnosis of a cardiac fibrosarcoma in the right atrium of a sheep.

This is a case report of a six-year-old female White Alpine sheep with a cardiac fibrosarcoma in the right atrium. Clinically, the sheep had right-sided cardiac insufficiency with tachycardia, engorgement of the jugular veins, brisket edema, and ascites. Chronic congestion of the liver resulted in increased hepatic enzyme activity. Based on clinical findings, a tentative diagnosis of endocarditis or pericarditis was made. Radiography of the thorax revealed hydrothorax. An echogenic mass was observed in the right atrium via echocardiography; it was interpreted as a tumor or thrombus. Ultrasonography of the abdomen revealed severe ascites and chronic congestion of the liver attributable to right-sided cardiac insufficiency. The clinical and sonographic findings were verified at post mortem. The mass in the right atrium was a pedunculated fibrosarcoma.

Animals↗

Transjugular intrahepatic portosystemic stent shunt.

The transjugular intrahepatic portosystemic stent shunt (TIPSS) is essentially a side-to-side portocaval shunt performed by interventional radiological methods which connects the hepatic vein to the portal vein via the liver parenchyma. It can be performed successfully in 85% to 95% patients. The procedure mortality is low (1% to 2%) and is mainly from intraperitoneal bleeding. Major indications for TIPSS are in patients in whom sclerotherapy for bleeding varices has failed, those who have recurrent variceal haemorrhage after sclerotherapy or band ligation and in patients with refractory ascites, hypersplenism and portal gastropathy. It has also been used in some patients with the Budd-Chiari syndrome, portal vein thrombosis and cirrhotic hydrothorax. TIPSS is followed by variceal rebleeding and encephalopathy in about 10% to 20% of cases, deterioration in liver function in about 25% to 35% and shunt dysfunction in 15% to 60%. Further research should be directed at developing newer types of stents to prevent shunt dysfunction.

Algorithms↗

[Observation of the effects of LAK/IL-2 therapy combining with Lycium barbarum polysaccharides in the treatment of 75 cancer patients].

Seventy nine advanced cancer patients in a clinical trial were treated with LAK/IL-2 combining with Lycium Barbarum polysaccharides (LBP). Initial results of the treatment from 75 evaluable patients indicated that objective regression of cancer was achieved in patients with malignant melanoma, renal cell carcinoma, colorectal carcinoma, lung cancer, nasopharyngeal carcinoma, malignant hydrothorax. The response rate of patients treated with LAK/IL-2 plus LBP was 40.9% while that of patients treated with LAK/IL-2 was 16.1% (P < 0.05). The mean remission in patients treated with LAK/IL-2 plus LBP also lasted significantly longer. LAK/IL-2 plus LBP treatment led to more marked increase in NK and LAK cell activity than LAK/IL-2 without LBP. The results indicate that LBP can be used as an adjuvant in the biotherapy of cancer.

Chemotherapy, Adjuvant↗

Experimentally induced sarcocystis infection in calves: pathology.

Calves fed sporocysts of Sarcocystis isolated from the feces of dogs and coyotes became anorectic, lost weight, and became anemic and prostrate, and died. The most severe pathologic changes occurred between 26 and 33 days after infection; schizonts were found throughout the body. Schizonts were not found after this time. Sarcocytis cysts were in skeletal and cardiac muscles between 33 and 54 days. Necropsy revealed lymphadenopathy, paleness of the mucous membranes and visceral organs, ascites, hydrothorax, hydropericardium, and serous atrophy of fat. Ecchymotic or petechial hemorrhage was in heart, brain, serosa of the alimentary tract, and urinary bladder. Microscopic changes observed in nearly all calves consisted of hemorrhage, mononuclear cell (primarily lymphocytic) infiltration and edema in heart, brain, liver, lung, kidney, and striated muscle. Necrotizing myocarditis with dystrophic calcification of the striated muscle and fat, as well as nonsuppurative inflammation of meninges and glial nodules in the brain, was observed in several calves.

Adipose Tissue↗

[Instrumental methods in the treatment of non-specific spontaneous pneumothorax].

The results of treatment of 226 patients with unspecific spontaneous pneumothorax in 1980-1990 are discussed. Poor efficacy of punctures of the pleural cavity (32.4%) is noted. Pleural cavity drainage proved to be effective in 79.7% of cases, both in primary and in recurrent pneumothorax. Chemical pleurodesis with tetracycline and 4% sodium bicarbonate solution was conducted in patients with complicated forms of pneumothorax (bronchopleural fistulas, hydropneumothorax). The advantage of 4% sodium bicarbonate solution over the tetracycline solution was obvious. To prevent the development of encapsulated hydrothorax the authors improved the method of pleural cavity drainage. The described method of instrumental treatment of spontaneous pneumothorax allowed injurious surgical intervention and recurrent pneumothorax to be avoided in 100% of cases.

Adult↗

Confirmation of a pulmonary component of multicentric lymphosarcoma with bronchoalveolar lavage in two dogs.

Histologic examination of lung tissue has been the only definitive diagnostic procedure used to confirm pulmonary involvement with lymphosarcoma (LSA) in dogs. Lung involvement with LSA was diagnosed by cytologic examination of bronchoalveolar lavage fluid in 2 dogs with multicentric LSA. Both dogs had cough or dyspnea, in addition to peripheral lymphadenopathy or visceral organomegaly. Both dogs had nonspecific, abnormal thoracic radiographic findings, including diffuse pulmonary interstitial pattern, hydrothorax, and mediastinal and retrosternal lymphadenopathy. In these 2 dogs, postmortem lung histologic examination, performed immediately after bronchoalveolar lavage, confirmed the cytologic diagnosis of pulmonary infiltration with LSA.

Animals↗

Nonvascular needle and shunt placements for fetal therapy.

The nonvascular placement of needles and shunts for the in utero treatment of fetuses with fluid-filled, space-occupying anomalies has been done for about 10 years. The rationale for this approach is to attempt to prevent progressive impairment of organ function or lethal damage by early decompression. Experience has taught us that the key to success in these cases is the exclusion of associated anomalies and the use of appropriate tests to assess the residual organ function at the time of first diagnosis. In fetuses with hydrothorax, shunts can prevent pulmonary hypoplasia, and in those with obstructive uropathy, they can prevent the development of progressive lung hypoplasia and renal damage before a fetus is fully viable. In fetuses with ovarian cysts, prenatal puncture is occasionally indicated, but in those with hydrocephalus, the beneficial effect of prenatal drainage is more controversial. The catheters used for in utero placement have been improved and carry a smaller risk than open fetal surgical procedures.

Catheterization↗

[Partial 12q trisomy and chylothorax].

The authors present a case of partial trisomy 12q associated with chylothorax, diagnosed at 30 weeks of pregnancy. Cordocentesis for the karyotype as well as thoracocentesis were carried out. In spite of the administration of tocolytic drugs the patient delivered a girl with multiple clinical abnormalities, who died at 7 days of age. From this case, the authors report 6 other cases of partial trisomy 12q in the literature, and, in the discussion they suggest the management after the diagnosis of hydrothorax has been made by ultrasound.

Abnormalities, Multiple↗

[A case of intrathoracic colon perforation due to adult Bochdalek hernia].

The patient, a 70-year-old man, diagnosed as having left pneumothorax and hydrothorax, was admitted and had a thoracic drain inserted. The evacuation of stool was noted from 3 days after insertion. With the abscess in the left thoracic cavity shown on emergency CT, a diagnosis of perforation of the digestive tract in the left thoracic cavity was made and emergency operation was performed. On the basis of the intraoperative findings, the case was diagnosed as adult Bochdalek hernia with intrathoracic colon perforation, and repair of hernia and colostomy were done by laparotomy and thoracotomy. However, the patient died of DIC and sepsis 5 days after operation. Two cases of adult Bochdalek hernia complicated with spontaneous pneumothorax have hitherto been report. However, there has been no reported case which had adult Bochdalek hernia complicated with pneumothorax considered due to intrathoracic colon perforation as in this case. So this case was considered very rare and worthy of reporting.

Aged↗