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[High serum ferritin levels in malignant lymphoma of the ileum].

A 61-year-old woman was admitted to our hospital with lower abdominal distension, anemia and slight emaciation. Primary malignant lymphoma of the ileum was diagnosed after laparotomy and palliative surgery was performed. Pathological specimens demonstrated diffuse lymphoma, and histiocytic (Rappaport's classification) aneurysm-type macroscopic development. The preoperative serum ferritin level was high and increased postoperatively with a slight decrease during VEMP chemotherapy, suggesting it to be a marker of tumor activity. Although palliation was observed during chemotherapy, this patient died of pulmonary complications a little less than 3 months after the operation.

Female↗

Abstaining and bulemic anorexics. Two sides of the same coin.

This article presents a psychodynamic approach to the understanding and treatment of abstaining and bulemic anorexics. While the abstainer starves herself to the point of emaciation and the bulemic may gorge to the point of obesity, the underlying emotional conflicts of the two groups of patients are the same. The ego (character structure) of the bulemic is not as perfectionistic and rigid as that of the abstainer, so the patient is periodically overwhelmed not only by impulses to gorge but also by impulses of all kinds. A description of the clinical syndrome, the physiological findings and details of the laboratory diagnosis of anorexia nervosa are provided. Family psychodynamics which are viewed as etiologic are presented. A psychodynamic therapeutic approach is described and examples of the treatment of an abstaining and bulemic patient are detailed. The crucial therapeutic role of the family physician is explored with emphasis on the importance of the physician's encouraging the patient to bring up questions about food and eating with the psychiatrist because such preoccupations mask other conflicts.

Adolescent↗

[Clinico-serologic study of humans with diseases epidemiologically related to halprowiosis (chlamydiosis) of farm animals].

A toxico-allergo-asthenic syndrome, primarily detected as a group disease (16 cases) affecting the workers of a cattle-ranch with the record of halproviosis (chlamydiosis) of agricultural animals, is described. A rise in temperature, sickness, vomiting, headache, loss of appetite, pain in the jaws and the joints, conjunctivitis and episcleritis, frequent urination, weakness, irritability, emaciation appeared to be its most characteristic symptoms. The halprovial nature of this syndrome was revealed on the basis of differential clinico-laboratory studies, serological, epizootic and epidemiological data.

Adult↗

Benign pedunculated intraluminal tumor of the esophagus.

Benign pedunculated intraluminal tumor of the esophagus is extremely rare. Although the correct diagnosis of this tumor is difficult, it should be extirpated early because, if untreated, it may result in death of the patient by progressive emaciation, bleeding from erosions, or acute airway obstruction. We present a case rescued from suffocation caused by regurgitation of a giant esophageal tumor. In the discussion on the difficulty of diagnosis, the necessity of repeated examination is emphasized. The classification of benign esophageal tumors is also discussed.

Airway Obstruction↗

Clinical presentation and biochemical abnormalities in black (Zulu) patients with cirrhosis in Durban.

A retrospective was designed to analyse the mode of presentation, clinical signs and haematological and biochemical abnormalities in 225 consecutive Black (Zulu) patients who were admitted to a general medical ward between the years 1970 and 1981 and in whom cirrhosis was later diagnosed. The most common presenting complaint was swelling of the body (60% of the patients), followed by abdominal pain (32%) and episodes of bleeding, mainly from the gastrointestinal tract (19%). On examination, hepatomegaly was encountered in 66% of the patients, with moderate to massive enlargement in 40%. Ascites was detected in 56%, with tense abdominal distension in 34%. Jaundice was present in 38% and emaciation, mental disturbance and splenomegaly in over 25%. Spider naevi (found in 2 patients) and Dupuytren's contracture (found in 1) were very rare. Thrombocytopenia and a high ESR were common. Over 90% of patients had low albumin and high globulin concentrations (albumin less than 20 g/dl and globulin greater than 60 g/dl in 25%). Bilirubin and alkaline phosphatase levels and the prothrombin index were found to be within normal limits in 32%, 24% and 52% of cases respectively. Histologically the lesion was most commonly micronodular (73%) with variable deposits of fat and iron. Peritoneoscopy was the most useful special investigation in the diagnosis of cirrhosis, leading to a correct diagnosis in 77% of cases. In conclusion, the clinical signs, biochemical abnormalities and histological features suggest that the factors causing cirrhosis in the community studied are mixed; it may result from the combined effects of alcohol abuse, malnutrition and chronic viral (e.g. hepatitis B) infections.

Abdomen↗

Fatty changes in the liver: the relation to age, overweight and diabetes mellitus.

Fatty changes in the liver were investigated and quantified in 678 consecutive autopsies. The changes were classified into four groups: no changes 46%, slight changes 43%, moderate changes 9%, severe changes 2%. A clear positive correlation was found between the degree of overweight and the degree of fatty changes in the liver. The fatty changes were found to be reversible. However, in emaciated patients with a long disease period the number of cases with pronounced fatty changes were significantly increased. No relation was found between diabetes and fatty changes in the liver. In patients more than 40 years old no correlation was found between age and the degree of fatty changes in the liver.

Adult↗

[Experimental and clinical studies of intravenous infusion of amikacin in acute respiratory tract infections].

Pharmacokinetic and clinical studies on amikacin (AMK) by intravenous drip (i.v.d.) infusion were performed, and the following results were obtained. 1. Serum concentrations of AMK were determined in 4 patients with normal renal function after 1 hour i.v.d. infusion of 200 mg of AMK. The mean peak serum concentration was 14.20 +/- 0.88 micrograms/ml at the termination of i.v.d. infusion and declined to 2.30 +/- 0.79 micrograms/ml at 4 hours later. The half-life was 1.55 +/- 0.28 hours. 2. Twenty-three patients with severe pulmonary infection received 1 hour i.v.d. infusion of 200 mg of AMK 2 to 3 times a day. Clinical response was good in 17 cases, fair in 4 and poor in 2. Thus, 73.9% of the patients responded to AMK. 3. No adverse effects were observed with the exception of tinnitus and hearing loss in 1 case. Therefore, it is thought that the i.v.d. infusion of AMK will be useful for treatment of severe infectious patients with bleeding tendency and emaciation.

Acute Disease↗

Weight-length relationships of wild-caught and captive Atlantic bottlenose dolphins.

Length and weight measurements were obtained on 144 Atlantic bottlenose dolphins (Tursiops truncatus). Data were compared for wild-caught dolphins (n = 124), dolphins in training (n = 34), and dolphins that had died in an emaciated condition (n = 15). The purpose of the study was to establish guidelines for use in estimating when a dolphin is over- or underweight. Regression lines were plotted to give the minimal acceptable weight for any length from 185 to 265 cm.

Animals↗

Oak (Quercus rubor)poisoning in cattle.

Two outbreaks of oak poisoning in cattle in the Republic of South Africa are described. In the first outbreak 22 out of 80 head of cattle were severely affected while 40 out of a herd of 135 cattle were affected in the second outbreak. Of these 40, only one survived after 9 months despite vigorous treatment. Only young cattle under 2 years were affected during both outbreaks in spite of an average herd age of approximately 6 years in the second group of cattle. Clinical signs included severe weakness with a swaying gait, diarrhoea and dehydration. Some were pot bellied while others were emaciated and remained stunted. The most prominent macroscopic and microscopic lesion present in 3 animals autopsied, was a non-suppurative interstitial nephritis which was accompanied by oedema and ulceration of the caecum and colon. Histochemical studies were carried out on pigment granules observed in kidney sections.

Animals↗

[Diaphragmatic hernia as a rare complication during caesarean section in a cow (author's transl)].

The literature on diaphragmatic hernia in cattle and buffaloes is reviewed. A heifer showed accelerated respiration, symptoms of dyspnoea, occasional coughing and groaning, a variable appetite and emaciation unaccompanied by an increase in temperature for sixteen days prior to parturition. A diagnosis was not established. During parturition which occurred at term, marked symptoms were not observed, and it was decided to perform caesarian section because of the unduly large foetus. During the operation, performed in the standing animal, the heifer offered violent resistance when the abdominal cavity had been opened, showing symptoms of severe dyspnoea and/or pain, an fell down. In this state of excitement, which subsequently came to resemble shock, the heifer showed cyanotic mucosae and a very quick pulse. The heart sounds on the left side were inaudible on auscultation. The operation could only be completed in the recumbent position after sedation. Nothing which could account for the symptoms was detectable throughout treatment. The animal then remained quiet, the mucosae having regained their pink colour, the pulse rate decreased. Respiration continued to be too rapid and it became plain that it was obviously of the pendular type. The animal having been slaughtered in agreement with the owner, diaphragmatic hernia was found to be present on the left side. The enlarged spleen was largely situated in the thorax and partly adhered to the lung. The history of the case is discussed.

Animals↗

A mycobacteriosis in a sheep resembling paratuberculosis (Johne's disease).

In a sheep which was euthanased because of severe emaciation and weakness, slight thickening of the ileum was seen grossly. Microscopically there was a granulomatous ileitis with obliterative lymphangitis and lymphangiectasis. Granulomatous lesions were also present in the liver and some mesenteric lymph nodes. Large numbers of acid-fast bacilli were present within epithelioid macrophages in the lamina propria of the ileum. Although the identity of the Mycobacterium spp. involved was not established, the possibility of paratuberculosis is discussed. The apparent rarity of this disease in sheep in South Africa is considered. Particular attention is drawn to the absence of diarrhoea in this case, to the slightness of the gross changes and to the importance of submitting material for mycobacterial culture.

Animals↗

Chronic effects of three crude oils on oysters suspended in estuarine ponds.

Gross and histological observations obtained from the study of oysters chronically exposed to single, low level (4 ppm) quantities of Empire Mix, Saudi Arabian, and Nigerian crude oils in estuarine ponds indicate a reduced intake and/or assimilation of food by the test animals. The tissues of many of the test animals, especially from the Saudi Arabian and Nigerian oil-treated ponds, were clear, watery, and emaciated in appearance, which was not the normal condition of oysters from the Gulf during the period of the samplings. Histologically, there were serious alterations in the connective tissues associated with the body wall, mantle, and food groove. The muscle and connective tissue fibers in these areas of many of the surviving oysters were swollen, translucent, homogeneous, structureless masses. These masses most nearly resembled the condition classically described as hyaline degeneration. In addition, there was a reduction in the development of the germinal epithelial tissues, indicating reduced reproductive potential.

Animals↗

[Enterological complications following ovariohysterectomy in dogs (author's transl)].

Of 109 dogs submitted with complications following ovariohysterectomy, twenty were found to show enterological problems. Presenting symptoms in these animals consisted in vomiting, diarrhoea and emaciation. A large number of animals also showed body temperatures above 39 degrees C. An irregular, often painful mass was palpable on examination of the mesogastrium in seventeen cases. Plain radiography revealed the features of ileus in ten dogs, a mass of soft tissues in the abdominal cavity in six and the pattern of peritonitis in five cases (two animals were classifiable with two groups). One dog did not show any changes. Laparotomy was performed in all twenty dogs. In view of the extent of the lesions, euthanasia was performed in ten animals. Partial enterectomy was performed in the other ten; some of these dogs are still alive at the time of writing. The findings at laparotomy and subsequent post-mortem examination, if any, may be summarized as follows: - there were adhesions between the ovarian-stump granulomas and an intestinal loop in five animals; - twelve animals showed adhesions between the ovarian-stump granuloma and the intestines which also adhered to each other; in five of these bitches, the intestinal loops were also attached to the wall of the abdomen, and also to the cervix stump in two cases; - three dogs only showed adhesions between intestinal loops; the cervix stump was involved in the adhesions in one dog.

Animals↗

[Nephrectomy with preoperative intraluminal occlusion of the renal artery in treating kidney cancer].

Based on their personal observations, the authors discuss the nephrectomy procedure with a preoperative intraluminal occlusion of the renal artery in tumor involved kidneys. Surgical intervention, performed according to the suggested principles, in 84% of cases perfectly provides for the primary arrest of arterial blood supply and ischemic reduction of the tumor and kidney in size, prevents dissemination of tumor cells or emboli, lessens the operative blood loss, shortens the time of surgery and the postoperative period, and facilitates the operative procedure even in emaciated aged and senile patients.

Adult↗

Ostertagia ostertagi infection and reinfection in cattle of different ages.

Twelve cattle, three per group, were each inoculated orally with 100,000 Ostertagia ostertagi infective larvae when they were 2 months, 4.5 months, 12 months, and 24 months-old, respectively. Signs of clinical parasitism did not develop through 30 days when the infections were terminated with an anthelmintic. The cattle were each reinoculated with 500,000 O ostertagi larvae 6 days later. Groups I to III then developed anorexia and diarrhea after 3 weeks. One calf, inoculated at 2 months of age, died 27 days after reinoculation; two calves became emaciated. Group IV calves did not develop clinical signs of parasitic disease. All cattle were necropsied 42 days after reinoculation. Pathologic lesions, characteristic of type I ostertagiasis, were found in cattle of all groups; lesions were most severe in group I and least severe in group IV calves. Groups II to IV averaged 56,397 to 65,817 worms, whereas group I averaged only 29,916 worms. Group I calves expelled the worms during a period of profuse diarrhea. Cattle from 2 to 24 months old were readily infected and reinfected experimentally with O ostertagi, but the oldest cattle were most resistant to the pathogenic effects of the parasites.

Age Factors↗

Observations on the course and pathology of Trypanosoma vivax in Red Sokoto goats.

The course of trypanosomiasis was observed over a period of 68 days in eight Red Sokoto goats experimentally infected with Trypanosoma vivax strain Y58. The goats developed parasitaemia five days after infection; the intensity of parasitaemia varied within and between individual goats. The course of the disease was acute, subacute or chronic. Anaemia was the principal clinocopathological feature of the disease. The rate of development of anaemia was not related to the degree of parasitaemia. Other clinical signs included emaciation, weakness, rough hair coat, profuse lacrimation and development of corneal opacity. Bone marrow of infected goats showed marked erythroid hyperplasia. Erythrophagocytosis and haemosiderosis in the bone marrow, liver and spleen were the principal histopathogical features in infected goats.

Animals↗

[Toxicological properties of fentirin].

Phentyrin toxicity depends to a large measure on the route of its administration. Adequately toxic doses of phentyrin intravenously are approximately ten times as less compared to peroral administration. High doses of the drug produce appetite loss, occasional vomiting, salivation, diarrhea, flabbiness and weight loss. ECG shows slow pulse, reduced voltage and changes in T wave. At early periods the animals' death ensues with phenomena of emaciation, a delayed death can be recorded only in some cases. Morbid anatomy shows atrophic changes in the lymphatic nodes, in the spleen, thyroid, in the gastrointestinal mucosa, and changes in the liver and kidneys. Phentyrin in tolerated doses exerts no adverse action on stem cells of bone marrow, but affects spleen cells. The drug alters the weight of some endocrine organs -- the thyroid, uterus and adrenals.

Animals↗

Clinical and pathologic features of chronic adriamycin toxicosis in rabbits.

Chronic adriamycin (ADR) intoxication was produced in 50 weanling rabbits by weekly injections of ADR (2.4 mg/kg of body weight) for up to 17 weeks. All ADR-treated rabbits developed prominent alopecia, edema, moderate anemia, and severe emaciation. The frequency and severity of cardiomyopathy were not strongly dose-related, but renal lesions were. The frequency and severity of cardiomyopathic lesions were highest in left ventricular free wall and ventricular septum, intermediate in atria, and lowest in right ventricular free wall. Cardiac lesions increased in frequency and severity basally in left ventricular free wall, ventricular septum, and atria, but not in right ventricular free wall. Nephropathy lesions were selective for inner cortex and constitute a common and important side effect of chronic ADR intoxication in rabbits. Other lesions observed at necropsy were hepatic necrosis, skeletal muscle degeneration, osteodystrophy-associated fractures, peripancreatic fat necrosis, and testicular degeneration and atrophy.

Alopecia↗