Granuloma leproide canino: estudo de 27 casos / Canine leproid granuloma: study of 27 cases

O granuloma leproide canino (GLC) é uma doença micobacteriana que cursa com lesão nodular, cutânea ou subcutânea, tipicamente auto limitante, decorrente de infecção pelo Mycobacterium. É uma doença dermatológica rara, usualmente relatada em países de clima tropical. O objetivo deste trabalho é caracterizar as alterações microscópicas e epidemiológicas de casos de GLC. Além disso, utilizar exames complementares para demonstração do Mycobacterium sp. na lesão analisada utilizando coloração de Ziehl-Neelsen, imuno-histoquímica e PCR para classificação e sequenciamento da espécie de Mycobacterium. Foram analisados 27 casos de GLC diagnosticados no período compreendido de 2005 a 2014 (21 exames histológicos e seis citológicos). A raça mais acometida foi Boxer (33,3%), seguida da Dachshund (11,1%). Foi frequente o acometimento de caninos de grande porte (64%) e de pelame curto (96%). Não foi possível estabelecer qualquer padrão de sazonalidade do GLC. As lesões se localizaram anatomicamente no pavilhão auricular na maioria dos casos (93%), constituindo-se de nódulos únicos ou múltiplos, ulcerados ou não. Em nenhum dos casos foi observado acometimento sistêmico. Lesões histológicas seguiram três padrões que variaram de nodulares a difusos, com infiltrado granulomatoso/piogranulomatoso com envolvimento de derme superficial e profunda. A observação de bacilos pela coloração de Ziehl-Neelsen confirmou o diagnóstico. Este teste demonstrou grande variação na quantidade de bacilos nas lesões, não relacionado estatisticamente ao tipo da lesão nem ao período evolutivo. A imuno-histoquímica foi positiva em 90% dos casos, e em alguns casos facilitou a identificação de bacilos, entretanto, em dois casos ocorreram resultados negativos mesmo havendo marcação pela coloração de Ziehl-Neelsen. Na técnica de PCR realizada em 18 amostras, 44% dos casos foram positivos, duas sequências inespecíficas, e demonstrou ainda, que Mycobacterium murphy foi responsável por 2 casos e Mycobacterium hodleri em um caso. Em outros três casos não se obteve 100% de semelhança entre o produto sequenciado e os demais Mycobacterium.(AU)

Canine leproid granuloma (CLG) is cutaneous diseases caused by mycobacteria that course with nodular cutaneous or subcutaneous lesion, typically self-limiting, due to Mycobacterium infection. It is an unusual dermatological disease, usually reported in tropical countries. The objective of the present study is to describe the epidemiological and histopathological findings of CLG. Furthermore, use additional tests for demonstration of Mycobacterium sp. in the lesion were performed, e.g. Ziehl-Neelsen staining, immunohistochemical and polymerase chain reaction (PCR) for classification and genetic sequencing of Mycobacterium species. Twenty seven cases of CLG diagnosed between 2005 and 2014 were studied (21 cases by histological examination and six by cytological examination). Boxer dogs were the breed most affected (33.3%) followed by Dachshund dog breed (11.1%). The disease affected dogs with mainly large size (64%) and short-coated (96%). There was no evidence predilection for occurrence in any season. The lesions were localized, in most cases, at the pinna (93%), comprise one or multiple nodules, ulcerated or not. None of the cases was observed with systemic involvement. Histopathological findings included three patterns of nodular to diffuse, with inflammatory infiltration granulomatous/pyogranulomatous that involved superficial and deep dermis. Definitive diagnosis was made by the presence of acid-fast bacilli by Ziehl-Neelsen stain, showing wide variation in the number of bacilli in the lesions, not being statistically correlated to the type of injury or the evolution period. Immunohistochemistry was effective, and in some cases facilitated the identification of bacilli, but in two cases were negative even with marking by Ziehl-Neelsen staining. The immunohistochemistry was positive in 90% cases, and in some cases facilitated the identification of bacilli, but in two cases were negative even with marking by Ziehl-Neelsen staining. The PCR technique was positive in 44% of cases, demonstrating that Mycobacterium murphy was responsible for two cases of GLC and Mycobacterium hodleri by a one case. In other three PCR-positive cases if not got 100% similarity between the sequenced and other Mycobacterium.(AU)

Evaluation effect of multi-detector CT on pulmonary changes in post-operative adult receptor of liver transplantation complicated with acute respiratory distress syndrome / 中国中西医结合急救杂志

Objective To evaluate the multi-detector CT (MDCT) on pulmonary changes in post-operative adult receptor of liver transplantation complicated with acute respiratory distress syndrome (ARDS).Methods Nineteen adult patients admitted into Tianjin First Center Hospital from January to December 2016 to perform the first time liver transplantation were enrolled in this study. Before operation, the CT showed no significant abnormality in the patients' lungs, after operation MDCT was applied to observe the pulmonary changes of ARDS post-operative complication in the adult receiver of liver transplantation, and the pulmonary changes in different gender of patients were analyzed and compared.Results MDCT showed that after liver transplantation all the 19 patients (100%) had lung pathological changes, of whom 18 cases (94.7%) manifested 2 or more than 2 kinds of pulmonary changes, including consolidation shadows (12 cases, 63.2%), patchy shadows (2 cases, 10.5%), ground glass opacity (6 cases, 31.5%) and pleural effusion (18 cases, 94.7%). In the comparisons between male and female patients with post-operative ARDS after liver transplantation, there were no significant differences in the lung pathological changes shown in MDCT (allP > 0.05) statistically.Conclusion The application of MDCT has great potential value in the evaluation of the disease situation after liver transplantation, that might providehelp to the postoperative treatment.

Outbreaks of canid herpesvirus 1 disease in puppies in southern Brazil / Surtos de doença por herpesvírus canino 1 em filhotes de cães no sul do Brasil

Canid herpesvirus 1 (CHV-1) is a widespread pathogen of dogs and produces infertility, abortions and severe systemic disease in young puppies. Clinical data indicate the circulation of CHV-1 among Brazilian dogs yet definitive diagnosis has rarely been accomplished. This article describes the clinicopathological findings of four independent cases/outbreaks of neonatal disease by CHV-1 in Bulldog puppies followed by virus identification and genetic characterization. Three events occurred in a kennel holding dogs of different breeds at reproductive age (March 2013, October 2013 and April 2014). Puppies from three French or English Bulldog litters, aging 9 to 30 days were affected, presenting dyspnea, agonic breathing, pale mucous, abdominal pain and tension, evolving to death within about 24 hours. At necropsy, the puppies presented necrohemorrhagic hepatitis, multifocal and moderate necrohemorrhagic nephritis and fibrinonecrotic interstitial pneumonia. Virus isolation was positive in clinical specimens from one litter and CHV-1 DNA was detected by PCR in tissues from all four cases. Virus-neutralizing assays with samples of the affected kennel revealed 9/12 adult animals with high antibody titers to CHV-1. Nucleotide sequencing of glycoprotein B, C and D genes revealed 99-100% of identity among the viruses and with CHV-1 sequences available in GenBank. Phylogenetic analyses of gC sequences showed a segregation of the samples, even among three isolates from the same kennel. These findings support CHV-1 infection as the cause of disease and death in these dog litters, reinforcing the need for correct etiologic diagnosis, prevention and immunization against CHV-1 in dogs from Southern Brazil.

O herpesvírus canino (CHV-1) é um patógeno de cães que possui distribuição mundial e que causa infertilidade, abortos e doença sistêmica severa em filhotes de cães. Achados clínicos tem indicado a circulação do CHV-1 em cães no Brasil, embora o diagnóstico definitivo seja raramente determinado. Este artigo descreve os achados clinicopatológicos de quatro casos/surtos independentes de morte neonatal de filhotes de cães da raça Bulldog causados pelo CHV-1, a identificação e a caracterização genética do vírus. Três eventos ocorreram no mesmo canil que abriga animais de diferentes raças em idade reprodutiva (março de 2013, outubro de 2013 e abril de 2014). Filhotes de três ninhadas de Bulldog Francês e/ou Inglês, com idade de 9 a 30 dias, foram afetados e apresentaram dispneia, respiração agônica, mucosas pálidas, dor e tensão abdominal, que evoluíram para morte dos cães dentro de, aproximadamente, 24 horas. Na necropsia foram observados hepatite necro-hemorrágica, nefrite necro-hemorrágica multifocal e moderada e pneumonia intersticial fibrinonecrótica. O isolamento viral foi positivo em amostras clínicas de um filhote e DNA de CHV-1 foi detectado por PCR em tecidos de filhotes de todos os surtos. Teste de soroneutralização com amostras de soro de cães provenientes do canil afetado revelaram que nove de 12 animais adultos possuíam altos títulos de anticorpos para o CHV-1. Sequenciamento de nucleotídeos do gene das glicoproteínas B, C e D revelaram 99-100% de identidade entre as amostras e com as sequências de CHV-1 disponíveis no GenBank. A análise filogenética baseada na sequência do gene da glicoproteína C mostrou uma segregação das amostras, mesmo entre os três isolados de vírus provenientes do mesmo canil. Esses achados demonstram que o CHV-1 é a causa da doença e da morte dos filhotes, reforçando a necessidade do correto diagnóstico etiológico e a implementação de medidas de prevenção e imunização contra o CHV-1 em cães no sul do Brasil.

Pathological findings in fetuses of goats and cattle poisoned by Sida carpinifolia (Malvaceae) / Achados patológicos em fetos de caprinos e bovinos intoxicados por Sida carpinifolia (Malvaceae)

In Brazil, the consumption of Sida carpinifolia by livestock has been associated with neurological diseases linked to lysosomal storage disorders. This paper describes the pathological findings in two caprine fetuses from dams that were experimentally poisoned with S. carpinifolia. The goats were orally dosed with 10 and 13g/kg of a paste of green chopped S. carpinifolia for 30 days and were observed for an additional 15 days period after the last dosage with the plant; thereafter they were euthanized and necropsied. The dams showed only slight clinical signs. The study also includes the findings in one bovine fetus from a naturally S. carpinifolia poisoned cow which showed mild incoordination, generalized tremors, staggering, and frequent falls. The cow was euthanized and necropsied. While there were no significant histopathological changes in the goats, in the cow vacuolation of Purkinje neurons of the cerebellum, pancreatic acinar cells, and thyroid follicular cells were observed. The main microscopic changes observed in the caprine and bovine fetuses were vacuolation in the epithelium of renal tubules, thyroid follicular cells, and Purkinje neurons of the cerebellum. Transmission electron microscopy of sections from CNS of the cow and its fetus revealed vacuoles containing fine granular material surrounded by membrane. Lectin-histochemistry of CNS sections from goat fetuses marked lightly to sWGA lectins, WGA, and Con-A.

No Brasil, o consumo de Sida carpinifolia por animais de produção tem sido associada a doenças neurológicas relacionadas com doença de depósito lisossômico. Este trabalho descreve os achados patológicos observados em dois fetos caprinos de mães que foram experimentalmente intoxicadas por S. carpinifolia. As cabras foram intoxicadas experimentalmente com S. carpinifolia nas doses de 10 e 13g/kg durante 30 dias e foram acompanhadas durante 15 dias após o consumo da planta. Após este período foram eutanasiadas e necropsiadas. O estudo também inclui os achados patológicos encontrados em um feto de uma fêmea bovina intoxicada naturalmente pela planta, que mostrou leve incoordenação, tremores generalizados, andar desequilibrado e quedas frequentes. A vaca foi eutanasiada e necropsiada. Embora não houvesse alterações histológicas significativas nas cabras, vacuolização dos neurônios de Purkinje do cerebelo, das células acinares do pâncreas e nas células foliculares da tireoide foram observadas na vaca. As principais alterações histológicas observadas nos fetos caprinos e no feto bovino foram vacuolização no epitélio dos túbulos renais, nas células foliculares da tireoide e nos neurônios de Purkinje do cerebelo. Na microscopia eletrônica de transmissão do sistema nervoso central da vaca e de seu feto revelaram-se vacúolos contendo material finamente granulado e delimitado por membrana. Na técnica de lectina-histoquímica dos fetos caprinos houve marcação leve no SNC para as lectinas sWGA, WGA e para Con-A.

Surgical Treatment of Small Hepatocellular Carcinoma

PURPOSE: The hepatectomy has been regarded as the only curative treatment for small hepatocellular carcinomas. However, in recent years, non-surgical methods, such as ethanol injection therapy, arterial embolization, and high frequency coagulation, have come to be widely used in the treatment of small hepatocellular carcinomas. There have also been reports that survival rates comparable to those obtained by surgical resection can be achieved with non-surgical methods. In a retrospective analysis, the authors evaluated the surgical role in treating small hepatocellular carcinomas, regarding the survival rate and the pathological report. METHODS: Eighty-seven patients with a small hepatocellular carcinoma, defined as less than 5 cm in diameter, underwent a hepatectomy at our department during the 9 years between January 1990 and December 1998. We analyzed the pathologic findings, the operation method, and the survival rate as functions of the tumor size. RESULTS: Multiple nodules were presented in 18 (20.7%) of the 87 patients, and the incidence of multiple nodules was significantly higher for large-sized tumors. The incidences of capsule invasion, extranodular growth, and portal and intrahepatic metastasis were closely related to tumor size. For tumors less than 2 cm, no multiple nodules, portal invasion, or intrahepatic invasion was observed; however, very small incidences of capsule invasion and extranodular growth (27.3% and 11.1% respectively) and a high incidence (45.5%) of well differentiated tumors were noted. The operative mortality was 3.45% (3/87 hepatectomies): two died of hepatic failure, and one died of gastrointestinal bleeding. The 1-, 3- and 5- year survival rates were 86.9%, 72.0%, and 61.1%, respectively, and the tumor size and number were significantly related to survival rate the amount of resections however, was not significantly related to the survival rate. CONCLUSION: Tumors less than 2 cm in size have a good prognosis and are quite different pathologic ally compared to tumors, over 2 cm in size.

Clinical Manifestations of Mitochondrial Diseases

According to the recently published reports about mitochondrial diseasbl the clinical manifestations are more various than expected. There have been no clinical studies covering whole spectrum of mitochond7iral disease except a few case reports in our country. The authors performed this studies to understand the various clinical and laboratory findings of mitochondrial disease and the usefulness of current tools for the diagnosis of mitochondrial diseases. We reviewed retrospectively the clinical, laboratory and pathologic findings of mitochondrial disease. The diagnosis of mitochondrial disease was based on clinical manifestations, 'ragged-red fiber' in Gomori stainging, and/or abnormal mitochondrial morphologies on electron microscopy. Twenty one patients were diagnosed as mitochondrial disease. Their clinical diagnosis included 7 MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes); 3 MERRF (myoclonic epilepsy with ragged red fibers); 2 KSS (Kearns-Sayre syndrome); 7 CPEO (chronic progressive external ophthalmoplegia); and 2 mitochondrial myopathy. The usefulness of electrodiagnostic studies, such as EMG, NCV and FEG, were limited in some patients. The muscle biopsy showed ragged red fibers in 10 of 15 sampled examined. Eleven patients had abnormal serum lactic acid level. The authors found that the mitochondrial disease revealed broad clinical spectrum and clinically available diagnostic tests, such as serum lactate and light microscopic examination showed limited value. Therefore, to evaluate the mitochondrial dysfunction with systemic involvement may be desirable to depend on sensitive and specific methods including succinate dehydrogenase (SDH) staining, electron microscopy and biologic studies of mitochondrial DNA.

Atypical C-T Features of Intracranial Meningiomas and Pathological Correlation

Most intracranial meningiomas present on the C-T as typical features with homogeneous, occasionally lobulated mass of density equal or greater than of surrounding brain tissue. After contrast injection, there is uniform and homogeneous enhancement in the density. Infrequently a significant number present as atypical features which are regional inhomogenecity of tumor mass on C-T and common source of error in the diagnosis of meningioma. The authors reviewed 25 consecutive meningiomas, all confirmed pathologically. 7 cases have been encountered as atypical features on the C-T. Among them, 2 cases of peritumoral low density were diagnosed as meningioma with C-T only. 5 cases(2 cases of peritumoral cyst, 2 cases of intratumoral cyst, 1 case of peritumoral bleeding) were misdiagnosed initially as malignant lesion based on C-T findings. Those C-T patterns have been found to correlate with certain histologic and morphologic alternation in tumor anatomy. Close correlation with pathological findings of tumor necrosis, cystic changes and hemorrhage was noted.