Interrogating the Functional Correlates of Collateralization in Patients with Intracranial Stenosis Using Multimodal Hemodynamic Imaging.

BACKGROUND AND PURPOSE: The importance of collateralization for maintaining adequate cerebral perfusion is increasingly recognized. However, measuring collateral flow noninvasively has proved elusive. The aim of this study was to assess correlations among baseline perfusion and arterial transit time artifacts, cerebrovascular reactivity, and the presence of collateral vessels on digital subtraction angiography. MATERIALS AND METHODS: The relationship between the presence of collateral vessels on arterial spin-labeling MR imaging and DSA was compared with blood oxygen level-dependent MR imaging measures of hypercapnic cerebrovascular reactivity in patients with symptomatic intracranial stenosis (n = 18). DSA maps were reviewed by a neuroradiologist and assigned the following scores: 1, collaterals to the periphery of the ischemic site; 2, complete irrigation of the ischemic bed via collateral flow; and 3, normal antegrade flow. Arterial spin-labeling maps were scored according to the following: 0, low signal; 1, moderate signal with arterial transit artifacts; 2, high signal with arterial transit artifacts; and 3, normal signal. RESULTS: In regions with normal-to-high signal on arterial spin-labeling, collateral vessel presence on DSA strongly correlated with declines in cerebrovascular reactivity (as measured on blood oxygen level-dependent MR imaging, P < .001), most notably in patients with nonatherosclerotic disease. There was a trend toward increasing cerebrovascular reactivity with increases in the degree of collateralization on DSA (P = .082). CONCLUSIONS: Collateral vessels may have fundamentally different vasoreactivity properties from healthy vessels, a finding that is observed most prominently in nonatherosclerotic disease and, to a lesser extent, in atherosclerotic disease.

The Contribution of Common Surgically Implanted Hardware to Functional MR Imaging Artifacts.

BACKGROUND AND PURPOSE: Blood oxygenation level-dependent MR imaging is increasingly used clinically to noninvasively assess cerebrovascular reactivity and/or language and motor function. However, many patients have metallic implants, which will induce susceptibility artifacts, rendering the functional information uninformative. Here, we calculate and interpret blood oxygenation level-dependent MR imaging artifact impact arising from surgically implanted hardware. MATERIALS AND METHODS: A retrospective analysis of all blood oxygenation level-dependent MRIs (n = 343; B0 = 3T; TE = 35 ms; gradient echo EPI) acquired clinically (year range = 2006-2014) at our hospital was performed. Blood oxygenation level-dependent MRIs were most commonly prescribed for patients with cerebrovascular disease (n = 80) or patients undergoing language or motor localization (n = 263). Artifact volume (cubic centimeters) and its impact on clinical interpretation were determined by a board-certified neuroradiologist. RESULTS: Mean artifact volume associated with intracranial hardware was 4.3 ± 3.2 cm(3) (range = 1.1-9.4 cm(3)). The mean artifact volume from extracranial hardware in patients with cerebrovascular disease was 28.4 ± 14.0 cm(3) (range = 6.1-61.7 cm(3)), and in patients with noncerebrovascular disease undergoing visual or motor functional mapping, it was 39.9 (3)± 27.0 cm(3) (range = 6.9-77.1 cm(3)). The mean artifact volume for ventriculoperitoneal shunts was 95.7 ± 39.3 cm(3) (range = 64.0-139.6 cm(3)). Artifacts had no-to-mild effects on clinical interpretability in all patients with intracranial implants. Extracranial hardware artifacts had no-to-moderate impact on clinical interpretability, with the exception of 1 patient with 12 KLS-Martin maxDrive screws with severe artifacts precluding clinical interpretation. All examined ventriculoperitoneal shunts resulted in moderate-to-severe artifacts, limiting clinical interpretation. CONCLUSIONS: Blood oxygenation level-dependent MR imaging yields interpretable functional maps in most patients beyond a small (30-40 cm(3)) artifact surrounding the hardware. Exceptions were ventriculoperitoneal shunts, particularly those with programmable valves and siphon gauges, and large numbers of KLS-Martin maxDrive screws.

Obstrução intestinal por Pythium insidiosum em um cão: relato de caso / Intestinal obstruction by Pythium insidiosum in a dog: case report

Relata-se um caso de pitiose intestinal em um Husky Siberiano, de um ano de idade, macho atendido em um Hospital Veterinário Escola com sinais de obstrução intestinal. Ao exame físico, notou-se massa cilíndrica na região abdominal cranial, posteriormente confirmada por meio de radiografia e ultrassonografia. Durante a laparotomia exploratória, constatou-se massa extraluminal envolvendo o jejuno e alterações na parede do órgão. Realizou-se a ressecção da porção afetada do intestino e, posteriormente, anastomose. O exame histológico do tecido evidenciou inflamação piogranulomatosa acentuada. Na coloração de prata metenamina de Grocott, hifas septadas foram observadas. O diagnóstico de infecção por Pythium insidiosum foi confirmado por meio da imunoistoquímica. Após a cirurgia, o animal restabeleceu a defecação; no 30º dia pós-cirúrgico, foi relatada ainda presença de diarreia. O tratamento com itraconazol e terbinafina foi instituído durante 60 dias. Após dois anos do procedimento cirúrgico e do tratamento com antifúngicos orais, o cão não apresentou recidiva.

A case of intestinal pythiosis in a one-year-old male Siberian Husky treated at a Veterinary School Hospital with signs of intestinal obstruction is reported. At physical examination, a cylindrical mass was palpable in the cranial abdomen, later confirmed by radiography and ultrasonography. During the exploratory laparotomy, it was evidenced an extraluminal mass involving the jejunum and alterations of the wall in the organ. After that, a resection of the affected portion of the intestine was made followed by anastomosis. The histologic examination evidenced accented pyogranulomatous inflammation. By the Grocott methenamine silver stain, branching hyphae were observed. The diagnosis of infection by Pythium insidiosum was confirmed by immunohistochemistry. The animal reestablished the defecation after the surgery; on the 30th postoperative day, it was also reported the presence of diarrhea. The treatment with itraconazol and terbinafina was instituted for 60 days. Two years after the surgical procedure and treatment with oral antifungals, the dog did not show recurrence.

Pelvic osteosarcoma ressection in a bitch: case report / Ressecção de osteossarcoma pélvico em cadela: relato de caso

An osteosarcoma involving the pelvis was diagnosed in a 9-year-old neutered Labrador bitch. The clinical signs manifested by the patient before surgical removal of the tumor included urinary difficulty, dyschezia, and inconstant non-weight-bearing on the hindlimbs. These signs were linked to the localization of the tumor, which was identified as a firm and painful mass of the size of an orange in the caudal abdomen. The favorable short term clinical results after surgery and carboplatin chemotherapy showed that the association of these approaches can be employed to manage discomfort inflicted by tumor and, therefore improve the quality of life of patient of bone cancer.

Diagnosticou-se um osteossarcoma pélvico em uma cadela da raça Labrador de nove anos. Os sinais clínicos manifestados pela paciente antes da remoção do tumor incluiam dificuldade urinária, disquezia e dificuldade de sustentação do trem posterior. Estes sinais estavam associados à localização do tumor, identificado como uma massa firme e dolorosa do tamanho de uma laranja à região caudal do abdômen. Os resultados clínicos favoráveis observados em curto prazo depois da instauração de tratamento cirúrgico e quimioterápico com carboplatina mostram que a associação dessas condutas pode ser empregada para diminuir o desconforto imposto pelo tumor e, portanto melhorar a qualidade de vida em pacientes com câncer ósseo.

Melanogenesis in dermal melanocytes of Japanese Silky chicken embryos.

The Japanese Silky chicken (SK) shows dermal and visceral hyperpigmentation. This study characterizes ultrastructurally the melanin granules developing in dermal melanocytes of the dorsal skin of SK, in an attempt to better understand the processes of melanogenesis in these permanently ectopic cells. The steps of melanogenesis are similar to those described for epidermal melanocytes, with melanosomes going from stage I to IV but, in SK, the maturation occurs in the cell body, as well as in the cytoplasmic processes. At stage III, the deposition of melanin is cumulative and can aggregate in rounded structures, which combine to turn into the mature granule. The final destiny of mature melanosomes is still unclear, although it was observed that dermal macrophages can accumulate melanin granules in their phagosomes. Even with the close proximity between melanocytes and other dermal cells, the transference of melanosomes was not observed. Our findings indicate that melanogenesis in dermal melanocytes in SK has the same morphological characteristics found in epidermal melanocytes, but the functional aspect still remains to be elucidated.

Evaluation of fixative solutions for ultrastructural analysis of brown spider Loxosceles intermedia (araneae: sicariidae) tissues

In view of the widely varying compositions of fixative solutions used for studying spiders, five different fixative formulas were tested for fixing male brown-spider (Loxosceles intermedia) gonad tissues. The brown spider represents a public health problem in Curitiba (Paraná State, Brazil). Morphological study of its gonads may aid in understanding the reproductive strategies of this species, and possibly in developing a reproduction control program. The fixatives tested contained glutaraldehyde alone or combined with paraformaldehyde, and the buffers cacodylate or phosphate, with or without the addition of sucrose or sodium chloride as osmolytes. Those containing 2.5 percent glutaraldehyde and 2 percent paraformaldehyde in 100 mM phosphate buffer with 200 mM sucrose, or in 200 mM sodium cacodylate, satisfactorily preserved mitochondria, the Golgi apparatus, and the membranes in general. These formulas were nearly isosmotic (439 mOsm/kg H2O and 455 mOsm/kg H2O respectively) to brown spider hemolymph (478 mOsm/kg H2O). With respective to the fixative agents, a glutaraldehyde-paraformaldehyde combination resulted in optimal fixation of Loxosceles intermedia cells. For other species of spiders, hemolymph osmolality should be considered, but the fixative formulas cited above would also probably yield good results.

Dada a variabilidade na composição de soluções fixadoras utilizadas em aranhas, cinco diferentes fixadores foram elaborados para a análise ultra-estrutural dos tecidos da aranha marrom Loxosceles intermedia. A aranha marrom representa um problema de saúde pública na cidade de Curitiba, e o estudo morfológico de suas gônadas pode auxiliar na compreensão de suas estratégias reprodutivas e, possivelmente, no desenvolvimento de um programa de controle da sua população. As fórmulas usadas continham glutaraldeído com ou sem paraformaldeído, tampão cacodilato ou fosfato, e NaCl ou sacarose como osmólitos. As soluções fixadoras compostas por 2.5 por cento glutaraldeído e 2 por cento paraformaldeído, em tampão fosfato com adição de sacarose ou em 200 mM cacodilato de sódio, preservaram bem estruturas como mitocôndrias, aparelho de Golgi e membranas em geral. Os tampões são praticamente isosmóticos (439 mOsm/kg H2O e 455 mOsm/kg H2O, respectivamente) à hemolinfa da aranha marrom (478 mOsm/kg H2O). Ainda, com relação aos agentes fixadores, a combinação do glutaraldeído e paraformaldeído levou a uma melhor preservação das células. Para outras espécies de aranhas, a osmolalidade da hemolinfa deve ser medida e considerada, mas as fórmulas acima citadas podem ser testadas, com chance de sucesso.

Evaluation of fixative solutions for ultrastructural analysis of brown spider Loxosceles intermedia (Araneae: Sicariidae) tissues.

In view of the widely varying compositions of fixative solutions used for studying spiders, five different fixative formulas were tested for fixing male brown-spider (Loxosceles intermedia) gonad tissues. The brown spider represents a public health problem in Curitiba (Paraná State, Brazil). Morphological study of its gonads may aid in understanding the reproductive strategies of this species, and possibly in developing a reproduction control program. The fixatives tested contained glutaraldehyde alone or combined with paraformaldehyde, and the buffers cacodylate or phosphate, with or without the addition of sucrose or sodium chloride as osmolytes. Those containing 2.5% glutaraldehyde and 2% paraformaldehyde in 100 mM phosphate buffer with 200 mM sucrose, or in 200 mM sodium cacodylate, satisfactorily preserved mitochondria, the Golgi apparatus, and the membranes in general. These formulas were nearly isosmotic (439 mOsm/kg H2O and 455 mOsm/kg H2O respectively) to brown spider hemolymph (478 mOsm/kg H2O). With respective to the fixative agents, a glutaraldehyde-paraformaldehyde combination resulted in optimal fixation of Loxosceles intermedia cells. For other species of spiders, hemolymph osmolality should be considered, but the fixative formulas cited above would also probably yield good results.

Clinical and pathological study of feline mammary fibroadenomatous change associated with depot medroxyprogesterone acetate therapy

Descrevem-se seis casos de alteração fibroadenomatosa mamária felina (AFAMF) associada à administração de uma única injeção de acetato de medroxiprogesterona (AMP) na dose recomendada pelos fabricantes. A doença foi observada em gatas jovens não-castradas atendidas em dois hospitais veterinários de 1999 a 2001. O diagnóstico de AFAMF foi feito com base no histórico, sinais clínicos e achados macroscópicos e confirmado histologicamente em quatro dos seis casos. Sugere-se que a ocorrência da AFAMF esteja associada ao efeito prolongado de uma única injeção de AMP de depósito administrada em situações nas quais o emprego dessa terapia não é recomendado.

Hyperpigmentation in the Silkie fowl correlates with abnormal migration of fate-restricted melanoblasts and loss of environmental barrier molecules.

In most homeothermic vertebrates, pigment cells are confined to the skin. Recent studies show that the fate-restricted melanoblast (pigment cell precursor) is the only neural crest lineage that can exploit the dorsolateral path between the ectoderm and somite into the dermis, thereby excluding neurons and glial cells from the skin. This does not explain why melanoblasts do not generally migrate ventrally into the region where neurons and glial cell derivatives of the neural crest differentiate, or why melanoblasts do not escape from the dorsolateral path once they have arrived at this destination. To answer these questions we have studied melanogenesis in the Silkie fowl, which is a naturally occurring chicken mutant in which pigment cells occupy most connective tissues, thereby giving them a dramatic blue-black cast. By using markers for neural crest cells (HNK-1) and melanoblasts (Smyth line serum), we have documented the development of the Silkie pigment pattern. The initial dispersal of melanoblasts is the same in the Silkie fowl as in Lightbrown Leghorn (LBL), White Leghorn (WLH), and quail embryos. However, by stage 22, when all ventral neural crest cell migration has ceased in the WLH, melanoblasts in the Silkie embryo continue to migrate between the neural tube and somites to occupy the sclerotome. This late ventral migration was confirmed by filling the lumen of the neural tube with DiI at stage 19 and observing the embryos at stage 26. No DiI-labeled cells were observed in the sclerotome of LBL embryos, whereas in the Silkie embryos DiI-filled cells were found as far ventral as the mesentery. In addition to this extensive ventral migration, we also observed considerable migration of melanoblasts from the distal end of the dorsolateral space into the somatic mesoderm (the future parietal peritoneum), and into the more medioventral regions where they accumulated around the dorsal aorta and the kidney. The ability of melanoblasts in the Silkie embryos to migrate ventrally along the neural tube and medially from the dorsolateral space is correlated with a lack of peanut agglutinin (PNA) -binding barrier tissues, which are present in the LBL embryo. The abnormal pattern of melanoblast migration in the Silkie embryo is further exaggerated by the fact that the melanoblasts continue to divide, as evidenced by BrdU incorporation (but the rate of incorporation is not greater than seen in the LBL). Results from heterospecific grafting studies and cell cultures of WLH and Silkie neural crest cells support the notion that the Silkie phenotype is brought about by an environmental difference rather than a neural crest-specific defect. We conclude that melanoblasts are normally constrained to migrate only in the dorsolateral path, and once in that path they generally do not escape it. We further conclude that the barriers that normally restrain melanoblast migration in the chicken are not present in the Silkie fowl. We are now actively investigating the nature of this barrier molecule to complete our understanding of melanoblast migration and patterning.

Specification and migration of melanoblasts at the vagal level and in hyperpigmented Silkie chickens.

The final pattern of neural crest derivatives used to be believed to be the result of unspecified neural crest cells haphazardly entering migratory paths and then receiving cues unique to that path that direct their differentiation. An alternative model, which we have coined the phenotype-directed model, is that neural crest cells are fate-specified first and then select a migratory pathway based on their developmental specification. Support for this model comes from recent studies demonstrating that, at the thoracic level, neural crest cells are specified as melanocyte precursors (melanoblasts) prior to entering the dorsolateral path, and that only melanoblasts have the ability to migrate dorsolaterally. Here we examine two examples of melanocyte patterning in birds that apparently contradict this model. The first is neural crest at the vagal level, where early crest cells migrate dorsolaterally and enter the branchial arches. Despite the fact that these cells migrate dorsolaterally (suggesting that they are melanoblasts), branchial arch-derived neural crest cells fail to differentiate as melanocytes in vitro. These observations suggest that the branchial arch environment may not support the survival or differentiation of melanogenic neural crest cells. The second example is the hyperpigmented Silkie chickens, which exhibit extensive internal pigmentation. The Silkie defect has been linked to a difference in the neural crest migratory environment that potentially causes (or allows) unspecified neural crest cells to undergo melanogenesis in the ventral path. In both of these situations, it appears that the final distribution of pigment cells is controlled by environmental factors, which would contradict the phenotype-directed model. Here we show that the final pattern of melanocytes at the vagal level and in Silkie chickens reflects the migratory behavior of lineage-specified melanoblasts, as predicted by the phenotype-directed model. At the vagal level, the early, dorsolaterally migrating crest cells that colonize the branchial arches are not melanoblasts and are biased against melanogenesis in vitro. Melanoblasts are not specified until later, just prior to a second wave of dorsolateral migration, and although these cells migrate dorsolaterally they do not invade the branchial arches. In Silkie embryos, melanoblasts are specified late and only invade the dorsolateral path after they have been specified. Unlike quail and White leghorn melanoblasts, however, Silkie melanoblasts also migrate ventrally, but again only after they are specified.

The delayed entry of thoracic neural crest cells into the dorsolateral path is a consequence of the late emigration of melanogenic neural crest cells from the neural tube.

Neural crest cells migrate along two pathways in the trunk: the ventral path, between the neural tube and somite, and the dorsolateral path, between the somite and overlying ectoderm. In avian embryos, ventral migration precedes dorsolateral migration by nearly 24 h, and the onset of dorsolateral migration coincides with the cessation of ventral migration. Neural crest cells in the ventral path differentiate predominantly as neurons and glial cells of the peripheral nervous system, whereas those in the dorsolateral path give rise to the melanocytes of the skin. Thus, early- and late-migrating neural crest cells exhibit unique morphogenetic behaviors and give rise to different subsets of neural crest derivatives. Here we present evidence that these differences reflect the appearance of specified melanocyte precursors, or melanoblasts, from late- but not early-migrating neural crest cells. We demonstrate that serum from Smyth line (SL) chickens specifically immunolabels melanocyte precursors, or melanoblasts. Using SL serum as a marker, we first detect melanoblasts immediately dorsal and lateral to the neural tube beginning at stage 18, which is prior to the onset of dorsolateral migration. At later stages every neural crest cell in the dorsolateral path is SL-positive, demonstrating that only melanoblasts migrate dorsolaterally. Thus, melanoblast specification precedes dorsolateral migration, and only melanoblasts migrate dorsolaterally at the thoracic level. Together with previous work (Erickson, C. A., and Goins, T. L., Development 121, 915-924, 1995), these data argue that specification as a melanoblast is a prerequisite for dorsolateral migration. This conclusion suggested that the delay in dorsolateral migration (relative to ventral migration) may reflect a delay in the emigration of melanogenic neural crest cells from the neural tube. Several experiments support this hypothesis. There are no melanoblasts in the ventral path, as revealed by the absence of SL-positive cells in the ventral path, and neural crest cells isolated from the ventral path do not give rise to melanocytes when explanted in culture, suggesting that early, ventrally migrating neural crest cells are limited in their ability to differentiate as melanocytes. Similarly, neural crest cells that emigrate from the neural tube in vitro during the first 6 h fail to give rise to any melanocytes or SL-positive melanoblasts, whereas neural crest cells that emigrate at progressively later times show a dramatic increase in melanogenesis under identical culture conditions. Thus, the timing of dorsolateral migration at the thoracic level is ultimately controlled by the late emigration of melanogenic neural crest cells from the neural tube.

Immunocytochemical identification of immature rat peritoneal mast cells using a monoclonal antibody specific for rat mast cells.

The lack of immunological or morphological markers makes identification of immature mast cells difficult. In the present study we have used a rat mast cell specific monoclonal antibody (mAb AA4) to immunolabel mast cells during repopulation of the peritoneal cavity. Peritoneal cells were collected six days after injection of distilled water and examined by light and electron microscopy. mAb AA4 stained immature mast cells in various stages of maturation including a population of very immature mast cells that could not be identified using conventional staining methods. These cells had virtually no cytoplasmic granules and peripherally located lobated nuclei. Thus, immunolabeling with mAb AA4 has revealed a population of very immature mast cells not previously reported during repopulation of the peritoneal cavity.

Microwave fixation improves antigenicity of glutaraldehyde-sensitive antigens while preserving ultrastructural detail.

Microwave fixation for electron microscopy has been used primarily for post-embedding immunocytochemistry. The present study examined the ability of microwave fixation to preserve the antigenicity of glutaraldehyde-sensitive antigens for pre-embedding immunocytochemistry. Five monoclonal antibodies (MAbs) directed against cell surface components of rat mast cells were tested. The MAbs failed to show any labeling of conventionally fixed rat bone marrow-derived mast cells even at glutaraldehyde concentrations as low as 0.1%. Strong staining of mast cell plasma membranes was seen when bone marrow was initially fixed with 2% formaldehyde and then refixed in 2% glutaraldehyde/2% formaldehyde after immunostaining. However, the ultrastructural preservation of the cells was poor. Antigenicity and morphological detail were both preserved when bone marrow was fixed in 0.05% glutaraldehyde/2% formaldehyde for 4 sec in a 550-W microwave oven. With this method, mast cells in various stages of maturation as well as cells that did not contain granules were immunoreactive. This method should prove useful with antigens from many different cell types that are sensitive to glutaraldehyde fixation.