Embryonal Rhabdomyosarcoma of the Oesophagus in a Young Dog.

A 15-month-old great Dane dog, showing clinical signs related to hypertrophic osteopathy, was diagnosed radiographically with a mass in the region of the thoracic oesophagus. Exploratory thoracotomy revealed an extensive, highly vascularized and locally invasive oesophageal mass and the presence of nodules in adjacent lung lobes. The dog was humanely destroyed intra-operatively. Histological examination revealed that the mass was an embryonal rhabdomyosarcoma. This is the first report of rhabdomyosarcoma of the oesophagus of a dog. Rhabdomyosarcoma should be considered a differential diagnosis when a mass adjacent to the oesophagus is diagnosed.

Computed tomographic features of lesions detected in horses with tarsal lameness.

REASONS FOR PERFORMING STUDY: Tarsal pain is a common cause of hindlimb lameness in horses. Diagnosis can usually be made with radiography and ultrasonography; however, in some cases, these techniques are inconclusive and additional imaging is necessary. No studies describing computed tomography (CT) features of different tarsal lesions in horses with tarsal lameness are reported. OBJECTIVES: Our aims were as follows: 1) to characterise CT abnormalities in horses with tarsal lameness; 2) to compare CT findings with those from other imaging techniques; and 3) to assess whether CT can help to diagnose tarsal pathology. STUDY DESIGN: Retrospective case series. METHODS: Computed tomography of the tarsus was performed on 15 horses (n = 17 joints) with tarsal lameness. The horses were divided into 3 groups depending on the reason for CT examination, as follows: 1) other imaging techniques were inconclusive; 2) evaluation of a fracture; or 3) other imaging techniques showed tarsal lesions, and CT was performed to assess whether additional lesions were present. RESULTS: Group 1 included 7 horses. Lesions detected with CT included subchondral cyst-like lesions (2 horses); an osteolytic lesion in the cochlea tibiae (one horse); degenerative changes of the distal tarsal joints (2 horses); osteolytic lesions tarsometatarsal joint (one horse); and sclerosis of the third tarsal bone with a lesion of the tarsometatarsal interosseous ligament (one horse). In this group, CT provided information on the character and extent of the lesion that was not available with other imaging techniques. Computed tomography revealed more information about the extent and complexity of the fracture than radiography in Group 2, whereas CT did not provide extra information in Group 3. CONCLUSIONS: Focal lesions located between the tarsal bone surfaces are difficult or even impossible to detect with radiography and ultrasonography, but they can be detected and characterised with CT. POTENTIAL RELEVANCE: Computed tomography of the tarsus should be considered when radiography and ultrasonography are inconclusive, or for further evaluation of tarsal fractures.

Early recognition of malignant lactic acidosis in clinical practice: report on 6 patients with haematological malignancies.

BACKGROUND: Malignant lactic acidosis is a potentially overlooked but life-threatening complication in patients with haematological malignancies. The aim of this study is to describe the features of six patients with malignant lactic acidosis and to discuss how its initial presentation can be differentiated from that of severe sepsis. METHODS: We prospectively collected data of all consecutive patients with haematological malignancies, admitted to the Ghent University Hospital Intensive Care Unit (ICU) between 2000 and 2007. RESULTS: Of 372 patients with haematological malignancies admitted to the ICU for life- threatening complications, 58 presented with lactic acid levels > or = 5 mmol/L. Six were diagnosed with malignant lactic acidosis. All patients with malignant lactic acidosis had high-grade lymphoblastic malignancies and were referred with a tentative diagnosis of severe sepsis or septic shock; lactic acid levels exceeded 9.45 mmol/L and lactate dehydrogenase (LDH) levels were at least 1785 U/L. Two patients had hypoglycaemia. All had a pronounced polypnea. In all patients hepatic malignant involvement was suspected. Two of the six patients survived their episode thanks to the early recognition of malignant lactic acidosis and the prompt administration of chemotherapy. One patient was still alive 6 months after initiating chemotherapy. CONCLUSION: Malignant lactic acidosis is a rare and often rapidly fatal metabolic complication if not promptly recognized and treated. An elevated lactic acid concentration, in disproportion with the level of tissue hypoxia, together with high serum LDH are cornerstones in the diagnosis. In contrast to septic shock patients, pronounced polypnea (Kussmaul's breathing pattern) rather than the haemodynamic instability is prominent.

Morphology of distal border synovial invaginations of the equine distal sesamoid bone: comparison between computed tomography and a hoof-specific radiographic projection.

OBJECTIVES: To compare the difference and agreement of the morphology of distal border synovial invaginations on a dorsoproximal-palmarodistal oblique (DPr-PaDiO) projection with hoof-specific angle versus computed tomography. METHODS: Computed tomography (CT) images and a DPr-PaDiO radiographic projection with hoof-specific angle were obtained on 50 cadaveric forefeet from 25 Warmblood horses. Computed tomography was assumed to be the gold standard. The number, shape and depth of penetration of distal border synovial invaginations into the distal sesamoid bone were evaluated with both methods, and the comparison of their measurements was statistically described. RESULTS: Significantly more invaginations were seen on CT compared to radiography, with an observed average difference of 1.2. In none of the cases did radiography have a higher number than that observed with CT. No statistically significant difference for depth between CT and the DPr-PaDiO projection was seen, however, there was quite a large variation of the actual difference of measurements against their mean found. Radiography was underestimated when high mean values applied. The agreement between both modalities for shape was moderate to good. A very high specificity of the specific DPr-PaDiO projection for shape was found (97%). CLINICAL SIGNIFICANCE: The radiographic projection with hoof-specific angle differs significantly from CT concerning the number and depth of the distal border synovial invaginations. Therefore, this specific view may not be considered useful in the evaluation of these invaginations.

Differences in the morphology of distal border synovial invaginations of the distal sesamoid bone in the horse as evaluated by computed tomography compared with radiography.

REASONS FOR PERFORMING STUDY: Distal border synovial invaginations of the distal sesamoid bone are radiographically assessed during the selection process of horses admitted as breeding stallions or in purchase examinations. Nowadays, many moderately or some deeply penetrating proximally enlarged synovial invaginations are considered as moderate or severe radiographic findings. OBJECTIVE: To measure the difference between and agreement of the morphology of distal border synovial invaginations on radiography vs. computed tomography (CT). It was hypothesised that the morphology of distal border synovial invaginations would be better evaluable on CT compared with radiography. METHODS: Computed tomography scans and 3 dorsoproximal-palmarodistal oblique (DPr-PaDiO) radiographs were obtained on 50 cadaver forefeet from 25 Warmblood horses. Computed tomography was assumed to be the gold standard. The number, shape and depth of penetration of distal border synovial invaginations into the distal sesamoid bone were evaluated with both methods, and the comparison of their measurements was statistically described. RESULTS: A statistically significant mean difference for number of distal synovial invaginations between CT and all 3 DPr-PaDiO projections was found and was approximately equal to 2, meaning that CT permits visualisation of an average of 2 more invaginations than radiography. In none of the cases did radiography have a higher number observed than CT. A large variation in the difference of measurements for depth of penetration against their mean difference between CT and the 3 radiographic projections was seen. Radiography underestimated the depth of invaginations, and more so when these were deeper. There was no statistically significant mean difference found between the techniques for depth. A moderate to good agreement between measurements on CT and the three DPr-PaDiO projections for shape was seen, in which the D55°Pr-PaDiO projection showed the best agreement. A high specificity (90-99%) and low sensitivity (65%) for all projections for shape were found. CONCLUSIONS AND POTENTIAL RELEVANCE: Radiography differs considerably from CT concerning the morphology of distal navicular border synovial invaginations. For the evaluation of the number, depth and shape of distal synovial invaginations in the distal sesamoid bone, radiography shows only partially the morphology seen on CT.

Ultrasonographic appearance of bony abnormalities at the dorsal aspect of the fetlock joint in geriatric cadaver horses.

This article describes the ultrasonographic (US) appearance of bony abnormalities on the dorsal aspect of the third metacarpal/metatarsal bone of the equine fetlock in cadavers with radiographic signs of osteoarthrosis. After US, computed tomography was undertaken to better characterise the lesions. Twelve fetlock joints were collected and all had more than one bone abnormality on US. Normal subchondral bone appeared on US as a well-defined and regular hyperechoic line with distal acoustic shadowing. Bone abnormalities detected on US included (1) gaps in the proximal subchondral bone filled with material of heterogeneous echogenicity, (2) bone fragments represented as small straight smoothly delineated hyperechoic lines with distal shadowing located superficial to the surface of the adjacent bone, (3) proximal new bone formation visible as mild to severe cortical protrusions, (4) marginal osteophytoses seen as an elevation of the hyperechoic surface of the subchondral bone at the edges of the joint surfaces, (5) indentations in subchondral bone seen as a concave deviation of the hyperechoic line without interruption, (6) focal or diffuse irregularities of the subchondral bone seen as disruptions of the normal smooth bony contours, and (7) focal hyperechoic spikes originating from the subchondral plate and invading the articular cartilage. These findings are discussed.

Computed tomographic morphology of the synovial invaginations of the distal sesamoid bone of the horse.

The morphological features of the distal border synovial invaginations (SI) of the distal sesamoid bone (DSB) in horses were described by the use of computed tomography (CT). Transverse CT images were obtained on 50 cadaver forefeet from 25 Warmblood horses. Dorsal and sagittal planes were reformatted. The CT images allowed the evaluation of the number, shape, depth of penetration and direction of the SI into the bone. The total number of SI was 295 (mean 5.9). The number of invaginations in a particular DSB ranged from 3 (n = 3), 4 (n = 6), 5 (n = 11), 6 (n = 12), 7 (n = 13), 8 (n = 3), 9 (n = 1) to 11 (n = 1). The shape of the SI was 'conical' (n = 118), 'linear' (n = 109), 'lollipop' (n = 38) or 'branched' (n = 30). Penetration of the SI into the DSB was 'mild' in 195 cases, 'moderate' in 67 cases and 'deep' in 33 cases. The SI ran in a 'straight', 'dorsoproximal' and 'palmaroproximal' direction in 187, 28 and 80 cases, respectively. In only six DSBs, all SI ran in the same direction. The images obtained in this study may serve as reference for the radiographic evaluation of these SI.

[Illicit drugs, medications and traffic accidents]. / Drogues, médicaments et accidentologie.

The European Union (EU) has 25 member-states and 455 million inhabitants. Statistics on traffic accidents in the EU show that more than 45,000 people are killed annually, including 5200 in France. At the same time, nearly two million persons in the EU require medical treatment for traffic-accident-related injuries, including 109,000 in France. In addition, traffic accidents are the major cause of death of those individuals aged 15 to 24 years. One third of the EU inhabitants will be hospitalized during their life due to a traffic accident with a cost over 160 billion euro (2-3% of the Gross Domestic Product). An important contributing factor to crashes is the use of alcohol and/or illicit drugs or medication when driving, as they exert negative effects on cognition and psychomotor functions. For illicit drugs, abuse of cannabis with or without alcohol is a major concern for the EU. In fact, three million Europeans use cannabis daily and 80% of them drive after use. A number of French studies since 1999 have underlined the high prevalence of cannabis found in the blood of injured or killed drivers. From medical or judicial observations, it is clear that cannabis use increases the risk of traffic accidents. Many groups outside Europe have also shown the association between drug abuse and crashes. The number of casualties related to certain medicines, especially benzodiazepines remains at a high level, particularly in the elderly. In many countries the prevalence of medicinal drugs associated with car accidents is higher than with cannabis. Annex III of the European Union Council Directive of July the 29th 1991 in fact states that a driving license should not be issued to or renewed for applicants or drivers who are dependent on psychotropic substances or use them regularly. Recently, France has categorized the medicinal drugs available in the country by using three pictograms: level one yellow, "be careful"; level two orange, "be very careful"; level three red, "don't drive". It is an important campaign that increases awareness among the public and the medical professionals about the potential dangerous effects of medicinal drugs when driving. The EU objective of reducing the number of fatalities to 25,000 by 2010 will require strengthening measures against the use of alcohol, illicit and medicinal drugs by not well-informed drivers. It is not only a really great challenge, but also a significant investment towards improving public health in France as well as in Europe.

[Cannabis and driving: the situation in Europe]. / Cannabis et conduite automobile: la situation en Europe.

In Europe, three million people consume cannabis every day. Investigations showed that more than two thirds of drug users drive after having smoked cannabis. Epidemiological studies show that between 0.5% and 8.2% of the general driving population is positive for cannabis. For drivers wounded or deceased as a result of an accident, the percentage varies respectively from 3.3% to 10% and from 2.2% to 8.4%. Finally, very high percentages are found in the studies which analysed the presence of drugs in drivers suspected of driving under the influence of drugs: more than 50% in Austria, Belgium, Germany, Switzerland and the United Kingdom. Six European countries adopted an analytical or 'per se' legislation and the cut-offs vary between 0.3 and 2 ng/mL THC. In the Netherlands, experimental studies carried out after administration of cannabis clearly showed the impairing effects, in particular in the event of simultaneous consumption of cannabis and alcohol. Various research projects financed by the European Union studied the epidemiologic aspects (IMMORTAL), detection by psychotechnical tests (CERTIFIED) and roadside drug detection (ROSITA and ROSITA-2).

ACE inhibitor captopril reduces ecdysteroids and oviposition in moths.

By using the selective ACE inhibitor captopril, we studied the effect of the angiotensin converting enzyme (ACE) on larval growth, metamorphosis, and reproduction in a lepidopteran species, the cotton leafworm, Spodoptera littoralis. Captopril was detrimental to adult formation and oviposition, and in female moths it elicited decreasing ecdysteroid levels, but increasing trypsin activities. Our results suggest that captopril downregulates oviposition by two independent pathways. Apparently, oviposition is influenced by a complex interaction of ACE, trypsin activity, and ecdysteroid levels.

The angiotensin converting enzyme inhibitor captopril reduces oviposition and ecdysteroid levels in Lepidoptera.

The role of angiotensin converting enzyme (ACE, peptidyl dipeptidase A) in metamorphic- and reproductive-related events in the Egyptian cotton leafworm, Spodoptera littoralis (Lepidoptera, Noctuidae) was studied by using the selective ACE inhibitor captopril. Although oral administration of captopril had no effect on larval growth, topical administration to new pupae resulted in a large decrease of successful adult formation. Oviposition and overall appearance of adults emerging from treated larvae did not differ significantly from those emerging from non-treated larvae. In contrast, topical or oral administration of captopril to newly emerged adults caused a reduction in oviposition. By evaluating the effect of captopril on ecdysteroid titers and trypsin activity, we revealed an additional physiological role for ACE. Captopril exerted an inhibitory effect on ecdysteroid levels in female but not in male adults. Larvae fed a diet containing captopril exhibited increased trypsin activity. A similar captopril-induced increase in trypsin activity was observed in female adults. In male adults, however, captopril elicited reduced levels of trypsin activity. Our results suggest that captopril downregulates oviposition by two independent pathways, one through ecdysteroid biosynthesis regulation, and the other through regulation of trypsin activity. Apparently, fecundity is influenced by a complex interaction of ACE, trypsin activity, and ecdysteroid levels.