Imagequest. A model self-assessment and self-teaching program for cytopathology.

OBJECTIVE: To develop a low-cost program for providing self-assessment and training for cytopathologists. STUDY DESIGN: Using an optical microscope with a color charge coupled device connected to a personal computer equipped with an ISA bus frame grabber, images were digitized. After the selection of proper images, they were attached to 100 questions with a single answer and five options each. For every question, references accompanied the answer. A colorful score and sounds were played while each question and its corresponding answer were on the screen in order to stimulate the learning process. RESULTS: A low-cost, attractive, effective program for providing self-assessment and training for cytopathologists was developed. CONCLUSION: The use of a high-level programming language permits the creation of a simple, assisted, programmable interface with accessibility for upgrades and customization for every pathologist. This feature permits the insertion of new questions, an essential feature to preserve the usefulness of the program for the future.

Comparison of conventional microscopy and digitized imaging for diagnosis in serous effusions.

OBJECTIVE: To compare diagnoses made from conventional microscopy and digitized imaging in preparation for teleconsultation cytopathology services that are affordable and efficient. STUDY DESIGN: One hundred six consecutive serous effusions received in the cytopathology laboratory of a general hospital in Porto Alegre, RS, Brazil, were studied. The diagnoses by the senior cytopathologist at the conventional microscope were considered the standard and identified 61 cases negative and 45 positive for malignant cells (40 epithelial and 5 nonepithelial). The same pathologist digitized 461 selected fields for analysis by a second experienced cytopathologist (observer A) and a senior cytotechnologist (observer B) without knowledge of the standard diagnoses. Ten cases were studied in daily sessions of one hour each. The diagnoses were negative for malignant cells, positive for malignant cells (epithelial) and positive for malignant cells (nonepithelial). RESULTS: The following kappa values were found: 0.91 (observer A and observer B versus standard) and 0.86 (observer A versus observer B). CONCLUSION: Remote digitized imaging diagnosis in serous effusions is possible and has a high degree of concordance with diagnosis by conventional microscopy. Similar studies involving a larger group of cytopathologists and cytotechnologists should be done to identify interobserver variability.

Evaluation of drugs against Onchocerca microfiliariae in an inbred mouse model.

The model of Onchocerca lienalis microfilariae (mf) injected into CBA mice has been examined for its application to chemotherapy studies in onchocerciasis. Parasite recoveries following treatment relative to the levels obtained from controls were not significantly affected by suramin, whereas they were reduced by up to 56% with amoscanate, 71% with levamisole, 82% with mebendazole, 82% with diethylcarbamazine (DEC) and 100% with ivermectin. More detailed evaluation of the latter two compounds demonstrated that far greater intrinsic microfilaricidal activity was possessed by ivermectin compared with DEC. Single doses of ivermectin down to 0.2 mg/kg destroyed 83% of the mf within 12 hours and 100% within 5 days. The same dose administered at various times prior to mf injection reduced parasite recoveries by 92% after four days and by 35-40% for up to one month. In contrast, DEC was only effective at doses of 5 X 50 mg/kg or higher, reducing mf levels by an equivalent amount following subcutaneous or intraperitoneal routes of administration. However, it was of limited efficacy when given to mice during the first week after mf injection compared with the third week, when parasite levels in untreated rodents start to decline under a host immune response. DEC treatment during the third week after mf injection resulted in a smaller depression in parasite recoveries from T-cell deprived mice compared with intact animals, but in similar levels of reduction in CBA/H (normal) and CBA/N (B-cell deficient) mice. Depletion of C3 complement levels in mice with cobra venom factor had a negligible effect on drug efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)

[Onchocerca raillieti n.sp. (Filarioidea) from a domestic donkey in Africa]. / Onchocerca raillieti n.sp. (Filarioidea) chez l'Ane domestique en Afrique

Onchocerca raillieti sp. n. (Filarioidea), from the domestic donkey (Equus asinus) in Africa, is described. The species is compared to O. bohmi (Supperer, 1953) n.comb, O. reticulata Diesing, 1841, O. cervicalis Railliet et Henry, 1910, O. flexuosa (Wedl, 1856) and O. armillata Railliet et Henry, 1909 and can be differentiated by numerous characters of which the most important are the anterior region of the female (which is straight and slender, 6 to 8 cm long, and bears longitudinal striae) and the 10 symmetrically arranged pairs of caudal papillae. O. raillieti seems to be a primitive species by several characters (caudal papillae, cervical papillae, oesophagus, vulva and cuticle.)

Apgar score and blood coagulation factors.

Blood coagulation tests were performed in 93 newborn infants with different Apgar score at the 1st and 5th minutes of life. The laboratorial determinations were periodically performed at 0, 24 and 48 hours of life. The following tests were performed: bleeding time, whole blood clotting time, prothrombin time, kaolin-cephalin clotting time, thrombin time, dosage of factors I, V, VIII and X, clot retraction, platelet count, englobulin lysis time and the tourniquet test. Immediately after birth, the mean values of the blood coagulation factors were significantly different among the groups, with the exception of the whole blood clotting time and the platelet count. Those differences were due to the presence of the more depressed neonates. Although these results could indicate some degree of hepatic damage, it was apparent that an activation of the blood coagulation mechanisms took place, leading to a consumption coagulopathy. The infants who died (10) presented clinical and laboratorial data suggestive of disseminated intravascular coagulation (DIC). Necroscopic findings of microthrombosis in the liver and in the central nervous system were diagnosed in two infants.

Ackertia globulosa sp. n. (Nematoda: Filarioidea) from rodents in Kenya.

Ackertia globulosa sp. n. (Nematoda: Filarioidea) is described from the pulmonary arteries of the striped mouse, Lemniscomys striatus striatus (L.), in Kenya. Distinguishing features are the small size of the adults; the short left spicule and arrangement of the caudal papillae (3 pairs preanal, 4 pairs postanal) of the male; small projecting lobes on the tail of the females; and 10 to 12 refractile globules in the microfilarial sheath. The microfilariae are found in the skin, mostly of the ear. The probable intermediate host is a hard tick, Haemaphysalis leachi.

Studies on Spirometra theileri (Baer, 1925) n. comb. 2. Pathology of experimental plerocercoid infections.

The pathology associated with the early migratory phase of infection by the sparganum larvae of Spirometra theileri (Baer, 1925) Opuni and Muller, 1974 (Pseudophyllidea:Diphyllobothriidae), has been investigated in TO strain mice and in rhesus monkeys (Macaca mulatta). All infected mice developed haemorrhagic skin lesions and oedema of the joints and often ascites and peritonitis 3-6 weeks after infection. There was a 25% mortality in mice given plerocercoids orally, 37.5% in those injected with procercoids intraperitoneally. From eight weeks after infection larvae in both mice and monkeys were at various stages of encapsulation. One monkey which died three weeks after oral infection with 100 procercoids had developed ascites, haemorrhagic lesions and an acute peritonitis; infarcts were observed in the liver, lungs and spleen. In plerocercoid infections, scolices migrated directly through the duodenal wall within 45 minutes of oral infection in mice and 2 hours in monkeys, causing a minimum of damage apart from small haemorrhagic patches at the sites of penetration. In monkeys an eosinopoenia occurred 7 days after infection (a mean drop from 300 to 150 cells per cu mm), followed by a sudden rise (maximum of 1450 cells per cu mm) lasting from the 3rd to the 7th week. The histopathology and immunopathology associated with the various phases of infection were investigated in both mice and monkeys.