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Post-mortem examination was carried out on a 2-week old male Friesian crossbred calf to determine the cause of death. The body condition of the calf was fair with pale mucous membranes. There was petechial to ecchymotic epicardial haemorrhages with mild hydroperitoneum and hepatomegaly. The enlarged rumen contained a large amount of white offensive rancidsmelling curdled milk mixed with watery content while the abomasum contained some sand sediment. A diagnosis of acute ruminal drinking was made based on the calf's age, reportedly feeding entirely on milk ration, and the presence of a large amount of curdled milk in the rumen. Early diagnosis and the treatment of underlying pathological conditions, correction of predisposing management practices, and rumenostomy are some of the ante-mortem ways to combat and improve the prognosis of the condition in affected calves. Keywords: Ruminal drinking; Friesian calf; Post mortem; Diagnosis

Se remite un caballo (Equus caballus), sexo macho, de raza Pinto y 8 años de edad. Con historia de balanopostitis nodular exudativa crónica complicada con infección bacteriana secundaria data de 4 años. Emaciación crónica severa. Oliguria, estranguria y polidipsia. Linfadenomegalia de nódulos linfáticos inguinales y femurales preescapulares. Se le practicó eutanasia. Posteriormente se le prácticó necropsia por las técnicas sistemáticas descritas para equinos. Se tomaron secciones de tejido para estudio histopatológico y fueron procesadas por los métodos convencionales de procesamiento histológico. Fueron tomadas muestras de heces para estudios parasitológicos. El examen macroscópico reveló emaciación crónica severa. Balanopostitis exudativa crónica severa con infección bacteriana secundaria. Se evidencio hidroperitoneo marcado. Linfadenomegalia de nódulos mesentéricos. Los cortes histológicos evidenciaron: Balanopostitis crónica severa, con focos de proliferación de células escamosas espinocelulares con abundante acantosis, pleomorfismo, hipercromasia nuclear, anaplasia, figuras mitóticas típicas y atípicas constantes, presencia de perlas corneas abundantes. En algunas zonas se observaron granulomas con formas parasitarias tipo Habronema. Los resultados del estudio coprológico fueron consistentes con huevos de Habronema muscae. En conclusión: la historia clínica, los hallazgos macroscópicos e histológicos evidencian un síndrome de balanopostitis crónica y carcinoma epidermoide metastásico.

Background: A Rottweiler male dog carcass (7 years) with clinical history of inappetence, pyrexia, diarrhoea and nasal discharge was received in the post mortem hall of the Department of Veterinary Pathology, LUVAS, Hisar, Haryana. The current work was aimed to study the clinical history, pathological and parasitological examination in the Rottweiler male dog carcass. Methods: After collection of the samples, laboratory work was undertaken in the laboratories of Department of Veterinary Pathology and Veterinary Parasitology, LUVAS, Hisar, Haryana (India) in the year 2018-2019 regarding the examination of the clinical history, pathological and parasitological investigation.Result: Necropsy revealed anaemic mucous membranes; pale conjunctiva; hydrothorax; hydroperitoneum; lungs and heart were congested, blackish discolouration of liver; fully distended gall bladder; congested along with thickened intestinal mucosa; intestinal lumen contained white nematode as well as long creamy cestodes identified as Toxocara canis and Dipylidium caninum, respectively. Histopathologically, intestine revealed presence of severe fibrino-necrotic enteritis characterized by infiltration of mono nuclear cells, degeneration and desquamation of microvilli, congested blood vessels and haemorrhages. Spleen revealed acute splenitis with presence of severe hemorrhages along with neutrophilic infiltration. Liver revealed areas of necrotic hepatitis. The case was confirmed as parasitic fibino-necrotic enteritis due to mixed infection by Toxocara canis and Dipylidium caninum.

Background : Pulmonary hypoplasia is characterized by incomplete development of the lungs, owing to congenital defectsor the action of toxic substances. Moreover, it has rarely been described in pigs. Ascites or hydroperitoneum is characterized by the presence of fluid inside the abdominal cavity and does not generally cause changes in the abdominal organs. However, hydrothorax, characterized by the presence of fluid within the thoracic cavity, is responsible for the compression of thoracic organs and consequent heart and respiratory failure. This study aims to describe a case of congenital pulmonary hypoplasia associated with ascites and hydrothorax in a newborn pig. Case : A male neonate Landrace pig that died shortly after delivery was presented for necropsy with increased abdominal volume and bilateral extension of the pelvic limbs. The pig belonged to a litter of 13 piglets, four of which died shortly after birth. The rest of the piglets were poorly developed, but only one was presented for necropsy. Significant external changes, along with permanent distension, interpreted as arthrogriposis, were observed in the pelvic limbs. The skin of the ventral abdominal region was thin, with evidence of all blood vessels, interpreted as telangectasis. An internal examination revealed the presence of a slightly yellowish liquid in the thoracic and abdominal cavities, interpreted as hydrothorax and ascites, respectively. The lungs were reduced in size, indicating pulmonary hypoplasia. The liver had rounded edges, which were dark red and firm, with an irregular surface. Significant microscopic findings were observed in the lungs, which were divided by fibrous connective tissue and showed evidence of small and atrophied alveoli. Furthermore, connective tissue was observed around the peribronchiolar regions and underdeveloped cartilage around the airways. The liver showed dilation of the centrilobular veins. Moreover, the sinusoids were filled with erythrocytes, indicating congestion. Discussion : Pulmonary hypoplasia is a rare birth defect in pigs and can be accompanied by malformations of other organs, including anasarca. Pulmonary hypoplasia is caused by conditions that compress the lungs, such as congenital diaphragmatic hernia, intrathoracic masses, and pleural effusion or malformations in the chest cavity. However, none of these conditions were observed in the current case. Instead, the histopathological changes observed in the lungs were characteristic of pulmonary hypoplasia. A microscopic examination revealed that the hypoplastic lungs showed a reduced number of alveoli, replacement of the peribronchiolar smooth muscle by the connective tissue, and underdeveloped cartilage around the airways, all of which are characteristic of pulmonary hypoplasia. Vascular telangiectasia is characterized by abdominal distention due to a marked ascitic condition. Invariably, ascitic fluid accumulation results from changes in hydrodynamic parameters. The hydrothorax observed in this animal was suggestive of changes in the hydrodynamic parameters, which consequently led to fluid accumulation in the chest cavity. This has been previously described in a newborn pig infected with Clostridium difficile . The permanently and bilaterally extended pelvic joints observed at birth in this animal were interpreted as arthrogriposis. This change is attributed to various factors, such as fetal paralysis in pigs that ingest toxic substances like alkaloids present in Conium maculatum and in the stalks of Nicotiana tabacum and Datura stramunium . The literature describes pelvic limb paralysis in Landrace pigs as a genetically inherited disorder. However, it was not possible for us to establish the cause of arthrogriposis for certain in this pig.

A 48-hour-old mixed breed pony colt was referred to the hospital because of abdominal discomfort, weak suckling reflex and prostration. During clinical investigation, supportive and symptomatic treatments were necessary, and an abdominal radiography was performed revealing a large intestine filled with feces and large amounts of gas, in addition to free fluid in the cavity. After 3 days of treatment, the foal had not yet defecated, thus exploratory abdominal surgery was indicated, but the owners declined. Therefore, the foal was humanly euthanized. Post-mortem examination revealed complete absence of the pelvic flexure. Subsequent portions of the dorsal, transverse and small colons were intensely reduced. In addition, at the abdominal cavity there was 850 ml of yellowish translucent liquid. These findings are compatible with hydroperitoneum and type III atresia coli at the pelvic flexure, associated with underdevelopment of the dorsal, transverse and small colons.

Aim. Evaluation of clinico-laboratorial and sonographic signs of adnexal torsion. Materials and methods. Follow-up of the patient in the Perinatal Center of the Regional Clinical Hospital No. 2; ultrasound performed on Medison and Voluson E6; laparoscopy performed with the use of endoscopic devices KARL STORZ. Results. Left adnexal torsion was seen on ultrasound while the patient with a gestation period of 7-8 weeks was in the hospital. The main sonographic criteria for dynamic examination were: ovarian displacement and enlargement, changes in its echostructure, paraovarian cyst adherent to it, lack of blood flow in the ovary, and increasing hydroperitoneum. The 192 diagnosis was verified with laparoscopy and histological examination. Laparoscopic adnexectomy was performed. The postoperative period was unremarkable. Pregnancy progresses without complications. Conclusion . In the absence of convincing clinico-laboratorial, instrumental data indicative of adnexal torsion and an absolute indication for laparoscopy, ultrasound is necessary in dynamics. The above signs make possible to diagnose the adnexal torsion. Laparoscopy carried out in early pregnancy does not cause any complications in carrying of a pregnancy now.

Background: Recently endoscopic combined intrarenal surgery (ECIRS) has been introduced as an innovative approach for the treatment of complex single, multiple, and staghorn urolithiasis, which reveals to be a viable alternative to standard percutaneous nephrolithotomy. Although considered to be a versatile, safe, and efficient endoscopic procedure, it is not free from complications. We would like to report two rare cases of hydroperitoneum that occurred during ECIRS and their management. Case Presentation: Two female patients, respectively, of 75 and 41 years of age, underwent ECIRS procedure for the treatment of complex staghorn kidney urolithiasis, previously evaluated by noncontrast computed tomography (CT) scan. A combined retrograde-percutaneous access to the intrarenal collecting system, under fluoroscopic and ultrasound guidance with the additional assistance of Endovision technique, was performed. At the end of the procedures, both patients revealed a taut and globous abdomen, and a perioperative CT and ultrasonography revealed the presence of intraperitoneal liquid. Both patients were effectively treated with immediate positioning of abdominal drain with rapid improvement of the clinical presentation. Conclusion: To our knowledge these are the first two cases of hydroperitoneum occurring during ECIRS and reported in the literature. An early detection of the complication and its prompt treatment revealed to be crucial to effectively prevent morbidity.

The paper considers the types of chronic herpesvirus infection in children, which involves several serous membranes (polyserositis). It discusses possible pathogenetic mechanisms for the development of such manifestations of the disease.

Resumen La monensina es un antibiótico del grupo de los ionóforos utilizado como coccidiostático y promotor de crecimiento en los animales domésticos. El objetivo del presente trabajo es describir tres focos de intoxicación por monensina en ovinos ocurridos en los años 2015 y 2016. Todos los focos ocurrieron en predios ovejeros-ganaderos de la región Este de Uruguay. Los principales síntomas clínicos fueron anorexia, rigidez, paresia del tren posterior, y finalmente decúbito costal. A la necropsia los principales hallazgos fueron edema subcutáneo generalizado, hidrotórax, hidroperitoneo e hidropericardio, y en un caso la orina tenía una coloración rojiza. Las masas musculares del tren posterior estaban pálidas y edematosas en todos los casos, mientras que se observó palidez en el músculo cardíaco en un caso. Las principales lesiones histológicas fueron degeneración y necrosis de músculo esquelético y cardíaco. Se concluye que la intoxicación por monensina en ovinos ocurre por la utilización de raciones o sales formuladas para bovinos y por errores en las plantas elaboradoras de raciones comerciales. Summary Monensin is an antibiotic widely used in domestic animals. The aim of this paper is to describe three monensin poisoning outbreaks in sheep, occurred in 2015 and 2016, in the eastern region of Uruguay. The main clinical symptoms were anorexia, rigidity, hindlimb paresis, and finally lying sack. At necropsy the main findings were generalized subcutaneous edema, hydrothorax, hydroperitoneum and hydropericardium. In one case the urine had a reddish color. The hindlimb muscle masses showed pallor in all cases, while paleness in the heart muscle was observed in one case. The main histological lesions were degeneration and necrosis of skeletal and cardiac muscle. It is concluded that monensin poisoning in sheep occurs by the use of rations or salts formulated for cattle and by errors in commercial ration processing plants.

Obstructive urolithiasis is the retention of urine subsequent to the lodgement of calculi in the urinary tract from the kidney up to the urethral orifice. This report describes the post-mortem and chemical analysis findings of the calculi in an 18-month old Ouda-Yankasa cross ram presented at the Large Animal Clinic of the Veterinary Teaching Hospital, Usmanu Danfodiyo University, Sokoto. The patient was presented on 20th of March, 2013 with reports of anorexia, disinclination to drink water and anuria that developed four days before presentation at the clinic. On clinical examination, urethral blockage and mild ascites were observed. Cystocentesis was performed to relieve the patient and plain radiograph taken but was not diagnostic. The patient died before definitive diagnosis was made for rational treatment. The post - mortem findings include frothy exudate in the trachea and bronchial airways, congestion of the lungs, hydroperitoneum with recovered fluid measuring 2,350 ml, splenomegaly, hydronephrosis, distended urinary bladder, severe haemorrhagic cystitis, urinary calculi in the bladder and throughout the urethral length and urethral stricture. The urinary calculi recovered were white, friable and amorphous, ranging from small particles to 5mm in diameter. Histopathologic section of the kidney showed atrophied glomeruli. It can thus be concluded that the atrophied glomeruli in turn impaired glomerular filtration which invariably pre-disposed the patient to uraemia leading to its death. The chemical analysis of the calculi showed that the calculi was either oxalate, phosphate or silicate, or any of these mixtures. Keywords: calculi, obstruction, phosphate, uraemia

One of the main challenges in transluminal surgery is sterile and safe access. For many interventions, a transanal approach would be ideal but it is considered too risky because of contamination and the danger of secondary leakage. A new safe and sterile transanal access was developed, combining four basic principles: (i) the creation of a decontaminating hydroperitoneum, (ii) the use of an overtube, (iii) defining the entry point with ultrasound and (iv) dedicated closure technique. Applicability and reliability was first proven in extensive animal experiments. Feasibility of the concept in humans was subsequently demonstrated in cadavers.

Background: Access sites other than the anterior gastric wall may provide improved ergonomics for natural orifice transluminal endoscopic surgery (NOTES). Endoscopic ultrasound (EUS) guidance significantly reduces, but does not eliminate, risk of access through these alternate sites. This study evaluates the utility of hydroperitoneum as an adjunct to EUS-guided access and closure of alternate access sites for NOTES. Methods: Access and closure procedures were initially performed with EUS guidance alone, and subsequently, because of complications resulting from this technique, the procedures were performed with the aid of a transabdominal hydroperitoneum. Results: In this nonrandomized study, 6 access and closure procedures performed with EUS guidance alone resulted in 4 complications. After modifying the technique to incorporate pre-access hydroperitoneum, 7 EUS-guided access and closure procedures were performed without significant complications. Conclusions: Hydroperitoneum appears to be an effective adjunct to ensure the safety of EUS-guided peritoneal entry and closure of alternate access sites for NOTES.

Background and Aim: We investigated the utility and safety of contrast-enhanced ultrasonography using Sonazoid in the diagnosis of hepatic hydrothorax. Methods: The study consisted of seven liver cirrhosis patients with hydrothorax and hydroperitoneum. After obtaining informed consent, Sonazoid was injected intraperitoneally, and enhancement in the peritoneal and pleural cavities was observed. Results: In all patients, the peritoneal cavity was quickly enhanced after the Sonazoid injection. The pleural cavity was enhanced in five of the seven patients, and these five patients were diagnosed with hepatic hydrothorax. Two patients without enhancement of the pleural cavity were diagnosed with inflammatory hydrothorax. Conclusions: This is the first report to confirm transdiaphragmatic movement of ascitic fluid into the pleural cavity using contrast-enhanced ultrasonography with Sonazoid. This method can safely detect ascitic flow in real time, and is thus very useful for the diagnosis of hepatic hydrothorax.

Concurrent infection with bovine leukaemia virus (BLV) and Theileria annulata was diagnosed in a Friesian calf about 6 months of age at a dairy farm at the Qassim region of central Saudi Arabia. The disease ended fatally with signs of liver and heart failure. There was anorexia, pyrexia, anaemia, generalized oedema and jaundice. Haematology showed low RBC counts, PCV percentage and haemoglobin concentration and WBC counts. Lymphocyte differential was high. Examination of blood smears stained with Giemsa's stain showed the presence of piroplasms in red blood cells. Autopsy showed enlarged lymph nodes and lymphosarcoma lesions in the omentum and the heart. There was hydroperitoneum, hydropericardium and hydrothorax. The liver was pale yellow and friable. Impression smears from sliced lymph nodes and stained with Giemsa's stain showed presence of Koch's blue bodies in lymphoblasts. Histopathological examination revealed fatty degeneration of hepatocytes and pleomorphic lymphoblasts and giant cells in lymph nodes. Lymphoblasts infiltrated the omentum and heart tissues. Amyloid was found around blood vessels in the liver, kidneys and lymph nodes. BVL infection was diagnosed by demonstrating antibodies against the virus in serum using agar gel immunodiffusion and was confirmed with ELISA.

The aim of this study is to present a novel neuroendoscopy simulation model in live animals, with the objective of enhancing patient safety with realistic surgical training. A simulation model using live Wistar rats was designed after the approval of the Institutional Committee for the Care and Use of Laboratory Animals. Under anesthesia, a hydroperitoneum was created in order to simulate a cavity with mesenteric membranes and vessels, viscera, and a solid and bleeding tumor (the liver) floating in a liquid environment. For validation purposes, we evaluated trainees’ basal and final skills for each neuroendoscopic procedure, and we also acknowledged trainees’ and instructors’ opinion on the model’s realism. This model is simple and low cost effective for complete and real-life training in neuroendoscopy, with the possibility of performing all the basic and advanced endoscopic procedures, such as endoscopic exploration, membrane fenestration, vessel coagulation, hematoma evacuation, and endoscopic tumor biopsy and resection using a ventricular neuroendoscopy set. Although the model does not represent human ventricular anatomy, a reliable simulation is possible in real living tissue in a liquid environment. Trainees’ skills improvements were notorious. Minimally invasive endoscopic techniques require specific training. Simulation training can improve and accelerate the learning curve. The presented training model allows simulating the different neuroendoscopic procedures. We believe that due to its practical possibilities, its simplicity, low cost, reproducibility, and reality, being live animal tissue, it can be considered a fundamental model within a complete training program on neuroendoscopy.

Sir, In the recent years much has been learnt about haemolytic uraemic syndrome (HUS), which is defined by symptomatic or bloody diarrhoea, acute nephropathy, thrombocytopenia and microangiopathic haemolytic anaemia. Often HUS is complicated by neurological symptoms in children [1]. The main aetiological culprit is Shiga-like toxin-producing E. coli (STEC) accounting for ∼85% of HUS cases. Recently the aetiological role of enteroviruses in HUS has been studied and rejected as being an aetiological agent [3] even though earlier case reports suggested a role (see references in [3]). We present a case of HUS, which was probably due to enteroviral infection. A 17-month-old girl, who was previously healthy, was admitted with bloody diarrhoea preceded by vomiting for a day or two. A few hours into the admission the girl developed a seizure and was transferred to an ICU. Extensive clinical and laboratory testing was carried out (Table 1). Tests showed uraemia, thrombocytopenia, haemolytic anaemia, leucocytosis and anuria. The patient developed cardiac arrest at 8 h into the admission. Resuscitation with concurrent peritoneal dialysis was attempted for an hour without success. On autopsy we found a normally developed girl without any deformities. The autopsy revealed a thickened haemorrhagic colon, stasis and oedema in the lungs, hydrothorax and hydroperitoneum. The CNS was without lesions (vascular or any other). There were no signs of iatrogenic injury. On histopathological examination we found signs of endothelial damage in the small vessels of the kidneys (Figure 1) and the intestine (with thrombosis), fragments of thrombi in the small lung vessels and a necrotic colon with submucosal haemorrhage and leukocyte infiltration. No thrombi were found in the brain. Concurrent to the autopsy we requested several tests expecting to find a STEC infection but instead we found an enteroviral infection (Table 1). Our case indicates that enteroviral infections may be able to inflict HUS, and contradicts other studies of HUS [3]. It is clear from the above-mentioned findings that the case presented as HUS, with all of its cardinal findings, uraemia, thrombocytopenia, haemolytic anaemia, and endothelial damage in the kidney and intestine. We used stool and tissue cultures for the bacterial tests whereas viral tests included PCR, serology and cultures. Sadly subtyping (using cell cultures) was unsuccessful after several attempts. A weakness in our report is that we do not have multiple tests (i.e. serology) to exclude a STEC infection, only a standard stool culture. Furthermore, one could speculate that the finding of enteroviral RNA is coincidental or from “leakage” of colonic virus into blood. In support of our conclusion, enteroviruses are known to be able to infect colonic cells and endothelial cells, and damage both by either lytic or immunological mechanisms, the prerequisites for inducing HUS [4,5]. Furthermore our detection techniques are more sensitive [6,7] than the ones used earlier in studies [3]. Our case underlines the need for a large-scale epidemiological investigation of STEC-negative HUS cases using the most recent sensitive diagnostic tests especially considering the poorer prognosis of STEC-negative cases [3]. Conflict of interest statement. None declared.

妊娠6ヵ月の黒毛和種牛(5歳)が、放牧場で腹痛と沈うつの症状を呈して衰弱していたとの稟告で来院した。初診時に著しい腹部膨満が認められたため超音波検査を行ったところ、腹水の貯留と腫瘍状組織の増生が認められた。血液および腹水検査では尿素窒素とクレアチニンの高値が認められた。腫瘍または膀胱破裂を疑い、診断的開腹により大量の腹水を確認したが、腹腔内の内視鏡検査では腫瘍状組織は認められなかった。膀胱の内視鏡検査では、尿中に浮遊物と膀胱粘膜の一部に糜爛が認められた。これらの検査結果から、放牧場にて何らかの腎毒性を有する植物を採食した事によるネフローゼ、尿毒症を疑って治療を試みた。持続点滴、抗生物質の全身投与、膀胱内への薬液注入、腹水の除去などを行ったが症状は改善せず、第11病日に死亡した。剖検では、腎皮質の出血および弓状動脈への血栓形成による多発性梗塞と、腎リンパ節の著しい腫大が認められた。本症例で見られた腹水は尿成分が主体となっていたことから、腎梗塞部からの尿の漏出が原因であると考えられた。しかし、腎臓の梗塞を起こした血栓の成因は明らかにできなかった。

In this study, three stillborn and five premature and blind calves from cows suffering from chronic nitrate poisoning were examined pathologically. The live calves were euthanized, due to a poor prognosis. Complete necropsy was performed on all the eight affected calves. Hydroperitoneum and ascites were the most predominant lesions in the stillborn calves. Edema and hemorrhage were observed in the lungs of all the calves. Hemorrhages were seen in the digestive systems of four calves. Blood samples were taken from five live calves and their mothers, and from two cows that had delivered stillborn or blind calves, for biochemical observations and measurement of methemoglobin levels. Blood values of five healthy cattle from a herd with no history of stillborn or blind calves were used as controls. Water and feed samples were taken from five different farms with a history of stillborn or blind calves and examined for nitrates. Nitrate and nitrite levels of feeds ranged from 154 to 480 and 1.5 to 20 ppm respect...

Osteochondroma is one of the most frequent benign bone tumors in children. Its incidence is hard to determine because this tumor usually is asymptomatic. These tumors may present as solitary, nonhereditary lesions or as hereditary multiple osteochondromas that are inherited in an autosomal dominant manner. Although osteochondromas are usually asymptomatic, significant symptoms may occur because of complications such as bone fracture, bone deformation, or joint problems. The tumor may also mechanically compress nerves or vessels. Osteochondromas growing inwardly may cause injury to internal organs. The authors present a preterm (34 weeks of corrected gestational age) neonate in whom osteochondroma, although histologically benign, caused death because of its size and location. Prenatal ultrasound imaging performed during the third trimester of pregnancy showed bilateral hydrothorax and hydroperitoneum as well as heterogeneous parenchymal area on the right side of the thorax. After birth, the neonate's condition was extremely severe. Although intensive and multidirectional treatment was applied, the condition of the infant continued to deteriorate and he died 26 h after birth. The autopsy confirmed presence of the tumor - osteochondroma - that caused total mediastinal shift with significant hypoplasia of both lungs and with signs of significant compression of the superior and inferior vena cava.

A 6-year-old Holstein cow was referred for necropsy due to sudden death. The necropsy indicated hydroperitoneum, hydropericardium, and petechial hemorrhage on serosal surfaces associated with pulmonary edema and multiple abscesses in the liver. Histopathological examination revealed extensive hepatocellular necrosis with neutrophilic infiltrates and abscess formation. Cultures of the liver lesions and blood revealed a Gram-negative anaerobic bacteria confirmed as Bacteroides melaninogenicus.

We report the case of a 68-year-old man suffering from incremental hepatic and renal failure one month after anterior myocardial infarction. Cardiac MRI showed a pronounced apical post-AMI aneurysm, a moderate to severe mitral and tricuspid regurgitation as well as a hemodynamically highly significant 12 mm apical ventricular septal defect with a left-to-right ventricular shunt of almost 63% as the underlying cause. Heart X-ray revealed a severe LAD in-stent restenosis. CAPD catheter drainage of hydroperitoneum due to congestive liver and renal failure was provided in combination with intensified CAPD hemodialysis. Heart surgery was performed where the apical aneurysm was excised, the mitral valve was reconstructed, the IVSD was closed and the subtotally in-stent occluded LAD was bypassed. Post-surgery, the ascites were significantly reduced, and CAPD hemodialysis therapy could be terminated since the renal function gradually improved (MDRD = 25 mL/min). To our knowledge, for the first time we report successful CAPD catheter drainage of hydroperitoneum in combination with CAPD hemodialysis.

Esse estudo teve por objetivo demonstrar experimentalmente que Tetrapterys acutifolia Cav. (fam. Malpighiaceae) é capaz de provocar aborto em bovinos e caracterizar as alterações clínico-patológicas nas vacas e nos fetos. Estas plantas são responsáveis por significativo número de mortes em bovinos com mais de um ano de idade, especialmente nos Estados de Rio de Janeiro e São Paulo, mas até agora não havia sido comprovado experimentalmente seu efeito abortivo em bovinos. Os experimentos foram realizados no município de Barra do Piraí, RJ. Quatro vacas de descarte receberam brotos e folhas novas frescas de T. acutifolia, coletadas em propriedades vizinhas, nas doses de 2,5g/kg/dia, 5,0g/kg/dia (2 vacas) e 10g/kg/dia, até ocorrer o abortamento. O quadro clínico nas vacas caracterizou-se por arritmia cardíaca, tremores musculares, anorexia, ascite, jugular ingurgitada, edema de peito e barbela e aborto (23-76 dias após o início da ingestão da planta); todas as vacas abortaram. Das quatro vacas apenas uma (a que recebeu 10g/kg/dia) morreu 36 dias após o abortamento, com sintomas de insuficiência cardíaca. O exame necroscópico dos fetos/natimortos revelou hidrotórax, hidropericárdio, hidroperitônio e congestão hepática; ao corte do miocárdio, verificaram-se áreas pálidas. No exame histológico havia edema intersticial com fibrose incipiente. Na vaca que recebeu a maior dose e foi a óbito, bem como em outra intoxicada naturalmente, os achados de necropsia foram similares aos observados nos fetos, exceto pela dilatação dos vasos da base do coração e mais acentuada palidez do miocárdio. Observaram-se ainda edema subcutâneo nas regiões cervical e esternal, bem como veias jugulares ingurgitadas. Os achados histopatológicos foram necrose e edema intersticial com acentuada fibrose no miocárdio, espongiose da substância branca do encéfalo e, no fígado, congestão e leve fibrose. Adicionalmente, observou-se na vaca intoxicada espontaneamente, 17 dias após o aborto, arritmia cardíaca, jugular ingurgitada, edema de peito e barbela, anorexia com morte 43 dias após o aborto. Este estudo demonstra que Tetrapterys acutifolia é capaz de induzir aborto e, dependendo da dose, ainda causar a morte das vacas que abortarem. Tetrapterys acutifolia Cav. (fam. Malpighiacae) stands out among the most important toxic plants of the Brazilian Southeast Region. These plants are responsible for a significant number of deaths in over 1-year-old cattle, especially in the states of Rio de Janeiro and São Paulo. This study aims to demonstrate that T. acutifolia is also able to induce abortion in cattle and to characterize the clinic-pathological alterations in cows and fetuses. Four cows, kept on pasture were used in the experiments which were performed on a farm in the county of Barra do Piraí, RJ, Brazil. The sprouts and young leaves of T. acutifolia were collected from the vicinity shortly before disposed in a trough. The experimental cows ingested the plant material at doses of 2.5g/kg/day (one cow), 5g/kg/day (two cows) and 10g/kg/day (one cow) until abortion occurred. All four cows aborted. The cows showed cardiac arrhythmia, muscular tremors, anorexia, ascites, distended jugular veins, edema of the sternal region and dewlap, and abortion (23 to 76 days after the beginning of ingestion of the plasnt) from the 5th to the 28th day of the experiment. Only one cow which received 10g/kg/day died with characteristic signs of heart failure, 36 days after she had aborted. Gross examination of the fetuses revealed hydrothorax, hydropericardium, hydroperitoneum, nutmeg appearance of the liver, few petechiae and ecchymoses in the epicardium, and pale areas in cross sections of the myocardium. The main postmortem findings in the cow that died were hydrothorax, hydropericardium and hydroperitoneum, engorged vessels at the heart base, exceedingly pale heart muscle with marked spots and stripes in cross sections. Distended jugular veins and severe edema in the sternal region and the abdominal wall were also observed. Histological examination of the fetal hearts revealed interstitial edema with incipient fibrosis and degenerative/necrotic changes of the myocytes. In the succumbed cow was found interstitial fibrosis, as well as necrotic areas and/or necrosis of individual myocytes in extensive portions of the heart, besides passive congestion of the liver. This study shows that Tetrapterys acutifolia can induce abortion in cattle and, depending on the dosage, can cause death.

A study was carried out to determine the toxicity of unripe fruits of S. incanum L in goats. Dried unripe fruits of S. incanum L, were orally fed to goats at a dose rate of 0 (group1), 0.75 (group 2), 1.5 (group 3) and 2.25 (group 4) g/Kg /day for 9 weeks. Clinical signs were observed daily while blood with and without anticoagulant was taken weekly for haematological and biochemical analysis. Clinical signs started on day two with shivering. All group 4 goats (2.25g/ kg) showed bloat, colic, coughing and shivering while one goat had additional signs of depression, staggering gait and continuous bleating before death. One goat in group 3 (1.5g/kg) had bloat, shivering, progressive weakness, depression, staggering gait, lateral recumbency, leg paddling movements, continuous bleating and death while the rest were asymtomatic. All group 2 goats (0.75g/kg) were asymptomatic. Group 4 goats had hydroperitoneum and hydropericardium while group 3 had hydroperitoneum and fibrinous pericarditis. Group 2 goats had no significant pathology. On histopathology the brain of group 3 and 4 goats showed microthrombi, marked wallerian degeneration of neurons and necrosis of purkinje cells while group 2 goats only showed congestion. Other organs in the body also showed significant pathology. The results indicate that unripe fruits of S. incanum L are toxic to goats and allowing animals to graze on this plant could be deleterious to their health. Key words: Poisonous plants, Solanum incanum, Solanaceae, cerebellar disease, diseases of goats, neuropathology

Descreve-se um surto de intoxicação por monensina em ovinos no Estado do Rio de Janeiro, no qual de 180 animais, oito morreram após serem alimentados com ração contendo o ionóforo. A enfermidade, de evolução variável, caracterizou-se clinicamente por apatia, arritmia cardíaca, mioglobinúria, incoordenação, incapacidade de se levantar, decúbito esternal; uma ovelha abortou. As lesões macroscópicas consistiram de áreas pálidas no miocárdio, hidroperitônio, hidrotórax e edema pulmonar. O exame histopatológico evidenciou alterações degenerativo-necróticas no coração e na musculatura esquelética. No miocárdio, as lesões eram mais marcadas e caracterizavam-se por necrose multifocal com substituição das miofibras por tecido conjuntivo fibroso e inflamação intersticial mononuclear. Adicionalmente, verificaram-se proliferação de células satélite e reação inflamatória mononuclear em músculos esqueléticos. Ao que tudo indica, a adição excessiva de monensina sódica, talvez associada à homogeneização inadequada da droga ao alimento, tenha determinado a ingestão de grande quantidade de monensina por parte dos animais. An outbreak of monensin poisoning in sheep in the State of Rio de Janeiro is described. From 180 animals, eight died after they had been fed with ration containing the ionophore. The poisoning had a variable course and was clinically characterized by apathy, heart arrhythmia, myoglobinuria, incoordenation, incapacity of getting up, and sternal decubitus; one sheep aborted. The macroscopic lesions consisted of pale areas in the myocardium, hydroperitoneum, hydrothorax, and pulmonary edema. Histopathological examination revealed degenerative-necrotic alterations in heart and skeletal muscles. In the myocardium lesions were more severe and were characterized by multifocal necrosis with substitution of the myofibres by fibrous tissue and interstitial mononuclear infiltration. Proliferation of satellite cells and mononuclear inflammatory reaction in skeletal muscles were also verified. It seems that the exaggerated addition of sodic monensin, eventually associated with improper homogenization of monensin in the ration, was responsible for the excessive ingestion of monensin by some animals.

Background Transluminal cholecystectomy is feasible. However, the procedure is time consuming, difficult, and poorly standardized so far. In the present study we therefore aimed to further evaluate and optimize a transsigmoid approach for cholecystectomy with minimal transabdominal assistance in the porcine model. Methods After a pilot series of 6 pigs, NOTES (natural-orifice transluminal endoscopic surgery) cholecystectomy was performed in a standardized manner in another 12 pigs. A transsigmoid approach was applied via a specially designed trocar (ISSA) with a double-channel gastroscope advanced into the peritoneal cavity. After identification of the infundibulum, the cystic duct and artery were closed by application of hemostasis clips. After dissection of these structures, the gallbladder was separated from the liver by electrocautery following injection of isotonic saline solution. A grasper introduced through a modified Veress needle (initially used for establishing the hydroperitoneum) and an additional transcutaneous stay suture were used to ease preparation of the gallbladder. Results Transluminal cholecystectomy was successfully performed in all animals. No serious acute complications occurred; minor bleeding in 4 out of 12 cases (1 cystic artery and 3 liver parenchyma) was successfully handled by electrocautery. Clip application to close the cystic duct and artery resulted in complete sealing. Standardization of the procedure was associated with a significant decrease in total operating time (113.3 +/- 31.8 minutes for the first 6 pigs and 73.6 +/- 17.2 minutes for the last 6 pigs). Conclusions In pigs with a healthy gallbladder, our standardized technique of transsigmoid cholecystectomy could be performed relatively fast with acceptable complication rates at this level of evolution, as shown in these acute experiments.

Sementes moídas de Crotalaria mucronata Desv. (=Crotalaria striata DC., Crotalaria pallida Ait., Crotalaria saltiana), com nomes populares de "xique-xique" ou "guizo-de-cascavel", foram administradas por via oral a 9 bovinos. As doses diárias de 1g/kg, 2g/kg, 3g/kg cada uma a um bovino, e 5g/kg em dois de três bovinos, dadas durante 61 a 63 dias, não causaram intoxicação. A dose de 5g/kg em um bovino, 7,5g/kg em dois bovinos e 10g/kg em um bovino, dadas durante 47-61 dias, causaram sintomas entre 47 e 80 dias após o início da administração e a morte entre 3 horas e 5 dias após o início dos sintomas. Os principais sintomas foram pulso venoso positivo da veia jugular, respiração abdominal, taquicardia, inapetência, fezes ressequidas, edema sub-mandibular e fraqueza. Os achados de necropsia foram palidez pulmonar, hidropericárdio, hidrotórax, hidroperitôneo, edema de mesentério, aumento da consistência hepática, alterações de cor do fígado, dilatação de ventrículo cardíaco direito e edema da parede ruminal. As principais alterações histológicas concentraram-se nos pulmões, sob forma de espessamento das paredes alveolares e da parede das arteríolas com diminuição da luz e fibrose periarteriolar; havia também lesões hepáticas e cardíacas de menor importância. Pode-se concluir que as principais lesões causadas pela ingestão das sementes de C. mucronata durante períodos prolongados, devem-se à dificuldade de passagem do sangue pelos vasos pulmonares em função da hipertensão arterial decorrente de fibrose e espessamento arteriolar determinada pela ação pneumotóxica da planta. Experiments were performed to define the clinical and pathological picture of prolonged administration of the seeds of Crotalaria mucronata Desv. to cattle, in order to obtain additional information about this toxicosis. The ground seeds were administered orally to 9 bovines. Doses of 1g/kg/day, 2g/kg/day, 3g/kg/day each in one bovine, and 5g/kg/day in two of three bovines, given for 61- 63 days, did not cause poisoning. Doses of 5g/kg, in one bovine, 7.5g/kg in two bovines and 10g/kg in one bovine, given for 47-61 days, caused symptoms between 47 and 80 days after the first administration and caused death between 3 hours and 5 days after the onset of symptoms. The main clinical signs were positive venous pulse of the jugular vein, abdominal breath, tachycardia, loss of appetite, dry feces, sub-mandibular edema and weakness. Bovines that did not die, were slaughtered 8 or 9 months after first administration. At necropsy pulmonary paleness, hydropericardium, hydrothorax, hydroperitoneum, mesenteric edema, augmented hepatic consistency, discoloration of the liver, right cardiac ventricle dilatation and ruminal wall edema were seen. The main histological lesions were thickening of the alveolar walls and of the arterioles with narrowing of their lumen, and periarteriolar fibrosis, besides hepatic and cardiac lesions of minor importance. It is concluded, that the lesions caused by ingestion of the seeds of C. mucronata over a long period are caused by the difficulties of blood passage through the pulmonar vessels due to fibrosis and thickening of the arteriolar walls through the pneumotoxic action of the plant.

Apoptosis as a novel target for cancer chemotherapy has generated an intense demand for new apoptosis-inducing agents. The newly revealed role of protein families involved in the apoptosis pathway, and resistance to cytotoxic therapies have opened new avenues for the development of novel anticancer strategies. We have established a novel strategy to rapidly obtain protein-targeted, instead of conventional DNA-targeted, apoptosis inducers as antitumor leads. First, a novel organic non-DNA intercalative compound S1 (8-oxo-3-thiomorpholin-4-yl-8H-acenaphtho[1,2-b]pyrrole-9-carbonitrile, M(W) = 331) was found with an IC50 of 10(-7)-10(-8) microM against diverse cancer cell lines. Further biological evaluation demonstrated that it was an apoptosis-inducer both in vivo and in vitro. The treatment of hydroperitoneum hepatoma cells (H22 cell line) with S1 at various concentrations (from 0.01 to 10 microM) for 24 h triggered these cells to enter the apoptosis process. The antitumor efficiency was also tested in the H22 xenotransplant models in mice. At a dosage of 0.3 mg kg(-1), S1 exhibited significant antitumor activity with a much longer survival time, a decrease in tumor size, and increased apoptosis cells in tumor tissue. More importantly, studies of the molecular mechanism of apoptosis induction by S1 revealed that S1 inactivated the Bcl-2 protein by binding to it, depolarizing the mitochondrial membrane, and then activating caspase 9, followed by caspase 3. Finally, structure-based virtual modification was performed by computer modeling. As a result, a derivative, S2 (8-oxo-3-[(thienylmethyl)amino]-8H-acenaphtho[1,2-b]pyrrole-9-carbonitrile, M(W) = 341) was identified that possessed a lower binding energy to Bcl-2, and demonstrated better antitumor potency, even on the Bcl-2-overexpressing human acute myeloid leukemia (HL-60) cells (IC50 = 1.3 microM) in vitro. S1 and S2 are the well-defined Bcl-2 inhibitors that give us a promising platform for the development of new therapeutic agents.

We report the imaging findings in a case of neonatal spontaneous gastric perforation presenting as massive hydroperitoneum rather than pneumoperitoneum. Plain abdominal radiography showed a diffuse ground-glass opacity with paucity of bowel gas. Subsequent ultrasonography demonstrated numerous echogenic peritoneal fluid collections containing echogenic debris shown at surgery to be due to milk and bile.

São descritos surtos de enterotoxemia em caprinos em cinco propriedades no Estado do Rio Grande do Sul. Os animais afetados eram, normalmente, encontrados mortos ou apresentavam evolução aguda de 2 a 3 horas com acentuada depressão, cólicas abdominais e diarréia profusa com fibrina. Em duas propriedades relataram-se casos com a evolução de até 12 horas. Em treze animais necropsiados observaram- se aumento de líquidos nas cavidades abdominal, torácica e pericárdica, congestão e hiperemia da serosa e mucosa do intestino, conteúdo do cólon líquido com fibrina além de hemorragias de serosa e fibrina. Em um animal constatou- se microangiopatia cerebral caracterizada por acúmulo de material homogêneo e eosinofílico no espaço perivascular. No conteúdo intestinal, colônias com bastonetes morfológica e bioquimicamente sugestivos de Clostridium perfringens foram caracterizadas no estudo bacteriológico. A soroneutralização em camundongos com conteúdo intestinal dos animais afetados, revelou a presença da toxina épsilon. Estes achados evidenciam a enterotoxemia como doença de importância para criação de caprinos no Rio Grande do Sul. Five outbreaks of caprine enterotoxaemia in Rio Grande do Sul, Brazil, were studied. The animals were found dead or had a clinical course that usually lasted 2-3 hours. From two farms a clinical manifestation period of 12 hours was reported. Clinical signs were characterized by depression, marked abdominal discomfort, profuse watery diarrhea with fibrin clots, and death. Thirteen necropsies were performed and hydropericardium, hydrothorax and hydroperitoneum were commonly found. The mucosa and serosa of the colon were congested, and its contents was watery with multiple fibrin clots. Serosal hemorrhages and fibrin clots in the gallbladder were also seen. Fibrinous colitis and thyphilitis were the most frequent histological changes. Cerebral microangiopathy was observed in one case, which was characterized by acute perivascular proteinaceous edema around arterioles of the nucleus caudatus and thalamus. Large numbers of Gram-positive rods, often in clumps and with morphology consistent with Clostridium perfringens, were seen in intestinal smears. The intestinal contents of six goats were positive for epsilon toxin by mouse neutralization test. These findings suggest that enterotoxaemia is an important disease of goat flocks in southern Brazil.

Laparoscopy was first used clinically to diagnose solid organ, abdominal disease. In independent accounts dating back to the turn of the 20th century, both Kelling and Jacobaeus described the earliest laparoscopies performed in patients with liver disease 1,2 in the presence of gross ascites. The practice of diagnostic laparoscopy for liver disease has evolved over the decades to a procedure often done under local anesthesia, where pneumoperitoneum has replaced hydroperitoneum. The role of laparoscopy in staging and diagnosis of pancreatic disease did not emerge for another 60 years. 3–5 The advance to therapeutic solid-organ laparoscopy has only recently occurred. Soon after the introduction of laparoscopic cholecystectomy, pioneering surgeons described successful laparoscopic resections of spleen, adrenal glands, and kidneys. As experience has accrued and favorable outcomes have been reported with these procedures, they have become widely adopted. Such has not been the case with laparoscopic pancreatic surgery. Reports of therapeutic laparoscopy of the pancreas have been few and of limited numbers. 4,6,7 Laparoscopic surgery of the pancreas remains in its infancy, and its role in pancreatic disease is still unclear. Although several laparoscopic pancreatic procedures have been described, debate continues over which procedures can be safely and adequately performed and which clearly benefit the patient when performed laparoscopically. In this study, to our knowledge the largest series of therapeutic laparoscopic procedures yet reported, we review our experience with these techniques for 1) the treatment of pancreatic pseudocyst [PP] and 2) resection of benign lesions of the pancreas. Perioperative data, surgical outcomes, techniques, and insights will be presented.

Objective: Vesicoamniotic shunting may be difficult or impossible in selected cases of fetal lower obstructive uropathy. The purpose of this article is to describe the performance of fetal hydrolaparoscopy and endoscopic fetal cystotomy in two fetuses with complicated lower obstructive uropathy. Study Design: Fetal hydrolaparoscopy–endoscopic fetal cystotomy was performed in a patient with a markedly thickened bladder that could not be entered percutaneously. A peritoneoamniotic (bridge) shunt was also placed. Fetal hydrolaparoscopy–endoscopic fetal cystotomy was performed in a second patient with a collapsed bladder from a previous vesicocentesis, because vesicoinfusion resulted in further ascites. Fetal cystoscopy was performed after endoscopic fetal cystotomy, and posterior urethral valves were ablated with neodymium:yttrium-aluminum-garnet laser energy. A vesicoamniotic shunt was left in place. Results: Adequate bladder drainage was obtained in both cases. The first baby required bilateral nephrotomy and a permanent cystotomy at birth and is scheduled for a bladder expansion procedure at the age of year. The second patient had premature rupture of membranes and fetal death from treatment of this complication 5 days after the original procedure. Conclusion: Fetal hydrolaparoscopy–endoscopic fetal cystotomy can be performed in complicated cases of lower obstructive uropathy. The procedure involves the creation of a defect in the bladder dome under direct endoscopic visualization within a spontaneous or intentional hydroperitoneum. Peritoneoamniotic shunting, vesicoamniotic shunting, or ablation of posterior urethral valves may then be performed. Fetal hydrolaparoscopy–endoscopic fetal cystotomy should be reserved only for complicated cases of lower obstructive uropathy in which conventional vesicoamniotic shunting is not safely possible. Further experience with fetal hydrolaparoscopy–endoscopic fetal cystotomy is necessary to establish its risks and benefits. (Am J Obstet Gynecol 2000;183:324-33.)

The majority of life-threatening injuries secondary to the placement of central venous catheters, such as bleeding and pneumothorax, occur at the time of initial insertion. When a catheter extravasates in the neck, edema of the neck wall or chest is usually seen, and the pump indicates occlusion. We present four cases in which an uneventful, successful placement of four central lines (three superior vena cava, one inferior vena cava) were followed at greater than 48 hours by either hydrothorax or hydroperitoneum, which resulted in either cardiorespiratory collapse or intraabdominal sepsis. In reviewing these cases, all showed both a change in catheter location on a subsequent x-ray and poor or no blood return on aspiration; paradoxically, the infusion pump in each case did not sense a catheter malposition or occlusion. We conclude that, although the success of central line placement may be documented on insertion, a continual reappraisal of both the function and location of the line is necessary.

19615 Background: Malignant hydrothorax or hydroperitoneum are common complications of the cancer. Pure chemotherapy couldn’t get good effect. We combined intracavitary chemotherapy with local thermotherapy to cure malignant hydrothorax or hydroperitoneum. In order to observe the recent effects and toxicity of thermochemotherapy and evaluate the change of the immunologic function, and to investigate the mechanism of thermochemotherapy. Methods: Fifty-two patients were treated with weekly intracavitary chemotherapy, and then combined with local thermotherapy twice a week. As the control, another fifty patients received weekly intracavitary chemotherapy. Treated for two weeks and rest for one week, and then observed the recent effects and toxicity. Test the level of the T cell subset, NK cells and VEGF in serum and effusion Results: Overall response rate of the malignant hydrothorax was 86.9% vs 60.0% (P No significant financial relationships to disclose.

Background Vesicoamniotic shunting may be difficult or impossible in selected cases of fetal lower obstructive uropathy (LOU). The purpose of this paper is to describe the performance of fetal hydrolaparoscopy (FHL) and endoscopic fetal cystotomy (EFC) in fetuses with complicated LOU. Method FHL-EFC was performed in one patient with a markedly thickened bladder that could not be entered percutaneously. A peritoneoamniotic shunt was also placed. FHL-EFC was performed in a second patient with a collapsed bladder from a previous vesicocentesis, as vesicoinfusion resulted in further ascites. Fetal cystoscopy was performed after EFC, and posterior urethral valves were ablated with YAG-laser. A vesicoamniotic shunt was inserted. Results Adequate bladder drainage was obtained in both cases. The first baby required bilateral nephrostomies and a permanent cystotomy at birth, and is scheduled for a bladder expansion procedure at one year of age. The second patient had premature rupture of membranes and fetal demise from treatment of this complication 5 days after the original procedure. Conclusion FHL-EFC can be performed in complicated LOU cases. The procedure involves the creation of a defect in the bladder dome under direct endoscopic visualization within a hydroperitoneum. Peritoneo or vesicoamniotic shunting, or ablation of posterior urethral valves may then be performed. FHL-EFC should be reserved only for complicated cases of LOU where conventional vesicoamniotic shunting is not possible.

Feeding a high concentration of cotton seed meal to young calves resulted in death with lesions compatible with gossypol toxicity. Calves were fed two different commercially prepared rations. Free gossypol concentrations in different lots of the 17% protein ration vaned from 250 to 380 ppm, and the 13% protein ration varied from 40 to 240 ppm. Serum sorbitol dehydrogenase elevation was the most consistent clinical pathological finding. The mean serum sorbitol dehydrogenase concentrations for moribund, hospitalized, and clinically healthy calves were 277, 34, and 45 units/liter. The mean for sorbitol dehydrogenase concentration for healthy calves not fed cotton seed meal was 18 units/liter. Gross lesions included severe effusion of a high protein content fluid into the body cavities of most calves, edema of the mesentery, and hepatomegaly. The most consistent histological lesion was severe centrilobular hepatic necrosis. Elevated levels of liver gossypol were demonstrated. The mean liver gossypol concentration for three calves was 4 1.7 Fglg on a wet weight basis. The toxicity of cotton seed products for animals has been attributed primarily to the intake level of free go~sypol,~.~ i.e., that part of the total gossypol in cotton seed which is soluble in 70% acetone.2 The availability of gossypol for gastrointestinal absorption is influenced by the method of cotton seed processing and other factors, which include the dietary concentration of iron, other metals, calcium, and pr~tein.',~,~J~ In adult cattle, toxicity from cotton seed product feeding is thought to be much less frequent than in pigs because of de- toxification in the rumen.13 In the rumen, gossypol forms stable complexes with soluble proteins which are resistant to subsequent en- zymatic breakdown. Lower levels of gossypol produce toxicity in calves prior to development of the rumen, but there are few reports of natural toxicity.'4 In one experimental study feeding 230 to 1,070 ppm free gos- sypol, the mortality varied from zero to 100°/o.6 When calves were fed cotton seed meal (CSM) in milk replac- er, Holsteins were more susceptible than Jerseys to gossypol toxicity.* Lesions reported in young calves included hydroperitoneum, hydrothorax, and slow clotting of blood with fatty degeneration in the liver.6 A second report indicated the major changes to be generalized edema and fluid effusion, which were most common in the thoracic cavity, pericardial sac, and peritoneal cavity.14 Edema was present in lungs, fat depots, kidneys, gall bladder, and other organs. Ad- ditional changes reported included acute toxic hepa- titis, petechiation, gastroenteritis, and enlarged dilated hearts with areas of myocardial degenerati~n.'~ These findings were similar to those reported for pigs." Depression of blood hemoglobin concentration and increased erythrocyte fragility occurred in adult cows fed cotton seed meal at a level which was clinically non-to~ic.~ In one group of calves fed cotton seed meal mixed with milk replacer, slight depressions in packed cell volume (24-30%) and hemoglobin (9.5-10.7 dl00 ml) were seen initially, with subsequent return to nor- mal.I4 In pigs, the hematocrit and blood hemoglobin levels were shown to decrease and the serum aspartate aminotransferase (SGOT) to in~rease.~ Assays of liver tissue from pigs with severe toxicosis demonstrated no change in cytochrome oxidase or succinoxidase activ- ity."

The toxic effects of imidocarb dipropionate (3,3'-bis[2-imidazolin-2-yl] carbanilide dipropionate) were studied in calves injected twice intramuscularly with 0, 5, 10 or 20 mg/kg dosages. Transient, dosage dependent signs of toxicosis consisted of excessive salivation, serous nasal discharge, diarrhoea and dyspnoea. Elevations in blood urea nitrogen concentrations and serum glutamic oxalacetic transaminase activities were related to dosage and markedly increased at the high dosage. Renal hyperaemia, hepatomegaly, pulmonary congestion and oedema, hydrothorax, hydroperitoneum, hydropericardium and mortality occurred at the 20 mg/kg dosage. Microscopic lesions observed at the high dosage included acute severe renal tubular necrosis and focal hepatocellular necrosis. Injection site reactions varied from microscopic areas of necrotising myositis at the 5 mg/kg dosage to focal grossly visible areas of necrosis, encapsulated by granulation tissue and surrounded by fascial oedema at the 20 mg/kg dosage.

Pigs fed a ration, 25% of which was rice culture, of Aspergillus ochraceus lost weight or failed to gain and became depressed. Some pigs died and most developed subcutaneous edema, hydrothorax, hydroperitoneum, pulmonary atelectasis, edema of the mesentery and perirenal edema. Microscopic lesions in addition to edema were primarily renal and consisted of tubular degeneration and necrosis, hyaline tubular casts, interstitial fibrosis and tubular cell regeneration. The first change found after 3 days was cytoplasmic vacuolation of the convoluted and straight segments of the proximal tubules. Necrotic proximal tubules were found after 4 days and after 9 days degeneration and necrosis involved predominantly proximal tubular segments. Pigs fed a ration, 12.5% of which was rice culture, for 8 weeks did not develop perirenal edema but had firm kidneys. Extensive interstitial fibrosis of the cortical labyrinth was the principal change. Within the fibrous connective tissue, some tubules were necrotic and others were atrophied.

Sonographic evaluation of the pancreas was performed in ten healthy research dogs following intraperitoneal fluid administration. Physiological saline solution was aseptically introduced into the peritoneal cavity of each dog to create an acoustic window that would facilitate sonographic delineation of normal pancreatic tissues. Abdominal ultrasound examinations were performed in all dogs before and after the production of the diagnostic hydroperitoneum. Sonograms of the pancreas and other abdominal organs were scored on the basis of image clarity by experienced and novice ultrasonographers. Statistical analysis was then used to compare the effectiveness of each preparation method. A significant difference (P < 0.05) was established between the scores from the diagnostic hydroperitoneum sonograms and the baseline scans performed without intraperitoneal fluid placement. Sonographic visualization scores for the pancreas and other abdominal organs were increased following production of the diagnostic hydroperitoneum. These results indicate that the technique of diagnostic hydroperitoneum will significantly improve ultrasonographic visualization of the pancreas, and may prove useful in the diagnosis of canine pancreatic disease.

The autopsy of a case of CHAGAS'S disease or American tryponosomiasis (a girl, 5 years old), dead in the 22nd day of illness is reported. The anatomic diagnosis was a follows: Acute diffuse chagasic nyocarditis. Chagasic encephalitis. Chagasic lymphadenitis of the right posterior auricular node. Tuberculosis of the bronchial and pulmonary nodes. Chronic passive hyperemia and atelectasia of the lungs. Chronic passive congestion and hemorrhages of the spleen. Serous hepatitis. Parotiditis. Edema of the right eyelids. Bilateral hydrothorax. Hydropericardium. Hydroperitoneum. The morphology of Schizotrypanum cruzi in the myocardium is considered. Besides agglomerates with typical small oval or round intracellular bodies, pre-flagellate and flagellate organisms, others are found in which the great amount of parasites and marked pressure exerted by them against each other render very difficult their identification; sometimes the similitude of such agglamerates to Toxoplasma is striking (Fig. 1 and 1 A). In such a case, the structure of the blepharoplast (Fig. 1 and IA), usually preserved, is profitable and allows the identification of the pre-flagellate and flagellate forms of Schizotrypanum cruzi. Most of the small sensitive nerves in the epicardium shows mononuclear infiltration of the perineurium (perineuritis, Figs. 12-14). Microscopically there is extensive Zenker's degeneration (Figs. 6-8) and parasitism of the heart muscle fibers, marked cellular infiltration of the interstitial connective tissue, which are found in the ordinary musculature of every chamber of the heart (Figs. 10-11) as well as in Tawara's node (Fig. 9), main bundle (Fig. 2) and right (Fig. 4) and left (Fig. 5) septal divisions of the bundle of His, and perineuritis. Those anatomic changes are associated to an abnormal electrocardiogram presenting some similitude to that of an anemic infarct of the anterior wall of the heart and which will be discussed elsewhere (unpublished paper by Dias, Nobrega & Laranja).

1.-Since the parietal endocarditis represents a chapter generally neglected, owing to the relative lack of cases, and somewhat confused because there various terms have been applied to a very same morbid condition, it justifies the work which previously we tried to accomplish, of nosographic classification. Taking into account the functional disturbances and the anatomical changes, all cases of parietal endocarditis referred to in the litterature were distributed by the following groups: A-Group-Valvulo-parietal endocarditis. 1st . type-Valvulo-parietal endocarditis per continuum. 2nd. type-Metastatic valvulo-parietal endocarditis. 3rd. type-Valvulo-parietal endocarditis of the mitral stenosis. B-Group-Genuine parietal endocarditis. a) with primary lesions in the myocardium. b) with primary lesions in the endocardium. 4th type-Fibrous chronic parietal endocarditis (B A U M L E R), « endocarditis parietalis simplex». 5th type-Septic acute parietal endocarditis (LESCHKE), «endocarditis parietalis septica». 6th type-Subacute parietal endocarditis (MAGARINOS TORRES), «endocarditis muralis lenta». 2.-Studying a group of 14 cases of fibrous endomyocarditis with formation of thrombi, and carrying together pathological and bacteriological examinations it has been found that some of such cases represent an infectious parietal endocarditis, sometimes post-puerperal, of subacute or slow course, the endocardic vegetations being contamined by pathogenic microorganisms of which the most frequent is the Diplococcus pneumoniae, in most cases of attenuated virulence. Along with the infectious parietal endocarditis, there occur arterial and venous thromboses (abdominal aorta, common illiac and femural arteries and external jugular veins). The case 5,120 is a typical one of this condition which we name subacute parietal endocarditis (endocarditis parietalis s. muralis lenta). 3.-The endocarditis muralis lenta encloses an affection reputed to be of rare occurrence, the «myocardite subaigue primitive», of which JOSSERAND and GALLAVARDIN published in 1901 the first cases, and ROQUE and LEVY, another, in 1914. The «myocardite subaigue primitive» was, wrongly, in our opinion, included by WALZER in the syndrome of myocardia of LAUBRY and WALZER, considering that, in the refered cases of JOSSERAND and GALLAVARDIN and in that of ROQUE and LEVY, there are described rather considerable inflammatory changes in the myocardium and endocardium. The designation «myocardia» was however especially created by LAUBRY and WALZER for the cases of heart failure in which the most careful aetiologic inquiries and the most minucious clinical examination were unable to explain, and in which, yet, the post-mortem examination did not reveal any anatomical change at all, it being forcible to admit, then, a primary functional change of the cardiac muscle fibre. This special cardiac condition is thoroughly exemplified in the observation that WALZER reproduces on pages 1 to 7 of his book. 4.-The clinical picture of the subacute parietal endocarditis is that of heart failure with oedemas, effusion in the serous cavities and passive chronic congestion of the lungs, liver, kideys and spleen associated, to that of an infectious disease of subacute course. The fever is rather transient oscillating around 99.5 F., being intersected with apyretic periods of irregular duration; it is not dependent on any evident extracardiac septic infection. In other cases the fever is slight, particularly in the final stage of the disease, when the heart failure is well established. The rule is to observe then, hypothermy. The cardiac-vascular signs consist of enlargement of the cardiac dullness, smoothing of the cardiac sounds, absence of organic murmurs and accentuated and persistent tachycardia up to a certain point independent of fever. The galloprhythm is present, in most cases. The signs of the pulmonary infarct are rather expressed by the aspect of the sputum, which is foamy and blood-streaked than by the classic signs. Cerebral embolism was a terminal accident on various cases. Yet, in some of them, along with the signs of septicemia and of cardiac insufficiency, occurred vascular, arterial (abdominal aorta, common illiac and femurals arteries) and venous (extern jugular veins) thromboses. 5. The autopsy revealed an inflammatory process located on the parietal endocardium, accompanied by abundant formation of ancient and recent thrombi, being the apex of the left ventricle, the junction of the anterior wall of the same ventricle, with the interventricular septum, and the right auricular appendage, the usual seats of the inflammatory changes. The region of the left branch of HIS’ bundle is spared. The other changes found consist of fibrosis of the myocardium (healed infarcts and circumscribed interstitial myocarditis), of recent visceral infarcts chiefly in lungs, spleen and brain, of recent or old infarcts in the kidneys (embolic nephrocirrhosis) and in the spleen, and of vascular thromboses (abdominal aorta, common illiacs and femurals arteries and external jugular veins), aside from hydrothorax, hydroperitoneum, cutaneous oedema, chronic passive congestion of the liver, lungs, spleen and kidneys and slight ictericia. 6. In the subacute parietal endocarditis the primary lesions sometimes locate themselves at the myocardium, depending on the ischemic necrosis associated to the arteriosclerosis of the coronariae arteries, or on an specific myocarditis. Other times, the absence of these conditions is suggestive of a primary attack to the parietal endocardium which is then the primary seat of the lesions. It matters little whatever may be the initial pathogenic mechanism; once injured the parietal endocardium and there being settled the infectious injury, the endocarditis develops with peculiar clinical and anatomical characters of remarkable uniformity, constituting an anatomo-clinical syndrome. 7.-The histologic sections show that recent lesions

AN APPARENTLY new syndrome of broiler chickens characterized by droopiness, ruffled feathers, labored breathing and increasing morbidity and mortality was reported by Schmittle et al. (1958). Necropsy of chickens dying as a result of this disease revealed a hydropericardium, hydroperitoneum, swollen liver, swollen and pale kidneys, with a subcutaneous edema often present in the ventral portions of the body. Similar clinical signs and lesions were reported by Sanger et al. (1958). The disease was found to be caused by feeding certain fats in the ration. Preliminary results on feeding toxic fat to hens were presented at the 47th Annual Poultry Science Meeting by Edgar et al. (1958) and Naber et al. (1958). They found that toxic fat decreased egg production and hatchability in hens. The studies reported in this paper were carried out to determine what effect feeding fat that was toxic to broilers would have on laying hens and …

Listeric abortion was diagnosed in sheep on 14 occasions between 1963-65, and 4 of these were associated with other major abortion pathogens. Except for infection in one district, the outbreaks were scattered sporadically over the southern agricultural area. The diagnosis in 1963 was the first time listeriosis had been found in animals or man in Western Australia. L. monocytogenes was readily recovered in pure culture from all organs and sites cultured. All the strains were serotype 5 Ivanov, with a distinctive double zone of haemolysis. The time-of-death of the 40 infected lambs was: ante-parturient death 50%, parturient death 10% and post-parturient death 40%. Three-quarters of the lambs had gross lesions, the most consistent being small necrotic foci in the liver. Typically, lambs with congenital listeriosis had subcutaneous oedema, hydrothorax, hydroperitoneum, distended abdomen, enlarged pale bronze-red friable livers with small necrotic foci, small abomasal erosions, increased yellow-orange mucoid meconium and enlarged mesenteric lymph nodes. The finding of small yellowish, necrotic foci in the liver, small abomasal erosions and yellow-orange meconium in an aborted lamb was considered to be almost pathognomonic for listeriosis. The origin of these outbreaks was unknown. No evidence of Listeria was found in 61 specimens from 7 species of native fauna caught in the infected areas. Epizootiological observations are reported. No cases of neuro-listeriosis were observed.

Clinical use of adriamycin, an effective chemofherapeutic agent, has been restricted because of a demonstrated dose-limiting cardiotoxicity. To study age-related differences in adriamycin-induced cardiotoxicity, clinical status, developed force, ultra-structure, and lipid peroxide changes in the myocardium were investigated in two age groups of rats termed younger (Cy) and older (Co). Experimental animals (Cy + A; Co + A) received a cumulative dose of 15 mg/kg of adriamycin over 2 weeks. Animals in the Co + A group showed hydroperitoneum, higher mortality, and a greater decline in weight and feed consumption. Decline in base-line developed force in papillary muscles from Cy + A and Co + A group was not significant, but responsiveness to different interventions was attenuated. Papillary muscles from the Co + A group showed a significantly lesser increase over its control (Co) group in peak developed force in response to higher Ca2+. The decline in the peak developed force due to low Ca2+ and frequency increase was also significantly less in the Co + A group. Qualitatively similar but quantitatively less or even statistically insignificant changes were seen in the younger treated (Cy + A) group compared with its controls. A greater cell damage indicated by the loss of myofibrils, swelling of the mitochondria as well as the tubular system and accumulation of lipofuscin granules was seen in the Co + A group. While there was no significant change in the malondialdehyde content in the Cy + A group compared with the age-matched controls, a 100% increase in myocardial malondialdehyde content was seen in the Co + A group. These data show that chronic adriamycin administration causes greater myocardial cell damage and heart failure in the older group indicating that age is one of the risk factors in adriamycin cardiotoxicity. Irrespective of the age, adriamycin treatment reduced responsiveness of the papillary muscles to inotropic interventions and these observations may explain the refractoriness of adriamycin-affected hearts to cardiotonic drugs.

It seems that artificial hydroperitoneum has a distinct place in the management of severe dehydration in children.

Hydrostatic pressure-induced colon injury is a rare occurrence in the pediatric population. We present a case of massive hydroperitoneum following a pool whip-induced injury. Although tension pneumoperitoneum or hydroperitoneum is rare, prompt recognition and surgical intervention are essential.

Locoweed (Oxytropis sericea) poisoning was confirmed in 16 free-ranging elk (Cervus elaphus nelsoni) from northern New Mexico over a 5-year period, 1977-81. Clinical signs consistently seen were emaciation, weakness, incoordination, muscular trembling, posterior ataxia, lethargy, and visual impairment. Gross morphologic changes included hydrothorax, hydroperitoneum, hydropericardium, meningeal edema, serous atrophy of fat deposits, and anemia. Consistent histological changes were widespread cytoplasmic vacuolation in the parenchyma of most major organ systems. This outbreak of locoweed poisoning coincided with poor range condition exacerbated by subnormal precipitation, and was not considered to be a significant mortality factor in the elk herd. However, locoweed poisoning may significantly affect population dynamics of elk herds restricted to ranges severely infested by locoweed.