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Melioidosis, a potentially fatal infectious disease of humans and animals, including nonhuman primates (NHPs), is caused by the high-consequence pathogen Burkholderia pseudomallei. This environmental bacterium is found in the soil and water of tropical regions, such as Southeast Asia, where melioidosis is endemic. The global movement of humans and animals can introduce B. pseudomallei into nonendemic regions of the United States, where environmental conditions could allow establishment of the organism. Approximately 60% of NHPs imported into the United States originate in countries considered endemic for melioidosis. To prevent the introduction of infectious agents to the United States, the Centers for Disease Control and Prevention (CDC) requires newly imported NHPs to be quarantined for at least 31 d, during which time their health is closely monitored. Most diseases of public health concern that are transmissible from imported NHPs have relatively short incubation periods that fall within the 31-d quarantine period. However, animals infected with B. pseudomallei may appear healthy for months to years before showing signs of illness, during which time they can shed the organism into the environment. Melioidosis presents diagnostic challenges because it causes nonspecific clinical signs, serologic screening can produce unreliable results, and culture isolates are often misidentified on rapid commercial testing systems. Here, we present a case of melioidosis in a cynomolgus macaque ( Macaca fascicularis ) that developed a subcutaneous abscess after importation from Cambodia to the United States. The bacterial isolate from the abscess was initially misidentified on a commercial test. This case emphasizes the possibility of melioidosis in NHPs imported from endemic countries and its associated diagnostic challenges. If melioidosis is suspected, diagnostic samples and culture isolates should be submitted to a laboratory in the CDC Laboratory Response Network for conclusive identification and characterization of the pathogen.

Nutrition assessment and intervention significantly contribute to the well-being of patients. NPs should advocate that patients be appropriately evaluated and implement recommendations as part of a comprehensive care plan to avoid malnutrition in patients while they are in the hospital and when they return home.

John Hughlings Jackson (1835-1911) created a science of brain function that, in scope and profundity, is among the great scientific discoveries of the 19th century. It is interesting that the magnitude of his achievement is not completely recognized even among his ardent admirers. Although thousands of practitioners around the world use the clinical applications of his science every day, the principles from which bedside neurology is derived have broader consequences-for modern and future science-that remain unrecognized and unexploited. This paper summarizes the scientific formalism that created modern neurology, demonstrates how its direct implications affect a current area of neuroscientific research, and indicates how Hughlings Jackson's ideas form a path toward a novel solution to an important open problem of the brain and mind.

The valence and oxygen defect properties of cerium oxide nanoparticles (nanoceria) suggest that they may act as auto-regenerative free radical scavengers. Overproduction of the free radical nitric oxide (NO) by the enzyme inducible nitric oxide synthase (iNOS) has been implicated as a critical mediator of inflammation. NO is correlated with disease activity and contributes to tissue destruction. The ability of nanoceria to scavenge free radicals, or reactive oxygen species (ROS), and inhibit inflammatory mediator production in J774A.1 murine macrophages is investigated. Cells internalize nanoceria, the treatment is nontoxic, and oxidative stress and pro-inflammatory iNOS protein expression are abated with stimulation. In vivo studies show nanoceria deposition in mouse tissues with no pathogenicity. Taken together, it is suggested that cerium oxide nanoparticles are well tolerated in mice and are incorporated into cellular tissues. Furthermore, nanoceria may have the potential to reduce ROS production in states of inflammation and therefore serve as a novel therapy for chronic inflammation.

We report a systemic mycosis in a German Shepherd dog caused by Geosmithia argillacea. Although this etiologic agent microscopically resembles a Penicillium species, and is histopathologically compatible with members of the genus Aspergillus, morphologic features and molecular characterization clearly separate it from these genera. This appears to be the first report of disseminated disease by this species in humans or animals. In vitro antifungal susceptibility testing suggests resistance to amphotericin B and voriconazole and susceptibility to caspofungin, itraconazole, and posaconazole.

Pluronic based core-shell nanostructures encapsulating gentamicin were designed in this study. Block copolymers of (PAA(+/-)Na-b-(PEO-b-PPO-b-PEO)-b-PAA(+/-)Na) were blended with PAA(-) Na(+) and complexed with the polycationic antibiotic gentamicin to form nanostructures. Synthesized nanostructures had a hydrodynamic diameter of 210 nm, zeta potentials of -0.7 (+/-0.2), and incorporated approximately 20% by weight of gentamicin. Nanostructures upon co-incubation with J774A.1 macrophage cells showed no adverse toxicity in vitro. Nanostructures administered in vivo either at multiple dosage of 5 microg g(-1) or single dosage of 15 microg g(-1) in AJ-646 mice infected with Salmonella resulted in significant reduction of viable bacteria in the liver and spleen. Histopathological evaluation for concentration-dependent toxicity at a dosage of 15 microg g(-1) revealed mineralized deposits in 50% kidney tissues of free gentamicin-treated mice which in contrast was absent in nanostructure-treated mice. Thus, encapsulation of gentamicin in nanostructures may reduce toxicity and improve in vivo bacterial clearance.

Uncouplers of oxidative phosphorylation have relevance to bioenergetics and obesity. The mechanisms of action of chemical uncouplers of oxidative phosphorylation on biological systems were evaluated using differential gene expression. The transcriptional response in human rhabdomyosarcoma cell line (RD), was elucidated following treatment with carbonyl cyanide p-(trifluoromethoxy) phenylhydrazone (FCCP), a classical uncoupling agent. Changes in mitochondrial membrane potential were used as the biological dosimeter. There was an increase in membrane depolarization with increasing concentrations of FCCP. The concentration at 75% uncoupling (20 microM) was chosen to study gene expression changes, using cDNA-based large-scale differential gene expression (LSDGE) platforms. At the above concentration, subtle light microscopic and clear gene expression changes were observed at 1, 2, and 10 h. Statistically significant transcriptional changes were largely associated with protein synthesis, cell cycle regulation, cytoskeletal proteins, energy metabolism, apoptosis, and inflammatory mediators. Bromodeoxyuridine (BrdU) and propidium iodide (PI) assays revealed cell cycle arrest to occur in the G1 and S phases. There was a significant initial decrease in the intracellular adenosine triphosphate (ATP) concentrations. The following seven genes were selected as potential molecular markers for chemical uncouplers: seryl-tRNA synthetase (Ser-tRS), glutamine-hydrolyzing asparagine synthetase (Glut-HAS), mitochondrial bifunctional methylenetetrahydrofolate dehydrogenase (Mit BMD), mitochondrial heat shock 10-kDa protein (Mit HSP 10), proliferating cyclic nuclear antigen (PCNA), cytoplasmic beta-actin (Act B), and growth arrest and DNA damage-inducible protein 153 (GADD153). Transcriptional changes of all seven genes were later confirmed with reverse transcription-polymerase chain reaction (RT-PCR). These results suggest that gene expression changes may provide a sensitive indicator of uncoupling in response to chemical exposure.

We describe and discuss microscopic findings in the brown adipose tissue (BAT) blood vessels of Han Wistar rats treated with GI262570X, a peroxisome proliferator-activated receptor-gamma agonist (PPAR-gamma agonist) by oral gavage for 28 days, 13 weeks, 27 weeks, and 2 years. Review of these studies revealed a consistent vascular change, consisting of multifocal fatty infiltration in the BAT of treated rats. A similar vascular change was not seen in other vessels or organs. Microscopically, fatty infiltration was characterized primarily by round, clear vacuoles within the tunica media and/or tunica adventitia of small and medium-sized arteries and arterioles. Occasionally, these vacuoles had peripherally located nuclei and morphologically resembled adipocytes, suggesting a well-characterized PPAR effect (ie, differentiation of stem cells or preadipocytes into mature adipocytes). However, administration of GI262570X up to 2 years failed to induce more severe or progressive lesions in the blood vessels of rat BAT and, in particular, did not result in induction of any atherosclerotic-like lesions or foam cell infiltration. At the longer exposure, there was an apparent reduction of severity and/or incidence, indicating a possible adaptive response. These results suggest that the possibility of generating atherosclerotic-like lesions through prolonged treatment of GI262570X (PPAR-gamma agonist) is highly unlikely in rats.

A full assessment of all heart valves in rats and mice is often impractical and is usually not performed in routine toxicity studies, largely due to an inevitable inconsistency of histological sampling. The majority of reported heart valve changes involve the examination of a single, semirandom section through the heart and the valvulopathy occurring with age or induced by xenobiotics may have been generally underestimated in mice and rats. Here we describe the incidence and microscopic features of endocardial myxomatous change (EMC) in Hsd:S-D rats and CD-1 mice. EMC was common and widespread in both CD-1 mice and Hsd:S-D rats (188 of 220 rats and 96 of 215 mice were affected by EMC). Microscopically, EMC consisted of focal or segmental thickening of valves, primarily due to the presence of fibromyxoid tissue in the subendocardium. Occasionally, fibrin or thrombi deposits and collection of neutrophils or mononuclear cells were observed. These microscopic features were similar to those seen in valvular disease in humans induced by fenfluramine-phentermine (fen-phen), ergot alkaloids (ergotamine, methysergide), and carcinoid syndrome. The mitral valve in rats and pulmonary valve in mice were most frequently affected. An association between murine progressive cardiomyopathy (MPC) and EMC was noted only in rats, suggesting that there may be a possible relationship between MPC and EMC. However, additional research is needed to confirm a relationship between EMC and MPC in rats and/or mice.

As the genomes of mammalian species become sequenced and gene functions are ascribed, the use of differential gene expression (DGE) to evaluate organ function will become common in the experimental evaluation of new drug therapies. The ability to translate this technology into useful information for human exposures depends on tissue sampling that is impractical or generally not possible in man. The possibility that the DGE of nucleated cells, reticulocytes, or platelets in blood may present the necessary link with target organ toxicity provides an opportunity to correlate preclinical with clinical outcomes. Adriamycin is highly effective alone and more frequently in combination with other chemotherapeutic agents in the treatment of a variety of susceptible malignancies. Adriamycin-induced cardiomyopathy was examined as an endpoint to measure the utility of DOE on whole blood as a predictor of cardiac toxicity. Statistically significant gene changes were observed between relevant blood and cardiac gene profiles that corroborated the accepted mechanisms of toxicity (oxidative stress, effects on carnitine transport, DNA intercalation). There were, however, clear indications that other target organs (bone marrow and intestinal tract) were affected. The divergent expression of some genes between the blood and the heart on day 7 may also indicate the timing and mechanism of development of the cardiomyopathy and confirm current therapeutic approaches for its prevention. The data demonstrate that whole blood gene expression particularly in relation to oxidative stress, in conjunction with standard hematology and clinical chemistry, may be useful in monitoring and predicting cardiac damage secondary to adriamycin administration. Appendices A & B, referenced in this paper, are not printed in this issue of Toxicologic Pathology. They are available as downloadable text files at http://taylorandfrancis.metapress.com/openurl.asp?genre=journal&issn=0192-6233. To access them, click on the issue link for 30(4), then select this article. A download option appears at the bottom of this abstract. In order to access the full article online, you must either have an individual subscription or a member subscription accessed through www.toxpath.org.

Introduction: Sparse recent data are available in the United States regarding the pathogens of acute otitis media (AOM) most likely to be recovered from children recently treated with the two most frequently prescribed antibiotics, amoxicillin or amoxicillin/clavulanate (AMC)., Methods: Of the 704 rural Kentucky children with culture-positive AOM who underwent a single tympanocentesis or culture of otorrhea between 1992 and 1998, 96 pathogens were recovered from 90 children during therapy or within 7 days posttherapy with an aminopenicillin. Identification and susceptibility testing of AOM pathogens were performed by routine National Committee for Clinical Laboratory Standards methods., Results: Pathogens recovered from children with AOM recently treated (0 to 7 days) with amoxicillin (n = 38) and AMC (n = 58), respectively, were as follows: Haemophilus influenzae (beta-lactamase-negative), 16 and 29%; H. influenzae (beta-lactamase-positive), 11 and 22%; penicillin-susceptible Streptococcus pneumoniae, 26 and 12%; intermediately penicillin-nonsusceptible S. pneumoniae (PNSP), 20 and 10%; resistant PNSP 13 and 17%; Moraxella catarrhalis (beta-lactamase-positive), 13 and 7%; and Streptococcus pyogenes, 3 and 2%. H. influenzae was also isolated from 8 (75%) of 12 children treated with high dose AMC ( approximately 80 mg/kg/day amoxicillin component). Significantly fewer children recently treated with amoxicillin were otitis-prone than those given AMC (24% vs. 74%, P < 0.0001)., Conclusions: The predominant pathogen recovered from children with AOM recently treated with amoxicillin was S. pneumoniae (59%) rather than beta-lactamase-producing organisms (24%). H. influenzae was the predominant (51%) pathogen, rather than PNSP (27%), recovered from children recently treated with AMC.

Peroxisome proliferator-activated receptors (PPARs) are members of the nuclear receptor subfamily of transcription factors with pleiotropic effects on intra- and extracellular lipid metabolism, glucose homeostasis, cell proliferation, control of inflammation, and atherosclerosis. Three PPARs, namely alpha, delta, and gamma have been identified with distinct tissue distribution patterns and metabolic functions. PPAR-alpha is predominantly expressed in brown adipose tissue, liver, kidney, duodenum, heart, skeletal muscle, and vascular endothelial cells and is involved in the control of lipoprotein metabolism, fatty acid oxidation, and the cellular uptake of fatty acids. PPAR-gamma is highly expressed in brown and white adipose tissues and, to lesser extent, in large intestine, retina, and some parts of the immune system, and plays a critical role in adipocyte differentiation and fat deposition. PPAR-delta shows a widespread tissue distribution but its regulation and functions are not yet known. Considerable evidence indicates that PPARs (PPAR-alpha and PPAR-gamma) have beneficial effects in inflammatory diseases, including atherosclerosis, through regulation of cytokine production, adhesion molecule expression on the endothelial cells, fibrinolysis, and modulation of monocyte-derived macrophages. In this review, the general and specific roles of the PPAR isotypes and their implications in the control of vascular inflammation and atherosclerosis are discussed.

The results of general chemistry profiles of canine patients from Angell Memorial Animal Hospital, Boston, Massachusetts, during 1993 were reviewed for low (<24) serum sodium:potassium (Na:K) ratios. Thirty-seven dogs had low Na:K ratios. The medical records for 34 these patients were available and sufficiently complete to identify conditions that were associated with low Na:K ratios. Of these 34 dogs, 8 (24%) had hypoadrenocorticism, and 14 had renal disease. Twenty-two of the 34 (65%) had Na:K ratios between 24 and 20. Of these 22 dogs, 9 (41%) had renal or urinary tract disease, and 2 (9%) had hypoadrenocorticism. Other diagnoses in this group included pancreatic disease (3), disseminated neoplasia (3), circulatory disturbance (2), pyometra (1), mushroom poisoning (1), and behavior problem (1). Eight of 34 dogs had Na:K ratios between 19.9 and 15. Of these 8 dogs, 4 (50%) had urinary tract disease, 2 had hypoadrenocorticism, 1 had pancreatic disease, and 1 had severe anemia and hypoproteinemia due to severe parasitism. All of the 4 dogs with Na:K ratios <15 had hypoadrenocorticism, and 1 of these 4 had concurrent renal failure. In all dogs, serum potassium concentration was above the laboratory's reference range, but sodium was below the laboratory's reference range in only 18 dogs (53%). Two of the 8 (25%) dogs with hypoadrenocorticism had serum sodium concentrations within the laboratory's reference range. In this population, low Na:K ratios were invariably associated with hyperkalemia but not always with hyponatremia. Although numerous conditions were associated with a low Na:K ratio, renal disease was the most common. Hypoadrenocorticism was present in only 13% of dogs with Na:K ratios between 24 and 15 but was present in all dogs with Na:K ratios <15.

From January, 1992, to January, 1994, penicillin-resistant (minimal inhibition concentration (MIC) > 0.06 microgram/ml) Streptococcus pneumoniae (PRSP) isolates accounted for 48 (17%) of 283 isolates from acute otitis media (AOM) or recurrent AOM in 246 ambulatory patients in rural Kentucky. By broth microdilution, relatively penicillin-resistant (MIC > 0.06 to 1.0 microgram/ml) and highly penicillin-resistant (MIC > or = 2.0 micrograms/ml) strains were detected in 25 (16%) and 23 (15%), respectively, of 157 pneumococcal middle ear isolates. Using 1994 National Committee for Clinical Laboratory Standards breakpoints for pneumococci (unavailable for oral cephalosporins except cefuroxime), highly PRSP strains were almost uniformly susceptible to clindamycin and vancomycin. In contrast highly PRSP strains were resistant to most oral antimicrobials customarily used for AOM with one-third of strains highly resistant (MIC > or = 2.0 micrograms/ml) to ceftriaxone. Serotypes 6B, 19F and 23F accounted for 95% of highly PRSP strains and serotype 9V for 48% of relatively PRSP strains. By multivariate analysis, otitis-prone condition (P = 0.0008) and number of antibiotic courses before day of culture (P < 0.0001) were independently predictive of PRSP. Highly PRSP isolates were more commonly isolated from patients recently treated within 3 days (30%) vs. those who completed therapy more than 3 days earlier (2%) (P < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Male wap-ras transgenic mice develop adenocarcinomas in salivary and/or mammary tissue by age 1 year. When the wap-ras transgene was bred into the FVB/N strain, males developed multiple mammary tumors between 1.5 and 3 mo. of age, but no salivary tumors. Crosses between ras/FVB mice and other strains produced moderate changes in mammary tumor onset and severity, but no salivary tumors. Histopathological analysis of 62 adenocarcinomas from 18 mice yielded: 14 tumors with areas of squamous metaplasia, many tumors with epithelium-lined cysts, few immune cells in tumors, and no lung metastases. Cyclophosphamide delayed tumor onset and inhibited the growth of established tumors. Our results suggest that wap-ras mice will be useful for studying ras-mediated tumor genetics and should be a good assay system for both preventative and curative anticancer therapies.

A novel cell line (WR21) was derived from a salivary tumor in a male wap-ras transgenic mouse. Salivary tumors in wap-ras transgenic mice are extremely aggressive and express high levels of oncogenic ras protein from the activated, human Ha-ras transgene. WR21 cells also expressed high levels of oncogenic ras protein in vitro and in vivo. They gave rise to aggressive, highly anaplastic solid tumors when injected subcutaneously into athymic nude mice and approximately 90% of the mice had lung metastases by the fifth week of tumor growth. WR21 tumors were inhibited by cyclophosphamide, 5-fluorouracil, adriamycin, mitomycin C and actinomycin D, but not methotrexate. Our results suggest that the WR21/nude mice model will be useful for testing the efficacy of drug therapies against ras-mediated neoplasias.

Pneumocystis carinii pneumonia was diagnosed in 3 foals. In 2 foals (No. 1 and 2), diagnosis was by histologic evaluation of pulmonary tissue. On retrospective evaluation, P carinii cysts were found on sediment smears of bronchoalveolar lavage fluid in 1 foal (No. 1). A different foal (No. 3) was diagnosed as having pneumocytosis by finding P carinii cysts in bronchoalveolar lavage fluid, and was treated successfully. Definitive diagnosis of pneumocytosis in animals is usually made at necropsy. However, careful cytologic evaluation in bronchoalveolar lavage fluid sediment can provide a diagnosis in some cases, allowing for initiation of appropriate treatment.

Many nursing administrators have implemented hospital wide professional practice systems in the form of shared governance or collaborative practice models. Current literature shows limited descriptions of shared governance from a staff nurse's perspective. This article describes the successful implementation of a staff-initiated professional practice model (PPM). Using the nursing process, a PPM can be instituted in any PACU when specific characteristics of professional practice are present within the group.

This study evaluated the immunogenicity and safety/tolerability profile of an investigational formalin-inactivated hepatitis A virus vaccine (VAQTA; Merck Research Laboratories) in 150 seronegative healthy children, 4 to 12 years old. The vaccine was derived from virus grown in infected MRC-5 cells in either roller bottles or Nunc cell factories (Nunc, Denmark). Subjects were vaccinated intramuscularly in a two dose regimen initially and at 24 weeks: Group A (n = 50) with a 12-unit dose from a roller bottle lot; Group B (n = 50) with a 25-unit dose from another roller bottle lot; and Group C (n = 50) with a 25-unit dose from a Nunc cell lot. Sera for anti-hepatitis A virus antibodies were drawn 3 weeks before vaccination and 4, 24 and 28 weeks after the first dose. Seroconversion from < 10 mIU/ml to > or = 10 mIU/ml by modified HAVAB (Abbott Laboratories) was observed in 99% of subjects at week 4 and persisted in 100% of subjects at week 28 (4 weeks after the second dose). The ranges of geometric mean titers of anti-HAV for all subjects at weeks 4, 24 and 28 were 31 to 49, 51 to 79 and 7059 to 29,609 mIU/ml, respectively. The 12- and 25-unit dose levels of roller bottle yielded similar geometric mean titers. The rise in geometric mean titers after the booster dose was > 120-fold and was highest in the recipients of the 25-unit Nunc cell lot (P < 0.05 for Group C vs. B).(ABSTRACT TRUNCATED AT 250 WORDS)

An open label randomized trial conducted in rural Kentucky compared the efficacy and safety of cefixime (CFX), 8 mg/kg once daily, with those of penicillin V (PEN), 250 mg 3 times daily, in 110 pediatric patients with Group A beta-hemolytic streptococcal pharyngitis. Forty-eight CFX and 47 PEN patients were evaluable for efficacy. At the end of therapy bacteriologic eradication was 45 of 48 (94%) and 36 of 47 (77%) in the CFX and PEN V groups, respectively (P < 0.05). Up to 6 weeks posttherapy 10 (21%) CFX patients and 21 (45%) PEN patients had positive Group A beta-hemolytic Streptococcus cultures (P < 0.05). Concordant serotypes were identified from 4 of 7 CFX and 15 of 17 PEN patients with positive repeat cultures. All discordant serotypes (5 of 31) were identified at greater than 19 days posttherapy. Symptomatic treatment failures (concordant serotypes) occurred in 1 (2%) CFX and 8 (17%) PEN patients (P < 0.05). Drug-related adverse experiences consisted of 2 cases of mild diarrhea and loose stools in the CFX group and none in the PEN group. No clinically significant laboratory test abnormalities occurred in either group. CFX, once daily, was as safe as and significantly more effective than PEN given 3 times daily for the treatment of Group A beta-hemolytic streptococcal pharyngitis.

Transgenic mouse models have provided many valuable insights into the molecular mechanisms of tumorigenesis; unfortunately, there is a paucity of published information on the utility of these models for evaluating potential anticancer therapeutics. Line 69 wap-ras transgenic mice have an activated, human c-Ha-ras gene on their Y chromosome. Adult males develop salivary and/or mammary adenocarcinomas. Both tumor types express high levels of human ras oncoprotein. Two new sublines, designated wap-ras/F, were created by selective breeding. Subline 69-2 wap-ras/F males developed multiple mammary tumors at puberty. Tumor onset was delayed by cyclophosphamide treatment prior to puberty. Mammary tumors from cyclophosphamide-treated mice weighed 0.57 +/- 0.09 g/mouse (SD +/- SEM; n = 8), while tumors from control mice weighed significantly more at 2.36 +/- 0.25 g/mouse (n = 8; P less than or equal to 0.001; SD +/- SEM). These results suggest that subline 69-2F mice will be valuable for testing therapeutic regimes designed to interfere with processes occurring early in tumorigenesis, before palpable tumor presentation. Tumor sensitivity to several clinically relevant cytotoxins was also tested in adult wap-ras males with palpable tumors. Both salivary and mammary tumors were sensitive to cyclophosphamide and 5-fluorouracil, but not methotrexate. This suggests that wap-ras transgenic mice will indeed be useful in the discovery of novel therapeutics against neoplasia.

Mutated ras genes are powerful transforming agents in vitro and are found in a wide variety of human tumors in vivo. We characterized the histopathology and p21 protein expression associated with tumorigenesis in line 69 transgenic mice carrying an activated, human c-Ha-ras gene on the Y-chromosome (A. C. Andres, C. A. Schonenberger, B. Groner, L. Hennighausen, M. LeMeur, and P. Gerlinger, Proc. Natl. Acad. Sci. USA, 84: 1299-1303, 1987). Male mice developed salivary and/or mammary gland tumors. The salivary tumors were adenosquamous carcinomas arising from serous areas of the submandibular gland. They characteristically exhibited densely packed cords and sheets of moderately anaplastic cells. Tumorigenic tissue had a high mitotic index, and all tumor-bearing animals had an ongoing inflammatory response as evidenced by extensive immune cell infiltration of affected tissue. Half of the mammary gland tumors were adenosquamous carcinomas with multiple foci of squamous metaplasia, while the rest were adenocarcinomas containing glandular tissue. Most tumors had a high mitotic index, and abnormal mitotic figures were common. All tumors produced p21 ras, as confirmed by immunohistochemistry and Western blots. Both tumor types expressed elevated levels of p21 protein. Microscopic lung metastases were present in 5 of 35 animals (14%). Our results suggest that this transgenic mouse will provide a useful model for testing therapies directed against ras-associated tumorigenesis.

In the decade from 1950 to 1960, two quality-related processes--medical audit and total quality management--were being developed, one directly in the health care field and the other in the manufacturing sector. These processes remained isolated from each other until the mid-1980s. Each would have a separate but major effect on the health care industry.

Three dogs were treated for acute severe systemic reactions following Hymenoptera stings. The reactions were characterized clinically by CNS depression, shock, and hemorrhage, and clinicopathologically by inflammation, liver injury, renal disease, hypoproteinemia, and possible disseminated intravascular coagulation. The severe systemic reaction may have resulted from allergic mechanisms, toxic, nonimmunologic mechanisms, or both. Rapid correction of hypovolemia and prevention of vascular stasis are the most important aspects of treatment.

An ear tick, Otobius megnini (Dugès) recovered from a child who had serologic evidence of ehrlichiosis, was examined for Ehrlichia species microscopically and by inoculation into a susceptible dog; no evidence of infection was found in the tick. Experimental transmission of E. canis by laboratory-reared O. megnini was attempted; neither transstadial nor transovarial transmission occurred.

The CSF creatine kinase (CK) activity was determined in 70 CSF samples from 69 horses with CNS disease. Abnormal values (greater than or equal to 1 IU/L) were determined from 32 CSF samples, and normal values (less than 1 IU/L) were found in 38 samples. Increased CK activity was most frequently associated with a diagnosis of equine protozoal myelitis; CK activity was not increased in 11 horses with cervical compressive myelopathy. Other diagnoses, in which CSF CK activity was increased included trauma (n = 1), idiopathic epilepsy (n = 2), botulism (n = 2), articular facet fracture (n = 1), intervertebral disk protrusion (n = 1), and toxemia (n = 1).

Certain diseases cause an increase in the amount of fluid present in the pleural and/or peritoneal cavity (an effusion). Uroperitoneum subsequent to kidney, ureter, bladder, or urethra rupture also can cause an increased amount of fluid in the abdomen. Evaluation of fluid samples often is helpful in identifying the mechanism causing the effusion and, occasionally, results in a specific diagnosis. The TP, TNCC, and general cytologic examination can be performed easily, quickly, and inexpensively in-house. The TP and TNCC are used to classify effusions as transudates, modified transudates, or exudates. Transudates usually are caused by hypoalbuminemia, but also can be caused by leakage of fluid from efferent intestinal lymphatics. Cytology and culture usually are not rewarding in the evaluation of transudates. Modified transudates usually are caused by increased vascular permeability or increased intrahepatic hydrostatic pressure. Cytologic and radiographic examinations often are helpful in evaluating patients with modified transudates, while cultures usually are unrewarding. The exudate class encompasses the inflammatory exudates (septic or nonseptic), neoplastic exudates, and chylous effusions. Inflammatory exudates have a high TP and predominantly contain inflammatory cells. They may be septic or nonseptic. When septic, degeneration neutrophils often, but not always, are found. Cultures often are needed to determine whether sepsis is present, to identify the specific organism, and to determine the best therapy. Neoplastic exudates may contain numerous neoplastic cells. If there is concern that the cells are dysplastic instead of neoplastic, the cytology preparation should be referred to a consultant. Chylous effusions usually contain many small lymphocytes with a variable number of neutrophils and macrophages. In chronic chylous effusions, however, neutrophils and/or macrophages may predominate. Chylous effusions usually are differentiated easily from pseudochylous effusions by cytology. Comparison of fluid and serum triglyceride and cholesterol concentrations can be used to differentiate chylous and pseudochylous effusions when differentiation cannot be accomplished by cytology.

One of the most utilitarian developments in the field of quality assurance in health care has been the introduction of industrial concepts of quality management. These concepts, coupled with buyer demand for accountability, are bringing new perspectives to health care quality assurance. These perspectives provide a new view of quality assurance as a major responsibility and strategic opportunity for management; a competitive and marketable commodity; and a method of improving safety, effectiveness, and satisfaction with medical care.

Disseminated histoplasmosis was diagnosed in a 10-year-old dog that had chronic diarrhea, weight loss, fever, and anemia. The diagnosis was based on detection of Histoplasma organisms in circulating neutrophils, monocytes, and eosinophils. The dog had severe histoplasmal fungemia, which may have been caused by treatment with prednisolone.

Normal reference ranges and pertinent background information on equine hematology are presented and briefly discussed. Diagnostic interpretation of hematologic data is discussed and three diagnostic algorithms and two diagnostic tables are provided to facilitate the use of the presented information for diagnosis. Two cases are presented and the information presented in the article is used to interpret the case data.

Anemia, weight loss, lethargy, fever, anorexia, and interstitial lung disease were the predominant clinical findings in 12 cats with disseminated histoplasmosis. Some cats were examined because of dysfunction or lesions of bone, eyes, or skin. In most cases, the clinical signs were observed by the owner for 4 weeks or less before seeking veterinary care. Young cats were most commonly affected, with 7 of the 12 cats less than or equal to 1 year old. Identification of Histoplasma organisms in bone marrow aspirates was used to confirm the diagnosis of histoplasmosis in 11 of the 12 cats. Histoplasma infection of multiple organs was found at necropsy. In this study, disseminated histoplasmosis had a higher prevalence in cats than in dogs at the same veterinary medical teaching hospital. Feline disseminated histoplasmosis was not associated with FeLV infection. Treatment was attempted in 7 of the 12 cats.

Pharmacokinetic values and possible toxic effects of chloramphenicol on bone marrow and hematologic and serum chemical values were determined in newborn calves given the drug (IV) once a week or in repeated doses, 12 hours between doses. The rates of elimination for chloramphenicol and antipyrine also were compared. Chloramphenicol also was administered to older calves by IM and subcutaneous routes, with an apparent bioavailability of 50% to 60%. The elimination half-lives for both chloramphenicol and antipyrine were markedly increased in the newborn calf for at least the first 3 to 4 weeks of life. Despite the high and prolonged serum chloramphenicol concentrations in these calves, there was little or no indication of toxic effects. Bone marrow aspirates did not reveal any signs of intoxication such as cytoplasmic or nuclear vacuolation. Marrow cellularity was not recognizably different from the control group.

This article discusses collection, slide preparation, culture technique, fluid analysis and evaluation, and cytologic evaluation of peritoneal and pleural effusions. The morphologic characteristics of various effusions are described, and the physical characteristics (volume, color, turbidity) of effusions are discussed. An algorithm for classifying effusions as transudates, modified transudates, or exudates is included, and each category is discussed.

Purified protein A from Staphylococcus aureus Cowan I was injected intraperitoneally or was incorporated in filters ex vivo through which plasma from cats with feline leukemia virus (FeLV)-associated leukemia-lymphoma was passed. Before treatment, 65% of the FeLV-infected cats were anemic, and 70% were thrombocytopenic. Concomitant infections, or immune-mediated disease, was common. During treatment 50% of the cats with FeLV-associated disease improved objectively with normal posttreatment hematocrits, thrombocyte and leukocyte counts, disappearance of dysplastic hematologic elements, and correction of marrow dyscrasias. A 33% response to treatment occurred in cats with unequivocal manifestations of malignant disease and was characterized by reductions in tumor size and marrow and peripheral blood neoplastic cell populations. Clearance of FeLV viremia was documented in 28% of the treated cats. The several possible mechanisms by which treatment with staphylococcal protein A causes reduction in the extent of malignant disease are considered.

Three cases of hypercalcemia were recognized among 11 cats presenting with leukemia-lymphoma for ex vivo immunoadsorption therapy using Staphylococcal Protein-A-coated filters. In addition, the initial mean serum calcium concentration of cats with leukemia-lymphoma was significantly higher (P less than 0.005) than that of healthy control cats or feline-leukemia-virus-infected cats without malignancy. During immunotherapy of the hypercalcemic cats, objective reduction in the extent of the malignancies was associated with a small reduction in the serum calcium concentrations. This response to treatment, the lack of skeletal metastasis, and the absence of renal and parathyroid pathologic findings imply that humorally mediated mechanisms may have been responsible for the production of the hypercalcemia.

A cat with feline leukaemia virus-associated malignant disease was treated by ex vivo immunoadsorption using staphylococcal protein A coated filters. During the 12-week course of treatment, the morphological manifestations of the haematopoietic disease showed a progressive transition from erythroid to myeloerythroid to myeloid predominance, and the disease was preceded by and associated initially and terminally with a blast transformation of lymphoblastic morphology. Necropsy revealed massive meningo-cerebral, as well as hepatic, renal, myeloid, lymphoid, peritoneal and pelvic infiltrations largely consisting of lymphoblastic cells. Evidence of myeloid and erythroid differentiation was present in all the infiltrates. The several possible bases for this shift of morphological expression are considered.

Chloramphenicol was administered intravenously for eight to 17 days to five newborn calves at a daily dosage of 100 mg kg-1. Haemodynamic, haematological, blood chemistry, serum enzyme, urinalysis and clinical responses were evaluated. High levels of serum chloramphenicol were observed throughout the study although a marked increase in elimination rate was seen with increasing age. The most severe adverse effects were severe hypotension following rapid intravenous administration and severe gastrointestinal dysfunction with diarrhoea accompanying prolonged high dosage. There appeared to have been a haematological effect in one calf, but it was of minor significance compared with the other effects.

Ehrlichia canis infection was diagnosed in a dog with a history of seizures and nonregenerative anemia. Serologic titer to E canis was greater than 1:100. Evaluation of CSF revealed a high cell count, high protein concentration, and a positive Pandy test result. Several mononuclear leukocytes in the CSF contained E canis morulae. Central nervous system lesions are commonly found on postmortem examination of animals with ehrlichiosis, although clinical reports of neurologic signs attributable to this disease are less common. Ehrlichiosis should be included in the differential diagnosis of CNS disease in dogs from enzootic areas.