A boxer dog with chronic hypertrophic gastritis resembling Menetrier's disease in man

Chronic hypertrophic gastritis in a 7-year-old Boxer dog is described. This gastritis resembles Menetrier's disease in man. The dog was emaciated, lethargic, vomiting and had a poor appetite over a 4-month period. There was anaemia, and the blood smear was characterized by hypochromasia, strong anisoplania and striking poikilocytosis. There was a protein loss and at a later stage of the disease, a hypoalbuminaemia. On gastroscopic examination the plicae gastricae were numerous and strongly marked; moreover, they were granulated with numerous small haemorrhages. Radiographically, the stomach had a marked folding, primarily at the greater curvature. The passage of contrast medium from the stomach into the duodenum was strongly retarded. The pathological findings included macroscopical folding caused by local gland cell hyperplasia in the body as well as the pylorus, foveolar hyperplasia and, in the fundus and in the corpus near the greater curvature, folding of the muscularis mucosae and the submucosa. A superficial gastritis was found particularly in the fundus and corpus, whereas the pyloric antrum showed a more diffuse inflammation.     

Chronic Monteggia injury in a child

The case of a Monteggia fracture neglected from two years of age and seen at the age of fourteen, is described. A shortening of the affected ulna by three cm and a relative elongation of the radius was found. The function of the arm and elbow joint was remarkably unaffected with nearly full extension and flexion, supination and pronation. The carrying angle was ten degrees on both sides. Based on the literature, it is stressed that diagnosis and treatment of Monteggia lesions should be immediate. Complications in non-treated cases and at late treatment are many, and the results of such treatment dubious. It is thus of great importance that, when dealing with ulnar fracture a radiograph is also taken of the elbow joint to secure immediate diagnosis.     

Tuberculosis in Hodgkin's disease in a child

During its evolution, Hodgkin disease is accompanied by changes in the cell immunity, mainly of delayed type. Tuberculosis can precede Hodgkin disease or complicate its evolution during a simultaneous development of both diseases, or the lymph node tuberculosis can hurry hemopathy onset. Tb lesions in such patients can have atypical features.     

Recurrent sinopulmonary disease in a young adult

In 50 patients aged 60 +/- 4 operated for colorectal carcinoma simultaneous combined radionuclide phlebography (RNP) and pulmonary perfusion scintigraphy (PPS) using 99Tcm labeled macroaggregates of the human serum albumin (MAHSA) were performed within 20 postoperative days aiming to detect deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE). The aim of the study was to determine the incidence and segmental DVT localization as well as incidence, localization and clinical characteristics of developed pulmonary perfusion disorders. Deep vein thrombosis was detected in 33 (66%) patients with rather uniform distribution in vein segments. According to their scintigraphic characteristics the findings suggested recent thrombosis in almost all cases (only two of them had signs of chronic thrombosis). Of patients with detected DVT 17 (52%) had pulmonary perfusion disorders of which 10 (59%) were unilateral (7 right and 3 left) and 7 (42%) bilateral. Characteristics and extent of perfusion defects suggested very probable PTE in 11 (65%) patients and less probable in 6 (35%). It has been concluded that patients operated for colorectal carcinoma were highly exposed to DVT and PTE development which necessitates all measures contributing to their prevention.     

Chronic arthritis and carpo:metacarpal ratio in Japanese patients with adult Still's disease

OBJECTIVE: To characterize Japanese patients having adult Still's disease (ASD) with chronic arthritis (> 6 months) and to examine the association of chronic arthritis with carpo:metacarpal ratio (CMC ratio), an index of radiographic progression in rheumatoid arthritis (RA). METHODS: Twenty-seven patients with ASD (16 women and 11 men, mean age at disease onset 27.7 years) were classified into 2 groups: patients with (chronic articular ASD, 16 patients, 59%) or without (systemic ASD, 11 patients, 41%) chronic arthritis. Clinical and laboratory findings were compared between both groups. CMC ratio was calculated on serial hand radiographs in patients with chronic articular ASD. RESULTS: In our series, serositis was rarely observed in chronic articular ASD. Peripheral arthritis (including transient arthritis), such as metacarpophalangeal, proximal interphalangeal, or ankle joint, was more frequently observed in chronic articular ASD than in systemic ASD (p < 0.05). Wrist arthritis was frequently observed also in systemic ASD; however, joint space narrowing of carpometacarpal or intercarpal joints was recognized only in chronic articular ASD (44%). CMC ratio at the last observation in 14 patients with chronic articular ASD was significantly decreased (0.526 +/- 0.039) compared to that at disease onset (0.553 +/- 0.034) (p < 0.05), while no decrease was observed in 4 with systemic ASD (0.565 +/- 0.062 at disease onset, 0.563 +/- 0.043 at the last observation). CONCLUSION: It is suggested that chronic articular ASD has certain characteristics. CMC ratio may be a quantitative index for assessment of radiographic changes of carpal joints, not only in RA but also in chronic articular ASD.     

Chronic parvovirus infection mimicking myelodysplastic syndrome in a child with subclinical immunodeficiency

1. The effect of cyclo(D-Trp-D-Asp-Pro-D-Val-Leu) (or BQ123), a selective ETA receptor antagonist, on the vasoconstrictor and diuretic responses elicited by endothelin-1 (ET-1) was examined in conscious sheep with chronic indwelling renal arterial cannulae. 2. Using low dose close renal arterial infusion, ET-1 has potent effects on the kidney causing a marked decrease in effective renal plasma flow and an increase in urine output and free water clearance in the normally hydrated animal. 3. The vasoconstrictor response to renal arterial infusion of ET-1 at 5 micrograms/h was blunted by renal arterial infusion of the ETA receptor selective antagonist, BQ123 (400 micrograms/h). 4. In contrast, the effect of ET-1 on urine production and free water clearance was not affected by this dose of BQ123. 5. The differential effect of BQ123 on renal blood flow and urine production suggests that these effects of endothelin on the kidney are mediated through different receptor mechanisms.     

Leucinosis--a case of congenital metabolic disease in a child

Trasditional Chinese medicine is based on inductive-synthetic reasoning with regard to all life processes, in contrast to the causal-analytic orientation in our Western medicine. This philosophical approach is based on a system of comparisons (equivalents), referred to as Yin and Yang. Vital functions are seen as "energizing" processes, whereby the acupuncture points and the system of meridians are seen as a means of regulation for this "energy". A disturbed balance in this energy results in illness. The therapy according to the acupuncture method is to acheive a balance in the disturbed flow of energy by means of acupuncture points. By utilizing biophysical methods of measurement, it is possible to prove that a change in this energy takes place. The complex active principle which results in the effectiveness of acupuncture includes neurophysiological, biochemical and biophysical functional processes.     

Hodgkin''s disease occurring in a child after liver transplantation

Broiler chicks were treated by oral gavage on the day of hatch with a continuous-flow competitive exclusion culture (PREEMPT). At 4 h, 1 day, or 2 days posttreatment, chicks were challenged by oral gavage with 10(2) or 10(4) Salmonella CFU to determine the effects of challenge time on Salmonella cecal colonization. Cecal propionic acid concentrations in two trials increased (P < or = 0.001) within 1 day posttreatment in chicks given PREEMPT, and the increases were indicative of the establishment of the PREEMPT bacteria. Salmonella cecal populations decreased (P < or = 0.001) on average 6 log10 units in these two trials in chicks challenged 4 h posttreatment with 10(4) Salmonella CFU. In a third trial propionic acid did not increase significantly until 2 days after treatment, and there was no decrease in Salmonella colonization when chicks were challenged at 4 h after treatment. However, there were decreases in that same trial when chicks were challenged at 1 and 2 days after treatment. The early establishment of PREEMPT followed by challenges with 10(2) and 10(4) Salmonella CFU resulted in 3% and 3%, respectively, of the ceca testing Salmonella-culture-positive, compared to 28% and 95%, respectively, culture-positive ceca in untreated chicks. The results from this study indicated that in most instances young broiler chicks can be protected against cecal colonization when challenged with 10(2) and 10(4) Salmonella CFU as early as 4 h posttreatment on the day of hatch with the PREEMPT bacteria.     

Pedophiles' ratings of adult and child photographs using a semantic differential

Recent knowledge of the widespread extent of child sexual abuse and its consequences has led to an increasing interest in the understanding and treatment of perpetrators. This study examined a group of pedophiles in an English Special Hospital to determine possible characteristics that make children attractive and adults unattractive to them, using Repertory Grid technique and Semantic Differential. A small number of significant findings suggest that pedophiles may perceive some children and women in an unusual way. The large number of insignificant findings are discussed with reference to the sensitivity of the instrument; the pedophiles' desire to give socially acceptable answers; and subject characteristics of low IQ and "psychopathic disorder." Future directions for research are suggested.     

Percutaneous transluminal coronary angioplasty in a child with Kawasaki disease

A successful attempt at percutaneous transluminanl coronary angioplasty (PTCA) to relieve stenosis of the mid-portion of the left anterior descending artery was achieved in a 6-year 9-month old boy who had multiple coronary aneurysms and stenosis due to Kawasaki disease. Despite the progression of coronary stenosis he had been well except for the perfusion defect of the anterior wall of myocardium on 99mTc-MIBI SPECT with dipyridamole infusion until PTCA was carried out after 4-year 4-months of the onset of illness. The area of stenosis was 70% before PTCA and 20% after PTCA. No restenosis at the site of PTCA was observed on follow-up angiography at 26 months after PTCA. This successful attempt may indicate that this procedure should be considered early in subclinical stenosis to prevent ischemic cardiac damage.     

Absorption of isomeric, palmitic acid-containing triacylglycerols resembling human milk fat in the adult rat

The effect of the positional distribution of palmitic acid (16:0) in triacylglycerols (TAG) on 16:0 apparent absorption in adult rats was investigated. The rats were fed two diets which contained 30 energy % as fat with identical total fatty acid compositions, both containing 30% 16:0. The Betapol diet contained TAG with 73% of total 16:0 in the sn-2 position, the control diet contained TAG with 6% of total 16:0 in the sn-2 position. After six weeks on these diets, the rats were killed two or six hours after the last meal, and the small intestine was removed, cut into 10-cm segments, and the fatty acid composition of the segment's contents was determined. At both time points the amount of 16:0 in the intestinal segments starting at 40 cm from the stomach was much lower in the animals fed Betapol than in the animals fed the control diet. Overall absorption of 16:0 and stearic acid was significantly greater in the Betapol group. Absorption of oleic and linoleic acid from the small intestine was similar in both groups, although the overall absorption was significantly greater in the animals fed Betapol. Total fat absorption was significantly higher in the Betapol-fed rats than in the control-fed rats. No effect on calcium and nitrogen absorption, on plasma total cholesterol and TAG levels, and on bodyweights (growth) was seen. The data demonstrate that the positional distribution of the fatty acids in the TAG molecule affects the site of absorption in the small intestine and particularly the net absorption of saturated fatty acids.     

Pulmonary disease in the immunocompromised child

Adhesion receptors that are known to initiate contact (tethering) between blood-borne leukocytes and their endothelial counterreceptors are frequently concentrated on the microvilli of leukocytes. Other adhesion molecules are displayed either randomly or preferentially on the planar cell body. To determine whether ultrastructural distribution plays a role during tethering in vivo, we used pre-B cell transfectants expressing L- or E-selectin ectodomains linked to transmembrane/intracellular domains that mediated different surface distribution patterns. We analyzed the frequency and velocity of transfectant rolling in high endothelial venules of peripheral lymph nodes using an intravital microscopy model. Ectodomains on microvilli conferred a higher efficiency at initiating rolling than random distribution which, in turn, was more efficient than preferential expression on the cell body. The role of microvillous presentation was less accentuated in venules below 20 micrometers in diameter than in larger venules. In the narrow venules, tethering of cells with cell body expression may have been aided by forced margination through collision with erythrocytes. L-selectin transfected cells rolled 10-fold faster than E-selectin transfectants. Interestingly, rolling velocity histograms of cell lines expressing equivalent copy numbers of the same ectodomain were always similar, irrespective of the topographic distribution. Our data indicate that the distribution of adhesion receptors has a dramatic impact on contact initiation between leukocytes and endothelial cells, but does not play a role once rolling has been established.     

Coeliac disease in the adult

Coeliac disease can by defined as a chronic disease characterized by a typical mucosal lesion of the small intestine and an impaired nutrient absorption which improves on withdrawal of gluten from the diet. The prevalence rate has increased over the last decades and just 1/3 of cases are diagnosed in childhood. There is a striking association with class II histocompatibility antigens, HLA-DR3 and HLA-DQ2. Cellular immune response mediated by intraepithelial and lamina propria lymphocytes is the primary event in the small intestine damage. Up to 50% of adult coeliac patients don't present intestinal symptoms being more frequent subclinic forms. The immunological markers of coeliac disease are antigliadin, antireticulin and antiendomysial antibodies, being the last one the most specific. Mortality of coeliac patient is increased mainly for malignancies, being the most frequent the intestinal T lymphoma.