Cavoatriopulmonary tunnel with valvular interatrial communication

We describe a 56-year-old Caucasian man with history of multiple regressed basal cell carcinomas. During the last 20 years approximately 200 histologically proven basal cell carcinomas preferentially localized on the face were surgically treated. Several large skin grafts were necessary to cover the extensive tissue defects on the face and scalp. Although all excised tissues were histologically proven to be basal cell carcinomas with tumor-free margins, new tumors developed in proximity to the skin graft margins. The dissemination of the new tumors made it difficult to perform additional invasive operation procedures without influencing the cosmetic result. Thus, we used photodynamic diagnosis to improve detection and demarcation of the neoplastic tissues. This procedure facilitated surgical planning and enabled primary in toto excisions. Surgical trauma and a number of interventions were thus minimized with the consequence of improved cosmetic and functional results.     

A case study in communication disorders

Often, children with language disorders exhibit other more subtle delays or deviance in social, communicative, and cognitive development. By focusing on these three areas, the clinician can understand the developmental context in which the language delay manifests. This approach includes the following: gathering information, psychological and communicative examinations, psychiatric examination, and medical evaluation.     

Disseminated candidiasis (moniliasis) in a dog. A case report

A case of systemic candidiasis (Candida albicans) in a 1 1/2 year old dog is reported. Clinically, the first manifestation was enlargement of a superficial inguinal lymph node. Later several peripheral lymph nodes were affected and a fistulous opening appeared, communicating with an inflammatory process in the right humerus. Necropsy revealed gross lesions in the kidneys, pancreas and multiple lymph nodes. In addition, microscopic lesions were observed in the myocardium and the bone marrow of the right humerus. The lesions, which contained large fungal colonies, were mainly granulomatous with numerous multinuclear giant and epitheloid cells, but necrosis and suppuration were also evident. The site of invasion is not known. However, a previous perianal and abdominal dermatitis, which was treated locally with antibiotics and corticoids, could possibly have been a mycotic infection.     

A rare case of patent ductus arteriosus in a dog with glomerular mesangiolysis

Rare case of patent ductus arteriosus (PDA) was observed in a 2-year and 9 month-old Miniature Dachshund which had been diagnosed as severe cardiac failure. Pulmonary artery from the right ventricle connected to dilated ductus arteriosus, and pulmonary artery-ductus arteriosus-descending aorta formed a continuous duct, which seemed to be the main route of bloodstream. Ascending aorta from the left ventricle was hypoplastic, and connected to the dilated ductus arteriosus. Glomerular mesangiolysis due to heart failure was also observed in the kidney.     

Phenytoin toxicity: a fatal case in a dog with hepatitis and jaundice

Pheyntoin (Epanutin: Parke, Davis) is widely used for the control of chronic convulsive disorders in the dog because it exerts an anti-epileptic effect without causing general depression of the central nervous system. To our knowledge fatal cases of phenytoin sensitivity in the dog have not been reported. A case is described in which hepatitis, jaundice and death followed the administration of the drug.     

Splenocaval shunting for alleviation of portal hypertension in a dog: a case report

To demonstrate the usefulness of in vivo 31P nuclear magnetic resonance spectroscopy (MRS) in the diagnosis of ischemic heart disease, major findings from three clinical cardiac MRS investigations performed at our institute are summarized. The first study investigated whether 31P MRS with handgrip exercise testing could detect myocardial ischemia demonstrated by exercise 201Tl scintigraphy. Contrary to findings in normal subjects or patients with fixed thallium defects, the ratio of phosphocreatine (PCr) to ATP decreased significantly during exercise in patients with reversible thallium defects. In the second study, PCr and ATP content was measured by 31P MRS and compared in human myocardium with reversible ischemia or scar diagnosed by exercise thallium scintigraphy. Although the PCr content decreased in patients with either reversible or fixed thallium defects, the ATP content decreased only in the latter group. In the third study, postischemic myocardium with chronic mechanical dysfunction that exhibits recovery after revascularization in left ventriculography was metabolically characterized using quantitative cardiac 31P MRS. Postischemic myocardium with reversible mechanical dysfunction demonstrated reduced PCr but normal ATP content. These results suggest that 31P MRS is a clinically important method both for the detection of myocardial ischemia and in the evaluation of myocardial viability.     

Lameness in a dog following gunshot wound; case report and management protocol

The clinical signs and surgical treatment of a 3-year old German wirehair Pointer with chronic intermittent lameness due to a gunshot injury are presented. In addition to routine radiography, ultrasound investigation and positive contrast arthrography of the radiocarpal joint showed that a bullet was located in the lateropalmar part of the radiocarpal joint cavity. Surgical removal of the bullet led to complete clinical recovery. A diagnostic and therapeutic protocol is presented for dogs and cats with gunshot injuries.     

Pseudorabies in a dog

Pseudorabies was diagnosed in a 5-year-old female crossbred dog by histologic examination and virus isolation. The clinical signs were depression, salivation, head pressing, and emesis. There were no gross pathologic findings. The microscopic findings in the brain stem consisted of mononuclear cell infiltrates in the leptomeninges, subarachnoid space, and neuropil. In addition, there were mononuclear cell perivascular cuffs, focal areas of gliosis, neuronal degeneration, and acidophilic intranuclear inclusions in neurons and astrocytes. Other microscopic findings were edema of lungs and fatty change in the liver. The virus was isolated from the brain and tonsils and identified by fluorescent antibody technique. Pseudorabies virus was isolated from pigs on the farm.     

Hepatoblastoma in a dog

BACKGROUND: In neonates and infants epicardial stimulation may be preferred to endocardial stimulation because of growth-associated lead problems and the risk of vascular complications associated with transvenous electrodes. This study analyzes the feasibility of atrioventricular implantation of a new epicardial lead using the video-assisted thoracic surgical (VATS) technique in an animal model. METHODS: Bipolar steroid-eluting epicardial leads were implanted in seven young white pigs. In five animals bipolar atrial and ventricular pacing leads (n = 10) were inserted and fixed by the VATS technique, while two animals served as controls and underwent implantation through anterolateral thoracotomy. Surgical feasibility, pacing, and sensing thresholds of the leads as well as hemodynamic parameters during pacing were studied. Histological changes beneath the electrodes were evaluated 1 week after the implantation. RESULTS: All animals survived the pacemaker lead implantation. One animal which underwent thoracotomy died because of irreversible ventricular fibrillation induced by rapid ventricular pacing. One animal in the VATS group exhibited intraoperative herniation of the heart through the pericardial window. All animals with left-sided VATS implantations demonstrated good individual pacing and sensing threshold values. The mean cardiac output was 1.6 times higher during AAI-mode pacing as compared to VVI-mode pacing at a heart rate of 140/min. One animal died postoperatively due to respiratory failure. No displacements of the pacemaker leads were observed in the survivors. CONCLUSION: While VATS-guided implantation of epicardial, atrial, and ventricular leads is feasible, technical improvements of the system are mandatory for safe clinical application.     

Lipomatous hamartoma of the interatrial septum

We investigated the effects of class III antiarrhythmic agents, d-sotalol, E-4031 and MS-551, on the currents of two cloned K channels, Kv1.2 (IKv1.2) and Kv1.4(IKv1.4), by using the Xenopus oocyte expression system. Both IKv1.2 and IKv1.4 were sensitive to 4-aminopyridine and quinidine, but insensitive to tetraethylammonium, d-sotalol, E-4031 and MS-551. The results suggest that some types of structural proteins may be necessary for class III agents to inhibit the cardiac cloned K channels.     

A case of unique communication between blind-ending ectopic ureter and ipsilateral hemi-hematocolpometra in uterus didelphys

Uterus didelphys with double vagina and hemi-vaginal atresia is a rare syndrome of congenital anomalies. A 17-year-old girl had a right blind-ending ectopic ureter, the proximal end of which communicated with the ipsilateral uterine cervix of uterus didelphys. The patient presented with vaginal urinary incontinence after incision of the vaginal wall for right hemi-hematocolpometra. Following various examinations, the ipsilateral kidney was found to be absent. The ectopic ureter and communicating duct were resected, and the fistula was closed. The genesis of malformation of the female genitalia and urinary tract resulting in such a unique communication is discussed. The importance of preoperative meticulous examinations, including cysto-genitography, pelvic magnetic resonance imaging and panendoscopy with the patient under anesthesia, is emphasized.     

Calcipotriol toxicity in a dog

The article describes the objectives and design of a prospective study of the prevalence, incidence and course of psychiatric disorders in a representative sample of non-institutionalized Dutch adults. A total of 7146 men and women aged 18-64, contacted through a multistage sample of municipalities and households, were interviewed at home in 1996. The primary diagnostic instrument was the CIDI, which determines the lifetime occurrence of DSM-III-R disorders. The disorders included were: mood disorders, anxiety disorders, eating disorders, schizophrenia and other non-affective psychotic disorders, and dependence and abuse of psychoactive substances. Follow-up measurements in the same sample were scheduled at 12 and 36 months. The net response to the first measurement was 69.7%. Poststratification weightings were applied for gender, age, marital status and degree of urbanization. Limitations and advantages of the study design are discussed. Findings are reported elsewhere in this issue.     

Compound odontoma in a dog

Compound odontomas are rare tumors of dental origin. Though benign, their effect as a space occupying lesion can be dramatic. A large compound odontoma in the caudal right mandible of a five and a half month old dog was managed by surgical enucleation of the abnormal tissues. No recurrence was evident 6 months later.