Variation in fat content between liver lobes and comparison with histopathological scores in dairy cows with fatty liver.

BACKGROUND: The assessment of a liver biopsy remains the gold standard for diagnosing and staging fatty liver in dairy cows, which is often necessary for diagnostic and research purposes. Accuracy of the diagnosis relays on the quality of the biopsy, the assumed representativeness of a small tissue sample for a disease process throughout the liver and accurate human evaluation of histologic specimens. The objective of the present study was to assess the distribution of triacylglycerol (TAG) infiltration throughout the parenchyma of livers with different degrees of fatty liver in dairy cows. In addition, histopathological scores from the corresponding specimens were compared to a quantitative measurement of TAG, as well as the agreement between two observers. METHODS: Thirty livers with different degrees of lipid infiltration were selected and 10 different locations throughout the liver were assessed. The TAG content was measured enzymatically, calculated in % or mg/g wet weight, and assigned to a scoring system. Corresponding tissue specimens were stained with hematoxylin-eosin (H&E) and Oil red O (ORO) for histopathological evaluation, using a scoring system. RESULTS: The difference in TAG content between any locations was less than 2%. Based on the scoring system the TAG concentration was even distributed in 79.3% of the livers. Based on kappa statistics the agreement between two pathologists and staining technique in scoring histological specimens was moderate to fair. CONCLUSIONS: Overall the distribution of TAG throughout the liver and the accuracy of human evaluation of liver biopsies may lead to acceptable diagnoses for clinical purposes. Within the liver lobules a common pattern of lipid distribution depending on severity could be observed. For the staging of lipid infiltration for research projects, some degree of variation needs to be considered.

Myocardial contusion: when does it have clinical significance?

A retrospective review of 53 patients with blunt chest trauma admitted to a monitored hospital bed demonstrated a single elderly patient with multiple injuries who developed dysrhythmias requiring treatment. The remainder of the relatively young group had no significant cardiac sequelae. We conclude that the routine use of expensive monitoring and extensive diagnostic tests in the young blunt chest trauma victim should be reconsidered.

[Psychosocial consequences of cancer in a child for its parents and siblings]. / Die psychosozialen Folgen der Krebserkrankung eines Kindes für seine Eltern und seine Geschwister.

Cancer in children leads to extreme situations not only for the child but for all members of the family. Fear of death quite often over years has severe psychosocial consequences for the sick child, its parents and siblings. Without sufficient help from the therapeutic team the family is usually not able, to cope with these problems.