Christine Gibbs.

A pioneer of veterinary radiology, she was a born teacher and a role model.

Veterinary pathology in the United Kingdom: past, present, and future.

This article presents a historical perspective on veterinary anatomic pathology in the United Kingdom from the late nineteenth century to the present. Prior to World War II, the specialty was a rather general one that also included bacteriology and parasitology and was only slightly affected by strong Germanic developments in cell and tissue pathology. The few notable figures of this era include John McFadyean, Sidney Gaiger, and J.R.M Innes. The specialty developed strongly in the second half of the twentieth century, led by a small number of individuals, and was greatly aided by the development of specialist colleges and residency training. Key individuals of this era include W.F. Blakemore, Ernest Cotchin, R.J.M. Franklin, W.F.H. Jarrett, A.R. Jennings, and A.C. Palmer. A remarkable feature of this period has been the increased employment of veterinary pathologists in biomedical industry and in private diagnostic laboratories. While standards of pathology practice have benefited from the college initiatives, there are major financial constraints on the availability of funded training posts in the United Kingdom, and there remain considerable shortages in the supply of pathologists trained to contemporary standards. The acknowledged professional and scientific importance of veterinary pathology needs to be translated into effective financial support for the training that underpins competence in this specialty. Further developments seem likely to be dominated by advances in the technology of tissue handling, applications of molecular biology to pathology, and greater use of telepathology in teaching, in quality assurance, and in continuing professional development.

Obstruction of equine small intestine associated with focal idiopathic eosinophilic enteritis: an emerging disease?

Idiopathic focal eosinophilic enteritis (IFEE) is a rare disease in the horse and few cases have been reported in the literature. The objective of this paper was to describe the clinical, surgical, histological features and post-operative progress of 12 horses with IFEE, a disease that had not been identified in the authors' hospital population prior to 2000. Diagnosis of IFEE was made at laparotomy and confirmed by histological examination of resected abnormal small intestine. In all 12 horses colic was associated with jejunal obstruction involving visibly striking and palpably thickened serosal plaques or circumferential constrictions. Surgical resection of affected intestine was performed in 10 horses, of which seven completely recovered. In one horse, on which surgical resection was not performed, ingesta re-obstructed post-operatively at one of the lesions. Histological examination of resected intestines revealed, in all cases, severe transmural enteritis in which eosinophilic leucocytes were the predominant inflammatory cells. No helminths were identified and the cause of this lesion is not known. IFEE is an uncommon but significant cause of small intestinal obstruction for which surgical resection can be curative. The gross lesions may be under-recognised and histology is essential for diagnosis.

Discriminant and multiple regression analysis of anemia and opportunistic infection in Fell pony foals.

A condition resembling acquired immunodeficiency with anemia has been described in British Fell pony foals. The pathogenesis is unknown. The present study involved 322 foals of which 164 were of Fell breed and 12 were affected. Discriminant and multiple regression analyses were used to test the results of all clinical pathology parameters from these foals for statistical association with (1) breed origin and (2) presence of disease. Only hematocrit associated significantly with presence of disease. However, significant associations were found with Fell breed origin, including serum albumin concentration and lymphocyte count. The unexpected discovery of sporadic lymphocytosis in the breed indicates the value of this kind of analysis and may be evidence that Fell foal immunodeficiency is associated with retroviral infection.

A retrospective study on hypothyroid patients

A retrospective study of 58 hypothyroid patients attending the Endocrine Clinic, University Hospital of the West Indies, Jamaica, between July and August 1989, was undertaken. The age range at initial presentation varied from one month to eighty-four years. The majority of cases (51 or 87.9 percent) were between 21 and 70 years. There were 50 females (86.2 percent) and 8 males (13.8 percent). The underlying causes were idiopathic hypothyroidism (35 or 60.3 percent), posthyroidectomy (13 or 22.4 percent), post 1 therapy (6 or 10.4 percent), panhypopituitarism (3 or 5.2 percent), hypophysectomy (1 or 1.7 percent). Biochemical parameters used in diagnosis were serum thyroxine (T4) and thyroid-stimulating hormone (TSH). Forty-six patients (79.2 percent) had elevated TSH, indicative of a high correlation of elevated TSH with hypothyroidism. Duration of symptomatology prior to diagnosis was one year in 27 patients (46.5 percent), 2 - 10 years in 23 (39.6 percent) and 10 years in 4 cases (6.9 percent). The major presenting signs and symptoms were lethargy (20 Or 34.5 percent), anemia (mixed normochromic, microcytic (16 or 27.6 percent), slow relaxation of tendon reflexes (16 or 27.6 percent), coarsening of skin (15 or 25.9 percent), weight gain 10 or 17. percent), hoarseness (9 or 15.5 percent) and psychiatric symptoms (7 or 12 percent). The known association of primary hypothyroidism with other autoimmune disorders was not borne out in this study. The time-lapse in diagnosis from symptomatology emphasized the need for clinicians to be more alert to the subtle and varied presentation of hypothyroidism (AU)

Thyrotoxic periodic paralysis in a Jamaican male patient

A case of thyrotoxic periodic paralysis occurring in a Black Jamaican male patient is described. Diagnosis is based on history and confirmed by evaluation of serum electrolyte during attacks and thyroid function studies. The physiopathology, associations, therapy and prognosis are discussed. It is important that clinicians recognise the condition as all forms of periodic paralysis are amenable to treatment, and progressive weakness can be prevented or even reversed.

Cushing's syndrome and its differential at the University Hospital of the West Indies - abstract

Crushing's syndrome is a rare condition with a potential for morbidity and mortality. During a 20-year retrospective review of patients with the diagnosis confirmed at the University Hospital, 20 cases were seen. There were 5 men and 15 women with an age range of 15 to 60 years and a mean age of 27 years. Sixty per cent of cases were due to hyperplasia, 15 percent to adenoma, 10 percent to carcinoma and 5 percent(1 case) was of ectopic origin in a patient with bronchogenic carcinoma. The zona fasciculata was involved in 90 percent of cases of hyperplasia. The clinical features of these black patients were as described elsewhere but we noted hypopigmentation alone in 45 percent of patients, with hyperpigmentation in 33 percent. One female patient, age 38, had a 13-year history of hypertension and later developed psychiatric symptoms. A 30-year-old man, who had severe hypertension of recent onset, developed congestive cardiac failure, and an adenoma compressing the renal artery was found at laparotomy. Difficult to control diabetes mellitus in a 27-year-old female was followed 3 years later by the development of cushionoid features. The mean time interval between the onset ofsymptoms and the confirmation of the diagnosis was 2 years 8 months. Serum cortisol levels with loss of diurnal variation and the dexamethasone suppression tests are still quite useful in confirming the diagnosis. Urinary cortisol and serum ACTH levels are not available here. Venography is the commonest and better-used method for localisation. Ultrasonography recently available has so far not been found to be helpful. Sixteen patients underwent successful surgery; two were scheduled for surgery, and one refused. Three patients developed Nelson's syndrome 1 to 4 years after surgery and two of them died, one in the perioperative period after transphenoidal resection of the pituitary tumor. Twenty-seven patients investigated for cushing's Syndrome during the same study period showed the cause to be simple obesity in 21 and Stein-Leventhal Syndrome in 6. It is concluded that blacks in Jamaica with cushing's syndrome present with similar clinical features as elsewhere, except for hypopigmented skin lesions. The zona fasciculata site involved. The serum cortisol and dexamethasone suppression tests are satisfactory in establishing a diagnosis (AU)

Disseminated infection caused by penicillin-resistant gonococci in two Jamaicans

Disseminated gonococcal infection due to penicillin-resistant organisms is very unusual. Two such cases occuring at the University Hospital of the West Indies are described. Implications for therapy are discussed (AU)

Malaria revisited: "Jamaican perspective" - abstract

A retrospective study of all reported smear-positive cases of malaria in Jamaica between 1966 and 1989 was undertaken. There were 76 cases of imported malaria. Fourteen (14) of these cases were seen and treated at the University Hospital of the West Indies or at the University Health Centre. The results and their implications are discussed (AU)

Thyrotoxic periodic paralysis in a Jamaican male patient

A case of thyrotoxic periodic paralysis occurring in a Black Jamaican male patient is described. Diagnosis is based on history and confirmed by evaluation of serum electrolyte during attacks and thyroid function studies. The physiopathology, associations, therapy and prognosis are discussed. It is important that clinicians recognise the condition as all forms of periodic paralysis are amenable to treatment, and progressive weakness can be prevented or even reversed. (AU)