Validation of novel promoter sequences derived from two endogenous ubiquitin genes in transgenic Aedes aegypti.

To date, only a limited number of promoter sequences have been described to drive transgene expression in the disease vector Aedes aegypti. We sought to increase this repertoire by characterizing the ability of upstream sequences derived from the Ae. aegypti Ub(L40) and polyubiquitin genes to drive the expression of marker proteins. Both genomic fragments were able to drive robust expression of luciferase in cultured mosquito cells. Following Mos1-transformation, the Ub(L40) promoter drove strong expression of a fluorescent marker in early larvae and in ovaries, while the polyubiquitin promoter drove robust EGFP expression in all stages of development, including constitutive expression throughout the midgut. These promoter fragments provide two new expression profiles for future Ae. aegypti genetic experiments.

Clinical, morphological and immunohistochemical characterization of cutaneous lymphocytosis in 23 cats.

Clinical, morphological and immunohistochemical features of cutaneous lymphocytosis, an uncommon disease histologically resembling well-differentiated malignant lymphoma, were characterized in 23 cats. Clinical outcome was correlated with histomorphology and immunophenotype in an attempt to predict benign vs. malignant behaviour. The disease mainly affected older cats. Lesions were solitary in 61% of cats and often characterized by alopecia (73.9%), as well as erythema, scaling and ulceration. The lateral thorax was most commonly affected (43.5%). Pruritus was frequent (65.2%). Systemic signs included anorexia and weight loss. Morphologically, lesions were characterized by dermal infiltrations of well-differentiated CD3+ T-cells (100%) and aggregates of CD79+ B-cells (64.3%). Cutaneous lymphocytosis is slowly progressive and relatively benign, although in some cats systemic signs led to euthanasia. Four of 12 euthanized cats and one live cat also had lymphoid infiltrates in internal organs. Unfortunately, we were unable to predict clinical outcome by histological and immunohistochemical evaluations of skin lesions.

Acrochordonous plaques in two Bulldogs and a Pug dog.

Acrochordons or fibroepithelial polyps are exophytic to pedunculated tumour-like lesions of the skin reported to occur in humans and animals. We report here a new and unusual presentation of numerous, closely associated acrochordons forming a plaque, preferentially located at the dorsal neck of two Bulldogs and a Pug dog. Histopathologically these plaques were characterized by oedematous to fibrous cores enclosed by normal to moderately hyperplastic epidermis. We propose the name acrochordonous plaque to reflect the clinical lesion and the histopathological appearance of numerous, closely spaced acrochordons. Although the aetiology of these lesions remains unclear, there may be a breed predisposition for Bulldog-like breeds.

Keloidal fibromas and fibrosarcomas in the dog.

Sixteen dogs (2-12 years of age) presented with one (n = 15) or two (n = 1) cutaneous nodules (n = 16) or a dermal plaque (n = 1). Intact males (n = 9) and neutered males (n = 4) were more affected than were females (n = 3). Histologically, these lesions were characterized by focal dermal and subcutaneous deposition of thick hyalinized collagen fibers intermingled with fibroblasts, and in 13 of 17 lesions, a variable number of CD18-positive cells were interpreted as reactive macrophages. Fibroblasts in three dogs formed intersecting fascicles, interpreted as evidence of malignant transformation. The terms keloidal fibroma and keloidal fibrosarcoma can be applied to these lesions. Excision was curative in five dogs with keloidal fibroma for which follow-up was available. However, because malignant transformation may occur, wide excision of canine keloidal lesions is warranted.

Clinical, microscopic, and molecular aspects of canine leproid granuloma in the United States.

Leproid granulomas from seven dogs in the United States were evaluated. Gross characteristics included nodular and ulcerated dermal and subcutaneous lesions primarily on the caudal aspects of the pinnae and to a lesser extent on the muzzle, face, and forelimbs. In all except one dog, there was complete regression of the lesions within 6 months, either with no therapy or after surgical resection. Cytology or histopathology revealed pyogranulomatous inflammation with few to many acid-fast mycobacterial bacilli within macrophages. The organisms could not be cultivated in vitro. DNA sequencing of part of the 16S ribosomal RNA gene region revealed 99-100% homology among fragments from five of these dogs and fragments from dogs in the south Pacific. This syndrome occurs in dogs in North America and the prognosis is excellent, in contrast to the prognosis for rapid-growing or tuberculous mycobacteriosis.

Degenerative mucinotic mural folliculitis in cats.

A novel form of mural folliculitis is described in seven cats. Clinically, all cats exhibited generalized alopecia with scaling or crusting that was more pronounced over the head, neck, and shoulders. The face and muzzle of all cats was unusually thickened. Six of seven cats were progressively lethargic but did not demonstrate any other consistent systemic abnormalities. Histologically, there was severe mixed inflammation of the wall of the follicular isthmus in all cats, accompanied by some follicular destruction in five cats. Sebaceous glands were not affected. All cats had variable, but often striking, follicular mucin deposition, as well as epidermal hyperkeratosis and crusting. The cause of the severe mural folliculitis was not identified, and all cats responded poorly to immunomodulating therapy. Follicular mucinosis may be a nonspecific finding, likely reflective of the follicular lymphocytic milieu, and does not always herald follicular lymphoma.

Prenatal diagnosis of fetal heart failure in twin reversed arterial perfusion syndrome.

Diagnosis of twin reversed arterial perfusion (TRAP) syndrome is a rare fetal anomaly that can be misdiagnosed on prenatal ultrasound. We confirmed the use of colour-flow Doppler for prenatal diagnosis of TRAP syndrome and used serial fetal echocardiography for non-invasive evaluation of the fetus. A patient with twin intrauterine pregnancy was referred to our centre with suspected intrauterine fetal demise following a 16 week ultrasound. Serial colour-flow Doppler ultrasonography demonstrated retrograde arterial flow in an acardiac twin. Following diagnosis of TRAP syndrome, serial fetal echocardiography was employed to follow the normal twin for signs of heart failure, including right atrial dilation, tricuspid regurgitation and pericardial effusion. When early signs of fetal heart failure were suspected a viable female infant was delivered at 32 weeks' gestation. We suggest that serial fetal echocardiography represents a non-invasive approach that can be used to follow fetal cardiac function of the normal twin in TRAP syndrome.

Prenatal ultrasound detection of a congenital epulis in a triple X female fetus: a case report.

A case of congenital epulis in a triple X infant, whose intra-oral mass was first detected on a 33-week prenatal ultrasound, is described. Two previous ultrasound studies performed at 21 and 28 weeks' gestation showed normal facial anatomy, suggesting accelerated tumour growth during the third trimester. Genetic amniocentesis also showed the infant to possess a 47, XXX karyotype.

Intrapartum factors in early-onset group B streptococcal sepsis in term neonates: a case-control study.

OBJECTIVE: A case-control study was used to (1) examine the intrapartum characteristics of term neonates with early-onset group B streptococcal sepsis and (2) determine what percentage of patients meet The American College of Obstetricians and Gynecologists guideline for intrapartum administration of antibiotics. STUDY DESIGN: Twenty-one women delivered of term neonates who contracted early-onset group B streptococcal sepsis were matched with 63 mothers who were colonized with group B streptococci. The women were matched for race, age, parity, and gestational age. A Student t test and chi2 analysis were performed. Significance was defined as p < 0.05. RESULTS: The attack rate was 2.1 instances of sepsis per 1000 live births. For both groups, the maternal demographics and the actual birth weights were similar. Case mothers compared with controls had longer labor (11.4 +/- 6.9 vs 5.8 +/- 4.3 hours, p < 0.0001), had longer time elapsed between rupture of membranes and delivery (10.3 +/- 6.4 vs 3.2 +/- 3.6 hours, p < 0.0001); required oxytocin more often (76% vs 32%, p < 0.001); required more pelvic examinations (6 or more; 71% vs 46%, p < 0.05); and had a significantly higher cesarean section rate (33% vs 3%; p < 0.001). Only 10% (2 of 21) of case mothers met The American College of Obstetricians and Gynecologists guideline for chemoprophylaxis. CONCLUSION: The American College of Obstetricians and Gynecologists guideline for chemoprophylaxis identifies only 10% of women whose term newborns contract early-onset group B streptococcal sepsis.

Superficial necrolytic dermatitis (necrolytic migratory erythema) in dogs.

Twenty-two dogs with superficial necrolytic dermatitis were evaluated prospectively, twenty-one of which had characteristic crusting lesions of the paw pads. Histologically, epidermal lesions included parakeratosis and laminar intracellular edema. The plasma amino acid concentrations of eight dogs were markedly depressed. Nine dogs had terminal diabetes mellitus. These clinical and morphologic findings were strikingly similar to those of necrolytic migratory erythema in human beings, the most common cause of which is hyperglucagonemia due to islet cell tumor of the pancreas. No pancreatic tumors were found in these dogs; plasma glucagon concentrations in the five dogs tested were normal. The serum alkaline phosphatase concentrations were elevated in all dogs. Severe vacuolar hepatopathy, suggesting metabolically or hormonally induced hepatic dysfunction, was found in 21 dogs at necropsy or by biopsy; one dog had ultrasonographic abnormalities of the liver. Histopathologically, severe vacuolar alteration resulted in parenchymal collapse and nodular regeneration, which grossly mimicked cirrhosis. Although the definitive metabolic stimulus was not discovered for the cutaneous and hepatic lesions, the similarity of the cutaneous and biochemical features of canine superficial necrolytic dermatitis to human necrolytic migratory erythema warrants further investigation into possible underlying pancreatic hormonal dysfunction.

The clinical utility of maternal body mass index in pregnancy.

To describe maternal body mass index and to compare the use of maternal weight and body mass index for risk assessment at the initial prenatal visit, 6270 gravid women who were consecutively delivered of infants were studied. Body mass index increased with advancing maternal age, parity, and advancing gestational age and was significantly greater in black women than in nonblack women. Risks for the development of adverse outcome associated with maternal obesity, including development of gestational diabetes, preeclampsia, fetal macrosomia, and shoulder dystocia, were comparably predicted by either maternal weight or body mass index greater than 90th percentile. Maternal weight was as predictive of preeclampsia, macrosomia, and shoulder dystocia as was body mass index when these factors were analyzed as continuous variables, whereas increasing body mass index was more predictive of gestational diabetes. The prediction of factors associated with low maternal weights, small-for-gestational-age birth, prematurity, low birth weight, and perinatal death was equivalent for maternal weight and body mass index that was less than 10th percentile. This study indicates that in the initial risk assessment of outcomes related to maternal weight, the calculation of maternal body mass index offers no advantage over simply weighing the patient. This finding contrasts with results in nonpregnant women.

Glucagon-producing pancreatic endocrine tumors in two dogs with superficial necrolytic dermatitis.

A newly recognized disease in dogs, ulcerative dermatosis associated with diabetes mellitus (diabetic dermatopathy), was diagnosed in 2 dogs with pancreatic endocrine tumors that had immunohistologic evidence of glucagon production. Dogs developed diabetes mellitus in the later stages of the illness, months after the skin disease was first observed. Liver disease was identified and characterized by high serum alkaline phosphatase and alanine transaminase activities. Clinically, erythema and crusting involved the footpads, the face, perioral and genital skin, and ventrum. Histologically, skin lesions were intercellular and intracellular edema and necrosis of the upper half of the epidermis and diffuse parakeratosis. Clinically and histologically, skin lesions closely resembled necrolytic migratory erythema of people, a skin disease that usually is associated with a glucagon-secreting pancreatic endocrine tumor and diabetes mellitus (glucagonoma syndrome): The morphologically descriptive term, superficial necrolytic dermatitis, was preferred over the previously proposed names hepatocutaneous syndrome and diabetic dermatopathy, which each connote only a single feature of the disease.

Correlation of commonly used measures of intrauterine growth with estimated neonatal body fat.

Several morphometric measures have been used to identify infants at greatest risk from aberrant intrauterine growth. 119 near-term infants were studied to answer the more basic question of how well measures, such as birthweight percentile, ponderal index, the body mass index and the weight/length ratio reflect body fat in the neonate. Skinfold thicknesses were measured as an estimate of fat stores. Multiple regression analysis revealed that the weight/length ratio showed the strongest correlation with relative adiposity, explaining 52% of the variance. Further, sequential exponentiation of the crown-heel length in body mass index and ponderal index decreased the correlation with estimates of body fat. The simple weight/length ratio, exhibiting both a close correlation with body fat and independence of gestational age, race and sex, in near-term infants may be the best morphometric measure of the nutritional component of intrauterine growth in the neonate.

Determinants of morbidity in obese women delivered by cesarean.

Studies examining the increased surgical morbidity among obese gravidas have focused mainly on differences in outcome between obese and nonobese mothers. Little is known, however, about the cause for worsened operative outcome in obese mothers or the potential impact of perioperative interventions. To define more precisely the clinical determinants of postoperative morbidity, multivariate analysis was used to relate antepartum and intrapartum variables to three measures of morbidity in 107 consecutively delivered obese women undergoing cesarean. Although obesity is clearly an operative risk factor, this study suggested that among obese gravidas, varying degrees of maternal obesity and accompanying medical complications, such as diabetes and hypertension, were not associated with greater operative morbidity. Furthermore, neither choice of skin incision nor type of anesthesia appeared to be related to operative morbidity. However, two factors potentially under the control of the clinician, increased length of surgery and operative blood loss, were associated significantly with measures of operative morbidity. A finding of worsened outcome with prophylactic antibiotics and heparin requires further study.

Recurrent small for gestational age birth: perinatal risks and outcomes.

The risk of recurrent small for gestational age birth, as well as maternal and fetal-neonatal characteristics associated with recurrence, was examined in 174 mothers of consecutively delivered small for gestational age infants followed through an additional 240 livebirths. There was a twofold and fourfold increase in the risk for small for gestational age birth after one and two small for gestational age births, respectively. Although an intervening average for gestational age birth decreased the risk of recurrence, these women remained at increased risk over the general population. Given the history of a previous small for gestational age birth, perinatal risks and outcomes considered individually would not improve the prediction of recurrence. However, the significantly higher frequency of these variables, considered as a group, among mothers with recurrent small for gestational age birth suggests an association with underlying maternal disease, for example, chronic hypertension, substance use and abuse, more severe fetal-neonatal compromise, and recurrent small for gestational age birth. Recurrent small for gestational age birth should initiate a search for persistent, underlying maternal disease.