Expression of regulatory T cell (Treg) activation markers in endometrial tissues from early and late pregnancy in the feline immunodeficiency virus (FIV)-infected cat.

Regulatory T cells (Tregs) support pregnancy maintenance by suppressing placental inflammation, while diminished Treg function may accompany reproductive failure. Experimental FIV infection frequently results in vertical transmission and increased pregnancy failure in the cat. The mechanism of reproductive compromise is unknown. We hypothesized that FIV infection alters endometrial Treg population dynamics and function, potentiating vertical transmission and reproductive failure. RNA collected from early and late gestation reproductive tissue and fetuses from FIV infected and control cats was probed for expression of FIV gag and Treg markers CD25, FOXP3, and CTLA4, using real time reverse-transcriptase (RT)-PCR. Frequent placental and fetal infection and reproductive failure were detected at early and late pregnancy. Expression of FOXP3 and CTLA4 was higher in early gestation tissues from control cats. FIV infection significantly reduced expression of FOXP3 and CTLA4 at early, but not late pregnancy. At late pregnancy, CTLA4 was expressed to higher levels in infected tissues. The number of tissues with decreased co-expression of FOXP3 and CTLA4 was significant in infected cats at early pregnancy. No significant changes in CD25 expression occurred between FIV-infected and control animals at early or late pregnancy. Differences in Treg marker expression were not significant between viable and non-viable pregnancies in infected cats. The detection of Treg markers in these feline tissues provides the first evidence of feline endometrial Tregs and suggests that such cells diminish as pregnancy progresses. These cells may be depleted or rendered less functional by viral infection, but understanding their role in pregnancy requires further study.

Multifocal variant of heterotopic ossification.

In this case report, we present a 25 year follow-up of a single patient with a previously undescribed multifocal variant of heterotopic ossification. The patient presented with multiple occurrences of lesions similar to myositis ossificans atraumatica as well as some lesions resembling exostoses/osteochondromas. Several images and histological sections show the range of appearances and locations of her somewhat disparate lesions, including an exostosis with intraspinal extension. Until additional similar cases are brought forward, we consider this a unique variant of heterotopic ossification. The precise aetiology of this patient's condition is unknown.

PCR detection of Anaplasma platys in blood and tissue of dogs during acute phase of experimental infection.

Four dogs were experimentally infected with Anaplasma platys to determine changes in real-time TaqMan PCR detection in blood and tissue, microscopically detectable parasitemia, and platelet concentrations during the first 28 days of infection. Buffy-coat blood cells were PCR positive for A. platys DNA at 4 days after inoculation and remained positive in all dogs until day 14. Marked thrombocytopenia and low parasitemia occurred in dogs during that initial period. During 17 and 28 days post-inoculation, the PCR results on buffy-coat blood cells were intermittently negative in each dog with marked thrombocytopenia and no microscopic evidence of parasitemia. Bone marrow and splenic aspirates collected from the A. platys-infected dogs were tested by real-time TaqMan PCR. Two dogs were PCR positive in spleen and marrow at 28 days post-inoculation, when PCR results for buffy-coat blood cells were negative. Spleen and/or bone marrow samples should be considered as additional samples for PCR testing of dogs, particularly when blood samples are PCR negative during the acute phase of A. platys infection.

Carbon dioxide laser abrasion. Is it appropriate for all regions of the face?

OBJECTIVES: To evaluate the effectiveness of the carbon dioxide laser for treatment of facial acne scarring and to determine if certain regions of the face would respond more favorably to carbon dioxide laser resurfacing than other areas of the face. METHODS: Twenty-five patients with facial acne scarring were treated with the carbon dioxide laser with the flash-scanning attachment. Physician and patient evaluations were performed at postoperative follow-up. The face was evaluated for improvement by 5 anatomic regions: medial and lateral cheeks, perioral region, temple, and forehead. SETTING: Office ambulatory surgery center. RESULTS: Patients demonstrated overall improvement with the carbon dioxide laser. However, certain areas, such as the lateral cheek and temple, responded less favorably than other areas, such as the medial cheek, perioral region, and forehead. These findings were found to be statistically significant (P < .001) for physician and patient assessments. No long-term complications were reported. CONCLUSIONS: The carbon dioxide laser is an effective modality for the treatment of facial acne scarring. Physician and patient satisfaction is high. Nevertheless, multiple treatments may be necessary to achieve improvement, especially in the temple and lateral cheek areas; these anatomic sites respond less favorably to laser resurfacing than the medial cheek, perioral region, and forehead.

Collagenous colitis in children.

Collagenous colitis, a disorder characterized by increased subepithelial collagen deposition associated with an inflammatory infiltrate in the lamina propria, has been reported infrequently in children. An 8-year-old girl with collagenous colitis is described who presented with chronic watery diarrhea and abdominal pain. Biopsy specimens of the colonic mucosa showed the pathological features of collagenous colitis. The patient's symptoms resolved following corticosteroid therapy. Collagenous colitis should be considered in the differential diagnosis of children with chronic diarrhea.

Diagnostic accuracy and appropriateness of care for seborrheic keratoses. A pilot study of an approach to quality assurance for cutaneous surgery.

In 1985 there were more than 40 million visits for ambulatory surgical procedures in the United States. Although benign cutaneous lesions are among the most frequent conditions to receive surgical treatment in ambulatory settings, their treatment is seldom subject to peer review. In this pilot study we assessed diagnostic accuracy and appropriateness of care using information available from the surgical pathology laboratory. We assessed these two measures of physician performance for 527 seborrheic keratoses removed by 133 clinicians affiliated with four different institutions. Overall, a correct preoperative diagnosis was provided in only 49% of cases. Dermatologists had the highest diagnostic accuracy (61% vs 35% for all other physicians). An appropriate procedure for the actual pathological diagnosis was performed in only 50% of cases. Lesions with a correct preoperative diagnosis were more than eight times more likely to receive appropriate care. Our data suggest that many clinicians fail to note a correct diagnosis of common cutaneous lesions before surgical removal, and many patients are treated with procedures that are more invasive than necessary for the final pathological diagnosis. Because the approach used in this pilot study relies on data already available, it has promise as a low-cost method of monitoring the quality of care of ambulatory surgery.

Transfusion-associated graft-vs-host disease in patients with malignancies. Report of two cases and review of the literature.

Graft-vs-host disease can develop in immunosuppressed individuals who receive blood-product transfusions that contain immunocompetent lymphocytes. We report two cases of fatal transfusion-associated graft-vs-host disease that developed in patients with Hodgkin's disease who were undergoing therapy. We review all cases of this entity in patients with malignancies, represented predominantly by patients with hematologic malignancies. The groups at risk for development of transfusion-associated graft-vs-host disease, the clinical presentation and course, and methods of diagnosis are summarized. Prevention of this highly fatal condition is possible by irradiation of blood products given to patients at risk, but problems remain in determining the groups that warrant such measures. Dermatologists need to have heightened awareness of this entity to facilitate more complete diagnosis and allow establishment of effective standards of care.

Copper toxicosis in cattle fed chicken litter.

Cattle from 2 herds developed copper toxicosis after the ingestion of chicken litter. The affected animals were adult Holstein cows and crossbred steers that ate 9 to 16 kg of litter/day. These cattle developed a sudden onset of weakness, depression, anorexia, icteric mucous membranes, and dark reddish brown urine. Liver copper concentrations in 2 cattle (1 from each herd) were 436 and 730 ppm. Results of copper analyses of chicken litter ranged from 620 to 920 ppm. Sodium molybdate and sodium thiosulfate were added to the ration of the dairy herd. Two cows with clinical signs of copper toxicosis recovered after being given additional sodium molybdate and thiosulfate supplements, orally.