Temporomandibular joint ankylosis and salivary mucocele in a cat: case report

An approximately 1.5-year-old, not neutered mixed breed cat was referred for evaluation of inability to open its mouth, and soft tissue swelling around the intermandibular region. Both signs were present since the cat was adopted, 1 year before presentation. The cause of the signs was not determined prior to referral. Based on the physical and radiographic examinations, left temporomandibular joint ankylosis and salivary mucocele were diagnosed. The lateral aspect of the condyloid process of the left mandible was removed and the salivary mucocele was treated by right mandibular and sublingual gland resection and drainage of the mucocele. After surgery, the cat showed good functional use of the mandible without discomfort.

Relata-se o caso de um gato de aproximadamente um ano e meio de idade, macho, não castrado, que foi encaminhado por apresentar incapacidade de abrir a boca e aumento de volume flutuante na região intermandibular. As lesões estavam presentes há um ano, desde quando o gato foi encontrado e adotado. A causa não foi determinada. Baseado nos exames físicos e radiográficos diagnosticou-se anquilose da articulação temporomandibular esquerda e mucocele salivar. O aspecto lateral do processo condilar da mandíbula esquerda foi removido, e a mucocele foi tratada por ressecção das glândulas salivares mandibular e sublingual direita e por drenagem da mucocele. Após a cirurgia, o gato mostrou bom uso funcional da mandíbula, sem sinais de desconforto.

Mistura de proteínas morfogenéticas ósseas, hidroxiapatita, osso inorgânico e colágeno envolta por membrana de pericárdio no preenchimento de defeito ósseo segmentar em coelhos / Mixture of bone morphogenetic protein, hydroxyapatite, inorganic bone and collagen interposed by pericardium barrier membrane in the filling of the segmental bone defect in rabbits

Avaliou-se o uso de biomaterial de origem bovina na regeneração de defeitos ósseos segmentares empregando-se 12 coelhos, fêmeas, da raça Norfolk, com idade de seis meses e pesos entre 3 e 4,5kg. Realizou-se falha segmentar bilateral de um centímetro de comprimento na diáfise do rádio, com inclusão do periósteo. No membro direito, o defeito foi delimitado por membrana de pericárdio liofilizada, contendo em seu interior mistura de proteínas morfogenéticas ósseas adsorvidas a hidroxiapatita, colágeno liofilizado e osso inorgânico. No membro esquerdo, o defeito não recebeu tratamento. Radiografias foram obtidas ao término do procedimento cirúrgico e aos sete, 30, 60, 90, 120 e 150 dias de pós-operatório. Após eutanásia de seis coelhos aos 60 dias e seis aos 150 dias de pós-cirúrgico, os resultados radiográficos e histológicos mostraram que a regeneração óssea foi inibida nos defeitos segmentares tratados com o biomaterial.

Biomaterials of bovine origin in regenerating segmental bone defects were evaluated. Twelve six-month old Norfolk rabbits, weighting 3 to 4.5kg were used. A 1cm long segmental defect was created in the radial diaphysis, including the periosteum, of both forelimbs. In the right forelimb, the defect was filled using a mixture of bone morphogenic proteins adsorbed to hydroxyapatite, agglutinant of lyophilized collagen in granules and anorganic cortical bone in granules delimited by a pericardial membrane. In the left forelimb, the defect did not receive treatment and served as a control. Radiographies were taken immediately after surgery and at seven, 30, 60, 90, 120 and 150 days post-operatively. Six rabbits were euthanized at 60 days and the other six at 150 days post-surgery for histological evaluation. Radiographic and histological results revealed that bone regeneration was inhibited in the segmental defects receiving biomaterials.

Estudo comparativo entre flunizina meglumina ou buprenorfina no procedimento de ovariohisterectomia em gatas

O artigo não apresenta resumo.

Large segmental radius and ulna defect treated by bone transportation with the Ilizarov technique.

An 8-year-old male Boxer with a severely contaminated open fracture of the left radius and ulna fracture, produced by a helicopter propeller, was treated using bone transport by the Ilizarov method. Extensive diaphyseal bone loss and soft-tissue vascular damage were present. The radius and ulna were stabilised with an Ilizarov ring external fixator. The bone defect was partially shortened and restored by gradual transport of a bone segment created from proximal segments of the radius and ulna. The external fixator was removed 4 fi months after the beginning of the latency period, due to instability caused by osteolysis around the wires. A cast was placed for 3 weeks. Although the bone transport had resulted in formation of approximately 4 cm of bone, the antebrachium showed approximately 50% shortening when compared to the contralateral limb. The infection was eradicated, and the dog was able to bear weight on the operated limb when walking.

Refinements in stress echocardiographic techniques improve inter-institutional agreement in interpretation of dobutamine stress echocardiograms.

AIMS: To determine the degree of inter-institutional agreement in the assessment of dobutamine stress echocardiograms using modern stress echocardiographic technology in combination with standardized data acquisition and assessment criteria. METHOD AND RESULTS: Among six experienced institutions, 150 dobutamine stress echocardiograms (dobutamine up to 40 microg x kg(-1) min(-1) and atropine up to 1 mg) were performed on patients with suspected coronary artery disease using fundamental and harmonic imaging following a consistent digital acquisition protocol. Each dobutamine stress echocardiogram was assessed at every institution regarding endocardial visibility and left ventricular wall motion without knowledge of any other data using standardized reading criteria. No patients were excluded due to poor image quality or inadequate stress level. Coronary angiography was performed within 4 weeks. Coronary angiography demonstrated significant coronary artery disease (> or = 50% diameter stenosis) in 87 patients. Using harmonic imaging an average of 5.2+/-0.9 institutions agreed on dobutamine stress echocardiogram results as being normal or abnormal (mean kappa 0.55; 95% CI 0.50-0.60). Agreement was higher in patients with no (equal assessment of dobutamine stress echocardiogram results by 5.5+/-0.8 institutions) or three-vessel coronary artery disease (5.4+/- 0.8 institutions) and lower in one- or two- vessel disease (5.0+/-0.9 and 5.2+/-1.0 institutions, respectively; P=0.041). Disagreement on test results was greater in only minor wall motion abnormalities. Agreement on dobutamine stress echocardiogram results was lower using fundamental imaging (mean kappa 0.49; 95% CI 0.44-0.54; P<0.01 vs harmonic imaging). CONCLUSION: Modern echocardiographic technology in combination with standardized digital image processing and uniform reading criteria results in a higher inter-institutional agreement in the interpretation of dobutamine stress echocardiogram compared to historic reports.

Acute shortening and subsequent lengthening of the radius and ulna for the treatment of an infected nonunion in a dog.

A 3-year-old, male crossbred dog with osteomyelitis of the radius and ulna was treated using Ilizarov's method. Two centimeters of infected bone was resected, then acute bone shortening and subsequent lengthening of a healthy bone site were performed. The infection was eradicated, but a residual leg-length discrepancy was present.

Streptococcus equinus endocarditis in a patient with pulmonary histiocytosis X.

Although Streptococcus equinus has been isolated from the human bowel in an appreciable percentage of the adult general population, it has only rarely been described as a human pathogen. Our report describes the occurrence of S. equinus endocarditis in a patient who had no history of pre-existing heart disease, but who showed evidence of a late-stage pulmonary histiocytosis X. Endocarditis resolved promptly after antibiotic treatment, but required aortic valve substitution. Abnormalities of the immune system that have been demonstrated in patients with histiocytosis X could explain the occurrence of endocarditis in this patient.

[Transesophageal and epicardial echocardiography in the evaluation of conservative surgery of the mitral valve. Complementary methods?]. / L'ecocardiografia transesofagea ed epicardica nella valutazione della chirurgia conservativa della valvola mitrale. Metodiche complementari?

BACKGROUND: Over the last two decades several new surgical methods for repairing a regurgitant mitral valve have been proposed. Unfortunately, early applications of such techniques were not always encouraging because the evaluation in the operating room led to false optimism due to a marked difference between static and functional anatomy of the repaired valve. By means of intraoperative echocardiography, be it transesophageal or epicardial, it is now possible to assess the functional result immediately after valvuloplasty and to decide about further surgery, right at the operating table. MATERIALS AND METHODS: Thirty-six patients (mean age 61.8 years) who underwent mitral valve repair were studied; all underwent preoperative transthoracic echocardiography in the week preceding surgery, and intraoperative transesophageal echo before cardiopulmonary bypass. The surgical results were evaluated by epicardial and/or transesophageal echocardiography in the operating room, and by transthoracic and/or transesophageal approach during follow-up. RESULTS: In 5 patients with intraoperative echocardiography done before valve repair, leaflets pathology and subvalvular apparatus were better evaluated. Besides, in 3 patients the more evident calcification of the leaflets led the surgeon to decide on direct replacement rather the reconstruction of the valve. The postoperative assessment has shown an unsatisfactory correction in 8 patients (24%). In 4 of these patients an important mitral regurgitation was reported and in 2 there was a moderate regurgitation. In the last 2, a iatrogenic stenosis had resulted. Of these 8 patients, 6 underwent valve replacement using an artificial valve. The other 2 patients (one with moderate stenosis and the other with moderate regurgitation) did not undergo a second operation because of the excessive operating time taken for valvuloplasty and the advanced age of the patients. During follow-up, from 6 to 54 months, a remarkable mitral regurgitation was present in 4 patients, one being severe and the other moderate. A persistence of ventricular dilatation was present only in these patients, while in the remainder the left ventricular diameters were normal. Finally, the mitral valve area after six months was between 1.5 an d4 cm2. CONCLUSIONS: Intraoperative echocardiography, both transesophageal and epicardial, can help the surgeon by giving him useful diagnostic information, if carried out before reconstructing the mitral valve with regurgitation. Its application is even more useful if applied straight after the surgical intervention. Unsatisfactory results may be evidenced at once and the operating team will decide right at the table for further repair or replacement, thus avoiding a second operation and the relevant risks.

Right atrial myxoma with pulmonary embolism.

Right atrial myxomas are rare tumors that often go undiagnosed. Pulmonary embolism originating from the tumor mass is a potentially fatal complication. We report the case of a young man in whom a right atrial myxoma with recurrent episodes of pulmonary embolism was diagnosed 1 month after the beginning of symptoms by two-dimensional transthoracic and transesophageal echocardiography. Early diagnosis of cardiac myxomas is important since surgical treatment is usually resolutive with low recurrence rates and good long-term survival.

Right ventricular tachycardia with left bundle branch block and inferior axis morphology: clinical and arrhythmological characteristics in 15 patients.

UNLABELLED: Fifteen patients (mean age 30) presenting with right ventricular tachycardia (VT) of the outflow tract type (left bundle branch block with inferior axis morphology), in the absence of obvious organic heart disease, were studied. Seven patients had palpitations, one presyncope and seven were asymptomatic. The echo and/or angiographic findings were normal in 11 patients (73%), suggesting arrhythmogenic right ventricular dysplasia (ARVD) in three (20%) and dubious in one (7%). The VT was sustained in three patients (20%), nonsustained (11 +/- 6 beats) in twelve (80%), inducible during exercise in two out of 15 patients (13%) and with ventricular stimulation in one out of eight (12.5%). Four patients were treated with sotalol, three with Class IC drugs and one with amiodarone. At follow-up of 36 +/- 30 months, only three patients had VT recurrences due to drug withdrawal. IN CONCLUSION: (1) abnormal echo and/or angiographic findings suggested that ARVD was observed in a minority of the patients (22%); (2) the low inducibility of VT and the good response to sotalol suggested a possible mechanism of abnormal automaticity; and (3) at a 3-year follow-up the prognosis appeared to be good in both patients with or without echo-angiographic signs suggestive of right ventricular dysplasia.

[Atrial involvement in arrhythmogenic right ventricular dysplasia: primary or secondary? Description of a case of occult ventricular dysplasia with right atrial enlargement and exclusively sinoatrial arrhythmia]. / L'impegno atriale nella displasia aritmogena ventricolare destra: primitivo o secondario? Descrizione di un caso di displasia ventricolare occulta con atriomegalia destra ed aritmie esclusivamente seno-atriali.

The atrial involvement in patients with arrhythmogenic right ventricular dysplasia is very rarely described. We here describe a patient with right atrial enlargement suffering from classical sinus and atrial electrical disease (tachycardia-bradycardia syndrome); the associated echo-angiographic aspects of the right ventricle are compatible, even in the absence of ventricular tachyarrhythmias, with a concealed form of right ventricular dysplasia. A common pathogenetic mechanism for the atrial and ventricular involvement is hypothetically considered.

[Significance of biliary lithiasic pathology in the etiopathogenesis of carcinoma of the large intestine]. / Significato della patologia litiasica biliare nella etiopatogenesi del carcinoma del grosso intestino.

With the purpose to study the eventual existence of a correlation between biliary lithiasis and colon-rectum carcinoma, the authors effected a retrospective study of the clinical material concerning 1283 patients hospitalized in the 1st Surgery Institute for large intestine carcinoma. The relative anamnestic data were compared with those of a control population. The results emerging from the research, checked in their statistic significance, seem to support the existence of such correlation. The hypothesis of a possible common etiopathogenesis of both diseases is proposed.