Acute Abdomen Secondary to a Spontaneous Perforation of the Biliary Tract, a Rare Complication of Choledocholithiasis.

INTRODUCTION: The spontaneous perforation of the biliary tract (SPBT) is an extremely rare cause of peritonitis, which was first described by Freeland in 1982, to date only around 70 cases have been reported. Here we present a case of spontaneous perforation of the biliary tract, in a patient with choledocholithiasis, which was treated with ultrasound-guided drainage and ERCP. CASE REPORT: A 51-year-old male was admitted to the emergency room for 15-day evolution jaundice, localized pain in the right flank and hypochondrium of 3days. He had a history of cholecystectomy 15 years ago and 4 episodes of cholangitis, the last one in 2015. A magnetic resonance imaging (MRI) was performed, that showed evidence of choledocholithiasis, in addition to a possible biliary leakage. The patient was treated with ultrasound-guided drainage and ERCP successfully. DISCUSSION: Spontaneous perforation of the biliary tract is a disease entity in which wall of the extrahepatic or intrahepatic duct is perforated without any traumatic or iatrogenic injury. The clinical presentation varies from nonspecific abdominal pain to biliary peritonitis, in most of the cases forming bilomas. Universal management involves decompression of the biliary tree and repair of the leak site. CONCLUSION: The spontaneous perforation of the biliary tract is a disease that represents a diagnostic challenge. The treatment in the patients with SPBT is not well established and has to be individualized for each case, depending on the history of the patient, the site of perforation, the time of evolution, the suspicion of infection, and the patient status.

A rare case of subacute appendicitis, actinomycosis as the final pathology reports: A case report and literature review.

INTRODUCTION: Acute appendicitis is the most common indication for an emergency abdominal surgery in the world, with a lifetime incidence of around 10%. Actinomycetes are the etiology of appendicitis in only 0.02%-0.06%, having as the final pathology report a chronic inflammatory response; less than 10% of the cases are diagnosed before surgery. Here, we present the case of a subacute appendicitis secondary to actinomycosis. CASE REPORT: A 39-year-old male presented with a twelve-day evolution of intermittent abdominal pain in the right lower quadrant, treated at the beginning with ciprofloxacin and urinary analgesic. The day of the admission he referred intense abdominal pain with nausea. An open appendectomy was preformed, finding a tumor-like edematous appendix with a diameter of approximately 2.5cm. DISCUSSION: Actinomyces are part of the typical flora of the oral cavity, gastrointestinal tract and vagina. The predominant form of human disease is A. Israelii, it requires an injury to the normal mucosa to penetrate and cause disease. Abdominal actinomycosis involves the appendix and caecum in 66% of the presentations, of these, perforated appendicitis is the stimulus in 75% of the cases. A combination of antibiotic therapy and operative treatment resolves actinomycosis in 90% of cases. CONCLUSION: Abdominal actinomycosis is an uncommon disease been the common presentation a perforated appendicitis, here we present a less common presentation of it with a non-perforated appendix.

Bud Rot Caused by Phytophthora palmivora: A Destructive Emerging Disease of Oil Palm.

Oomycetes from the genus Phytophthora are among the most important plant pathogens in agriculture. Epidemics caused by P. infestans precipitated the great Irish famine and had a major impact on society and human history. In the tropics, P. palmivora is a pathogen of many plant species including cacao (Theobroma cacao), citrus (Citrus sp.), durian (Durio zibethines), jackfruit (Artrocarpus heterophyllus), rubber (Hevea brasiliensis), and several palm species including coconut (Cocos nucifera), and the African oil palm (Elaeis guineensis) as determined recently. The first localized epidemics of bud rot in oil palm in Colombia were reported in 1964. However, recent epidemics of bud rot have destroyed more than 70,000 ha of oil palm in the Western and Central oil palm growing regions of Colombia. The agricultural, social, and economic implications of these outbreaks have been significant in Colombia. Identification of the pathogen after 100 years of investigating the disease in the world enabled further understanding of infection, expression of a range of symptoms, and epidemiology of the disease. This review examines the identification of P. palmivora as the cause of bud rot in Colombia, its epidemiology, and discusses the importance of P. palmivora as a major threat to oil palm plantings globally.

Origin of the subepidermal tissue in Piper L. leaves.

Studies on the anatomy of Piper leaves demonstrate the presence of a subepidermal tissue distinct from the adjacent epidermis, which cells show thin walls and hyaline contents. Some authors consider such cells a hypodermal tissue, while others refer to them as components of a multiple epidermis. In this study, the nature of this subepidermal tissue was investigated through the analysis of leaf ontogeny in three Piper species. The analysis showed that the referred tissue originates from the ground meristem and, thus, should be considered a hypodermis. The studied species suggests that the role of the hypodermis would be to protect the photosynthetic apparatus from excess light, regulating the intensity of light reaching the chlorophyll parenchyma.

Mapping of a quantitative trait locus controlling susceptibility to Coxsackievirus B3-induced viral hepatitis.

The pathogenesis of coxsackieviral infection is a multifactorial process involving host genetics, viral genetics and the environment in which they interact. We have used a mouse model of Coxsackievirus B3 infection to characterize the contribution of host genetics to infection survival and to viral hepatitis. Twenty-five AcB/BcA recombinant congenic mouse strains were screened. One, BcA86, was found to be particularly susceptible to early mortality; 100% of BcA86 mice died by day 6 compared with 0% of B6 mice (P=0.0012). This increased mortality was accompanied by an increased hepatic necrosis as measured by serum alanine aminotransferase (ALT) levels (19547±10556 vs 769±109, P=0.0055). This occurred despite a predominantly resistant (C57BL/6) genetic background. Linkage analysis in a cohort (n=210) of (BcA86x C56Bl/10)F2 animals revealed a new locus on chromosome 13 (peak linkage 101.2 Mbp, lod 4.50 and P=0.003). This locus controlled serum ALT levels as early as 48 h following the infection, and led to an elevated expression of type I interferon. Another locus on chromosome 17 (peak linkage 57.2 Mbp) was significantly linked to heart viral titer (lod 3.4 and P=0.046). These results provide new evidence for the presence of genetic loci contributing to the susceptibility of mice to viral hepatitis.

First Report of Bud Rot Caused by Phytophthora palmivora on African Oil Palm in Colombia.

A bud rot disease, referred to as "pudricion del cogollo" or PC (for its name in Spanish), is a major disease of oil palm in four production areas of Colombia. Even though the disease has been studied for more than 40 years in Central and South America, the causal agent remained unknown (1). Infection first develops in the palm heart (cogollo) above the meristematic zone. Initial external symptoms appear as necrotic lesions on the sides of the spear leaf (youngest, unexpanded leaf) and the sizes of the lesions remain static as tissues emerge, expand, and mature. Under favorable environmental conditions (temperature around 26°C and relative humidity above 80%), further rotting of the heart eventually destroys the bud. A baiting technique with papaya and cocoa fruits was successfully used to trap the causal agent from symptomatic spear leaf tissue collected from the provinces of Nariño and Santander (2), where the disease is severe. Small, triangular-shaped pieces were removed from healthy fruits that had been surface sterilized, and a corresponding piece of diseased oil palm tissue was inserted into the hole and sealed with the removed fruit tissue. The whole fruit was wrapped with plastic and incubated at 25°C. Once the fruit traps showed initial necrotic symptoms, fruit tissue from the advancing point of the lesions was plated on Phytophthora-selective media. Four isolates of Phytophtora palmivora, all A2 mating type, were obtained during this study and each presented similar white and depressed mycelium when grown on oatmeal agar (OMA) medium. Papillated, ellipsoidal sporangia with short pedicels had an average size of 37.1 (breadth) × 52.8 µm (length). Chlamydospores averaged 35.1 µm in diameter and were similar to those observed in diseased palm tissue. DNA from the Phytophthora isolates was used as a template for PCR using ITS1/ITS4 primers. BLASTn analysis of the ITS sequences (GenBank Accession No. GQ398157) showed 99.9% homology with P. palmivora. The sequences of the four isolates were identical. For pathogenicity testing, cultures were grown on OMA. Two milliliters of distilled water containing 40,000 sporangia were injected into the base of the spear leaf of 105 nursery palms; the same number of palms was injected with 2 ml of distillated water as controls. Initial PC symptoms were observed 3 to 4 days after inoculation on 85% of inoculated palms and 15% of these palms developed typical bud rot symptoms under favorable conditions. No symptoms were observed on the controls. The presence of Phytophthora was confirmed by light microscopy and P. palmivora was reisolated from symptomatic palms with the fruit-baiting technique. The presence of Phytophthora in the four Colombian growing areas was also confirmed using Agdia (Elkhart, IN) immunostrips followed by DNA extraction from the Immunostrip wick and ITS sequencing to confirm the species. To our knowledge, this is the first report of P. palmivora causing PC on oil palm in Colombia. References: (1) H. de Franqueville. Exp. Agric. 39:225, 2003. (2) G. Sarria et al. Rev. Palmas, Colombia. 29(3):31, 2008.

Karyotypic studies of Cratylia argentea (Desv.) O. Kuntze and C. mollis Mart. ex Benth. (Fabaceae - Papilionoideae).

Cratylia argentea and C. mollis (Fabaceae-Papilionoideae) are legume shrubs native to the Cerrado and Caatinga, respectively. Both species show great resistance to drought and high nutritive value, which makes them a valuable forage resource in tropical regions. Cytogenetic studies were carried out on accessions of C. argentea and C. mollis from Germplasm Banks of Embrapa Gado de Leite (Juiz de Fora, MG) and Embrapa Semi-Arido (Petrolina, PE), respectively. Root tips were treated with 3 mM 8-hydroxyquinoline and slides were made using the air-dry technique. Karyotype description for each accession took into account the following features: chromosome number; total length, relative length and arm ratio of each chromosome; haploid set length, and degree of asymmetry. Mitotic metaphases in both species showed 2n = 22 chromosomes, where this is the first report of diploid number for C. mollis. Chromosome length was also quite similar for the two species, ranging from 5.08 to 2.50 microm in C. argentea and 5.12 to 2.51 microm in C. mollis, with haploid sets of equal size, measuring 38.10 and 37.85 microm, respectively. However, they did not show the same karyotypic formula, which was 5 m + 4 sm + 2 st for C. argentea and 7 m + 2 sm + 2 st for C. mollis. This indicates the occurrence of rearrangements within chromosomes I and VI. Both karyotypes showed a tendency for asymmetry.

Ammonia poisoning causes muscular but not liver damage in cattle

Twelve steers were intraruminally administered a high dose (0.5g/kg BW) of urea to study the damage effect of ammonia poisoning on liver and/or muscles. Blood samples were collected to determine ammonia and activities of gammaGT, AST and CK. Eleven steers were successfully poisoned and treated properly, but one succumbed. Poisoned cattle showed high concentration of ammonia, and higher activities of AST and CK. The higher the ammonia, the greater were the activities of AST (r=0.59) and CK (r=0.61). The correlation between AST and CK was high and significant (r=0.80), but not between AST and gammaGT (r=0.19). The activities of AST and CK were higher after the beginning of the convulsive episodes due to ammonia poisoning. Those results showed that occurred muscle damage instead of liver damage since CK is a typical enzyme from skeletal muscle; AST is found either in skeletal muscle and hepatocytes, while gammaGT is present in hepatic cells.

Doze novilhos foram experimentalmente intoxicados por administração intrarruminal com alta dose de uréia (0,5g/kg PV) para estudar o efeito da intoxicação por uréia sobre o fígado e/ou musculatura. Foram coletadas amostras de sangue no decorrer do experimento para determinar o teor de amônia e as atividades de gama glutamiltransferase (gamaGT), aspartato aminotransferase (AST) e creatina quinase (CK). Onze novilhos apresentaram quadro clínico típico de intoxicação por amônia, porém um animal sucumbiu. Animais intoxicados apresentaram alto teor de amônia e elevada atividade de CK e AST. Quanto mais elevados foram os teores de amônia maiores foram as atividades de AST (r=0,59) e CK (0,61). A correlação entre AST e CK foi alta e significativa (r=0,80), ocorrendo o inverso com AST e gamaGT (r=0,19). Tanto a atividade de AST como de CK aumentaram significativamente a partir dos episódios convulsivos decorrentes da intoxicação por amônia. Estes resultados indicam que ocorreu uma expressiva lesão muscular, mas não hepática, visto que a CK é uma enzima típica da musculatura estriada; e o AST encontra-se tanto na musculatura estriada como nos hepatócitos, enquanto que a gamaGT está presente somente em células hepáticas.

Karyotypic studies of Cratylia argentea (Desv.) O. Kuntze and C. mollis Mart. ex Benth. (Fabaceae - Papilionoideae)

Cratylia argentea and C. mollis (Fabaceae-Papilionoideae) are legume shrubs native to the Cerrado and Caatinga, respectively. Both species show great resistance to drought and high nutritive value, which makes them a valuable forage resource in tropical regions. Cytogenetic studies were carried out on accessions of C. argentea and C. mollis from Germplasm Banks of Embrapa Gado de Leite (Juiz de Fora, MG) and Embrapa Semi-Árido (Petrolina, PE), respectively. Root tips were treated with 3 mM 8-hydroxyquinoline and slides were made using the air-dry technique. Karyotype description for each accession took into account the following features: chromosome number; total length, relative length and arm ratio of each chromosome; haploid set length, and degree of asymmetry. Mitotic metaphases in both species showed 2n = 22 chromosomes, where this is the first report of diploid number for C. mollis. Chromosome length was also quite similar for the two species, ranging from 5.08 to 2.50 µm in C. argentea and 5.12 to 2.51 µm in C. mollis, with haploid sets of equal size, measuring 38.10 and 37.85 µm, respectively. However, they did not show the same karyotypic formula, which was 5 m + 4 sm + 2 st for C. argentea and 7 m + 2 sm + 2 st for C. mollis. This indicates the occurrence of rearrangements within chromosomes I and VI. Both karyotypes showed a tendency for asymmetry.