Immunohistochemical characteristics of normal canine eyes.

Immunohistochemistry is widely utilized in diagnostic laboratories to study neoplastic and nonneoplastic diseases. Knowledge of the immunohistochemical characteristics of normal tissue is essential for interpretation of immunoreactivity in pathologic conditions. In this study, immunohistochemistry was performed with a broad panel of diagnostically relevant antibodies on 4 normal canine globes--namely, vimentin, pan-cytokeratin (AE1/AE3), cytokeratin 7, cytokeratin 8/18, cytokeratin 20, α-smooth muscle actin, muscle specific actin, desmin, Melan-A, microphthalmia transcription factor, S-100, glial fibrillary acidic protein, triple neurofilaments, neuron-specific enolase, chromogranin A, synaptophysin, laminin and CD31. Results include cytokeratin immunoreactivity limited to the conjunctival epithelium, corneal epithelium, and retinal pigment epithelium; distinct patterns of immunopositivity of muscle markers; and widespread immunoreactivity for vimentin and most neural/neuroendocrine markers. These findings in normal eyes provide the basis for interpretation of ocular immunohistochemistry in dogs. Published immunophenotypes of primary ocular neoplasms are also reviewed.

Classification of canine malignant lymphomas according to the World Health Organization criteria.

A study was carried out to test the accuracy and consistency of veterinary pathologists, not specialists in hematopathology, in applying the World Health Organization (WHO) system of classification of canine lymphomas. This study represents an initiative of the ACVP Oncology Committee, and the classification has been endorsed by the World Small Animal Veterinary Association (WASVA). Tissue biopsies from cases of canine lymphoma were received from veterinary oncologists, and a study by pathologists given only signalment was carried out on 300 cases. Twenty pathologists reviewed these 300 cases with each required to choose a diagnosis from a list of 43 B and T cell lymphomas. Three of the 20 were hematopathologists who determined the consensus diagnosis for each case. The 17 who formed the test group were experienced but not specialists in hematopathology, and most were diplomates of the American or European Colleges of Veterinary Pathology. The overall accuracy of the 17 pathologists on the 300 cases was 83%. When the analysis was limited to the 6 most common diagnoses, containing 80% of all cases, accuracy rose to 87%. In a test of reproducibility enabled by reintroducing 5% of cases entered under a different identity, the overall agreement between the first and second diagnosis ranged from 40 to 87%. The statistical review included 43,000 data points for each of the 20 pathologists.

Recommended guidelines for submission, trimming, margin evaluation, and reporting of tumor biopsy specimens in veterinary surgical pathology.

Neoplastic diseases are typically diagnosed by biopsy and histopathological evaluation. The pathology report is key in determining prognosis, therapeutic decisions, and overall case management and therefore requires diagnostic accuracy, completeness, and clarity. Successful management relies on collaboration between clinical veterinarians, oncologists, and pathologists. To date there has been no standardized approach or guideline for the submission, trimming, margin evaluation, or reporting of neoplastic biopsy specimens in veterinary medicine. To address this issue, a committee consisting of veterinary pathologists and oncologists was established under the auspices of the American College of Veterinary Pathologists Oncology Committee. These consensus guidelines were subsequently reviewed and endorsed by a large international group of veterinary pathologists. These recommended guidelines are not mandated but rather exist to help clinicians and veterinary pathologists optimally handle neoplastic biopsy samples. Many of these guidelines represent the collective experience of the committee members and consensus group when assessing neoplastic lesions from veterinary patients but have not met the rigors of definitive scientific study and investigation. These questions of technique, analysis, and evaluation should be put through formal scrutiny in rigorous clinical studies in the near future so that more definitive guidelines can be derived.

Neuropsychological Sequelae of Coronary Heart Disease in Women: A Systematic Review.

Heart disease, such as coronary heart disease (CHD), is the leading cause of death among aging women. However, over the past years, the mortality rate has declined, resulting in an increased number of CHD survivors. In this context, research has uncovered relationships between cardiovascular disease (CVD) and the development of neurodegenerative diseases, suggesting that CHD can act as a precursor. Despite heart disease affecting both sexes, CVD research has significantly neglected women. Therefore, we conducted the first systematic review of neuropsychological sequelae of CHD in women to gain a clear portrait of the current knowledge of the association of CHD on women's neuropsychological status. We found that studies continue to include an insufficient number of women in their research. Our work also uncovered that there is variability in the definition of CHD by researchers (i.e., operationalization of the variable), which could explain inconsistencies across studies. Overall, we found evidence that supports the heart-brain disease hypothesis. To conclude, we provide several guidelines for future research involving the impact of CHD in women.

A systematic review of the Trier Social Stress Test methodology: Issues in promoting study comparison and replicable research.

Since its development in 1993, the Trier Social Stress Test (TSST) has been used widely as a psychosocial stress paradigm to activate the sympathetic nervous system and hypothalamic-pituitary-adrenal axis (HPAA) stress systems, stimulating physiological functions (e.g. heart rate) and cortisol secretion. Several methodological variations introduced over the years have led the scientific community to question replication between studies. In this systematic review, we used the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) to synthesize procedure-related data available about the TSST protocol to highlight commonalities and differences across studies. We noted significant discrepancies across studies in how researchers applied the TSST protocol. In particular, we highlight variations in testing procedures (e.g., number of judges, initial number in the arithmetic task, time of the collected saliva samples for cortisol) and discuss possible misinterpretation in comparing findings from studies failing to control for variables or using a modified version from the original protocol. Further, we recommend that researchers use a standardized background questionnaire when using the TSST to identify factors that may influence physiological measurements in tandem with a summary of this review as a protocol guide. More systematic implementation and detailed reporting of TSST methodology will promote study replication, optimize comparison of findings, and foster an informed understanding of factors affecting responses to social stressors in healthy people and those with pathological conditions.

Insulin-resistant lipolysis in abdominally obese hypertensive individuals. Role of the renin-angiotensin system.

Resistance to the capacity of insulin to suppress lipolysis may be an important link in the association between abdominal obesity and hypertension. Furthermore, a more active renin-angiotensin system in adipose tissue may contribute to insulin-resistant lipolysis in abdominally obese hypertensive subjects. We determined nonesterified fatty acid concentrations and turnover as well as lipid oxidation under basal conditions and during steady-state euglycemia with two levels of insulinemia (72 and 287 pmol/L) in lean normotensive, abdominally obese normotensive, and abdominally obese hypertensive subjects. To assess the role of the renin-angiotensin system in determining non-esterified fatty acid turnover, we repeated studies in the abdominally obese hypertensive subjects after double-blind random assignment to placebo or enalapril for 1 month each. The main findings were the following: (1) Nonesterified fatty acid flux was significantly higher in abdominally obese hypertensive subjects at both levels of insulinemia than in either abdominally obese normotensive or lean normotensive subjects and correlated significantly with both mean blood pressure and total systemic resistance during the higher level of insulinemia. (2) Enalapril significantly improved insulin-resistant lipolysis in the abdominally obese hypertensive subjects. The improvement in insulin suppressibility of nonesterified fatty acid flux at the high hormonal concentrations correlated positively with the magnitude of reduction in blood pressure. (3) Basal lipid oxidation and suppression in response to insulin were similarly impaired in both obese groups. Resistance to the antilipolytic actions of insulin is thus a characteristic feature in abdominally obese hypertensive subjects and may be linked to the elevated blood pressure in these individuals. A more active renin-angiotensin system may partly explain the insulin-resistant lipolysis in this form of hypertension.

Effects of lovastatin in diabetic patients treated with chlorpropamide.

Patients with non-insulin dependent diabetes mellitus (NIDDM) have a higher risk of atherosclerotic cardiovascular disease than nondiabetic subjects. In seven patients with both hypercholesterolemia and NIDDM controlled by chlorpropamide, lovastatin (20 mg b.i.d. for 6 weeks) lowered low-density lipoprotein cholesterol by 28%, total cholesterol by 24%, and apolipoprotein B by 24%. Lovastatin levels for a 4-hour period (measured as 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitory activity) were similar to those measured previously in nondiabetic patients. Lovastatin did not alter chlorpropamide kinetics or glycemic profiles. No patient had an elevation in serum transaminases or creatinine phosphokinase, and no patient had any other laboratory or clinical drug-related adverse experience during the study. Lovastatin was as effective in reducing low-density lipoprotein cholesterol in patients with NIDDM as in nondiabetic subjects. Diabetic control was unaltered, and no evidence of alteration in lovastatin or chlorpropamide blood levels was noted.

Retinal detachment after strabismus surgery.

Four nonmyopic eyes in three patients developed retinal detachment after strabismus surgery. Certain features common in all four eyes included the presence of a chorioretinal scar corresponding in location to the muscle operated on, proliferating fibrous tissue adjacent to the scar, and varying degrees of vitreous hemorrhage. These findings were similar to those in retinal detachments after perforation of the eye by foreign bodies. Penetration of the globe by the needle during muscle surgery was considered the etiologic factor. The use of spatula needles to prevent piercing of the globe is suggested, and in case such accident is suspected, diathermy or cryoapplication over the perforation site is advised.

Successful goniosynechialysis for angle-closure glaucoma after vitreoretinal surgery.

PURPOSE: To describe 2 cases of long-term successful clinical outcome after goniosynechialysis for secondary angle-closure glaucoma after vitreoretinal surgery. METHODS: Case reports. Goniosynechialysis was performed bilaterally in 1 patient and unilaterally in another for uncontrolled angle-closure glaucoma after vitreoretinal surgery. RESULTS: Angle reopening was performed 2 to 4 months after initial closure. After follow-up of between 3 and 5 years, intraocular pressure has remained below 21 mm Hg without medication in all three eyes. CONCLUSION: Goniosynechialysis should be considered a viable therapeutic alternative to filtration surgery in selected patients with a recent history of angle-closure glaucoma after vitreoretinal surgery.

Effect of simvastatin on Lp(a) concentrations.

The effect of HMG-CoA reductase inhibitors on Lp(a) concentrations is controversial, with some studies showing an increase and others showing no effect on Lp(a) concentrations. Many of these studies have been limited by small sample size and the lack of a prospective design. We evaluated the effect of four treatments: (1) placebo, (2) simvastatin 10 mg PO QPM, (3) simvastatin 20 mg PO QAM, and (4) simvastatin 20 mg PO QPM on Lp(a) concentrations in a prospective, randomized, controlled clinical trial of 24 weeks in 343 subjects in 28 clinical sites in the United States. Simvastatin was not associated with a change in Lp(a) concentrations relative to placebo. These results were not affected by controlling for race, initial Lp(a) level, or urinary albumin excretion. Simvastatin significantly reduced low-density lipoprotein (LDL) cholesterol levels (10 mg PO QPM: -27.6%; 20 mg PO QAM: -28.1%; and 20 mg PO QPM: -34.3%, all p < 0.001). It was concluded that in a large, randomized, controlled trial, simvastatin does not affect Lp(a) levels but markedly lowers LDL cholesterol levels.

Fibroleiomyomas of the tubular genitalia in female beluga whales.

Fibroleiomyomas of the tubular genitalia were diagnosed in 6 of 9 adult female beluga whales from the St. Lawrence estuary, Quebec, Canada. These tumors were located in the vagina (6 of 6), the cervix (2 of 6), and the uterus (1 of 6). Endogenous hormones or xeno-estrogens may be implicated in the occurrence of these tumors.

Seroprevalence of antibodies to Toxoplasma gondii in lynx (Lynx canadensis) and bobcats (Lynx rufus) from Québec, Canada.

The seroprevalence of antibodies to Toxoplasma gondii was investigated in trapped lynx (Lynx canadensis) and bobcats (Lynx rufus) from Québec, Canada. Forty-seven of 106 (44%) lynx and 4 of 10 (40%) bobcats had positive titers for T. gondii (> or = 25) by means of the modified agglutination test incorporating mercaptoethanol and formalin-fixed tachyzoites. Seroprevalence was significantly higher (P < 0.0001) in adult lynx than in juvenile lynx. The presence of antibodies to T. gondii in lynx and bobcats suggests that this organism is widespread in the wild and that exposure to wild felids and game animals from Québec may represent a potential source of infection for humans.

Estimation of the misclassification rate of self-reported visual disability.

PURPOSE: To estimate the misclassification rate of self-reported visual disabilities in a hospital-based population with known visual impairment. METHODS: Subjects (N=570) were recruited among patients aged 50 years and more and classified to three categories of visual impairment level. The questionnaire was administered to consenting patients through a telephone interview. Data collected from questionnaires and medical records were compared regarding severity of visual impairment. Sensitivity and specificity were determined for each question. Predictive ability and misclassification rates were computed for various prevalences. RESULTS: Questions related to near and far distance visual acuity with glasses have both a good sensitivity (82.6% and 81.8%) and a good specificity (85.6% and 88.9%) for the presence of severe visual impairment. CONCLUSION: The findings allow the determination of the misclassification rate and predictive ability. This could be useful to estimate the prevalence of visual impairment from health surveys.

Primary diffuse tracheobronchial amyloidosis in a dog.

Primary diffuse tracheobronchial amyloidosis was diagnosed at necropsy in an intact male Akita dog aged 11 years, a non-productive chronic cough having been the only related clinical sign. Histologically, eosinophilic hyalinized deposits were found as a band in the lamina propria underneath the epithelium of the trachea and bronchi. When stained with Congo red, apple-green birefringence was observed in the deposits viewed with polarized light. The amyloid did not lose sensitivity to Congo red staining after incubation with potassium permanganate, indicating that it was of the AL (amyloid light chain) type. Ultrastructural features of the amyloid included a typical fibrillar meshwork with individual fibrils measuring 9.5 to 10.5 nm in diameter. This is the first report of primary diffuse tracheobronchial amyloidosis in the dog.

Ameloblastic carcinoma in a horse.

The clinical, gross morphological, histological and immunohistochemical characteristics of an ameloblastic carcinoma in a 30-year-old Quarter Horse mare are reported. This tumour was fast growing, locally invasive and destructive. Histologically, it showed an infiltrative pattern of large islands, broad sheets and, at the periphery, small cords of moderately pleomorphic round, oval to spindle-shaped cells. Immunohistochemical evaluation revealed positive labelling for vimentin, cytokeratin 5/6 and cytokeratin 14. In the oral cavity of human beings, this immunolabelling pattern is unique for the embryonal enamel organ and tumours of ameloblastomatous epithelial origin, which strongly supports the diagnosis of equine ameloblastic carcinoma.

Retinal detachment in renal insufficiency a report of 3 cases.

Three cases of retinal detachment associated with renal insufficiency are presented. The authors feel that dilutional hyponatremia and hypervolemia were not significant in the genesis of the detachments and that control of the blood pressure was the key factor in their cure. The importance of hypertensive retinochoroidopathy in the pathogenesis of the detachment is emphasized.

Prophylactic argon laser photocoagulation of the second eye in presumed ocular histoplasmosis syndrome.

Fifty-six patients with presumed ocular histoplasmosis syndrome who exhibited a disciform macular detachment or macular scar in one fundus and one or more inactive atrophic lesions within the high-risk area of the second eye were seen at the Retina Service of Maisonneuve-Rosemont Hospital, Montreal, between 1972 and 1984. All 56 were followed for at least 10 months. Of the 56, 28 had received prophylactic argon laser photocoagulation of the inactive chorioretinal lesions. The rate of activation of the lesions was similar in the treated and untreated groups (10/28 over a mean follow-up period of 44.2 months and 11/28 over a mean period of 43.2 months respectively). In the untreated group there was an increased risk of activation with a higher number of lesions (t = 2.386). In both groups the risk of activation increased with the proximity of the lesions to the centre of the fovea (chi 2 = 29.97). Of the 10 treated eyes that showed activation, 4 did so within 1 month, which suggests that prophylactic photocoagulation may not be without risk of complications.

Seroprevalence of Toxoplasma gondii in Canadian pinnipeds.

Sera (n = 328) collected from phocids (1995-97) from the east coast of Canada, including harp seals (Phoca groenlandica), hooded seals (Cystophora cristata), grey seals (Halichoerus grypus), and harbor seals (Phoca vitulina), were diluted 1:25, 1:50, and 1:500 and tested by a modified agglutination test for antibodies to Toxoplasma gondii. Titers equal to or greater than 1:25 were considered evidence of exposure. Grey seal (11/122, 9%), harbor seal (3/34, 9%), and hooded seal (1/60, 2%) had titers of 1:25 and 1:50. Harp seals (n = 112) were seronegative. Probable maternal antibody transfer was observed in one harbor and one grey seal pup at 10 and 14 day of age, respectively. Transmission of T gondii in the marine environment is not understood. The discovery of T. gondii in marine mammals might indicate natural infections unknown because of lack of study or might indicate recent contamination of the marine environment from the terrestrial environment by natural or anthropogenic activities.

[The evaluation of the Harrington technique in the treatment of double-curved scoliosis (author's transl)]. / Evaluation de la technique de Harrington dans le traitement des scolioses doubles.

Double-curved scoliosis was present in 18.5 of 750 scolioses operated on at the St. Justine Hospital in Montreal. 128 cases were reviewed with a follow up of more than 3 years. Pre-operative curves measured 61 and 58 degrees on average and post-operative curves measured 27 and 23 degrees. At the time of review, the curves were 39 and 36 degrees. The loss of correction varied with the age of the patient and the severity of deformity. The technique of early ambulation improved the post-operative results. However, it was concluded that compression rods did not provide a better correction of the curve or of the thoracic kyphosis.

Eye Injuries in Sports: Results of a Five-Year Study.

In brief: From 1982 to 1986, Quebec ophthalmologists reported 869 sports-related eye injuries. Hyphema was the most common injury, with a frequency of 33%. Most injuries occurred in ice hockey, followed by racket sports (32% and 28%, respectively); most of the injured players were not wearing eye protection. The authors suggest that wearing eye protection should be mandatory in some sports and encouraged in many others.