Opisthorchis viverrini-like liver fluke in birds from Vietnam: morphological variability and rDNA/mtDNA sequence confirmation.

Flukes were found in the bile ducts of domestic ducks (Anas platyrhynchos), necropsied in the Binh Dinh province of Central Vietnam. Following staining, morphological characteristics of the bird flukes were compatible with Opisthorchis viverrini, although some characteristics differed from those described in specimens collected from mammal hosts. Computation of the phylogenetic trees on the partial sequences of the second internal ribosomal spacer (ITS2) of the ribosomal DNA and cytochrome c oxidase subunit I (COI) markers of the mitochondrial DNA showed close similarity of the 'bird' Opisthorchis sp. with O. viverrini. We speculate that these bird flukes are O. viverrini that show intraspecies morphological and molecular variability compared to isolates from mammals. This demonstrates the complex epidemiological situation of opisthorchiasis in Vietnam and urges investigations on the potential of birds as a reservoir host of this zoonotic fluke.

The standard tangential fields used for breast irradiation do not allow optimal coverage and dose distribution in axillary levels I-II and the sentinel node area.

BACKGROUND: Recent data from ACOSOG Z0011 and NSABP B32 trials suggested no need for axillary lymph node dissection (ALND) in patients with micrometastatic involvement of the sentinel lymph node (SLN). The low rate of axillary recurrence was attributed to the axilla coverage by the tangential fields (TgFs) irradiation and systemic therapy. This study aimed to evaluate dose distribution and coverage of the axilla levels I-II and the SLN area. PATIENTS AND METHODS: One hundred and nine patients were analyzed according to three groups: group 1 (50 Gy; n = 18), group 2 (60 Gy; n = 34) and group 3 (66 Gy; n = 57). Patients were treated using the standard (STgF; n = 22) or high (HTgF; n = 87) TgF. RESULTS: The median doses delivered to level I using HTgF versus STgF were 33 and 20 Gy (P = 0.0001). The mean dose delivered to the SLN area was only 28 Gy. Additionally, the SLN area was totally included in the HTgF in 1 out of 12 patients who had intraoperative clip placement in the SNL area. CONCLUSIONS: TgFs provide a limited coverage of the axilla and the SNLB area. This information should be considered when only TgFs are planned to target the axilla in patients with a positive SLN without ALND. Standardization of locoregional radiotherapy in this situation is urgently needed.

Spray-dried porcine plasma enhances feed efficiency, intestinal integrity, and immune response of broilers challenged with necrotic enteritis.

Re-emergence of enteric diseases in the postantibiotic era has imposed severe loss to the poultry industry leading to the urgent need for appropriate additives to maintain gut health. Recently, more attention has been paid to animal plasma due to its high concentrations of active components such as albumins and globulins. The objective of this study was to evaluate the effects of spray-dried porcine plasma (SDP) supplementation during the starter phase (d 0-10) on growth performance, intestine health, and immune response of broilers under necrotic enteritis (NE) challenge. A total of 720 day-old male broiler parental line chicks (Ross 308) were randomly assigned to a 2 (NE challenge: no, yes) × 2 (SDP: 0, 2%) factorial arrangement with 12 replications of 15 chicks each. To induce NE, birds were inoculated with live Eimeria vaccine on d 9 and Clostridium perfringens on d 14. The body weight of birds and feed consumption were measured per pen on d 8, 10, 24, and 29 to calculate performance parameters. On d 16, three birds per pen were sampled to analyse the intestinal lesion score, gut permeability, villi morphology, relative weight of organs, and immune response. Results showed that SDP improved (P < 0.001) FCR in the pre-challenge phase (d 0-8). The results indicated that supplementing SDP lowered (P < 0.01) FCR at the end of the experiment (d 29). Dietary SDP decreased (P < 0.05) the concentration of FITC-d in serum samples of challenged broilers, although it did not affect the intestinal morphology and lesion score. Birds fed with SDP had a higher (P < 0.05) relative weight of bursa (g/kg live body weight) compared to non-supplemented birds. Supplementing SDP reduced the concentration of interleukin-6 (P < 0.05) and α-1 acid glycoprotein (P = 0.051) in serum samples of broilers. In conclusion, supplementation of SDP in the starter phase enhanced feed efficiency and gut integrity in NE challenged broilers, possibly through manipulating the immune response, while further studies targeting intestinal microflora and key genes are required to explore the mode of action.

Assessment of a 27-kDa antigen in enzyme-linked immunosorbent assay for the diagnosis of fasciolosis in Vietnamese patients.

Fasciolosis has emerged as an important zoonotic disease in many parts of the world. In recent years, an increasing number of human cases were reported in Vietnam. In this study, the 27-kDa component protein from the excretory/secretory production of adult Fasciola gigantica, purified by high performance liquid chromatography, was assessed in an enzyme-linked immunosorbent assay (ELISA) to detect antibodies against Fasciola spp. for diagnosis of human fasciolosis. The ELISA showed a high sensitivity (100%) and specificity (97.67%) when tested on patients with fasciolosis, other parasitic infections, cholangiocarcinoma and on healthy controls. The assay was applied for diagnosis on 143 patients in the Viet Duc-Hanoi hospital who presented with clinical signs of liver disease and lesions in their livers as shown by imaging techniques. Antibodies were found in 37 (25.9%) of these patients, of whom only 3 shed Fasciola eggs in their stools (2.1%). The excellent response to triclabendazole treatment of 37 sero-positive patients confirmed the diagnosis of fasciolosis. This study demonstrated the diagnostic potential for human fasciolosis of the 27-kDa antigen ELISA. Fasciolosis should be considered in the differential diagnosis of hepatic disease in Vietnam.

Intraoperative augmented reality with heads-up displays in maxillofacial surgery: a systematic review of the literature and a classification of relevant technologies.

Although the term augmented reality appears increasingly in published studies, the real-time, image-guided (so-called 'hands-free' and 'heads-up') surgery techniques are often confused with other virtual imaging procedures. A systematic review of the literature was conducted to classify augmented reality applications in the fields of maxillofacial surgery. Publications containing the terms 'augmented reality', 'hybrid reality', and 'surgery' were sought through a search of three medical databases, covering the years 1995-2018. Thirteen publications containing enough usable data to perform a comparative analysis of methods used and results obtained were identified. Five out of 13 described a method based on a hands-free and heads-up augmented reality approach using smart glasses or a headset combined with tracking. Most of the publications reported a minimum error of less than 1mm between the virtual model and the patient. Augmented reality during surgery may be classified into four categories: heads-up guided surgery (type I) with tracking (Ia) or without tracking (Ib); guided surgery using a semi-transparent screen (type II); guided surgery based on the digital projection of images onto the patient (type III); and guided surgery based on the transfer of digital data to a monitor display (type IV).

A study of edema disease in pigs in Vietnam with particular reference to the use of autovaccine for the prevention of disease.

Edema disease caused by Escherichia coli is one of the most common diseases in postweaning piglets throughout Vietnam. Verotoxigenic E. coli (VTEC) was isolated from 197 of 261 samples (75.5%). All isolates were confirmed by basic biochemical tests and carbohydrate fermentation characteristics. Of these, 70.1% of isolates are hemolytic, 45% isolates belonged to serotypes O149:K91, possessed the VT2e gene, and was the most predominant VTEC pathotype associated with edema disease in pigs. Serogroup O139 accounted for 30% of the isolates, followed by serogroup O138 and O141 (25%). In addition to VT2e gene, the ST (72.7%) and LT (52.7%) genes were also recognized. A total of 10 representative isolates were subjected to toxigenicity testing by intraperitoneal injection in mice and experimental infection in pigs. It was shown that 100% of the mice were killed 17-24 h post injection (p.i.). All pigs experimentally infected with challenge strains and developed typical symptoms of edema disease 36-72 h p.i. A multivalent killed whole-cells vaccine containing aluminum hydroxide was prepared from 5 VTEC strains. The vaccine was 100% safe when administered by the intramuscular route into the pigs. A field trial for over 100,000 pigs (21-90 days old) showed that vaccinated pigs were protected against edema disease at a level of 90% compared to 100% of pigs from unvaccinated groups.

Ipsilateral breast cancer recurrence after Deep Inferior Epigastric Perforator (DIEP) flap reconstruction: Incidence and radiological presentation.

PURPOSE: To assess the incidence and presentation of ipsilateral cancer recurrences (ICR) after deep inferior epigastric perforator (DIEP) flap reconstruction for breast cancer. PATIENTS AND METHODS: Data of 247 consecutive women with DIEP flap reconstruction after breast cancer in our institution between 1997 and 2009 were retrospectively reviewed. RESULTS: Mean follow-up time was 4.1years±3.2 (SD) (median: 3years; range: 1month - 14years). Thirty-one patients (12.5%, 95%CI: =8.7-17.3) presented 34 relapses, in average 4.1years±2.6 after mastectomy: 14 (41%) were ipsilateral, 6 (18%) contralateral and 14 (41%) metastatic. ICRs occurred earlier (3.9 vs. 5.8years; P<0.05) than non-ICRs. Most ICRs (10/14, 71%) involved the periphery of the flap and presented as palpable nodules. The remaining (4/14, 29%) involved the axilla and 3/4 (75%) were palpable. Imaging procedures detected infra-clinical ICRs in 3 of 10 imaged patients (30%). CONCLUSION: ICRs after DIEP flap reconstruction are more frequent than contralateral recurrences suggesting the need for imaging follow-up of the reconstructed breast.

Phosphorus extractability of soils amended with stockpiled and composted cattle manure.

Managing fertilizer applications to maintain soil P below environmentally unacceptable levels should consider the contribution of manure and synthetic fertilizer sources to soluble and extractable forms of P. Our objective was to evaluate soil and manure characteristics and application rates on P extractability in recently amended soils. Five soils of the U.S. southern High Plains were amended with beef cattle manures, composted beef manure, and inorganic fertilizers [Ca(H(2)PO(4))(2) or KH(2)PO(4)] at five rates and incubated under controlled conditions. Mehlich 3-, Olsen (NaHCO(3))-, Texas A&M extractant (TAM)-, and water-extractable P were determined for the soils after selected incubation periods. Except for TAM and some water extractions, P extractability as a function of total P applied was linear (P < 0.001) for a wide range of application rates. Mehlich-3, NaHCO(3), and water P extraction efficiencies of KH(2)PO(4)-amended soils averaged 22, 34, and 115% greater (P < or = 0.036), respectively, than efficiencies of soils amended with manures except for the Texline (calcareous) loam and Pullman clay loam soils. Phosphorus extraction efficiencies decreased with time for KH(2)PO(4)-amended soils (P < 0.05) but remained stable or increased for manure-amended soils during the 8-wk incubation period. Across all soils and manure sources, changes in water-extractable P per unit increase in Mehlich 3-, NaHCO(3)-, and TAM-extractable P averaged 100, 85, and 125% greater, respectively, for inorganic as compared with manure-amended soils. These source-dependent relationships limit the use of agronomic soil extractants to make correct inferences about water-extractable P and dissolved P in runoff.

Breast tomosynthesis: Dosimetry and image quality assessment on phantom.

PURPOSE: To evaluate using phantom study the average glandular dose (AGD) and image quality in breast tomosynthesis. MATERIALS AND METHODS: The study was performed with a full-field digital mammography system (Mammomat Inspiration(®), Siemens, Erlangen, Germany) combined with tomosynthesis equipment (3D). For AGD evaluation, polymethyl methacrylate (PMMA) plates and a dosimeter were used to directly measure the absorbed doses in 2D and in 3D. The doses were then compared to the doses displayed on the equipment using the Mann-Whitney test. Three phantoms, accredited for 2D digital mammography (MTM 100, ACR RMI 156, BR3D), were imaged three times in 2D then in 3D. For each acquisition, the AGD was recorded. For image quality assessment, scores, defined by the rate of visible inserts, obtained for each acquisition both in 2D and in 3D, and for each phantom, were compared (Kruskall-Wallis and post-hoc Dunn tests). RESULTS: There was no significant difference between the measured and displayed AGD, both in 2D and in 3D imaging (P>0.05). With identical acquisition parameters, AGD were significantly greater in 3D than in 2D P<0.01). For phantoms MTM 100 and ACR RMI 156, there was no significant difference between the rate of visible inserts in 2D and in 3D (P=0.06 and P=0.36, respectively). However for phantom BR3D, the rate was significantly higher in 3D than in 2D (P<0.0001). CONCLUSION: Doses are significantly greater in 3D than in 2D. With tomosynthesis, out of the three phantoms tested, only phantom BR3D showed a higher rate of visible inserts.

When private actors matter: Information-sharing network and surveillance of Highly Pathogenic Avian Influenza in Vietnam.

The effectiveness of animal health surveillance systems depends on their capacity to gather sanitary information from the animal production sector. In order to assess this capacity we analyzed the flow of sanitary information regarding Highly Pathogenic Avian Influenza (HPAI) suspicions in poultry in Vietnam. Participatory methods were applied to assess the type of actors and likelihood of information sharing between actors in case of HPAI suspicion in poultry. While the reporting of HPAI suspicions is mandatory, private actors had more access to information than public actors. Actors of the upstream sector (medicine and feed sellers) played a key role in the diffusion of information. The central role of these actors and the influence of the information flow on the adoption by poultry production stakeholders of behaviors limiting (e.g. prevention measures) or promoting disease transmission (e.g. increased animal movements) should be accounted for in the design of surveillance and control programs.

Percutaneous Fine Needle Aspiration Cytology and Biopsy in the Diagnosis and Classification of Lymphoma: Clinical Evaluation.

In some patients with suspected de novo or recurrent lymphoma, the absence of a palpable mass or peripheral lymph node enlargement can be a diagnostic challenge. We report our experience of fine needle aspiration (FNA) and biopsy in the management of 47 consecutive patients investigated in our institution over a period of 4 years. Lymphoma was suspected in 32 cases, and recurrent disease in 15 cases. Cytology was performed in all patients and biopsy in 16 patients, when a safe approach was possible. The specimens were obtained with computed tomography guidance and were diagnostic by cytology in 85% of cases: 28 patients had a newly diagnosed lymphoma and 3 had recurrent disease; residual fibrosis was diagnosed in 2 cases. Five patients with a previously diagnosed lymphoma had a new neoplasm: lung carcinoma: 3, renal adenocarcinoma: 1, metastatic lymph nodes: 1. One patient had non-neoplastic intercurrent disease (pulmonary nocardiosis). In 7 patients, no conclusive tissue was obtained (acellular: 1, blood: 3, necrosis: 3). In one case of suspected recurrent disease, a false-positive result was obtained. Cytology always allowed distinction between non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD), with attempts to subclassify NHL according to the International Working Formulation. In 12 patients, immunochemical studies could be performed for immunologic subclassification of lymphoma on the basis of cytology (n = 6) and biopsy (n = 6). Our results show that percutaneous fine needle aspiration cytology is a reliable method for the diagnosis and classification of lymphoma, and immunologic studies can be performed on cytology alone if biopsy is unsafe.

Pancreatic cystic neoplasms.

Cystic neoplasms are an uncommon group among pancreatic tumors. Because of advances in noninvasive diagnostic procedures, these lesions are more frequently detected and surgically treated. New pathological entities have been recently described with their own prognosis. 1. In a large number of cases, the imaging procedures can differentiate microcystic adenoma from mucinous cystadenoma, the more frequently encountered lesions. A well-defined mass with innumerable small cysts producing a honeycomb appearance with central stellate septae is suggestive of microcystic adenoma. A well-defined multilocular mass containing thin, straight or curvilinear septae with papillary projections and local thickening is suggestive of mucinous cystadenoma. 2. No sonographic or CT finding allows the differentiation between mucinous cystadenoma and cystadenocarcinoma, however; the imaging features depend on the grade of malignancy. 3. Thus, in the majority of cases of cystic lesions, fine needle aspiration with appropriate stains is recommended.

Intraarticular tolerability and kinetics of gadolinium tetra-azacyclododecane tetraacetic acid.

RATIONALE AND OBJECTIVES: We assessed the tolerability and the intraarticular kinetics of gadolinium tetra-azacyclododecane tetraacetic acid (Gd-DOTA) using magnetic resonance (MR) imaging. METHODS: Twelve of 18 dogs received an intraarticular injection of Gd-DOTA solution. Pathologic examination of all joints was performed with assessment of Gd-DOTA bone absorption. Effects of Gd-DOTA on chondrocyte viability and proliferation in vitro were determined using cultures of rabbit chondrocytes. Four dogs underwent MR imaging of the stifle joint before and after intraarticular injection of 0.8 ml Gd-DOTA at a concentration of 2 mmol/l (300 mOsm/l). Intraarticular kinetics of Gd-DOTA were determined from quantitative measurements using repeated sagittal spin-echo T1-weighted images. RESULTS: No microscopic changes of the joints or Gd-DOTA bone absorption were detected. No cytotoxicity for chondrocytes was observed at a concentration of 5 mmol/l, but a decreased cell count was observed at a high concentration (50 mmol/l). The intraarticular Gd-DOTA concentration decreased with time according to a logarithmic curve with an intraarticular half-life of 103-152 min (M = 127 min). CONCLUSION: Gd-DOTA is a safe intraarticular contrast agent with a long half-life in the joint cavity.

MR imaging of the breast in the follow-up evaluation of conservative nonoperatively treated breast cancer.

Because of postradiation changes in the breast, evaluation of the efficacy of conservative local radiation treatment is difficult, and early detection of recurrent disease is often a diagnostic challenge. MR imaging of the breast aids in the follow-up of conservatively treated breast cancers. When recurrent disease is suspected, MR imaging allows for the differentiation between late postradiation changes in the breast and recurrent carcinoma.

Manure phosphorus extractability as affected by aluminum- and iron by-products and aerobic composting.

Shifts in manure phosphorus (P) chemical forms and pool sizes induced by water treatment residuals and industrial mineral by-products are largely undefined. We conducted a manure P fractionation study to determine mechanisms of reduction of dissolved reactive phosphorus (DRP) in poultry manure upon mineral by-product additions. The effects of composting on the P immobilization efficacy of the by-products were determined using laboratory self-heating composting simulators. The mineral by-products included an aluminum-water treatment residual (Al-WTR) and an iron-rich titanium-processing by-product. The noncomposted manure averaged 0.11 g g(-1) of total P as DRP forms. The by-products significantly reduced manure DRP, by an average of 39 and 48% in the Al- and the Fe-treated manure, respectively. The by-products also reduced the 0.5 M NH4F-extractable phosphorus (FEP) fraction. Shifts in P forms between FEP and 0.1 M NaOH-extractable phosphorus (SHEP) depended upon the Al and Fe contents of the by-products while the combined FEP + SHEP pool remained constant. Phosphate sorption measurements supported the observations that the Fe-rich by-product was more effective at reducing manure DRP and enhancing the formation of SHEP forms at the expense of FEP than the Al-WTR. Composting had no effect on the efficacy of either by-product to reduce DRP. Potential mechanisms of enhanced P stabilization in treated manure upon composting included chemical shifts from the DRP and FEP fractions to the citrate-bicarbonate-dithionite extractable P fraction. Thus, the choice of P immobilization agents affected the stability of immobilized P forms and should be taken into consideration in developing manure processing and nutrient stabilization methods.

[Infiltrating hematoma of the hepatic pedicle and gallbladder wall. Ultrasonographic and x-ray computed tomographic aspects]. / Hématome infiltrant du pédicule hépatique et de la paroi vésiculaire. Aspect échographique et tomodensitométrique.

A case of infiltrative hematoma of the porta hepatitis and the gallbladder wall is reported. It is a rare complication of anticoagulant treatment. The sonographics findings were 1 degree an echogenic material surrounding the porta hepatis, and 2 degrees a gallbladder wall thickening. Both these lesions appeared as dense areas on computed tomography (CT) scan. The aetiologies of hemorrhagic cholecystitis are discussed.

[Spontaneous remission of renal artery stenosis in Takayasu's disease]. / Régression spontanée d'une sténose de l'artère rénale au cours d'une maladie de Takayashu.

The authors report about one rare case of spontaneous subsidence of tight stenosis of the left renal artery in Takayashu's disease, which was followed up on two angiograms taken with an 11-year time interval. Knowing such evolution patterns may influence the treatment of such stenoses.

[Comparison of MRI and CT X-ray in the evaluation of bladder cancer. Apropos of 26 cases]. / Comparaison IRM-TDM dans le bilan des cancers de vessie. A propos de 26 cas.

26 urothelial carcinomas studied with MRI and CT have been reviewed. The results are connected with surgical and histological data. The assessment of the size and number of tumoral sites is more accurate with MRI, which allows a correct assessment of bladder wall infiltration in 20 of the 22 tumors studied with T2-weighted sequences. The sensitivity of both techniques is the same for the invasion of fat (92%) and the involvement of neighboring organs (67%), although MRI seems to be more specific (85% and 95% for 77% and 89%). The results are similar for the study of lymph node invasion (71% sensitivity). The performances of MRI for the assessment of bladder cancer extension are therefore comparable to those of CT. The advantages of the former technique include the clearer visualization of the tumor itself, especially for cancers of the neck and dome of the bladder owing to exploration in several planes. In addition, it allows a reliable assessment of the degree bladder wall infiltration and differentiates tumors that are not or not very infiltrating from highly infiltrating tumors.

[Letters to the editor : Cards on the table with Carlo Sterlin.]. / Tribune libre : Cartes sur table avec Carlo Sterlin.

In this interview with Mrs. Thi Hong Trang Dao, resident in Psychiatry at the University of Montreal, Carlo Sterlin retraces his career of 25 years in psychiatry in Quebec and makes a critical review of his experience in various fields: practical clinical work both in urban centers and in remote areas, teaching, research, practice amongst ethnic groups, etc. He endeavours to show that community practice is not truly biopsychosocial and that, so far as it is confined, refuses respon-sability and rejects bio-energetics, it contributes to the aggravation of the mental health of the population. Taking his inspiration from the work of W. Reich and from the traditions of non western cultures, he suggests ideas to be explored which are likely to open up genuine alternative methods of intervention. Like wise he invites the new generations of clinicians to leave the well worn paths established by the dominant ideologies in order to free their creativity.

Response of coliform populations in streambed sediment and water column to changes in nutrient concentrations in water.

As sediments increasingly become recognized as reservoirs of indicator and pathogen microorganisms, an understanding of the persistence of indicator organisms becomes important for assessment and predictions of microbial water quality. The objective of this work was to observe the response of water column and sediment coliform populations to the change in nutrient concentrations in the water column. Survival experiments were conducted in flow-through chambers containing sandy sediments. Bovine feces were collected fresh and introduced into sediment. Sixteen days later, the same fecal material was autoclaved and diluted to provide three levels - 1×, 0.5×, and 0.1× of nutrient concentrations - spike in water column. Total coliforms, Escherichia coli, and total aerobic heterotrophic bacterial concentrations were monitored in water and sediment. Bacteria responded to the nutrient spike with initial growth both in the water column and in sediment. The response of bacterial concentrations in water column was nonlinear, with no significant changes at 0.1 and .5× spikes, but a substantial change at 1× spike. Bacteria in sediment responded to the spikes at all added nutrient levels. Coliform inactivation rates both in sediment and in water after the initial growth occurred, were not significantly different from the inactivation rates before spike. These results indicate that introduction of nutrients into the water column results in nonlinear response of E. coli concentrations both in water and in sediments, followed by the inactivation with the same rate as before introduction of nutrients.