Osseous Infections Caused by Aspergillus Species

Background: Osteomyelitis caused by Aspergillus spp. is a severe, but rare, clinical entity. However, clear guidelines regarding the most effective medical management have not yet been established. The present study is a literature review of all such cases, in an effort to elucidate epidemiology, as well as the therapeutic management and the infection’s outcome. Methods: A thorough review of all reports of osteomyelitis of the appendicular and the axial skeleton, without the skull and the spine, caused by Aspergillus spp. was undertaken. Data about demographics, imaging techniques facilitating diagnosis, causative Aspergillus, method of mold isolation, antifungal treatment (AFT), surgical treatment, as well as the infection’s outcome were recorded and evaluated. Results: A total of 63 cases of osseous infection due to Aspergillus spp. were identified. The studied population’s mean age was 37.9 years. The most commonly affected site was the rib cage (36.8%). Most hosts suffered immunosuppressive conditions (76.2%). Regarding imaging methods indicating diagnosis, computer tomography (CT) was performed in most cases (42.9%), followed by plain X-ray (41.3%) and magnetic resonance imaging (MRI) (34.9%). The most frequent isolated mold was Aspergillus fumigatus (49.2%). Cultures and/or histopathology were used for definite diagnosis in all cases, while galactomannan antigen test was additionally used in seven cases (11.1%), polymerase chain reaction (PCR) in four cases (6.3%), and beta-d-glucan testing in three cases (4.8%). Regarding AFT, the preferred antifungal was voriconazole (61.9%). Most patients underwent surgical debridement (63.5%). The outcome was successful in 77.5%. Discussion: Osteomyelitis due to Aspergillus spp. represents a severe infection. The available data suggest that prolonged AFT in combination with surgical debridement is the preferred management of this infection, while identification of the responsible mold is of paramount importance.

New anomalies and pathologies in the caudal region of the lizard’s axial skeleton

Currently, more than 58 skeletal anomalies and pathologies are known in the recent Squamata reptiles. In this paper, eight pathologies of a complex nature are described in Agamidae and Lacertidae: Paralaudakia caucasia (Eichwald, 1831) and Lacerta agilis Linnaeus, 1758. Description of tail pathologies was carried out based on the analysis of X-ray images and on the results of computer microtomography. In the specimen of P. caucasia (ЗИН 19116.1) complete ablation of the caudal vertebra was revealed, which provoked the detachment of chevron and the proliferation of soft tissues. In some Agamidae, after pseudoautotomy, partial ablation of the caudal vertebra occurs to promote wound healing. Complete ablation of the distal caudal vertebra has not been previously reported in literature. In females of L. agilis, deformation of the right transverse process of the vertebra with “false bifurcation” without the formation of a cartilaginous tube (VOLSU 98.2), scoliosis, hematoma and callus on the cartilaginous tube were noted, as well as the absence of an autotomy plane in the postpygal vertebra (ZIN 31549). An unusual pathology in L. agilis (ZIN 31549) is the absence of an autotomy plane in the postpigal vertebra and of its anterior neural spine. The loss of the plane of autotomy during ontogeny is characteristic of some Iguanidae, but it has not been previously noted in Lacertidae. The described cases of anomalies expand the spectrum of known pathologies in reptiles.

On the Taxonomic Status of the Red Icefish Channichthys rugosus (Notothenioidei: Channichthyidae) from the Kerguelen Islands (South Ocean)

The presented work is the final part of the taxonomic revision of the Antarctic icefishes of the genus Channichthys Richardson, 1844 (Notothenioidei: Channichthyidae) from the Kerguelen Islands, the species composition of which was discussed until recently. Based on the morphological study of all available specimens from the ZIN and BMNH collections (including the holotype), a comprehensive redescription of the Red icefish Channichthys rugosus Regan, 1913 from the waters of the Kerguelen islands (South Ocean) was carried out, including external morphology, seismosensory system, gill apparatus, and axial skeleton. As a result, new diagnostic features of Red icefish were discovered and previously known ones were clarified, which made it possible to confirm the species validity. Comparison with other valid species icefishes was done. Channichthys rugosus differs from Ch. rhinoceratus Richardson, 1844 by a high anterior dorsal fin, the fin membrane of which reaches the apexes of its longest rays (does not reach in Ch. rhinoceratus), as well as a narrow and concave interorbital space (compared to the wider and flat one), by stronger granulation and a uniform reddish body color (dark spotted-marble in Ch. rhinoceratus). Channichthys rugosus differs from Ch. velifer Meissner, 1972 by the number of rays in the first dorsal fin (7–9 versus 9–12) and pectoral fin (18–20 versus 20–21), the presence of bone plaques in the proximal part of the medial lateral line (absent in Ch. velifer), and monochromatic reddish body coloration (spotted in Ch. velifer). Channichthys rugosus differs from Ch. panticapaei Shandikov, 1995 by the presence of only 1 row of gill rakers on the first gill arch (2 rows in Ch. panticapaei) and by light coloration (brownish-black in Ch. panticapaei).

hox gene expression predicts tetrapod-like axial regionalization in the skate, Leucoraja erinacea

The axial skeleton of tetrapods is organized into distinct anteroposterior regions of the vertebral column (cervical, trunk, sacral, and caudal), and transitions between these regions are determined by colinear anterior expression boundaries of Hox5/6, -9, -10, and -11 paralogy group genes within embryonic paraxial mesoderm. Fishes, conversely, exhibit little in the way of discrete axial regionalization, and this has led to scenarios of an origin of Hox-mediated axial skeletal complexity with the evolutionary transition to land in tetrapods. Here, combining geometric morphometric analysis of vertebral column morphology with cell lineage tracing of hox gene expression boundaries in developing embryos, we recover evidence of at least five distinct regions in the vertebral skeleton of a cartilaginous fish, the little skate (Leucoraja erinacea). We find that skate embryos exhibit tetrapod-like anteroposterior nesting of hox gene expression in their paraxial mesoderm, and we show that anterior expression boundaries of hox5/6, hox9, hox10, and hox11 paralogy group genes predict regional transitions in the differentiated skate axial skeleton. Our findings suggest that hox-based axial skeletal regionalization did not originate with tetrapods but rather has a much deeper evolutionary history than was previously appreciated.

B Cell Involvement in the Pathogenesis of Ankylosing Spondylitis

Extensive research into ankylosing spondylitis (AS) has suggested the major role of genetics, immune reactions, and the joint–gut axis in its etiology, although an ultimate consensus does not yet exist. The available evidence indicates that both autoinflammation and T-cell-mediated autoimmune processes are actively involved in the disease process of AS. So far, B cells have received relatively little attention in AS pathogenesis; this is largely due to a lack of conventional disease-defining autoantibodies. However, against prevailing dogma, there is a growing body of evidence suggestive of B cell involvement. This is illustrated by disturbances in circulating B cell populations and the formation of auto-reactive and non-autoreactive antibodies, along with B cell infiltrates within the axial skeleton of AS patients. Furthermore, the depletion of B cells, using rituximab, displayed beneficial results in a subgroup of patients with AS. This review provides an overview of our current knowledge of B cells in AS, and discusses their potential role in its pathogenesis. An overarching picture portrays increased B cell activation in AS, although it is unclear whether B cells directly affect pathogenesis, or are merely bystanders in the disease process.

A fresh look at Cladarosymblema narrienense, a tetrapodomorph fish (Sarcopterygii: Megalichthyidae) from the Carboniferous of Australia, illuminated via X-ray tomography

Background The megalichthyids are one of several clades of extinct tetrapodomorph fish that lived throughout the Devonian–Permian periods. They are advanced “osteolepidid-grade” fishes that lived in freshwater swamp and lake environments, with some taxa growing to very large sizes. They bear cosmine-covered bones and a large premaxillary tusk that lies lingually to a row of small teeth. Diagnosis of the family remains controversial with various authors revising it several times in recent works. There are fewer than 10 genera known globally, and only one member definitively identified from Gondwana. Cladarosymblema narrienense Fox et al. 1995 was described from the Lower Carboniferous Raymond Formation in Queensland, Australia, on the basis of several well-preserved specimens. Despite this detailed work, several aspects of its anatomy remain undescribed. Methods Two especially well-preserved 3D fossils of Cladarosymblema narrienense, including the holotype specimen, are scanned using synchrotron or micro-computed tomography (µCT), and 3D modelled using specialist segmentation and visualisation software. New anatomical detail, in particular internal anatomy, is revealed for the first time in this taxon. A novel phylogenetic matrix, adapted from other recent work on tetrapodomorphs, is used to clarify the interrelationships of the megalichthyids and confirm the phylogenetic position of C. narrienense. Results Never before seen morphological details of the palate, hyoid arch, basibranchial skeleton, pectoral girdle and axial skeleton are revealed and described. Several additional features are confirmed or updated from the original description. Moreover, the first full, virtual cranial endocast of any tetrapodomorph fish is presented and described, giving insight into the early neural adaptations in this group. Phylogenetic analysis confirms the monophyly of the Megalichthyidae with seven genera included (Askerichthys, Cladarosymblema, Ectosteorhachis, Mahalalepis, Megalichthys, Palatinichthys, and Sengoerichthys). The position of the megalichthyids as sister group to canowindrids, crownward of “osteolepidids” (e.g.,Osteolepis and Gogonasus), but below “tristichopterids” such as Eusthenopteron is confirmed, but our findings suggest further work is required to resolve megalichthyid interrelationships.

Dangerous Behavior and Intractable Axial Skeletal Pain in Performance Horses: A Possible Role for Ganglioneuritis (14 Cases; 2014–2019)

Introduction: Dangerous behavior is considered an undesired trait, often attributed to poor training or bad-tempered horses. Unfortunately, horses with progressive signs of dangerous behavior are often euthanized due to concerns for rider safety and limitations in performance. However, this dangerous behavior may actually originate from chronic axial skeleton pain. This case series describes the medical histories and clinical presentations of horses presented for performance limitations and dangerous behavior judged to be related to intractable axial skeleton pain.Material and Methods: Fourteen horses that developed severe performance limitations resulting in euthanasia were included. A complete spinal examination and behavioral responses, gait and neurologic evaluations, diagnostic imaging, gross pathologic and histopathologic examinations of the axial skeleton were performed on all horses. A tentative diagnosis of the affected spinal region was formulated using medical records, owner and trainer complaints, and antemortem examination findings. The selected spinal regions were further examined with gross and histopathologic evaluations of the associated osseous, soft tissue and neural tissues.Results: Ten horses showed severe behavioral responses during the myofascial and mobilization examinations. Based on an aggregate evaluation, the cervicothoracic and lumbosacral regions were the most common regions believed to be the primary area of concern. All horses had moderate to severe ganglionitis present at multiple vertebral levels. Subdural and epidural hemorrhage or hematomas were a common finding (71%) in the cervicothoracic and lumbosacral regions.Discussion: In this case series, neuropathic (i.e., structural) pain was judged to be the underlying cause of dangerous behavior. The dorsal root ganglia (DRG) serve an important role in relaying peripheral sensory information to the central nervous system and ganglionitis has been associated with neuropathic pain syndromes. This series highlights the need for more in-depth understanding of pain behavior and its clinical presentation and progression in chronic or severely affected horses. Limitations of the study are the lack of age-matched control DRG and the incomplete collection of DRG from every vertebral level of interest.

A rare case of fetus in fetu in the sacrococcygeal region: CT and MRI findings

Background Fetus in fetu is a rare condition in which a malformed fetus is found in the body of a living twin. The retroperitoneum is the most common location of this condition. However, the sacrococcygeal region is a rare site of the disease. The presence of vertebral bodies and limbs differentiates FIF from teratoma. Imaging modalities are important for diagnosing FIF. Case presentation A 12-months old boy was hospitalized because of a mass in the sacrococcygeal region. CT showed a large, complex mass with bony structure resembling sacrococcygeal bone, hip bone and the femur in the sacrococcygeal region of the boy. The blood supply of the mass was from the aorta of the host. MRI revealed the mass was connected with the dilated sacral canal of the host, which resulted in tethered cord. A preoperative diagnosis of FIF was made and surgery was performed to remove the mass. Surgical removal and subsequent pathological examination revealed the anencephalic fetus had limb buds and a sacrum but no axial skeleton, which supported the diagnosis of FIF. Conclusions CT and MRI played important roles in diagnosing FIF based on the location of the lesion.