The comparative pathology of enterocolitis caused by Clostridium perfringens type C, Clostridioides difficile, Paeniclostridium sordellii, Salmonella enterica subspecies enterica serovar Typhimurium, and nonsteroidal anti-inflammatory drugs in horses

To determine if there were significant differences produced by 5 of the most prevalent causes of equine enterocolitis, we studied retrospectively the gross and microscopic pathology of 90 cases of enterocolitis submitted to the San Bernardino laboratory of the California Animal Health and Food Safety Laboratory. Included were cases caused by Clostridium perfringens type C (CP; n = 20), Clostridioides difficile (CD; n = 20), Paeniclostridium sordellii (PS; n = 15), Salmonella enterica subspecies enterica serovar Typhimurium (ST; n = 20), and NSAID intoxication (NS; n = 15). Grossly, necrotizing hemorrhagic typhlocolitis was seen most frequently in cases of CD, ST, and NS disease. Cases of CP and PS had enteritis or colitis in similar percentages. Congestion, hemorrhage, and pleocellular inflammatory infiltrates followed by mucosal and submucosal necrosis were the main lesions found in horses with enteritis or colitis produced by any of the etiologic agents investigated. Severe lesions were more frequent in cases of CD and CP than in cases associated with any of the other 3 etiologies. Pseudomembranes were observed with similar prevalence in the small intestine and colon affected by all agents studied. Thrombosis of the lamina propria and/or submucosa was observed in ~50% of the cases of enteritis and colitis by all etiologies, except for PS, in which the majority of the cases had thrombosis. Gross and microscopic lesions of enterocolitis were not sufficiently specific for any of these etiologic agents to enable these enteritides to be distinguished by gross and/or histologic examination.

Histopathological Study of Myometrial Lesions of Uterus in a Tertiary Care Hospital of South India

BACKGROUND The most commonly done gynaecological surgery worldwide is hysterectomy. Myometrial lesions contribute to majority of cases with abnormal uterine bleeding. Leiomyoma and adenomyosis are most common lesions seen in the myometrium. The present study was undertaken to identify the various types of myometrial pathologies in hysterectomy samples. METHODS This is a two-year retrospective cross-sectional study done from January 2017 to December 2018, in the Department of Pathology, Kodagu Institute of Medical Sciences, Madikeri. All the patients who underwent hysterectomy and myomectomy for myometrial lesions of uterus were included in the study. Hysterectomy specimens showing secondaries, gross infection, massive haemorrhage and necrosis were excluded from the study. Gross appearance and microscopic pathology were noted and results were analysed. RESULTS In this study, 148 specimens were included. Age range was from 20 years to 65 years. Histopathological examination revealed that 58.25 % of myometrial lesions were present in the age group of 41 to 50 years followed by age group of 31 to 40 years. Histopathological examination done showed the following diagnosis in patients - leiomyoma (85.13 %), adenomyosis (8.79 %) and leiomyoma with adenomyosis (6.08 %). CONCLUSIONS The commonest histopathological lesion in myometrium was leiomyoma (85.13 %) followed by adenomyosis (8.79 %). It is mandatory to examine the hysterectomy specimens adequately to diagnose myometrial lesions. KEYWORDS Myometrium, Leiomyoma, Adenomyosis

Amoebiasis of the Penis: A Review and Update

Ulceration of the penis/foreskin which would tend to be painful, Swelling of the penis, Oedema of the penis, Discharge from ulcer or inflamed area of penis that could be purulent or may contain blood, Balanoposthitis, Exudation from a penile ulcer which could be mild, profuse, purulent or bloody, Sloughing off of part of the foreskin and other tissues with resulting hypospadias, indurated swelling of the penis which may initially involve one part of the penis but could quickly spread, A history of homosexual coital activity may be obtained, The spouse of a man who has Amoebiasis of the penis could also have Amoebiasis of vulva, cervix or endometrium, The prepuce may not be retractable, There may be ulceration or swelling of the glans penis that may be irregular. Clinical examination findings in cases of Amoebiasis of the penis could reveal some of the ensuing: The general and systematic examinations may be normal. Examination of the penis may show: Tight non-retractile foreskin, Ulceration of foreskin, Swelling of the foreskin, Swelling of the glans penis, Ulceration and swelling of glans penis., Swelling and inflammation of the shaft of the penis, Ulceration on the shaft of the penis, Development of an iatrogenic hypospadias which was not there before, The inguinal lymph nodes may not be palpable but sometimes they may be enlarged on one side or on both sides, The penile swelling may involve part of the penis but at times on rare occasions the entire penis may be swollen, the penile swelling could on rare occasions extend to the supra-pubic area, On rare occasions the swelling of the penis could extend to include the scrotum but this is extremely rare. Amoebiasis of the penis does mimic various common conditions that affect the penis including: squamous cell carcinoma of the penis, chancroid, primary syphilitic ulcer of the penis, granuloma inguinale, balanoposthitis, and many other lesions affecting the penis. A high-index of suspicion is required to diagnose Amoebiasis of the penis. Clinicians need to be aware that male homosexuals who practice penetrative penis-anal coital activity have a higher risk of developing amoebiasis of the penis especially in Amoebiasis endemic countries. If an individual is suspected to have balanoposthitis or non-specific infection of the penis and is treated with antibiotics but the lesion does not respond to treatment, amoebiasis of the penis should be suspected. Secretions and discharges from the penile ulcer as well as biopsies of the penile lesion should be submitted for pathology examination which would demonstrate trophozoites, entamoebae as well as inflammatory cells. Even if carcinoma of the penis is initially suspected biopsy of the penile lesion would show features of Amoebiasis in the absence of any features of malignancy but in the very rare situation of a combination of Amoebiasis of the penis and carcinoma of the penis microscopic pathology examination of a biopsy specimen of the penile lesion would show features of Amoebiasis and carcinoma of the penis. .Amoebiasis of the penis does quickly and effectively respond to anti-amoebic medicaments.

PRECLINICAL TOXICITY STUDY OF THE NEW ANTIFUNGAL DRUG AMPHAMID

Introduction. Amphotericin B remains the drug of first choice in the treatment of most severe systemic fungal infections. However, it is characterized by very low solubility and high toxicity. Amphamide – semisynthetic derivative of Amphotericin B – have been prepared at the Gause Institute of New Antibiotics. It showed several advantages over amphotericin B in vivo.Objective. The aim of the study was to investigate the toxicological safety of amphamide drug formulation in chronic experiment on rats.Materials and methods. The study was performed in male and female Wistar rats. Amphamide drug formulation was injected intraperitonealy at the total doses of MTD and LD50 (30 × 0,07 mg/kg or 30 × 0,17 mg/kg with 24-h interval). During the experiment body weight, hematological parameters, blood biochemical parameters, electrocardiography and urinalysis were performed. Animals were sacrificed on 1st and 30th day after the end of treatment. At necropsy, the mass coefficients of heart, liver, kidneys, spleen and thymus were calculated. The internal organs were subjected to histological evaluation.Results. It has been shown that the treatment with total dose of amphamide produces an increase of urea and creatinine level in serum, changes in urine composition and its specific gravity. Microscopic pathology observation showed dose-dependent structure abnormalities in kidneys, liver, lungs, stomach, and testes. Multiple administration of low dose of the drug produces transient toxic effects completely reversible within 30 days. When amphamide was used in a high dose, morphological signs of toxic cardiomyopathy were found.Conclusion. The results of the clinical and laboratory studies and microscopic pathology observation of kidneys demonstrate that nephrotoxicity is the main limiting type of drug toxicity. Dose dependence and reversibility within a month of toxic effects of amphamide allows us to recommend it to further advance.

Gross, microscopic, radiologic, echocardiographic and haematological findings in rats experimentally infected with Angiostrongylus cantonensis

Although the gross and microscopic pathology in rats infected with Angiostrongylus cantonensis has been well described, corresponding changes detected using diagnostic imaging modalities have not been reported. This work describes the cardiopulmonary changes in mature Wistar rats chronically infected with moderate burdens of A. cantonensis using radiology, computed tomography (CT), CT angiography, echocardiography, necropsy and histological examinations. Haematology and coagulation studies were also performed. Thoracic radiography, CT and CT angiography showed moderately severe alveolar pulmonary patterns mainly affecting caudal portions of the caudal lung lobes and associated dilatation of the caudal lobar pulmonary arteries. Presumptive worm profiles could be detected using echocardiography, with worms seen in the right ventricular outflow tract or straddling either the pulmonary and/or the tricuspid valves. Extensive, multifocal, coalescing dark areas and multiple pale foci affecting the caudal lung lobes were observed at necropsy. Histologically, these were composed of numerous large, confluent granulomas and fibrotic nodules. Adult worms were found predominantly in the mid- to distal pulmonary arteries. An inflammatory leukogram, hyperproteinaemia and hyperfibrinogenaemia were found in most rats. These findings provide a comparative model for A. cantonensis in its accidental hosts, such as humans and dogs. In addition, the pathological and imaging changes are comparable to those seen in dogs infected with Angiostrongylus vasorum, suggesting rats infected with A. cantonensis could be a model for dogs with A. vasorum infection.

Data-Driven Development of an Institutional “Gross-Only” Policy for the Examination of Select Surgical Pathology Specimens

Objectives To determine diagnostic, workflow, and economic implications of instituting a gross-only policy at our institution. Methods Retrospective (2017) key word searches were performed to identify “gross-only” cases for which microscopic evaluation could potentially be omitted, but was performed, and those who underwent gross evaluation per surgeon request. Cases were evaluated for type(s), part(s), block volume, turnaround time, demographics, and diagnosis. Laboratory costs and reimbursement were evaluated. Results In total, 448 potential gross-only cases with 472 specimens consisted of atherosclerotic plaques (33.5%), bariatric stomach/bowel (32.6%), hernia (15.7%), heart valves (12.7%), and other (5.9%). Four (2.6%) bariatric surgery cases had Helicobacter pylori infection; these were the only cases with “significant” histologic findings. Cost analysis revealed that converting all potential gross-only specimens to gross only would result in overall losses based on average reimbursements, most influenced by bariatric specimens (Current Procedural Terminology code 88307), comprising 65.2% of estimated loss. Conclusions Establishing a gross-only policy should be guided by established recommendations but institutionally individualized and data driven. It was reasonable for us to establish a gross-only policy for most evaluated specimens, while excluding bariatric stomach specimens in which microscopic pathology could be missed, given the lack of H pylori screening at our institution.

Serial optical coherence microscopy for label-free volumetric histopathology

The observation of histopathology using optical microscope is an essential procedure for examination of tissue biopsies or surgically excised specimens in biological and clinical laboratories. However, slide-based microscopic pathology is not suitable for visualizing the large-scale tissue and native 3D organ structure due to its sampling limitation and shallow imaging depth. Here, we demonstrate serial optical coherence microscopy (SOCM) technique that offers label-free, high-throughput, and large-volume imaging of ex vivo mouse organs. A 3D histopathology of whole mouse brain and kidney including blood vessel structure is reconstructed by deep tissue optical imaging in serial sectioning techniques. Our results demonstrate that SOCM has unique advantages as it can visualize both native 3D structures and quantitative regional volume without introduction of any contrast agents.