[An enzootic with pseudo-tumoral manifestations in Vipera lebetina in captivity]

The authors report the clinical and epizootic evolution of an epizooty, characterized by pseudo-tumours, observed on some vipers (Vipera lebetina) maintained in captivity at the "institut Pasteur de Tunis". The disease was characterized by 2.3 cm size nodules, scattered under the skin or into splanchnic cavities. These ones, spherical and well capsuled, were formed by a mass of clear rounded cells (histiocytes or monocytes), the necrotic central area of which contained innumerable bacteria. Several reviewed works show that this appearance of chronic abcess is a common and univocal reaction to various pathogenic factors, such as bacteria and parasites. As to etiology, the authors have doubt about the pathological role of the germs which they have identified (Salmonella and other anterobacteria) because these latter belong to the normal microbial flora of snakes and are, in the present case, probably occasional infective agents only.

Diseases of the retina: 1975-76 review

Articles on the retina which appeared in the American Journal of Ophthalmology, Archives of Ophthalmology, and British Journal of Ophthalmology from July 1975 to June 1976 are summarized. Topics include a specific receptor for retinol-binding protein, retinal pigment epithelium, retinitis pigmentosa, diabetic retinopathy, infections, degenerations, maculopathy, sickle hemoglobinopathy, retinoblastoma and retrolent fibroplasia, and macular hole and retinal detachment.

Epitheloid germinal centers: an acquired immunologic deficit?

The histologic structure of lymphoid tissue in cases of fatal infection was reviewed, and epithelioid germinal centers, completely devoid of the usual dark zone of rapidly dividing blast cells, were found in 16 infants and children, one of whom also had Reye's syndrome. Epithelioid change has been previously reported to occur in various childhood infections and in the sudden infant death syndrome. All reported cases have been fatal. In four additional cases there was toxic follicle alteration, or massive necrosis of germinal center cells. Toxic follicle alteration and epithelioid change have been found in childhood infections and sudden infant death syndrome, and some evidence of a pathogenetic relationship between the two was found in this study. It is concluded that epithelioid change represents a definite pathologic alteration of germinal centers associated with total destruction of a whole population of cells. It probably represents an acutely acquired immunologic deficit and therefore may well contribute to the thus far uniformly fatal outcome of the associated diseases.

Oral infection in immunosuppressed renal transplant patients

The most common cause of death in patients taking immunosuppressive (IS) drugs is infection. Many of the microorganisms which infect these IS patients may be found in the mouth, but the mouth has not been investigated as a potential source of lethal infection. In view of this, we studied twenty-seven IS patients taking Imuran and prednisone for 6 to 61 weeks and eighteen normal controls. The patients were followed monthly, and the incidence of oral and systemic complications was recorded. There were no deaths due to infection during the 10-month study period. Oral infection occurred as frequently as pneumonia or urinary tract infection. Systemic factors which were related to the development of dental infection were lymphocyte count and length of time on immunosuppressive drug therapy.

Disseminated prothothecosis in a dog

This is a report on the clinical history and pathological lesions of a dog suffering from disseminated protothecosis due to Prototheca zopfi. Clinically, the dog was presented with bilateral conjunctivitis followed by blindness, deafness and posterior paresis. Pathological lesions were most severe in the eyes and consisted of subacute panophthalmitis with secondary posterior subcapsular cataract, posterior synechia, retinal detachment and microscopic evidence of glaucoma. The kidney, liver, brain, spleen and lungs were also affected. This is believed to be the first published account of protothecosis in mammals other than man in Africa. A review of the literature is included.

Frontal sinus disease. IV. Cellular response to experimentally-induced infection

The pathogenesis of chronic frontal sinusitis is poorly understood. The canine frontal sinus model was developed to isolate experimentally the variables involved. We have recently determined that blockage of the naso-frontal duct does not, by itself, produce sinusitis or mucocele experimentally. The purpose of the present investigation is to examine the histological and ultrastructural responses of the sinus mucosa to artificially-induced infection. Bone wax was implanted in the canine frontal sinus via an osteoplastic flap, and subsequently removed three months later. Radiological, histological and ultrastructural analysis of the resultant infected mucosa was performed at periods up to one year. The sinus mucosa did not return to normal up to nine months following removal of the infection-inciting foreign body. Persistent changes included epithelial and submucosal thickening, polypoid degeneration, matting of the ciliary carpet, and "bursting" of the ciliary cell bodies. In the light of this and previous experiments, an insidious cycle of events leading to irreversible frontal sinus disease is postulated, requiring the interplay of at least three variables: the infectious insults, the response of the sinus mucosa, and the variable patency of the nasofrontal duct.

The pathology of the joint tissues and its clinical relevance in prosthesis failure

Thirty-four hip and knee total arthroplasty failures due to infection, loosening, intractable pain and dislocation were examined for synovial and capsular tissue debris. Simiquantitative assessments were made for metal polyethylene, acrylic and cellular debris and inflammation. The most important finding was that in the amounts normally shed into joints, debris particles do not appear to stimulate a polymorphonuclear response. The magnitude of this response correlates best with clinical and/or bacteriological evidence of infection. The quantity of acrylic particles could be correlated with clinical evidence of loosening. Since the correlation between infection and polymorphonuclear leukocytes, debris particles, and the reasons for failure is high, frozen section may aid the surgeon in determining the methods and timing of revision operations.

Anatomic considerations in infections of the face and neck: review of the literature

An attempt was made to summarize the literature concerning the potential spaces between fascial layers in the face and neck and to correlate the variations in terminology used by different authors. It soon became evident in a search of the literature that far too many names are given to the same anatomical space and that there is a wealth of written material for study. As a result, the descriptions given here deal with the terminology that was most frequently encountered (Table). As anatomical relations form the basis of diagnosis and therapy, a thorough knowledge of the nature of infective processes in the facial and cervical regions is essential. The various fascial spaces are described and some general aspects of diagnosis are considered.

[The unspecific reaction of inflammation in rickets due to lack of vitamin D (author's transl)]

10 children (3--18 months old) with Vit. D Deficiency Rickets were investigated by Rebuck skin windows for their ability to elicit unspecific inflammation before and after therapy. Differences to a control group (13 children) were statistically significant. In the acute phase of the disease beginning of inflammation is retarded, reduction of polymorphonuclear leucocytes in favour of mononuclear cells is less then in controls, the absolute quantity of exsudation is reduced too. After therapy inflammation is intensified and accelerated, but exsudation is still different from control children qualitatively and quantitatively. These findings add new facts to the data already known on impaired defence mechanisms in rickets.

Acute monomyelocytic leukemia presenting as a felon. Case report

We present a case of acute leukemic infiltration in the distal phalanx of the thumb, resulting in a chronic felon with bone involement.

[Uncommon malformative association (author's transl)]

An uncommon malformative association is presented ((hydrocephalus, bilateral renal hypoplasia, aplasia cutis) associated with neonatal gastrointestinal perforation. The bibliography related with these problems is reviewed, discussing the possible relationship between them. The etiological hypothesis is infective, and pathogenic interpretation is pointed out in this context.

Viral disease of the labyrinth. II. An experimental model using mouse cytomegalovirus

Investigation of the routes of infection of viral labyrinthitis was undertaken using mouse cytomegalovirus (CMV) and CMV-free Swiss-Webster mice. Intraperitoneal and intranasal inoculation caused no CMV infection of the ears or central nervous system. Intraperitoneal inoculation of pregnant mice yielded no evidence of fetal infection. Intracerebral inoculation of newborn mice resulted in viral infection of the ear by extension: 1) from the arachnoid into cochlear periotic connective tissue via the cochlear aqueduct and 2) along the perineurium of the acoustic nerve into the modiolus. There were neither changes in the stria vascularis nor endolymphatic labyrinth in spite of vasculitis and viremia. This experimental labyrinthitis resembles that found in human temporal bones infected with herpes zoster rather than the endolymphatic labyrinthitis seen in rubella, rubeola, mumps, and cytomegalovirus. The chronic effects of the mouse CMV labyrinthitis are under study.