Acute necrotizing encephalopathy is a fulminant neurologic disease seen predominantly in Japan and Taiwan. We present two cases diagnosed at a Canadian center within the same year in Caucasian children. Both were previously well, developed an acute viral illness with fever and vomiting, and progressed to brain death within 2 to 4 days. Neuroimaging and postmortem examination demonstrated the unique features of bilateral and severe necrosis of deep gray- and subcortical white-matter structures. The first case was associated with extensive, but transient, hepatic involvement, recent varicella and rotavirus infections, and detailed metabolic studies, including mitochondrial functional analysis, were normal. The second case tested positive for influenza A infection, whereas evidence of liver damage was lacking. Both children demonstrated early lymphopenia and myocardial necrosis, two features not previously associated with acute necrotizing encephalopathy. These cases are unique in their occurrence in non-Japanese children and are among the first published reports in Canada.
To propose and evaluate a novel nonrigid image registration approach for improved myocardial T1 mapping.
Myocardial motion is estimated as global affine motion refined by a novel local nonrigid motion estimation algorithm. A variational framework is proposed, which simultaneously estimates motion field and intensity variations, and uses an additional regularization term to constrain the deformation field using automatic feature tracking. The method was evaluated in 29 patients by measuring the DICE similarity coefficient and the myocardial boundary error in short axis and four chamber data. Each image series was visually assessed as "no motion" or "with motion." Overall T1 map quality and motion artifacts were assessed in the 85 T1 maps acquired in short axis view using a 4-point scale (1-nondiagnostic/severe motion artifact, 4-excellent/no motion artifact).
Increased DICE similarity coefficient (0.78 ± 0.14 to 0.87 ± 0.03, P
A lethal case is reported of chronic Q-fever in a patient aged 34 who regarded himself as completely healthy six months before his death. The diagnosis was made on the basis of vital investigation of blood sera in a complement-fixation test and indirect fluorescent-antibody test (antibody titers 1 : 1280 against phase 1 and 1 : 320 against phase 2 Coxiella burnetii), differentiation of antibodies as distinct classes of immunoglobulins, results of pathoanatomical and microbiological investigations. Pathoanatomical features of the organs are fully detailed, especially those of the heart. Death occurred in the presence of cardiac failure growing progressively worse, involving many organs. Patients with cardiovascular pathology have to be examined for Q-fever in order that we should be able to early detect and apply specific therapy to treat its chronic form.
Aging is associated with left ventricular hypertrophy, dilatation, and fibrosis of the heart. The Fischer 344/Brown Norway F1 (F344/BNF1) rat is recommended for age-related studies by the National Institutes on Aging because this hybrid rat lives longer and has a lower rate of pathological conditions than inbred rats. However, little is known about age-associated changes in cardiac and aortic function and structure in this model. This study evaluated age-related cardiac changes in male F344/BNF1 rats using ECHO, gross, and microscopic examinations. Rats aged 6-, 30-, and 36-mo were anesthetized and two-dimensional ECHO measurements, two-dimensional guided M-mode, Doppler M-mode, and other recordings from parasternal long- and short-axis views were obtained using a Phillips 5500 ECHO system with a 12 megahertz transducer. Hearts and aortas from sacrificed rats were evaluated grossly and microscopically. The ECHO studies revealed persistent cardiac arrhythmias (chiefly PVCs) in 72% (13/18) of 36-mo rats, 10% (1/10) of 30-mo rats, and none in 6-mo rats (0/16). Gross and microscopic studies showed left ventricular (LV) dilatation, borderline to mild hypertrophy, and areas of fibrosis that were common in 36-mo rats, less evident in 30-mo rats, and absent in 6-mo rats. Aging was associated with mild to moderate decreases of LV diastolic and systolic function. Thus, male F344/BN F1 rats demonstrated progressive age-related (a) decline in cardiac function (diastolic and systolic indices), (b) LV structural changes (chamber dimensions, volumes, and wall thicknesses), and (c) persistent arrhythmias. These changes are consistent with those in humans. The noninvasive ECHO technique offers a means to monitor serial age-related cardiac failure and therapeutic responses in the same rats over designated time intervals.
Department of General Pathology and Pathomorphology, Institute of Regional Pathology and Pathomorphology, Siberian Division of the Russian Academy of Medical Sciences, Novosibirsk. firstname.lastname@example.org
The development of regenerative and plastic myocardial insufficiency induced by anthracycline antibiotic rubomycin is accompanied by a decrease in cardiomyocyte sensitivity to damage produced by synthetic catecholamine isoproterenol. The incidence and the size of coagulation necrosis foci of cardiomyocytes developed 6 h after isoproterenol injection significantly decreased with increasing in the interval between rubomycin injection and subsequent administration of isoproterenol. In Wistar rats receiving rubomycin 3-5 days prior to isoproterenol and exhibiting signs of regenerative and plastic insufficiency, no cardiomyocyte contracture, intracellular myocytolysis, or lump degradation characteristic of cardiac insufficiency induced by endo- and exogenous catecholamines were found.
The 20th of May 1869, Professor Emanuel Winge used a human heart as an exhibit at a meeting of The Medical Society in Christiania. This heart was later conserved and kept in the museum of the Institute of Pathology. Sixty years later, one of Winge's successors, Professor Francis Harbitz, used the very same heart, also at a meeting of The Medical Society. Harbitz had then confirmed Winge's hypothesis of 1869, that the endocarditis of this heart was due to a bacterial infection. This article contemplates the disparity between the "scientific gazes" of Winge and Harbitz, and why Harbitz was able to convert Winges hypothesis of 1869 into a scientific discovery in 1929.
To study the pattern of lethal outcomes due to rheumatic diseases (RD) in Moscow.
Annual reports of 38 pathological departments of Moscow have been analysed for 1999 and 2000.
RD accounted for 1.8% diagnosis at autopsies (n = 784). RD as the main diagnosis was in 668 cases (1.53%). Diseases of the bone-muscle system caused death 3.5 times less often than rheumatism. As concommitent diseases RD were encountered in 118 cases (0.27%), diseases of the bone-muscle system were registered 2 times less frequently than rheumatism. Chronic rheumatic diseases of the heart were diagnosed in 590 cases (98.5%), rheumatic fever was detected in 9 (1.5%) patients. The main diagnosis of RA, seronegative arthritides, systemic vasculitides, SLE, osteoarthrosis was made in 49, 10 9.3, 12.7, 1.3%, respectively. Such nosological entities as osteoporosis, gout and other microcrystalline arthritides were referred to the group "other rheumatic diseases" and made up 12.7%. As concomitant pathology RA, OA, seronegative spondyloarthritides, SLE, other RD occurred in 54, 8.1, 27, 2.7, 2.7%, respectively.
The share of RD in autopsy diagnosis accounts for 1.8% of the total number of necropsies. These figures seem to underestimate the real situation and may be explained by poor registration of RD at autopsy and a fall in the total number of autopsies for the last 10 years. For Moscow and Russia as a whole there is a prevalence of rheumatism mortality (76%), primarily deaths of chronic rheumatic cardiac diseases, over mortality due to diseases of the bone-muscular system (24%).
The records of all 2427 autopsies performed at the Brantford (Ont.) General and Paris (Ont.) Willett hospitals from Jan. 1, 1969 to Aug. 15, 1978 were reviewed. Of the 1299 cases of sudden unexpected death investigated by a coroner almost 28% were due to unnatural causes--violence or poisoning. The main cause of natural sudden death was coronary artery disease, which accounted for 43.3% of all the sudden unexpected deaths. In 20 cases the cause of death was thought to be viral myocarditis, and in 9 of the 20 there was serologic evidence of at least previous coxsackievirus disease. Two of the nine cases were of special interest because of the finding of giant-cell myocarditis in one and aortic valve disease in the other. Eleven of the 20 persons were aged 13 to 46 years. These findings support the view that the most serious manifestation of enterovirus infection today is cardiac damage by coxsackieviruses.
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