High Prevalence Of Lesions Research Articles

CT-Kolonographie versus Videokoloskopie zum Nachweis kolorektaler Läsionen in der Vorsorgepopulation

BACKGROUND AND OBJECTIVE: It was the aim of this study to compare the sensitivity and specificity of low-dose CT colonography (CTC) with that of optical colonoscopy (OC) in asymptomatic patients undergoing these tests in a screening program for colonic cancer. PATIENTS AND METHODS: 58 patients (mean age 62.6 years) were included. They underwent low dose CTC and, immediately afterwards, colonoscopy. The colonoscopists were unaware of the CTC findings. A 'second look” was performed if a lesion seen in CTC had been missed in the first colonoscopy. RESULTS: A total of 150 lesions were detected and histologically confirmed. 136 were found to be polypoid lesions, classified as either hyperplastic polyps (n = 66) or polyps with intraepithelial neoplasia (n = 70). In the per-patient analysis only 22.4 % of patients had no polypoid lesion, 27.6 % had at least one hyperplastic and 50.0 % had at least one adenomatous lesion. Sensitivity for adenomas of all size categories was calculated 55.7 % for CTC and 92.9 % for OC. This marked difference (both for the detection of individual lesions and the per-patient analyses) does not reach significance in the two-sided McNemar test. CONCLUSIONS: There was a high prevalence of lesions with intraepithelial neoplasia in this screening group. OC had a higher sensitivity than CTC in the detection of lesions smaller than 10 mm.

Dynamics ofMoraxella bovisinfection and humoral immune response to bovine herpes virus type 1 during a natural outbreak of infectious bovine keratoconjunctivitis in beef calves

Infectious bovine keratoconjunctivitis (IBK) is an acute disease caused by Moraxella bovis (Mb). Several factors may predispose animals to an IBK outbreak; one commonly observed is infection with bovine herpes virus type 1 (BHV-1). The aim of this study was to investigate the dynamics of BHV-1 virus infection and its relation with clinical cases of IBK in weaned calves from a beef herd with a high prevalence of lesions caused by Mb. Sampling was carried out in six stages and included conjunctival swabs for isolating Mb as well as blood samples for identifying antibodies specific for BHV-1. A score for IBK lesions after observing each eye was determined. The findings of this study showed a high prevalence of BHV-1 virus infection (100% of animals were infected at the end of the trial); 67% of animals were culture-positive for Mb, but low rates of clinical IBK (19% of calves affected) were detected at the end of the trial. These results suggest that infection with BHV-1 did not predispose these animals to IBK, and that Mb infection produced clinical and subclinical disease in the absence of BHV-1 co-infection.

CT-Kolonographie versus Videokoloskopie zum Nachweis kolorektaler Läsionen in der Vorsorgepopulation

It was the aim of this study to compare the sensitivity and specificity of low-dose CT colonography (CTC) with that of optical colonoscopy (OC) in asymptomatic patients undergoing these tests in a screening program for colonic cancer. 58 patients (mean age 62.6 years) were included. They underwent low dose CTC and, immediately afterwards, colonoscopy. The colonoscopists were unaware of the CTC findings. A "second look" was performed if a lesion seen in CTC had been missed in the first colonoscopy. A total of 150 lesions were detected and histologically confirmed. 136 were found to be polypoid lesions, classified as either hyperplastic polyps (n = 66) or polyps with intraepithelial neoplasia (n = 70). In the per-patient analysis only 22.4 % of patients had no polypoid lesion, 27.6 % had at least one hyperplastic and 50.0 % had at least one adenomatous lesion. Sensitivity for adenomas of all size categories was calculated 55.7 % for CTC and 92.9 % for OC. This marked difference (both for the detection of individual lesions and the per-patient analyses) does not reach significance in the two-sided McNemar test. There was a high prevalence of lesions with intraepithelial neoplasia in this screening group. OC had a higher sensitivity than CTC in the detection of lesions smaller than 10 mm.

Eosinophilic granuloma of spine in adults: a report of 30 cases and outcome

Eosinophilic granuloma (EG) of the spine is rare, especially in adults. There had been few large and long-term studies reported in the literature. The management goals of this disease in adults are preservation of neurologic function, relief of pain and reconstruction of spinal stability. However, there are still controversies over appropriate management modality of eosinophilic granuloma. Clinical manifestations, radiographic presentations, therapeutic outcomes and follow-up findings of 30 adults who were histiologically diagnosed with spinal eosinophilic granuloma, including 28 patients who received surgical treatment at our institutions from 1985 to 2008 were reviewed retrospectively. There were 25 males and five females with a mean age of 34.5 years (range, 18-71 years). The post-operative follow-up period ranged from 2 to 22.4 years (mean, 8.3 years). Neurologic deficits developed in 21 patients, apparent kyphosis developed in four cases. In contrast to the classic feature of vertebra plana in children, we found that more severe lesions often led to asymmetric collapse in adult patients and only three patients presented with vertebra plana. Thirty-three vertebral lesions distributed throughout the spine column. Twenty-one lesions were in cervical spine, seven in the thoracic spine and five in the lumbar spine. Twenty-eight adult patients underwent surgical resection with or without chemotherapy or radiotherapy, and four (13.3%) patients had recurrence after surgery. No patient in our series died. The onset of spinal EG is insidious and mainly presents as osteolytic destruction. There is a particular high prevalence of lesions in the cervical spine and more severe lesions often led to asymmetric collapse. As the skeleton of adults is well-developed and the epiphysis has stopped growing, individualized management including surgical intervention should be considered in adult patients with spinal EG who present with neurological damage and spinal instability.

Diseases of the Chilean Flounder, Paralichthys adspersus (Steindachner, 1867), as a Biomarker of Marine Coastal Pollution Near the Itata River (Chile): Part II. Histopathological Lesions

This study evaluated the histopathological lesions of the Chilean flounder, Paralichthys adspersus, inhabiting the marine coastal area influenced by the Itata River (central Chile) in order to provide an environmental baseline given the plans to discharge effluents from a cellulose plant through a submarine pipe in the area. Flounder were also sampled at two reference sites over the course of 1 year. Pathological examinations and descriptions of histopathological lesions follow the ICES suggested protocol: internal and histopathological lesions, condition factor, and hepatosomatic and spleen indexes. The prevalence of fish with histopathological lesions differed significantly among sites. The flounder sampled in the Itata area were the most affected. Evaluation of histopathological lesions observed on the flounder caught in the Itata area revealed (i) 16 different types of histopathological lesions, (ii) a high prevalence of lesions in gills and epidermal and hepatic tissue, and (iii) a normal K factor and hepatosomatic index. Significant differences were found in epidermal hyperplasia (EH), chronic dermatitis, telangiectasis (TEL), localized edema in the base of lamellae (LE), fusion of secondary lamellae (FSL), foci of cellular alteration (FCA), melanomacrophagic centers (MMCs), and hemosiderin (HEM) lesions among sites and among sites by season of the year. Winter 2006 was the most affected. A seasonal analysis of histopathological lesions on flounder caught in the Itata area showed significant differences for EH, progressive focal invasion of muscle fibers (PFIMF), TEL, LE, FSL, lamellar bifurcation, hepatitis, FCA, MMCs, and HEM lesions between the sampled seasons of the year; flounder caught in winter 2006 had the highest prevalence of these lesions except for PFIMF, which was higher in winter 2007. These results are discussed in relation to the contents of inorganic and organic compounds in the water column and the contents of organic compounds in sediments of the subtidal environment in the Itata area.

Genetic and phenotypic aspects of foot lesion scores in sheep of different breeds and ages

Footrot is a costly endemic disease of sheep. This study investigates the potential to decrease its prevalence through selective breeding for decreased lesion score. Pedigreed mule and Scottish Blackface (SBF) ewes were scored for lesions on each hoof on a 0 to 4 scale for up to 2 (SBF ewes) or 4 (mules) times over 2 years. One score was obtained for SBF lambs. An animal was deemed to have lesions (severe lesions) if at least one hoof had a score of at least 1 (2). The prevalence of lesions was 34% in lambs, 17% in SBF ewes and 51% in mules. The heritability of lesions (severe lesions) analysed as repeated measurements of the same trait in a threshold model was 0.19 (0.26) in SBF ewes and 0.12 (0.19) in mules. Estimates for the sum and maximum of scores as well as the number of feet affected were much lower, as were estimates for permanent animal effects (i.e. non-genetic effects associated with an animal). When successive scores on the same animal were analysed as correlated traits, heritability estimates for most traits tended to be higher, except for severe footrot in mules where estimates varied greatly over time. The phenotypic correlations between successive scores in SBF ewes were close to 0, genetic correlations were moderately positive (0.18 to 0.55). Correlations in mules were generally of a similar size, but some genetic correlations were higher (up to 0.92). There was a clear trend for heritabilities for lesions and severe lesions to increase with higher prevalence of lesions, even when analysed in a threshold model. Heritability estimates for traits that combine scores over several events in mules, identifying the more persistently affected animals, ranged from 0.12 to 0.23 with the highest estimates for the average number of feet that were (severely) affected in animals scored for a minimum at two events. The heritability of all lesion traits in lambs was estimated as 0. It is concluded that selection for lower lesions is possible in ewes but not lambs, and that a simple binary score at an animal level is at least as effective as a comprehensive score at hoof level. Given the low repeatability of lesion scores, repeated measures over time will improve effectiveness of selection. Selection across environments (flocks, seasons) with different prevalences of lesions scores will need to take account of variation in the heritability.

Assessment of Stress-Related Bioindicators in Winter Flounder (Pleuronectes americanus) Exposed to Discharges from a Pulp and Paper Mill in Newfoundland: A 5-Year Field Study

This study assessed the effects of discharges from a sulphite-bleaching paper mill on winter flounder (Pleuronectes americanus) sampled each spring over a 5-year period in St. George's Bay, Newfoundland, prior to foraging activity. The fish were captured by SCUBA divers near the mill and at a reference site 10 km up current. Several bioindicators were used to assess fish health. Larger and older flounder exhibiting gross and microscopic tissue lesions, lower condition factor, and elevated hepatosomatic index but lower gonadosomatic index that was associated with delayed development, were observed in samples caught near the mill compared to those at the reference site. Additionally, fish examined near the mill were infested with an ectoparasite, Cryptocotyle lingua, that causes black spot disease but harbored fewer numbers of a digene, Steringophorus furciger, in the digestive tract than samples taken at the reference site. These results suggest that abnormal size distribution, interruption of growth, high prevalence of lesions, lower condition factor, enlarged liver, delayed gonadal development, and differences in parasitic levels were indicative of stress in winter flounder caused by discharges from the mill compared to samples from a reference site. There was no evidence of a population decline in the inlet because of annual recruitment possibly from St. George's Bay into which it opens.

Assessment of the welfare of working horses, mules and donkeys, using health and behaviour parameters

Working animals provide an essential transport resource in developing countries worldwide. Many of these animals are owned by poor people and work in harsh environments, so their welfare is a cause for concern. A protocol was developed to assess the welfare of working horses, mules and donkeys in urban and peri-urban areas, using direct observation of health and behaviour parameters. In this study, 4903 animals used for draught, pack and ridden work in Afghanistan, Egypt, India, Jordan and Pakistan were assessed between December 2002 and April 2003. The data showed that donkeys were more likely than mules or horses to demonstrate avoidance or aggressive behaviour towards an observer, while horses were most likely to make a friendly approach. Fewer than 8% of working equines had abnormal mucous membranes, ectoparasites or poor coat condition. Body lesions occurred predominantly in the areas of the breast/shoulder, withers and girth in all three species, with mules having the highest prevalence of lesions in these areas (22.5, 21.3 and 28.4%, respectively). Among horses and donkeys, the prevalence of these lesions was influenced by the type of work carried out. Lesions on the head, neck, ribs, flank and tail base were seen in less than 10% of animals. Across all three species approximately 70% of animals were thin, having a body condition score (BCS) of 2 or less on a scale of 1–5 (1, very thin; 5, very fat) and more horses were in very thin condition (BCS 1) than mules or donkeys. Over 75% of animals demonstrated limb deformities and abnormalities of gait. The results of this study are being used as the initial stage of a long-term strategy to inform priorities for welfare interventions in working equines and to establish a welfare benchmark. Subsequent stages will rank the welfare concerns identified, assess the contributing risk factors and implement specific interventions to address these risks. Following intervention, success in improving welfare will be measured by repetition of this protocol and comparison with the benchmark.

Langerhans cell histiocytosis of the spine in children. Long-term follow-up.

Langerhans cell histiocytosis causes destructive lesions in a child's spine. Few large, long-term studies have evaluated the clinical and radiographic presentation, natural history, outcomes of modern treatment approaches, and maintenance of normal spinal growth and stability after the diagnosis of this disease in children. Twenty-six children with biopsy-proven Langerhans cell histiocytosis involving the spine were treated at our institution between 1970 and 2003. They had a total of forty-four involved vertebrae (twenty cervical, fourteen thoracic, and ten lumbar). Vertebral body collapse was measured on radiographs and classified as grade I (0% to 50% collapse) or grade II (51% to 100% collapse) and subclassified as A (symmetric collapse) or B (asymmetric collapse). Lesions of the posterior elements of the spine were classified as grade III. Twenty-three children were followed for two years or more (mean, 9.4 years), and the analyses of treatment and long-term outcomes were performed in that group of patients. There was a predominance of lesions in the cervical spine (p </= 0.02). Sixteen (62%) of the twenty-six children were found to have multifocal skeletal disease. Cervical and lumbar lesions were more commonly associated with multilevel spinal disease. The extent of the initial collapse seen radiographically was grade IA for twenty vertebrae, IB for three, IIA for ten, IIB for nine, and III for two. Grade-I lesions were more likely to be associated with symmetric collapse than were grade-II lesions. Spinal deformity developed in four children, and two later required spinal fusion. No relationship was observed between the grade of the initial collapse and the subsequent development of spinal deformity. Despite heterogeneous treatment, all patients were alive and well with resolution of all presenting signs and symptoms and no evidence of active disease at the time of the most recent follow-up. We found a particularly high prevalence of lesions in the cervical spine and a high prevalence of multiple skeletal lesions. In contrast to the classic finding of vertebra plana, we found that more severe lesions often led to asymmetric collapse; yet, asymmetric collapse was not found to be associated with the development of subsequent spinal deformity. The natural history of these lesions in the spine in the absence of systemic disease or spinal deformity is such that aggressive surgical management is usually not indicated; only follow-up is necessary to monitor recovery and spinal balance.

Prospective blinded evaluation of computed tomographic colonography for screen detection of colorectal polyps

Background & Aims: This study used a low lesion prevalence population reflective of the screening setting to estimate the sensitivity and specificity of computerized tomographic (CT) colonography for detection of colorectal polyps. Methods: This prospective, blinded study comprised 703 asymptomatic persons at higher-than-average risk for colorectal cancer who underwent CT colonography followed by same-day colonoscopy. Two of 3 experienced readers interpreted each CT colonography examination. Results: Overall lesion prevalence for adenomas ≥1 cm in diameter was 5%. Seventy percent of all lesions were proximal to the descending colon. With colonoscopy serving as the gold standard, CT colonography detected 34%, 32%, 73%, and 63% of the 59 polyps ≥1 cm for readers 1, 2, 3, and double-reading, respectively; and 35%, 29%, 57%, and 54% of the 94 polyps 5–9 mm for readers 1, 2, 3, and double-reading, respectively. Specificity for CT colonography ranged from 95% to 98% and 86% to 95% for >1 cm and 5–9-mm polyps, respectively. Interobserver variability was high for CT colonography with κ statistic values ranging from −0.67 to 0.89. Conclusions: In a low prevalence setting, polyp detection rates at CT colonography are well below those at colonoscopy. These rates are less than previous reports based largely on high lesion prevalence cohorts. High interobserver variability warrants further investigation but may be due to the low prevalence of polyps in this cohort and the high impact on total sensitivity of each missed polyp. Specificity, based on large numbers, is high and exhibits excellent agreement among observers.

Myxosporean plasmodial infection associated with ulcerative lesions in young-of-the-year Atlantic menhaden in a tributary of the Chesapeake Bay, and possible links to Kudoa clupeidae.

Ulcers in Atlantic menhaden Brevoortia tyrannus (Latrobe) (Clupeidae), observed along the USA east coast, have been attributed to diverse etiologies including bacterial, fungal and, recently, harmful algal blooms. To understand the early pathogenesis of these lesions, we examined juvenile Atlantic menhaden collected during their seasonal presence in Chesapeake Bay tributaries from April to October 1999 and from March to August 2000. We conducted histopathological examinations of young-of-the-year fish from the Pocomoke River tributary, which has a history of fish mortalities and high lesion prevalence. Kudoa clupeidae (Myxozoa: Myxosporea) spores were present in the muscles of fish collected in both years. Of the fish assessed by histology in April, 5 to 14% were infected, while in May 90 to 96% were infected. Infection rates remained high during the summer. Mature spores were primarily located within myomeres and caused little or no observable pathological changes. Ultrastructure showed spores with capsulogenic cells bearing filamentous projections, and a basal crescentic nucleus with mottled nucleoplasm containing cleaved, condensed chromatin. Also, a highly invasive plasmodial stage of a myxozoan was found in the lesions of juvenile Atlantic menhaden. The plasmodia were observed in fish collected between May and July, with the maximum occurrence in late June 1999 and late May 2000. Plasmodia penetrated and surrounded muscle bundles, causing grossly observable raised lesions in 73% of all fish infected with this invasive stage. Plasmodia were also detected in the visceral organs, branchial arches, and interocular muscles of some fish. Some of the invasive extrasporogonic plasmodial lesions were associated with ulcers and chronic inflammatory infiltrates. The plasmodial stage appeared to slough out of the tissue with subsequent evidence of wound healing. Ultrastructure showed plasmodia with an elaborate irregular surface, divided into distinct ectoplasm and endoplasm; the latter contained numerous spherical vegetative nuclei, secondary generative cells, and occasional cell doublets. Our ultrastructural studies indicate that the plasmodial organisms, which are important in the etiology of the skin lesions, are myxozoans, and they may represent early stages of K. clupeidae.

Characteristics of noncarious cervical lesions: A clinical investigation

The purpose of the authors' in vivo investigation was to analyze the characteristics of noncarious cervical lesions, or NCCLs, in adult patients who had a high incidence of them. The patient pool consisted of a total of 57 patients and 171 teeth (three teeth per patient), with one NCCL per tooth. The characteristics the authors evaluated were shape, dimensions, sensitivity, sclerosis and occlusion. In terms of lesion characteristics, 91 percent of the lesions had axial depths of 1 to 2 millimeters, 49 percent had occlusogingival widths of 1 to 2 mm, 74 percent had an angular shape of 45 to 135 degrees, 76 percent had mild or moderate sclerosis, and 73 percent had no or mild sensitivity. In terms of occlusion, 75 percent of teeth had an Angle Class I occlusion on the involved side, 60 percent had group function or mixed excursive guidance, 82 percent had wear facets, and 99 percent had Type 0 or I mobility. In terms of tooth location, 70 percent of NCCLs were on posterior teeth, 65 percent were on maxillary teeth, and 46 percent were on premolars. The evaluated NCCLs were found mainly to have small dimensions of depth and width (< 2 mm) and to be roughly right-angled in shape, and many had sclerosis and low sensitivity. A majority of the dentitions studied had Class I occlusion, with group function, prevalent wear facets, and little or no mobility. Cervical lesions were more common with posterior maxillary teeth and premolars, especially first premolars, which had the highest prevalence of lesions. Older patients were more likely to exhibit noncarious cervical lesions, but no great difference in incidence was found between men and women. Clinical Implications. A knowledge of the NCCL characteristics and etiologic covariables aids in proper case selection for treatment, aids in selection of appropriate treatment protocols and improves assessment of prognosis.

Endoscopic Findings of the Gastric Antrum and Pylorus in Horses: 162 Cases(1996–2000)

Medical records and endoscopy images were examined for 209 horses that had gastroscopic examinations performed with a 2.5- or 3-m-long endoscope by one of the authors (MJM) during a 4-year period (1996-2000). The antrum and pylorus were viewed in 162 horses, and the duodenum was viewed in 94 horses. Of these 162 horses, the gastric squamous mucosa was seen in 157 horses and 50% or more of the glandular mucosa of the body of the stomach was seen in 156 horses. Erosions or ulcers were seen in the gastric squamous mucosa in 91 (58%) horses. Erosions or ulcers were seen in the glandular mucosa of the body of the stomach in only 8% of the horses. Lesions consisting of erosion or ulceration were seen in the antrum or pylorus in 94 (58%) horses. Lesions consisting of hyperemia and a rough or "bumpy" appearance were seen in the mucosa of the duodenum of 16 horses. An association between the presence of lesions in the squamous mucosa and the presence of lesions in the mucosa of the antrum/pylorus was examined by Fisher's exact test, and the linear association of lesion severity scores between the squamous mucosa and the mucosa of the antrum/pylorus was tested using a Monte Carlo estimate for linear-by-linear association. There was no association (P = .88) between these sites for presence of lesions or lesion severity scores. Similarly, there was no association between scores for the glandular mucosa in the gastric body and those in the antrum/pylorus. Because of the high prevalence of lesions in the antrum and pylorus of the stomachs of adult horses examined in a hospital setting, the entire stomach should be viewed during a gastroscopic examination.

Spatial Aspects of Foot-Pad Dermatitis in Swedish Broilers

This study aimed at analysing spatial and spatio-temporal aspects of foot-pad dermatitis in Swedish broilers. The information on disease prevalence and severity was based on a two-year foot-health surveillance programme where information on producer, breed, feed manufacturer, region, abattoir, date of slaughter and several other variables was recorded. The level of clustering in space was analysed on 2-digit zipcode level using Moran's I test which measures similarity of location. The level of clustering in space was also analysed using the Ipop test, which takes the population at risk into consideration. The examination of time-space interaction was carried out using the Barton method and the Knox method. We found a significant (p < 0.001) clustering of regions with respect to foot-pad dermatitis score using Moran's I test, and a significant (p < 0.0001) clustering in space also when related to the number of flocks delivered from each region. The flocks with very high prevalence of foot-pad dermatitis were significantly (p < 0.05) clustered in both time and space, i.e. the flocks with high prevalence of lesions came from the same geographic area during the same time periods. This information will permit us to focus the control efforts within the foot-health surveillance programme on specific regions in specific time periods, thus making the programme more effective.

Abdominal ultrasound findings mimicking hematological malignancies in a study of 218 Gaucher patients.

Gaucher disease, the most prevalent sphingolipidosis, generally presents with splenomegaly, anemia, and thrombocytopenia. Hence, hematologists are often the specialists involved in diagnosis and management of these patients. We present ultrasonographic characteristics in a cohort of 218 consecutive Gaucher patients evaluated in our clinic during the past 5 years. Our data emphasize the high prevalence of lesions mimicking hematological malignancies in Gaucher disease. One fifth of 184 non-splenectomized patients had intra-splenic lesions, 6% of all patients had similar lesions in the liver, and 32% of 34 splenectomized patients (but none of the other patients) had marked retroperitoneal or peri-portal lymphadenopathy. The presence of splenic lesions correlated with age and splenic size, but not with extent of bone involvement or genotype. Interestingly, they were not affected by reduction in splenomegaly following enzyme replacement therapy. The importance of these findings is to include Gaucher disease in the differential diagnosis of splenic or hepatic lesions, especially in Ashkenazi Jews. Conversely, they are relevant for follow-up of all Gaucher patients, including asymptomatic individuals, because of the reported increased incidence of hematological malignancies in Gaucher disease.

Abdominal ultrasound findings mimicking hematological malignancies in a study of 218 gaucher patients

Gaucher disease, the most prevalent sphingolipidosis, generally presents with splenomegaly, anemia, and thrombocytopenia. Hence, hematologists are often the specialists involved in diagnosis and management of these patients. We present ultrasonographic characteristics in a cohort of 218 consecutive Gaucher patients evaluated in our clinic during the past 5 years. Our data emphasize the high prevalence of lesions mimicking hematological malignancies in Gaucher disease. One fifth of 184 non-splenectomized patients had intra-splenic lesions, 6% of all patients had similar lesions in the liver, and 32% of 34 splenectomized patients (but none of the other patients) had marked retroperitoneal or peri-portal lymphadenopathy. The presence of splenic lesions correlated with age and splenic size, but not with extent of bone involvement or genotype. Interestingly, they were not affected by reduction in splenomegaly following enzyme replacement therapy. The importance of these findings is to include Gaucher disease in the differential diagnosis of splenic or hepatic lesions, especially in Ashkenazi Jews. Conversely, they are relevant for follow-up of all Gaucher patients, including asymptomatic individuals, because of the reported increased incidence of hematological malignancies in Gaucher disease. Am. J. Hematol. 55:28-34, 1997. © 1997 Wiley-Liss, Inc.

Barium enema: detection of colonic lesions in a community population.

The purposes of this study were to assess the prevalence of colonic lesions detected at barium enema in a community practice, to compare the findings at barium enema between patients who are asymptomatic and have no known risk factors for colorectal cancer (screening group) and patients who have symptoms of colonic disease or have known risk factors, and to determine if a questionnaire about symptoms and risk factors is an appropriate screening tool. A self-administered questionnaire about colorectal symptoms and risk factors was given to 1779 patients scheduled for barium enema examination. On the basis of their responses, patients were divided into three groups: screening group (asymptomatic, without risk factors), symptomatic, and asymptomatic with risk factors. Each patient underwent a fluoroscopic barium enema. We then compared the results (number, histologic type, size of lesion(s), location in the colon, and Patient's age) and risk factors among the three groups. At least one lesion within the colorectum was found in 166 (9%) of 1779 patients at combined proctosigmoidoscopy and barium enema. The prevalence of lesions in the 111 patients with at least one lesion above the rectum at barium enema was 4% (32 of 738) for the screening group, 8% (38 of 476) for asymptomatic patients with risk factors, and 7% (41 of 565) for symptomatic patients (p = .015 when comparing the prevalence in the screening group with the prevalences in the other two groups). Twenty-nine percent of all colonic lesions were found in the screening group. Among the asymptomatic patients, risk factors that included a history of colorectal polyps and advanced age were associated with a significantly higher prevalence of colonic polyps found at barium enema. In the symptomatic group, if patients with histories of polyps were excluded, we were unable to identify other risk factors that led to a significantly higher prevalence of polyps. Asymptomatic patients without known risk factors have a significantly lower prevalence of colonic polyps than either symptomatic patients or patients with risk factors alone. Despite this lower prevalence, 29% of all lesions in our series were in the screening group. Assessment of risk factors through a patient questionnaire was not helpful in identifying a group of patients with a higher prevalence of lesions--except for a history of polyps. Management decisions based on a patient questionnaire should be approached with caution. When low-risk patients are denied screening examinations, a significant number of lesions will be missed.

Gill histopathology of two species of buffalo fish from a contaminated Swamp

Two species of buffalo fish, smallmouth buffalo ( Ictiobus bubalus) and bigmouth buffalo ( Ictiobus cyprinellus), were collected from a contaminated (multiple metals and organic chemicals) Mississippi River Basin ecosystem, Devil's Swamp and a control site, Tunica Swamp, both near Baton Rouge, Louisiana, USA. The buffalo fish were examined for general health and histopathological effects. This research consists of an analysis of the prevalence of infectious and non-infectious disease from the contaminated vs the relatively uncontaminated control site. Tissue burdens were also determined by chemical analysis of buffalo fish muscle (fillets) samples. Both bigmouth buffalo (BMB) and smallmouth buffalo (SMB) from Devil's Swamp accumulated metals in muscle tissue and generally had a higher prevalence of gill lesions than fish collected from the control site, Tunica Swamp. SMB from Devil's Swamp had higher prevalences of lesions than BMB from Devil's Swamp. The primary types of infectious gill lesions observed in the buffalo fish were protozoan infections in the gill filament cartilage and gill lamellae. Chondrolysis, chondritis and bronchitis were associated with parasitic infection. Eosinophils were the predominant cell type involved with bronchitis and chondritis. The proliferative lesions observed were chondroplasia, chloride cell hyperplasia, mucus cell hyperplasia, and epithelial cell hyperplasia and fusion. Based on these preliminary findings, SMB appeared to be a potentially sensitive biomarker of exposure.

Oral mucosal lesions in 65-74-year-old Hong Kong Chinese.

There have been no reported surveys of oral mucosal lesions among the elderly in Asian countries. Therefore, the purpose of this study was to determine the prevalence of oral mucosal lesions among 65-74-yr-old, community-dwelling elderly Chinese in Hong Kong and to determine the prevalence of lesions in denture wearers, tobacco smokers, and alcohol drinkers. A total of 537 noninstitutionalized 65-74-yr-olds were interviewed and clinically examined in an oral health survey conducted in 1991. In the survey, the elderly underwent a systematic examination of their oral mucosa by one of the three examiners with the aid of an overhead light. The examiners were trained and calibrated before and during the survey, and a specially prepared colour atlas of oral mucosal lesions was used for lesion recognition. No mucosal lesions were detected in 64% of the elderly. In the 193 elderly subjects with lesions, 80% exhibited only one lesion. There was no difference in prevalence between men and women. The more common lesions, each being found in 5-7% of the elderly, were lingual varicosities, frictional keratosis on the buccal mucosa, denture stomatitis on the palatal mucosa, and denture-induced hyperplasia in the maxillary and mandibular buccal sulcus. Denture wearers had a higher prevalence of lesions (40%) than nonwearers (32%). There was no difference in the prevalence or number of oral mucosal lesions between those defined as users of tobacco and alcohol and those defined as nonusers in this study. No confirmed oral malignancies were found.

Haematological and clinicochemical blood profiles in slaughter pigs.

In a cohort study, 40 pig finishing herds were selected: twenty pig herds with a low and twenty pig herds with a high prevalence of several pathological lesions recorded at slaughter in a six-month period before the start of the study. Blood samples were taken from 20 pigs per herd at the end of the finishing period to investigate haematological and clinicochemical profiles. There was only a significant difference in serum albumin concentration between the low and high lesion prevalence groups. There were distinct differences in blood profiles between pig herds, but also between batches of pigs within a herd, housed in different compartments. Differences between castrated males and gilts were also demonstrated with respect to mean values of the blood variables haemoglobin, iron, copper, beta-globulin, eosinophils and segmented neutrophils. However, the differences were not of a biologically important magnitude. The mean values of the blood variables pepsinogen and lymphocytes differed significantly between pig herds from the two participating integration groups. Pigs with a higher albumin concentration, a lower gamma-globulin concentration, a higher copper concentration and a higher creatine kinase activity in serum showed a higher daily weight gain.