Superficial Nodes Research Articles

Characteristics and risk factors of cervical lymph node metastasis in cN0 papillary thyroid microcarcinoma of the isthmus.

The surgical resection range of papillary thyroid microcarcinoma of the isthmus (PTMCI) is controversial, and the guidelines do not fully guide the central lymph node dissection (CLND).We retrospectively studied the comparison of PTMCI (Group A, n = 65 cases) and non-PTMCI (Group B, n = 80 cases). Based on whether central lymph node metastasis (CLNM) was further detected, they were further divided into the PTMCI with CLNM (group C, n = 42 cases), the PTMCI without CLNM (group D, n = 23 cases), the non-PTMCI with CLNM (group E, n = 45 cases), the non-PTMCI without CLNM (group F, n = 35 cases). All patients underwent total thyroidectomy and CLND. The CLNM pathological examination was divided into right recurrent laryngeal nerve superficial lymph nodes (Right VI a), right recurrent laryngeal nerve deep lymph nodes (Right VI b), left VI area lymph nodes (Left VI), prelaryngeal lymph node, and pretracheal lymph node. The extent of lymph node metastasis and risk factors of PTMCI were analyzed by univariate and multivariate analysis. The ROC curve was used to calculate the maximum diameter of the tumor and the Youden index was calculated to analyze the impact of diameter on the risk factors for CLNM in PTMCI. To construct a prediction model of transfer risk of high risk factors by Nomogram, there were significant differences in prelaryngeal lymph nodes (p = 0.034) and pretracheal lymph nodes ( n = 0.035) between group A and group B, and the risk factors of lymph node metastasis were tumor invasion (p = 0.003), multifocality (p = 0.001), and the maximum tumor diameter≧6.5mm. PTMCI is more prone to metastasis of pretracheal lymph nodes and prelaryngeal lymph nodes, and the presence of tumor invasion, multifocality, and tumor diameter≧6.5mm are high risk factors for metastasis in PTMCI. According to the prediction model, with all risk factors the risk of cervical lymph node metastasis is up to 90%.

The sonographic features of lymph node venous networks and flow patterns in patients with primary chronic venous disease.

Our study aims to enhance the understanding of lymph node venous networks (LNVNs) by summarising their anatomical, sonographic features, and reflux patterns. We examined 241 legs from 141 patients with primary chronic venous disease (CVD) using duplex ultrasound. The findings indicated variations in the shape, size, vascularity, and echogenicity of LNVN. The superficial inguinal lymph node with reflux appeared slightly larger, exhibiting higher velocities in the hilar artery. Regarding connections, venous flow within LNVN was predominantly drained through the saphenofemoral junction (SFJ), anterior accessory great saphenous vein (AAGSV), and great saphenous vein (GSV). A significant number of LNVNs were observed to be associated with anterolateral thigh tributaries. The study also identified valve cusps within LNVN. This study revealed a 12% prevalence of primary LNVN. Understanding the anatomical and haemodynamic features of LNVN informs treatment strategies and potentially helps prevent the recurrence of varicose veins.

Molecular identification, risk factor assessment, and phylogenetic analysis of tick-borne pathogens in symptomatic and asymptomatic cattle from South-Eastern Iran.

Tick-borne pathogens (TBPs) represent a substantial threat to cattle globally, exerting adverse impacts on production, health, and economic viability. This study delves into the prevalence and implications of TTBPs in cattle sourced from resource-limited smallholder livestock farms situated in southeastern Iran, proximate to Afghanistan and Pakistan. Blood and tick specimens were systematically collected from a cohort of 230 cattle, comprising 150 asymptomatic and 80 symptomatic individuals. Genomic DNA isolated from blood samples underwent rigorous examination for the presence of key TBPs, including Anaplasma marginale, A. phagocytophilum, A. bovis, A. centrale, Babesia bigemina, and Theileria annulata, utilizing multiple genetic markers. Nucleotide sequence analysis facilitated the reconstruction of phylogenetic relationships. The study also evaluated various potential risk factors, such as clinical status, gender, age, breed, tick infestation, and management practices, to elucidate their associations with TTBPs. Among the cattle cohort, a staggering 87.8% (202/230) tested positive for at least one pathogen. Prevalence statistics encompassed A. marginale (72.2%), T. annulata (68.3%), A. phagocytophilum/A. platys-like complex (66.1%), A. centrale (16.7%), B. bigemina (10.0%), and A. bovis (6.1%). Remarkably, mixed infections involving two, three, and four pathogens were detected in 23%, 52.1%, and 2.2% of animals, respectively. Notably, all asymptomatic cattle were positive for at least one TBP. Tick infestation was observed in 62.2% (143/230) of cattle, predominantly caused by Hyalomma anatolicum (82.5%), Rhipicephalus (Boophilus) annulatus (13.1%), and R. sanguineus sensu lato (4.4%). Risk factors linked to TBPs encompassed tick infestation, older age, and crossbred animals. Clinical presentations among symptomatic cattle encompassed fever, anemia, weight loss, anorexia, jaundice, and enlarged superficial lymph nodes. This study underscores the pivotal role of asymptomatic carriers in the propagation of TTBPs within endemic regions. Furthermore, it emphasizes the potential for the implementation of molecular diagnostics to unmask subclinical infections, thereby affording the opportunity for targeted interventions aimed at ameliorating the burden of TTBPs in resource-constrained smallholder dairy farms.

Activity of biogenic silver nanoparticles in planktonic and biofilm-associated Corynebacterium pseudotuberculosis.

Corynebacterium pseudotuberculosis is a gram-positive bacterium and is the etiologic agent of caseous lymphadenitis (CL) in small ruminants. This disease is characterized by the development of encapsulated granulomas in visceral and superficial lymph nodes, and its clinical treatment is refractory to antibiotic therapy. An important virulence factor of the Corynebacterium genus is the ability to produce biofilm; however, little is known about the characteristics of the biofilm produced by C. pseudotuberculosis and its resistance to antimicrobials. Silver nanoparticles (AgNPs) are considered as promising antimicrobial agents, and are known to have several advantages, such as a broad-spectrum activity, low resistance induction potential, and antibiofilm activity. Therefore, we evaluate herein the activity of AgNPs in C. pseudotuberculosis, through the determination of minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), antibiofilm activity, and visualization of AgNP-treated and AgNP-untreated biofilm through scanning electron microscopy. The AgNPs were able to completely inhibit bacterial growth and inactivate C. pseudotuberculosis at concentrations ranging from 0.08 to 0.312 mg/mL. The AgNPs reduced the formation of biofilm in reference strains and clinical isolates of C. pseudotuberculosis, with interference values greater than 80% at a concentration of 4 mg/mL, controlling the change between the planktonic and biofilm-associated forms, and preventing fixation and colonization. Scanning electron microscopy images showed a significant disruptive activity of AgNP on the consolidated biofilms. The results of this study demonstrate the potential of AgNPs as an effective therapeutic agent against CL.

A clinical case of enzootic bovine leukosis in a Holstein cow with minor clonality of B-cell in the peripheral blood.

A 4-year 9-month-old Holstein-Friesian dairy cow presented with anorexia. On physical examination, swelling of superficial lymph nodes, pelvic masses, and prolonged urination posture after urinating a small amount were noted. Hematological examination revealed no lymphocytosis. The bovine leukemia virus proviral load was relatively high. At necropsy, enlarged lymph nodes, a large mass in the pelvic cavity, and mass lesions in several organs were observed. Histopathological examination revealed the proliferation of neoplastic lymphocytes, which were immune-positive for CD79α and negative for CD3. B-cell clonality test indicated the presence of monoclonality in the urine, masses, and lymph nodes and minor clonality in the peripheral blood. These findings led to a diagnosis of EBL with minor clonality of B-cell in the peripheral blood.

Full-thickness chest wall reconstruction after resection of recurrent desmoid-type fibromatosis

Introduction. Desmoid-type fibromatosis (DF) is a benign but locally infiltrative soft tissue tumor that develops from fascia and musculoaponeurotic tissue with high local recurrence rate. The aim of this article was to present a case of recurrent DF of the chest wall and chest wall reconstruction after tumor resection. Case outline. A 62-year-old man came for an examination due to a tumor localized on the right anterior chest wall. The previous year, the patient had undergone surgical excision of DF of the abdominal wall. Physical examination found a firm and painless 6?7 cm mass on the right side of the chest wall with no swelling of superficial lymph nodes. A computed tomography scan revealed a homogenous mass of soft tissue density, measuring 7.12 ? 4.23 cm, arising from right anterolateral wall of thoracic cage with adjoining ribs destruction. The patient was taken to surgery, and right thoracotomy was done with excision of tumor along with resection of the eighth, nineth and tenth rib. The results of pathological examination were consistent with the frozen section, and the patient was diagnosed with DF. Despite the absence of postoperative radiotherapy, there was no evidence of local recurrence two years later. Conclusion. Surgical treatment of recurrent DF of the chest wall requires a wide resection with negative margins. Multidisciplinary approach in case of full-thickness defect of the chest wall and combination of pedicled muscle flap and polypropylene mesh are important to provide chest wall stability.

Ultrasound characterization of superficial lymph nodes in HIV patients with Talaromyces marneffei infection.

This study aimed at exploring the ultrasound characteristics of superficial lymph nodes (LNs) in HIV patients with Talaromyces marneffei infection to provide assistance and understanding for diagnosis and therapy. A retrospective analysis was conducted on 26 patients with confirmed HIV and T.marneffei coinfection. These patients underwent ultrasound examination and ultrasound-guided puncture biopsies at our hospital from March 2015 to March 2023. In all 26 patients, lymphadenectasis was observed. Among the 21 cases (80.76%), LNs showed a diffusely hyperechoic appearance with a tulle-like change, and 6 cases (23.07%) showed liquefaction. When the hila were present or thinned, the blood flow signals were primarily hilar, whether rich or poor, and when the hila were absent, the blood flow signals were peripheral or poor. The axillary LN long-to-short diameter (L/S) ratios exhibited a significant positive correlation with CD4+T cell counts (r = 0.8214, p = 0.0341). Patients with retroperitoneal lymphadenectasis showed decreased NK cell counts (p = 0.03). In summary, the T.marneffei infection of LNs in HIV patients often manifests with superficial LN enlargement, mostly affecting the cervical LNs. The T.marneffei-infected LNs exhibit several characteristics such as echogenicity, hilum, and blood flow signal. Furthermore, there might be associations between lymphocyte subsets and enlarged superficial LNs. Ultrasound examinations should be paid attention to if patients have superficial LN enlargement, and the diagnosis of the T.marneffei infection is considered.

Effects of caseous lymphadenitis agent (corynebacterium pseudotuberculosis) isolated from superficial abscesses of sheep on oxidative stress factors

In this study, it was aimed to determine the incidence of Corynebacterium pseudotuberculosis (C. pseudotuberculosis) in caseous lymphadenitis cases in superficial lymph nodes of sheep and to evaluate its effect on oxidative stress factors. Thus, it was aimed to determine the early diagnosability of superficial and visceral caseous lymphadenitis cases and to prevent the spread of diseases and related economic losses. A total of 103 sheep, 50 of which were healthy and 53 of which had caseous lymphadenitis, were evaluated in the study. Microbiological examinations were performed by taking 3-5 ml of pyogenic aspirate from the superficial lymph nodes of sheep with caseous lymphadenitis. Blood samples were taken from sheep with C. pseudotuberculosis isolated in microbiological examinations and the levels of oxidative stress factors were determined. C. pseudotuberculosis was isolated in 23 of the pyogenic aspirates of 53 sheep with caseous lymphadenitis. When sheep isolated from C. pseudotuberculosis were compared with healthy sheep, it was determined that there was a statistically significant decrease in the levels of antioxidant molecules such as GSH-pX (14.62%), GSH (23.81%), SOD (4.70%), CAT (22.23%) (p˂0.001). The level of toxic malondialdehyde (MDA) (18.62%), the end product of lipid peroxidation, was found to be statistically significantly increased in sheep isolated from C. pseudotuberculosis (p˂0.001). As a result, it was determined that oxidative stress factors showed statistically significant variability in cases of superficial caseous lymphadenitis (caused by C.pseudotuberculosis). For this reason, by determining the levels of oxidative stress factors in suspected herds, it was possible to make early diagnosis of the superficial and visceral forms of caseous lymphadenitis, and a basis was established for future studies.

Peritoneal lymphomatosis with pleural and peritoneal effusions in a dog: a case report

Peritoneal lymphomatosis (PL) is a rare lymphoid neoplasm in dogs. A nine-year-old spayed female Labrador retriever presented with pleural and peritoneal effusions. Diagnostic imaging revealed diffuse nodular to massive lesions in the mesentery, particularly in the caudal abdomen. While the superficial lymph nodes did not show significant changes, enlargement was observed in the intra-abdominal and intra-thoracic lymph nodes. Cytological and flow cytometric analyses of the effusion indicated the presence of large B-cell lymphocytes expressing CD3-/CD5-/CD14-/CD21-/CD34+/CD45+/CD79a+. PL was diagnosed using diagnostic imaging and fluid analysis. This case report highlights the clinical and diagnostic features of canine PL.

Mediastinal lymphadenopathies and skin lesions in a 49-year-old Sinhalese man.

Leprosy is a neglected disease sporadically reported in high-income countries. Skin lesion and peripheral nerve involvement represent most common manifestations. Mediastinal lymphadenopathy in the absence of superficial lymph nodes involvement is very rare. Atypical or rare clinical presentations of disease may delay diagnosis and therapy and cause potential life-threatening manifestations and disabilities. We describe the case of a 49-year-old Sinhalese man who was admitted to our hospital with a one-month history of peripheral neurological symptoms and skin lesions on lower limbs. CT scan showed the presence of mediastinal lymphadenopathies without lung parenchymal and superficial lymph nodes involvement. Endobronchial ultrasound-guided transbronchial needle aspiration showed the presence of granulomas while skin biopsy revealed dermo-hypodermic granulomas with perineural lymphohistiocytic inflammatory reaction. Fite-Faraco staining demonstrated the presence of acid-fast bacilli in both lymph nodal and skin biopsy and polymerase chain reaction was positive for Mycobacterium leprae. Multibacillary leprosy was then diagnosed.

Successful definitive‐intent radiation therapy for recurrent and metastatic feline thymoma with unusual extra‐thoracic metastasis

AbstractA 10‐year‐old, male, neutered, domestic shorthair cat was referred for investigation of cough and dyspnoea episodes. A large cranial mediastinal mass was detected using computed tomography. Upon surgical removal, the mass was diagnosed as a lymphoid‐rich thymoma. Ten months postoperatively, the tumour was reported to recur, followed 2 months later by the development of an axillary mass and enlarged thoracic and superficial cervical lymph nodes. Recurrent and metastatic thymoma was confirmed, which was successfully treated with radiation therapy.

Tuberculosis in Superficial Lymphadenopathy Based on Fine Needle Aspiration Cytology: A Cross Sectional Study

Objective: To investigate the prevalence of tuberculosis among individuals presenting with superficial lymphadenopathy using Fine Needle Aspiration Cytology (FNAC) as a diagnostic method. Methodology: This cross-sectional research spanned three years, conducted at HBS General Hospital in Islamabad from July 2016 to June 2019. The study enrolled individuals meeting specified inclusion and exclusion criteria, presenting with superficial lymph node enlargement. All participants provided written consent before undergoing fine needle aspiration cytology (FNAC), and the diagnosis of tuberculosis relied on histopathological findings. Results: Among 632 patients aged 15 to 60 years who underwent FNAC following clinical examination and relevant lab investigations, 85.4% (n=540) exhibited cervical lymphadenopathy. Among these, 57.7% (n=312) were diagnosed with tuberculous lymphadenitis, comprising 58.3% females (n=182) and 41.6% males (n=130). Axillary lymphadenopathy was observed in 5.53% (n=35) of patients, among whom 3.64% females (n=23) and 2.1% males (n=13) were diagnosed with tuberculous lymphadenopathy. Generalized lymphadenopathy was seen in 5.1% (n=32) of cases, with 0.94% males (n=6) and 0.79% (n=5) demonstrating histological evidence of TB on FNAC. Inguinal lymphadenopathy was observed in 3.95% (n=25) of patients, including 0.94% males (n=5) and 0.47% females (n=3). Conclusion: Lymphadenopathy, a prevalent clinical condition, encompasses various underlying causes, ranging from manageable tuberculosis to malignant conditions. FNAC serves as a safe and rapid diagnostic technique, reducing the need for excisional biopsies. In this study, cervical lymph nodes were most frequently affected by tuberculous lymphadenopathy, particularly among females.

Surgical templates for inguinal lymph node dissection in cN0 penile cancer: A comparative study.

Modified and superficial inguinal lymph node dissection (MILD and SILD) are the 2 widely used templates for surgical staging of clinically node negative (cN0) penile cancer (PeCa); however, no previous reports have compared their outcomes. We compared these 2 surgical templates for oncological outcomes and complications. We retrospectively reviewed records of cN0 PeCa patients who underwent MILD/SILD at our cancer care center from January 2013 to December 2019. Patients who developed a penile recurrence during follow up were excluded from analysis of oncological outcomes. The 2 groups (MILD and SILD) were compared for baseline clinico-pathological characteristics. The primary outcome was the groin recurrence free survival (gRFS). Secondary outcomes included the false negative rate (FNR) and disease free survival (DFS) for both templates and also the post-operative wound related complication. Of the 146 patients with intermediate and high risk N0 PeCa, 74 (50.7%) and 72 (49.3%) underwent MILD and SILD respectively. The 2 groups were comparable with regards to the distribution of T stage, tumor grade and the proportion of intermediate and high-risk patients. At a median follow up of 34 months (47 for SILD and 23 for MILD), a total of 5 groin recurrences were encountered; all of them occurred in the MILD group. The gRFS and DFS for the MILD group was 93.2% and 91.8% respectively; while that for the SILD group was 100% and 94.4% respectively. Too few events had occurred to determine any statistically significant difference. The FNR for MILD and SILD was 26.3% and 0% respectively. The overall complication rate was significantly higher in the SILD group (46% vs 20.3%, p=0.001), especially for Clavien Dindo 3A complications. MILD can fail to pick up micro-metastatic disease in a small proportion of cN0 PeCa patients, while SILD provides better oncological clearance with no groin recurrences. This oncological superiority comes at the cost of a higher incidence of wound-related complications.

Case Reports: Clinical features and postmorteum findings of sheep-associated malignant catarrhal fever in a 2-years old bull

Malignant Catarrhal Fever (MCF) is a fatal lymphoproliferative disease of cattle and other ungulates caused by alcelaphine herpesvirus 1 (AlHV-1) and ovine herpesvirus 2 (OvHV-2), the main causative agents of wildebeest-associated MCF (WA-MCF) and sheep-associated MCF (SA-MCF), respectively. The virus is mainly spread by aerosols from pregnant or newborn sheep, goats, and wildebeest to susceptible animals. This case report presents the clinical features and post-mortem findings of an unusual case of malignant catarrhal fever (MCF) in a two-year-old bull brought to the Professor Feseha Gebreab Memorial Veterinary Teaching Hospital in Bishoftu, Ethiopia. The bull was semi-intensively managed, co-housed, and fed with sheep and other domestic animals. The animal was shivering upon arrival, with naso-ocular discharge and clouding of the eyes. The bull was febrile, with a rectal body temperature of 41.4 oC and a respiratory and heart rate of 40 and 48 beats per minute, respectively. On physical examination, the bull was emaciated, with bilateral yellowish mucopurulent naso-ocular discharge, frequent blinking, bilateral corneal opacity, salivation, a foamy mouth, head pressing, and enlargement of superficial lymph nodes. Malignant catarrhal fever was suspected based on the history and clinical signs, and empiric therapy with 10% oxytetracycline, diclofenac, and IV fluid was initiated. The bull died after receiving the third day of treatment. At necropsy, hemorrhages were found in the esophagus, trachea, and small and large intestines. In the kidney, white foci, enlargement, and fatty degeneration were observed. An ulcerated lesion was seen on the abomasum. In the gall bladder, enlargement and vascularization were also noted. The current case report confirms the rare case of clinical SA-MCF based on the history, exhibited clinical pictures, post-mortem findings, and PCR results. Separation of cattle and sheep is strongly advised to prevent SA-MCF, as no vaccine has yet been developed.

Non-invasive enhancement of intracortical solute clearance using transcranial focused ultrasound

Transport of interstitial fluid and solutes plays a critical role in clearing metabolic waste from the brain. Transcranial application of focused ultrasound (FUS) has been shown to promote localized cerebrospinal fluid solute uptake into the brain parenchyma; however, its effects on the transport and clearance of interstitial solutes remain unknown. We demonstrate that pulsed application of low-intensity FUS to the rat brain enhances the transport of intracortically injected fluorescent tracers (ovalbumin and high molecular-weight dextran), yielding greater parenchymal tracer volume distribution compared to the unsonicated control group (ovalbumin by 40.1% and dextran by 34.6%). Furthermore, FUS promoted the drainage of injected interstitial ovalbumin to both superficial and deep cervical lymph nodes (cLNs) ipsilateral to sonication, with 78.3% higher drainage observed in the superficial cLNs compared to the non-sonicated hemisphere. The application of FUS increased the level of solute transport visible from the dorsal brain surface, with ~ 43% greater area and ~ 19% higher fluorescence intensity than the unsonicated group, especially in the pial surface ipsilateral to sonication. The sonication did not elicit tissue-level neuronal excitation, measured by an electroencephalogram, nor did it alter the molecular weight of the tracers. These findings suggest that nonthermal transcranial FUS can enhance advective transport of interstitial solutes and their subsequent removal in a completely non-invasive fashion, offering its potential non-pharmacological utility in facilitating clearance of waste from the brain.

Review on Lumpy Skin Disease Virus Characteristics and its Diagnosis in Cattle

Lumpy skin disease is characterized by its signs including eruptive, infectious and occasionally causing death to affected animals. It is caused by the family Poxviridea and genus Capripox with a strain of Neethling virus, a double stranded DNA virus. LSD clinical signs are mainly observed on skin as nodules (0.5 to 5 cm in diameter) throughout the skin surface or subcutaneous tissue involving superficial lymph nodes. Diagnosis of CaPV is based upon clinical signs with laboratory confirmation by virus isolation, polymerase chain reaction (PCR) and electron microscopy. Field diagnosis of LSD is often based on characteristic clinical signs of the disease. However, mild and subclinical forms require rapid and reliable laboratory testing to confirm diagnosis. Isolation of virus can be made from collected biopsy or at post-mortem from skin nodules, lung lesions or lymph nodes within the first week of the occurrence of clinical signs, before the development of neutralizing antibodies. There are different methods to detect LSD virus antibody from blood samples. These are serum neutralization test (SNT), indirect fluorescent antibody test (IFAT) and enzyme-linked immune-sorbent assay. LSD as a member of CaPVs, it has a single serotype, do not cause persistent infection, have a limited host range and vaccines are available that may provide long term immunity. These attributes increase the prospect of successfully implementing regional control programs, leading to the elimination of the virus and conceivably global eradication.

ОЦЕНКА ЭФФЕКТИВНОСТИ ИСПОЛЬЗОВАНИЯ РЕГИОНАРНОЙ ЛИМФОТРОПНОЙ ТЕРАПИИ ПРИ ЭКССУДАТИВНОМ СРЕДНЕМ ОТИТЕ В ЭКСПЕРИМЕНТЕ

In lymphology, there is a great potential of knowledge about the role of the lymphatic system in the implementation of water homeostasis, as one of the most important factors of the constancy of the internal environment of the body, drainage, and detoxification of tissue fluid and lymph. The lymphatic system is one of the first to react to the inflammatory process in any region of the human body; therefore, an obligatory element of the standard of examination of patients is to assess the condition of regional lymph nodes. At the same time, the lack of data on the involvement of the lymphatic system in the development of exudative otitis media hinders the development of new pathogenetically sound modern methods of lymphotropic therapy of one of the diseases common in otorhinolaryngology. In this work, the features of structural transformations of different groups of neck lymph nodes (superficial, facial, deep) belonging to the lymphatic region of the middle ear are studied and shown under physiological conditions, when modeling exudative otitis media and after lymphotropic therapy involving the introduction of a mixture of drugs into tissues using low-frequency ultrasound. According to the degree and nature of the response of the structural components of the nodes to the modeling process in the experiment of exudative inflammation in the middle ear and therapeutic measures aimed at lymphosanation, nodes of the first order – deep lymph nodes, and of the second order – superficial lymph nodes were identified. Therapy aimed at the rehabilitation of the lymphatic region of the middle ear and associated cavities leads to complete normalization of the lymph nodes and relief of inflammatory processes, therefore it can be considered pathogenetically justified.

Variations in Penile Cancer Management: Results From the Global Society of Rare Genitourinary Tumors Survey.

There is paucity of evidence and consensus on various aspects of management of penile cancer (PeCa), which is intuitive considering the rarity of this disease. We present here the details of an online survey conducted by the Global Society of Rare Genito-urinary Tumors (GSRGT) with the aim of capturing the variations in PeCa care across different regions of the world. An online questionnaire was developed by experts within the GSRGT and then circulated via email in English and Spanish versions to clinicians dealing with PeCa. Respondents were allowed 8 weeks to reply. We received 102 responses; the majority of them were from South America (37.2%) followed by North America and Asia (17.6% each). Only 11.7% of the respondents treated more than 25 patients with PeCa annually. Total penectomy is performed by 21.5% of the respondents in >50% of their patients. Less than a fifth of the experts (19.6%) responded that >50% of their patients are clinically node-negative (cN0) at presentation. For intermediate-risk cN0 patients (T1 G2 cancer), about a third of the experts chose surveillance. For invasive inguinal staging, the options of Dynamic Sentinel Lymph Node Biopsy (DSNB), Modified Inguinal Lymph Node Dissection (MILD), Superficial Inguinal Lymph Node Dissection (SILD), and Video-Endoscopic Inguinal Lymphadenectomy (VEIL) were chosen by 28.4%, 26.4%, 31.3%, and 13.7% of the respondents respectively. Considerable variation was seen in the worldwide use of these techniques. For clinically node-positive patients, respondents were in favor of giving adjuvant chemotherapy instead of neoadjuvant chemotherapy, except for cN3 patients. The results of this questionnaire objectified the variations in global practices in the management of PeCa. This serves as the baseline information which can help prioritize research areas for multinational collaborative efforts, a key mission of the GSRGT.

Compartment 1 acidosis associated with hemorrhagic diathesis causing mortalities among racing camels in Oman.

Camels are adapted to digestion of dry rough forages for their nutrition, and sudden change to highly digestible feed during the racing season causes digestive disorders. The current study investigated the cause of death among racing dromedary camels within 3-7 days following a sudden onset of fever ≈ 41 °C, colic with tarry feces, and enlarged superficial lymph nodes. Marked leukopenia, low RBC count and thrombocytopenia, deranged liver and renal function tests, and prolonged coagulation profiles were reported. Compartment 1 fluid revealed a pH of 4.3-5.2 with absence or few ciliated protozoa and Gram-positive microbial flora. Widespread petechial to ecchymotic hemorrhages were observed in various organs including the gastrointestinal tract (compartment 3 and colon), lungs, and heart. Fibrin thrombi in arterioles, capillaries, venules, and medium-sized veins were observed especially in the pulmonary interstitium, submucosa of the large intestine (ascending colon), deep dermis, and renal cortex. Furthermore, widespread hemorrhages and necrosis were constant histopathological lesions in parenchymatous organs. Based on clinical signs, hematology, blood biochemistry, and gross and microscopical findings, the cases were diagnosed as compartment 1 acidosis associated with hemorrhagic diathesis and endotoxicosis. Finally, compartment 1 acidosis associated with hemorrhagic diathesis is a serious fatal disease on the Arabian Peninsula in racing dromedaries causing multi-organ dysfunction and coagulopathy and disseminated hemorrhages.

Revisiting the question of endolymphatic therapy

Lymphotropic therapy was the first step in the development of endolymphatic therapy. Lymphotropic therapy was carried out by creating a subcutaneous depot of a contrast agent or injecting the drug directly into the lymph node. The next step was the introduction of the drug into the lymphatic system by a single puncture of the peripheral lymphatic vessel. After G. V. Bondar put his idea into action by making a special tool, it became possible to do long-term endolymphatic infusion.
 Lymphatic catheterization is performed in a clean operating room. Catheterization of the thigh lymphatic vessels is the most common technique. A network of superficial lymphatic vessels extends from the medial edge of the sartorius muscle into the subcutaneous fat, reaching the lower superficial inguinal lymph nodes. The deep lymphatic vessels of the thigh are adjacent to the femoral vein. The use of a longitudinal or longitudinal-oblique skin incision is preferable. The benefits of this access are that lymphatic vessels can be catheterized more than once during chemotherapy and wounds heal faster because the skin is cut along the fibers instead of across them.
 When comparing endolymphatic and intravenous methods of administration of platinum group chemotherapy drugs in combination with fluorouracil or methotrexate in 289 patients with T3N0-1 M0-1 ovarian cancer, the vast majority of whom had serous adenocarcinomas (85.62±2.77 and 84.93±3.17), a significantly higher frequency of complete and partial regressions was registered (59.63±3.87%) with the endolymphatic technique than with intravenous administration (32.03±4.14%).
 Endolymphatic chemotherapy with fluorouracil 700–800 m g/m daily for 5 days in combination with intravenous administration of doxorubicin 40 mg/m in the treatment of patients with advanced, inoperable gastric cancer (n=33) increased overall efficacy to 39.4%±8.5% when compared to patients (n=32) who received the same drugs intravenously (12.5%±5.84%). The compared groups had significantly different median survival (35 and 19 weeks) and life expectancy (41.3±4.4 and 23.8±3.4 weeks).
 The endolymphatic administration of cytostatics, which demonstrates less toxicity compared to the intravenous one, has the right to exist and the potential to further develop improved techniques of administration.