Objective
To describe the clinical presentation, diagnostic imaging, management, and follow‐up of a dog that presented with sequential, bilateral, spontaneous, subcapsular and perirenal hemorrhage ...(Wunderlich syndrome) due to bilateral renal arterial malformations.
Case Summary
A 9‐year‐old intact male Field Spaniel presented for acute onset abdominal pain following a possible syncopal episode. Abdominal ultrasonography, contrast‐enhanced ultrasound, and computed tomography (CT) revealed right‐sided perirenal hemorrhage that extended into the peritoneum. The dog was discharged following stabilization with analgesia, fluid therapy, and tranexamic acid. One month later, the patient presented with identical clinical signs. A CT scan at this stage revealed bilateral kidney infarcts with new left‐sided perirenal hemorrhage. Abdominal ultrasound and contrast‐enhanced ultrasound were repeated and showed similar findings. Follow up with four‐dimensional CT angiography revealed bilateral renal arterial malformations, likely causing spontaneous renal hemorrhage and secondary subcapsular hematomas , retroperitoneal and peritoneal hemorrhage.
Unique Information Provided
This is the first reported case of both bilateral renal arterial malformations and bilateral spontaneous subcapsular and perirenal hemorrhage in the absence of neoplasia, coagulopathy, or trauma in a dog. Advanced imaging modalities, including selective angiography, were required to diagnose this condition successfully. Arterial malformations should be considered as a differential diagnosis in cases of hemoretroperitoneum. Nephrectomy due to perirenal hemorrhage should be cautiously considered, especially in the absence of angiography, because of the sequential bilateral nature of this case. Conservative management in this case resulted in a good long‐term outcome 10 months later.
OBJECTIVETo describe the clinical presentation, diagnostic imaging, management, and follow-up of a dog that presented with sequential, bilateral, spontaneous, subcapsular and perirenal hemorrhage ...(Wunderlich syndrome) due to bilateral renal arterial malformations. CASE SUMMARYA 9-year-old intact male Field Spaniel presented for acute onset abdominal pain following a possible syncopal episode. Abdominal ultrasonography, contrast-enhanced ultrasound, and computed tomography (CT) revealed right-sided perirenal hemorrhage that extended into the peritoneum. The dog was discharged following stabilization with analgesia, fluid therapy, and tranexamic acid. One month later, the patient presented with identical clinical signs. A CT scan at this stage revealed bilateral kidney infarcts with new left-sided perirenal hemorrhage. Abdominal ultrasound and contrast-enhanced ultrasound were repeated and showed similar findings. Follow up with four-dimensional CT angiography revealed bilateral renal arterial malformations, likely causing spontaneous renal hemorrhage and secondary subcapsular hematomas , retroperitoneal and peritoneal hemorrhage. UNIQUE INFORMATION PROVIDEDThis is the first reported case of both bilateral renal arterial malformations and bilateral spontaneous subcapsular and perirenal hemorrhage in the absence of neoplasia, coagulopathy, or trauma in a dog. Advanced imaging modalities, including selective angiography, were required to diagnose this condition successfully. Arterial malformations should be considered as a differential diagnosis in cases of hemoretroperitoneum. Nephrectomy due to perirenal hemorrhage should be cautiously considered, especially in the absence of angiography, because of the sequential bilateral nature of this case. Conservative management in this case resulted in a good long-term outcome 10 months later.
Dendritic cells (DCs) are targets of measles virus (MV) and play central roles in viral dissemination. However, DCs express the RIG-I-like receptors (RLRs) RIG-I and Mda5 that sense MV and induce ...type I interferon (IFN) production. Given the potency of this antiviral response, RLRs are tightly regulated at various steps, including dephosphorylation by PP1 phosphatases, which induces their activation. We demonstrate that MV suppresses RIG-I and Mda5 by activating the C-type lectin DC-SIGN and inducing signaling that prevents RLR dephosphorylation. MV binding to DC-SIGN leads to activation of the kinase Raf-1, which induces the association of PP1 inhibitor I-1 with GADD34-PP1 holoenzymes, thereby inhibiting phosphatase activity. Consequently, GADD34-PP1 holoenzymes are unable to dephosphorylate RIG-I and Mda5, hence suppressing type I IFN responses and enhancing MV replication. Blocking DC-SIGN signaling allows RLR activation and suppresses MV infection of DCs. Thus, MV subverts DC-SIGN to control RLR activation and escape antiviral responses.
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•Measles virus (MV) suppresses antiviral type I IFN responses via DC-SIGN•DC-SIGN signaling inhibits RIG-I and Mda5 activation by blocking PP1 phosphatases•Raf-1 induces association of the PP1 inhibitor I-1 with GADD34-PP1α/γ phosphatases•MV targets phosphatases through DC-SIGN to infect dendritic cells
Measles virus (MV) must evade RIG-I- and Mda5-mediated antiviral activity to infect dendritic cells (DCs). Mesman et al. show that MV activates the C-type lectin DC-SIGN on DCs to induce signaling via Raf-1 kinase that prevents PP1-mediated dephosphorylation and subsequent activation of RIG-I and Mda5.
1 Laboratory of Food Microbiology and Leuven Food Science and Nutrition Research Centre (LFoRCe), Department Microbial and Molecular Systems, Katholieke Universiteit Leuven, B-3001 Leuven, Belgium
2 ...Research Group Microbial Ecology and Biorational Control, Scientia Terrae Research Institute, B-2860 Sint-Katelijne-Waver, Belgium
3 Research Group Process Microbial Ecology and Management and Leuven Food Science and Nutrition Research Centre (LFoRCe), Department Microbial and Molecular Systems, Katholieke Universiteit Leuven Association, De Nayer Institute, B-2860 Sint-Katelijne-Waver, Belgium
4 Center for Microbial Ecology, Michigan State University, East Lansing, Michigan 48824, USA
5 Department of Biotechnology, Südzucker AG, Mannheim/Ochsenfurt, ZAFES, Obrigheim/Pfalz, Germany
Correspondence Kris A. Willems kwi{at}scientiaterrae.org
Tetragenococcus halophilus is known to flourish in extreme salt environments. Recently, this halophilic bacterium also appeared as the dominant microflora during storage of sugar thick juice, an intermediate product of beet sugar production. Although T. halophilus can cause degradation of thick juice, dominance of this bacterium does not always result in degradation. In this study T. halophilus strains from high-salt and high-sugar environments, and in particular from degraded and non-degraded thick juice, were compared in detail. Both physiological and genetic characterization using Biolog, repetitive PCR fingerprinting (rep-PCR) and random amplified polymorphic DNA (RAPD) technology, revealed clear differences between T. halophilus strains isolated from salt- and sugar-rich environments. However, no strain pattern could be specifically and systematically associated with degraded or non-degraded thick juice. Remarkably, halophilic T. halophilus strains were not able to grow in sugar thick juice. Irrespective of the differences between the strains from high-salt or high-sugar environments, DNA–DNA hybridization grouped all strains within the species T. halophilus , except one isolate from sugar thick juice that showed different physiological and genetic characteristics, and that may represent a new species of Tetragenococcus .
Abbreviations: RAPD, random amplified polymorphic DNA; rep-PCR, repetitive PCR fingerprinting
The GenBank/EMBL/DDBJ accession numbers for the sequences determined in this work are given in Fig. 2.
The industrial storage of sugar thick juice was simulated on a laboratory scale. Terminal Restriction Fragment Length Polymorphism (T-RFLP) analysis and the application of Clone Libraries in parallel ...with classical microbiology were used to study the bacterial diversity and all revealed a dominance (>99%) of
Tetragenococcus halophilus during storage. The degradation of thick juice correlated with the appearance of
l-lactic acid and high concentrations of
T. halophilus. In addition, pure cultures of
T. halophilus induced degradation of sterile thick juice. A specific PCR was developed to detect
T. halophilus and industrial thick juice samples from Belgium, Germany and France all contained
T. halophilus, suggesting a consistent association of this organism with thick juice.
T. halophilus has been known only as a halophile thus far, and this report is the first to show an association of this organism with a sugar-rich environment.
In 1992 a new Vibrio cholerae strain, designated V. cholerae O139 Bengal, emerged which has been responsible for large outbreaks of cholera in India and Bangladesh. Previously, we have shown that ...this strain arose from a V. cholerae O1 strain by the acquisition of novel DNA. Sequence analysis revealed that the novel DNA is flanked by two genes, rfaD and rfbQRS, which are also found in O1 strains. The mosaic structure of rfaDVCO139 indicated that it was one of the regions involved in recombination between donor and acceptor DNA. However, sequence divergence between the O1 and O139 rfbQRS genes indicated that the second recombination site between donor and O1-acceptor DNA is probably located downstream of rfbDVCO139. The DNA region between rfaDVCO139 and rfbQRSVCO139, designated otn, contained seven open reading frames (ORFs). Two ORFs, otnA and otnB, showed homology with genes involved in cell-wall polysaccharide synthesis. Mutations in otnA and otnB indicated that they are required for capsule synthesis but not lipopolysaccharide synthesis. The otn DNA is also found in V. cholerae O69 and O141 strains, and the organization of this DNA was essentially identical to that in the O139 strain. However, sequence divergence of the otnAB genes indicated that the O139 otn DNA region was not derived from the O69 or O141 strains. No antigenic relationship was found between the different V. cholerae serotypes carrying otn DNA, so the genes determining the antigenic specificity of the O antigen or capsule must be located outside the otn DNA. The O139 otn DNA contained a JUMPstart sequence, which is associated with polysaccharide-synthetic genes in several bacterial species. Furthermore, a repeat motif was observed in extragenic regions. A number of observations suggest that these sequences may facilitate gene flow between V. cholerae strains and the assembly of clusters of functionally related genes.
Right ventricular (RV) wall volumes, chamber volumes, and RV ejection fractions were assessed by means of magnetic resonance (MR) imaging in 17 patients with moderate chronic obstructive lung disease ...and in 11 healthy subjects. Short-axis spin-echo or gradient-echo images encompassing the entire right ventricle were obtained. The mean RV wall mass in patients was significantly higher than that in healthy subjects (61 g +/- 13 standard deviation vs 47 g +/- 7, P = .005), while the ejection fraction was in the normal range in both groups. Interobserver agreement for measurements of both RV ejection fraction and RV wall mass was high (r = .91 for both). When a 60-g cutoff point was used to define RV hypertrophy, eight patients were considered to have cor pulmonale, which had been previously defined, on clinical grounds, in only five of these patients. It is concluded that detection of RV myocardial hypertrophy with MR imaging may aid in the early diagnosis of cor pulmonale complicating chronic obstructive lung disease.
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