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Melukis Di Atas Media Tekstil Yati Mariana Garnadi Full Chapter Download PDF
Melukis Di Atas Media Tekstil Yati Mariana Garnadi Full Chapter Download PDF
Mariana Garnadi
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CHOLELITHIASIS. BILIARY CALCULI. GALL
STONES.
Largely secondary, from stomach, intestine, lymph glands, spleen, pancreas; the
hepatic tumor may be disproportionately large. In horse: sarcoma rapidly growing
soft, succulent, slow-growing, fibrous, tough, stroma with round or spindle shaped
cells and nuclei. Symptoms: emaciation, icterus, enlarged liver, rounded tumors on
rectal examination. Melanoma, in old gray or white horses, with similar formations
elsewhere; not always malignant. Lymphadenoma. Angioma. Carcinoma.
Epithelioma, lesions, nodular masses, white or grayish on section, and having firm
stroma with alveoli filled with varied cells with refrangent, deeply staining, large,
multiple nuclei, cancerous cachexia and variable hepatic disorder. In cattle:
sarcoma, adenoma, angioma, cystoma, carcinoma, epithelioma. In sheep:
adenoma, carcinoma. In dog: lipoma, sarcoma, encephaloid, carcinoma,
epithelioma. Wasting and emaciation, yellowish pallor, temporal atrophy, ascites,
liver enlargement, tender right hypochondrium, dyspepsia, symptoms of primary
deposits elsewhere.
The great quantity of blood which passes through the liver lays it
open, in a very decided way, to the implantation of germs and
biological morbid products. Hence tumors of the liver are largely
secondary, the primary ones being found mostly in the stomach,
intestine, abdominal lymph glands, spleen and pancreas. The
primary neoplasm is often comparatively small, while the hepatic
one supplied with a great excess of blood may be by far the most
striking morbid lesion. The hepatic tumors are mostly of the nature
of angioma, sarcoma, melanoma, adenoma, lipoma, cystoma,
carcinoma, and epithelioma.
NEOPLASMS IN HORSES LIVER.
Sarcoma. This is usually a secondary formation from the primary
tumors in the spleen and peritoneum, and it occurs as multiple
masses throughout the substance of the gland. The liver is greatly
increased in size, extending far beyond the last rib on the right side,
and weighing when removed as high as 70 ℔s. (Mason), or even 88
℔s. (Cadeac), in extreme cases.
The whole surface of the liver may show bulging, rounded masses,
and the morbid growth may have involved the capsule and caused
adhesion to the back of the diaphragm (Bächstädt). The cut surface
of the neoplasm is smooth, elastic, yellowish and circular or oval in
outline. It may have a variable consistency—friable or tough,
according to the activity of growth and the relative abundance of cells
and stroma. The portal glands are hypertrophied and thrombosis of
the portal vein is not uncommon.
Microscopic examination of the dark red scrapings shows
numerous blood globules, intermixed with the round or spindle
shaped cells and nuclei of the tumor. Sections of the tumor show
these cells surrounded by a comparatively sparse fibrillated stroma.
The round cells may vary from .005 to .05 m.m. They contain one or
more rather large nuclei and a number of refrangent nucleoli. The
nuclei are often set free by the bursting of the cells in the scrapings.
They become much more clearly defined when treated with a weak
solution of acetic acid. Small grayish areas in the mass of the tumor
represent the original structure of the liver, the cells of which have
become swollen and fatty.
A liquid effusion more or less deeply tinged with red is usually
found in the abdominal cavity.
Symptoms are those of a wasting disease, with some icterus,
sometimes digestive disorder, and a marked enlargement of the liver.
The last feature can be easily diagnosed by palpation and percussion.
If an examination through the rectum detects the enlargement and
irregular rounded swellings of the surface of the liver or spleen, or
the existence of rounded tumors in the mesentery or sublumbar
region, this will be corroborative. The precise nature of the
neoplasms can only be ascertained after death.
Melanoma. Melanosis of the liver is comparatively frequent,
especially in gray horses, and above all when they are aging and
passing from dark gray to white. In many cases a more certain
diagnosis can be made than in sarcoma for the reason that primary
melanotic neoplasms are especially likely to occur on or near the
naturally dark portions of the skin, as beneath the tail, around the
anus or vulva, in the perineum, sheath, eyelids, axilla, etc. The extent
of the disease is likely to be striking, the liver, next to the spleen,
being the greatest internal centre for melanosis. The whole organ
may be infiltrated so that in the end its outer surface is completely
hidden by melanotic deposit. The surface deposits tend to project in
more or less rounded, smooth masses of varying size according to the
age of the deposit and the rapidity of its growth. Individual deposits
may vary in size from a pea to a mass of 40 or 50 lbs. They are
moderately firm, and resistant, and maintain a globular or ovoid
outline. The color of the melanotic deposits is a deep black with a
violet or bluish tint. If the pigmentary deposit is in its early stage it
may be of a dark gray. The deposits are firmer than the intervening
liver tissue and rarely soften or suppurate.
Melanosis in the horse is not always the malignant disease that it
shows itself to be in man, and extensive deposits may take place
externally and considerable formations in the liver and other internal
organs without serious impairment of the general health. It is only in
very advanced conditions of melanosis of the liver that appreciable
hepatic disorder is observed. If, however, there is marked
enlargement of the liver, in a white or gray horse, which shows
melanotic tumors on the surface, hepatic melanosis may be inferred.
Lymphadenoma. Adenoid Tumor. Lienaux describes cases of this
kind in which the liver was mottled by white points which presented
the microscopical character of adenoid tissue, cells enclosing a
follicle and a rich investing network of capillaries.
Angioma. These are rare in the horse’s liver, but have been
described by Blanc and Trasbot as multiple, spongy tumors on the
anterior of the middle lobe, and to a less extent in the right and left,
of a blackish brown color, soft and fluctuating. The largest mass was
the size of an apple, and on section they were found to be composed
of vascular or erectile tissue. The tendency is to rupture and
extensive extravasation of blood (30 to 40 lbs.) into the peritoneum.
Carcinoma. Epithelioma. These forms of malignant disease are
not uncommon in the liver as secondary deposits, the primary
lesions being found in the spleen, stomach, intestine, or pancreas, or
more distant still, in the lungs. The grafting or colonization of the
cancer in the liver depends on the transmission of its elements
through the vena portæ in the one case, and through the pulmonary
veins, the left heart and hepatic artery in the other.
Lesions. The liver may be greatly enlarged, weighing twenty-seven
pounds (Benjamin) to forty-three pounds (Chauveau), hard, firm,
and studded with firm nodules of varying sizes. These stand out from
the surface, giving an irregular nodular appearance, and are
scattered through its substance where, on section, they appear as
gray or white fibrous, resistant, spheroidal masses shading off to a
reddish tinge in their outer layers. Microscopically these consist of a
more or less abundant fibrous stroma, enclosing, communicating
alveoli filled with cells of various shapes and sizes, with large nuclei
(often multiple) which stain deeply in pigments. The relative amount
of fibrous stroma and cells determines the consistency of the mass,
and whether it approximates to the hard cancer or the soft. In the
horse’s liver they are usually hard, and, on scraping off the cut
surface, yield only a limited quantity of cancer juice. In the epithelial
form, which embraces nearly all that have originated from primary
malignant growth in the walls of the intestine, the epithelioid cells,
flattened, cubical, polyhedral, etc., are arranged in spheroidal masses
or cylindrical extensions, which infiltrate the tissues more or less.
These seem in some cases to commence in the radical bile ducts
(Martin), and in others in the minor coats of the larger biliary ducts.
As the disease advances a brownish liquid effusion is found in the
abdomen, and nodular masses formed on the surface of the
peritoneum.
Symptoms. As in other tumors of the liver these are obscure. As
the disease advances there may be œdema of the legs and sheath,
indications of ascites, stiff movements, icterus, occasional colics,
tympanies, and diarrhœa. Nervous symptoms may also appear, such
as dullness, stupor, coma, vertigo and spasms. Emaciation goes on
rapidly and death soon supervenes.
TUMORS OF THE LIVER IN CATTLE.