Electromyogram of bovine abomasum (author's transl)]

The electrical activities in abomasum were studied on the normal and left abomasal displaced cows. Electromyograms were obtained using eight bipolar-needle electrodes fixed by suture in the serosal surface of the various portions of the abomasum; one in the cardia, three in the fundus, and four in the pylorus. The results were summarized as follows: 1. In the cardia and fundus, the repetetive but irregular spikeburst was observed. 2. In the pylorus, the single spike followed by the spikeburst was observed. These spikes were rhythmic and propagative. The propagation velocity in the pylorus was shown the tendency to increase with approach to the pyloric canall. The electomyographic pattern in the cows was similar to goats except the discharge interval was longer in cattles than in goats. 3. The electrical activities in the abomasum received the left abomasal displacement showed the higher amplitude, the more prolonged discharge interval and accerelated propagation velocity than in controls.     

Survival of Dairy Cows After Surgery to Correct Abomasal Displacement: 1. Clinical and Laboratory Parameters and Overall Survival

The objective of this study was to compare the clinical and laboratory consequences of left and right displacement of the abomasum (LDA and RDA), short‐ and long‐term survival after surgery and the findings in cows, that could not be cured by omentopexy. Data from 564 cases of displaced abomasum (466 LDA, 98 RDA) were analysed retrospectively. Clinical and laboratory findings were compared between the two manifestations of DA. Survival was assessed after 10 days and after 15 months. Necropsy was carried out on cows that died or were killed. On arrival at the clinic, left displacement of the abomasum (LDA) cows had been recognized as diseased for longer. LDA occurred earlier in lactation, and more cows with right displacement of the abomasum (RDA) were pregnant. Overall clinical symptoms were more severe in RDA than in LDA cows. Heart rate was higher, body temperature was lower, inanition, abnormal faeces and ruminal stasis were more frequent in RDA cows. Leucocyte counts were higher, and potassium and chloride levels were lower in RDA cows. Acetonuria was more frequent in LDA cows. More LDA than RDA cows were released from the clinic as cured (82.0% versus 74.5%). However, survival after the early post‐surgical period was similar for RDA and LDA cows. At necropsy, diseases of the gastrointestinal system were the predominant finding in RDA cows, while in LDA cows, diseases of the liver and other concurrent diseases were more important.     

Relationships between Lactational Incidence of Displaced Abomasum and Milk Production Traits in German Holstein Cows

The objective of this study was to analyse the heritabilitiy of the lactational incidence of displaced abomasum (DA) and the relationships of DA with milk production traits in German Holstein cows. Data were recorded between February 1999 and January 2000 in cooperation with five veterinary practitioners. Their veterinary practices were located in the northern part of Lower Saxony. The investigation included 160 dairy farms under the official milk‐recording scheme with 9315 cows. The lactational incidence of the left abomasal displacement amounted to 1.21%, and of the right abomasal displacement to 0.41%, respectively. The linear heritability estimates for the lactational incidences of left and right DA were h² =0.05 ± 0.012 and h² = 0.004 ± 0.005, respectively. Using the Dempster–Lerner‐transformation the corresponding heritabilities were h² = 0.53 and 0.09, respectively. Milk losses for the lactation when DA was diagnosed were significant and reached 1016 kg milk, 41 kg fat, 36 kg protein and 0.07% protein. Fat content significantly increased by 0.18%. The analysis could not show significant differences between cows diagnosed with DA and cows not diagnosed with DA in the 305‐day milk production traits of the lactation preceding the diagnosis of DA. There was also no indication for an unequal distribution of breeding values for milk performance traits between cows with and without DA. The additive genetic correlations between 305‐day milk performance and left DA were low. The results indicated that cows with a high milk production and superior breeding values for milk performance were not exposed to an increased risk for DA.     

基于磁压榨技术的无创化胃造瘘的大鼠模型研究

背景与目的 胃造瘘术是普通外科常见手术,传统胃造瘘术创伤大,已逐步被内镜下胃造瘘、X线下胃造瘘术取代,但实施过程需要内镜系统或X线机辅助,且操作较为繁琐。基于应用磁压榨技术行无创化胃造瘘的设想,本研究采用自行设计加工的胃造瘘磁体装置,在大鼠模型上验证该设想的可行性和安全性。方法 根据大鼠消化道解剖特点和尺寸自行设计加工适合于大鼠胃造瘘的钕铁硼子母磁体,电子万能试验机测试子母磁体的磁力学曲线。10只SD大鼠麻醉后经口置入子磁体至胃内,在大鼠左上腹部放置母磁体,子母磁体自动吸合,腹部X线明确磁体相吸情况。术后单笼饲养,观察大鼠存活状况、磁体脱落时间、磁体留置期间并发症发生情况。术后2周处死动物,获取造瘘口标本,肉眼及光镜下观察造瘘口形成情况。结果 设计和生产出的子母磁体均为圆柱状,采用N42烧结钕铁硼加工而成,表面电镀镍防护处理。子磁体直径5 mm、高3 mm,母磁体直径6 mm、高5 mm,子母磁体质量分别为0.410 g和1.035 g。子母磁体在零距离时最大吸力达4.36 N,磁体吸力随位移增加而逐渐减小。10只大鼠麻醉后均成功经口置入子磁体至胃内,在大鼠左上腹部放置母磁体后,子母磁体迅速相吸,腹部X线检查显示磁体对位吸合良好。术后大鼠均存活,子母磁体留置期间,未出现磁体移位、子母磁体分离等意外事件,所有实验动物无消化道梗阻、腹腔感染等并发症。术后10~13 d子母磁体脱落,胃造瘘通道建立。术后2周开腹观察可见造瘘口处胃壁和腹壁粘连愈合牢固,腹腔无渗液及粘连。获取造瘘口标本肉眼可见瘘口形成良好,HE及Masson染色光镜下观察可见瘘口组织结构层次清晰。结论 基于磁压榨技术的胃造瘘磁体设计巧妙、易于加工、成本低,该方法建立无创化大鼠胃造瘘操作简单,安全可行,造瘘口各层组织愈合良好。下一步可开展与人体解剖特点更接近的大动物实验验证其可行性并评价造瘘口形成的长期效果。未来优化磁体设计和操作路径后,该技术有望在临床试用开展。     

Effects of Abdominal Surgery on Thiobarbituric acid Reactive Substances and Plasma Anti‐oxidative Capacity in Dairy Cows

The present investigation was undertaken to study the effects of surgical stress on thiobarbituric acid reactive substances (TBARS) and ferric reducing ability of plasma (FRAP) in dairy cows. Ten Holstein–Friesian dairy cows, mean age 5.26 years, admitted for treatment of left abomasal displacement (omentopexy), were used in our study. Blood samples were collected from the jugular vein prior to surgery, immediately and then 15, 30, 60, 90 min, and 2, 5, 10, and 24 h after reposition of abomasum. Surgical stress resulted in a significant increase in plasma cortisol concentrations (P < 0.001) with the highest mean levels 15 min after surgery (32.4 ± 18.1 μg/l) as well as in serum levels of glucose (P < 0.001) and non‐esterified fatty acids (P < 0.001). Similarly, surgery transiently enhanced the plasma levels of TBARS (P < 0.001). The highest TBARS plasma levels (0.91 ± 0.18 μmol/l) were recognized 60 min after reposition of abomasums. There were no significant differences in FRAP in dairy cows before and after reposition of abomasum. In conclusion, these data indicate that stress reaction caused by surgical correction of left displacement of abomasum can be associated with higher production of TBARS.     

Abomasal Cannulation in the Milk‐fed Calf Using a 7 mm Polyurethane Tube

The main objective of this study was to develop a simple and effective surgical technique for abomasal cannulation in neonatal calves. General anaesthesia was induced in 12, 3‐day‐old male dairy calves and a polyurethane cannula surgically implanted in the abomasal body (n = 12) and pyloric antrum (n = 6) through a right paracostal incision. Fifteen cannulae remained in situ from day 3 to 34 of life (mean: 29 days), and three cannulae were extruded 13–14 days after placement. Calves were clinically healthy and gained weight during the study. Cannulae were well tolerated by the calves and abomasal contents did not leak from the cannula sites. Necropsy examination revealed firm adhesions between the abomasum and parietal peritoneum at the cannula sites with no evidence of leakage or peritonitis. We conclude that surgical placement of polyurethane tubes designed for percutaneous endoscopic gastrostomy provided a useful method for cannulation of the abomasum of neonatal calves. The cannulation technique can be used for experimental studies, as well as for nutritional and fluid support of sick calves that cannot be managed by oral treatment.     

Classification of Abomasal Displacement in Cows According to Histopathology of the Liver and Clinical Chemistry

Histopathological features of livers and blood chemical values in cows with abomasal displacement were investigated. Liver biopsy samples were collected during redressment operations in 92 cows with abomasal displacement, and the samples were stained with haematoxylin and eosin or periodic acid Schiff (PAS). Blood was collected for chemical tests. Livers were histopathologically divided into the following four types: normal histology cases (21%), fatty degeneration cases (36%), cloudy swelling cases (19%) and fatty degeneration cases with cloudy swelling (24%). The number of PAS‐positive samples was significantly higher in the normal histology group and significantly lower in the severe fatty degeneration group and severe cloudy swelling group. Cows with fatty degeneration had significantly higher levels of serum 3‐hydroxybutyric acid, non‐esterified fatty acid and aspartate aminotransferase than did those with cloudy swelling or normal histology. The results indicate that the morbid conditions of cows with abomasal displacement can be classified into four types.     

A case of an abdominoscrotal hydrocele surgically treated under laparoscopic assistance

We herein describe a 9-month-old boy who presented with bilateral scrotal hydroceles shortly after birth. The right hydrocele spontaneously resolved during this period, and a nonpalpable testis of the right side was noted. In contrast, the left hydrocele gradually increased in size. Ultrasound and magnetic resonance investigations performed at the age of 7 months could not detect the right testis either in the inguinoscrotal region or the abdominal cavity. These examinations also pointed out a huge hydrocele that extended from the left scrotum to the abdominal cavity. At the age of 9 months, a laparoscopic-assisted operation for both the right undescended testis and the left abdominoscrotal hydrocele (ASH) was performed. During the operation, an atrophic testis secondary to in utero intravaginal torsion was shown on the right inguinal region, and a huge ASH was revealed in the left inguinoscrotal region. The finding of the left ASH was confirmed by a laparoscope inserted through the processus vaginalis of the right side. At first, the processus vaginalis of the left side was highly ligated by the inguinal approach, and then the ASH was opened and its wall was resected. Our findings suggest that both an understanding of the pathogenesis and a corrective operation of ASH can be made via the inguinal approach. In cases associated with cryptochidism owing to an intraabdominal testis or an in utero extravaginal torsion, a laparoscopic-assisted operation may therefore be useful both for making a precise diagnosis and for surgically removing an ASH.     

Intestinal perforation due to multiple magnet ingestion: a case report

Multiple magnet ingestion during childhood may result in emergency situations. A single magnet may be discharged with intestinal peristalsis, but multiple magnets may stick together and cause significant intestinal complications. Here we present a case with intestinal perforation due to ingestion of multiple magnets and metal pieces. An eight-year-old girl presented with abdominal pain and vomiting. She had abdominal tenderness and defense on the physical examination. Abdominal X-ray showed air and fluid levels. Metallic images were not considered at first as important in the diagnosis. Abdominal ultrasonography was reported as acute appendicitis. During the abdominal exploration, the appendix was normal, but there were dense adherences around the ileum and cecum. After adhesiolysis, intestinal perforations were seen in the cecum and 15 and 45 cm proximal to the cecum. Magnet and metal pieces were present in the perforated segments. Wedge resection and primary repair was performed. There were no postoperative complications, and she was discharged on the postoperative fifth day. Pediatric surgeons should be aware of the complications of multiple magnet ingestion. If the patient has a history of multiple magnet ingestion, follow-up with daily abdominal X-rays should be done, and in cases where magnets seem to cluster together or if acute abdominal signs develop, surgical exploration should be considered.     

Ultrasonographic Characteristics of Abdominal and Thoracic Abscesses in Cattle and Buffaloes

Six cows and five buffaloes with abdominal and thoracic abscesses were examined clinically and ultrasonographically. There was a wide range of clinical signs and at least 50% of the animals exhibited dull demeanour, anorexia, abdominal pain, recurrent tympany and/or weight loss. Three cases of abdominal abscesses were imaged in the left ventral abdomen between the rumen and abdominal wall, two cases were imaged at the xiphoid cartilage near the reticular wall and one case was imaged on the right ventral abdomen between the jejunum and right abdominal wall. Four cases of thoracic abscesses were imaged in the third intercostal space on the left side; however, one case of abscess was imaged in the fourth intercostal space, also on the left side. The content of the abscess was echogenic in eight animals and anechoic in three. In three animals, the content of the abscess was partitioned by echogenic septae. In two cows, the echogenic content of the abscess was surrounded by a narrow rim of anechoic fluid. The diameters of the abscesses were 5–10 cm in three cows, 11–15 cm in seven cows and >15 cm in one cow. In every case, the diagnosis was confirmed by centesis and aspiration of the abscess, which yielded purulent material. There were biochemical data of hypoalbuminaemia and hyperglobulinaemia and 90% of tested animals had neutrophilia. Five cows were examined at slaughter, where the ultrasonographic diagnosis was confirmed.     

Studies on the pH Value of Abomasal Contents in Dairy Cows During the First 3 Weeks after Calving

The pH value of the abomasal contents in adult cattle is normally constant and has a value of 2. Abomasal contents with pH values of 5.5 and higher could give rise to bacterial fermentation with subsequent gas production. The accumulation of gas is thought to form a key event in the pathogenesis of abomasal displacement. The aim of the present study was to determine the pH values of abomasal contents of dairy cows in the first 3 weeks after calving. The pH of the abomasal contents was, over several days, higher than the pH value of the abomasal juice in mid‐lactation cows. The highest pH values were measured on day 14 after calving, thereafter the pH declined. Possible explanations for the rise in the pH value of the abomasal contents are discussed.     

改良C-Kugel补片修补腹壁膨出症

目的 探讨用C-Kugel补片修复腹壁膨出症的效果.方法 回顾性分析了2例因腰腹壁区手术发生的腹壁膨出症临床资料,1例为左侧膨出,另一例为右侧膨出.CT显示腹壁薄弱区分别为12 cm×9 cm和10 cm×8 cm.手术方式:两侧均取原切口内侧段长度约10 cm.左侧将结肠脾曲及降结肠侧腹壁剪开,右侧将结肠肝曲及升结肠侧腹壁剪开,向下内游离至骶脊前,在腹腔内游离出大约25 cm×22 cm的间隙,将一25 cm×19 cm的C-Kugel自膨式补片置于腹内,补片的e-PTFE面朝向腹腔,用2-0的Prolene线和auto-suture行全腹壁固定,网片外放置引流.结果 术后恢复快,形体恢复满意,术后CT提示原薄弱的腹壁增厚.目前随访已达半年和3年,未复发.结论 腹壁膨出症应用C-kugel补片行腹膜内修补具有手术方法简单,创伤小,恢复快的优点.     

微型腹腔镜幽门环肌切开术182例报告

目的:总结微型腹腔镜幽门环肌切开术治疗小儿先天性肥厚性幽门狭窄(congenital hypertrophic pyloric stenosis,CHPS)的临床经验,探讨手术成功因素及并发症的防治。方法:回顾分析2001年3月至2009年5月应用微型腹腔镜技术治疗182例CHPS患儿的临床资料,术中分别于左、右、上腹部各穿刺3mm Trocar。结果:180例顺利完成腹腔镜手术,术中2例幽门粘膜损伤中转开腹,术后2例并发脐部戳孔疝经修补治愈;随访至今,无呕吐及肠粘连、肠梗阻等并发症发生。结论:丰富的开腹手术经验、娴熟的腹腔镜技术、专用的腹腔镜器械及固定的手术团队是保障腹腔镜幽门环肌切开术顺利完成的基础。     

Plasma Gastrin Activity and the Diagnosis of Bleeding Abomasal Ulcers in Cattle

The present study was designed to evaluate the usefulness of plasma gastrin determinations as a diagnostic aid and to review the clinical and haematological findings in cattle with bleeding abomasal ulcers. Twenty‐nine cows with bleeding abomasal ulcers and six healthy cows were used. Clinical and laboratory examinations, including plasma gastrin levels, were performed. Anorexia, depression, dark‐coloured to black faeces, pale mucous membranes, abdominal pain, moderate tachycardia and tachypnoea were the most pronounced clinical symptoms in the cattle with bleeding abomasal ulcers. Plasma gastrin concentration was significantly higher (P < 0.05) in the cattle with bleeding abomasal ulcers than in healthy cows. The mean plasma gastrin concentration in healthy cattle was 103.2 pg/ml, while the mean plasma gastrin concentrations in cattle with bleeding abomasal ulcers were found to be 213.6 pg/ml. Haemoglobin levels, packed cell volume, total white blood cell count and mean corpuscular volume were significantly lower (P < 0.05) in the cows with bleeding abomasal ulcer than in the healthy cattle. The results of this study show that measurement of plasma gastrin can be useful in the diagnosis of bleeding abomasal ulcers in cattle.     

A case of pelvic arteriovenous malformation

Congenital pelvic arteriovenous malformation (AVM) is an uncommon lesion. This disorder occurs in female frequently than in male. A 44 year-old male complained of right lower abdominal discomfort and hemorrhoids. He had neither history of abdominal trauma nor abdominal surgery. A pulsatile mass was palpable on rectal digital examination and bruit was heard at right lower abdominal quadrant. Pelvic computerized tomogram showed an abnormal mass with homogeneous density near the right side of the bladder. The mass was equally enhanced by the contrast medium. Digital subtraction angiogram revealed the pelvic AVM which originate from right hypogastric artery. Selective angiogram showed many feeding arteries and a dilated vein. Surgical procedure was performed with transabdominal approach because this AVM was localized. All feeding arteries and aneurysmally dilated vein were completely removed. Post operative course was uneventful. Follow up arteriogram after the surgery showed no further abnormal arteriovenous connections.     

Dislocation of three segments of the liver due to hernia of the right diaphragm

Right diaphragmatic hernia is a rare injury (0.25–1%) following blunt abdominal trauma. The diagnosis may be delayed and achieved years after the trauma during laparotomies for other reasons. A 75-year-old male fell 6 years before, and was symptom-free since then. He was admitted to the hospital for abdominal pain, and chest X-rays revealed intestinal gas in the lower right thoracal region. Abdominal ultrasonography showed agenesis of the gallbladder, and computed tomography demonstrated that the right upper abdominal viscera were located in the vicinity of the heart. The patient underwent a laparotomy for right diaphragmatic hernia, and the right hepatic lobe and the medial segment of the left lobe, the gall bladder, the proximal part of the transverse colon, the omentum and some segments of the intestine were dislocated into the thoracal cavity by a tear in the right diaphragm. The organs were returned to the abdominal cavity uneventfully and the defect in the diaphragm, measuring 10 × 5 cm, was repaired by unabsorbable sutures. The diagnosis, surgical treatment and postoperative course of the right diaphragmatic hernia is discussed with a review of the literature.     

Agenesis of the right lung: an unusual presentation

A case of agenesis or aplasia of the right lung, in a cyanosed neonate, exceptionally associated with a `vascular ring' abnormality produced by a right aortic arch, an aberrant left subclavian artery, and a patent ductus arteriosus, is reported. The presence of an abnormal lobe of the liver, projecting together with small gut and a subhepatic caecum into the right hemithorax, caused mediastinal displacement to the left side and produced the illusion of a diaphragmatic hernia, thereby obscuring the correct preoperative diagnosis.     

The Use of Magnetic Anchors in the Bowel Lumen for Laparoscopic Anterior Resection of Rectosigmoid Colon in Pigs: with Video

Background  This article describes a new technique for retracting the rectum upward during laparoscopic surgery using the pulling force created between two magnets. Methods  A magnet and a colonoscope were inserted into the rectal cavity of a swine model, and a second magnet was placed on the abdominal wall creating a magnetic anchor or retraction that pulled the rectum upward. Subsequently, a laparoscopic anterior resection of the rectosigmoid colon was performed. The magnetic anchor transferred an electromagnetic force through the abdominal wall, creating effective organ retraction without the need of a trocar. Results  Surgery without the use of trocars allows for increased flexibility in the angle, distance, and location of the retraction. Since retraction was achieved without a shaft device that can impede visibility within the abdominal cavity, the surgeons achieved excellent endoscopic views. Because the intraluminal magnetic anchor was placed directly on the inside wall of the target organ, tracking target organ movement closely with the movement of the extracorporeal control magnet was possible and synchronizing their movements was not difficult. Conclusion  The technique presented in this article might be less invasive and could provide more effective manageability for laparoscopic surgery. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

睾丸横过异位的诊断和治疗：附1例报告并文献复习

目的探讨睾丸横过异位的诊断和治疗。方法患儿,7岁,男性,术前超声、CT判断右侧隐睾位于同侧腹腔内,腹腔镜下见患侧睾丸精索血管横过异位,双输精管单侧起源伴行,与对侧精索及横过睾丸精索血管共同穿过已闭合的内环口,进入对侧腹股沟管。腹腔镜下游离患侧精索,经腹股沟开放手术将异位睾丸通过阴囊中隔复位固定到对侧阴囊肉膜下。结果术中未发现苗勒管残留,手术顺利。术后随访3个月,患儿双侧睾丸位置理想,血流良好。结论睾丸横过异位是罕见睾丸下降不良畸形,术前难确诊,宜及早诊治,腹腔镜处理有优势。     

A patient with a traumatic right diaphragmatic hernia occurring 4 years after sustaining injury--statistical observations of a delayed diaphragmatic hernia caused by uncomplicated injury in Japan.

We describe our experience with a patient in whom a traumatic right diaphragmatic hernia developed 4 years after sustaining injury and review cases of delayed diaphragmatic injury reported in Japan. The patient was a 28-year-old man who sustained a severe contusion of the right epigastric region and fractured a right rib in a traffic accident in September 1992. In August 1996, the patient presented with shortness of breath on effort or after meals. A chest roentgenogram revealed intestinal gas in the right side of the thoracic cavity. A right diaphragmatic hernia was diagnosed on the basis of a gastrointestinal series, and the patient was operated on. The hernial orifice extended anteriorly from the central tendon in an 11:00 direction and measured 11 x 6 cm. The small intestine, right side of the colon, and liver were herniated. A total of 297 cases of blunt traumatic diaphragmatic hernia were reported in Japan between 1981 and 1996, including 47 cases (left side, 32 cases; right side, 15 cases) of delayed diaphragmatic hernia, defined as occurring one month or more after injury. Diaphragmatic hernia should be considered as a possible diagnosis in patients with abnormal shadows in the thoracic region who have recently sustained injury or who have a past history of injury.