Neuronal ceroid lipofuscinosis in a mallard duck (Anas platyrhynchos)

A 3-year-old male, hybrid mallard duck (Anas platyrhynchos) was presented with a 2-year history of progressive, ascending paresis and paralysis. On presentation, the bird was in sternal recumbency and displayed intermittent focal seizures and intention tremors. Proprioceptive deficits and absent withdrawal reflexes were observed in both pelvic limbs, wing extension was limited, and reflexes were diminished bilaterally. Other findings included emaciation and dehydration. Results of a complete blood count and plasma biochemical analysis revealed anemia, hypoproteinemia, hypoglycemia, and hyperuricemia. Radiographs were unremarkable and results of an Aspergillus antibody were weakly positive. The duck went into cardiopulmonary arrest and died approximately 1 hour after initiating treatment with intravenous crystalloid fluids. A postmortem diagnosis of neuronal ceroid lipofuscinosis (NCL) was made based on the presence of neuronal granular cytoplasmic material that was autofluorescent and stained with periodic acid-Schiff and Luxol fast blue. To our knowledge, this is only the second case report of NCL in an avian species and the first in waterfowl.     

Marbofloxacin disposition after intravenous administration of a single dose in wild mallard ducks (Anas platyrhynchos)

Marbofloxacin, a fluoroquinolone developed specifically for veterinary use, has demonstrated considerable pharmokinetic variation among avian species. The goal of this study was to determine the disposition kinetics of marbofloxacin in mallard ducks (Anas platyrhynchos) after a single intravenous injection. Six wild mallard ducks were used in the study. Marbofloxacin was injected at a dose of 2 mg/kg into the basilic vein, and blood was subsequently collected at regular intervals from each bird. Plasma marbofloxacin concentrations were determined by using high-performance liquid chromatography. The volume of distribution at steady state was 1.78 +/- 0.37 L/kg, and the total plasma clearance was 0.59 +/- 0.08 L/kg per hour. Marbofloxacin had a relatively short permanence, with a elimination half-life of 2.81 +/- 1.20 hours, a terminal half-life of 2.43 +/- 0.61 hours, and a mean residence time of 2.99 +/- 0.52 hour. The maximum observed concentration (Cmax) and area under the curve (AUC) were 1.34 +/- 0.27 microg/mL and 3.75 +/- 0.56 microg x h/mL, respectively. Values of minimum inhibitory concentration (MIC), Cmax, and AUC have been used to predict the clinical efficacy of a drug in treating bacterial infections, with a Cmax: MIC value of 10 and an AUC: MIC ratio of 125-250 associated with optimal bactericidal effects. By using the study data and MIC breakpoints of 0.125 microg/mL or 0.2 microg/mL, values derived for Cmax: MIC were 9.37 +/- 0.99 and 5.85 +/- 0.62, respectively, and for AUC: MIC were 29.99 +/- 4.51 and 18.74 +/- 2.82, respectively. By using MIC values of 0.125 and 0.2 microg/mL and a target AUC: MIC = 125, the calculated optimal daily marbofloxacin dosages for mallard ducks were 9.24 and 14.78 mg/kg, respectively. These results suggest that, primarily because of the high total plasma clearance observed, the marbofloxacin dose for treatment of bacterial diseases in mallard ducks should be increased after intravenous administration. Intravenous doses of 10-15 mg/kg should be assessed by studying their potential toxicity and efficacy in sick birds.     

Use of a portable tower and remote-controlled launcher to improve physical conditioning in a rehabilitating wild mallard (Anas platyrhynchos)

Prerelease reconditioning improves the chance of survival of rehabilitating raptors. Reconditioning may also help to rehabilitate waterfowl, including those that are threatened or endangered, especially if the birds are released during periods of migration. A flying harness, creance, remote-controlled launcher, and portable tower were used to create a means of reconditioning a rehabilitating 5-month-old female wild mallard duck (Anas platyrhynchos) that had been housed in a rehabilitation center for 7 weeks while recovering from an injury. Pre- and postflight serum lactate levels, body condition index scores, and controlled flight distances were used to assess the bird's degree of conditioning. Postflight serum lactate levels never returned to preflight levels and were not deemed a reliable indicator of physical fitness. However, the mallard showed an increase in endurance and strength as well as improved body condition index scores over the course of the reconditioning program.     

Tracheal resection with primary anastomosis in children

We observed nine tracheal stenoses following intensive respiratory care in 524 neonates and infants. For all but four of them, we used medical and endoscopic treatment only, with satisfactory immediate and late results. In four children between 6 and 16 yr, we were obliged to perform a tracheal resection with primary anastomosis.All four children had primary tracheostomies as emergency procedures. Subsequent respiratory distress was the result of a dense fibrotic stenosis resistant to medical and endoscopic management. The technique of resection is described, especially, in dealing with the innominate artery. Three to five rings were resected. Cardiopulmonary bypass, was found to be unnecessary.One patient died 1 mo after operation, from an endoscopic accident. The remaining three had excellent results assessed clinically and by endoscopy and radiocinematography.Iatrogenic tracheal stenosis in children is a serious lesion, which can be prevented by correct intensive respiratory care.     

Tracheal growth after resection and anastomosis in puppies

Tracheal morphology, morphometric changes, and growth and histologic changes were studied in puppies submitted to tracheal resection and anastomosis. Fifteen mongrel puppies about 12 weeks old and weighing on an average 5.5 kg were operated under general anesthesia using fluothane. A median cervicotomy incision was made in ten puppies (experimental group, EG) and the proximal 14 tracheal rings were resected (average length 5.08 cm or about 35% to 38% of total tracheal length). One layer anastomosis was done using vicryl 4.0 maintaining the average tension of 1,450 g. Five puppies (control group, CG) were submitted to tracheal transection and anastomosis and the following parameters were studied. Tracheal morphology the trachea of the EG was a rounded triangle whereas in the CG it was oval in shape, there was increase in the intercartilageneous spaces in the EG, no granulation tissue was present, two mucous webs were seen in the EG and one in the CG. Morphometric changes average tracheal length EG 13 cm, CG 17.7 cm, intercartilagenous space EG 3.08 mm, CG 1.3 mm, intercricothyroid space EG 1.2 cm, CG 0.53 cm, sagittal and transverse tracheal thickness at the anastomosis EG 2.6 and 3.3 mm, CG 2 and 1.5 mm, sagittal and transverse diameter reduced on an average 2 mm in EG. Histology Moderate fibrosis was found at the level of anastomosis with no modification of chondrocytes at the cartilagenous rings in the EG. Even with high anastomotic tension, the dogs had normal tracheal growth without stenosis; the sagittal and transverse growth at the anastomosis in the EG was 90% and 85%, respectively, when compared with the CG.     

Tracheal sleeve resection for iatrogenic stenoses (subglottic laryngeal and tracheal).

Since 1975 200 tracheal sleeve resections for iatrogenic tracheal and subglottic laryngeal stenoses have been performed in our institution. Preoperative Nd:YAG laser is of paramount help in opening the stenoses. Tracheography is usually performed to specify the length of the stenosis and the distance from the vocal cords. Operative procedures are described. One hundred seventy five (87.5%) patients are definitely cured, but in this group 16 patients required a Montgomery tube for 6 months to 1 year to recover a normal tracheal diameter. Two patients needed a second tracheal sleeve resection. Nine (4.5%) patients died, and 16 (8%) had recurrent stenoses. Stenoses in these patients were treated with use of a tracheostomy tube, a permanent Montgomery tube, or an endotracheal stent. Partial anterior cricoid resections performed in 21 patients have had the same results as those of the whole series. Twenty one laryngeal releases were performed and proved to be efficient and safe. In our experience complications can be avoided by good selection and preparation of the patients, accurate identification of the level and length of the stenosis, and meticulous technique.     

Abortive spermatogenesis in the hybrid duck (cross of male Anas platyrhynchos and female Cairina moschata). Ultrastructural study]

The ultrastructural study of the abortive spermatogenesis of the hybrid drake (cross: male Anas platyrhynchos L. X female Cairina moschata L.) shows the following characteristics: 1) deep anomalies during the pachytene stage (meiotic prophase) where the chromosomes form more or less irregular packs close to the nuclear enveloppe; 2) the total lack of 2nd spermatocytes and in their place were found: --either some cells with lobed or fragmented nuclei in a cytoplasm filled with numerous annulate lamella, lipid droplets and centrioles, --or necrosing cells, with vacuolised chromatin close to the inner side of the nucleus and with abundant smooth endoplasmic reticulum vesicles and dark mitochondria; 3) numerous Sertoli cells overloaded with lysosomes. The mitochondria of the spermatogonia, the basal membrane of seminiferous tubules and the Leydig cells have the same structure that exists in the fertile Barbary drake testis.     

Tracheal intubation in a patient with undetectable tracheal narrowing on chest radiography

We report here a 59-year-old man with a saber-sheath tracheal narrowing who was scheduled to undergo pharyngeal tumor resection under general anesthesia. The tracheal narrowing was not clearly detected by chest radiography during the preoperative examination, but it was visible on axial computed tomography (CT) images taken earlier for diagnostic purposes. Following fiber optic examination of the narrowed segment with the patient under anesthesia, the tube was inserted into the trachea using an Airway Scope. The tube was deliberately advanced into the trachea and was able to pass through the stenosis without any resistance. On postoperative radiological analysis, three-dimensional reconstruction of the trachea and virtual bronchoscopic images revealed a saber-sheath type tracheomalacia located from below the cricoid cartilage to the carina. The membranous wall had a normal width. This case indicates that chest radiographs may occasionally be inadequate for evaluating asymptomatic patients with tracheomalacia. If CT images have been taken for diagnostic purposes, they should be examined together with the chest radiograph. Digital chest radiography with edge enhancement may become a useful tool in the preoperative detection and evaluation of undetectable tracheal narrowing on conventional chest films.     

Tracheal mucosal bulla found on tracheal extubation in a patient with pemphigus vulgaris--a case report

A 49-year-old female with pemphigus vulgaris underwent the removal of a meningioma under general anesthesia. Neither bulla nor erosion was observed on her skin and oral cavity mucosa. She had been on prednisolone 15 mg for six years daily to avoid the recurrence of skin lesion. Anesthesia was induced and maintained with total intravenous anesthesia with propofol and fentanyl. No adverse episodes were encountered during the operative procedure. We checked the tracheal mucosa using bronchofiberscope before extubation. A small bulla was found on the tracheal mucosa, where the cuff of the tracheal tube was located. The trachea was extubated slowly under bronchofiberscopic observation, and no other bullae were found. It would have been formed by mechanical stimulation of the tracheal tube. This case suggests that we have to pay careful attention to the formation of bullae at any part of the body by mechanical stimuli during anesthetic management of patients with pemphigus vulgaris.     

Tracheal intubation in a child with trismus pseudocamptodactyly (Hecht) syndrome.

Tracheal intubation of a child with trismus pseudocamptodactyly (Hecht) syndrome is described. This disorder is characterized by progressive trismus and the need for repeated surgeries. Children intubated orally on a prior occasion may require an alternative approach subsequently due to progressive inability to open the mouth. An antegrade fiberoptic-guided nasotracheal technique initially was chosen due to extremely limited mouth opening. After this approach was unsuccessful, a retrograde guidewire-assisted fiberoptic intubation was performed. The manifestations of Hecht syndrome, as well as both techniques for tracheal intubation employed, are reviewed.     

Pancreatic head resection (Frey technique) and Wirsungo-jejunal anastomosis in the treatment of chronic pancreatitis

We report herein a modification of the standard wirsungojejunostomy in patients with chronic pancreatitis, which includes concomitant duodenum-preserving resection of the head of the pancreas as described by Frey. This technique is safe and seems to provide more effective long-term pain relief than standard wirsungo-jejunal anastomosis.