Harnessing the Near-Peer Effect in Anatomy Education.

Benefits of near-peer teaching are well-documented, but its time requirements can be prohibitive. We integrated the near-peer effect into a clinical anatomy course with weekly student-developed handouts vetted by faculty to provide an element of near-peer teaching without the burden of extra time.

Photodynamic therapy of spontaneous cancers in felines, canines, and snakes with chloro-aluminum sulfonated phthalocyanine.

This is the first report on the photodynamic treatment with a second-generation sensitizer, chloro-aluminum sulfonated phthalocyanine (CASPc) of spontaneously arising tumors and on the photodynamic therapy (PDT) of snake neoplasms. Each of 10 cats, 2 dogs, and 3 snakes presenting with a variety of tumor types (squamous cell carcinoma, mast cell malignant tumor, and mixed carcinoma/sarcoma) was given an intravenous injection of 1 mg of CASPc per kilogram body weight 48 hours prior to irradiation with 675-nm light. Some larger tumors (greater than 1.5 cm deep) were surgically debulked prior to PDT. No significant systemic toxicity or skin photosensitization was observed in any animal. The tumor responses were comparable to those seen with conventional cryotherapy, hyperthermia, or surgery. PDT with CASPc of these cases led to 67% (12 of 18) complete response, 22% (4 of 18) partial response, and 11% (2 of 18) no response (less than 50% reduction in tumor size). Four cases could not be evaluated. Since the overall tumor response to CASPc is very good, and the problem of skin photosensitivity is nonexistent, it is expected that using CASPc-PDT to eradicate human tumors would also yield comparable results. Further studies with long-term follow-up are necessary to optimize the use of CASPc-PDT in veterinary and human medicine.

Enkephalin fibers in autonomic nuclear regions: intraspinal vs. supraspinal origin.

The present studies in the rat employ spinal transections and hemisections, dorsal and/or ventral rhizotomies to determine whether enkephalin fibers in spinal sympathetic and parasympathetic nuclei are of supraspinal, intraspinal, or peripheral origin. Our results suggest enkephalin fibers in thoracolumbar sympathetic nuclei are of both supraspinal and intraspinal origin, whereas the enkephalin innervation of the sacral parasympathetic nucleus is primarily intraspinal in origin. Furthermore, the majority of descending enkephalin systems selectivity project to the intermediolateralis, pars principalis and pars funicularis, and the dorsal commissural sympathetic nuclei, whereas intraspinal enkephalin pathways appear to exist primarily in the intercalatus spinalis and intercalatus spinalis, pars paraependymalis sympathetic nuclei. These new observations suggest that specific patterns exist for supraspinal and intraspinal enkephalin pathways.

Reconstruction of the nasal cap with a thin septal graft.

Following hump resection, dorsal irregularities are common. Patients with thin skin or those whose skin will become thin will develop the stigmata of rhinoplasty due to an open roof, irregular osseous cartilaginous junction, or twisted septum becoming visible. Although other techniques have been described to overcome this problem, they have significant drawbacks. We describe a technique for dorsal camouflage using a thin septal graft. The technique has the advantages of providing dependable camouflage with autogenous tissue without raising the dorsum and without the need for a separate donor site. It involves sanding a 35 x 7 mm shield-shaped dorsal graft to less than 3/4-mm thickness and placing this over the nasal dorsum to simulate the preoperative fused dorsal cap. We have performed this technique in 18 patients followed for 28 months. We utilize this graft in all patients with twisted noses and all thin-skinned individuals. It is not a technique of dorsal augmentation but rather of camouflage.

Hip joint communication with pressure sore: the refractory wound and the role of Girdlestone arthroplasty.

Fifteen patients who underwent Girdlestone arthroplasty (proximal femoral head resection) were reviewed at The Johns Hopkins Hospital and Northwestern Memorial Hospital. Ages ranged from 24 to 57 years (mean 36.7 years). All patients were paraplegics or quadriplegics (C7-L3). All patients presented with signs of sepsis and had evidence of osteomyelitis. Soft-tissue reconstruction was most commonly performed with the vastus lateralis, and no femoral stabilization was used. There were no deaths. Recurrent ulcers at the site of the Girdlestone arthoplasty were found in 23 percent of patients in whom follow-up was possible. No recurrence was noted at the original site in 77 percent with a mean follow-up of 20 months. Additional pressure sores occurred at other nonsurgical sites in six patients at a mean of 23.3 months. Girdlestone arthroplasty with soft-tissue coverage is mandatory for successful treatment of pressure sores with hip joint involvement.

Anti-Trypanosoma brucei activity of nonprimate zoo sera.

Constitutive anti-Trypanosoma brucei subsp. brucei S 427 clone 1 and 22 activities were evaluated in sera from 22 species of nonprimate mammals. The sera fell into 5 categories. Sera from Cape buffalo, giraffe, and greater kudu showed a concentration-dependent inhibition of replication of the 2 clones of organisms, which was dependent on the presence of xanthine oxidase. Sera from warthog and springbok also severely limited trypanosome replication but lacked xanthine oxidase. Their antitrypanosome activity was inactivated by heating at 56 C for 30 min but not affected by absorbing with trypanosomes at 4 C. Sera from lion and leopard showed a concentration-dependent inhibition of the growth of T. brucei S427 clone 1 organisms, but not clone 22 organisms. These sera lacked xanthine oxidase. Their anti-T. brucei S 427 clone 1 activity was inactivated by heating at 56 C for 30 min but not removed by absorbing with trypanosomes. Serum from Grant's gazelle prevented replication of both T. brucei clones, lacked xanthine oxidase, and was not affected by heating at 56 C. Sera from waterbuck, Thompson's gazelle, sitatunga, Cape hartebeeste, gerenuk, Grant's zebra, cow, several cat, cougar, bobcat, and domestic cat were fully supportive of trypanosome replication irrespective of concentration tested up to a maximum of 48% v/v in culture medium. Sera from different individuals of the same mammal species had similar effects on trypanosomes, and samples collected from the same individual at different times also had similar activities indicating species-specific stable expression, or lack thereof, of constitutive serum antitrypanosome components.

Comparative efficacy of tricaine methanesulfonate and clove oil for use as anesthetics in red pacu (Piaractus brachypomus).

OBJECTIVE: To compare the anesthetic efficacy and physiologic changes associated with exposure to tricaine methanesulfonate and clove oil (100% eugenol). ANIMALS: 15 adult cultured red pacu (Piaractus brachypomus). PROCEDURE: Fish were exposed to each of 6 anesthetic concentrations in a within-subjects complete crossover design. Stages of anesthesia and recovery were measured, and physiologic data were collected before and during anesthesia. RESULTS: Interval to induction was more rapid and recovery more prolonged in fish exposed to eugenol, compared with those exposed to tricaine methanesulfonate. The margin of safety for eugenol was narrow, because at the highest concentration, most fish required resuscitation. Mixed venous-arterial PO2 consistently decreased with anesthesia, while PCO2 consistently increased with anesthesia in all fish regardless of anesthetic agent. The increase in PCO2 was accompanied by a decrease in pH, presumably secondary to respiratory acidosis. Anesthesia was associated with increased blood glucose, potassium, and sodium concentrations as well as Hct and hemoglobin. Fish anesthetized with eugenol were more likely to react to a hypodermic needle puncture than fish anesthetized with tricaine methanesulfonate. CONCLUSIONS AND CLINICAL RELEVANCE: Anesthesia induced with tricaine methanesulfonate or eugenol contributes to hypoxemia, hypercapnia, respiratory acidosis, and hyperglycemia in red pacu. Similar to tricaine methanesulfonate, eugenol appears to be an effective immobilization compound, but eugenol is characterized by more rapid induction, prolonged recovery, and a narrow margin of safety. Care must be taken when using high concentrations of eugenol for induction, because ventilatory failure may occur rapidly. In addition, analgesic properties of eugenol are unknown.

Epizootic of balantidiasis in lowland gorillas.

Acute enteritis characterized by watery diarrhea and lethargy occurred in 4 lowland gorillas (Gorilla gorilla gorilla) during a 5-week period at the Los Angeles Zoo. Numerous trophozoites of Balantidium coli were seen in fresh feces from each gorilla. Potentially pathogenic bacteria were isolated from 1 fecal sample. Results of fecal flotation examinations were negative for eggs of metazoan parasites. The gorillas were treated with antibiotics and metronidazole or paromomycin, or both. The most severely affected gorilla had blood and mucus in its feces, became dehydrated, and required hospitalization for supportive fluid therapy. This gorilla as well as the other gorillas recovered rapidly with treatment. Balantidium coli was not seen in fecal samples after the gorillas' recovery.

Thyrotropin stimulation test for evaluation of thyroid function in psittacine birds.

Serum thyroid hormone concentrations were determined before and after thyrotropin (thyroid stimulating hormone [TSH]) stimulation in caged psittacine birds to determine whether the TSH stimulation test could be used to evaluate thyroid function in this class of birds. The mean (+/- SD) resting thyroxine concentrations (ng/ml) for the species studied were: cockatoos, 13.63 +/- 6.53 (n = 6); Amazon parrots, 8.19 +/- 6.90 (n = 8); scarlet macaws, 1.34 +/- 0.51 (n = 9); blue and gold macaws, 3.41 +/- 1.78 (n = 8); African gray parrots, 1.42 +/- 0.44 (n = 6); conures, 1.76 +/- 0.77 (n = 5); and cockatiels, 11.83 +/- 6.76 (n = 3). The mean (+/- SD) thyroxine concentrations (ng/ml) 4 to 6 hours after TSH stimulation were 35.10 +/- 13.16, 27.40 +/- 15.93, 6.46 +/- 3.10, 12.36 +/- 6.34, 9.30 +/- 2.90, 13.50 +/- 7.71, and 39.0 +/- 5.66, respectively. Serum tri-iodothyronine concentration did not increase significantly after TSH stimulation. The results demonstrated that the TSH stimulation test can be used to evaluate thyroid function in caged psittacine birds.

Fatal herpesvirus infection in patas monkeys and a black and white colobus monkey.

Fatal herpesvirus infections were diagnosed in 3 patas monkeys and 1 black and white colobus monkey over a 4-week period. Herpesvirus was isolated from 1 patas monkey and from the black and white colobus monkey. Both isolates had growth characteristics similar to Herpesvirus hominis and Herpesvirus simiae. The isolate from the colobus monkey antigenically appeared to be H simiae or H simiae-like, whereas the isolate from the patas monkey could not be conclusively identified with the antisera used. All affected animals were housed in close proximity to rhesus monkeys, the carrier host of H simiae.

Hepatic and gastric amebiasis in black and white colobus monkeys.

Three cases of hepatic amebiasis and one case of gastric amebiasis were diagnosed in black and white colobus monkeys during a 9-month period. The diagnosis was difficult because of the absence of trophozoites and cysts in the feces and because of few trophozoites found in many of the hepatic lesions. Indirect hemagglutination titers were diagnostic in 2 monkeys.

Evaluation of adrenal function in psittacine birds, using the ACTH stimulation test.

The effect of ACTH (16 units) on plasma cortisol and corticosterone concentrations in healthy psittacine birds was evaluated. Plasma corticosterone significantly increased (P less than 0.01) from a mean (+/- SD) basal concentration of 3.25 +/ 3.6 ng/ml to 26.47 +/- 9.25 (one hour after ACTH administration) and 25.69 +/- 13.23 ng/ml (2 hours after ACTH administration). For maximal increase in plasma corticosterone as measured by radioimmunoassay (RIA), heat denaturation was necessary to release corticosteroids from steroid-binding proteins. As measured by RIA, plasma cortisol concentrations did not increase, whether or not the heat denaturation step was included. Addition of cortisol to avian plasma did not prevent accurate quantification of cortisol as measured by RIA. Plasma corticosterone concentrations in cockatoos, macaws, Amazon parrots, conures, and lorikeets before and after ACTH administration indicated that the ACTH stimulation test could be used to evaluate adrenal secretory capacity in psittacine birds.

Cardiorespiratory effects of four alpha2-adrenoceptor agonist-ketamine combinations in captive red wolves.

OBJECTIVE: To evaluate the cardiopulmonary effects of immobilizing doses of xylazine-ketamine (XK), medetomidine-ketamine (MK), medetomidine-ketamine-acepromazine (MKA), and medetomidine-butorphanol-ketamine (MBK) in captive red wolves. DESIGN: Prospective study. ANIMALS: 32 adult captive red wolves. PROCEDURE: Wolves were randomly assigned to 1 of 4 treatment groups: XK, MK, MKA, or MBK. Physiologic variables measured included heart rate, blood pressure, respiratory rate, tidal volume, oxygen-hemoglobin saturation (Spo2), end-tidal CO2, arterial blood gases, and rectal temperature. Induction time, muscle relaxation, and quality of recovery were assessed. RESULTS: Heart rates were lower in wolves in the MBK group than for the other groups. All 4 drug combinations induced considerable hypertension, with diastolic pressures exceeding 116 mm Hg. Blood pressure was lowest in wolves receiving the MBK combination. Respiratory rate was significantly higher in wolves receiving XK, MK, and MKA. Tidal volumes were similar for all groups. Wolves receiving XK, MK, and MKA were well-oxygenated throughout the procedure (SPo2 > 93%), whereas those receiving MBK were moderately hypoxemic (87% < Spo2 < 93%) during the first 20 minutes of the procedure. Hyperthermia was detected initially following induction in all groups. CONCLUSIONS AND CLINICAL RELEVANCE: The alpha2-adrenoceptor agonist-ketamine combinations provide rapid reversible anesthesia for red wolves but cause severe sustained hypertension. Such an adverse effect puts animals at risk for development of cerebral encephalopathy, retinal hemorrhage, pulmonary edema, and myocardial failure. Although the MBK combination offers some advantages over the others, it is advised that further protocol refinements be made to minimize risks associated with acute hypertension.

Treatment of Argulus sp. infestation of river frogs.

Ten river frog tadpoles (Rana hecksheri) were collected from Pointsett State Park in South Carolina in April 1995. They were housed together in a tank at the North Carolina Zoological Park. Although no skin lesions were evident at collection, skin scrapings performed 4 weeks later revealed numerous immature and adult Argulus sp. on the tails and dorsal trunks of many of the tadpoles. The adult parasites were removed manually, and the tadpoles were treated with lufenuron (15 mg/l; Program, Novartis Animal Health, Greensboro, N.C.) and sodium chloride (3 g/l) in the tank water for 3 weeks. A single immature Argulus was found on a skin scraping on day 2 of treatment, and no parasites were seen thereafter on skin scrapings obtained through day 28 after the initiation of treatment. Metamorphosis occurred in all tadpoles within 4 weeks of initiating treatment. No deleterious effects of the treatment were noted.

Evaluation of epidural morphine for postoperative analgesia in ferrets (Mustela putorius furo).

We evaluated the analgesic efficacy of epidural morphine for relieving postoperative pain in domestic ferrets by evaluating behavior and fecal cortisol concentrations. The 12 laboratory-reared, intact, female, domestic ferrets were anesthetized then underwent ovariohysterectomy and bilateral anal sacculectomy. Using a double-blind procedure, we provided epidural morphine (0.1 mg/kg) to six ferrets and epidural saline (0.1 mL/ferret) to the remaining animals prior to surgery. Compared to the animals that received saline, the morphine-treated ferrets were more likely to have attenuated pain responses, and they returned more rapidly to preoperative behavior. Although fecal cortisol concentrations during the first 24 h after surgery increased in all animals, the increase was statistically significant only in the ferrets that received saline epidurals. These data suggest that morphine epidurals administered to ferrets prior to surgery may attenuate both the physiologic and behavioral manifestations of surgically induced pain.

A simple method of providing intermittent positive-pressure ventilation to etorphine-immobilized elephants (Loxodonta africana) in the field.

Five African elephants (Loxodonta africana) were immobilized with etorphine in Waza National Park, Cameroon, for the purpose of deploying radio/satellite tracking collars. A portable ventilator constructed from two high-flow demand valves and the Y-piece of a large animal anesthesia circuit was used to provide intermittent positive-pressure ventilation with 100% oxygen. Oxygenation status improved dramatically in all five elephants. In one hypoxemic elephant, arterial PaO2 increased from 40 to 366 mm Hg. The results of this study demonstrate that both oxygenation and ventilation can be readily controlled in etorphine-immobilized elephants even under remote field conditions.

Cardiopulmonary assessment of medetomidine, ketamine, and butorphanol anesthesia in captive Thomson's gazelles (Gazella thomsoni).

This investigation evaluated the cardiopulmonary effects of medetomidine, ketamine, and butorphanol anesthesia in captive juvenile Thomson's gazelles (Gazella thomsoni). Butorphanol was incorporated to reduce the dose of medetomidine necessary for immobilization and minimize medetomidine-induced adverse cardiovascular side effects. Medetomidine 40.1 +/- 3.6 microg/kg, ketamine 4.9 +/- 0.6 mg/kg, and butorphanol 0.40 +/- 0.04 mg/kg were administered intramuscularly by hand injection to nine gazelles. Times to initial effect and recumbency were within 8 min postinjection. Cardiopulmonary status was monitored every 5 min by measuring heart rate, respiratory rate, indirect blood pressure, end-tidal CO2, and indirect oxygen-hemoglobin saturation by pulse oximetry. Venous blood gases were collected every 15 min postinjection. Oxygen saturations less than 90% in three gazelles suggested hypoxemia. Subsequent immobilized gazelles were supplemented with intranasal oxygen throughout the anesthetic period. Sustained bradycardia (<60 beats per minute, as compared with anesthetized domestic calves, sheep, and goats) was noted in eight of nine gazelles. Heart and respiratory rates and rectal temperatures decreased slightly, whereas systolic, mean, and diastolic blood pressure values were consistent over the anesthetic period. Mild elevations in end tidal CO2 and PCO2 suggested hypoventilation. Local lidocaine blocks were necessary to perform castrations in all seven of the gazelles undergoing the procedure. Return to sternal recumbency occurred within 7 min and return to standing occurred within 12 min after reversal with atipamezole (0.2 +/- 0.03 mg/kg) and naloxone (0.02 +/- 0.001 mg/kg). Medetomidine, ketamine, and butorphanol can be used to safely anesthetize Thomson's gazelles for routine, noninvasive procedures. More invasive procedures, such as castration, can be readily performed with the additional use of local anesthetics.

A comparison of sampling methods for airborne fungal spores during an outbreak of aspergillosis in the forest aviary of the North Carolina Zoological Park.

An outbreak of aspergillosis with the death of six birds in the North Carolina Zoological Park R. J. Reynolds Forest Aviary in the spring of 1993 led to an investigation of the concentration of Aspergillus fumigatus spores in the air. No Aspergillus sp. was found in the facility through use of the drop plate method (gravitometric sampling) along with swab-sampling of selected surfaces within the exhibit and plating of food samples and nesting material onto petri dishes of nutrient media. A number factors that could stress the avian population were identified. These included excessive heat in the upper portion of the aviary due to the failure of an air handling system, a malfunctioning cooling tower, and large numbers of visitors to the facility (an average of 3,500/day). In addition, the outbreak occurred during a period of increased nesting behavior. Sampling of the fungal population of the air was conducted 1 year later, when no disease was noted, to compare the sensitivity of the commonly used drop plate method (open plates of nutrient media) with a volumetric impaction method (Andersen N-6 Air Sampler). The volumetric method delivered quantitative as well as qualitative data and exhibited more sensitivity for fungal spores of size similar to those of Aspergillus sp.

Trombiculid mites (Hannemania sp.) in canyon tree frogs (Hyla arenicolor).

Six wild-caught, captive canyon tree frogs (Hyla arenicolor) purchased as a group and housed at the North Carolina Zoological Park were diagnosed with intradermal Hannemania mites, the first described infestation of this frog species by this mite. Typical gross lesions were orange-colored skin vesicles approximately 1 mm in diameter, predominantly located on the ventrum and ventral hind limbs. The larval mites had ovoid bodies approximately 44 microm in length and 240 microm in width. Three of the frogs died, and three became free of mites and pathologic changes after approximately 28 wk of treatment with transcutaneous ivermectin and manual mite removal. The frogs remained free of mites at a 1-yr recheck.

Hypospadias in a polar bear (Ursus maritimus).

Corrective surgery on a 1.5-yr-old male polar bear (Ursus maritimus) with hypospadias included amputation of the vestigial penis, bilateral orchiectomy with scrotal ablation, and distal perineal urethrostomy. Hypospadias in other species is a congenital deformity that may be caused by extra- and intrauterine factors resulting in a disruption of the testosterone balance during urethral development, but the causative mechanism in this bear is unknown. The urethrostomy site was functional without complications 8 mo after surgery.