Use of a vascular access system for administration of chemotherapeutic agents to a ferret with lymphoma.

Two months after initiation of chemotherapy, a totally implantable vascular access system was used for the continuing administration of chemotherapeutic agents to a ferret with multicentric lymphoma. The subcutaneously located injection port minimized the need for restraint and facilitated repeated IV administration of drugs. Treatment with a combination of L-asparaginase, vincristine sulfate, doxorubicin, cyclophosphamide, methotrexate, chlorambucil, and prednisone failed to induce complete remission. Survival time (interval from histologic diagnosis to euthanasia) was 10 months. The vascular access system remained patent and did not cause infection in the surrounding subcutaneous tissues during the 5-month period that it was in position.

Evaluation of urinary cortisol:creatinine ratios for the diagnosis of hyperadrenocorticism associated with adrenal gland tumors in ferrets.

Assays were validated for the measurement of urinary concentrations of cortisol and creatinine in domestic ferrets (Mustela putorius furo). Urinary concentrations of cortisol and creatinine and the calculated urinary cortisol:creatinine ratio (UCCR) values were determined for 29 clinically normal female ferrets, 22 clinically normal male ferrets, and 12 ferrets with adrenal gland tumors. The UCCR values for the 51 clinically normal ferrets ranged from 0.04 x 10(-6) to 1.66 x 10(-6), with a median value of 0.22 x 10(-6). The UCCR values were significantly (P < or = 0.01) higher in the 12 ferrets with adrenal tumors, with a range of 0.5 x 10(-6) to 60.13 x 10(-6) and a median of 5.98 x 10(-6). We concluded that determination of UCCR values was useful in the diagnosis of hyperadrenocorticism associated with adrenal neoplasia in domestic ferrets.

Evaluation and treatment of the unilateral paralyzed vocal fold.

The evaluation and treatment of patients with unilateral vocal fold paralysis have evolved as improvements in objective measurements of phonatory function and new modalities for treatment have developed. A thorough history, physical examination, subjective voice evaluation, objective voice analysis, and electromyography are used to make a diagnosis, determine the cause, and plan treatment. The goal of treatment of the patient with a unilateral vocal fold paralysis is to restore normal phonatory function without aspiration. Multiple modalities have developed to allow for restoration of nearly normal phonatory function, and these include voice therapy alone or in combination with injection medialization, laryngoplastic phonosurgery, or laryngeal reinnervation. Otolaryngologists should be familiar with the incidence, cause, evaluation, and state-of-the-art treatment of unilateral vocal fold paralysis of optimize patient care and avoid suboptimal results often seen with antiquated or inappropriate treatment.

Malignant histiocytosis in a cat.

A 13-year-old male domestic shorthair cat was found to have normocytic hypochromic regenerative anemia, lymphopenia, eosinopenia, thrombocytopenia, hyperglycemia, hyperbilirubinemia, and a prolonged activated partial thromboplastin time. Transfusions of packed RBC failed to maintain the PCV above 13% for > 8 hours. The cat was euthanatized. At necropsy, the spleen liver, lymph nodes, and bone marrow were infiltrated with malignant histiocytes undergoing erythrophagocytosis.

Unilateral adrenalectomy as a treatment for adrenocortical tumors in ferrets: five cases (1990-1992).

Adrenocortical tumors were diagnosed in 5 adult spayed ferrets. Four ferrets had bilaterally symmetrical alopecia of the caudal femoral region, abdomen, and tail, and 1 had alopecia of the distal limbs and feet. All 5 ferrets had vulvar swelling. During abdominal ultrasonography, irregular masses, believed to involve the adrenal glands, were seen in all 5 ferrets. Unilateral adrenalectomy was performed successfully in each ferret by use of ventral midline celiotomy. On histologic examination of biopsy samples, 4 ferrets were found to have adrenocortical adenomas, and 1 ferret was found to have an adrenocortical adenocarcinoma. All clinical signs resolved after adrenalectomy, suggesting that the adrenocortical tumors had been secreting adrenocortical hormones.

Use of fenbendazole for treatment of Crenosoma vulpis infection in a dog.

An 8-month-old Labrador Retriever was examined because of a 1-month history of productive coughing unresponsive to ampicillin treatment. Larvae of Crenosoma vulpis were found in fecal samples examined by zinc sulfate centrifugation and Baermann technique. Physical examination abnormalities or larvae in fecal samples were not detected 6 weeks after treatment with prednisone (1 mg/kg, PO, q 24 h, for 7 days, then 0.5 mg/kg, PO, q 48 h, for 8 days) and fenbendazole granules (50 mg/kg, PO, q 24 h, for 3 days). This report suggests that fenbendazole may be effective for treating Crenosoma vulpis infection in dogs.

Detection of retrovirus sequences in budgerigars with tumours.

Renal tumours are a common neoplastic disease of budgerigars. Although a retro-virus has been implicated as the aetiological agent, there is no definitive proof for this hypothesis. Sixteen birds suspected to have renal tumours were examined in an attempt to elucidate the possible role of retroviruses. Thirteen birds had renal tumours and the majority of these birds showed abdominal enlargement and paresis. Renal masses were detected by radiography in nine birds. Post-mortem examination confirmed the presence of abdominal tumours which were mostly confined to the kidneys. All of the renal tumours were carcinomas. ELISA tests to detect the presence of p27 of avian leukosis virus and virus isolation attempts were negative. DNA from eight tumours was examined by dot-blot hybridization for the presence of sequences hybridizing with a full length clone of the RAV-2 strain of the avian leukosis virus. A positive reaction was detected with DNA from 6/8 tumours. Southern blot hybridization demonstrated the presence of a 7.2 kb fragment following restriction with BamHI and a 4.6 kb fragment in an additional tumour following digestion with EcoRI that were recognized by the RAV-2 probe. These results suggest the presence of a retrovirus in tumours of budgerigars.

Surgical correction of an intestinal obstruction in a turtle.

Ingested scutes caused an intestinal obstruction in an 18-year-old turtle. An enterotomy, performed through a flank approach to the celiac cavity, successfully relieved the obstruction. The scutes were ingested during a period of neglect by the owner.

Myiasis in two box turtles.

Two eastern box turtles (Terrapene carolina carolina) were treated for myiasis caused by Sarcophaga cistudinis. The tortoises were examined because of swellings of the proximal cervical regions. Both fully recovered following surgical removal of multiple larvae.

Effects of lateral manual compression upon glottic incompetence: objective evaluations.

Forceful manual compression of the thyroid and cricoid cartilages modifies the position, shape, and tension of the vocal folds. This is the basis of the four laryngeal manual compression tests, adjunctive examinations used as a means of preoperative assessment of patients for medialization laryngoplasty, ie, Isshiki thyroplasty types I and IV and arytenoid adduction. The laryngeal manual compression tests are simple to perform and noninvasive. Each of the four examinations yields valuable information on the effects on the voice of changes in vocal cord characteristics produced by manual compression. In this report, one of the four tests, lateral manual compression, is evaluated objectively with well-attested methods of videostroboscopic, aerodynamic, and acoustic analysis. The technique of performing lateral manual compression is described, and advantages and disadvantages are noted and compared in 10 patients. Preliminary findings in 4 patients in this group indicate that medialization laryngoplasty should be considered when test results are conclusive of effective glottic closure. Data derived in this preliminary study will be augmented as patients are added to the series.

Condylomatous lesions of the upper aerodigestive tract.

Condyloma acuminatum is one of four types of common human verrucous lesions that are of viral etiology. Also known as "moist wart," condyloma acuminatum is most often seen on the mucosal surfaces of the anogenital area. However, occurrences in the mucosal lined areas of the head and neck region are quite rare. Since 1901, 30 cases of condylomatous lesions have been reported in the upper aerodigestive tract, occurring mainly in the various regions of the oral cavity. Eighteen of the cases were confirmed by histopathologic documentation, while the remainder were anecdotal. We have recently encountered six new cases of condyloma acuminatum, verified by histologic examination. One occurred on the tongue, another in the tonsillar fossa, one in the hypopharynx and three on the vocal cords. We present these cases and review the previously reported cases. In addition, we will discuss the differential diagnosis of these lesions, and their importance to the practicing otolaryngologist.

Frequency and amplitude perturbation analysis of electroglottograph during sustained phonation.

Electroglottography (EGG) was used to monitor vocal fold vibration patterns in normal subjects and patients with various laryngeal disorders. In order to evaluate the regularity of vocal fold vibration, frequency and amplitude perturbation of EGG waves during sustained phonation were measured with a laboratory computer. The data were compared to the degree of hoarseness evaluated by auditory perception and by sound spectrographic analysis. Frequency and amplitude perturbation measures showed some overlap between normal and pathological groups. However, there was a close relation between perturbation analysis of EGG waves and degree of hoarseness (Spearman's rank correlation coefficient rs = 0.73, p less than 0.0005). Amplitude perturbation was found to be a more sensitive measure of the irregularity of vocal fold vibration than frequency perturbation.

Vocal efficiency and aerodynamic aspects in voice disorders.

The variation of vocal efficiency for the mean values for normal subjects was investigated in patients with laryngeal disease. The relative contributions of mean flow rate and intrapulmonic pressure to the variation of efficiency were explored to explain aerodynamic aspects in voice disorders. Vocal efficiency was determined by use of expressions involving simultaneous values of sound pressure level, mean flow rate, and intrapulmonic pressure. The intrapulmonic pressure was noninvasively obtained by plethysmographic and pneumotachographic methods. Values of vocal efficiency were generally abnormally low for the types of larynges studied. An aerodynamic-biomechanical classification of laryngeal disease was inferred from the data: 1) large chink of glottis, associated with high flow rate; 2) mass on vocal fold, associated with high values of both flow rate and intrapulmonic pressure; and 3) high stiffness of vocal fold, associated with high values of intrapulmonic pressure.

Symptom improvement of spastic dysphonia in response to phonatory tasks.

It has been acknowledged that for many patients with spastic dysphonia, reflexive phonation remains essentially free of the spasticity that characterizes this disorder. The purpose of this paper is to document the extent to which various phonatory tasks change the patient's voice. We retrospectively reviewed 37 patients with spastic dysphonia evaluated at the Center for Communication Disorders of Lenox Hill Hospital, New York, between 1977 and 1981. The patients' responses to various phonatory tasks were observed. These tasks were grouped into the following ten categories: noncommunicative vocalization, primitive communication, speech superimposed on noncommunicative phonation, communicative phonation with varied mode of vocal fold vibration, normal communicative phonation with unusual pitch, normal communicative phonation with unusual emphasis, normal communicative phonation with normal laryngeal adjustments, use of the vocal folds in an artistic manner, speech in which normal auditory feedback was eliminated, and speaking with whisper which was not associated with vocal fold vibration. The results are summarized as follows: 1) whispered speech always resulted in an improvement of the symptom, in most cases markedly; 2) there was a tendency for a task that was more effective in reducing spasticity to be reduced in communicative function; 3) there was a tendency for a task that was more effective in reducing the spasticity to deviate more from the normal mode of phonation; and 4) there were some patients in whom an improvement occurred with elimination of auditory feedback.