Hyoid bone fracture identified only with nasal Valsalva manoeuvre.

OBJECTIVE: We present two cases of a hyoid bone fracture identified through careful clinical examination with a Valsalva manoeuvre during nasendoscopy. METHOD: Case reports and review of the literature, with emphasis on technique during nasendoscopy. RESULTS: The first patient had sustained a blow to the neck with a stick, six months prior to presentation with a globus sensation. External examination and standard nasendoscopy were unremarkable. The second patient had been struck across the neck by a wire whilst riding a motorbike at low speed. Endoscopy revealed swelling of the supraglottis. He recovered and was asymptomatic at review one month later. Computed tomography scans on both patients were unremarkable. During nasendoscopy, both patients were asked to forcibly expire with their mouths closed (the so-called nasal Valsalva manoeuvre), and the hyoid bone was seen to swing into view on the side where the first patient complained of symptoms, and in the second case where swelling had been noticed previously. CONCLUSION: We would not ordinarily have reached a diagnosis in these patients, as radiography and examination were otherwise unremarkable. The use of the nasal Valsalva manoeuvre during routine nasendoscopic examination is recommended, as unusual pathology may be demonstrated and the need for direct laryngoscopy under general anaesthesia may, in some instances, be avoided.

Diagnostic and therapeutic use of the flexible nasendoscope in the management of an impacted upper oesophageal food bolus.

The flexible nasendoscope is now an integral tool in most otorhinolaryngology departments for visualizing the hypopharyngolarynx. A technique has been described using the modified Valsalva manoeuvre to improve visualization of the hypopharynx during flexible nasopharyngoscopy. The authors report an alternative technique for visualizing the upper oesophagus using the flexible nasendoscope, and highlight three cases where there was accurate visualization of an impacted oesophageal food bolus. Subsequently, these patients underwent flexible oesophagoscopy to dislodge the foreign body. The authors also describe three cases where the flexible nasendoscope was successfully used to visualize and negotiate the impacted food bolus beyond the cricopharyngeus. This is a safe and simple procedure performed without any sedation and reduces the need for prolonged hospitalization.

Chronic non-progressive pneumonia of sheep in New Zealand - a review of the role of Mycoplasma ovipneumoniae.

Chronic non-progressive pneumonia (CNP) is a common disease which affects lambs in New Zealand during late summer and autumn. Mycoplasma ovipneumoniae can be recovered from a high proportion of lesions but it is also present in some normal lungs. Bacteria, especially Pasteurella haemolytica, can also be recovered from more than half the lungs of affected animals. Isolates of M. ovipneumoniae are genetically heterogeneous, as demonstrated by examination of their DNA or total cellular proteins, and are serologically heterogeneous as shown by metabolic inhibition tests. The number of strains present in New Zealand is large and several distinguishable strains can be recovered from each affected lung. Mycoplasma ovipneumoniae has pathogenic potential as indicated by its ability to produce hydrogen peroxide, cause ciliostasis and by its possession of a capsule. Chronic non-progressive pneumonia can be transmitted consistently to over 50% of lambs by inoculation of pooled pneumonic lung homogenate and transmission can be suppressed by broad spectrum antibiotics. In contrast, penicillin does not prevent the development of lesions but diminishes their severity. Pooled lung homogenate treated with digitonin, which inactivates mycoplasmas, has failed to transmit CNP. Pure cultures of M. ovipneumoniae produce only mild lesions in some animals, whereas inoculation with pooled lung homogenate (from which no viruses were isolated) containing mixed strains of M. ovipneumoniae and free from bacteria, is more effective in producing lesions. Research work to date suggests that CNP may be initiated by colonisation of the lung by M. ovipneumoniae which causes ciliostasis and elicits an exudate allowing colonisation of the lungs by bacteria especially M. haemolytica and by other strains of M. ovipneumoniae. The immune response to the initial strain of M. ovipneumoniae may inhibit its replication but would be less effective in inhibiting heterologous strains of the organism allowing their sequential replication. Eventually production of a broad immune response to M. ovipneumoniae would lead to its elimination which in turn would facilitate the elimination of other microorganisms and the resolution of lesions. As natural immunity to CNP occurs within the first year, it may be possible to develop an effective and useful vaccine. Such a vaccine may need to include multiple strains of M. ovipneumoniae.

A study of the heterogeneity of isolates of Mycoplasma ovipneumoniae from sheep in New Zealand.

To investigate the heterogeneity of Mycoplasma ovipneumoniae, sixty isolates from three sheep on each of twenty farms were examined by restriction endonuclease analysis (REA) and SDS-PAGE. All were found to be different except for three isolates obtained from one farm. The protein and REA patterns of individual isolates were both highly reproducible and remained unchanged following long term passage (approximately 400 generations) in vitro. No plasmids were detected in the twelve strains which were examined and when two isolates were co-cultured in vitro, no genetic interchange, as judged by changes in REA patterns were detected. Since the heterogeneity of M. ovipneumoniae when examined by SDS-PAGE is too great to allow groups to be recognised, it could be advantageous for this purpose if only surface proteins were compared. As a preliminary step to this end we have identified several surface proteins of M. ovipneumoniae and found that some are common to all strains, one surface protein was shared by five of the eight strains examined and another was unique to one strain. This approach has the potential to allow the recognition of grouping of M. ovipneumoniae isolates.

The isolation of multiple strains of Mycoplasma ovipneumoniae from individual pneumonic sheep lungs.

The heterogeneity of Mycoplasma ovipneumoniae isolates from the lungs of sheep with chronic non-progressive pneumonia (CNP) from the same flock raised the possibility that multiple isolates derived from one lung were not all identical. To test this hypothesis, thirty isolates were obtained from each of six pneumonic sheep lungs at slaughter. Four lungs had relatively severe lesions and from each of these, three or four strains of M. ovipneumonia, distinguishable by REA and in most cases by SDS-PAGE, were detected. From the lungs of each of two sheep with mild lesions, two strains of M. ovipneumoniae were detected. Four isolates from one lung were further examined by restriction endonuclease analysis (REA) using many restriction endonucleases. Those which differed with EcoRI also differed when other restriction endonucleases were used. However, partial digests occurred mainly with those restriction endonucleases which recognise cytosine-rich sequences. The presence of multiple strains of one species of microorganism in individual lesions is an unusual concept which may not be limited to one disease or to one host.

Big liver and spleen disease of broiler breeders.

Five adult broiler breeders were inoculated with faeces and tissue extracts from birds with big liver and spleen (BLS) disease. Five birds were placed in contact with the inoculated birds. After 8 weeks all inoculated and four of the five in-contact birds were shown to be infected as evidenced by the detection of an immune response and/or the demonstration of BLS antigen in spleen and tissue smears, by an immunofluorescence test and by agar gel immunodiffusion. Using appropriate antisera BLS antigen was found mainly in phagocytic liver cells and in splenic macrophages and dendritic cells. Fewer cells containing antigen were found in the kidney. Double staining of liver and spleen tissue for BLS antigen and chicken immunoglobulin indicated that many cells were positive for both. It is possible that BLS antigen in most cells may represent phagocytosed material rather than a replicating agent. If so, while this could explain the failure to detect virus-like particles, it implies that the primary site of replication of the BLS agent and its nature remain to be established.

Colonisation of the respiratory tract of lambs by strains of Mycoplasma ovipneumoniae.

The age and time of year when colonisation of the nasal cavity of lambs by Mycoplasma ovipneumoniae occurs; the persistence of the organism, and its prevalence in the lungs at slaughter were examined in 2 flocks of sheep in New Zealand. No colonisation had occurred at the time of weaning at 6-7 weeks, but M. ovipneumoniae was recovered from most lambs on at least one occasion before they were slaughtered when about 8 months old. In most cases, colonisation of the nasal cavity by M. ovipneumoniae was a transient phenomenon. At slaughter M. ovipneumoniae was recovered from the lungs of 89% of the lambs of one flock and 80% of the other flock. Bacterial restriction endonuclease DNA analysis (BRENDA) of 34 nasal isolates from one flock showed that it was possible to identify 7 "groups" each with markedly different BRENDA patterns. Lambs initially colonised by one strain, often lost that strain, and if recolonisation occurred it was with a different strain. M. ovipneumoniae was recovered at slaughter from the lungs of most lambs, both normal and pneumonic. The isolates from one flock were examined by BRENDA, and approximately 90% of them gave similar or identical patterns. The predominant strain isolated from the lungs had been recovered from the nasal cavity of many of the lambs about 3 weeks earlier. This suggests that the nasal and lung isolates do not represent independent populations. However, nasal strains may differ in their ability to colonise the lungs.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of Mycoplasma ovipneumoniae isolates using bacterial restriction endonuclease DNA analysis and SDS-PAGE.

Sixteen isolates of Mycoplasma ovipneumoniae recovered from the nasal tract or lungs of sheep from different flocks in New Zealand were examined by bacterial restriction endonuclease DNA analysis (BRENDA) using EcoR1 and by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). All isolates gave BRENDA patterns which differed entirely from one another. Following 20 serial passages (corresponding to approximately 67 generations) of an isolate, no change was detected in the BRENDA pattern. When eight isolates were examined by SDS-PAGE most bands were common but, nevertheless, each isolate was unique in the sense that they differed from one another in one or more bands. The marked heterogeneity of patterns observed when strains of M. ovipneumoniae are compared by BRENDA, together with the stability of such patterns over many generations, will enable this approach to be used to study the epidemiology of individual strains of M. ovipneumoniae within a flock.

Spray vaccination of chickens using infectious laryngotracheitis virus.

Day-old chickens were vaccinated with the SA2 strain of infectious laryngotracheitis vaccine using a coarse spray and 14-day-old chickens were vaccinated using a coarse or a fine (Turbair Vaccinair 240) spray. The Conjunctiva was the most common site of infection in all cases but this almost invariably led to involvement of the nasolacrimal ducts. Other sites in the nasal cavity were affected less frequently. The clinical consequences of infection in day-old chickens were too severe for field use but the mortality (0 to 1.4% in different experiments) in 14-day-old chickens may be acceptable in some circumstances although about 9% developed infection of the trachea. It is concluded that a less pathogenic vaccine is needed if spray vaccination with ILT is to be recommended as a routine procedure particularly for day-old chickens.

Isolation of an adeno associated virus from sheep. Brief report.

An adenovirus and a spherical virus 20--24 nm diameter were isolated from ovine faeces. The small virus replicated in the nucleus, and was associated especially with the nucleolus. It haemagglutinated guinea pig and human erythrocytes, was thermostable and required an adenovirus for replication. It is concluded that this represents the first recorded isolate of an ovine AAV.