Ventral abdominal approach for laparoscopic cryptorchidectomy in horses.

OBJECTIVE: To report a ventral abdominal approach and a ligating loop technique for laparoscopic cryptorchidectomy in horses. STUDY DESIGN: Prospective. SAMPLE POPULATION: Six horses, aged 1 to 5 years, with retained testes. METHODS: One laparoscopic portal and three to four instrument portals were used for ventral abdominal laparoscopic cryptorchidectomy. Laparoscopic instruments were used to maneuver and secure the testis through a ligating loop (modified Roeder knot) that was secured from outside the abdominal cavity. Only minimal enlargement of one instrument portal was used to remove the testicle. RESULTS: Three horses were bilateral cryptorchids, and three were unilateral (left side, two; right side, one) cryptorchids. Operative time, defined as the time from laparoscope insertion to removal, ranged from 20 to 25 minutes for unilateral cryptorchids and from 40 to 50 minutes for bilateral cryptorchids. CONCLUSIONS: The reported technique allowed decreased tension on the tissues during ligation and removal of the testis from the peritoneal cavity. Improved observation of the abdominal cavity, ligation security, shortened patient confinement time, and minimally invasive technique are all considered to be benefits of laparoscopic cryptorchidectomy. CLINICAL RELEVANCE: Direct observation of retained testes and intraabdominal castration are distinct advantages of the use of laparoscopy in horses that have had previous unsuccessful surgical attempts, horses with unknown histories that have retained testicular tissue, or bilateral abdominal cryptorchids.

Use of tenoscopy for management of septic tenosynovitis caused by a penetrating porcupine quill in the synovial sheath surrounding the digital flexor tendons of a horse.

A 6-year-old Quarter Horse gelding with acute onset of a grade-4/5 lameness of the left forelimb 21 days after an encounter with a porcupine was examined. Quills had been removed by the referring veterinarian, and the horse had been treated with antibiotics and hydrotherapy for 14 days. The horse was pyretic and had effusion in the digital synovial sheath. Signs of pain were elicited on palpation of the area. A tentative diagnosis of septic tenosynovitis caused by a porcupine quill was made. Exploratory tenoscopy revealed large amounts of fibrin in the sheath and a 1.2-cm quill. Bacteriologic culture of synovial fluid yielded a pure growth of Staphylococcus aureus. The horse improved dramatically after tenoscopic removal of the quill, debridement of fibrin, and lavage to dilute inflammatory mediators and bacteria, debridement of fibrin, discovery and removal of a quill, and complete evaluation of the sheath for prognostic purposes. Tenoscopy can provide a means for direct observation and enhance the ability of clinicians to debride a septic synovial sheath in a minimally invasive manner.

Laparoscopic diagnosis of ischemic necrosis of the descending colon after rectal prolapse and rupture of the mesocolon in two postpartum mares.

Two mares were referred for evaluation after dystocia and rectal prolapse. Diagnostic laparoscopy, performed while the horses were standing, was used to evaluate the condition of the distal portion of the colon, rectum, uterus, and mesocolon. In both horses, laparoscopic observation revealed tears in the mesocolon of the descending colon. Exploration from the left or right flank was adequate. Because of the poor prognosis associated with the findings, euthanasia was elected at completion of laparoscopy. Tears in the mesocolon are not easily detected by use of traditional tests. Laparoscopy proved to be a more thorough means of evaluating the caudal portion of the abdomen including the digestive and urogenital tracts in these horses. As a less invasive diagnostic tool, laparoscopy can be performed earlier in the course of disease than alternative approaches for direct viewing. Furthermore, laparoscopy can be used to access the viability of tissues as well as the location and severity of lesions for prognostic purposes. The distal portion of the descending colon can also be evaluated to determine whether celiotomy with anastomosis or colostomy may be the surgical procedure of choice.

Bumetanide binding to normal albumins and to albumin in renal failure.

Binding of bumetanide, a loop diuretic, to partially purified albumins from renal failure patients (RF-HA), and healthy subjects (N-HA), human serum albumin (HSA) and defatted-HSA (D-HSA), was studied with equilibrium dialysis at a constant albumin concentration and various ligand concentrations. Binding parameters (n and K) were estimated from Scatchard plots and with a non-linear two-binding site model computer program, assuming two classes of independent sites. The binding capacities (n1K1) decreased in the order N-HA > RF-HA > D-HSA > HSA. Computer estimates of K1 for the partially purified albumin preparations were not markedly different. However, the graphical estimate of K1 for N-HA was greater than that for RF-HA. When the degree of binding (r) was plotted as a function of the logarithm of the free bumetanide concentration, an asymptotic plateau was not observed, indicating that the protein binding sites were not saturated. Consequently, the calculated binding estimates may not adequately describe the binding of bumetanide.

Metabolism of the diuretic bumetanide in healthy subjects and patients with renal impairment.

The pharmacokinetics and metabolism of orally administered bumetanide were studied in five healthy subjects and in five patients with renal insufficiency. Healthy subjects excreted 51% of the dose as unchanged drug in the urine, whilst the patients with renal insufficiency excreted only 11% of the dose as bumetanide. Similarly the urinary excretion of the gamma-hydroxybutyl metabolite was reduced from 6% in healthy subjects to 2.3% in patients with renal impairment. In both groups of subjects the mean elimination half-life of the metabolite was greater than for bumetanide. The results indicate a possible accumulation of bumetanide and metabolite in patient with renal failure.

Metabolism and growth yields in Bacteroides ruminicola strain b14.

Metabolism of D-glucose by Bacteroides ruminicola subsp. brevis, strain B14, has been examined. Growth yield studies gave molar growth yields, corrected for storage polysaccharide, of approximately 66 g (dry weight)/mol of glucose fermented. The storage polysaccharide amounted to about 14% of the total dry weight, or 55% of the total cellular carbohydrate, at full growth. After correcting glucose utilization for incorporation into cellular carbohydrate, measurement of product formation showed that 1.1 succinate, 0.8 acetate, and 0.35 formate are produced and 0.5 CO2 net is taken up during the fermentation of 1 glucose under the conditions used. The implication of these results with respect to adenosine 5'-triphosphate (ATP) molar growth yield calculations is discussed. If substrate-level phosphorylation reactions alone are responsible for ATP generation, then the ATP molar growth yield must be about 23 g (dry weight)/mol of ATP. Alternatively, if anaerobic electron transfer-linked phosphorylation also occurs, the ATP molar growth yield will be lower.