Primary mucinous carcinoma of the vulva with signet ring cells deriving from the cloaca

Vulvar neoplasias are rarely encountered lesions at female genital tract, regardless if they are primary or metastatic. Presence of signet ring cells in a tumour at female genito-urinary tract is highly suggestive of a metastatic lesion particularly from a gastrointestinal tumour. Here the authors present a case of vulvar carcinoma with signet ring cells with an undetermined primary site possibly originating from embryonic cloaca.

Cloacal Prolapse in Raptors: Review of 16 Cases

Sixteen cases of cloacal prolapse in raptors were reviewed in this study. Colonic prolapse was the most common presentation (56% of cases). Red-tailed hawks ( Buteo jamaicensis ) were overrepresented, comprising 66% of colonic prolapse cases. In cases of colonic prolapse, postsurgical stricture formation was a commonly identified complication after resection and anastomosis of the colon. A novel technique was used in 2 cases of colonic prolapse, in which sterile, semirigid rubber tubing was placed in the distal colon and removed per-cloaca at the end of the procedure; this facilitated a secure, fluid-tight anastomosis while maintaining sufficient intestinal lumen. Oviductal prolapse (31% of cases) was associated with the most guarded prognosis (40% treatment success). Cloacoliths were treated successfully in 2 birds (13% of cases) by minimally invasive per-cloacal manual removal.

Monitoring free-living Japanese Bush Warblers (Cettia diphone) in a most highly radiocontaminated area of Fukushima Prefecture, Japan

The Fukushima-Daiichi Nuclear Power Plant (F1NPP) accident is an IAEA level 7 event, the same as that of Chernobyl, while the amount of radionuclides released is not comparable. Radioactivity attributed to the F1NPP accident was detected 250 km away from the F1NPP. Although we have not yet systematically studied the effect of radionuclides on the environment and wildlife, one of three Japanese Bush Warblers (Cettia diphone), captured in Akaugi district in August 2011, was observed to have a conspicuous lesion near the cloaca, which is rare in Japan. All of the birds' feathers were strongly contaminated. Further study is needed to determine the significance of this result. We emphasize the importance of continuing assessment of the effects of the F1NPP accident on wildlife.

[First detection of psittacid herpesvirus 2 in Congo African grey parrots (Psittacus erithacus erithacus) associated with pharyngeal papillomas and cloacal inflammation in Germany]

Congo African Grey Parrots (GP; Psittacus erithacus erithacus) from four different avicultures, presented in the Clinic for Exotic Pets, Reptiles and Birds, University of Veterinary Medicine Hannover, Foundation, showed choanal papillomas or hyperemia of the cloacal mucosa. Histologically, the mucosal choanal proliferations were diagnosed as exophytic papillomas and a mild hyperplasia of the cloacal mucosa with lympho-histiocytic inflammation with no visible inclusion bodies was found. Herpesvirus genome was detected by nested PCR in pooled choanal and cloacal swabs from clinically diseased parrots and healthy contact animals. Sequencing of parts of the herpesvirus DNA-polymerase gene indicated 98-100% homology of the detected herpesviruses with the Psittacid Herpesvirus 2 (PsHV-2). In one aviculture with cloacal inflammation papillomavirus-DNA was concurrently found to a PsHV-2 infection. In addition to the four avicultures with clinical symptoms 25 more flocks of grey parrots, in total 57 Congo-GP and 13 Timneh-GP, were examined for a herpesvirus infection. A total of six out of 29 studied parrot avicultures were tested positive for PsHV-2. The detection of this virus also in flocks of GP, which were bred in Europe, shows the establishment of this infection in the GP population in captivity. As indicated in the literature as well as in our study PsHV-2 could be only detected in Congo-GP, independently if they were kept either alone or in mixed avicultures with amazon and macaw species. These findings suggest that PsHV-2 is adapted to this Psittacus species.

Norfloxacin drug induces reproductive toxicity and alters androgen receptor gene expression in testes and cloacal gland of male Japanese quail (Coturnix Japonica)

In an attempt to investigate the reproductive toxicity of norfloxacin in Japanese quail, male quail were given norfloxacin at 20 mg/kg body weight for 14 d. Then reproductive function and androgen receptor (AR) gene expression was examined in treated and control birds. The results of the present study indicate that fertility, cloacal gland area, sperm concentration, and serum testosterone were reduced significantly (p < 0.05) on day 14 in the norfloxacin-treated birds. Upregulation (p < 0.05) of AR mRNA was also seen in the testes on the 14th d of treatment. A trend toward downregulation of AR mRNA was seen in the cloacal gland of norfloxacin-treated birds. Histological observations revealed that norfloxacin induces cellular atrophy in testes and changes in glandular tissue in the cloacal gland. The results of the present study demonstrate that norfloxacin induces testicular toxicity in Japanese quail.

Congenital prepubic sinus associated with a urachal remnant: report of a case

Congenital prepubic sinus is a rare congenital anomaly situated in the midline of the lower abdomen. We report a case of congenital prepubic sinus, closely associated with a urachal remnant. Preoperative magnetic resonance imaging showed clearly that the sinus tracked the urachus caudally. This finding supports the theory that the anomaly is caused by abnormal remnant tissue originating from the cloacal membrane, which tracks the allantois duct caudally along with fetal longitudinal growth.

What is the clinicopathological characteristic of cloacogenic carcinoma outside the anorectal zone?

This study aimed to examine English-language publications on cloacogenic carcinoma which has developed outside the anorectal zone. Studies published in English literature on cloacogenic carcinoma developing in the colorectal area were accessed via Pubmed and Google scholar databases. Within these articles, studies in which there were developments in the other segments of the colon outside the anorectal zone were examined. We retrieved seven studies matching our selection criteria from the research. The studies were published between 1977 and 2009. Four of the patients were female and three were male; patient age ranged from 23 to 69 years. The anatomic tumors were in the sigmoid colon in four patients, and splenic flexure, descending colon and proximal rectum in one patient each. Four patients developed liver metastases. Basaloid carcinoma above the rectum is difficult to diagnose clinically. When suspected, the diagnosis can be made by immunohistochemical staining.

Cloacal exstrophy: a case report and literature review

Cloacal exstrophy is an extremely rare congenital malformation resulting in an exstrophy of the urinary, intestinal, and genital organs and associated with anomalies of other organ systems. We present a complicated case of cloacal exstrophy and the recent progress in the management of this probably most complicated anomaly in pediatric urology and surgery.

Occurrence of cloacal prolapse in wild hylids in the Wet Tropics, Australia

The idiopathic syndrome of cloacal prolapse was observed in the frog Litoria rheocola at 2 sites in the Wet Tropics of Australia; 1 of 365 individuals (0.3%) at Tully Gorge National Park and 5 of 92 individuals (5.4%) at Murray Upper National Park. The condition appeared to have resolved spontaneously with no clinical complications in 2 individuals at successive captures 14 and 155 d later. It was not observed in the sympatric frogs L. genimaculata (n = 206), L. nannotis (n = 357) or Nyctimystes dayi (n = 304) at either location. The underlying cause was not conclusively determined.

Cell apoptosis during the cloacal embryonic development in rats with anorectal malformations

OBJECTIVE

In the normal embryonic development of anorectum, apoptosis plays an important role. To explore the role of apoptosis in anorectal malformations (ARM), this study investigated cell apoptosis during the cloacal embryonic development in ARM embryos.

METHODS

ARM embryos were induced by intragastric administration of ethylenethiourea (125 mg/kg) for pregnant rats on embryonic day 10 (E10). The distribution of apoptotic cells in the cloaca was ascertained by hematoxylin and eosin and TUNEL staining in the normal control embryos (n=102) and ARM embryos (n=147) on E13, E13.5, E14, E15 and E16.

RESULTS

On E13, apoptotic cells were detected in the urorectal septum of rat embryos in the control group. With the development of embryos, the number of apoptotic cells in the mesenchyme of urorectal septum gradually increased and a large number of apoptotic cells were seen in the dorsal rectal mesenchyme. On E14, apoptotic cells appeared at the terminal rectum and the dorsal cloacal membrane. On E15, the urorectal septum fused with the cloacal membrane and apoptotic cells in the urorectal septum mesenchyme continuously extended down to the fusion region. Compared with the control group, apoptotic cells in the urorectal septum, the dorsal rectal mesenchyme and the cloacal membrane of the ARM rat embryos were significantly reduced during the embryonic development. The development of the urorectal septum was delayed and it did not fuse with the cloacal membrane in ARM embryos.

CONCLUSIONS

During the embryonic development of cloaca, abnormal apoptosis in the urorectal septum, the dorsal rectal mesenchyme and the cloacal membrane may be one of the reasons for anorectal malformations. The proper regulation of cell apoptosis may be one of the key mechanisms for normal development of anorectum in the embryonic stage.

[Detection of psittacid herpesvirus 1 in Amazon parrots with cloacal papilloma (internal papillomatosis of parrots, IPP) in an aviary of different psittacine species]

Amazon parrots (Amazona aestiva aestiva;Amazona ochrocephala, n=6) from an aviary with different psittacine species (n=100) were submitted to the Clinic for Pet Animals, Reptiles, Pet- and Wild birds with the clinical picture ofa cloacal prolaps. The cloacal mucosa showed papillomas, and internal papillomatosis of parrots (IPP) was suspected. Hepatomegaly was detected in the radiographs of the clinically diseased amazon parrots, indicating the involvement of the liver in the disease process. The cloacal area was enlarged and showed higher densities in the radiographic picture. One of the amazons had an increased level of bile acids in the plasma supporting the suspicion of the involvement of the liver. Macroscopical and histological investigation of amazons with cloacal prolaps revealed a papillomic adenoma of the cloacal mucosa accompanied by varying degrees of bile duct carcinomas in the liver and adenocarcinomas of the pancreas. Herpesvirus genome was detected by nested PCR in cloacal swabs, liver, and cloacal tissue samples. Sequencing of part of the herpesvirus DNA-polymerase gene indicated 95% homology of the detected herpesviruses with the Psittacid Herpesvirus (PsHV) 1. No cytopathic herpesvirus was recovered from cloacal swabs and liver samples after up to four passages in chicken embryofibroblast cultures. Cloacal and choanal swabs, which were taken from the remaining 47 healthy amazon parrots and 5 Green-winged Macaws (Ara chloroptera) of the aviary, were negative for herpesvirus in the nested PCR. Only birds with cloacal papillomas and the Green-winged Macaws were tested positive for herpesvirus DNA in the nested PCR. We may speculate that there is correlation between the infection with PsHV-1 and the development of cloacal adenomas, adenocarcinomas in the pancreas and carcinomas of the bile ducts. Our results indicate that there may be a higher susceptibility in certain amazon species, while other species may not get infected even if housed in close contact to infected birds. A therapy approach with the immunomodulator Imiquimod did not improve the clinical disease of the birds, although circulating interferon levels were detected in serum samples of treated birds. We may speculate that in the case of already developed tumors an Imiquimod therapy may not lead to tumor regression.

Morphology of the enteric nervous system in the hindgut of an infant with cloacal exstrophy

The authors describe the morphology of the enteric nervous system in the hindgut of an infant with cloacal exstrophy. Cloacal exstrophy was diagnosed at 32 weeks' gestation using prenatal ultrasonography. The baby was delivered at 34 weeks' gestation and underwent a separation of the cecum from bladder halves, reapproximation of hemibladders, closure of the omphalocele and pubic symphysis, and a distal colostomy. Intestinal wall specimens were obtained at colostomy from the distal end of the rudimentary hindgut. Serial frozen sections were prepared for histochemical acetylcholinesterase staining. Histological investigations demonstrated a strikingly crowded, immature enteric ganglia and prominent bundles of wandering cholinergic nerves. These findings suggest the unique pathology of the enteric nervous system development in cloacal exstrophy, in which the rudimentary hindgut behaves as a blind alley of the migratory pathway for neural crest-derived cells during embryogenesis. Histological examinations of the hindgut enteric nervous system in cloacal exstrophy may be beneficial for evaluating the postnatal development of the distal colon which might be utilized for a pull-through procedure.

Lymphoid follicular cloacal inflammation associated with a novel herpesvirus in juvenile alligators (Alligator mississippiensis)

Multifocal hyperemic nodules and plaques associated with the cloacal mucosa of juvenile alligators (Alligator mississippiensis) at a public aquarium were investigated. Grossly, pale pink to dark red multifocal, circular lesions of varying degrees of severity were identified on the cloacal and, in males, phallus mucosa. Cloacal mucosa biopsies were obtained from 2 of the alligators. These samples were examined histologically and by polymerase chain reaction (PCR) using consensus primers targeting a conserved region of the herpesvirus polymerase gene. Microscopically, the lesions were characterized as submucosal lymphoid follicles with hyperemia and hemorrhage. No inclusion bodies were observed. Minimal to no anisokaryosis was present, and no etiologic agents were identified. Through PCR, a band consistent in size with herpesvirus was observed. Tissues showing similar clinical, histopathologic, and PCR findings were collected from animals at an alligator farm several months later. Sequencing of the PCR amplicon resulted in a 180-base pair sequence that shared 85% sequence identity with tortoise herpesvirus-1.

The morphogenesis of the exstrophy-epispadias complex: a new concept based on observations made in early embryonic cases of cloacal exstrophy

BACKGROUND

The term exstrophy-epispadias complex (EEC) has been coined for a group of congenital malformations that includes epispadias, bladder exstrophy and cloacal exstrophy. It is usually thought that these malformations develop against a similar embryological background. This background, however, is still obscure. This is mainly due to the lack of availability of abnormal human or non-human embryos showing the crucial developmental steps in the morphogenesis of EEC malformations. In this paper, we present chick embryos that show cloacal exstrophy at early developmental stages. To the best of our knowledge, this is the first documentation of this rare malformation in young embryos.

MATERIALS AND METHODS

Embryos with cloacal exstrophy (n=4) were found among embryos from two experimental series (n=50) that were primarily performed to document the early morphogenesis of facial and cardiovascular malformations. The malformations were induced by the administration of suramin according to established protocols. Suramin can induce a spectrum of malformations including facial clefts, heart defects, and cloacal exstrophy.

RESULTS AND CONCLUSIONS

Besides the presence of an abnormal opening into the cloaca, all embryos were characterised by an abnormal broadening of the caudal trunk at the level of the leg buds, which, in the youngest embryos, was associated with the abnormal presence of large aneurysmatic swellings of the dorsal aortae at this side. We postulate that these aneurysmatic swellings might be the primary defects leading to the development of EEC malformations. These space-occupying anomalies seem to cause abnormal distensions of the developing pelvis and of the infra-umbilical portion of the developing body wall. In consequence, the mid-portion of the developing ventral body wall between the origin of the umbilical cord and the cloacal plate becomes stretched and thinned out. Tension and thinning of the ventral body wall might ultimately lead to its rupture with exposure of the lumen of the embryonic cloaca and allantois. This new concept on the morphogenesis of the EEC is the first not to be inferred from the conditions seen in fetal or postnatal human cases but is based entirely on data from malformed embryos.

Pathology of spontaneous and experimental infections by Goose haemorrhagic polyomavirus

Haemorrhagic nephritis enteritis of geese (HNEG) is a fatal disease of geese aged from 3 to 12 weeks. The causative virus, Goose haemorrhagic polyomavirus (GHPV), is a member of the Polyomaviridae family We examined goslings either spontaneously or experimentally infected with GHPV. Tissues were sampled for histology, GHPV DNA detection and electron microscopy. Clinical signs and gross lesions observed in experimentally infected goslings were largely consistent with those noticed in field cases. Histological examination showed that, in the acute phase of HNEG, GHPV replicates in almost all the tissues with a particular tropism for endothelial and lymphoid cells. Haemorrhagic foci were widespread in many tissues, including brain. Ultrastructural features were largely consistent with other polyomavirus infections, with accumulation of virions in the nucleus. Non-typical, double-membraned organelles were observed in the cytoplasm. GHPV DNA distribution was widespread in tissues of infected birds, from day 5 post-infection. GHPV therefore induces a systemic disease in its host, leading to severe vascular dysfunction and immunosuppressive B-cell depletion.

Primary villoglandular adenocarcinoma of cloacogenic origin of the vulva

Primary villoglandular adenocarcinomas of the vulva are rare, and only seven cases have been described to date. Hypotheses about the origin of this neoplasm remain highly speculative. We report the case of a 58-year-old woman who developed this very uncommon malignant tumor. Immunohistochemical studies of the tumor revealed positive staining for cytokeratins 7 and 20 and a negative staining for estrogen and progesterone receptors. Special stains showed the presence of intracellular mucin. No other primary lesion was found on clinical evaluation and extensive investigation. The patient was first treated by radical hemivulvectomy, followed by ipsilateral inguinal lymph node dissection and laparoscopic right salpingo-oophorectomy for an incidental finding of an ovarian cyst. The patient remained free of disease 16 months after the initial surgery.

Surgical management of cloacal malformations: a review of 339 patients

BACKGROUND/PURPOSE

The aim of this study was to describe lessons learned from the authors' series of patients with cloaca and convey the improved understanding and surgical treatment of the condition's wide spectrum of complexity.

METHODS

The medical records of 339 patients with cloaca operated on by the authors were retrospectively reviewed.

RESULTS

A total of 265 patients underwent primary operations, and 74 were secondary. All patients were approached posterior sagittally; 111 of them also required a laparotomy. The average length of the common channel was 4.7 cm for patients that required a laparotomy and 2.3 cm for those that did not. Vaginal reconstruction involved a vaginal pull-through in 196 patients, a vaginal flap in 38, vaginal switch in 30, and vaginal replacement in 75 (36 with rectum, 31 with ileum, and 8 with colon). One hundred twenty-two patients underwent a total urogenital mobilization. Complications included vaginal stricture or atresia in 17, urethral strictures in 6, and urethro-vaginal fistula in 19, all of which occurred before the introduction of the total urogenital mobilization. A total of 54% of all evaluated patients were continent of urine and 24% remain dry with intermittent catheterization through their native urethra and 22% through a Mitrofanoff-type of conduit. Seventy-eight percent of the patients with a common channel longer than 3 cm require intermittent catheterization compared with 28% when their common channel was shorter than 3 cm. Sixty percent of all cases have voluntary bowel movements (28% of them never soiled, and 72% soiled occasionally). Forty percent are fecally incontinent but remain clean when subjected to a bowel management program. Forty-eight patients born at other institutions with hydrocolpos were not treated correctly during the neonatal period. The surgeons failed to drain the dilated vaginas, which interfered with the drainage of the ureters and provoked urinary tract infections, pyocolpos, and/or vaginal perforation. In 24 patients, the colostomy was created too distally, and it interfered with the pull-through. Twenty-three patients suffered from colostomy prolapse. All of these patients required a colostomy, revision before the main repair. Thirty-six patients underwent reoperation because they had a persistent urogenital sinus after an operation done at another institution, and 38 patients underwent reoperation because they suffered from atresia or stenosis of the vagina or urethra. The series was divided into 2 distinct groups of patients: group A were those with a common channel shorter than 3 cm (62%) and group B had a common channel longer than 3 cm (38%).

CONCLUSIONS

The separation of these groups has important therapeutic and prognostic implications. Group A patients can be repaired posterior sagittally with a reproducible, relatively short operation. Because they represent the majority of patients, we believe that most well-trained pediatric surgeons can repair these type of malformations, and the prognosis is good. Group B patients (those with a common channel longer than 3 cm), usually require a laparotomy and have a much higher incidence of associated urologic problems. The surgeons who repair these malformations require special training in urology, and the operations are prolonged, technically demanding, and the functional results are not as good as in group A. It is extremely important to establish an accurate neonatal diagnosis, drain the hydrocolpos when present, and create an adequate, totally diverting colostomy, leaving enough distal colon available for the pull-through and fixing the colon to avoid prolapse. A correct diagnosis will allow the surgeon to repair the entire defect and avoid a persistent urogenital sinus. Cloacas comprise a spectrum of defects requiring a complex array of surgical decisions. The length of the common channel is an important determinant of the potential for urinary control, and predicts the extent of surgical repair.

Cloacal exstrophy in an infant with 9q34.1-qter deletion resulting from a de novo unbalanced translocation between chromosome 9q and Yq

Cloacal exstrophy is a rare malformation, belonging to a spectrum of birth defects, which, in order of severity, includes phallic separation with epispadias, pubic diastasis, bladder exstrophy, and cloacal exstrophy. This malformation overlaps the OEIS complex (O = omphalocele, E = bladder exstrophy, I = imperforate anus, S = spinal defects). The etiology of cloacal exstrophy is unknown to date. It may result from either a single defect of early blastogenesis or a defect of mesodermal migration during the primitive streak period. We report an infant with cloacal exstrophy, exomphalos, right kidney agenesis, ambiguous external genitalia, and axial hypotonia. The karyotype showed a de novo unbalanced translocation between the long arm of chromosome 9 and the long arm of chromosome Y resulting in a 9q34.1-qter deletion. Reviewing the literature, we did not find any observation of cloacal exstrophy associated with a structural chromosomal abnormality. The steroidogenic factor 1 (SF1) gene, included in the deleted region, was a good candidate gene but no pathogenic mutation was found by direct sequencing. We hypothesize that another gene, expressed early in embryogenesis and responsible for cloacal exstrophy, is present in the 9q34.1-qter region.

How to Investigate Neurovesical Dysfunction in Children With Anorectal Malformations

PURPOSE

Neurovesical dysfunction (NVD) is common in children with anorectal malformation (ARM). NVD is mainly related to tethered cord or iatrogenic injury but how to investigate it is still debated. We evaluate the usefulness of routine magnetic resonance imaging (MRI) and urodynamics (UDS) for ARM.

MATERIALS AND METHODS

A total of 89 children were screened for sacral, spinal or urological anomalies using sacrum x-ray, MRI, renal and spinal ultrasound, uroflowmetry and/or 4-hour voiding observation. UDS was performed in 60 patients with suspected NVD. Mean +/- SD followup was 9.8 +/- 5.2 years.

RESULTS

Of the 89 patients 29 presented with urinary tract anomalies. The prevalence of sacral (53 cases) and spinal cord (54) anomalies was no different between patients with low, intermediate and high ARM. Spinal cord tethering was present in 13 patients with a normal sacrum x-ray. NVD was found in 31 of the 89 patients (hyperreflexia 21 and hypo-areflexia 10), and was associated with sacral and spinal anomalies in 23, occult spinal dysraphism without bone lesion in 3 and sacral anomalies in 5. The incidence of NVD was 40% of cases with low and 51% with high ARM.

CONCLUSIONS

Because tethered cord occurs in children without sacral anomalies as well as in those with low ARM, we recommend evaluation of all patients using MRI. When MRI is positive UDS should be performed. We agree with a previous suggestion to evaluate all males with rectourethral fistula and females with cloaca malformations. Finally we recommend a noninvasive evaluation for all other children and UDS when neurogenic dysfunction is suspected.

Reproductive impairment in Japanese quail (Coturnix japonica) after in ovo exposure to o,p'-DDT

We have previously described various effects in adult Japanese quail consequent on treatment with oestrogenic compounds in ovo. In the present study, the environmental contaminant o,p'-DDT [1-(2-chlorophenyl)-1-(4-chlorophenyl)-2,2,2-trichloroethane] was administered to quail eggs to further evaluate test endpoints for oestrogenic effects related to reproduction in the Japanese quail. Exposure to 2 mg o,p'-DDT/egg (150 micro g/g egg) resulted in impaired sexual behaviour, reduced cloacal gland area and lowered plasma testosterone concentration in males. Females displayed oviductal abnormalities, including retained right oviduct, decreased length of left oviduct, alterations in shell gland morphology and disrupted distribution of carbonic anhydrase in the shell gland. Egg laying was severely impaired. Consequently, a number of endpoints in adult quail may be useful for demonstrating an oestrogen-like mode of action by environmental contaminants during embryonic development.

An adenovirus associated with intestinal impaction and mortality of male common eiders (Somateria mollissima) in the Baltic Sea

We examined 10 common eider (Somateria mollissima) males found dead in 1998 during a die-off in the northern Baltic Sea off the southwestern coast of Finland. We diagnosed impaction of the posterior small intestine with mucosal necrosis as the cause of death in all 10 and isolated adenoviruses from cloacal samples of six birds. The adenovirus isolates were not neutralized by reference antisera to group I, II, or III avian adenoviruses. Cloacal swabs from 22 apparently healthy eider females nesting at the mortality area were negative for viruses. An adenovirus isolated from one of the eiders caused clinical signs of illness and gastrointestinal pathology in experimentally infected mallard (Anas platyrhynchos) ducklings. These findings suggest that the adenovirus contributed to the mortality of common eider males in the Finnish archipelago.

Comparison of methods to detect Pasteurella multocida in carrier waterfowl

We conducted laboratory challenge trials using mallard ducks (Anas platyrhynchos) to compare methods for detecting carriers of Pasteurella multocida, the bacterium that causes avian cholera, in wild birds. Birds that survived the initial infection were euthanized at 2-4 wk intervals up to 14 wk post challenge. Isolates of P. multocida were obtained at necropsy from 23% of the birds that survived initial infection. We found that swab samples (oral, cloacal, nasal, eye, and leg joint) were most effective for detecting carrier birds up to 14 wk post infection. No detectable differences in isolation were observed for samples stored in either 10% dimethysulfoxide or brain heart infusion broth. The frequency of detecting carriers in our challenge trials appeared to be related to mortality rates observed during the trial, but was not related to a number of other factors including time after challenge, time delays in collecting tissues postmortem, and route of infection. In our trials, there was little association between antibody levels and carrier status. We concluded that swabs samples collected from recently dead birds, stored in liquid nitrogen, and processed using selective broth provide a feasible field method for detecting P. multocida carriers in wild waterfowl.

Effects on health and blood plasma parameters of laying hens by pure nivalenol in the diet

The effects of trichothecene nivalenol (NIV) on the health and production of laying hens were determined in a feeding study. White Leghorn hens, 55 weeks old, were fed diets containing 0, 1, 3 and 5 mg NIV/kg during 50 days. Feed intake was reduced by NIV, but there were no effects on body weight, egg production and egg quality. Traces of unaltered NIV were found in liver and bile. Alkaline phosphatase in the blood plasma increased in the hens fed 0, 1 and 3 mg NIV/kg diet but decreased in the birds fed 5 mg NIV/kg feed. Total protein and glucose were slightly reduced in hens fed 5 mg NIV/kg diet. Pathological examination revealed that 40-75% of hens fed NIV (3 and 5 mg/kg) supplemented diet showed gizzard lesions, haemorrhages in the duodenum and swollen cloaca and oviducts with immature eggs while certain birds in the 1 mg NIV group showed light and fragile livers. NIV and the metabolite de-epoxy-NIV in faeces were found to constitute up to 10% of ingested NIV.

Histopathological and ultrastructural changes associated with herpesvirus infection in waterfowl

Duck virus enteritis is an acute contagious viral disease affecting birds of the order Anseriformes (ducks, geese and swans). The disease agent is a member of the Herpesviridae family (Anatidae herpes virus 1). A group of Anseriformes waterfowl from a Nature Reserve and Centre for the Recovery of Endangered Species in Spain suffered an outbreak of the disease, affecting adults, young and newborns. Other non-Anseriformes waterfowl such as coots, from the family Rallidae, order Gruiformes, were also affected. Histopathological and ultrastructural findings confirmed the viral infection. The present study provides evidence that birds different from the order Anseriformes can be affected, suggesting that the virus has the ability to infest other non-Anseriformes waterfows.

Avian influenza virus subtypes inside and outside the live bird markets, 1993-2000: a spatial and temporal relationship

Between 1993 and 2000, gallinaceous birds, waterfowl, and environmental specimens from the live bird markets (LBMs) of the northeastern United States and non-LBM premises were tested for the presence of avian influenza virus (AIV), pathogenic properties of AIV subtypes, especially of hemagglutinin (H) subtypes H5 and H7, and a possible association between LBM and non-LBM infections. Ten H subtypes of AIV were isolated from the LBM specimens: H1, H2, H3, H4, H5, H6, H7, H9, H10, and H11. During this period, the 10 subtypes also were isolated from birds in non-LBM premises. In the LBMs, subtypes H2, H3, H4, H6, H7, and H11 were present for 5-8 yr despite efforts to clean and disinfect the premises. The H5 or H7 subtypes present during the same year in both LBMs and non-LBMs within a state or in contiguous states were (subtype/year): H5N2/1993, 1999, and H7N2/1994-99. The AIV subtypes including the H5 and H7 that were evaluated for pathogenicity in chickens were low pathogenic. The deduced amino acid sequence at the H cleavage site of H5 and H7 subtypes was consistent with those of low pathogenic AIV. Although the H5N2 and H7N2 subtypes remained low pathogenic, they did undergo mutations and acquired an additional basic amino acid at the H cleavage site; however, the minimum number of basic amino acids in correct sequence (B-X-B-R, where B = basic amino acid, X = need not be basic amino acid, and R = arginine) required for high pathogenicity was lacking. A low pathogenic H5 or H7 subtype may become highly pathogenic by acquiring additional basic amino acids at the H cleavage site. The LBMs have been and will likely continue to be a source of AIV for commercial poultry.

Four-legged broiler chicken with two cloacae and three ceca

This case report examines an Arbor Acres female x Peterson male crossbred 6-wk-old female broiler chicken with four legs, two cloacae, and three ceca. The intestines occupied the caudodorsal portion of the abdominal cavity with three ceca attached to the terminal end of the ileum. The left lateral cecum was larger and had a divided distal end that terminated into 2-cm-long blind sacs. The rectum was dilated and divided into two cloacae that each opened on the dorsolateral aspect of both the right and left cloacal elevator muscles. The two extra legs were attached to the pygostyle by cartilage and skin tissue. Both femoral heads of the extraneous legs were fused together. The extra legs were smaller in size (approximately 17 cm in length) compared with the normal legs (approximately 22 cm). The femoral heads of the two normal legs were disarticulated from the acetabulum.

Cholangiocarcinoma with metastasis in a captive Adelie penguin (Pygoscelis adeliae)

A captive male Adelie penguin (Pygoscelis adeliae), wild caught in 1976, died unexpectedly. Necropsy revealed cholangiocarcinoma with metastases to lung, pancreas, mesentery, and cloaca, the first known case of a penguin hepatic tumor.

OEIS complex (omphalocele-exstrophy-imperforate anus-spinal defects): a review of 14 cases

OEIS complex refers to a combination of defects consisting of omphalocele, exstrophy of the cloaca, imperforate anus, and spinal defects. Possible embryologic mechanisms proposed for these findings have included: a single defect of early blastogenesis or a defect of mesodermal migration during the primitive streak period. Fourteen cases with OEIS complex and related malformations were reviewed for demographic features, prenatal and family histories, and clinical, radiological and pathological findings including the frequency and types of associated anomalies. The pathogenetic mechanisms causing OEIS complex and related malformations, such as anorectal and spinal defects, are discussed. The findings in these cases illustrate the spectrum of defects that can occur in the embryologic development of the cloaca and the urorectal septum. Differences in the timing and extent of mesenchymal ingrowth as well as cloacal membrane rupture may account for these variable findings. A developmental field defect involving the intraembryonic mesoderm suggests a possible etiologic role for homeobox genes, such as HLXB9 with mutations, resulting in anorectal and spine abnormalities, or retinoic acid receptors. OEIS complex with its mostly sporadic occurrence suggests etiologic heterogeneity with a possible role for environmental and genetic causes.

Mycobacterium avium infection in an ostrich (Struthio camelus)

Acid-fast organisms were identified by histopathology of granulomatous lesions in an ostrich (Struthio camelus). The organisms were grown in Herrold's egg media with and without mycobactin and identified as Mycobacterium avium. An agar gel immunodiffusion (AGID) test for Mycobacterium avium paratuberculosis was performed for detection of antibody for M. avium in this infected ostrich and seven other ostriches that were in contact. The results of the AGID were consistent with the pathologic diagnosis of mycobacteriosis and the isolation of M. avium in the affected ostrich.

Apoptosis during regression of the tailgut and septation of the cloaca

PURPOSE

Apoptosis is involved in the embryonic morphogenesis of many organs. The current study was undertaken to ascertain the role of apoptosis during cloacal development in the rat.

METHODS

One hundred five rat embryos, ranging from gestational days 11 to 16, were sectioned serially in the transverse or sagittal planes and stained with H&E. The cloaca, urorectal septum, rectum, urogenital sinus, Wolffian ducts, and tailgut (TG) were examined consecutively in temporospatial sequence.

RESULTS

The tailgut immediately distal to the hindgut starts to regress by apoptosis on day 12 of gestation in a craniocaudal direction and has regressed completely by day 13.5. A large number of apoptotic cells and debris can be identified in the urorectal septum during cloacal septation. Vacuoles are formed by coalescence of apoptotic cells at the tip of urogenital sinus from day 15 to 16, and, at the same time, sporadic apoptotic bodies in the anal membrane contribute to its thinning.

CONCLUSION

Results of the current study confirm that apoptosis occurs in a specific temporo-spatial sequence in the hindgut and cloaca and appears to be an important mechanism in TG regression, uro-rectal separation, urethral opening, and rupture of the anal membrane.

Prenatal diagnosis of cloacal exstrophy before rupture of the cloacal membrane

We describe a case of cloacal exstrophy what was diagnosed prenatally by ultrasound and confirmed at birth. We also review the literature on 15 previous prenatally diagnosed cloacal extrophy cases.

Gonadal morphology in cloacal exstrophy: implications in gender assignment

OBJECTIVE

To compare the histology of gonads excised from males with cloacal exstrophy (the most severe variant of the exstrophy-epispadias complex) undergoing early gonadectomy and gender reassignment (to obviate difficulties in reconstructing male external genitalia) with those published previously.

PATIENTS AND METHODS

Testicular tissue was obtained from males with cloacal exstrophy undergoing gender reassignment shortly after birth. Slides were stained for histological evaluation and reviewed by one author. The histology was compared with known normal features for newborn testicular tissue. The mean age at the time of gender reassignment was 6 months.

RESULTS

There were no significant abnormalities in the architecture of the rete testis, epididymis or vas of the study specimens. There were more germ cells in some patients with cloacal exstrophy, but this finding was not specific and is of unknown clinical significance.

CONCLUSIONS

Despite the severity of the malformations in cloacal exstrophy, testicular histology is preserved. In highly selected genotypic males who have adequate phallic structures, congruent gender assignment is appropriate and early orchidopexy is recommended.

Cloacal inoculation with the Connecticut strain of avian infectious bronchitis virus: an attempt to produce nephropathogenic virus by in vivo passage using cloacal inoculation

Avian infectious bronchitis virus (IBV) strain Connecticut A-5968 isolated from respiratory tissue of chickens in USA in the 1960s, is considered as representative of respiratory disease causing IBV strains. Specific pathogen free chicks inoculated with the strain via the cloaca replicated the virus more rapidly in their kidneys than did chicks inoculated with the same virus intratracheally. Virus passaged thirteen-times via the cloaca caused stronger nephrotropism and nephropathogenicity than the parent virus. It is suggested that cloacal inoculation of IBV provides new and interesting information concerning the mechanisms of nephropathogenicity of IBV which has became increasingly important worldwide during the last ten years.

Concordance for cloacal dysgenesis

Monozygotic (MZ) twins concordant for cloacal dysgenesis were diagnosed at 15 weeks' gestation on ultrasound exam. The structural alterations result from abnormal morphogenesis of the cloacal membrane and contiguous anlage with resultant secondary changes. These defects are suggestive of teratogen exposure or an endogenous event early in gestation, resulting in MZ twinning and the development of a polytopic field defect.

Sodium toxicity and pathology associated with exposure of waterfowl to hypersaline playa lakes of southeast New Mexico

Cause of mortality was studied in waterfowl in hypersaline playa lakes of southeast New Mexico during spring and fall migration. Mortality was not common in wild ducks resting on the playas during good weather. However, when birds remained on the lakes for prolonged periods of time, such as during experimental trials and stormy weather, a heavy layer of salt precipitated on their feathers. Sodium toxicity was the cause of death for all experimental mallards housed on playa water and for 50% of the wild waterfowl found moribund or dead during the spring of 1995. Gross lesions included heavy salt precipitation on the feathers, ocular lens opacities, deeply congested brains, and dilated, thin-walled, fluid-filled cloacae. Microscopic lesions in the more severely affected birds included liquefaction of ocular lens cortex with lens fiber swelling and multifocal to diffuse ulcerative conjunctivitis with severe granulocytic inflammation, edema, and granulocytic vasculitis resulting in thrombosis. Inflammation similar to that seen in the conjunctiva occasionally involved the mucosa of the mouth, pharynx, nasal turbinates, cloaca, and bursa. Transcorneal movement of water in response to the hypersaline conditions on the playa lakes or direct contact with salt crystals could induce anterior segment dehydration of the aqueous humor and increased osmotic pressure on the lens, leading to cataract formation.

Mortality in black siskins (Carduelis atrata) with systemic coccidiosis

Ninety-five (97%) of 98 black siskins (Carduelis atrata) died within 2 months of arrival in Italy from South America with the following clinical sings: rapid weight loss, breast muscle atrophy, congested and distended abdomen, diarrhea, and lethargy. Macroscopically we observed hepato-splenomegaly, pulmonary congestion, and thickening of the interstinal wall. Histologically, lymphomonocytic transmural enteritis, interstitial mononuclear cell infiltrates in the lungs and in the liver, as well as activation of splenic follicles were common features. Large numbers of protozoa belonging to Isospora sp. were observed in various stages of their life-cycle in the intestinal epithelium, and some zoites were found in the extra-intestinal cellular infiltrate as well. No viral or bacterial pathogens were found.

Persistent cloaca and caudal spinal agenesis in calves: three cases

Three newborn calves were affected by caudal spinal dysgenesis or agenesis (coccygeal vertebra) and persistent cloaca. The cloacas were lined by a mixture of transitional and colonic epithelium. The vertebral column of one calf was internalized into the cloaca. The association of persistent cloaca and caudal spinal anomalies is thought to be related to cell loss in the caudal cell mass, which affects caudal spinal column formation and cleavage of the cloaca by the urorectal septum. This association is well documented in humans and has been reported in Manx cats. By extrapolation, it appears likely to exist also in neonatal calves. Identification of cloacal lesions in neonatal animals should be cause for careful examination of the vertebral column because many of the associated spinal lesions are occult.

Pasteurella multocida in raptors: prevalence and characterization

Several cases dealing with Pasteurella multocida infection have been documented in raptors. However, the isolates have not been fully characterized nor has the prevalence of P. multocida in raptors been determined. Three hundred ninety-eight raptors were cultured for P. multocida. Results indicated that P. multocida was not normally carried in the pharyngeal, choanal, or cloacal regions. However, P. multocida was isolated from raptors with avian cholera. Isolates from eight cases were characterized by biotype, somatic serotype, and antibiogram. Most (six of eight) of the P. multocida isolates belonged to somatic serotype 1. The remaining two P. multocida isolates belonged to somatic serotypes 3 and 3,4. The majority of the isolates belonged to the subspecies multocida. All isolates were susceptible to penicillin G, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. Various restriction site heterogeneities of P. multocida chromosomal DNA were found among the raptor isolates. Results indicated that isolates of P. multocida somatic serotype 1 from diurnal raptors were genetically related.

Pasteurella multocida in psittacines: prevalence, pathology, and characterization of isolates

Although the pathogenicity of Pasteurella multocida for psittacines (parrots and their relatives) has been documented in several case reports, the associated pathologic syndromes have not been well defined nor have the isolates been characterized. In addition, the prevalence of P. multocida in psittacines has not been determined. Three hundred twenty-eight psittacines (253 clinically healthy and 75 clinically ill) were cultured for P. multocida. Pasteurella multocida was not isolated from the pharynx, choana, or cloaca of psittacines. However, in five dead psittacines submitted for necropsy, P. multocida was isolated. These isolates were characterized, and all belonged to either somatic serotype 3 or 4,7. Pasteurella multocida somatic serotype 3 was isolated from psittacines with septicemia, whereas P. multocida somatic serotype 4,7 was isolated from psittacines with cutaneous lesions. The majority (four out of five) of the P. multocida isolates belonged to the subspecies multocida, and all isolates were susceptible to penicillin G, sulfisoxazole, gentamicin, erythromycin, tetracycline, and trimethoprim-sulfamethoxazole but resistant to streptomycin. DNA fingerprints demonstrated that isolates belonging to the same somatic serotype were genetically related. The isolate from a cockatiel that had been caught by a cat belonged to somatic serotype 3 and was not genetically related to the other two isolates belonging to this somatic serotype.

Evidence for cryptosporidial infection as a cause of prolapse of the phallus and cloaca in ostrich chicks (Struthio camelus)

Cloacas of male ostrich chicks that had suffered prolapse of the phallus and cloaca were compared with cloacas of normal ostrich chicks of both sexes from the same area. Heavy infection of the cloacal and bursal tissue with Cryptosporidium sp. was present in all the cases of prolapse, while no cryptosporidia were observed in the normal chicks. Histopathological lesions as described in cryptosporidial infection in other species were present in the infected cloacas. These included loss of the microvillous border and epithelial hyperplasia and degeneration, which was indicated ultrastructurally by vacuolation of the apical cytoplasm, swelling of organelles, and nuclear changes. It is suggested that these lesions, in combination with the anatomy of the male ostrich cloaca, may be responsible for prolapse of the phallus and cloaca.

Prolapse of the phallus and cloaca in the ostrich (Struthio camelus)

The incidence of cloacal prolapse in ostrich chicks hatched and raised on the Oudtshoorn Experimental Farm during the 1992-1993 breeding season was investigated. The condition which occurred primarily in male chicks, affected 14.65% of the total number of chicks hatched. The mortality rate amongst chicks with cloacal prolapse was very high. Although the pathogenesis and aetiology of the condition is unknown, a species of Cryptosporidium was present in large numbers in affected cloacas. Treatment with systemic antibiotics was found to be effective in some cases.

Heterotopic hindgut duplication: a cloacal remnant associated with exstrophy of the bladder

Lower hindgut duplications, although very rare, usually present as a cystic mass located posterior to the rectum and confined to the pelvis. Hindgut duplications are often associated with genitourinary or spinal anomalies. We describe a neonate with a previously unreported heterotopic colonic duplication presenting as an exophytic perineal mass associated with classic bladder exstrophy. The embryonic significance of these anomalies is discussed.

Cloacal exstrophy: prenatal diagnosis before rupture of the cloacal membrane

Embryologically, cloacal exstrophy is thought to result from persistence and subsequent rupture of the infraumbilical cloacal membrane during the fifth embryonic week. We report a case of cloacal exstrophy in which a prenatal diagnosis was made prior to rupture of the cloacal membrane. A routine ultrasound at 17 weeks' gestation demonstrated monoamniotic twins. One twin was normal, but the other was found to have a sacral myelomeningocele, "rocker-bottom" feet, splaying of the pubic rami, and a large cystic mass protruding from the infraumbilical anterior abdominal wall. A repeat ultrasound was performed at 22 weeks, with the same findings. At 26 weeks, further examination showed disappearance of the abdominal cyst, a small omphalocele, no demonstrable bladder, and the suggestion of prolapsed bowel inferior to the umbilical cord insertion. After delivery at 34 weeks, the abnormal twin was found to have the typical findings of cloacal exstrophy, myelomeningocele, bilateral lower limb anomalies, and extremely foreshortened small bowel. Rupture of the presumed cloacal membrane after 22 weeks in this case is inconsistent with our current understanding of the embryology of this anomaly, and should stimulate a reexamination of the current concepts. If the characteristic features are recognized, cloacal exstrophy can be diagnosed by prenatal ultrasound, permitting prenatal counseling and appropriate perinatal management.

Genital outflow tract obstruction in an adolescent with cloacal exstrophy

The combination of congenital anomalies in patients with cloacal exstrophy presents a difficult management problem. Experience with these problems is limited because of the infrequent occurrence of the disorder and because few patients survive to adulthood. The present paper describes a 14-year-old female who presented with hyperchloremic metabolic acidosis, secondary to retained urine in a redundant ileal conduit, and symptoms of müllerian outflow tract obstruction. The literature is reviewed on genetic females with cloacal exstrophy, revealing a high incidence of müllerian fusion defects. Data are presented showing that women with cloacal exstrophy have a high potential incidence of genital outflow tract obstruction. These patients must be followed closely during adolescence so that diagnosis and treatment may be initiated early.