By O. Moff. Utica College.
Controversy still exists as to whether double adenomas are a distinct entity or part of four gland hyperplasia presenting metasynchronously purchase 400mg indinavir free shipping. Some authors feel that the most reliable clinical criteria to document double adenomas cheap 400mg indinavir amex, is the absence of recurrent hyperparathyroidism on follow up of at least 5 years following selective gland excision (Baloch & LiVolsi generic indinavir 400 mg with mastercard. Meanwhile some others have authoritatively documented the existence of double adenoma as a separate entity and are not simply missed cases of four-gland hyperplasia buy discount indinavir 400mg on-line. Photomicrograph of a solitary parathyroid adenoma showing hypercellular parathyroid tissue, absence of fat cells and surrounding capsule (Haematoxylin & Eosin *40) 3. However it should be understood that absence of any of the obvious classical clinical presentations is what is commonly referred to as asymptomatic disease. But studies have shown that the so called asymptomatic patients will often have symptoms or metabolic complications when carefully evaluated with standardized health questionnaires. The signs and symptoms of hyperparathyroidism largely reflect the effects of hypercalcemia and may involve multiple organ systems (Taniegra, 2004). Bone related problems were the first to call attention to the disease and include manifestations of selective cortical bone loss. It should be remembered that the symptoms may not be proportional to magnitude of hypercalcaemia. In developing countries the scenario and spectrum of the disease are therefore different. The symptomatic disease is identified much later after a series of management for fractures and renal stones. Clincal features of classical disease Management of Primary Hyperparathyroidism: Past, Present and Future 155 The association between pancreatitis and hyperparathyroidism was first reported in 1940 by Smith and Cooke. In such cases, other causes of hypercalcaemia should be excluded (history of vitamin D intake, thiazide diuretics and family history of hypercalcemia). Elevated parathyroid hormone levels in the presence of persistent hypercalcemia confirms the diagnosis of primary hyperparathyroidism. Also, 10-40% of patients have elevated levels of serum alkaline phospatase and almost all these patients have significant bone invovelment. Imaging studies have no role in the diagnosis of primary hyperparathyroidism and are mainly used for localization. Eucalcemic primary hyperparathyroidism may represent the earliest manifestation of primary hyperparathyroidism. However, among the so called asymptomatic patients only about 2-5% are truly asymptomatic. The most recent conference (the third) was held in 2008 from which summary of guidelines are available for reference. Important aspects based on the current guidelines for surgical intervention and for medical surveillance, for patients with asymptomatic hyperparathyroidism are listed in table 3. In the past the only way of identifying an abnormal gland was at the time of bilateral neck exploration and the best tool available was an experienced surgeon!! This is aptly reflected in the words of Doppmann in my opinion, the only localizing study indicated in a patient with untreated hyperparathyroidism is to localize an experienced parathyroid surgeon. Management of Primary Hyperparathyroidism: Past, Present and Future 157 The argument was that, in the hands of an experienced parathyroid surgeon, 95%to 97% of the cases could be resolved by a single neck exploration. Thus, in the past, the only indication for preoperative localization was re-exploration following an unsuccessful parathyroidectomy. The interest in preoperative localization techniques is being given even more importance now, as more and more minimal access techniques are being developed for parathyroidectomy. Therefore it would be logical if the offending gland could be accurately localized as a part of preoperative planning. Preoperative localization would be advantageous for a single gland disease, but its utility in multi-gland disease is questionable. At present no single method of parathyroid localization matches to the unguided neck exploration by an experienced surgeon. Thereafter and for a considerably long time the standard accepted procedure was wide exposure, for bilateral neck exploration and evaluation of all the four parathyroids. When performed by experienced surgeons, cure rates with parathyroidectomy are 95% to 98%, and complication rates are 1% to 2%. The present era of minimal access surgery has made considerable progress in the field of parathyroid surgery too. The recent trend is to develop procedures that require significantly smaller incisions for performing the same procedure. The routinely performed parathyroid exploration which made use of the large Kocher cervicotomy can be now be conveniently referred to as the, conventional or standard parathyroidectomy. The protocol of bilateral neck exploration was challenged initially in the 1980s, when a unilateral approach was advocated in an attempt to avoid the need for contralateral exploration and its associated risks (Wang, 1985; Tibblin, et al. There was a dramatic change in concept following the introduction of Tc99m-sestamibi parathyroid scanning especially with reports such as simultaneous sestamibi and ultrasound of the neck could localize an enlarged parathyroid gland with almost 95% accuracy. The rationale was that if the abnormal parathyroids could be localized accurately then they could be appropriately targeted and removed through very small incisions, thereby offering the proclaimed advantageous of minimally invasive surgery in a general perspective. With time surgeons learned to perform the conventional bilateral exploration utilizing smaller incisions of about 4. The point at which the procedure becomes a minimal-access operation probably is best defined by the length of the incision. Schematic representation comparing length of incisions of conventional (A) and minimally invasive parathyroidectomy (B). The unilateral approach to the solitary parathyroid adenoma was advocated by Wang and later refined by Tibblin et al. A meta-analysis of 99mTc sestamibi scanning has revealed a sensitivity and specificity of 90. A prospective randomized trial compared unilateral versus bilateral neck exploration in 91 patients. There was no statistically significant difference in the incidence of multiglandular disease, costs, or cure rate (95. However patients who underwent unilateral neck exploration had a lower incidence of biochemical and early severe symptomatic hypocalcaemia compared to patients who underwent bilateral exploration (Bergenfelz et al, 2002). The technique usually makes use of a small (2cm) lateral incision to enter the space between the lateral border of the strap muscles and sternomastoid and thereby reach the lateral border of the thyroid gland and gain direct access to the parathyroid bearing areas. Similar conclusions were drawn from a retrospective study comparing 255 focused lateral approaches to 401 bilateral neck explorations,where there was no significant difference in surgical success (99% versus 97%) or complication rates (1. Early work on endoscopic approach to parathyroid disease was first described by Gagner. Enthusiasts have tried and tested various approaches including a three-port lateral approach along the anterior border of the sternomastoid muscle (Henry et al,1999) to a midline suprasternal port and two lateral ports on the same or opposite sides of the neck, in front or behind the sternomastoid muscle (Gauger et al, 1999). Irrespective of the port placement, the technique is essentially an endoscopic lateral approach.
Statistically significant difference in averages of perceived social support from an important order indinavir 400 mg without a prescription, not specified person has not been proved in patients within the follow up period buy indinavir 400mg cheap. A difference in averages discount indinavir 400 mg on-line, close to the edge of significance indinavir 400mg lowest price, appeared in patients during the follow up after the surgery, and on the edge of significance there was indicated a linear decrease in use of emotional social support. We have not found out any statistically significant differences in averages in other coping strategies within the follow up period. Statistically significant difference in averages of the life satisfaction level in the patients has not been found out during the follow up. On the edge of statistical significance, respectively close to it there has been indicated a significant difference in averages and a significant linear decrease of quality of life (p < 0. We have not proved a statistically significant difference of depression averages in patients during the follow up. A difference in average scores on the edge of statistical significance has been indicated and a statistically significant linear trend (p < 0. Hypothesis H10 has been confirmed, hypotheses H6 and H9 have been proved partially, hypotheses H7 and H8 have not been proved (see Tab. During the half-year follow up period there occurred significant decrease of anxiety in patients, an increase in comprehensibility and in the feeling of the control over the situation has been indicated on the edge of significance (comp. Our finding is in compliance with the fact that in managing a difficult situation a man at first tries to understand it (comprehensibility) (comp. A linear decrease in coping strategy of use of emotional social support was indicated in patients within the follow up, and a significant decrease was indicated in perceived social support from the family, apparently due to the fact the stress situation of operation passed. Total social support, support from friends and coping strategy of focus on and venting of emotions changed in a quadratic way at first, there was a significant decrease after 3 months, and a slight increase after 6 months after hospitalisation. Apparently it relates to the fact, the patient can feel himself isolated during the first 3 months after the surgery. Close to the edge of statistical significance a decrease in total quality of life was indicated in patients within the follow up, that relates to original overvaluation of life satisfaction with individual areas, but at the same time it can relate to the fact what was apparent in first interviews with them inappropriate expectations in relation to the medical intervention (they expected complete cure). Caption: means that the given variable was dealt with a linear increase means that the given variable was dealt with a linear decrease depicted curve illustrates course of a quadratic trend ed. Follow up of patients with thyreopathy since surgery during the period of six months 7. There were not found out statistically significant differences of averages among the patients with different types of thyreopathies, nor in the total sense of coherence, or in manageability or meaningfulness within any of the 3 measurements. Comparing the average scores of comprehensibility there were not found any significant differences during 1st measurement, bur with 2nd and 3rd measurements, there were indicated lower average scores of comprehensibility on the edge of statistical significance in patients with carcinoma compared to other types of thyreopathies. Statistically significant differences of averages were not proved in patients with different types of thyreopathies, neither in total perceived social support, nor in the social support from significant others, in social support from family members and from friends. Concerning the variances there was not found any statistically significant difference in the sphere of social support from friends within 1st measurement, but they Psychosocial Factors in Patients with Thyroid Disease 297 showed higher variance in social support from friends in 2nd measurement (p < 0. We did not prove any statistically significant differences of average scores in different coping strategies, except for 2, in 1st measurement among the patients with different types of thyreopathies. During 2nd measurement, the patients with thyroid carcinoma use coping strategy of humour significantly less frequently (p < 0. During 2nd measurement there were not proved any statistically significant differences of averages in other coping strategies among the patients with different types of thyreopathies. We did not find statistically significant differences of averages in any of the coping strategies in patients with different types of thyreopathies within 3rd measurement. During 2nd and 3rd measurements, any statistically significant differences in averages of satisfaction were not found out. Statistically significant difference in averages with quality of live among the patients with different types of thyreopathies was not proved in any of the measurements. Statistically significant difference in averages of anxiousness among the patients with different types of thyreopathies was not proved in any of the measurements. Higher average scores of state anxiety in patients with carcinoma were indicated on the edge of significance during 2nd and 3rd measurements compared to other ills. During 2nd measurement there was indicated difference in variances on the edge of significance, where the highest variance was in the results of patients with carcinoma. Statistically significant difference in depression among patients with different types of thyreopathies was not proved within any measurement. Comparing the average scores of locus of control there were not found any statistically significant differences in 1st and 3rd measurements. A higher tendency to externality (external locus of control) and the feeling they cannot influence their lives were indicated in patients with carcinoma on the edge of statistical significance during 2nd measuring compared to other patients. Comparison of patients with different types of thyreopathies brought interesting results (see Tab. The patients with nodular goitre were significantly more satisfied with life at the time of surgery than other patients. Variables Nodular goitres at the time of surgery QoL line - life satisfaction ed. Comparison of results in patients with different types of thyreopathies thyreopathies is in patients with thyroid carcinoma. Only a small amount of these was in our researched file, but we will try to indicate statistically significant and marginally significant differences and trends. The biggest differences appear after 3 months since surgery when patients with carcinoma score lower in coping strategies as humour, suppression of competing activities and focus on and venting emotions, as well as in locus of control. In the period after 3 and 6 months since surgery the patients with carcinoma are more anxious compared to the others and score lower in comprehensibility. Bigger interindividual differences can be captured in carcinomas compared to the others after 3 and 6 months since surgery in coping strategy in religious coping and in social Psychosocial Factors in Patients with Thyroid Disease 299 support from friends. Support from friends is probably related to what the patients referred to during the interviews; some of them hid till the end of observation from their family and friends that thyroid cancer had been found out with them. Tschuschke (2004) also refers on similar findings, for example a tendency to apply mechanisms of suppression and increased level of anxiety in patients with carcinoma. Statistically significant difference in average scores of life satisfaction was not proved, neither in total quality of life within the observed period, nor in patients with hyperthyroidism, or in patients with carcinoma. We found out a statistically significant difference in average scores in patients with nodular goitre and a significant linear decrease of life satisfaction was proved (always for p < 0. Patients with nodular goitre, who underwent total thyroidectomy, had lower level of life satisfaction in 3rd measuring on the edge of significance compared to those who underwent hemithyroidectomy. We attribute this finding to the fact that nodular goitre recently undergoing total intervention experienced more changes in life than those with hemithyroidectomy. Statistically significant difference in averages of locus of control was not proved during the follow up period in patients with nodular goitre. The patients with nodular goitre, who had already undergone hemithyroidectomy, had higher tendency to internality (internal locus of control) with 3rd measurement on the edge of significance compared to those who had undergone total thyroidectomy. Differences on the edge of significance in average scores of locus of control were indicated in patients with hyperthyroidism and carcinoma within the observed period. During operation follow up, the linear trend to higher internality (internal locus of control) was indicated on the edge of significance in patients with hyperthyroidism.
Further modelling indicated that it will be possible to maintain 85% of gene diversity for 30 years (a more realistic time span) with a nucleus population of 60 breeders (feasible in terms of space and resources) 400 mg indinavir overnight delivery, if 4 wild cubs can be added to the programme each year cheap indinavir 400mg with amex, for the next fve years (spread over Doana and Sierra de Morena a rate deemed viable according to the study by Palomares et al 400mg indinavir amex. Is 85% gene diversity retained (and therefore an average level of inbreeding after 30 years of 15%) much worse than 90% (and 10% inbreeding) and will this compromise the success of reintroduction? There is no guarantee that a captive population generic indinavir 400mg visa, or a reintroduced population derived there from, with less gene diversity and higher inbreeding levels will go extinct or suffer in other ways, but the chance that it does increases. It is therefore always a case of trying to achieve the highest possible retention of gene diversity within the restraints of the particular situation of the species and the space and resources available. From a genetic point of view, what you would ideally like to do in an ex situ programme is magically freeze the founders and thaw them out again at some point in the future so they can be available for breeding. In that way, all gene diversity would have been retained and all allele frequencies would remain exactly the same. Although 81 gene banking and reproductive technologies allow us to take important steps in this direction (Ballou, 1984), generally the gene diversity of the founders is preserved for the future by having them breed by natural means and pass on their genes to the next generation. Ideally one would like each founder to have a very large and equal number of offspring. This not only maximises retention of gene diversity but would also preserves the existing allele frequencies. In other words, one would ideally like to stop selection such that the gene diversity that is available for reintroduction is the same as that collected from the wild generations earlier. Allele frequencies will change (and some alleles may be lost) due to a combination of genetic drift (i. Whereas the emphasis is very much on maximising growth rate during the growth phase of the population, during the carrying capacity stage attention should be paid to correcting inequalities that have developed in the founder representation (Lacy, 1994). In order to achieve this, the technique that is currently employed by the zoo and aquarium community is to base the pairings of the animals (i. Mean kinship is a measure of the relatedness of an individual to every living individual in the population (Ballou, 1991; Ballou & Lacy, 1995). It is calculated as the average of the coeffcients of kinship of an animal with every animal in the population. The coeffcient of kinship between a pair of animals in turn is the inbreeding coeffcient of any offspring produced by that pair of animals. Priority for breeding is given to individuals with low mean kinship values (and few relatives). After all, if such an individual should die before it gets a chance to breed, there are very few other individuals in the population that share some of its genetic variation and can help pass this on to the next generation. Chances are high that alleles only present in this individual will be lost from the population. For an individual with a high mean kinship value, chances are high that the majority of its gene diversity is also present in its many relatives. Individuals with high mean kinship values are therefore given lower breeding priority. Furthermore, efforts should be made to combine individuals with similar mean kinship values. If an animal with low mean kinship would be combined with one with high mean kinship, the resulting offspring would be half important and half not important. Every time this offspring is bred, not only the rare alleles are spread, but also the already common alleles of the individual with high mean kinship value (Wilcken & Lees, 1998). The offspring is also going to be related to many individuals in the population which will make it harder to fnd breeding opportunities for it that do not result in inbreeding. Apart from basing breeding priority and pair combinations on mean kinship, it is also important to minimise the level of inbreeding in a population. Inbreeding not only increases the level of homozygosity and reduces the amount of gene diversity retained, it often also causes inbreeding depression (a reduction in ftness of the inbred individual), partly due to an increased probability for homozygosity of recessive deleterious or lethal alleles (Frankham et al. Inbreeding depression may express itself in many forms, some of which may not be immediately obvious unless one consciously sets out to investigate them, e. Despite earlier skepticism about the importance of inbreeding depression in wildlife populations, numerous wild populations have now been shown to suffer from inbreeding depression (Roelke et al. Captive populations too have been shown to suffer from inbreeding depression (Ralls and Ballou, 1986; Ralls et al. The level of inbreeding depression signifcantly infuences the extinction risk of a population (OGrady et al. In addition, populations with a high level of inbreeding that appear to be coping well enough in captivity may have signifcantly lower success rates upon reintroduction (i. For example, inbred white-footed mice (Peromyscus leucopus) showed signifcantly lower survival upon reintroduction than non-bred individuals (Jimnez et al. Inbreeding is reversible, meaning that when an inbred individual is mated with an unrelated animal, the resulting offspring are no longer inbred. For this reason, it may sometimes be preferable to allow a modest level of inbreeding among low mean kinship animals, rather than pairing unrelated individuals with very different mean kinship levels. Naturally, these theoretically ideal breeding strategies for captive management need to be married with the specifc social and life history strategies of the species. Especially for species as critically endangered as the Iberian lynx, the temptation is large to start reintroducing as soon as possible. Reintroductions are risky and the probability for whole or partial failure of particularly the frst release attempts is high. The urge to reintroduce is therefore best contained until the required, secure, reliable nucleus breeding population has been obtained (Lacy, 1994). Rather than limiting breeding to keep the population at carrying capacity, growth can at this stage be maintained and the surplus animals used for reintroduction. This automatically leads to the question, which individuals are best chosen for reintroduction? It is obvious that reintroduced individuals have to help improve the genetic and demographic health of the wild population. What is often forgotten however is that the removal of the animals destined for reintroduction should also not compromise the genetic and demographic health of the nucleus ex situ breeding population. For that reason, individuals for reintroduction are preferably those that beneft the gene diversity of the wild population (i. Once release methods have been tested and fne tuned and once survival and reproduction in the reintroduced population have improved, animals more valuable to the wild population can be added (Frankham et al. Leus is also affliated with the European Association of Zoos and Aquaria, and wishes to thank the Flemish Government for structural support to the Centre for Research and Conservation of the Royal Zoological Society of Antwerp. Cambridge University inbreeding depression and purging in captive pedigreed Press, Cambridge, pp. National Foundation for Research in Zoological Gardens, population size: demography meets population genetics.
Average Ct value purchase 400mg indinavir visa, the operations buy indinavir 400 mg cheap, as well as the guidance for the cleaning positive rate discount indinavir 400 mg without a prescription, and the standard deviation of Ct values and disinfection practices purchase 400mg indinavir with amex. Of the th 84 65 Western Poultry Disease Conference 2016 141 samples, those collected inside the barn had the barns. The Pennsylvania/Virginia Ct values between the inside the infected barns group Experience in Eradication of Avian Influenza and other groups are significant (p-value < 0. Environment: a potential source of animal linear regression model, we discovered no linear and human infection with influenza A (H5N1) virus. Location Total number of % of positive Average Ct value of Sample type of samples samples positive samples positive samples Inside the infected barns 44 50 30. The cells were harvested 72 h remained constant until the termination of the post-infection, freeze thawed five times, experiment. The copy number of hexon weeks of age (first time point) and remained gene was calculated by using the formula; plasmid consistent through-out the experiment. Sera samples were heat present for the serotypes of species E, but not for inactivated at 56C for 30 min and 2-fold serial species D. Adult broiler breeders were previous studies showing anti-viral IgA exists in gut randomly divided in two groups of 24 birds each (n = mucous (3) or at other mucosal surfaces (7), it is 24/group). Locally produced mucosal IgG in th 87 65 Western Poultry Disease Conference 2016 chickens immunized with conventional vaccines for adenovirus 9 vector. Induction of fecal excretion patterns of strain 93 chick embryo mucosal immunity in the avian Harderian gland with lethal orphan virus in chicks. Infection and Immunity a replication-deficient Ad5 vector expressing avian 5:60-64. Journal of Adenovirus Associated with Inclusion Body Hepatitis virological methods 183:147-153. Adenoviral gizzard with Inclusion Body Hepatitis in Saskatchewan erosion in commercial broiler chickens. Protective immunity induced by Six chickens were randomly selected on day combined, in ovo vaccination with herpesvirus of four postchallenge and necropsied. The speed, efficiency and success of infection control depends on the ability of these Highly pathogenic Eurasian origin H5 influenza groups to work cooperatively to address a goal. The regulatory community gains in turkeys and from Mar 4April 11, the outbreak information during the outbreak, and hoarding of was restricted to turkeys. On April 11, the first egg information may leave the industries, the scientific layer flock was infected. From April 11June 5, both communities, and the public without needed turkey and egg laying hens were infected. The eradication team may not have time cases from June 518 were in egg laying chicken to access information held by the scientific flocks. The region is covered by Eastern forest and constitutes effective disease control vary within the grasslands biomes and is largely defined by the broiler, layer and turkeys industries. The poultry Mississippi river and its tributaries, the Ohio and industries are structured to reduce the risk of Missouri rivers. The climate of the area varies from common diseases but have little experience in the subtropical at the southern extent of the range to a control of diseases that go beyond the boundaries of a humid continental climate at the northern extent. Regulatory officials region is covered by two migratory bird flyways, the have specific training and expertise in the control of Central and Mississippi flyways, and nine states. In transboundary diseases but are often unfamiliar with this region, there are nearly 47 million turkeys, more standard operating procedures in the poultry than 100 million egg laying hens and approximately industries. The affected farmer may have It was apparent during and after the outbreak little to do, while the industries must figure out how that, in addition to these regional risks, the barriers to to keep operating safely. This may result in cooperative efforts in infection control also inattention to details surrounding virus containment contributed to the outbreak. The barriers to effective on the infected farm while these scores or hundreds cooperative control that may go unrecognized in an of contaminated people leave the farm each day. As the communication channels that exist to make everyday outbreak unfolds, great confusion exists about the activities of business and government go smoothly. In introductions presumably from the wild bird the absence of an outbreak, these groups interact very reservoir. Whether these primary introductions arose differently than how they need to interact during an from dust borne virus carried into barns or from th 92 65 Western Poultry Disease Conference 2016 being tracked in has not been established. Lateral months; and continuity of business efforts transmission from farm to farm appeared to occur via successfully allowed low-risk movement of poultry familiar means: movement of live or dead birds or industry products and day-old poultry. Silos tend to Lessons learned include the continuing need to keep fragmentary phylogenetic analysis, survey break down communication silos involving results, and industry information from coalescing into industries, agencies and academics; to explore an enlightening epidemiology report of what regional biosecurity practices; to change industry happened (1). Dexamethasone, rye-based of inflammation can cause a decrease in nutrient diet, and water withdrawal resulted in the highest absorption efficiency and growth. In process not conducive to high-throughput screening Experiment 2, all chicks were exposed to a mild cold models. Additionally, morphological repairs are slow stress, (30C for six h) at three days of age plus an to develop and may not be fully indicative of enteric inflammation-inducing treatment, followed by function once treatment has begun. Birds were circulation has previously been associated with bone monitored for lameness through day 70. Two and short-term water withdrawal may be sufficient experiments were conducted to evaluate the effect of for inducing meaningful amounts of decreased stress on intestinal permeability induced by enteric integrity. All numerical data were nutritional requirements of poultry recommended by subjected to Analysis of Variance as a completely National Research Council (1994). Incidence Institutional Animal Care and Use Committee at the data were compared using the Chi Square Test of University of Arkansas. Microbiota Composition and Bone Mineralization in Bone circulatory disturbances in the development of Turkey Poults. Work undertaken in both the laboratory and the field has looked at the impact The use of oregano oil in laboratory infections of oregano-based (Orego-Stim) and carrier-based with Eimeria has been well documented with organic acid products on the prevalence of Eimeria promising results, although typically the studies are infections or histomoniasis. Where hatchery Eimeria and Histomonas are responsible for two vaccination with a anticoccidial vaccine significantly of the main protozoal diseases that affect poultry: adversely affected performance relative to a coccidiosis and Blackhead (histomoniasis). In a acid to have a significant role in protozoal (Eimeria laboratory study, four out of 43 plant substance and Histomonas) management programs. More work extracts demonstrated in vitro efficacy against is necessary to explore and understand their potential Histomonas meleagridis but all failed to be protective further. Blackhead disease improvement in turkey performance following (Histomoniasis) in poultry: a critical review. In vitro effect of herbal products against laboratory work is underway to understand the Histomonas meleagridis. Evaluation of dietary Natustat for control of Histomonas meleagridis in male turkeys on infected litter. The yearly number of cases disease of chickens, mostly broilers, of two to eight varied widely between three and 56 showing no clear weeks of age. Monthly numbers were more enlargement, atony and pallor of the proventriculus evenly distributed and varied between 13 and 33 and weakness of the gastric isthmus (9). The flocks were between lesions consist of glandular epithelial necrosis, ductal six and 60 days old. Their average age was 35 days epithelial degeneration and hyperplasia, infiltration of and the median age 36 days.