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X. Bogir, M.B.A., M.D.

Co-Director, University of Arizona College of Medicine – Tucson

Steller sea lion numbers in the northern part of the Sea of Okhotsk declined during 1930­2002 from 7,200 to 3,100 individuals. Numbers at Tuleny Island have increased since establishment of a rookery there during 1983­2005 and by immigration from other sites. Walrus Island is designated an "intermittent" monitoring site on the Refuge, meaning that it should be surveyed at least every 10 years. The primary breeding species in 2006 were red-faced cormorant (68 birds and 7 nests), common murre (679 birds), black-legged kittiwake (154 birds and 20 nests), and Steller sea lion (159 adults and 27 pups). Results of this survey show continued decrease in numbers of common and thick-billed murres, but more blacklegged kittiwakes were counted in 2006 than in previous surveys (1987 and 1997). In addition, the number of northern fur seals recorded by the Refuge on the island has risen sharply (1 in 1987, 15 in 1997, and 120 in 2006). Population Assessment, Ecology and Trophic Relationships of Steller Sea Lions in the Gulf of Alaska. Extralimital Distribution of Galapagos (Zalophus Wollebaeki) and Northern (Eumetopias Jubatus) Sea Lions in Mexico. El Niсo events also have been reported to directly influence pinniped distribution. These events have increased in frequency and intensity changing the foraging ecology of the two pinniped species analyzed. In this paper, we present new extralimital records of distribution of two species rarely found in Mexican waters: the Galapagos (Zalophus wollebaeki) and the Northern (Eumetopias jubatus) sea lions. These new records increase the number of marine mammal species recorded in Mexico and add evidence to the fact that large-scale climatic variation and possible effects of global warming shift the distribution of marine mammals. Interactions between marine mammals and commercial fisheries are addressed under three new Sections. This new regime replaced the interim exemption that had regulated fisheries-related incidental takes since 1988. California and Steller Sea Lion Use of a Major Winter Haulout in the Salish Sea over 45 Years. However, there remains substantial and unexplained variance in the annual number of sea lions using a major winter haulout at the entrance to the Salish Sea. We used linear regression on principal components to show maximum annual sea lion counts, adjusted for population growth, varied as a function of herring biomass and not local sea surface temperatures or precipitation. Results suggest that Race Rocks, British Columbia, Canada, is used as a stopover for an increasing number of sea lions approaching southern Vancouver Island to feed during the nonbreeding season. Reports of resource-driven movements of sea lions are not new, but this is the first study to use a multidecade data set to show resource-driven movements can underlie long-term patterns of population growth. Finally, we found an unexplained change in the seasonal use of Race Rocks affecting both species. Arrival at Race Rocks has occurred in late summer since 1965, but up to 1979 departure had occurred the following spring; since as late as 1997, departure has occurred mid winter. This study 148 highlights the complexities of enacting conservation plans for species with latitudinal distributions and undergoing long-term population change. Satellite Tracking of Adult Female Steller Sea Lions in the WesternCentral Aleutian Islands Reveals Diverse Foraging Behaviors. However, attaching satellite-telemetry instruments capable of recording diving behavior and tracking locations requires the safe capture and restraint of sea lions that may weigh more than 350 kilograms. Based on that success, captures were next attempted in the western and central Aleutian Islands in November 2011, but the effort was confounded by weather and ocean conditions. The successful capture of one adult female (identified as "=24") on Ulak Island in the central Aleutian Islands resulted in the subsequent tracking of her movements for a period of 175 days. We fit multi-state mark-recapture models to resighting data of 369 known-aged Steller sea lion (Eumetopias jubatus) females marked as pups on their natal rookeries in southeastern Alaska from 1994-2005 and monitored from 2001-15. We estimated probabilities of females being first observed parous at their natal site (natal philopatry), and of not moving breeding sites among years (breeding philopatry) at large (> 400 km, all five rookeries in southeastern Alaska) and small (< 4 km, all islands within the largest rookery, Forrester Island Complex, F) spatial scales. At both spatial scales, the probability of pupping at a non-natal site increased with population size of, and declined with distance from, the destination site.

This theory, however, does not explain the occurrence of syringomyelia in patients with non-patent central canals. This will demonstrate the syrinx with any associated Chiari malformation and exclude intramedullary tumour. With coexisting Chiari malformations, screening in the supine position will show the cerebellar tonsils descending below the foramen magnum. Puncture of the syrinx is occasionally possible and subsequent injection of contrast shows its exact extent. Management the natural history is variable and operative techniques only of limited benefit. The approach depends on progression of symptoms and the presence or absence of an associated Chiari malformation. If Chiari malformation is present ­ decompression by removing the posterior rim of the foramen magnum and posterior arch of the atlas and widening the dura with a patch, improves symptoms in most patients and should halt progression. This operation relieves the obstructed foramen magnum and alters the hydrodynamics of the syrinx. Some patients benefit from this procedure but in others, progressive deterioration continues. Despite all efforts, about one-third of patients suffer progressive deterioration. Cord damage occurs either from direct compression or secondary to a thrombophlebitis and venous infarction. Clinical features: Develops over several days mimicking a rapidly progressive extradural tumour or haematoma with bilateral leg weakness, a sensory level and urinary retention, but distinguishing features are: ­ very severe pain and tenderness over the involved site. Investigations: Straight X-ray may or may not show an associated osteitis or discitis. Management: Urgent decompressive laminectomy and abscess drainage combined with intravenous antibiotic therapy over some weeks provide the best chance of recovery of function. In the cervical spine, anterior collections may be drained through the disc space. In Britain it usually affects the middle aged and is particularly prevalent in immigrant populations and in the immunocompromised. The incidence is now increasing, probably due to the development of antibiotic resistance. The lower thoracic spine is commonly involved and the disease initially affects the intravertebral disc and spreads to adjacent vertebral bodies. Clinical features: the classic systemic features of weight loss, night fever and cachexia are often absent. The onset may be gradual as pus, caseous material or granulation tissue accumulate, or sudden as vertebral bodies collapse and a kyphosis develops. Infective process spreads throughout the vertebral body and may involve the pedicles or facet joints. A needle biopsy is often sufficient, but occasionally an exploratory operation (costotransversectomy) is required. This permits clearance of pus and caseous debris without retracting the spinal cord. A tough outer layer ­ the annulus fibrosis surrounds a softer central nucleus pulposus. Discs degenerate with age, the fluid within the nucleus pulposus gradually drying out. An acute disc prolapse occurs when the soft nucleus herniates through the annular tear causing irritation and/or compression of the adjacent nerve root. Herniation usually occurs posterolaterally, but may occasionally occur centrally, compressing the cauda equina. Transverse process Superior articular facet Compressed nerve root Inferior articular facet Spinous process Posterolateral disc protrusion Compressed roots within cauda equina Disc degeneration may contribute to hypertrophy and degeneration of adjacent facet joints, a further source of back and leg pain and an important cause of root compression. Here the spinal canal diameter is considerably diminished and minor disc protrusion or mild joint hypertrophy may more readily compress the nerve root. Posterolateral disc herniations usually compress the nerve root exiting through the foramen below the affected level.

As this capsule develops the connection of the prominent testicular (seminiferous) cords with the surface epithelium is disrupted. Gradually the testis separates from the regressing mesonephros, becoming Fetal testosterone level Male external genital differentiation & growth Genital tubercle formation Leydig cell activity Sertoli cell activity Testis descent Wolffian duct differentiation Germ cell migration? Concurrent with testicular cord formation, fetal Leydig cells differentiate from loosely packed, undifferentiated mesenchymal cells in the interstitium (Pelliniemi, 1975). These interstitial Leydig cells produce the male sex hormone testosterone, which induces masculine differentiation of the Wolffian duct and external genitalia. Intratesticular vasculature differentiates in the gonadal mesenchyme along with the growth of epithelial components. A testis-specific distribution of blood vessels is obvious from an early phase of testicular development (Pelliniemi, 1975). The fetal testis is composed of testicular cords containing supporting immature Sertoli cells and centrally placed spermatogonia, derived from the surface epithelium and primordial germ cells respectively. These cords are surrounded by a highly vascularized interstitium containing fetal Leydig cells and mesenchyme (Pelliniemi and Niei, 1969). The seminiferous cords turn into tubules when the Sertoli cells undergo terminal differentiation. This occurs after birth when they finish dividing (roughly at the onset of puberty). In the rodent and human species, fetal testicular androgen production is not only necessary for proper testicular development and normal male sexual differentiation but also differentiation of the Wolffian ducts into the epididymides, vasa deferentia, and seminal vesicles (Barker et al. Near the testis, some tubules persisting and are transformed into efferent ductules, which open into the mesonephric duct, forming the ductus epididymis. Distal to the epididymis, the mesonephric ducts acquire a thickening of smooth muscle to become the ductus deferens, or vas deferens (Moore, 1982). In the human the external genitalia are indistinguishable until the ninth week of gestation, and not fully differentiated until the twelfth week of development. Early in the fourth week of gestation, the sexually undifferentiated fetus develops a genital tubercle at the cranial end of the cloacal membrane. Labioscrotal (genital) swellings and urogenital (urethral) folds then develop on each side of the cloacal membrane. In response to testicular androgens the phallus enlarges and elongates forming the penis while the labioscrotal swellings ultimately form the scrotum. At the end of the sixth week of gestation, the urorectal septum fuses with the cloacal membrane dividing the membrane into a dorsal anal and a ventral urogenital membrane. Approximately a week following, these membranes rupture forming the anus and urogenital orifice, respectively (Moore, 1982). Fetal testicular androgens are responsible for the induction of masculinization of the indifferent external genitalia. The testis remains caudally positioned during the tenth to fifteenth week until entry into the inguinal canal and transabdominal descent. Testicular descent through the inguinal canal begins in the twenty-eighth week and the testes enter the scrotum by the thirty-second week. There are two critical phases of testis descent, transabdominal and inguinoscrotal, essential to move the testes into the scrotum. Cryptorchidism or undescended testes occurs in about 3% of full-term and 30% of preterm males making it the most common human birth defect (Boisen et al. However, a comparative study of the prevalence of cryptorchidism in cohorts of children in Denmark and Finland, a higher prevalence of cryptorchidism was observed in Denmark, with a 9% incidence rate in full-term males reported at birth (Boisen et al. These data add further evidence to the concept that there is a significant geographical difference in male reproductive health in two neighboring countries, and therefore potential exposure to similar environmental effects. As the major difference was found in the milder forms of cryptorchidism, an environmental rather than a genetic basis for effect is favored. If correct, there is a need to determine the nature of the environmental agents responsible, because similar agents may well be implicated in the trends noted in other geographically diverse countries where an increasing frequency of cryptorchidism and testicular cancer has been found (Boisen et al. Thus male, but not female, reproductive tract development is totally hormonally dependent and thus inherently more susceptible to endocrine disruption (see section "Endocrine Disruption" including "Screening and Puberty").

In plasma, zinc concentration is about 1 mg/L, and is bound to albumin (60­80%), which represents the metabolically active pool of zinc. The concentration of zinc in the plasma is not a sensitive indicator of zinc status and does not reflect the dose­response relationship between zinc levels in the body and effects at various target sites. Zinc ions are involved as inter- and intracellular messengers and the homeostasis of zinc has to be tightly controlled. Zinc is an effective inducer of metallothionein synthesis and, when metallothionein is saturated in intestinal cells, zinc absorption is decreased. Liver metallothionein concentration is influenced by hormonal factors, including adrenocorticotropic hormone and parathyroid hormone, and various stimuli that impact zinc metabolism. The high concentration of zinc in the prostate is probably related to the rich content of zinc-containing enzyme acid phosphatase. Essentiality and Deficiency More than 300 catalytically active zinc metalloenzymes and 2000 zinc-dependent transcription factors exist (Ziegler and Filer, 1996; Cai et al. Zinc participates in a wide variety of metabolic processes, supports a healthy immune system, and is essential for normal growth and development during pregnancy, childhood, and adolescence. Zinc deficiency is related to poor dietary zinc intake, dietary phytate intake, chronic illness, or over-supplementation with iron or copper (Prasad, 2004). Symptoms of zinc deficiency include growth retardation, appetite loss, alopecia, diarrhea, impaired immune function, cognitive impairments, dermatitis, delayed healing of wounds, taste abnormalities, and impaired sexual function (Prasad, 2004; Cai et al. Acrodermatitis enteropathica is a rare genetically based, heredity disorder involving zinc deficiency due to poor intestinal absorption (Perafan-Riveros et al. Zinc supplementation, alone or with other micronutrients, is recommended for zincdeficient children, especially in developing countries. Therapeutic uses of zinc include the treatment of acute diarrhea in infants with severe zinc deficiency, the treatment of common cold by its antiviral and immunomodulatory effects, therapy for Wilson disease to help reduce copper burden and to induce metallothionein, and in the prevention of blindness in age-related macular degeneration (Prasad, 2004). Toxicity Acute zinc toxicity from excessive ingestion is uncommon, but gastrointestinal distress and diarrhea have been reported following ingestion of beverages standing in galvanized cans. Following inhalation of zinc oxide, and to a lesser extent other zinc compounds, the most common effect is "metal-fume fever" characterized by fever, chest pain, chills, cough, dyspnea, nausea, muscle soreness, fatigue, and leukocytosis. Acute inhalation of high levels of zinc chloride as in the military use of "smoke bombs" results in more pronounced damage to the mucous membrane including interstitial edema, fibrosis, pneumonitis, bronchial mucosal edema, and ulceration. Following long-term exposure to lower doses of zinc, symptoms generally result from a decreased dietary copper absorption, leading to early symptoms of copper deficiency, such as decreased erythrocyte number or decreased hematocrit. Zinc can also act as a neurotransmitter for normal brain functions (Frederickson et al. Zinc modulates the solubility of -amyloid in the brain and protects against -amyloid toxicity, but excess zinc may trigger neuronal death that is independent or synergistic with the toxic effect of -amyloid (Valko et al. In addition, excess zinc released by oxidants can act as a potent neurotoxin (Frederickson et al. Pancreatic Toxicity Because large amounts of zinc accumulate in secretory granules of pancreatic islet beta-cells, zinc released under certain conditions can affect the function or survival of islet cells and cause beta-cell death. A single, high-dose injection of zinc increases plasma -amylase activity and can produce fibrosis and necrosis of pancreatic exocrine cells, but does not affect the islets of Langerhans cells (Cai et al. In addition, zinc deficiency may be associated with increased risk of cancer in humans (Prasad and Kucuk, 2002). Zinc supplementation could decrease oxidative stress and improve immune function, which may be a possible mechanism for its cancer preventive activity (Prasad and Kucuk, 2002). In experimental animals, zinc prevents cadmiuminduced testicular cancer, but facilitates cadmium-induced prostate tumors (Waalkes, 2003). Chemical compounds of aluminum occur typically in the trivalent valence state (Al3+). As a hard trivalent ion, aluminum binds strongly to oxygen-donor ligands such as citrate and phosphate. The chemistry of aluminum compounds is complicated by a tendency to hydrolyze and form polynuclear species, many of which are sparingly soluble (Harris et al. Aluminum has many uses, mainly in the form of alloys, and finds use in packing, construction, transportation, electrical applications, and beverage cans.