The effectiveness of gender determination using polymerase chain reaction and radioimmunoassay methods in cattle.

The aim of this study was to use polymerase chain reaction (PCR) by amplifying DNA from bovine (Bos taurus) fetal cells recovered through uterine puncture and subsequent amniotic fluid aspiration and to compare the effectiveness of the PCR method with amniotic dihydrotestosterone (DHT) levels in gender determination. Amniotic DHT levels between sexes were significantly higher in males than in females in all periods except the period 91 to 120 d. The differences among the amniotic DHT levels at different gestation periods (61 to 90, 91 to 120, 121 to 150, 151 to 180, 181 to 210 d) were not significant in females but were significant in males in the period 61 to 90 d compared with three other periods. Sensitivity was equal to 97.8% (95% CI=88.2% to 99.6%), and specificity was equal to 85.4% (95% CI=80.0% to 97.6%). These two values correspond with a cutoff of DHT in amniotic fluid. Distributions of the two sex groups were classified according to the 192.1 pg/mL cutoff value. A total of 93 amniotic fluid samples were examined by PCR analysis. The sex determination of 91 samples by PCR and electrophoresis was in agreement with the visual sexes of the fetuses. In two amniotic fluid samples, DNA was not isolated, and thus no sex determination was made. Fetal gender was correctly identified by PCR in 44 of 45 males and in 47 of 48 females. In PCR, one band (at the length of 102bp) and two bands (at the lengths of 102 and 226bp) were observed respectively for female and male fetuses. It may be concluded that the levels of amniotic DHT and PCR might be used for embryo sexing in pregnant cows.

An unmasked neurological pathology (schwannoma) following spinal anesthesia.

A neurological deficit occurred following spinal anaesthesia that unmasked a relatively important neurological pathology. Spinal anesthesia was performed between L3 and L4 by midline approach at the first attempt. Postoperative clinical examination of the patient showed sensory loss below the T5 segment. Whenever new neurological signs are seen after regional anesthesia, further investigations should be done immediately for differential diagnosis. - ÖZET - Spinal anestezi sonrasi gelisen oldukça önemli bir nörolojik patolojiyi kapsayan olgu sunuldu. Spinal anestezi ilk girisimde L3-4 arasindan orta hattan gerçeklestirildi. Postoperatif klinik muayenesinde T5 segmentinin altinda duyusal kayip tespit edildi. Rejyonel anestezi sonrasi ne zaman yeni nörolojik bulgular gözlenirse ayirici tani için hemen ileri tetkikler yapilmalidir.

Inhalation versus total intravenous anesthesia for lumbar disc herniation: comparison of hemodynamic effects, recovery characteristics, and cost.

The clinical effects, recovery characteristics, and costs of total intravenous anesthesia (TIVA), sevoflurane, and isoflurane anesthesia have been measured in various out-patient operations, but have not been evaluated in patients undergoing laminectomy or discectomy. In the current study, the authors assessed the hemodynamic characteristics, recovery, and cost analyzes after laminectomy and discectomy operations, comparing TIVA, sevoflurane, and isoflurane anesthesia. Sixty American Society of Anesthesiologists I and II patients were randomly divided into three groups, each consisting of 20 patients. Group I received propofol-alfentanil, Group 2 received sevoflurane-N2O, and Group 3 received isoflurane-N2O. At the end of surgery, the anesthetics were discontinued, and recovery from anesthesia was assessed by measuring the time until spontaneous eye opening and the time until response to verbal commands. The drug and delivery costs were calculated in United States dollars. No significant differences were found in the demographic data. Heart rate and mean arterial pressure decreased significantly after induction of anesthesia in the TIVA group, compared to the two other groups ( P < .05 for both comparisons). The fastest recovery was seen in the TIVA group. Incidences of postoperative nausea, vomiting, and pain were significantly reduced after TIVA ( P < .05 for both comparisons). Thus, TIVA patients required fewer additional drugs and showed the lowest additional costs in the post-anesthesia care unit. However, the total cost was significantly higher in the TIVA group than in the sevoflurane and isoflurane groups (52.73 dollars, 29.99 dollars, and 24.14 dollars, respectively) ( P < .05). Total intravenous anesthesia was associated with the highest intraoperative cost but provided the most rapid recovery from anesthesia, and the least frequent postoperative side effects.

The effects of intravenous fentanyl and lidocaine infiltration on the hemodynamic response to skull pin placement.

The aim of this study was to evaluate the effects of intravenous fentanyl and local lidocaine infiltration on the hemodynamic response to Mayfield skull pin head holder (MH) placement. Forty-five patients scheduled for elective craniotomy were studied. They were randomly divided into three groups. Group F received fentanyl 2 microg/kg IV 5 min before placement of the MH, group L was administered plain lidocaine 3 ml 1% by infiltration at each pin site 1 minute before placement, and both methods were applied together in group FL. Mean blood pressure (MAP) and heart rate (HR) were recorded at 5 preset times. In group F during and after MH placement, MAP and HR were significantly higher than in the L and FL groups. In the L group, there was significantly higher MAP and HR during the placement of MH than in the FL group. In the FL group, there was no significant increase in MAP or HR at any time of the recordings. We conclude that intravenous fentanyl with local infiltration of lidocaine into the periosteum is effective in reducing the hemodynamic response to MH placement in patients undergoing craniotomy.

The effects of intravenous fentanyl and lidocane infitration on the haemodynamic response to skull placement.

The aim of this study is to evaluate the effects of intravenous fentanyl and local lidocaine infiltration on the haemodynamic response to Mayfield skull pin head holder (MH) placement. Forty-five patients scheduled for elective craniotomy were studied. They were randomly divided into three groups. Group F received 2 microg/kg(-1) fentanyl i.v. 5 min before placement of the MH, group L was administered 3 ml 1% plain lidocaine by infiltration at each pin site 1 minute later and before placement of the MH, and both methods were applied together in group FL. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded at 5 preset times. Both were significantly increased during and after MH placement in group F compared to groups L and FL. In group L, there was a significant increase in MAP and HR during the placement of MH compared to group FL. In group FL, there was no significant increase in MAP or HR at any time of the recordings. We conclude that intravenous fentanyl with local infiltration of lidocaine into the periosteum is effective in reducing the haemodynamic response to MH placement in patients undergoing craniotomy.

Vertebral osteoblastoma: are radiologic structural changes necessary for diagnosis?

BACKGROUND: A case of osteoblastoma localized at the pedicle of the 10th thoracic vertebra is presented. CASE DESCRIPTION: The patient complained of nocturnal back pain not relieved by salycilates, a typical symptom of osteoblastoma. Bone scintigraphy showed a lower thoracic focus of increased osteoblastic activity; however, X-rays, computed tomography, and magnetic resonance images (MRI) were within normal limits, showing only obscure changes that were also noted in the rest of the spine. Repeat MRI with contrast revealed a focal enhancement. After pediculectomy, histopathologic examination confirmed the diagnosis of osteoblastoma. Fifteen months postoperatively, the patient is symptom-free. CONCLUSION: Our case demonstrates that some cases of osteoblastoma may not have the classical radiological appearance. Although non-contrast computed tomography and T1-weighted MRI are mildly positive in some instances, osteoblastoma is best visualized on MRI with gadolinium. Like any other neoplasm, osteoblastoma should be detected and removed early, before it can cause structural bony changes.

Antiischemic effect of ZK-118.182 in rabbits: a comparative study with iloprost.

The effects of ZK-118.182, a stable analogue of PGD2, were evaluated in an endothelin-1-induced cerebral ischemia rabbit model. Ischemia was induced by endothelin-1 injection (0.25 ng bolus) into subcavian artery and ischemic changes were assessed histologically by the number of ischemic neurons in the brain stem. ZK-118.182 (2 micrograms/kg, bolus into subclavian artery) reduced the number of ischemic neurons when injected 20 min after endothelin-1 injection, Iloprost, a stable analogue of PGI2, was also effective in reducing the number of ischemic neurons in a dose of 0.5 microgram/kg (bolus into subclavian artery). The results suggested that ZK-118.182 has a potent antiischemic effect which is comparable to that of iloprost in rabbits.

Assessment of mortality associated with mild head injury in the pediatric age group.

Reducing mortality among accident and trauma patients requires careful attention to monitoring those regarded as being at low risk. We hospitalized almost 1600 head-injured patients in the period between 1979 and 1992 at the Neurosurgery Department of Gazi University Medical School, Ankara, Turkey. These patients were selected from among the numerous patients admitted to our emergency unit and treated with the same protocol in the same department. Among the hospitalized children, there were three patients defined as having a mild head injury on the basis of Glasgow Coma Scale scores of 15 who later had unfavorable outcomes. Clinical signs that might identify potentially endangered patients with mild injury were gathered; these included the presence of post-traumatic amnesia, somnolence, irritability, anisocoria, local evidence of trauma to the head, associated injuries, history of altered consciousness, and skull fracture. The study was designed to identify features by which patients who are in real danger can be distinguished among the many with trivial trauma that we face every day. We did not find any identifying clinical features and concluded that computed tomographic scanning is the only reliable answer. This will reduce avoidable mortality and morbidity by identifying the patients who are at higher risk than is at first evident.

Sella turcica fractures in a trauma series and their clinical significance.

BACKGROUND: Fractures in the region of the sella turcica (ST) are usually associated with severe blunt head trauma and may produce many complications. The true incidence is difficult to assess since there have been only about 30 cases reported in the literature. METHODS: A total of 470 computed tomography (CT) sections--with optimum bone window images of skull bone--of 1600 head trauma patients who were admitted between 1979 and 1992, inclusive, to the Neurosurgery Department of Gazi University Medical School were analyzed retrospectively. RESULTS: There were a total of 17 patients with a fracture of the ST, constituting an incidence of 3.6%, and there was a preponderance of children. CONCLUSIONS: Computed tomography was very helpful in assessing the extent of ST fractures. In our cases, these fractures were not associated with a high complication or death rate, although a cerebrospinal fluid fistula was present in 53%.

Moderate head injuries in children as compared to other age groups, including the cases who had talked and deteriorated.

Patients defined as having a moderate head injury on the basis of Glasgow Coma Scale scores within the ranges of 9 to 13 after acute nonsurgical procedures were selected. Almost 1600 cases were hospitalized in the Neurosurgery Department. The cases were admitted through the Emergency Unit of Gaz University Medical School, Ankara, Turkey during the period between 1979 and 1992. The group studied consisted of 231 selected patients assessed separately in paediatric, adult and elderly age groups. Possible risk factors such as: GCS score, anisocoria, unilateral or bilateral fixed pupils, impaired oculocephalic reflexes, presence of multiple systemic injuries, aetiology of head trauma, presence of linear or depressed skull fractures, space occupying mass on CT or operation was also assessed. Subarachnoid haemorrhage turned out to be the only independent significant risk factor in predicting mortality. The data about the patients who have "talked and deteriorated" were also reported so as to assisst physicians charged with the care of trauma victims.