The mid-point transverse process to pleura (MTP) block: a new end-point for thoracic paravertebral block.

Current descriptions of thoracic paravertebral block techniques require the needle tip to be anterior to the superior costotransverse ligament. We hypothesised that an injection point midway between the posterior border of the transverse process and the pleura would result in spread to the paravertebral space. We completed bilateral injections of 5 ml methylene blue 0.2% midway between the posterior border of the transverse process and the pleura at T2, T4, T6, T8 and T10 in three unembalmed cadavers. The presence of methylene blue dye at the nerve root in the paravertebral space, the corresponding intercostal nerve and sympathetic chain at the level of injection, and at additional levels, was examined. We identified the superior costotransverse ligament, pleural displacement and spread to the erector spinae plane. We describe two case reports using this technique in patients. Our cadaver results and clinical cases demonstrate that, with the exception of cadaver 1, an injection point midway between the posterior border of the transverse process and pleura consistently achieved spread of dye at least to the paravertebral space at the level of injection, and frequently to adjacent levels. This may be a plausible explanation for the landmark technique's inability to reliably achieve a multilevel block. We describe a new ultrasound-guided technique for a single level paravertebral block.

Failed landings after laying hen flight in a commercial aviary over two flock cycles.

Many egg producers are adopting alternative housing systems such as aviaries that provide hens a tiered cage and a litter-covered open floor area. This larger, more complex environment permits expression of behaviors not seen in space-limited cages, such as flight. Flight is an exercise important for strengthening bones; but domestic hens might display imperfect flight landings due to poor flight control. To assess the potential implications of open space, we evaluated the landing success of Lohmann white laying hens in a commercial aviary. Video recordings of hens were taken from 4 aviary sections at peak lay, mid lay and end lay across two flock cycles. Observations were made in each focal section of all flights throughout the day noting flight origin and landing location (outer perch or litter) and landing success or failure. In Flock 1, 9.1% of all flights failed and 21% failed in Flock 2. The number of flights decreased across the laying cycle for both flocks. Proportionally more failed landings were observed in the double row sections in Flock 2. Collisions with other hens were more common than slipping on the ground or colliding with aviary structures across sections and flocks. More hens slipped on the ground and collided with physical structures at peak lay for Flock 2 than at other time points. More collisions with other hens were seen at mid and end lay than at peak lay for Flock 2. Landings ending on perches failed more often than landings on litter. These results indicate potential for flight-related hen injuries in aviary systems resulting from failed landings, which may have implications for hen welfare and optimal system design and management.

scyllo-inositol and myo-inositol levels in tissues of the skate Raja erinacea.

1. Many organs of the skate Raja erinacea have been found to contain scyllo-inositol levels that are much higher than myo-inositol, the opposite to that found in mammals. 2. Both inositols were found in all skate organs studied. 3. myo-Inosose-2 was found to accompany the inositols in many of these organs.

Identification and measurement of plasticizer in neonatal tissues after umbilical catheters and blood products.

Because of concern about tissue uptake of pasticizers used in medical equipment, di-(2-ethylhexyl) phthalate was measured by gas chromatography-mass spectrometry in neonatal heart and gastro-intestinal tissue. Seventeen infants who had umbilical catheterization alone or with administration of blood products, and 13 stillborn or older controls were studied. The mean levels of the plasticizer for heart residue and pressed extract in the study group --1.27 plus or minus 0.42 and 0.66 plus or minus 0.22 mug per gram respectively--were significantly (pgreater than 0.005) higher than the corresponding control levels (less than 0.07 plus or minus 0.03 and less than 0.07 plus or minus 0.04 mug per gram). Higher levels were associated with larger amounts of blood products, more extensive use of catheters, and early death. Levels in gastrointestinal tissue from three infants who had died of necrotizing enterocolitis were significantly (less than 0.05) higher than those in gastrointestinal tissue from infants without this disease. Thus, plasticizer from medical use of plastics does accumlate in tissues of critically ill infants.