Erector Spinae Plane Block Catheter Insertion under Ultrasound Guidance for Thoracic Surgery: Case Series of Three Patients

The erector spinae plane (ESP) block is a novel plane block first reported for thoracic analgesia. It affects the dorsal and ventral rami of the thoracic nerves. Owing to the ease of the technique and decreased risk of complication of the ESP block under ultrasound guidance, it can be a preferable procedure compared with other invasive techniques, such as neuraxial and nerve blocks. In this case report, we presented three patients who had thoracic surgery under general anesthesia. The ESP block and catheter placement was applied to the patients before operation. The catheter was inserted deep into the erector spinae muscle and was used successfully for postoperative pain management.

Does a single-dose preemptive intravenous ibuprofen have an effect on postoperative pain relief after septorhinoplasty?

PURPOSE

Septorhinoplasty is a surgical procedure widely employed by otolaryngologists and plastic surgeons. The purpose of this study was to investigate the effects of a single pre-emptive dose of iv ibuprofen on postoperative pain and opioid consumption in patients undergoing septorhinoplasty.

MATERIAL AND METHODS

50 patients scheduled for septorhinoplasty were included in this prospective, randomized, double-blinded study. Control group (n = 25) was administered 100 mL iv saline solution 30 min preoperatively, while Ibuprofen group (n = 26) received 800 mg ibuprofen iv. in 100 mL saline solution. Intravenous fentanyl was administered with a Patient Controlled Analgesia device after surgery for postoperative pain management. Postoperative pain was evaluated using a Visual Analogue Scale (VAS) with 0 representing no pain and 10 the worst pain possible.

RESULTS

VAS scores at 10, 20, and 30 min and at 1, 2, 4, 8, 12 and 24 h were lower in the ibuprofen group than in the control group (p < 0.05). Total fentanyl consumption was lower in the ibuprofen group compared to the placebo group (148.8 ± 86.4 mcq vs 338.00 ± 81.00 mcq), respectively.

CONCLUSION

We suggest that the pre-emptive use of iv ibuprofen at a dosage of 800 mg 30 min before septorhinoplasty will be beneficial in reducing opioid consumption and pain scores.

The effects of chronic smoking on lung tissue and the role of alpha lipoic acid

We investigated the effects of alpha lipoic acid (ALA) on blood and lung tissue exposed chronically to cigarette smoke (CS). Female Sprague-Dawley rats were divided into three groups. Group 1 was the control group (CON): fresh air was supplied twice daily and 0.1 ml physiological saline was given orally for 8 weeks. Group 2 was exposed to CS: 12 cigarettes were smoked daily at two sessions for 1 h and 0.1 ml saline was given orally for 8 weeks. Group 3 (CS + ALA) was exposed to 12 cigarettes daily in two sessions for 1 h and 100 mg/kg/day ALA was given orally for 8 weeks. DNA damage was assessed using comet analysis; oxidative damage was assessed using ischemia-modified albumin (IMA) from blood; and total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) were measured in blood and lung tissue. Histopathological and immunohistochemical evaluation of hypoxia-inducible factor (HIF)-1α, and -2α, caspase-3, vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF₂) were conducted using lung tissue. The oxidative markers, TOS, OSI and IMA, and the comet analysis score were increased and the TAS level was decreased in the blood of the CS group compared to the CON group. IMA levels in blood, and TOS and OSI levels in the lung were decreased significantly in the CS + ALA group compared to the CS group. We observed increased septal wall thickness, marked and diffuse inflammatory reaction, emphysema, and necrotic cell debris in bronchial and bronchiolar lumens in the CS group. HIF-1α, HIF-2α, caspase-3 and FGF₂ expressions were increased, while VEGF expression decreased in the lung tissues of the CS group compared to the CON group. ALA slightly ameliorated the damage caused by chronic exposure to CS in the lungs, but further investigation is needed to determine its possible protective effects at different dosages.

Immunohistochemical examination of osteopontin and sirtuin-1 expression in cattle tuberculosis

We evaluated osteopontin (OPN) and sirtuin-1 (SIRT-1) expression in bovine tuberculosis lesions. The organs of cattle with tuberculosis (TB) were examined for morphology, histopathology and immunohistochemistry of OPN and SIRT-1 expression. Macroscopic lesions commonly were localized in the lungs and mediastinal lymph nodes as well as in livers and hearts. Mycobacterial agents were detected in lesions using the Ziehl-Neelsen method. No OPN or SIRT-1 expression was detected by immunohistochemistry in normal tissues, whereas a marked increase in their expressions was observed in tuberculous lesions. The most intense immunopositive cells were Langerhans giant cells and inflammatory cells. Our findings indicate that OPN and SIRT-1 participate in the pathogenesis of bovine TB.

Immunohistochemical evaluation of bcl-2, ER-alpha, caspase -3, -8, -9, PCNA and Ki-67 expressions in canine mammary carcinomas

We investigated the expression of bcl-2, estrogen receptor alpha (ER-alpha), caspase-3, -8, -9, proliferating cell nuclear antigen (PCNA) and Ki-67 in canine mammary carcinomas. We used 65 paraffin embedded and re-diagnosed archival canine mammary tumor samples to which we applied the routine streptavidin-biotin-peroxidase technique. Seventeen cases were re-diagnosed as tubulopapillary carcinoma, 31 were re-diagnosed as complex carcinoma and 17 were re-diagnosed as carcinosarcoma. Differences of expression of bcl-2 and PCNA were statistically significant according to tumor type. Differences in expression of ER-alpha, caspase-3, -8, -9 and Ki-67 were not statistically significant. Differences of expression of bcl-2 and PCNA were statistically significant compared to ER-alpha, caspase-3, -8, -9 and Ki-67 in carcinosarcomas. We report the prognostic significance of bcl-2 and PCNA expression in canine mammary carcinosarcomas.

Somatic SNPs of the BRCA2 gene at the fragments encoding RAD51 binding sites of canine mammary tumors

Mammary tumors are the most common tumor type both in women and in female dogs. In women, heritable breast cancers have been linked mutations in the breast cancer susceptibility gene BRCA2 and it contains eight BRC repeats in exon 11 that bind to RAD51. In this study, we investigated the sequence variations of BRC1-BRC8 and C-terminus of canine BRCA2 gene. From a total of 64 canine patients with mammary tumors, 31 mammary tumors with benign and malign carcinomas and the 3 normal mammary glands were used for the study. In this study, 19 SNPs of exon 11 of BRCA2 in canine mammary tumors were detected for the first time. The c.2383A>C (T1425P) SNP was found to be the most probable disease-associated nsSNP. Our findings suggest that T1425P variation in BRC3 to be the most probable disease-associated nsSNP and may affect RAD51 binding strength.

Pheniramine Maleate is more effective than Lidocaine on Fentanyl Induced Cough

OBJECTIVE

Fentanyl is frequently used during anesthesia induction. The use of fentanyl can cause cough through different mechanisms. Here, we aimed to investigate effects of pheniramine maleate (PM), an antihistaminic agent, and compare it with lidocaine on fentanyl induced cough.

METHODS

This is a randomized double-blind prospective clinical study of ASA I-II, 120 patients scheduled for elective abdominal surgery. Patients were administered drugs intravenously and randomly allocated into three groups: Group C (2 ml 0.9 % normal saline), Group L (1mg/kg lidocaine), and Group F (PM 45.5 mg). 90 seconds after administration, 2µ/kg fentanyl was applied in three seconds to all patients. Severity of cough (mild: 1-2, moderate: 3-5, severe> 5), time of the cough and vital parameters were recorded 90 seconds after fentanyl injection.

RESULTS

Eight patients (25%) in Group C had fentanyl induced cough whereas three patients (7.5%) in Group L and one patient (2.5%) in Group F experienced this phenomenon. There was statistically significant difference between Group F and Group C (p<0.05); however, differences between Group L and Group C or Group F and Group L were not statistically significant (p>0.05).

CONCLUSIONS

Pheniramine Maleate 45.5 mg is better that placebo and as effective as lidocaine to prevent fentanyl induced cough.

Takayasu's arteritis as the aetiology of unresolved fever in an adult patient with cystic fibrosis

Vasculitis is an unusual complication of cystic fibrosis (CF), normally affecting patients with more severe lung disease. Typical presentation is with skin disease but other organ involvement has been reported. Systemic response to bacterial colonisation and immune complex deposition secondary to chronic airway inflammation is thought to be underlying mechanism of the disease. The authors describe a 28-year-old female Turkish patient with CF presented with fever and arthralgias. The patient was known to have chronic Pseudomonas infection; therefore, a respiratory tract infection was assumed and the patient was treated with imipenem and amikacin for 14 days. Following through investigations of fever of unknown origin, Takayasu's arteritis was identified and the patient responded well to immunosuppression with corticosteroid.

Polymorphism of sheep POU1F1 gene exon 6 and 3'UTR region and their association with milk production traits

The purpose of the study was to detect the AluI and DdeI polymorphisms within POU1F1 gene exon 6 and 3'UTR region in Turkish sheep breeds, and their association with milk productive traits. Jugular blood samples were collected from 50 Sakiz, 50 White Karaman, and 50 Awassi sheep using EDTA as an anticoagulant. PCR-RFLP and sequencing analysis were performed to investigate possible polymorphisms in the exon 6 and 3' flanking region of the sheep POU1F1 gene. The PCR products were digested with restriction endonuclease AluI and DdeI, and biallelic polymorphism was found with restriction endonuclease AluI and two genotypes (TT (296 bp and 173 bp) and CC (235 bp, 173 bp and 61 bp)) were detected. White Karaman and Awassi breeds did not show polymorphisms for AluI restriction sites. No polymorphism at the DdeI cleavage sites was detected in the three sheep breeds. Significant statistical results were found in milk yield ((***)P0.001), fat ((***)P0.001) and lactose ((*)P0.05) values with TT and CC genotypes, however no significant association of TT and CC genotypes with protein values was detected (P>0.05) and individuals with genotype TT had a superior milk yield in Sakiz sheep breeds. As sequence results, seven variation points were determined for exon 6 (g.185T>C) and 3'UTR (g.220G>A, g.229C>T, g.248C>T, g.250A>T, g.255T>C, g.258C>T) of the sheep POU1F1 gene. We have reported here for the first time single nucleotide polymorphisms of the POU1F1 gene for both exon 6 and 3'UTR and its effects on milk traits in Turkish sheep breeds were evaluated.

Haplotype variation of estrogen receptor-alpha (ER-alpha) gene exon 4 in Turkish sheep breeds

Estrogen receptor a (ERalpha) gene has previously been found to related with sexual development and reproduction. In this study, on the basis of the sequences of human, cattle and caprine estrogen receptor a (ERalpha) genes, available in the GenBank database, sets of PCR primers were designed and used to amplify the ovine ERalpha gene exon 4 region. We identified six single nucleotide polymorphisms (SNP) in the ERalpha exon 4. Some variations determined for exon 4 g.43A > G, p.T43A; g.49C > T, p.L49F; g.178A > T, p.T178S led to changes in the amino acids, but no amino acid changes were determined in g. 18G > C, g.27C > T, g.96G > A. These fragments were deposited in the GenBank database under accession number: JF262030-JF262035. It was noted in particular that White Karaman and Awassi breeds were similar to each other, whereas the Chios breed had a different variation.

Prolactin receptor (<i>PRLR</i>) gene polymorphism in Chios, White Karaman and Awassi sheep breeds

Abstract. The objective of the present study was to determine the polymorphism in the prolactine receptor (PRLR) gene in Chios, White Karaman and Awassi, which are native sheep breeds in Turkey. By means of PRLR gene sequence homology between sheep and humans, two primer pairs were designed for polymerase chain reaction (PCR) amplification within intron 1 and exon 10 of the PRLR gene in sheep. A total of 160 amplicons (99 for intron 1 and 61 for exon 10) were subjected to DNA sequence analysis. For intron 1, 6 different haplotypes were determined. For exon 10, 7 different haplotypes were obtained. Some variations determined for exon 10 (g.14A>T p.Q14L; g.160G>A p.D160N; g.166G>A p.E166K; g.167A>T p.E167V; g.176A>T p.H176L; g.206G>A p.S206N; g.208G>A p.G208R) led to changes in the amino acids, but no amino acid changes were determined in g.2A>T, g.81A>G, g.138A>G, g.186C>T, g.207T>C. It was noted in particular that White Karaman and Awassi were similar to each other in both PRLR exon 10 and intron 1 haplotypes, whereas the Chios breed had a different variation.

Erythrocyte potassium, sodium and glutathione concentrations and their relationship with reproduction, body weight and fleece weight traits in Awassi sheep

Abstract. Relationship between erythrocyte potassium (Ke), erythrocyte sodium (Nae) and blood glutathione (GSH) concentrations and production/ reproduction traits were investigated in Awassi sheep. Thirty healthy sheep subjected to analyze for phenotypic and gene frequencies of Ke, Nae and GSH concentrations. Correlation between these parameters and production/ reproduction traits such as greasy fleece weight, milk production, birth rate, single and twin birth rate and body weight were calculated. A positive correlation was found between birth rate and mean Ke concentration (r=0.481, P<0.008) and Nae concentration (r=−0.454, P<0.013). Another correlation between GSH concentration and greasy fleece weight (r=−0.368, P<0.049) and milk production (r=0.379, P<0.050) parameters was also evidenced. These suggest that Ke, Nae and GSH concentrations may be included in the metabolic profile testing parameters.

Clinocopathologic and immunohistochemical findings of multiple genital leiomyomas and mammary adenocarcinomas in a bitch

A 13-year-old female Pointer dog was presented for evaluation of mammary tumours and bloody vaginal discharge at the Veterinary Teaching Hospital of Mehmet Akif Ersoy University, Faculty of Veterinary Medicine. On the history, owner complained of mammary tumours and bloody vaginal discharge. Three mammary tumours and lymphadenopathy at the mammary lymph nodes were observed at the clinical examination. A big, firm, palpable mass was found in the abdominal cavity. Vaginal cytology revealed numerous pleomorphic and anaplastic cells. Abdominal ultrasonography demonstrated a large mid-abdominal mass at the distal part of the left uterine horn. Also multiple masses in the cervix and vagina were found. Because of the poor prognosis and the desire of the owner, the bitch was killed. At the necropsy numerous masses were seen at the vagina and cervix and one big mass seen at the left cornu uteri. Histopathological diagnosis was leiomyoma. Multiple metastases of mammary tumours were seen at the lungs. Histopathologically, mammary tumours were diagnosed as complex type tubulopapillary adenocarcinoma. The objectives of this study were to measure the proliferation indices in canine complex type mammary adenocarcinoma and genital leiomyomas using immunohistochemical detection of Ki-67 and proliferating cell nuclear antigen to determine the relationship of these antigens to clinical and pathologic variables; and to examine the immunoreactivity of these tumours with different markers. Pan-cytokeratin and S100 were negative, desmin and glial fibriler acidic protein were slight positive and the other markers (carsinoembryogenic antigen, proliferating cell nuclear antigen, vimentin, smooth muscle actin, p53, fibronectin, Ki67) were found strong positive at the genital tumours. Only desmin were negative; the other markers were strong positive at the mammary tumours.

Observations and immunohistochemical detection of Coronavirus, Cryptosporidium parvum and Giardia intestinalis in neonatal diarrhoea in lambs and kids

In this study, clinical, parasitological, macroscopical, histopathological and immunohistochemical examinations were performed on 19 kids and 11 lambs (30 animals) with neonatal diarrhoea to detect the presence of Coronavirus, Cryptosporidium parvum and Giardia intestinalis. Clinically, severe dehydration, yellowish-green to brown coloured diarrhoea and death were observed. Mortality rates were 10-30% in the examined flocks. The most common agent was C. parvum diagnosed in 20 animals as a single causative agent, whereas G. intestinalis was found in 5 of 30 animals. These two protozoa were detected together in 4 animals upon faeces examination. Fifteen of 24 cases of C. parvum and 3 of 11 cases of G. intestinalis were also confirmed histopathologically. Following immunohistochemical examination, all cryptosporidiosis cases were confirmed by positive immunostaining of intestinal sections. Two additional Giardiosis cases with negative results upon parasitological and histopathological examinations were diagnosed by means of immunohistochemical examination. Coronavirus was detected immunohistochemically in one kid with neonatal enteritis. Following diagnosis, herds were treated with Trimethoprim + Sulfodoxine and multivitamin complexes. Intravenous and intramuscular administrations of these drugs were effective for both treatment and prevention of neonatal diarrhoea in lambs and kids.

Bovine tuberculosis in Burdur, southern Turkey: epidemiological, pathological and economic study

SETTINGS

Burdur is the most important dairy cattle breeding and milk production area of Turkey, and Burdur slaughterhouse is one of the biggest slaughterhouses in the southern part of the country. No scientific information is available on the prevalence of tuberculosis (TB) in cattle in Burdur. A survey was therefore undertaken to determine the prevalence of disseminated TB infection in cattle in this district.

OBJECTIVES

To implement a disease monitoring system in Burdur slaughterhouse to estimate the annual prevalence of disseminated TB in cattle slaughtered and inspected in 2003-2004.

DESIGN

Epidemiological survey.

RESULTS

Prevalence of bovine TB was investigated in Burdur slaughterhouse from January 2003 to December 2004. All of the affected animals were Holstein breed. The prevalence of disseminated TB in all slaughtered cattle was 0.38% in this period. The value of the condemned meat and organs was calculated to establish economic loss.

CONCLUSION

Despite a strict eradication programme, bovine TB is still an important health issue among cattle and remains one of the greatest threats to cattle and human health in southern Turkey. Veterinarians and cattle producers in this region are encouraged to develop and work on herd plans aimed at controlling and eradicating TB.