Sponge Insertion Research Articles

Palatal Augmentation Technique: A Predictable Method to Increase the Palatal Connective Tissue at Donor Sites- A Consecutive Case Series.

The palatal masticatory mucosa between the canine and first molar is the main source of connective tissue graft (CTG) for use in periodontal plastic surgery. The purpose of this study was to evaluate the palatal augmentation technique (PAT) to increase the palatal connective tissue donor area using a collagen sponge inserted between the palatal flap and bone. The 26 patients enrolled in this study were referred for root coverage and ridge augmentation procedures. All patients lacked adequate donor palatal tissue thickness. The PAT uses a full-thickness flap and insertion of a sterile lyophilized bovine collagen sponge between the flap and bone. The palatal thickness was clinically assessed before and after collagen sponge insertion. A manual probe was inserted in the mucosal surface perpendicular to the long axis of each tooth approximately 6 mm from the gingival margin. Probing depth (PD) and recession (REC) were also recorded. Treatment with PAT resulted in a statistically significant increase in the palatal thickness. The overall mean increase was from 2.03 mm before surgery to 3.57 mm after surgery, with no major alterations in PD and REC. Healing proceeded uneventfully and occurred by primary intention. PAT appeared to be a predictable procedure to create connective tissue donor graft in deficient areas and had uneventful postoperative healing.

Efficacy of anti-microbial agents on vaginal microorganisms and reproductive performance of synchronized estrus ewes

Objective: To isolate and identify microflora and fungal species at different phases during estrus synchronization of ewes and estimate their prevalence; compare the effectiveness of antimicrobial administration to intravaginal sponge on the changes in the vaginal microorganisms and reproductive performance. Methods: Sixty Egyptian ewes were allocated into three equal groups (G: 1, 2 and 3). G1 was inserted with vaginal sponge containing medroxy- progesterone acetate and served as control; without antimicrobial additive. The other two groups were treated as G1, but sponges were previously injected with ciprofloxacin (G2), while sponges of G3 were injected with ciprofloxacin and clotrimazole. Vaginal swabs were collected from each treated ewe, prior sponge insertion, at sponge withdrawal and 48 h later for microbiological investigation and bacterial count. On the day of sponge removal, 300 IU/eCG was administered for each treated ewe. The identified bacterial strains before sponge insertion were tested for sensitivity with antimicrobial disks. Results: Bacterial isolates before sponge insertion were more sensitive to ciprofloxacin. Frequencies of ewes in estrus; the interval from sponge withdrawal to onset estrus and the duration of estrus were statistically similar among treated groups. The pregnancy rate in G2 (100.0%) was higher than G1 (66.7%) and G3 (82.4%). The total bacterial count before sponge insertion was similar between all treatments and increased significantly in all groups on the day of sponge withdraw. The prevailing bacteria on D0, D14 and 48 h after sponge removal for all treated groups were Staphylococcus spp. followed by Escherichia coli. Regarding to fungus species, percentages of isolation increased from 5.00% (before sponge insertion) to 100.00% and 88.89% at sponge withdraw for G1 and G2, respectively. In G3, the fungus was declined from 10% (before sponge insertion) to 5% (at sponge removal). Conclusions: The concomitant treatments by antimicrobial to the vaginal sponge which used for estrus synchronization in ewes can improve reproductive performance.

The prediction of estrus synchronization in Awassi ewes by vulvar bi-ometry and vaginal cytology

The characteristics of exfoliated vaginal cells and vulvar biometry following estrus synchronization via insertion of vaginal sponges impregnated with 6-Methyl- 17- Acetoxyprogesterone (MAP) were investigated with the aim to predict estrus in ten adult Awassian ewes .The animals were maintained on green and concentrated ration with water ad libitium . All measurements in the ewes were taken before insertion of intravaginal sponges and at 0hrs , 24hrs , 72hrs after removed of intravaginal sponges. Nine out of ten ewes showed estrus behavior in synchronization rate 90%.The results of vaginal cytology showed dominancy of parabasal cells 49.9% before insertion of intravaginal sponges, and dominancy of intermediate cells 62.4% at 0 hour after removed of intravaginal sponges , while at 24hrs and 72 hrs. the dominant cells were nucleated superficial cells and intermediate cells in percentage rate of 44.3% and 41.8% respectively. The results showed that the measurements of vulvar biometry of synchronized ewes during the study period increase in the vertical dimension of vulva significantly (P≤0.05) only after 24hrs of removing of intravaginal sponges.

Effect of altering the intervals between consecutive superovulatory doses of porcine follicle-stimulating hormone on ovarian responses and embryo yields in anestrous ewes

The effect of varying intervals between successive gonadotropin injections on the superovulatory outcomes in anestrous Rideau Arcott ewes superstimulated for ovarian follicular development with multiple doses of porcine FSH (pFSH) was evaluated in a single study. Twenty-five animals received six (1×2.5ml and 5×1.25ml) injections of Folltropin®-V given at 0800 and 1600h or at 0800 and 2000h in Group 1 (n=9) or Group 2 (n=16), respectively. An i.m. injection of 500 IU of equine chorionic gonadotropin (eCG; Folligon®) was given concurrently with the first pFSH dose. Time of estrus was synchronized among ewes with intravaginal sponges containing 60mg of medroxyprogesterone acetate (Veramix®) that were left in place for 14days; sponges were removed at the time of the 5th pFSH injection. Six days after insertion of MAP sponges, all ewes received an i.m. injection of estradiol-17β dissolved in 1ml of sesame oil (350μg/ewe) to synchronize follicular wave emergence. Following the last pFSH dose, all animals were given a single i.m. injection of 50μg of gonadotropin-releasing hormone (GnRH; Cystorelin®) to induce ovulations before placing in a pen with four fertile rams for 36h. The ovarian responses were assessed and embryos recovered surgically 7days after GnRH injections. The mean number of corpora lutea was greater (P<0.05) in Group 1 compared with Group 2 ewes (21.0±2.9 compared with 10.4±1.6, respectively; mean±SEM) but there was no difference (P>0.05) in the number of transferable embryos (5.4±2.4 compared with 5.4±1.3/ewe, respectively), and Group 1 animals had significantly more degenerated embryos than Group 2 ewes (2.6±1.2 compared with 0.6±0.3/ewe, respectively). A superovulatory protocol wherein pFSH injections were given at 0800 and 1600h was more effective in terms of inducing multiple ovulations than the protocol with 12-h intervals between consecutive pFSH doses, but it was not associated with an increased production of transferable quality embryos by anestrous ewes.

Controlo reprodutivo em ovelhas Churras Galegas Bragançanas

The main aim of this paper was to study the effect of exogenous melatonin and the efficiency of two short-term progestogens protocols in controlling breeding activity of Portuguese Churra Galega Bragancana ewes on May. Forty five adult ewes were divided in two groups: Control (n=24) and Melatonin (n=21). Melatonin ewes received a subcutaneous implant of melatonin (18 mg). Forty five days later ewes were divided in two subgroups: FGA (n=22) and MAP (n=23). FGA ewes were treated with 20 mg of FGA and MAP ewes with 60 mg of MAP (intravaginal devices). At sponge insertion all ewes were injected with PGF2α (100 µg). Progestagen treatment lasted for six days. At sponge removal 500 IU of eCG were administered. Ovarian activity was assessed by measuring the plasmatic levels of progesterone. Four adult rams with markers harnesses were used to estrus detection. Pregnancy diagnosis was carried out by transrectal ultrasonography (5 MHz). Two weeks before sponge insertion 64.4% of all ewes presented plasmatic levels of progesterone higher than 0.5 ng/ml. Difference between Control and Melatonin ewes was no statistically significant. Melatonin improved the rate of ewes presenting high plasmatic levels of progesterone (95.2% vs. 83.3%) and fertility (95.2% vs. 75.0%). FGA and MAP treatments were equally efficient in controlling breeding activity in Churra Galega Brgancana ewes.

HORMONAL PROFILES OF BLOOD PLASMA ASSOCIATED ESTRUS SYNCHRONIZATION USING DIFFERENT CONCENTRATION OF MAP AND ECG IN BARKI EWES

The current study aimed to characterize the plateau patterns of plasma progesterone in the peripheral circulation during the application of vaginal sponge impregnated with different concentrations of medroxyprogesterone acetate (MAP) and co-treated without and with different doses of equine chorionic gonadotropin (eCG) and its effects on some items of reproductive performance. Determination the onset surges (time and level) of LH and estradiol-17β were also aimed in the study as a necessary pinpoint to the time of ovulation after MAP sponge-eCG treatment. Forty Barki ewes were randomly allocated into 2 main groups (A & B) of equal numbers (n=20/group). Groups A and B were treated with vaginal sponges containing 25 and 50 mg MAP, respectively. On day of sponge's withdrawal, ewes of each main group were randomly reassigned according to eCG dose into three subgroups (1, 2 and 3). Groups A1 and B1 (n=6 each group), served as control, without eCG injection, while groups A2 and B2 (n=7/subgroup) were injected at sponge removal with 300 IU/eCG, whereas, groups A3 and B3 (n=7/subgroup) were injected with 500 IU/eCG. Blood samples were taken immediately before sponge insertion and after the placement subsequently every 2 days and continued to the end of sponge application to studying the plateau pattern of progesterone in the peripheral circulation. Nine hours after sponge removal to 74h latter, blood samples were also taken every 3h and 6h for determination LH and estradiol-17β surges, respectively. The time to onset estrus (h), estrus duration, pregnancy and lambing rates (%) were recorded as reproductive performance measuring related to the study. The started level of plasma progesterone in group A increased gradually with level reaching to its maximum level on days 6 and 8 of sponge application and then rapidly decreases reaching to minimum level on day of sponge removal. On contrast, the patterns of plasma progesterone changes in group B were forcefully increased but with slightly high level from the beginning reaching its highest concentration on day 6 and day 8, then decline gradually to reach lower level on the day of sponge withdraw. The mean time from sponge withdraw to LH and estradiol-17β surges were significantly shorter (P<0.05) in-group A than B and significantly longer (P<0.01) in group A1B1 than other eCG treated groups. Neither MAP nor eCG have significant effects on LH concentration, while, eCG have positive effects on the concentration of estradiol-17β. Generally, the hormonal plateau patterns of group A were associated with acceleration the time to onset estrus with high pregnancy rate. In conclusion, the protocols used for estrus synchronization in sheep are associated with different plateau patterns of circulating reproductive hormones and subsequently affect reproductive performance.

Effect of Nigella Sativa seeds, Royal jelly and Pregnant Mare Serum Gonadotrophine on Some Reproductive Traits of Ossimi Ewes

ABSTARCTForty-eight Ossimi ewes aged 2-4 years and averaged 41±2.5 kg body weights were randomlyassigned into four equal groups (12/ each). All ewe groups were synchronized for estrous by intra -vaginal progesterone-releasing sponges.Sponges were inserted and remained in situ for 12 days before removal (as estroussynchronization protocol). Control group not drenched anything. First group (T1) daily drenched orally100 mg Nigella Sativa seeds (NSS) powder/kg/head for 12 days starting at the time of sponge insertionuntil the time of sponge withdrawal. The second group (T2) drenched orally fresh Royal jelly (RJ) 500mg per day/for 12 days, starting at time of sponge insertion until sponge withdrawal. Royal jelly (RJ)was kept into natural drug capsules. The third group (T3) was intramuscularly injected at time of spongewithdrawal, with 750 IU of Pregnant Mare Serum gonadotropin (PMSG).A fertile, Ossimi ram ran with the ewes immediately following sponge removal at (day 0). Ewesobserved three times daily to identify and detect estrus for 3 days. Ultrasound scanner apparatus wasused to count number of corpus luteum and diagnose of pregnancy. Detection of pregnancy dependedon presence of embryos and/or embryonic fluid that filled the uterus.The results indicated that the response of ewes to estrus synchronization did not differ amongthe four groups. The response of the four groups was 100%. At the same time treatments led to increasepercentage of occurred estrus in the first 24 hr and also the estrus duration increased in the control group.Ovulation rate at 8±1 days post mating as indicated by number of corpus luteum (CLs) recorded (p<0.01 ) the higher values in T3 followed by T2, T1 and then control group for single or twin pregnantewes. The percentages of improvement in ovulation rate were 150%, 130% and 105% for T3, T2 andT1, respectively compared to the control group (100%). Regardless of treatments, progesterone levelsat 8±1 or at 34±1 days were higher in twining pregnant ewes compared to single pregnant ones. Also,percentages of conception rate were higher in T2 and T3 (91%), while the lowest value was recorded incontrol group. Litter size per ewe at birth increased as a result of treatment effect. The highest valuesrecorded in T3 (1.63) flowed by T2 (1.54) and T1 (1.50), while the lowest values were recorded incontrol group (1.22).According to the net profit percentages, it could conclude that the best and more beneficial effects are occurred with PMSG. However, from the practical point of view, treatment with Nigella Sativa seeds could be preferred and effectively applied as it showed the lowest cost.

Lambing rate and prolificacy in inseminated hair sheep treated with bovine somatotropin.

This study evaluated whether the administration of 50 and 100 mg bovine somatotropin (bST) at the start of estrous synchronization and at the time of artificial insemination improves lambing rate and prolificacy in hair sheep. Four hundred eighty adult hair ewes (Pelibuey, Blackbelly, Dorper, Katahdin, and their crosses) were synchronized with intravaginal sponge containing 40 mg of fluorogestone acetate. On the day of sponge insertion, ewes were assigned to three treatments: the bST-100 treatment (n = 156) received 100 mg bST at the start of synchronization (d 0) and at the time of insemination (d 14), the bST-50 treatment (n = 159) received 50 mg bST in the same schedule as the previous group, and the control (n = 165) did not receive any bST. Lambing rate and percentage of multiple births were analyzed using the GENMOD procedure of SAS. Prolificacy data were analyzed using the MIXED procedure of SAS. The IGF-1 and insulin concentrations were analyzed with ANOVA for repeated measures. The bST application did not affect the lambing rate (P = 0.06). The proportion of ewes with multiple births (P = 0.01) and prolificacy (P = 0.04) were higher in the bST-50 (54.3% and 1.57 ± 0.1) than the bST-100 (18.2% and 1.25 ± 0.1) and control (33.3% and 1.28 ± 0.1) groups. The IGF-1 and insulin concentrations were higher (P < 0.05) in the bST-treated groups, but the insulin concentration was higher (P = 0.001) in the bST-100 group than in the bST-50 group. The administration of 50 or 100 mg bST at the start of synchronization and at the time of artificial insemination does not increase lambing rate. However, the dose of 50 mg increased the proportion of multiple births and prolificacy.

Development of a deformable dosimetric phantom to verify dose accumulation algorithms for adaptive radiotherapy.

Adaptive radiotherapy may improve treatment outcomes for lung cancer patients. Because of the lack of an effective tool for quality assurance, this therapeutic modality is not yet accepted in clinic. The purpose of this study is to develop a deformable physical phantom for validation of dose accumulation algorithms in regions with heterogeneous mass. A three-dimensional (3D) deformable phantom was developed containing a tissue-equivalent tumor and heterogeneous sponge inserts. Thermoluminescent dosimeters (TLDs) were placed at multiple locations in the phantom each time before dose measurement. Doses were measured with the phantom in both the static and deformed cases. The deformation of the phantom was actuated by a motor driven piston. 4D computed tomography images were acquired to calculate 3D doses at each phase using Pinnacle and EGSnrc/DOSXYZnrc. These images were registered using two registration software packages: VelocityAI and Elastix. With the resultant displacement vector fields (DVFs), the calculated 3D doses were accumulated using a mass-and energy congruent mapping method and compared to those measured by the TLDs at four typical locations. In the static case, TLD measurements agreed with all the algorithms by 1.8% at the center of the tumor volume and by 4.0% in the penumbra. In the deformable case, the phantom's deformation was reproduced within 1.1 mm. For the 3D dose calculated by Pinnacle, the total dose accumulated with the Elastix DVF agreed well to the TLD measurements with their differences <2.5% at four measured locations. When the VelocityAI DVF was used, their difference increased up to 11.8%. For the 3D dose calculated by EGSnrc/DOSXYZnrc, the total doses accumulated with the two DVFs were within 5.7% of the TLD measurements which are slightly over the rate of 5% for clinical acceptance. The detector-embedded deformable phantom allows radiation dose to be measured in a dynamic environment, similar to deforming lung tissues, supporting the validation of dose mapping and accumulation operations in regions with heterogeneous mass, and dose distributions.

Surgical Endoscopic Vacuum Therapy for Defects of the Upper Gastrointestinal Tract

IntroductionIntraluminal therapy used in the gastrointestinal (GI) tract was first shown for anastomotic leaks after rectal resection. Since a few years vacuum sponge therapy is increasingly being recognized as a new promising method for repairing upper GI defects of different etiology. The principles of vacuum-assisted closure (VAC) therapy remain the same no matter of localization: Continuous or intermittent suction and drainage decrease bacterial contamination, secretion, and local edema. At the same time, perfusion and granulation is promoted. However, data for endoscopic vacuum therapy (EVT) of the upper intestinal tract are still scarce and consist of only a few case reports and small series with low number of patients. ObjectivesHere, we present a single center experience of EVT for substantial wall defects in the upper GI tract. MethodsRetrospective single-center analysis of EVT for various defects of the upper GI tract over a time period of 4 years (2011–2015) with a mean follow-up of 17 (2–45) months was used. If necessary, initial endoscopic sponge placement was performed in combination with open surgical revision. ResultsIn total, 126 polyurethane sponges were placed in upper gastrointestinal defects of 21 patients with a median age of 72 years (range, 49–80). Most frequent indication for EVT was anastomotic leakage after esophageal or gastric resection (n = 11) and iatrogenic esophageal perforation (n = 8). The median number of sponge insertions was five (range, 1–14) with a mean changing interval of 3 days (range, 2–4). Median time of therapy was 15 days (range, 3–46). EVT in combination with surgery took place in nine of 21 patients (43 %). A successful vacuum therapy for upper intestinal defects with local control of the septic focus was achieved in 19 of 21 patients (90.5 %). ConclusionEVT is a promising approach for postoperative, iatrogenic, or spontaneous lesions of the upper GI tract. In this series, EVT was combined with operative revision in a relevant proportion of patients.

Endoscopic Vacuum Therapy in Colorectal Surgery

IntroductionEndoscopic vacuum therapy (EVT) has been established in Germany for the treatment of anastomotic leakage after rectal resection. Continuous or intermittent suction and drainage decrease bacterial contamination, secretion, and local edema promoting perfusion and granulation at the same time. However, data for use and long-term results of EVT in colorectal surgery are still scarce and are often limited by short-term follow-up. ObjectivesHere, we aimed at analyzing the treatment spectrum and long-term outcome of EVT for defects of the lower gastrointestinal tract. MethodsThis is a retrospective single-center analysis of EVT for defects of the lower gastrointestinal tract of different etiology in 41 patients over a time period of 8 years (2007–2015) with a mean follow-up of 36 (2–89) months. ResultsIn total, 426 polyurethane sponges were placed in lower GI defects of 41 patients (31 male, 10 female) with a median age of 70 years (range, 29–91). Most frequent indications for EVT were anastomotic leakage after rectal resection (n = 20), Hartmann’s stump insufficiency (n = 12), and rectal perforation (n = 3). The median number of sponge insertions was six (range, 1–37) with a mean changing interval of 3 days (range, 1–5). Median time of therapy was 20 days. A successful vacuum therapy with local control of the septic focus was achieved in 18 of 20 patients (90 %) with anastomotic leakage after rectal resection and in nine of 12 patients with a Hartmann’s stump insufficiency. In 15 of 19 (79 %) patients with a diverting stoma, take-down after successful treatment was possible. Median time to closure was 244 days (range, 152–488 days). ConclusionTo our knowledge, this retrospective observation of EVT application for rectal lesions represents the largest patient series in literature. EVT has earned its indication in complication management after colorectal surgery and can achieve a successful control of a local septic focus in the majority of patients.

Effect of long-term or short-term supplementation of high energy or high energy-protein diets on ovarian follicles and blood metabolites and hormones in ewes

This study was conducted to compare the effect of high energy or high energy-protein diets in long-term (16 days, flushing) or short-term (6 days, focus feeding) supplementation period on ovarian performance and serum metabolites and hormones of ewes. For this purpose 40 cyclic Naeini ewes (40±1kg BW and 2–3 years of age) were randomly assigned to experimental groups: 1—Control (CON), 2—long-term high energy diet (LE), 3—short-term high energy diet (SE), 4—long-term high energy-protein diet (LEP), and 5—short-term high energy-protein diet (SEP). Ewes were housed in the individual pens with free access to food and water. The estrous cycle of ewes was synchronized with insertion of intravaginal progesterone sponges for a 12-day period. Follicular development was observed by ultrasound four days before to one day after sponge removing (−4 to +1) and blood was sampled once a day during this time. Results showed that LE and SE groups had more large-size (>5mm) follicles (P<0.05) than those the other group on day +1. Double ovulation rate was high in ewes fed with high energy diets. The LE and SE groups had higher (P<0.05) serum glucose, cholesterol and insulin, but lower urea concentration compared to the other groups. Feeding high energy caused low serum oestradiol before the sponge removing. However, the LE and SE groups had the highest (P<0.05) oestradiol concentration before the estrus time. Results of the present study revealed that change in dietary energy levels for a short-term or long-term period just before ovulation could improve the blood metabolites and reproductive performance of the ewes.

Effect of feeding greater amounts of dietary energy for a short-term with or without eCG injection on reproductive performance, serum metabolites and hormones in ewes

This study was conducted to compare the effect of transient high-energy diet in a short-term period with or without eCG injection on ovarian follicle development, twining rate, serum metabolites and hormones in ewes. A total of 45 estrous cyclic Naeini ewes were randomly assigned to three experimental groups: 1—Control (control), 2—High energy short-term feeding (HE), and 3—high energy short-term feeding+eCG injection (HEe). Ewes were housed in individual pens with free access to feed and water. The stage of the estrous cycle of all ewes was synchronized by insertion of intravaginal progesterone sponges. Focus feeding started from 4 days before until 1 day after sponge removal. Follicle development was monitored from 4 days before until 1 day after sponge removal and blood samples were taken during this time. Results showed that ewes fed high energy diets (HE and HEe) had greater (P<0.05) large follicle numbers compared with the control group. Feeding high energy diets increased (P<0.05) serum glucose, cholesterol and insulin, but had lesser (P<0.05) serum urea nitrogen concentrations near the time of ovulation. After the start of experiment, ewes fed high energy diets had less (P<0.05) serum estradiol. However, 1 day after sponge removal, serum estradiol in HE and HEe groups increased (P<0.05). It was concluded that short-term (6-day) changes in amount of dietary energy with or without eCG injection increased twin births and had beneficial effects on the blood metabolites and hormone concentrations in Naeini ewes.

Supplementation with rumen-protected L-arginine-HCl increased fertility in sheep with synchronized estrus

The aim of the present study was to evaluate the effects of L-arginine-HCl supplementation on ovulation rate, fertility, prolificacy, and serum VEGF concentrations in ewes with synchronized oestrus. Thirty Suffolk ewes with a mean body weight of 45 ± 3 kg and a mean body condition score (BCS) of 2.4 ± 0.28 were synchronized for estrus presentation with a progestin-containing sponge (20 mg Chronogest® CR) for 9 days plus PGF2-α (Lutalyse; Pfizer, USA) on day 7 after the insertion of the sponge. The ewes were divided into two groups; i.e., a control group (n = 15) that was fed on the native pasture (basal diet) and an L-arginine-HCl group (n = 15) that received 7.8 g of rumen-protected L-arginine-HCl from day 5 of the sponge insertion until day 25 after mating plus the basal diet. The L-arginine-HCl was administered daily via an esophageal probe between days 5 and 9 of the synchronization protocol and every third day subsequently. Blood samples were drawn from the jugular vein every 6 days throughout the entire experimental period. The results revealed that the L-arginine-HCl supplementation increased fertility during the synchronized estrus (P = 0.05). However, no effects were observed on the final BCS (P = 0.78), estrus presentation (P = 0.33), multiple ovulations (P = 0.24), prolificacy (P = 0.63), or serum VEGF concentration. In conclusion, L-arginine-HCl supplementation during the period used in this study increased fertility in sheep with synchronized estrus possibly due to improved embryo-fetal survival during early pregnancy.

Effect on hemostasis of an absorbable hemostatic gelatin sponge after transrectal prostate needle biopsy.

Objectives To examine the usefulness of an absorbable hemostatic gelatin sponge for hemostasis after transrectal prostate needle biopsy.Subjects and Methods The subjects comprised 278 participants who underwent transrectal prostate needle biopsy. They were randomly allocated to the gelatin sponge insertion group (group A: 148 participants) and to the non-insertion group (group B: 130 participants). In group A, the gelatin sponge was inserted into the rectum immediately after biopsy. A biopsy-induced hemorrhage was defined as a case in which a subject complained of bleeding from the rectum, and excretion of blood clots was confirmed. A blood test was performed before and after biopsy, and a questionnaire survey was given after the biopsy.Results Significantly fewer participants in group A required hemostasis after biopsy compared to group B (3 (2.0%) vs. 11 (8.5%), P=0.029). The results of the blood tests and the responses from the questionnaire did not differ significantly between the two groups. In multivariate analysis, only “insertion of a gelatin sponge into the rectum” emerged as a significant predictor of hemostasis.Conclusion Insertion of a gelatin sponge into the rectum after transrectal prostate needle biopsy significantly increases hemostasis without increasing patient symptoms, such as pain and a sense of discomfort.

Determination of the proper time for mating after oestrous synchronisation during anoestrous or oestrous by measuring electrical resistance of cervical mucus in ewes

The purpose of the present study was to investigate whether the electrical resistance values of the cer - vical mucus and/or blood οestradiol-17β and progesterone concentrations at mating, after oestrous synchronisation during the anoestrous or oestrous period in ewes, are related to fertility. Oestrus was induced by medroxyprogesterone acetate-impregnated intravaginal sponges (Veramix, Upjohn, USA), either for 12 days (12-day group; 24 Kymi and 28 Chios) or for 14 days (14-day group; 24 Kymi and 28 Chios), plus 400 IU equine chorionic gonadotropin (Intergonan, Intervet, the Netherlands) i.m., at the time of sponge removal. In each case, one blood sample was collected from all ewes at sponge insertion, at sponge removal and at oestrus, for the determination of serum οestradiol-17β and progesterone concentrations, using a radioimmunoassay. The electrical resistance of the cervical mucus was meas - ured once, just after oestrus detection by teaser rams, using a digital heat detector. All ewes found to be in oestrus were mated to fertile rams. Pregnancy was determined by transabdominal ultrasonography 35-40 days after mating. Kymi ewes were in anoestrous, while those of Chios were in the oestrous period. The 14-day treatment resulted in better outcome as concerns oestrus detection and pregnancy rate than the 12-day treatment, in either oestrous or anoestrous period ewes. Oestradiol-17β concentrations at sponge removal and at oestrus were lower ( P < 0.05) in the 14-day group than in the 12-day group, in both oestrous or anoestrous period ewes. Progesterone concentrations at sponge insertion and removal were higher ( P < 0.05), while progesterone concentrations and electrical resistance values of the cervical mucus at oestrus were lower ( P < 0.05) in ewes of both groups who conceived compared to those that did not, either in oestrous or in the anoestrous period. Linear regression analysis revealed a positive relation between the electrical resistance values of the cervical mucus and blood serum progesterone concentrations in both oestrous or anoestrous period ewes. The electrical resistance of cervical mucus could be useful for the detection of the proper time for mating after oestrous synchronisation in ewes.

Effect of intravaginal fluorogestone acetate sponges on prolactin levels of Damascus-local cross breed goats.

The effect of intravaginal fluorogestone acetate (FGA) sponges on prolactin levels (PRL) and correlations between PRL and milk somatic cell count (SCC) and steroid hormones levels of Damascus-local cross goats during transitional period to anestrous were investigated in this study. Fifty-six goats were assigned to three groups. Group 1 (FGA, n = 19) was treated with 40mg FGA and equine chorionic gonadotropin (600IU, i.m.) at time of sponge withdrawal (day 0). Group 2 (FGA-PGF; n = 19) was treated similar to group 1 but was also injected with dinoprost tromethamine (naturally occurring PGF2α) (10mg, i.m.) on day 0. Control goats (n = 18) were left untreated. On day 0, five fertile bucks were turned in with all goats. Milk and blood samples were collected on days -13 (day of sponge insertion), -6, 0, 1, 2, 7, 13, and 20. Prolactin levels were at lowest values on day -13 of the study and increased (p < 0.05) from day -6 to day 20 in all groups. A significant positive correlation (p < 0.05) between PRL and progesterone and between PRL and estradiol levels was found in this study. No significant correlation was found between PRL and SCC of all groups during the study except on days 2 and 20 where PRL levels were correlated (p < 0.05) with SCC of left udder halves of FGA group. In conclusion, estrus induction with FGA resulted in significant increase in PRL. A positive correlation was found between PRL and steroid hormones, but there was no correlation between PRL and goat milk SCC.

Endometrial echotexture parameters in Turkish Saanen Goats (Akkeci) during oestrus and early pregnancy

This experiment was conducted to evaluate endometrial echotexture in oestrus and early pregnancy and its association with ovarian hormones and foetal count in goats. Akkeci goats (Saanen×Kilis crossbreed, n=40) were randomly divided into two groups. Ten does (NAT) were mated on natural oestrus and 30 does (SYN) were subjected to synchronisationprior to mating. The uterus was scanned on the days of sponge insertion (d −14), sponge removal (d −2) and mating (d 0) as well as 17 (d 17) and 30 (d 30) days after mating. Mean gray level (MGL), homogeneity (HOM) and contrast (CON) values were calculated. Blood samples were collected on days ultrasonography was performed. Data were analyzed by Chi-square, ANOVA, regression tests. HOM value reached the highest level on the mating day and then continuously decreased (P<0.0001). Overall, HOM values were greater for SYN does than for NAT does after mating. CON values were virtually stable during the experimental period. MGL value fluctuated during the breeding period (P<0.03) at a similar fashion in NAT and SYN does. Foetal count was not correlated with plasma hormones and echotexture parameters. Plasma progesterone concentration was correlated with echotexture parameters (r=−0.28 for HOM; r=0.29 for CON; r=0.25 for MGL; P<0.05 for all) during post-mating. In conclusion, echotexture parameters changed during the breeding period, in association with plasma progesterone concentration. Future studies should test if the echotextural changes during embryonic fixation days can be used as a marker for early detection of pregnancy in does.

Endoscopic Endoluminal Vacuum Therapy in Esophageal Perforation

Esophageal perforation is a serious disease with a high morbidity and mortality rate. Endoscopic vacuum therapy (EVT) is a new endoscopic treatment option, which is used to treat anastomotic leakages after rectal and esophageal resections. We report on 10 patients treated with EVT for esophageal perforation. Clinical and therapy-related data such as age, sex, duration of intensive care stay, length of hospital stay, reasons for perforation, EVT-associated complications, mortality, need for alternative treatment options, and course of infectious variables were analyzed. Ten patients were treated with 54 vacuum sponges that were placed in upper gastrointestinal defects. Causes for perforation were iatrogenic, spontaneous, or foreign body-associated. Mean number of sponge insertions was 5.4 (range, 2 to 12) with a mean period of 19 ± 14.26 days. Successful therapy was achieved in 9 of 10 patients. After successful primary treatment, 1 patient died during therapy as a result of general failure of the cardiovascular system. In 1 patient, surgical resection was necessary after repeated Mallory-Weiss lesions and minor perforations during the course of immunosuppressive therapy. In a third patient an endoscopic stent was inserted in the clean wound cavity after primary EVT. In this small trial EVT has been shown to be a safe and feasible therapy option for perforations of the upper gastrointestinal tract. If necessary, EVT can be combined with operative revision for better control of the local septic focus or used as a bridging procedure for wound conditioning before aggressive surgical treatment.

Effects of cloprostenol and flurogestone acetate sponge on embryo yields and quality in indigenous ewes in Bangladesh

The effects of two doses of cloprostenol and two doses of flurogestone acetate sponge on the onset of oestrus, and embryo recovery and quality were evaluated. Thirty-two indigenous ewes (Wera breed) were allocated into four groups of eight. All ewes were synchronised with 100 µg (Group I) or 175 µg (Group II) cloprostenol injection, 9 days apart, or insertion of intravaginal sponges containing 30 mg (Group III) or 45 mg (Group IV) flurogestone acetate (FGA) for 12 days. The ewes were superovulated with 600 IU PMSG intramuscularly 10 days after the second cloprostenol injection or immediately after sponge removal on Day 12. After the detection of oestrus, the ewes were mated naturally at 6 and 12 h, and some ewes were inseminated laparoscopically. Embryos were recovered surgically 5 or 6 days after service. All ewes exhibited oestrus. The onset of oestrus occurred significantly (P &lt; 0.05) earlier in FGA-treated (50.0 ± 1.5 and 48.0 ± 0.00 h) than in cloprostenol-treated groups. There were no significant differences (P &gt; 0.05) in the mean time of onset of oestrus (50.0 ± 1.5 and 48.0 ± 0.00 h) between the two doses of cloprostenol. The mean number of corpora lutea (8.1 ± 1.26) and embryos recovered (6.1 ± 1.00) was significantly (P &lt; 0.05) higher in ewes treated with 45 mg FGA than in ewes treated with cloprostenol. Embryo recovery rate was significantly (P &lt; 0.05) higher in ewes treated with 45 mg FGA (75.4%) than in other groups (41.7% and 51.6% in 100 μg and 175 μg cloprostenol- and 52.7% in 30 mg FGA-treated groups, respectively). Fertilisation rate was 93.3% in ewes given 100 µg cloprostenol, whereas other groups showed 100% fertilisation rate. The highest percentage (100%) of Grade 1 embryos was in FGA groups. In conclusion, despite FGA protocol presenting superior results, cloprostenol protocol was equally efficient in synchronising oestrus. The embryo recovery rate was better after 45 mg FGA than 30 mg FGA or after either dose of cloprostenol.