57 research outputs found
EFFICACY AND SAFETY OF TC DOSE-DENSE CHEMOTHERAPY AS FIRST-LINE TREATMENT OF EPITHELIAL OVARIAN CANCER : A SINGLE-INSTITUTION RETROSPECTIVE COHORT STUDY
CILJ ISTRAŽIVANJA: Ispitati djelotvornost TC protokola veÄe gustoÄe na populaciji hrvatskih pacijentica s karcinomom jajnika u svakodnevnoj kliniÄkoj praksi u KBC Split.
MATERIJALI I METODE: Provedena je retrospektivna analiza laboratorijskih i kliniÄkih podataka konsekutivnih pacijentica lijeÄenih u jednom onkoloÅ”kom centru u periodu od 2008.- 2016. godine. Analizirane su 74 pacijentice u konvencionalnoj TC grupi, te 70 pacijentica u TC grupi āveÄe gustoÄeā. UkljuÄene su samo one pacijentice koje su primile minimalno 4 ciklusa kemoterapije. Glavni cilj studije je bio usporedba ukupnog preživljenja (OS). Sekundarni ciljevi su usporedba PFS-a (preživljenje bez progresije bolesti), te usporedba toksiÄnosti.
REZULTATI: Nakon nužnih prilagodbi za kliniÄke i socidemografske faktore u dvama grupama studije, u skupini veÄe gustoÄe pokazan je znaÄajno manji rizik od umiranja od bilo kojeg uzroka (HR=0,50; 95% CI 0,25-0,97; P=0,040). Medijan OS-a nakon medijana praÄenja od 60 mjeseci nije postignut kod TC grupe veÄe gustoÄe, dok je kod grupe lijeÄene standardnim TC protokolom bio 48 mjeseci (95% CI 33-62). Nemodificirani PFS (preživljenje bez progresije bolesti) je bio signifikantno dulji u TC skupini veÄe gustoÄe (HR=0,58; 95% CI 0,38-0,88; P=0,011), ali ne i nakon modifikacija za preplanirane kovarijable (P= 0,096). ToksiÄnost je bila sliÄna u obe grupe.
Potreba za transfuzijama krvi i upotrebom filgrastima je bila signifikantno veÄa kod bolesnica lijeÄenih protokolom veÄe gustoÄe (p=0,010 i p<0,001). UÄestalost neutropenija i trombocitopenija stupnja 3 i 4 se nije znaÄajno razlikovala u dva ordinirana protokola.
ZAKLJUÄAK: TC protokol veÄe gustoÄe pokazuje bolje rezultate uz sliÄnu toksiÄnost u usporedbi s klasiÄnim TC protokolom u lijeÄenju bolesnica bijele rase s rakom jajnika u jednoj instituciji.Goals: Our goal was to investigate efficacy of TC dose dense chemotherapy on Croatian population of ovarian carcinoma patients in everyday clinical practice at University Hospital of Split.
Methods: A retrospective cohort study was used on consecutive laboratory and clinical samples of 74 patients treated with the conventional 3-weekly TC protocol (2008-2011) and on 70 patients treated with TC dose dense protocol (2012-2016). Only those patients who recieved at least four chemotherapy cycles were included. The primary endpoint of this study was overall survival (OS). Secondary endpoints were progression free survival (PFS) and toxicity.
Results: After adjustment for pre-planned clinical and sociodemographic factors, patients treated with dose dense protocol showed a significantly lower hazard for dying from any cause, than patients treated with conventional protocol (HR=0.50; 95% CI 0.25-0.97; P=0.040). Median OS, at 60 months follow-up had not been reached in the dose-dense group, while in the standard treatment group was 48 months (95% CI 33-62). Unadjusted PFS was significantly longer in the dose dense group (HR=0.58; 95% CI 0.38-0.88; P=0.011), but not after the adjustment (P=0.096). Generally, the level of toxicity was similar in both groups of patients. The need for blood transfusions andusage of filgrastim was significantly higher in the TC dose dense group (p=0,010 i p<0,001). The incidence of neutropenia and thrombocytopenia grade 3 or 4 were not significanly different in both regimens.
Conclusions: Our retrospective study has shown the superior efficacy and comparable toxicity of dose dense chemotherapy regimen over the conventional regimen in treatment of ovarian cancer on Caucasian population at a single-institution
EFFICACY AND SAFETY OF TC DOSE-DENSE CHEMOTHERAPY AS FIRST-LINE TREATMENT OF EPITHELIAL OVARIAN CANCER : A SINGLE-INSTITUTION RETROSPECTIVE COHORT STUDY
CILJ ISTRAŽIVANJA: Ispitati djelotvornost TC protokola veÄe gustoÄe na populaciji hrvatskih pacijentica s karcinomom jajnika u svakodnevnoj kliniÄkoj praksi u KBC Split.
MATERIJALI I METODE: Provedena je retrospektivna analiza laboratorijskih i kliniÄkih podataka konsekutivnih pacijentica lijeÄenih u jednom onkoloÅ”kom centru u periodu od 2008.- 2016. godine. Analizirane su 74 pacijentice u konvencionalnoj TC grupi, te 70 pacijentica u TC grupi āveÄe gustoÄeā. UkljuÄene su samo one pacijentice koje su primile minimalno 4 ciklusa kemoterapije. Glavni cilj studije je bio usporedba ukupnog preživljenja (OS). Sekundarni ciljevi su usporedba PFS-a (preživljenje bez progresije bolesti), te usporedba toksiÄnosti.
REZULTATI: Nakon nužnih prilagodbi za kliniÄke i socidemografske faktore u dvama grupama studije, u skupini veÄe gustoÄe pokazan je znaÄajno manji rizik od umiranja od bilo kojeg uzroka (HR=0,50; 95% CI 0,25-0,97; P=0,040). Medijan OS-a nakon medijana praÄenja od 60 mjeseci nije postignut kod TC grupe veÄe gustoÄe, dok je kod grupe lijeÄene standardnim TC protokolom bio 48 mjeseci (95% CI 33-62). Nemodificirani PFS (preživljenje bez progresije bolesti) je bio signifikantno dulji u TC skupini veÄe gustoÄe (HR=0,58; 95% CI 0,38-0,88; P=0,011), ali ne i nakon modifikacija za preplanirane kovarijable (P= 0,096). ToksiÄnost je bila sliÄna u obe grupe.
Potreba za transfuzijama krvi i upotrebom filgrastima je bila signifikantno veÄa kod bolesnica lijeÄenih protokolom veÄe gustoÄe (p=0,010 i p<0,001). UÄestalost neutropenija i trombocitopenija stupnja 3 i 4 se nije znaÄajno razlikovala u dva ordinirana protokola.
ZAKLJUÄAK: TC protokol veÄe gustoÄe pokazuje bolje rezultate uz sliÄnu toksiÄnost u usporedbi s klasiÄnim TC protokolom u lijeÄenju bolesnica bijele rase s rakom jajnika u jednoj instituciji.Goals: Our goal was to investigate efficacy of TC dose dense chemotherapy on Croatian population of ovarian carcinoma patients in everyday clinical practice at University Hospital of Split.
Methods: A retrospective cohort study was used on consecutive laboratory and clinical samples of 74 patients treated with the conventional 3-weekly TC protocol (2008-2011) and on 70 patients treated with TC dose dense protocol (2012-2016). Only those patients who recieved at least four chemotherapy cycles were included. The primary endpoint of this study was overall survival (OS). Secondary endpoints were progression free survival (PFS) and toxicity.
Results: After adjustment for pre-planned clinical and sociodemographic factors, patients treated with dose dense protocol showed a significantly lower hazard for dying from any cause, than patients treated with conventional protocol (HR=0.50; 95% CI 0.25-0.97; P=0.040). Median OS, at 60 months follow-up had not been reached in the dose-dense group, while in the standard treatment group was 48 months (95% CI 33-62). Unadjusted PFS was significantly longer in the dose dense group (HR=0.58; 95% CI 0.38-0.88; P=0.011), but not after the adjustment (P=0.096). Generally, the level of toxicity was similar in both groups of patients. The need for blood transfusions andusage of filgrastim was significantly higher in the TC dose dense group (p=0,010 i p<0,001). The incidence of neutropenia and thrombocytopenia grade 3 or 4 were not significanly different in both regimens.
Conclusions: Our retrospective study has shown the superior efficacy and comparable toxicity of dose dense chemotherapy regimen over the conventional regimen in treatment of ovarian cancer on Caucasian population at a single-institution
On the influence of the changing state of the atmosphere above the fire site on performance of the helicopter
U ovom radu je prikazan razvijeni matematiÄki model atmosfere pod odreÄenim pretpostavkama, kao i matematiÄki model helikoptera koji se sastoji od modela njegovog noseÄeg rotora. Glavni rezultat, kakav se i oÄekivao, pojednostavljenog modela atmosfere iznad požariÅ”ta je smanjenje gustoÄe s porastom temperaturne anomalije u odnosu na uvjete standardne atmosfere. Sa smanjenjem gustoÄe opada i pogonska sila na disku rotora, odnosno uzgonska sila, Å”to može rezultirati ugrozom sigurnosti letenja helikoptera.In this paper a developed mathematical model of the atmosphere with certain assumptions as well as mathematical model of the helicopter which comprise a model of its main rotor model. Main result of the simplified mathematical model of atmosphere above the wildfire, as it was expected, is decreasing of density with increasing of temperature anomaly in comparison with standard atmosphere conditions. With density decreasing driven force of the main rotor also decreases (i.e. lift force)
The tactics of firefighting and stability analysis of helicopters equipped with water cannon
GaÅ”enje požara sustavom vodenog topa pokazuje se pouzdanim u urbanim ili teže dostupnim podruÄjima gdje se zahtijevaju precizna djelovanja vodom. Zbog ukupnih tehniÄkih i operativnih znaÄajki sustava helikoptera i vodenog topa, razvijeno je nekoliko razliÄitih taktika za gaÅ”enje odreÄene vrste požara. Ovisno o režimu rada vodenog topa na helikopter djeluju trenutne i kontinuirane sile (impulsi) Äiji momenti utjeÄu na ukupne performanse helikoptera te mogu dovesti do ugrožavanja sigurnosti letenja. Tijekom rada topa u razliÄitim taktiÄkim uvjetima gaÅ”enja može doÄi do naruÅ”avanja stabilnosti i kvalitete upravljanja helikoptera. Primjenom linearnog modela helikoptera s vodenim topom analiziran je utjecaj vodenog topa s impulsnim i kontinuiranim mlazom na dinamiku helikoptera.Fire extinguishing with system of water cannon is proved very reliable in urban or remote areas as well as on the ships at sea, where precise water action is required. Because of the overall both technical and operational features of helicopter and water cannon, several different tactics for firefighting are developed and practiced. Depending on the mode of the water cannon operation, on a helicopter may act both impulse and continualy developed forces and moments which affect the overall performance of the helicopter and can lead to degradation of flying safety. While working in a variety of tactical conditions, water cannon may additionaly cause degradation of stability and handling quality of helicopter.
Helicopter equipped with water cannon firefighting tactics may be out of position from hovering or progressive flight. Generarly, water cannon may be able to shift both in azimuth and in elevation. Installation of a cannon on a helicopter can be done in two ways - under the helicopter fuselage parallel to its longitudinal axis or inside the passenger or cargo space when the cannon is mounted sideways.
Applying a linear model of helicopter with a water cannon, the effect of a water cannon with impulse and continuously jet on helicopter is analized. The mathematical analysis of stability will be considered on generic transport helicopter with a conventional configuration, which is equipped with single-tube water cannon mounted on the longitudinal axis of the helicopter and in both impulse and continuously jet action regimes
UtjeÄe li tehnika zbrinjavanja diÅ”noga puta u uvjetima izvanbolniÄke hitne medicine na ishod kardiopulmonalne reanimacije?
According to current European Resuscitation Council guidelines, priorities in advanced
life support in adult are chest compression with minimal interruption and early defibrillation.
Endotracheal intubation is still considered the gold standard in airway management, but guidelines
suggest that securing the airway be incremental, ranging from basic techniques to more complex
ones. Doctors who work in pre-hospital emergency medicine teams (EMT) in Croatia usually lack
sufficient education and expertise. The aim of this study was to determine whether there was a significant
difference in recovery of spontaneous circulation during cardiopulmonary resuscitation (CPR)
in out-of-hospital setting depending on the EMT airway management technique of choice. This
retrospective analysis included data collected during a 10-year period at the Krapina-Zagorje County
Emergency Medicine Institute on all patients with CPR performed by EMTs 20 minutes from initial
emergency call. The airway management groups included oropharyngeal tube, i-gel supraglottic
device, and endotracheal tube. There were 968 patients, mean age 70. In 74.61% of patients, the cause
of arrest was of cardiac etiology. Our study did not find a statistically significant in difference of CPR
success among the three groups analyzed according to the airway management technique of choice
(p=0.74, Ļ2-test).Prema aktualnim smjernicama Europskog reanimacijskog vijeÄa prioriteti u naprednim mjerama održavanja života u
odraslih su kompresija prsnoga koŔa s minimalnim prekidima i rana defibrilacija. Iako je endotrahealna intubacija zlatni standard
zbrinjavanja diÅ”noga puta, smjernice upuÄuju na zbrinjavanje diÅ”noga puta postupno, od baziÄnih tehnika zbrinjavanja
diÅ”noga puta prema složenijim, sukladno iskustvu lijeÄnika i uÄinkovitosti ventilacije. U Hrvatskoj timovi izvanbolniÄke hitne
medicine (IBHM) najÄeÅ”Äe ukljuÄuju mlade lijeÄnike bez dovoljno izobrazbe i iskustva u naprednim tehnikama zbrinjavanja
diŔnoga puta. Cilj istraživanja bio je utvrditi postoji li razlika u oporavku spontane cirkulacije pri kardiopulmonalnoj reanimaciji
(KPR) u uvjetima IBHM ovisno o izboru tehnike zbrinjavanja diŔnoga puta. Retrospektivno smo analizirali podatke
iz programa e-Hitna kroz desetogodiŔnje razdoblje u Zavodu za hitnu medicinu Krapinsko-zagorske županije. U analizu su
ukljuÄeni svi bolesnici kod kojih su KPR proveli timovi IBHM unutar 20 minuta od poziva. Tehnike zbrinjavanja diÅ”noga
puta koje su se analizirale bile su: orofaringealni tubus, i-gel maska, endotrahealni tubus. Istraživanjem je obuhvaÄeno 968
ispitanika srednje dobi od 70 godina. U 74,61% ispitanika uzrok aresta bio je kardijalne etiologije. U provedenom istraživanju
nije pronaÄena statistiÄki znaÄajna razlika u uspjeÅ”nosti oživljavanja izmeÄu tri skupine ovisno o tehnici zbrinjavanja diÅ”noga
puta (p=0,74, Ļ2-test)
ZnaÄaj FHIT i Bcl-2 u bolesnika s oralnim lihen planusom u usporedbi s zdravom oralnom sluznicom i oralnim karcinomom ploÄastih stanica
Background: Oral lichen planus (OLP) is a precancerous lesion which might progress into oral squamous cell cancer (OSCC) in 0-1.2 % of the affected patients. Albeit there are many published studies upon this topic, there are no universally accepted clinical and histopathological criteria which would suggest which patients will develop OSCC. Therefore, the aim of this study was to compare epithelial and sub epithelial FHIT and Bcl-2 expression between patients with OLP, OSCC and healthy oral mucosa.Materials and Methods: Fifty patients with OLP, 20 with OSCC who had histologically confi rmed diagnoses and 20 healthy controls were included in this study. Immuno-histochemical analysis was performed on primary monoclonal antibodies Bcl-2 (Dako, Finland) and FHIT (Zymed Laboratories Inc., USA) were used. Statistical analysis included Kolmogorov-Smirnoff test, Ļ2 test and Spearmanās correlation. All p values lower than p<0.05 were considered as significant. Results: Expression of FHIT in the OLP and OSCC epithelium is significantly decreased when compared to the healthy oral mucosa. However, no significant differences between FHIT expression between OLP and OSCC could be found.
OLP and OSCC patients have signifi cantly increased expression values of Bcl-2 in the epithelium when compared to the epithelium of healthy participants. Furthermore, Bcl-2 expression is significantly increased in patients with OLP when compared to the patients with OSCC. Subepithelial infiltrate in OLP and OSCC reveals signifi cantly higher Bcl 2 expression when compared to the healthy controls. However, Bcl-2 expression in the infl ammatory infi ltrate is signifi cantly higher in OSCC patients when compared to the OLP patients. Conclusion: Loss of FHIT expression in the epithelium is not suffi cient for malignant transformation in OLP patients. It seems that other molecular changes are needed for OLP progression into OSCC. Bcl-2 expression in the infl ammatory infi ltrate is signifi cantly higher in OSCC patients when compared to the OLP patients and healthy controls, however bcl-2 expression in the epithelium does not correlate with precancerous (OLP) and OSCC lesions.Uvod: Oralni lihen planus (OLP) je prekancerozna lezija koji u 0-1,2 % oboljelih može progredirati u oralni karcinom ploÄastih stanica (OKPS). Premda su objavljeni brojni radovi na ovu temu, ne postoje opÄe prihvaÄeni kliniÄki i patohistoloÅ”ki kriteriji koji bi upuÄivali na to u kojih Äe se bolesnika razviti OKPS. Dakle, cilj je ovog istraživanja bio usporediti ekspresiju FHIT i Bcl-2 u epitelu i subepitelu pacijenata s OLP, OKPS te osoba sa zdravom oralnom sluznicom. Materijal i metode: U istraživanje je bilo ukljuÄeno pedeset pacijenata s histoloÅ”ki potvrÄenom dijagnozom OLP, 20 pacijenata s histoloÅ”ki potvrÄenom dijagnozom OKPS te 20 zdravih pacijenata kao kontrolna skupina. KoriÅ”tene su imunohistokemijske analize na primarnim monoklonim protutijelima Bcl (Dako, Finska) i FHIT (Zymed Laboratories Inc., SAD). U statistiÄkoj analizi koriÅ”teni su Kolmogorov-Smirnovljev test, hi kvadrat test i Spearmanov koefi cijent korelacije. P vrijednosti manje od 0.05 su smatrane znaÄajnima. Rezultati: Ekspresija FHIT u epitelu zahvaÄenom s OLP i OKPS je znaÄajno smanjena u usporedbi sa zdravom oralnom sluznicom. MeÄutim, nije naÄena znaÄajna razlika u FHIT ekspresiji kod OLP i OKPS. Pacijenti oboljeli od OLP i OKPS imaju znaÄajno pojaÄanu ekspresiju Bcl-2 u usporedbi s zdravim sudionicima. Nadalje, Bcl-2 ekspresija je znaÄajno veÄa u pacijenata s OLP, nego u pacijenata s OKPS. Subepitelni infi ltrat u pacijenata s OLP i OKPS pokazuje znaÄajno poveÄanje Bcl-2 ekspresije u odnosu na zdrave osobe iz kontrolne skupine. MeÄutim, Bcl-2 ekspresija u upalnom infiltratu je znaÄajno viÅ”a u OKPS pacijenata nego li u OLP pacijenata. ZakljuÄak: Gubitak FHIT ekspresije u epitelu sam po sebi nije dovoljan za zloÄudnu transformaciju kod pacijenata koji boluju od OLP. Äini se da su za progresiju OLP u OKPS potrebne i druge molekularne promjene. Ekspresija Bcl-2 u upalnom infi ltrate je znakovito visa u bolesnika s OPKS u odnosu na bolesnicke s OLP i zdrave kontrole, ipak, ekspresija bcl-2 u epitelu ne korelira s prekanceroznim (OLP) odnosno lezijama OPKS
The specific immunological reactivity in breast cancer patients
Istraživali smo specifiÄnu imunoreaktivnost u 58 bolesnica s rakom dojke uporabom testa inhibiranja adherencije leukocita (IAL). Željeli smo doznati da li razina preoperativne reaktivnosti izmjerena ovim testom utjeÄe na 6-godiÅ”nje preživljenje bolesnica. Alogenske ekstrakte raka dojke, fibroadenoma i raka rektuma dobili smo ekstrakcijom pomoÄu 3 M KCI. 72% bolesnica s rakom dojke oÄituje specifiÄnu imunoreaktivnost u testu IAL. Bolesnice s uz napredovalom boleÅ”Äu (stadij II. i III.) imaju bolju reaktivnost (82%) od bolesnica I. stadija bolesti (50%). SpecifiÄna imunoreaktivnost nakon kirurÅ”kog uklanjanja tumora i postoperativne radioterapije opada u bolesnica II. i III. stadija bolesti, a u bolesnica I. stadija bolesti ostaje nepromijenjena tijekom 6 mjeseci promatranja. ViÅ”e je bolesnica preživjelo 6 godina ako su imale dobru preoperativnu imunoreaktivnost u testu IAL.We used the leukocyte adherence inhibition (LAI) assay in detecting the specific immune reactivity and monitoring of the dynamics of this immunity in 58 breast cancer patients. We wanted to find out if the level of preoperative specific immune reactivity is in correlation with the survival rate. Soluble antigenic preparations from a breast cancer, rectal carcinoma and fibroadenoma were obtained with 3M KCI. 72% of breast cancer patients showed the specific reactivity to the allogeneic KCI extract from reast carcinoma. Stage II and III patients react better than stage I patients (82% versus 50%). The specific reactivity after surgery and postoperative radiotherapy decreased in stage II and III patients. The reactivity in stage I patients was at the same level during six months. The LAI reacitivity prior to surgery correlates with significantly higher 6-years survival rate
The influence of environmental factors on daily milk yield and fat and protein content in Istrian sheep
Cilj ovog istraživanja bio je utvrditi utjecaj stadija i redoslijeda laktacije, veliÄine legla i sezone janjenja na dnevnu proizvodnju mlijeka te sadržaj mlijeÄne masti i bjelanÄevina u mlijeku istarske ovce. U tu svrhu koriÅ”teno je 9533 zapisa kontrola mlijeÄnosti prikupljenih od 2024 ovce u raz-doblju od listopada 2005. do svibnja 2009. godine. Dnevna koliÄina proizvedenoga mlijeka te sadržaj mlijeÄne masti i bjelanÄevina u mlijeku utvrÄeni su redovitim mjeseÄnim kontrolama mlijeÄnosti, primjenom AT4 metode. Stadij laktacije opisan Wilmink-ovom krivuljom statistiÄki je znaÄajno(P<0,001) utjecao na sva istraživana svojstva mlijeÄnosti istarske ovce. NajviÅ”a korigirana prosjeÄna dnevna koliÄina mlijeka utvrÄena je izmeÄu dvadesetog i tridesetog dana nakon janjenja te se prema kraju laktacije postupno smanjivala. Krivulje kojima su opisane promjene sadržaja mlijeÄne masti i bjelanÄevina u mlijeku tijekom laktacije bile su suprotnog oblika od onog utvrÄenog za dnevnu koliÄinu proizvedenoga mlijeka. Redoslijed laktacije statistiÄki je znaÄajno (P<0,05) utjecao na promjenu dnevne koliÄine mlijeka i sadržaja bjelanÄevina u mlijeku, ali ne i na sadržaj mlijeÄne masti. NajviÅ”e korigirane prosjeÄne vrijednosti dnevne koliÄine mlijeka i sadržaja bjelanÄevina u mlijeku utvrÄene su u ovaca u treÄoj laktaciji. VeliÄina legla statistiÄki je znaÄajno utjecala na dnevnu proizvodnju mlijeka te na sadržaj mlijeÄne masti u mlijeku (P<0,05). Ovce s dvoje ojanjene janjadi prosjeÄno su dnevno proizvele viÅ”e mlijeka s nižim sadržajem mlijeÄne masti od ovaca s jednim janjetom. Isto tako utvrÄena je razlika u dnevnoj proizvodnji i kemijskom sastavu mlijeka (P<0,001) obzirom na sezonu janjenja. NajviÅ”a korigirana prosjeÄna dnevna proizvodnja mlijeka utvrÄena je u ovaca ojanjenih tijekom prosinca odnosno u studenom u prvoj godini istraživanja, dok su najnižu prosjeÄnu dnevnu proizvodnju mlijeka imale ovce ojanjene u veljaÄi.The objective of this study was to analyse the effect of stage of lactation, parity, litter size, and lambing season on daily milk production and fat and protein content in Istrian sheep. Data included
9.533 test-day records of 2.024 ewes for the period from October 2005 to May 2009. Daily milk yield and fat and protein content were determined during monthly milking controls using AT4 method. The stage of lactation, described by Wilmink lactation curve, had significant effect (P<0.001) on all studied milk traits of Istrian sheep. The peak of daily milk production was achieved between the 20th and 30th day of lactation and gradually decreased towards the end of lactation. Lactation curves for fat and protein content had opposite shape compared to the daily milk yield lactation curve. Parity affected (P<0.05) the daily milk yield and protein content. Daily milk yield and protein content were the lowest in the first and the highest in the third parity. Statistically significant influence of litter size (P<0.05) was determined for daily milk yield and fat content. A higher daily milk yield and lower fat content was observed in ewes lambing twins compared to ewes lambing singles. Differences in daily milk yield and contents were observed for the lambing season effect (P<0.001). Istrian ewes lambed in December and November (first lambing season) had the highest daily milk production, while the lowest daily milk yield had ewes lambed in February
Using Magnetic Resonance Imaging to Identify the Lumbosacral Segment in Children
Identification of the lumbosacral (L-S) segment on magnetic resonance (MR) images is important for appropriate
treatment of disease in the lumbosacral (L-S) area. In the study, data obtained from plain A-P radiographs of the L-S
spine and sagittal MR imaging scans (sagittal T1- and T2-weighted sequences) of the L-S spine and sacrum with the
coccygeal bone, are analyzed. Twenty-six children aged 10 to 14 years were examined for back pain. On the standard A-P radiographs of the L-S spine, a L-S transitional vertebra as classified according to the method of Castellvi et al. was found in 17 subjects. The problem arose as to whether this was lumbalisation or sacralisation, and how to determine which vertebra was L5 wich S1. On the sagittal MR imaging studies the same question applied. A need emerged for a simple method which would identify the L-S segment on the sagittal MR imaging studies of the L-S spine in children so that in case of a tumor, inflammation, spondilolystesis, or protrusion of a disc, the level in the L-S spine where the problem is localized can be accurately identified. To this objective we selected the method using detection of the S1 vertebra. This involved that, in addition to the sagittal MR imaging scans of the L-S spine, sagittal images of the sacrum and coccygeal bone be also obtained. on the T2-weighted sequence, the sacrum can be clearly distinquished from the coccygeal bone. By counting from the S5 up, the S1 vertebra can be accurately identified. Determination of the S1 vertebra enables detection of the L5 vertebra and, in turn, of all other lumbar vertebrae. In patients in whom a T2-weighted MR studies were done S1 could be precisely determined and so could the L5 vertebra. In this process, whether the patient had a transitional vertebra or whether there was lumbarisation or sacralisation was irrelevant
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