Relationship among cattle breed and anabolic implant protocol relative to feedlot performance: Growth, temperament, feeding behavior, carcass traits, and economic return.

Recent research has suggested that different cattle breed types may respond differently to anabolic implant protocols of varying intensity. Therefore, the purpose of this research was to compare anabolic implant protocols in feedlot steers of 2 different breed types. Sixty steers were stratified by weight and breed in a 2 × 3 factorial design examining 2 different breeds: Angus (AN; n=38) or Santa Gertrudis influenced (SG; n=22), and 3 implant strategies: no implant (CON; n=20), a moderate intensity implant protocol (d0 implant: Revalor-G, d56 implant: Revalor-IS, d112 implant: Revalor-S; MI; n=20), or a high intensity implant protocol (d0 implant: Revalor-IS, d56 implant: Revalor-S, d112 implant: Revalor-200; HI; n=20). Steers were randomly placed into pens equipped with GrowSafe bunks to collect dry matter intake and feeding behavior. All animals were fed the same diet. Weight, chute score, exit velocity, serum, rectal temperature, hip height and 12th rib fat thickness were collected approximately every 28 d over a 196 d period. Serum urea nitrogen (SUN) was evaluated as well. Total average daily gain was increased (P < 0.0001) in both the HI and MI steers compared to the CON steers by 29.4% and 26%, respectively. A treatment × breed interaction was observed (P < 0.0001) for hip height, with AN-CON steers being shorter (P < 0.0007) than AN-HI, SG-CON, SG-MI, and SG-HI steers. A breed × treatment interaction was observed (P < 0.004) for chute score and rectal temperature, with SG-HI and SG-MI steers having increased chute scores (P < 0.001) when compared to AN-HI, AN-MI, AN-CON, and SG-CON throughout the course of the trial. Additionally, SG-HI and SG-MI steers had an increased rectal temperature (P < 0.004) compared to AN-HI, AN-MI, AN-CON, and SG-CON steers. A breed effect was observed (P = 0.002) for SUN with AN steers having increased (P = 0.002) SUN concentration compared to SG sired steers, in addition to a treatment effect (P < 0.0001), with CON steers having a higher (P < 0.0001) SUN concentration than MI and HI steers, regardless of breed. The MI implant protocol increased net return per head, on average, by $97.28, regardless of breed, while the HI implant protocol increased net return by only $80.84. Taken together, despite the cattle breed types responding differently to the different anabolic implant protocols at times, a moderate intensity anabolic implant protocol was optimal in this experiment for steers raised in a temperate climate.

Esophageal reconstitution by simultaneous antegrade/retrograde endoscopy: re-establishing patency of the completely obstructed esophagus.

Complete obstruction of the proximal esophagus is an uncommon complication of radiotherapy. Standard endoscopic dilation is not possible because no lumen exists. We describe a retrospective case series in which rendezvous endoscopy, tissue puncture, dilation, and stenting were used to restore function to a group of patients with complete esophageal obstruction. The series consisted of patients referred for complete esophageal obstruction after radiation therapy over 5 years. Ultimately, five patients underwent successful initial recanalization via rendezvous endoscopy. All patients were able to resume eating and four have been able to maintain oral alimentation with periodic dilation. One patient developed self-limited pneumomediastinum after needle puncture and cervical osteomyelitis after stenting, and another developed an anterior neck abscess after stenting. Rendezvous endoscopy can successfully treat complete esophageal obstruction resulting from radiation therapy. Temporary stenting may allow patients to swallow immediately and leave the hospital sooner but does not appear to reduce the need for subsequent dilation and may result in serious complications.

Management of thyroid carcinoma invading the aerodigestive tract.

OBJECTIVES: To evaluate approaches to thyroid carcinoma invading the aerodigestive tract, with particular attention to well-differentiated carcinomas. STUDY DESIGN: Retrospective review of experience with thyroid carcinoma invading the aerodigestive tract over a 20-year period at a tertiary referral hospital. METHODS: The medical records of all patients with a diagnosis of thyroid cancer treated at Emory University Hospital, Atlanta, Georgia, from 1977 through 1997 were reviewed. Multiple clinical variables were analyzed including treatment, development of recurrence, and survival. Survival and time to local recurrence were determined by Kaplan-Meier analysis, and statistical comparisons were made using log-rank analysis. RESULTS: Five hundred thirty-six cases were identified; 28 patients (5.2%) were identified with invasive disease involving the aerodigestive tract. Histologic findings at the time of invasion included 15 well-differentiated (WD) carcinomas and 13 poorly differentiated (PD) carcinomas. Eight of the 28 patients (5 WD, 3 PD) underwent surgical resection of some portion of the aerodigestive tract with curative intent. Ten patients (8 WD, 2 PD) underwent incomplete resection with tumor left adjacent to aerodigestive tract structures. All patients undergoing incomplete resection developed local recurrence. Six required salvage resection, as opposed to no recurrences in WD carcinomas following complete resection (P = .01). Survival at 5 years for WD carcinomas undergoing complete resection versus initial incomplete resection was 100% versus 50%, respectively (P = .27). CONCLUSION: Review of our experience shows that complete resection of thyroid carcinoma invading the aerodigestive tract can offer prolonged palliation, improved local control, and the opportunity for cure in selected patients.

Subclavian pseudoaneurysm mimicking recurrent head and neck cancer.

Vascular blowouts are devastating complications of head and neck oncologic surgery that are easily diagnosed with oropharyngeal or external bleeding. We present herein a case of a pseudoaneurysm of the subclavian artery that mimicked recurrent head and neck carcinoma. Vascular lesions arising in the base of the neck may present with few signs of vascular injury. Head and neck surgeons should be aware of this unusual complication to avoid a potentially life-threatening event. We report difficulties in diagnosing subclavian pseudoaneurysm, a review of the vascular injuries related to this condition, as well as approaches to bleeding at the base of the neck.

Mandibular fracture and associated cervical spine fracture, a rare and predictable injury. Protocol for cervical spine evaluation and review of 1382 cases.

OBJECTIVES: To assess the relationship and incidence of cervical spine injuries in patients with mandibular fractures and to recommend an organized approach to cervical spine evaluation in these patients. DESIGN: A retrospective review of medical records of all patients with mandibular fractures at a level I trauma hospital from 1984 through 1993. Patient demographics, injury, mechanism of injury, associated symptoms, physical presentation, and adjuvant radiographic evaluations were recorded. SETTING: Level I, 1000-bed, urban trauma center in Atlanta, Ga. RESULTS: A total of 1382 patients with mandibular fractures were examined during the 10-year period of review. Cervical spine radiographs were obtained on 501 (36.3%) of these patients. From these radiographs, only 8 cervical spine fractures were found. All of the patients with cervical spine injuries (n = 8) had other associated maxillofacial injuries (n = 4), were involved in a motor vehicle accident (n = 7), or sustained gunshot wounds (n = 1). CONCLUSIONS: Judicious use of cervical spine radiographs in the appropriate setting of mandibular trauma is beneficial. However, clinical criteria should dictate rational use of radiographs, since the association between cervical spine injuries and mandibular trauma is rare and predictable.

Demonstration that phosphorescent 6-bromo-2-naphthyl sulfate can be used to probe heme accessibility in heme proteins.

The phosphorescence properties of 6-bromo-2-naphthyl sulfate (BNS) in aqueous solution were studied. The phosphorescence lifetime is several hundred microseconds and is self-quenched. Although a fluorescent photoproduct is formed from BNS, it does not interfere with the decay properties of triplet-state BNS and its utility as a probe of the accessibility of the heme group in heme proteins. Quenching of BNS phosphorescence does not occur for the non-heme protein lysozyme and apomyoglobin but occurs by a dynamic mechanism with a quenching constant of 1-2 x 10(9) M-1 s-1 for cytochrome c and myoglobin and with a quenching constant of 6.2 x 10(9) M-1 s-1 for protoporphyrin IX. The phosphorescence of an inclusion complex of 1-bromonaphthalene and beta-cyclodextrin is not quenched by heme-containing proteins. The temperature and viscosity dependencies of the rate with which BNS phosphorescence is quenched by microperoxidase-11 are consistent with unit quenching efficiency. These results indicate that quenching of BNS phosphorescence occurs only upon contact with the quencher, and the quenching constant can be used to assess the degree of accessibility of the heme group.