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A simple technique to reduce the incidence of accidental dural puncture (2002)

Cohen, S. ; Chokkra, R. ; Bokhari, F.

Oxford, UK : Blackwell Science Ltd

Anaesthesia 57 (2002), S. 0

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ISSN: 1365-2044

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: We would like to respond to recent comments (Reynolds. Anaesthesia 2001: 56: 1129) on our epidural technique. In our practice we apply loss of resistance to air technique, which helps identify a nick in the dura with a small leak of CSF. On many occasions, only a few drops of CSF and not a constant leak helped identify dural puncture, which could have been missed with the use of saline. Upon inserting the epidural needle, we remove the stylet when the needle is engaged in the interspinous ligament or the ligamentum flavum. Very often, it is difficult for our residents to advance the epidural needle with one hand and apply constant pressure on the plunger with the other hand. Excessive pressure with one hand, by a resident, had caused dural puncture when the needle was pushed in too far. By reinserting the stylet with each advancement of the needle, we remove tissues that may enter and occlude the epidural needle. It is quite possible that constant plunger pressure with saline may also avert this problem.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1365-2044.2002.2520_34.x

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The ultrastructure of the diffuse kinetochore in Luzula nivea (1980)

Bokhari, F. S. ; Godward, M. B. E.

Springer

Chromosoma 79 (1980), S. 125-136

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ISSN: 1432-0886

Source: Springer Online Journal Archives 1860-2000

Topics: Biology , Medicine

Notes: Abstract Material of Luzula nivea was fixed and processed in the normal way for sectioning and use of the transmission electron microscope. In addition, irradiated as well as control material was employed. Irradiation is known to produce chromosome breaks which rejoin. Apparent side-by-side adherence at metaphase of the chromosomes of Luzula nivea in control material disappeared at the earliest moment of anaphase and because of the high visibility of the kinetochores of this species, one pair of sister kinetochores could be readily associated with one pair of chromatids. Rejoining of chromosome breaks which does not disappear at anaphase, could not be distinguished at metaphase from the above described adherence. Chromatids also were apparently adherent at metaphase and it is pointed out that this is commonly seen in most organisms sectioned for the electron microscope. The apparent adherence is regarded as an artifact of fixation and subsequent processing. The authors do not agree with the interpretation of the chromosomes of Luzula as polycentric. From serial sections it has been established that in Luzula nivea a single diffuse kinetochore extends along most of the length of the chromosome, but does not occupy the whole width.