Somatosensory tinnitus and temporomandibular disorders: A common association.

BACKGROUND: Although the association between tinnitus and temporo-mandibular disorders (TMD) has been frequently reported, their rate of association in the literature shows a great variability. OBJECTIVE: We aimed to investigate the prevalence of TMD in patients with somatosensory tinnitus and, vice versa, the occurrence of somatosensory tinnitus in patients with TMD. METHODS: The study included patients with somatosensory tinnitus (audiological group) and patients with TMD (stomatological group), evaluated at the audiologic and stomatologic clinics of the Policlinic Hospital of Milan, Italy. Common causes of tinnitus, such as hearing and neurological disorders, were excluded. A cervicogenic somatic tinnitus was also ruled out. Different TMD symptoms, including joint noise and joint pain, were considered. The collected data were analysed using descriptive statistical methods, and the Pearson's Chi-squared test was performed to study the prevalence of the different symptoms by clinical groups. RESULTS: Audiological group included 47 patients with somatosensory tinnitus. Overall, TMD was diagnosed in 46 patients (97.8%), including TMJ noise in 37 (78.7%), clenching in 41 (87.2%) and pain in 7 (14.8%) patients. Stomatological group included 50 patients with TMD, including joint noise in 32 (64.0%), clenching in 28 (56.0%) and TMJ pain in 42 (84.0%) patients. A somatosensory tinnitus was diagnosed in 12 (24.0%) patients. CONCLUSION: Our study showed a high prevalence of TMD in patients with tinnitus, as well as a not uncommon occurrence of tinnitus in patients presenting with TMD. The distribution of TMD symptoms, such as joint noise, and joint pain was different between the two groups.

Intestinal permeability and Ménière's disease.

PURPOSE: Ménière disease (MD) is a multifactorial chronic disabling condition characterized by episodic vertigo, ear fullness, and hearing loss. MD patients often complain of aspecific gastrointestinal symptoms associated with autonomic dysregulation, frequently outweighed by the otological manifestations. Dietary modifications have been reported to improve the typical MD symptoms in some cases. Our purpose was to test the urinary levels of lactulose and mannitol (double sugar test) and the fecal calprotectin, both markers of altered intestinal permeability, in subjects with definite MD in an active and inactive stage. MATERIALS AND METHODS: Twenty-six with definite unilateral MD were studied: 14 patients were symptomatic for at least 3months with moderate to severe vertigo spells and a functional level ≥4; 12 patients had been asymptomatic (no vertigo spells) for at least 3months and had a functional level=1 at the time of testing. Twenty healthy volunteers were recruited as "control group". RESULTS: Lactulose and mannitol absorption was significantly increased in the symptomatic M patients compared to the asymptomatic group (p<0.02 and p<0.004, respectively) and to the controls. FC were also higher than normal only in the symptomatic group. (p<0.01). CONCLUSIONS: An altered intestinal permeability, according to the two assays, was found only in symptomatic MD patients. The rationale for a possible relationship between MD and intestinal permeability is forwarded. The double-sugar test and FC quantification might be implemented in the MD diagnostic workup.

Energy and protein requirements for growth of Holstein × Gyr heifers.

There is little information regarding the nutritional requirements for dairy heifers, leading the majority of nutrient requirement systems to consider dairy heifers to be similar to beef heifers. Therefore, we evaluated the muscle protein metabolism and physical and chemical body composition of growing Holstein × Gyr heifers and estimated the energy and protein requirements. We performed a comparative slaughter experiment with 20 Holstein × Gyr heifers at an initial body weight of 218 ± 36.5 kg and an average age of 12 ± 1.0 months. Four heifers were designated as the reference group, and the 16 remaining heifers were fed ad libitum. The 16 heifers were distributed using a completely randomized design in a 2 × 2 factorial arrangement with two roughages (corn silage or sugarcane) and two concentrate levels (30 or 50%) for 112 days. Greater (p < 0.05) values for fractional rates of muscle protein synthesis, degradation and accretion were observed for heifers that were fed 50% concentrate. The following equations were obtained to estimate the net energy for gain (NEg ) and net protein for gain (NPg ): NEg (Mcal/day) = 0.0685 × EBW0.75  × EBWG1.095 and NPg (g/day) = 203.8 × EBWG - 14.80 × RE, respectively, in which EBW is the empty body weight, EBWG is the empty body weight gain and RE is the retained energy. We concluded that increased rates of protein turnover are achieved when a greater quality diet is provided. In the future, these results can be used to calculate the nutritional requirements for growth of Holstein × Gyr heifers after equation validation rather than using the recommendations provided by other systems, which use values developed from beef heifers, to determine the nutritional requirements of dairy cattle.

Assessment of the Membranous Labyrinth in Infants Using a Heavily T2-weighted 3D FLAIR Sequence without Contrast Agent Administration.

BACKGROUND AND PURPOSE: Imaging is fundamental to assessing the acoustic pathway in infants with congenital deafness. We describe our depiction of the membranous labyrinth in infants using the heavily T2-weighted 3D FLAIR sequence without a contrast agent. MATERIALS AND METHODS: We retrospectively reviewed 10 infants (20 ears) (median term equivalent age: 2 weeks; IQR: 1-5 weeks) who had undergone brain MR imaging including a noncontrast heavily T2-weighted 3D FLAIR scan of the temporal bone. For each ear, 3 observers analyzed, in consensus, the saccule, the utricle, and the 3 ampullae, assessing the visibility (score 0, not appreciable; score 1, visible without well-defined boundaries; score 2, visible with well-defined boundaries) and morphology ("expected" or "unexpected" compared with adults). The heavily T2-weighted 3D FLAIR sequence was scored for overall quality (score 0, inadequate; score 1, adequate but with the presence of image degradation; score 2, adequate). RESULTS: Six (60%) MR examinations were considered adequate (score 1 or 2). The saccule was visible in 10 ears (83.3%) with an expected morphology in 9 ears (90%). In 1 ear of an infant with congenital deafness, the saccule showed an unexpected morphology. The utricle was visible as expected in 12 ears (100%). The lateral ampulla was visible in 5 ears (41.6%), the superior ampulla was visible in 6 ears (50.0%), and the posterior ampulla was visible in 6 ears (50.0%), always with expected morphology (100%). CONCLUSIONS: MR imaging can depict the membranous labyrinth in infants using heavily T2-weighted 3D FLAIR without an injected contrast agent, but the sequence acquisition time reduces its feasibility in infants undergoing MR studies during natural sleep.

Metabolizable amino acids and energy requirements of Nellore and crossbred Angus × Nellore bulls fed rations of different crude protein concentrations.

Growth rate of cattle depends on their genetic makeup and nutrient intake. Moreover, increased growth rate may lead to increased amino acid (AA) requirements. Therefore, we evaluated the AA content of the empty body and estimated the net AA and energy requirements of purebred and crossbred beef bulls fed rations of different dietary CP concentrations. We performed a comparative slaughter experiment with 24 Nellore and 24 Angus × Nellore (A × N) bulls (8 months; initial shrunk BW: Nellore = 208.0 ±â€¯12.78 kg; A × N = 221.9 ±â€¯14.16 kg). Eight bulls (four Nellore and four A × N) were designated as the reference group, eight bulls (four Nellore and four A × N) were fed to maintenance level and 32 bulls (16 Nellore and 16 A × N) were fed ad libitum. The 32 bulls fed ad libitum were distributed using a completely randomized design in a 2 × 3 factorial scheme with two genetic groups (Nellore or A × N) and three dietary CP contents (100, 120 or 140 g CP/kg DM), being four groups with five bulls and two groups with six bulls. The experimental period lasted for 224 days. There were no interactions (P ≥ 0.056) between the dietary CP contents and genetic groups for any of the response variables. The dietary CP contents did not affect (P ≥ 0.062) the AA content in the empty body (g/kg empty BW [EBW]), with exception for Tryptophan (P = 0.027, linear effect). The dietary CP contents did not affect (P ≥ 0.051) AA content in the empty body (g/100 g of CP), with exception for Alanine (P = 0.013) that responded quadratically to dietary CP increase. The equations to estimate the net Lysine (Lys) and Methionine (Met) requirements (g/100 g of CP) were: Lys = 5.1 × EBW0.0594 and Met = 1.7 × EBW0.0255. Metabolizable Lys and Met to metabolizable energy (ME) ratios decreased as bulls EBW increased. Also, the metabolizable protein to ME ratio decreased as bulls EBW increased. In conclusion, the present study provides useful information regarding net and metabolizable requirements of AA of purebred and crossbred beef bulls. In the future, after the validation of the equations, these results can be used to calculate the AA requirements for growth of purebred and crossbred beef bulls. Nevertheless, it is important to highlight that the small sample size was one limitation of this present experiment.

MR Imaging in Menière Disease: Is the Contact between the Vestibular Endolymphatic Space and the Oval Window a Reliable Biomarker?

BACKGROUND AND PURPOSE: No reliable MR imaging marker for the diagnosis of Menière disease has been reported. Our aim was to investigate whether the obliteration of the inferior portion of the vestibule and the contact with the stapes footplate by the vestibular endolymphatic space are reliable MR imaging markers in the diagnosis of Menière disease. MATERIALS AND METHODS: We retrospectively enrolled 49 patients, 24 affected by unilateral sudden hearing loss and 25 affected by definite Menière disease, who had undergone a 4-hour delayed 3D-FLAIR sequence. Two readers analyzed the MR images investigating whether the vestibular endolymphatic space bulged in the third inferior portion of the vestibule contacting the stapes footplate. This sign was defined as the vestibular endolymphatic space contacting the oval window. RESULTS: We analyzed 98 ears: 27 affected by Menière disease, 24 affected by sudden sensorineural hearing loss, and 47 that were healthy. The vestibular endolymphatic space contacting the oval window showed an almost perfect interobserver agreement (Cohen κ = 0.87; 95% CI, 0.69-1). The vestibular endolymphatic space contacting oval window showed the following: sensitivity = 81%, specificity = 96%, positive predictive value = 88%, and negative predictive value = 93% in differentiating Menière disease ears from other ears. The vestibular endolymphatic space contacting the oval window showed the following: sensitivity = 81%, specificity = 96%, positive predictive value = 96%, negative predictive value = 82% in differentiating Menière disease ears from sudden sensorineural hearing loss ears. CONCLUSIONS: The vestibular endolymphatic space contacting the oval window has high specificity and positive predictive value in differentiating Menière disease ears from other ears, thus resulting in a valid tool for ruling in Menière disease in patients with mimicking symptoms.

MR imaging of endolymphatic hydrops in Ménière's disease: not all that glitters is gold.

Ménière's disease (MD) is a chronic condition characterised by fluctuating hearing loss, intermittent vertigo, tinnitus and aural fullness. Its anatomical and pathological counterpart is represented by endolymphatic hydrops (EH). Recent development and progress in magnetic resonance (MR) imaging techniques has enabled visualisation of EH in living human subjects using a 3 Tesla (T) scanner and gadolinium-based contrast-agent (GBCA) via intravenous (IV) or intra-tympanic (IT) administration. Data emerging from the literature about MR imaging of EH in MD patients are limited, and we therefore reviewed the most common MR imaging findings in the study of the endolymphatic space in both MD and non-MD patients.

MR Imaging in Sudden Sensorineural Hearing Loss. Time to Talk.

Sudden sensorineural hearing loss is defined as acute hearing loss of the sensorineural type of at least 30 dB over 3 contiguous frequencies that occurs within a 72-hour period. Although many different causative factors have been proposed, sudden sensorineural hearing loss is still considered "idiopathic" in 71%-85% of cases, and treatments are empiric, not based on etiology. MR imaging implemented with a 3D FLAIR sequence has provided new insights into the etiology of sudden sensorineural hearing loss. Herein, we review the current management trends for patients with sudden sensorineural hearing loss, from the initial clinical diagnosis to therapeutic strategies and diagnostic work-up. We focused primarily on MR imaging assessment and discuss the relevance that MR imaging findings might have for patient management, pointing out different perspectives for future clinical research.

Flat Panel Angiography in the Cross-Sectional Imaging of the Temporal Bone: Assessment of Image Quality and Radiation Dose Compared with a 64-Section Multisection CT Scanner.

BACKGROUND AND PURPOSE: Cross-sectional imaging of the temporal bone is challenging because of the complexity and small dimensions of the anatomic structures. We evaluated the role of flat panel angiography in the cross-sectional imaging of the temporal bone by comparing its image quality and radiation dose with a 64-section multisection CT scanner. MATERIALS AND METHODS: We retrospectively collected 29 multisection CT and 29 flat panel angiography images of normal whole-head temporal bones. Image quality was assessed by 2 neuroradiologists, who rated the visualization of 30 anatomic structures with a 3-point ordinal scale. The radiation dose was assessed with an anthropomorphic phantom. RESULTS: Flat panel angiography showed better image quality than multisection CT in depicting the anterior and posterior crura of the stapes, the footplate of the stapes, the stapedius muscle, and the anterior ligament of the malleus (P < .05). In contrast, multisection CT showed better image quality than flat panel angiography in assessing the tympanic membrane, the bone marrow of the malleus and incus, the tendon of the tensor tympani, the interscalar septum, and the modiolus of the cochlea (P < .05). Flat panel angiography had a significantly higher overall image quality rating than multisection CT (P = .035). A reduction of the effective dose of approximately 40% was demonstrated for flat panel angiography compared with multisection CT. CONCLUSIONS: Flat panel angiography shows strengths and weaknesses compared with multisection CT. It is more susceptible to artifacts, but due to the higher spatial resolution, it shows equal or higher image quality in assessing some bony structures of diagnostic interest. The lower radiation dose is an additional advantage of flat panel angiography.

Reducing mineral usage in feedlot diets for Nellore cattle: I. Impacts of calcium, phosphorus, copper, manganese, and zinc contents on microbial efficiency and ruminal, intestinal, and total digestibility of dietary constituents.

This study evaluated intake, microbial efficiency, and ruminal, small and large intestinal, and total digestibility of DM, OM, CP, and NDF, as well as availability of Ca, P, Mg, Na, K, Cu, Mn, and Zn in Zebu cattle fed with or without supplemental sources of Ca and P or a micromineral premix. Five rumen- and ileum-cannulated Nellore bulls (BW = 200 ± 10.5 kg; 9 mo) were used in the experiment, distributed in a 5 × 5 Latin square design. The experiment was developed in a 2 × 2 + 1 factorial design to measure the effects of mineral supplementation on intake, digestibility, and site of nutrient absorption. The factors consisted of 2 Ca and P levels (macromineral factor; CaP+ or CaP-) and 2 microminerals levels (micromineral factor; CuMnZn+ or CuMnZn-). In addition, a treatment with alimentary restriction (REST) was evaluated at 1.7% of BW. Nutrient fluxes were measured in the omasum and ileum, in addition to intake and fecal excretion. Microbial efficiency was estimated using purine derivative excretion. Dry matter, OM, NDF, CP intake, and total digestibility were not affected ( ≥ 0.058) by the absence of Ca, P, Cu, Mn, and Zn supplementation. Intake of Ca, P, and Mg were reduced ( < 0.01) by CaP-. The absence of CuMnZn reduced ( < 0.01) Cu, Mn, and Zn intake. Ruminal recycling of P, Na, and K is significant for increasing the influx of these minerals to the digestive tract; however, influences of treatments were not observed. The small and large intestines contributed to mineral absorption in different proportions ( < 0.05), according to minerals and treatments. Because of the similarity ( > 0.05) of OM, NDF, and CP digestion sites and coefficients, we assume that omitting supplemental sources of Ca, P, Cu, Mn, and Zn may be an option in raising cattle on feedlots. If supplementation is viable, knowledge about the specific absorption site of each mineral could positively impact choices about the supplemental source.

Reducing mineral usage in feedlot diets for Nellore cattle: II. Impacts of calcium, phosphorus, copper, manganese, and zinc contents on intake, performance, and liver and bone status.

Weaned Nellore bulls ( = 36; 274 ± 34 kg) were used in a randomized block design with a 2 × 2 factorial arrangement of treatments to evaluate intake, fecal excretion, and performance with different concentrations of minerals. Experimental diets were formulated with 2 concentrations of Ca and P (macromineral factor; diet supplying 100% of Ca and P according to BR-CORTE () [CaP+] or diet without limestone and dicalcium phosphate [CaP-]) and 2 concentrations of microminerals (micromineral factor; diet with supplementation of microminerals [Zn, Mn, and Cu; CuMnZn+] or diet without supplementation of microminerals [Zn, Mn, and Cu; CuMnZn-]). The factor CaP- was formulated without the addition of limestone and dicalcium phosphate, and the factor CuMnZn- was formulated without inorganic supplementation of microminerals (premix). The diets were isonitrogenous (13.3% CP). Intake was individually monitored every day. Indigestible NDF was used as an internal marker for digestibility estimates. The bulls were slaughtered (84 or 147 d on feed), and then carcass characteristics were measured and liver and rib samples were collected. Feed, feces, rib bones, and liver samples were analyzed for DM, ash, CP, ether extract (EE), Ca, P, Zn, Mn, and Cu. There were no significant interactions ( ≥ 0.06) between macro- and micromineral supplementation for any variables in the study. Calcium, P, and micromineral concentrations did not affect ( ≥ 0.20) intake of DM, OM, NDF, EE, CP, TDN, and nonfiber carbohydrates (NFC). Calcium and P intake were affected ( < 0.01) by macromineral factor. Animals fed without Ca and P supplementation consumed less of these minerals. Dry matter and nutrient fecal excretion (OM, NDF, EE, CP, and NFC) were similar ( ≥ 0.23) among all factors. Performance and carcass characteristics were similar ( ≥ 0.09) among diets. The content of ash in rib bones was not affected by diets ( ≥ 0.06). Plasma P and phosphatase alkaline concentrations were similar ( ≥ 0.52) among diets. Supplementation of microminerals decreased ( < 0.01) plasma Ca concentration; nevertheless, all analyzed blood metabolites were within the reference values. Supplementation of Ca and P increased ( < 0.01) fecal excretion of these minerals. These results indicate that mineral supplementation (Ca, P, Zn, Mn, and Cu) of conventional feedlot diets for Nellore bulls may be not necessary. Dietary reductions in these minerals would represent a decrease in the cost of feedlot diets. Dietary reduction in Ca and P content cause a decrease in fecal excretion of these minerals, which, in turn, represents an opportunity to reduce the environmental impact of feedlot operations.

Estimating mineral requirements of Nellore beef bulls fed with or without inorganic mineral supplementation and the influence on mineral balance.

The objectives of this study were to quantify the mineral balance of Nellore cattle fed with and without Ca, P, and micromineral (MM) supplementation and to estimate the net and dietary mineral requirement for cattle. Nellore cattle ( = 51; 270.4 ± 36.6 kg initial BW and 8 mo age) were assigned to 1 of 3 groups: reference ( = 5), maintenance ( = 4), and performance ( = 42). The reference group was slaughtered prior to the experiment to estimate initial body composition. The maintenance group was used to collect values of animals at low gain and reduced mineral intake. The performance group was assigned to 1 of 6 treatments: sugarcane as the roughage source with a concentrate supplement composed of soybean meal and soybean hulls with and without Ca, P, and MM supplementation; sugarcane as the roughage source with a concentrate supplement composed of soybean meal and ground corn with and without Ca, P, and MM supplementation; and corn silage as the roughage source with a concentrate supplement composed of soybean meal and ground corn with and without Ca, P, and MM supplementation. Orthogonal contrasts were adopted to compare mineral intake, fecal and urinary excretion, and apparent retention among treatments. Maintenance requirements and true retention coefficients were generated with the aid of linear regression between mineral intake and mineral retention. Mineral composition of the body and gain requirements was assessed using nonlinear regression between body mineral content and mineral intake. Mineral intake and fecal and urinary excretion were measured. Intakes of Ca, P, S, Cu, Zn, Mn, Co, and Fe were reduced in the absence of Ca, P, and MM supplementation ( < 0.05). Fecal excretion of Ca, Cu, Zn, Mn, and Co was also reduced in treatments without supplementation ( < 0.01). Overall, excretion and apparent absorption and retention coefficients were reduced when minerals were not supplied ( < 0.05). The use of the true retention coefficient instead of the true absorption coefficient provided a better estimate of mineral requirements. Dietary mineral requirements were lower for P, Cu, and Zn and greater for Fe compared with previously published recommendations. This study provides useful information about mineral requirements and mineral supplementation to obtain adequate dietary mineral supply of Nellore cattle in tropical conditions.

Technical note: Prediction of chemical rib section composition by dual energy X-ray absorptiometry in Zebu beef cattle.

It is expensive and laborious to evaluate carcass composition in beef cattle. The objective of this study was to evaluate a method to predict the 9th to 11th rib section (rib) composition through empirical equations using dual energy X-ray absorptiometry (DXA). Dual energy X-ray absorptiometry is a validated method used to describe tissue composition in humans and other animals, but few studies have evaluated this technique in beef cattle, and especially in the Zebu genotype. A total of 116 rib were used to evaluate published prediction equations for rib composition and to develop new regression models using a cross-validation procedure. For the proposed models, 93 ribs were randomly selected to calculate the new regression equations, and 23 different ribs were randomly selected to validate the regressions. The rib from left carcasses were taken from Nellore and Nellore × Angus bulls from 3 different studies and scanned using DXA equipment (GE Healthcare, Madison, WI) in the Health Division at Universidade Federal de Viçosa (Viçosa, Brazil). The outputs of the DXA report were DXA lean (g), DXA fat free mass (g), DXA fat mass (g), and DXA bone mineral content (BMC; g). After being scanned, the rib were dissected, ground, and chemically analyzed for total ether extract (EE), CP, water, and ash content. The predictions of rib fat and protein from previous published equations were different ( < 0.01) from the observed composition. New equations were established through leave-one-out cross-validation using the REG procedure in SAS. The equations were as follows: lean (g) = 37.082 + 0.907× DXA lean ( = 0.95); fat free mass (g) = 103.224 + 0.869 × DXA fat free mass ( = 0.93); EE mass (g) = 122.404 + 1.119 × DXA fat mass ( = 0.86); and ash mass (g) = 18.722 + 1.016 × DXA BMC ( = 0.39). The equations were validated using Mayer's test, the concordance correlation coefficient, and the mean square error of prediction for decomposition. For both equations, Mayer's test indicated that if the intercept and the slope were equal to 0 and 1 ( > 0.05), respectively, then the equation correctly estimated the rib composition. Comparing observed and predicted values using the new equations, Mayer's test was not significant for lean mass ( = 0.26), fat free mass ( = 0.67), EE mass ( = 0.054), and ash mass ( = 0.14). We concluded that the rib composition of Nellore and Nellore × Angus bulls can be estimated from DXA using the proposed equations.

Factors affecting residual hearing preservation in cochlear implantation.

The likelihood of residual hearing preservation in cochlear implantation (CI) is related to surgical factors such as type of cochleostomy (trans-fenestral vs. promontorial), use of lubricants and protective drugs, and device-related factors such as shape, length and flexibility of the array. We investigated the impact of these factors on the hearing preservation rate in adults and children with conventional audiological indications to CI. Eighty-two children aged 1-9 years and 73 adults (16-79 years) received a CI in the right (59%) or left ear (41%). An anterior-inferior promontorial cochleostomy was performed in 143 ears (92%); a trans-fenestral approach was used in 12 (8%). A perimodiolar electrode was implanted in 144 ears (93%), and a straight electrode in the remaining 11 (7%). Overall, some post-operative hearing was retained in 39% of ears. The rate of preservation was higher at the low than at the high frequencies. When correlated with age, side of implant, implant model and type of cochleostomy, the mean threshold variations did not reach statistical significance for any of these variables. A slight trend in favour of better residual hearing preservation in children vs. adults was seen, especially at lower frequencies.

Effects of roughage sources produced in a tropical environment on forage intake, and ruminal and microbial parameters.

Our objective was to study the effect of different roughage sources produced in a tropical environment on intake, digestibility, and ruminal parameters of crossbred bulls. Five rumen-fistulated 30-mo-old Holstein × Bos indicus bulls (average BW =459 ± 32.5 kg) were utilized in a 5 × 5 randomized Latin square design. The experiment consisted of five 19-d experimental periods (10 d for adaptation and 9 d for data collection) and 5 treatments. Experimental diets consisted of corn (Zea mays L.) silage (CS), Brachiaria grass (Brachiaria decumbens Stapf.) silage (BGS), elephant grass (Pennisetum purpureum Schumach.) silage(EGS), Tifton 85 (Cynodon spp.) hay (T85), and fresh sugarcane (Saccharum officinarum L.; SC). Diets were formulated to have approximately 11% CP (DM basis)using a mixture of urea and ammonium sulfate (9:1 ratio) that was diluted in water and then mixed with roughage. Intake, ruminal outflow, digestibility coefficients,ruminal pool, intake, passage (kp) and digestion rates, microbial parameters, and pH data were assessed.D ry matter intake was greater (P < 0.01) for CS compared with SC. Among treatments, lesser (P < 0.01)potentially digestible NDF, ash- and protein-free NDF(apNDF), and digestible ash- and protein-free NDF intake values were observed for SC. Ruminal outflows of DM and nonfibrous carbohydrates were lesser (P <0.01) for SC compared with other treatments. Dry matter apparent digestibility and ruminal digestibility did not differ (P > 0.27) among treatments. No differences (P = 0.11) were observed for ruminal apNDF pool and ruminal kp of apNDF (P = 0.06) among treatments. No treatment effect (P > 0.28) was observed for DM and nitrogen of rumen-isolated bacteria, and microbial efficiency was greater (P = 0.02) for BGS among treatments.A treatment × time interaction (P < 0.01) was found for ruminal pH, with a quadratic pattern in terms of time for CS, BGS, EGS, and T85, whereas pH values for CA linearly decreased as a function of time. In summary, these roughages, when supplemented with an additional nitrogen sources, show similar overall apparent digestibility and ruminal pool values, but conversely, bulls fed sugarcane had less overall nutrient intake and lower ruminal outflow and digestion rate values. We conclude that fresh-cut sugarcane, when provided with urea, can affect digestion rate and, consequently, impact nutrient intake.

4-hydroxynonenal and transforming growth factor-beta1 expression in colon cancer.

In vivo studies on human colon adenocarcinoma showed decreased transforming growth factor-beta1 (TGF-beta1) antiproliferative cytokine content in tumour tissue related to malignancy progression, with a corresponding decrease in lipid peroxidation aldehydic end-product, 4-hydroxynonenal (HNE). The tumour mechanism to escape TGF-beta1-mediated growth inhibition may be due to an altered TGF-beta1 receptor system. Subsequent in vitro analyses showed a differential distribution of TGF-beta1 receptors depending on the human colon cancer cell line considered (CaCo-2 or HT-29): compared to HT-29 cells, CaCo-2 cells showed a decrease of the two main TGF-beta1 receptors, RI and RII. Notwithstanding their partial TGF-beta1 RI and RII deficiency, treatment of CaCo-2 cells with adequate doses of the cytokine (10 ng/ml) was able to induce apoptosis. Of note, co-treatment of these cells with 1 microM HNE increased the apoptotic effect. The constant low concentration of TGF-beta1 in the tumour mass may be related to the low content of antiproliferative HNE observed in colon cancer: the latter phenomenon, which reduces TGF-beta1 production in the tumour area, may represent a favourable condition for neoplastic progression. The enhancement of TGF-beta1-induced apoptosis by HNE in CaCo-2 cells supports this hypothesis. The different transcriptional components regulated by the distinct signaling pathways of these two molecules might be proposed; in particular, crosstalk between the MAPK and the Smad pathway could modulate and co-operate in the transcription of target genes involved in regulation of cell proliferation.

Surgical repair of bone defects of the ear canal wall with flexible hydroxylapatite sheets: a pilot study.

OBJECTIVE: Evaluation of suitability of flexible composite sheets (hydroxylapatite and polymer) for outer ear canal (OEC) wall reconstruction in tympanoplasty. STUDY DESIGN: Prospective, open label pilot study. SETTING: University and regional hospital. PATIENTS: Forty-two randomly selected patients with chronic otitis media (n = 20) and cholesteatoma (n = 22) among 356 patients admitted between 1996 and 1997. INTERVENTIONS: Eradication of disease through a partial or total canal wall down mastoidectomy; immediate reconstruction of canal wall with flexible composite sheet (hydroxylapatite and polymer) and connective tissue graft. OUTCOME MEASURES: Anatomic integrity of the OEC and neotympanum, extrusion rate, complications. RESULTS: At minimum follow-up of 24 months: recurrent cholesteatoma (n = 0), residual cholesteatoma (n = 3/22) (13.6%) in the mesotympanum (none behind the hydroxylapatite sheet or in the attic or antrum). The neotympanum was intact in 38 ears (90.4%), reperforated in 2, and severely retracted and lateralized in 1, respectively. Anatomic integrity of the OEC was obtained in 37 (88%) of 42 patients; stenosis or membranous synechiae were observed in 5 ears and treated in the office. Extrusion of the hydroxylapatite sheet occurred in 7 patients (16.6%) because of purulent otorrhea and granulation tissue formation. Surgical revision achieved complete epithelialization of the rebuilt canal wall in 33 ears (78.6%). CONCLUSIONS: A dry, disease-free ear and normal anatomy may be expected 2 years postoperatively in more than three-fourths of the patients treated using the described surgical technique. Complete protection with a connective tissue graft is essential to avoid extrusion of the implant. The failure rate is significantly higher if otorrhea is present at the time of the operation.