Supplementation of isoacids to lactating dairy cows fed low or high forage diets: Effects on performance, digestibility, and milk fatty acid profile.

Our objective was to determine the effects of isoacids (ISO) on the lactation performance, digestibility, and milk fatty acid (FA) profile of Holstein cows fed 2 forage NDF levels (FL). The study was 10-wk long (including 2-wk for covariate) utilizing a randomized complete block design. Sixty-four mid-lactating Holstein cows [662 ± 71 kg BW, 119 ± 51 DIM, 2 ± 0.9 parity] were blocked by parity, DIM, and prior milk yield (MY) for multiparous cows or genetic merit for primiparous cows, and randomly assigned to 1 of the 4 diets (n = 16). Diets were arranged as a 2 × 2 factorial, with 2 FL containing 21 (HF) and 17% forage NDF (LF) without (WIA) or with ISO supplementation (IA, 7.85 mmol/kg DM and 3.44 mmol/kg DM for isobutyrate and 2-methylbutyrate, respectively). Diets were balanced for similar NEL (1.58 Mcal/kg DM), CP (16.0%) and total NDF (27.2%). Feed intake and MY were recorded daily. Nutrient digestibility for each cow was determined using indigestible NDF as a marker, and fecal samples were collected at 8-time points (4 h intervals between samples). Individual cow milk samples composited over a 10-wk period were analyzed using gas chromatography for FA profile. The statistical model included FL, ISO, and FL × ISO as fixed effects and block as a random effect (lme4 in R). The ISO did not affect DMI (P = 0.13), while LF had greater DMI than HF diets (27.8 vs. 26.0 kg/d; P < 0.01). However, ISO increased MY (34.7 vs. 37.2 kg/d; P < 0.01) and ECM (41.9 vs. 39.0 kg/d; P < 0.01) by 7% in HF but not in the LF diet, suggesting FL × ISO interaction (P = 0.04). Interestingly, ISO increased ADG (0.4 kg/d) but decreased MUN by 9% only in LF diet as indicated by FL × ISO interaction (P < 0.01). Additionally, ISO increased DM, OM, NDF, and CP digestibility by 10-24% in HF (P < 0.01), but not in LF (FL × ISO; P > 0.05). As expected, ISO increased milk odd chain FA profiles in the IA groups irrespective of FL, e.g., the IA had greater C15:0 (1.87 vs. 1.54 g/100g FA; P = 0.03) and a tendency to be greater C17:0 levels (0.86 vs. 0.76 g/100g FA; P = 0.05) compared with WIA groups. Overall, ISO improved MY and nutrient digestibility in the HF whereas it increased ADG and decreased MUN in LF diet. Additionally, ISO increased milk odd chain FA (C15:0 and C17:0) regardless of FL.

Use of micellar casein concentrate and milk protein concentrate treated with transglutaminase in imitation cheese products-Unmelted texture.

The amount of intact casein provided by dairy ingredients is a critical parameter in dairy-based imitation mozzarella cheese (IMC) formulation because it has a significant effect on unmelted textural parameters such as hardness. From a functionality perspective, rennet casein (RCN) is the preferred ingredient. Milk protein concentrate (MPC) and micellar casein concentrate (MCC) cannot provide the required functionality due to the higher steric stability of casein micelle. However, the use of transglutaminase (TGase) has the potential to modify the surface properties of MPC and MCC and may improve their functionality in IMC. The objective of this study was to determine the effect of TGase-treated MPC and MCC powders on the unmelted textural properties of IMC and compare them with IMC made using commercially available RCN. Additionally, we studied the degree of crosslinking by TGase in MPC and MCC retentates using capillary gel electrophoresis. Three lots of MCC and MPC retentate were produced from pasteurized skim milk via microfiltration and ultrafiltration, respectively, and randomly assigned to 1 of 3 treatments: no TGase (control); low TGase: 0.3 units/g of protein; and high TGase: 3.0 units/g of protein, followed by inactivation of enzyme (72°C for 10 min), and spray drying. Each MCC, MPC, and RCN was then used to formulate IMC that was standardized to 21% fat, 1% salt, 48% moisture, and 20% protein. The IMC were manufactured by blending, mixing, and heating ingredients (4.0 kg) in a twin-screw cooker. The capillary gel electrophoresis analysis showed extensive inter- and intramolecular crosslinking. The IMC formulation using the highest TGase level in MCC or MPC did not form an emulsion because of extensive crosslinking. In MPC with a high level of TGase, whey protein and casein crosslinking were observed. In contrast, crosslinking and hydrolysis of proteins were observed in MCC. The IMC made from MCC powder had significantly higher texture profile analysis hardness compared with the corresponding MPC powder. Further, many-to-one (multiple) comparisons using the Dunnett test showed no significant differences between IMC made using RCN and treatment powders in hardness. Our results demonstrated that TGase treatment causes crosslinking hydrolysis of MCC and MPC at higher TGase levels, and MPC and MCC have the potential to be used as ingredients in IMC applications.

Use of micellar casein concentrate and milk protein concentrate treated with transglutaminase in imitation cheese products-Melt and stretch properties.

Melt and stretch properties in dairy-based imitation mozzarella cheese (IMC) are affected by the amount of intact casein provided by dairy ingredients in the formulation. Rennet casein (RCN) is the preferred ingredient to provide intact casein in a formulation. Ingredients produced using membrane technology, such as milk protein concentrate (MPC) and micellar casein concentrate (MCC), are unable to provide the required functionality. However, the use of transglutaminase (TGase) has potential to modify the physical properties of MPC or MCC and may improve their functionality in IMC. The objective of this study was to determine the effect of TGase-treated MPC and MCC retentates on melt and stretch properties when they are used in IMC and to compare them with IMC made using RCN. The MCC and MPC retentates were produced using 3 different lots of pasteurized skim milk and treated with 3 levels of TGase enzyme: no TGase (control), low TGase: 0.3 units/g of protein, and high TGase: 3.0 units/g of protein. Each of the MCC and MPC treatments was heated to 72°C for 10 min to inactivate TGase and then spray dried. Each MCC, MPC, and RCN powder was then used in an IMC formulation that was standardized to 48% moisture, 21% fat, 20% protein, and 1% salt. The IMC were manufactured in a twin-screw cooker by blending, mixing, and heating various ingredients (4.0 kg). Due to extensive crosslinking, the IMC formulation with the highest TGase level (MCC or MPC) did not form an emulsion. The IMC made from MCC treatments had significantly higher stretchability on pizza compared with their respective MPC treatments. The IMC made from TGase-treated MCC and MPC had significantly lower melt area and significantly higher transition temperature (TT) and stretchability compared with their respective controls. Comparison of IMC made using TGase-treated MCC and MPC to the RCN IMC indicated no difference in TT or texture profile analysis-stretchability; however, the Schreiber melt test area was significantly lower. Our results demonstrated that TGase treatment modifies the melt and stretch characteristics of MCC and MPC in IMC applications, and TGase-treated MPC and MCC can be used to replace RCN in IMC formulations.

Effect of prophylactic granulocyte-colony stimulating factor (G-CSF) on acute hematological toxicity in medulloblastoma patients during craniospinal irradiation (CSI).

OBJECTIVES: Haematological toxicity and treatment breaks are common during cranio-spinal irradiation (CSI) due to irradiation of large volume of bone marrow. We conducted this study to see the effect of prophylactic granulocyte colony stimulating factor (GCSF) in reducing treatment breaks. PATIENTS AND METHODS: The study was conducted over a period of 15 months from August 2017 to November 2018. Histopathologically proven Medulloblastoma patients received prophylactic GCSF during CSI. Acute hematological toxicities and treatment breaks were noted and effect of age and pretreatment blood counts were analyzed by SPSS (Statistical Package for Social Sciences) version 23. RESULTS: A total of 28 patients were included in the study. During CSI, hematological toxicity leading to treatment breaks was observed in 11 (39.3 %) patients, of which grade 3 and 2 toxicities were seen in ten and one patients respectively. Younger age (<10 years) at diagnosis was significantly associated with the development of hematological toxicity (p = 0.028, Chi-Square). No correlation was found with pre-treatment blood counts. CONCLUSION: Prophylactic use of GCSF may be effective in preventing radiation induced hematological toxicity and treatment breaks.

Manufacture of modified milk protein concentrate utilizing injection of carbon dioxide.

Dried milk protein concentrate is produced from skim milk using a combination of processes such as ultrafiltration (UF), evaporation or nanofiltration, and spray drying. It is well established that dried milk protein concentrate (MPC) that contains 80% (MPC80) and greater protein content (relative to dry matter) can lose solubility during storage as a result of protein-protein interactions and formation of insoluble complexes. Previous studies have shown that partial replacement of calcium with sodium improves MPC80 functionality and prevents the loss in solubility during storage. Those studies have used pH adjustment with the addition of acids, addition of monovalent salts, or ion exchange treatment of UF retentate. The objective of this study was to use carbon dioxide to produce MPC80 with improved functionality. In this study, reduced-calcium MPC80 (RCMPC) was produced from skim milk that was subjected to injection of 2,200 ppm of CO2 before UF, along with additional CO2 injection at a flow rate of 1.5 to 2 L/min during UF. A control MPC80 (CtrlMPC) was also produced from the same lot of skim milk without injection of CO2. The above processes were replicated 3 times, using different lots of skim milk for each replication. All the UF retentates were spray dried using a pilot-scale dryer. Skim milk and UF retentates were tested for ζ-potential (net negative charge), particle size, and viscosity. All the MPC were stored at room (22±1°C) and elevated (40°C) temperatures for 6 mo. Solubility was measured by dissolving the dried MPC in water at 22°C and at 10°C (cold solubility). Injection of CO2 and the resultant solubilization of calcium phosphate had a significant effect on UF performance, resulting in 10 and 20% loss in initial and average flux, respectively. Processing of skim milk with injection of CO2 also resulted in higher irreversible fouling resistances. Compared with control, the reduced-calcium MPC had 28 and 34% less ash and calcium, respectively. Injection of CO2 resulted in a significant decrease in ζ-potential and a significant increase in the size of the casein micelle. Moreover, RCMPC had a significantly higher solubility after storage at room temperature and at elevated temperature. This study demonstrates that MPC80 with a reduced calcium and mineral content can be produced with injection of CO2 before and during UF of skim milk.

Armoured brain due to chronic subdural collections masking underlying hydrocephalus.

Calcified chronic subdural collection (armoured brain) is a known long-standing complication of shunt overdrainage. We report a young male who became symptomatic eleven years after a shunt surgery. Radiology showed bilateral calcified subdural collections. Drainage of these collections did not help, but shunt revision did. Patients with armoured brain syndrome who suddenly become symptomatic should possibly undergo shunt revision before the more extensive and morbid procedure of drilling the membranes.

Central liponeurocytoma: case report and review of literature.

The lipomatous differentiation occurring within neurocytoma has more frequently been reported in neurocytoma of cerebellar origin as case reports and short series. This case report describes the clinical, radiological, histopathological and ultrastructural findings of supratentorial central neurocytoma with lipomatous differentiation in a 45-year-old female. Magnetic resonance imaging (MRI) revealed an intraventricular lesion in the right trigone which was isointense on T1 and hyperintense on T2 weighted images. There were small cystic areas and it enhanced brilliantly and homogenously on contrast. The rare lipomatous differentiation occurring in neurocytoma in the supratentorial location lends it a distinct morphological profile and thus recommends its designation as "central liponeurocytoma".

Isolation of Streptobacillus moniliformis from the blood of a child with acute lymphoblastic leukaemia.

This is an unusual report of isolation of Streptobacillus moniliformis from the blood of a male child with acute lymphoblastic leukaemia. No history of rat bite was there, but rats were present in the house. The possible source of infection may be food or water contaminated with rat excreta. Whether this bacteria can cause opportunistic infection in leukaemic patients, need to be evaluated further.

Chiari I malformation associated with atlanto-axial dislocation: focussing on the anterior cervico-medullary compression.

BACKGROUND: Chiari I malformation with atlantoaxial dislocation may cause both posterior and anterior cervicomedullary compression. We studied the clinicoradiological features and surgical outcome in patients having Chiari I malformation with atlantoaxial dislocation. METHOD: Thirty-nine patients with Chiari I malformation with atlanto-axial dislocation underwent preoperative and follow-up neurological status assessment. In Chiari I malformation with reducible atlanto-axial dislocation (n = 11), a direct posterior stabilization was done. In Chiari I malformation with irreducible atlanto-axial dislocation (n = 28), a single stage transoral decompression with posterior stabilization and/or posterior decompression and duraplasty were done in 18 patients. In 10 patients, only posterior decompression and/or posterior stabilization was performed. Seven among the latter patients subsequently deteriorated and required transoral decompression. Comparison of mean neurological status scores of patients with Chiari I malformation with irreducible atlanto-axial dislocation who underwent single stage transoral decompression with posterior stabilization versus the posterior procedure alone was done using T-test and proportional significance also calculated. FINDINGS: Patients with Chiari I malformation with atlanto-axial dislocation have a high incidence of long tract signs and sphincteric disturbances with a decrease in the mean foramen magnum diameter. The mean neurological status scores of patients with Chiari I malformation with irreducible atlanto-axial dislocation who underwent single stage transoral decompression with posterior stabilization were significantly better than those patients who underwent the posterior procedure alone. The latter patients also showed significant clinical improvement following transoral decompression. In the presence of Chiari I malformation with reducible atlanto-axial dislocation, reduction and stabilization of atlanto-axial dislocation resulted in neurological improvement. The follow up neurological status scores of these patients improved after surgical intervention even in the presence of poor preoperative grades. CONCLUSIONS: Patients with Chiari I malformation should be investigated for the presence of atlanto-axial dislocation. In case atlantoaxial dislocation coexists, priority must be given to relieving anterior cervicomedullary compression.

Cutaneous metastases in pancreatic adenocarcinoma.

A patient with pancreatic carcinoma who developed disseminated cutaneous and scalp metases is reported. To the authors knowledge scalp metases have hitherto not been reported with pancreatic carcinoma.

A large waterborne viral hepatitis E epidemic in Kanpur, India.

In 1991 the largest epidemic of viral hepatitis E yet reported occurred in Kanpur (population, 2.1 million), India. The incidence of icteric hepatitis from December 1990 to April 1991 among the inhabitants of 420 randomly sampled houses in seven of the city's 50 wards was 3.76% (138 out of 3666 individuals), i.e., an estimated 79,091 persons in the city as a whole were affected. The attack rate was higher for males than females (5.3% versus 3.3%; P = 0.013) and for adults than children aged < 10 years (4.26% versus 1.29%; P = 0.0006). The incidence of hepatitis was higher in those city wards that were supplied with drinking-water consisting of a mixture of river Ganges and tubewell water than in those wards supplied only with tubewell water (5.6% versus 1.2%; P = 10(-6)). In the mixed-water areas, the incidence decreased as the drinking-water source changed from only tap to both tap and handpump, to only handpump (7.8%, 6.8%, and 4.3% respectively; P = 0.023). None of the sera collected from 41 hepatitis patients during the epidemic showed evidence of hepatitis virus A or B. There were two peaks in the epidemic (in February and April 1991). The first peak was probably caused by faecal contamination of river water, indicated by water analysis data, and the second, by inadequate chlorination of water in a reservoir. There was no evidence of secondary intrafamilial spread.

Hepatitis E virus genome in stools of hepatitis patients during large epidemic in north India.

Stool samples from patients affected during a large epidemic of hepatitis in north India were examined for the presence of hepatitis E virus (HEV) genome by means of reverse transcription-polymerase chain reaction. 6 of 10 samples studied were positive for the HEV genome, which suggest that HEV caused this large epidemic.