Bacillus subtilis 29784 induces a shift in broiler gut microbiome toward butyrate-producing bacteria and improves intestinal histomorphology and animal performance.

The study reports the effects of Bacillus subtilis 29784 on broiler performance. A total of 1,600 one-day-old Cobb 500 male broiler chicks received either a control diet or the same diet to which B. subtilis 29784 spores were added (1E8 CFU/kg of feed). The birds were slaughtered at 42 D of age. Ileal and cecal tissues and content were collected for histomorphological analysis and 16S rRNA gene sequencing, respectively. The inclusion of B. subtilis 29784 led to an increase of final body weight gain of broilers (+5.7%; P < 0.0001) and an improvement in feed conversion ratio (-5.4%; P < 0.0001). Higher feed efficiency in the Bacillus-fed group was correlated with a significant increase in intestinal microvilli length (+18% in ileum and +17% in cecum; P < 0.001). Among the differences revealed by 16S rRNA analysis, Ruminococcus, Lachnoclostridium, and Anaerostipes were found in higher relative abundance in Bacillus-treated birds at the cecal level. These bacterial genera include species that produce butyrate, the main source of energy for enterocytes and known to be an immune modulator. There was also a slight increase in the Butyrivibrio genus in the cecum, which is known to be an important player in the production of conjugated linoleic acid, also considered an anti-inflammatory compound. In conclusion, dietary supplementation of B. subtilis 29784 significantly improved the growth performance of broilers, likely through beneficial effects on microbiota and host.

Bacillus subtilis strain specificity affects performance improvement in broilers.

The study reports the effects on broiler performance of a newly isolated Bacillus subtilis strain, which is phylogenetically not closely related to already well-described strains of B. subtilis. In the first experiment, birds were reared in battery cages and exposed to C. perfringens. An increase in growth performance was observed with the strain when compared to the challenged animals. Three additional growth trials were conducted to 35 d of age, in different rearing conditions (genetic breeds, corn-soybean meal-based diet with or without animal proteins, in presence or absence of phytase, on fresh or used litter) to investigate the efficacy and the specificity of this new B. subtilis strain on the improvement of BWG and FCR of broilers in comparison with a B. subtilis-based DFM already used in the field. Whatever the rearing conditions tested, the new B. subtilis strain led to an average 3.2% improvement in feed conversion ratio or bodyweight. Comparatively, the commercial Bacillus strain significantly improved broiler performance in only one trial out of 3 with an average improvement reaching 2%. All these results indicate that this new B. subtilis strain consistently improves broiler performances.

A methodology based on NMR spectroscopy for the forensic analysis of condoms.

Both solution and solid state Nuclear Magnetic Resonance (NMR) spectroscopic techniques have been used to determine differences in commercially available condoms. Whilst solid state NMR is useful for determining the polymer backbone, it is not useful for forensic analysis due to the commonality of the latex condom. However solution NMR spectra obtained following a simple extraction procedure using hexane, provides a fingerprint of the additives in the lubricants. Following the development of a flow chart, basing decisions on the presence of particular peaks present in the solution spectra, 33 of 38 condoms could be individualized. Samples were also analyzed after having the lubricant manually removed and soaking the condom in water for 3 to 24 h. These experiments were performed to simulate a case of the sample having been used and disposed of by flushing down the toilet, as may be experienced in a case of a sexual assault. The results indicated that the only significant water soluble component was polyethylene glycol. The overall results suggest that the method developed may be a quick and useful technique in characterizing condoms. The information obtained can be used to provide associative evidence between suspect and crime, and so be useful in sexual assault cases.

[Scientific activities in departments of clinical physiology/nuclear medicine in Denmark during the period 1989-1994. A bibliometric analysis of the "impact" and citation frequency]. / Videnskabelig aktivitet på klinisk fysiologisk/nuklearmedicinske afdelinger i Danmark i perioden 1989-1994.En bibliometrisk analyse af "impact" og citeringsfrekvens.

This study reports a bibliometric analysis of 860 scientific publications of which 763 are papers in scientific journals emanating from departments of clinical physiology and nuclear medicine in Denmark in the years 1989-1994. The number of publications decreased significantly over time. The 763 papers were published in 239 different scientific journals, 80% in journals with an official "impact factor". The average impact per paper remained almost constant over time and was significantly above the national average. A close relationship was found between the number of papers from a department and its cumulated impact. In an analysis of 217 papers a direct relation was found between the journal impact factor and the citation factor. A linear relation was found between cumulated citations and time, and the number of citations per year reached a maximum 3-7 years after publication, whereas the general maximum for all medical specialties is 2-3 years. It is concluded that the total number of scientific papers from Danish departments of clinical physiology & nuclear medicine fell in the years 1989-1991, but the impact per paper was almost constant and above the national average. There seems to be a good agreement between journal impact factor and overall citation frequency in papers from clinical physiology & nuclear medicine.

[Portal hypertensive gastropathy]. / Portal hypertensiv gastropati.

Portal hypertensive gastropathy (PHG) as defined by congestive changes in the gastric mucosa owing to increased portal pressure, was first described about ten years ago. Whereas definition and grading of severity are still under debate, there is general agreement that PHG is a new clinical entity. PHG is present in 50-80% of patients with liver cirrhosis. PHG is a major cause of upper gastrointestinal bleeding in patients with portal hypertension (25-90% depending on severity). Presence of portal hypertension is a prerequisite for the development of PHG, and reduction of portal pressure and splanchnic blood flow with beta-adrenergic blockers has shown promising results, but an established medical treatment of PHG does not exist. Trials with new vasoactive drugs are awaited.

Simplified scintigraphic methods for measuring gastrointestinal transit times.

To investigate whether simple transit measurements based on scintigraphy performed only 0, 2, 4 and 24 h after intake of a radiolabelled meal can be used to predict the mean transit time values for the stomach, the small intestine, and the colon, a study was conducted in 16 healthy volunteers. After ingestion of a meal containing 111indium-labelled water and 99mtechnetium-labelled omelette, imaging was performed at intervals of 30 min until all radioactivity was located in the colon and henceforth at intervals of 24 h until all radioactivity had cleared from the colon. Gastric, small intestinal and colonic mean transit times were calculated for both markers and compared with fractional gastric emptying at 2 h, fractional colonic filling at 4 h, and geometric centre of colonic content at 24 h, respectively. Highly significant correlations were found between gastric mean transit time and fractional gastric emptying at 2 h (111In: r=0.95, P<0.00001; 99mTc: r=0.96, P<0.00001), between small intestinal mean transit time and fractional colonic filling at 4 h (111In: r=-0.97, P<0.00001; 99mTc: r=-0.89, P<0. 00001), and between colonic mean transit time and geometric centre of colonic content at 24 h (111In: r=- 0.88, P<0.00001). We therefore conclude that reliable regional gastrointestinal transit times can be estimated from scintigraphic images taken 0, 2, 4 and 24 h after intake of radiolabelled markers.

Effect of octreotide on systemic, central, and splanchnic haemodynamics in cirrhosis.

BACKGROUND/AIMS: Cirrhosis with portal hypertension is associated with changes in the splanchnic and systemic haemodynamics, and subsequent complications, such as bleeding from oesophageal varices, have led to the introduction of long-acting somatostatin analogues in the treatment of portal hypertension. However, reports on the splanchnic and systemic effects of octreotide are contradictory and therefore the aim of the present study was to assess the effects of continuous infusion of octreotide on central and systemic haemodynamics, portal pressures, and hepatic blood flow. METHODS: Thirteen patients with cirrhosis underwent liver vein catheterisation. Portal and arterial blood pressures were determined at baseline and 10, 30, and 50 min after a bolus injection of octreotide 100 micrograms, followed by continuous infusion of octreotide 100 micrograms/ h for 1 h. Hepatic blood flow, cardiac output, central and arterial blood volume, and central circulation time were determined at baseline and 50 min after the start of the octreotide infusion. RESULTS: The mean arterial blood pressure increased during the first 10 min (p < 0.0005), but returned to baseline after 50 min. The central and arterial blood volume (-16%, p < 0.005) and the central circulation time (-8%, p < 0.05) were significantly decreased after 50 min, whereas the cardiac output did not change significantly. The hepatic venous pressure gradient and the hepatic blood flow did not change significantly at any time after infusion of octreotide. CONCLUSIONS: Octreotide does not affect the portal pressure or hepatic blood flow, whereas it may further contract the central blood volume and thereby exert a potentially harmful effect on central hypovolaemia in patients with cirrhosis. However, these early effects do not exclude the possibility that administration of longacting somatostatin analogues over a longer period may have a beneficial effect.

Scientific publications from departments of clinical physiology and nuclear medicine in Denmark. A bibliometric analysis of "impact' in the years 1989-1994.

This study reports a bibliometric analysis of scientific publications emanating from departments of clinical physiology and nuclear medicine, Denmark, during the years 1989-1994. The total number of publications during this period was 860 (763 scientific journal papers, 71 book/book chapters and 26 theses). Whereas the number of publications per year (188-113) decreased significantly with time (r = -0.94, P < 0.02), the number of authors (mean 4.1) was almost constant over time. University/ university-related departments accounted for 96% of the papers. Only 8% of the papers resulted from a collaboration between two or more departments of clinical physiology and nuclear medicine, but the collaboration with other medical specialities and institutions was much greater (85%). The 763 papers were published in 239 different scientific journals, 80% in journals with an official 'impact factor', a bibliometric measure of quality (the average number of times a paper is cited in a journal in the publishing year and the subsequent year). Twenty per cent (20%) and 8.4% were printed in journals with an impact factor, respectively, of above 2.1 (the 500 journals most cited) and 3.7 (the 200 most cited), which is significantly above the national average 16.6% and 6.0%, P < 0.001). The "cumulated impact' (i.e. the impact of all papers) showed a borderline significant decrease over time (r = -0.77, P = 0.1), whereas the average impact per paper (1.53) remained almost constant and was significantly above the national average (1.10, P < 0.001). A close relationship was found between the number of papers from a department and its cumulated impact (r = -0.97, P < 0.001). It is concluded that the total number of scientific papers from Danish departments of clinical physiology and nuclear medicine fell in the period, whereas the volume of quality, as assessed on the cumulated impact, only fell with borderline significance, and the impact per paper was almost constant from 1989 to 1994, and was above the national average.

A deconvolution technique for processing small intestinal transit data.

The deconvolution technique can be used to compute small intestinal impulse response curves from scintigraphic data. Previously suggested approaches, however, are sensitive to noise from the data. We investigated whether deconvolution based on a new simple iterative convolving technique can be recommended. Eight healthy volunteers ingested a meal that contained indium-111 diethylene triamine penta-acetic acid labelled water and technetium-99m stannous colloid labelled omelette. Imaging was performed at 30-min intervals until all radioactivity was located in the colon. A Fermi function=(1+e-alphabeta)/(1+e(t-alpha)beta) was chosen to characterize the small intestinal impulse response function. By changing only two parameters, alpha and beta, it is possible to obtain configurations from nearly a square function to nearly a monoexponential function. Small intestinal input function was obtained from the gastric emptying curve and convolved with the Fermi function. The sum of least squares was used to find alpha and beta yielding the best fit of the convolved curve to the observed small intestinal time-activity curve. Finally, a small intestinal mean transit time was calculated from the Fermi function referred to. In all cases, we found an excellent fit of the convolved curve to the observed small intestinal time-activity curve, that is the Fermi function reflected the small intestinal impulse response curve. Small intestinal mean transit time of liquid marker (median 2.02 h) was significantly shorter than that of solid marker (median 2.99 h; P<0.02). The iterative convolving technique seems to be an attractive alternative to ordinary approaches for the processing of small intestinal transit data.

Gastrointestinal mean transit times in young and middle-aged healthy subjects.

To investigate the effects of age and gender on gastric, small intestinal and colonic mean transit times, a study was conducted in 32 healthy volunteers: eight young women (22-30 years), eight young men (20-28 years), eight middle-aged women (43-51 years) and eight middle-aged men (38-53 years). After ingestion of a meal containing 111Indium-labelled water and 99mTechnetium-labelled omelette imaging of the abdomen was performed at intervals of 30 min until all radioactivity was located in the colon and henceforth at intervals of 24 h until all radioactivity had cleared from the colon. Gastric, small intestinal and colonic mean transit times were calculated. The gastric, small intestinal and colonic mean transit times were significantly longer in women. Ageing was shown to accelerate the gastric and small intestinal transit significantly. In the group of men the colonic mean transit time was unaffected by age, but middle-aged women had a significantly slower colonic transit than young women. We therefore conclude that both age and gender have to be considered when reference values for gastric, small intestinal and colonic mean transit times have to be established.

Gastrointestinal motor function in patients with portal hypertension.

BACKGROUND: Existing data on gastric emptying and small-intestinal transit rates in portal-hypertensive patients are scarce and contradictory, and so far, the motor function of the colon has not been assessed in these patients. In this study we evaluated the propulsive effect of all main segments of the gastrointestinal tract in patients with well-characterized portal hypertension. METHODS: Eight patients with a postsinusoidal hepatic pressure gradient of at least 13 mmHg and eight age- and sex-matched healthy controls participated in the study. Gastric emptying, small-intestinal transit, and colonic transit rates were evaluated in all subjects by means of a gamma camera technique. The technique was also used to measure the frequency of antral contractions. RESULTS: No difference was observed in gastric mean emptying time or small-intestinal mean transit time of liquid and solid markers between patients and controls. After 24 h, however, the geometric center of the liquid marker had a more caudal localization in the colon of the patient group than in the controls (P = 0.04); that is, the patients had a faster colonic transit. No difference was found in the frequency of antral contractions 45 min after the test meal between patients and controls. CONCLUSIONS: These data suggest that the colonic transit is often accelerated in patients with portal hypertension, whereas the motor function of the stomach and the small intestine is unaffected.

Central and systemic haemodynamic effects of terlipressin in portal hypertensive patients.

AIMS/BACKGROUND: Cirrhotic patients exhibit a hyperdynamic and hyporeactive circulation with central hypovolaemia which may influence the course of the disease. As terlipressin, a vasopressin analogue, may modify systemic haemodynamics in these patients, the aim of the present study was to assess the acute effects of terlipressin on central and systemic haemodynamics. METHODS: Sixteen patients with alcoholic cirrhosis and portal hypertension had their systemic, central, and splanchnic haemodynamics determined at baseline and after a blind randomised bolus infusion (2 mg) of terlipressin/placebo. RESULTS: After terlipressin, the arterial blood pressure and the systemic vascular resistance increased by 26% and 61%, respectively (both p<0.001), and the cardiac output, heart rate, and arterial compliance decreased by 18%, 11%, and 32%, respectively (all p<0.001). The central circulation time increased by 36% (p<0.001), whereas the central and arterial blood volume only increased by 4% (p= 0.07). As expected, both portal pressure and hepatic blood flow decreased (17% and 29%, both p<0.001). The decrease in portal pressure after terlipressin was significantly related to the increase in systemic vascular resistance (r=-0.52, p<0.05) and the central circulation time (r=-0.80, p<0.0001). CONCLUSIONS: Terlipressin significantly attenuates the hyperdynamic circulation in portal hypertensive patients without a further contraction of the central and arterial blood volume. The systemic haemodynamic response to terlipressin is moreover associated with the decrease in portal pressure. Terlipressin may therefore have potentially beneficial effects on the hyperdynamic circulation in cirrhosis in addition to its effects on portal pressure.

Increased circulating leptin in alcoholic cirrhosis: relation to release and disposal.

Leptin is a cytokine peptide that decreases appetite and thereby food intake and increases energy expenditure. It is produced in fat cells, but recent animal experiments have shown expression of leptin in modified stellate hepatic cells. Because a change in circulating leptin in cirrhosis could be caused by an altered production rate, altered disposal rate, or both, the present study was undertaken to identify regions of leptin overflow into the blood stream and regions of leptin extraction. Patients with alcoholic cirrhosis (n = 16) and control patients without liver disease (n = 12) were studied during catheterization with elective blood sampling from different vascular beds. Blood samples for leptin determination (radioimmunoassay) were taken simultaneously from artery/hepatic vein, artery/renal vein, artery/iliac vein, and artery/cubital vein. Patients with cirrhosis had significantly increased circulating leptin (7.3 vs. control 2.6 ng/mL, P <.002) that correlated directly to ascitic-free body mass index (r = 0.71, P <.005). A significant renal extraction ratio of leptin was observed in control patients (0. 16) and in patients with cirrhosis (0.07), but the latter value was significantly lower than in the control patients (-44%, P <.05) and inversely correlated to serum creatinine (r = -0.60, P <.05). A significant, but equal, hepatosplanchnic extraction of leptin was observed in cirrhotic patients and control patients (0.08 vs. 0.07). In patients with cirrhosis a significant cubital venous-arterial difference in leptin was observed, but not in control patients. The iliac venous/arterial leptin ratio was significantly above 1.0 in both groups and of similar size (1.16 vs. 1.15), but a higher difference in concentration was found in the cirrhotic patients (+33%, P <.05). The spillover rates of leptin in cirrhotic patients may be even higher than estimated from the increased systemic veno-arterial gradients. In conclusion, the elevated circulating leptin in patients with cirrhosis is most likely caused by a combination of decreased renal extraction and increased release from subcutaneous abdominal, femoral, gluteal, retroperitoneal pelvic, and upper limb fat tissue areas. The hepatosplanchnic bed drained through hepatic veins could not be identified as a source of increased circulating leptin in cirrhosis, but a contribution by the portosystemic collateral flow cannot be excluded.

Endoscopic Doppler ultrasound for measurement of azygos blood flow. Validation against thermodilution and assessment of pharmacological effects of terlipressin in portal hypertension.

BACKGROUND: Endoscopic ultrasound (EUS) is a new modality allowing real-time flow measurements by means of the Doppler technique. The aim of the study was to evaluate azygos blood flow measurements by endoscopic ultrasound. METHODS: Measurements of azygos blood flow by EUS and by the thermodilution technique were compared in 20 patients with portal hypertension. The ability of EUS flowmetry to detect changes in the azygos and portal venous flow after an intravenous dose of 2 mg of terlipressin was evaluated in 13 of the patients in a double-blind, randomized, placebo-controlled, cross-over design. RESULTS: The EUS Doppler and thermodilution measurements correlated significantly (R=0.81, P < 0.001). The azygos blood flow was found to be 14% higher by the EUS method than by thermodilution. The coefficient of variation of the EUS Doppler measurements of the azygos blood flow was 14.8%. After administration of terlipressin, the azygos blood flow, as measured by EUS Doppler, decreased significantly by 23% from 915 to 704 ml/min (P = 0.014) and the portal venous flow decreased by 28% from 1170 to 789 ml/min (P = 0.03). No effects of placebo were detected. CONCLUSIONS: These results show that EUS measurement of the azygos blood flow correlate strongly to the measurements by the thermodilution technique, and EUS is moreover well tolerated by the patients. The method is applicable for monitoring pharmacological effects on the superior porto-systemic collateral circulation and portal venous flow in patients with portal hypertension.

No effect of oxygen therapy on myocardial ischaemia during gastroscopy.

BACKGROUND: Myocardial ischaemia (defined as an ST-segment depression on ECG) may occur during upper gastrointestinal endoscopy, but the mechanism is still unknown. The aim of our study was to evaluate the effect of oxygen therapy and tachycardia on the occurrence of ST-segment depression during routine diagnostic esophagogastroduodenoscopy. METHODS: Eighty-nine consecutive patients were randomized to receive either oxygen (21/min by nasal prongs) or nothing during endoscopy, in which arterial oxygen saturation was measured by continuous pulse oximetry, and ECG was measured continuously with a Holter tape recorder. RESULTS: A total of 28 patients (12 receiving oxygen) developed ST-segment depression ( > 0.1 mV) during endoscopy. In 22 patients (12 receiving oxygen) ST depression was related to tachycardia, and in 5 of these (none receiving oxygen) simultaneous episodic hypoxaemia was present during the event. Thus, in every case of ST depression related to episodic hypoxaemia there was simultaneous tachycardia. In six patients developing ST depression during endoscopy we did not find preendoscopy levels, and 63 patients (29 receiving oxygen) developed tachycardia during the procedure (rate > 100 min-1_. CONCLUSIONS: Oxygen therapy had no significant effect on the occurrence of ST-segment depression during upper gastrointestinal endoscopy. The results suggest that tachycardia is more important than hypoxaemia in the pathogenesis of ST depression during gastroscopy.

Sexual dysfunction in male and female patients with epilepsy: a study of 86 outpatients.

Sexual dysfunction is a well-known complication of chronic somatic illness. Eighty-six consecutive epileptic outpatients, 38 men and 48 women, without accompanying disorders, were studied. The frequency and symptoms of sexual dysfunction were compared with results from previous studies using identical sexological methodology. The previous studies were of diabetic patients and healthy controls. Eight percent of the epileptic men reported a sexual dysfunction compared to 44% of the diabetics and 13% of the controls. Epileptic women, diabetic women, and controls showed no significant differences in sexual dysfunction (29%, 28%, and 25%, respectively). In both sexes, the sexual function measured by frequencies of coitus and masturbation was normal. Most patients had good control of epileptic attacks on a treatment of monotherapy. Hormonal status was generally within normal limits in both men and women; only a few minor differences were found and they showed no correlation with sexual dysfunction. Psychologically and socially the patients did not differ appreciably from normals, and they exhibited a high degree of disease acceptance. This study, using a biopsychosocial approach in understanding sexual dysfunctions, is in contrast with previous, mainly uncontrolled, studies of epileptic patients that reported high frequencies of "hyposexuality" in males. We conclude that epilepsy does not necessarily increase the risk of sexual dysfunction in male or female.