Assessment of probiotics supplementation via feed or water on the growth performance, intestinal morphology and microflora of chickens after experimental infection with Eimeria acervulina, Eimeria maxima and Eimeria tenella.

In this study, the effect of probiotic supplementation via drinking water or feed on the performance of broiler chickens experimentally infected with sporulated oocysts of Eimeria acervulina (5 × 10(4)), Eimeria maxima and Eimeria tenella (2 × 10(4) each one) at 14 days of age was evaluated. Two hundred and forty 1-day-old Ross 308 male chicks were separated into eight equal groups with three replicates. Two of the groups, one infected with mixed Eimeria oocysts and the other not, were given a basal diet and served as controls. The remaining groups were also challenged with mixed Eimeria species and received the basal diet and either water supplemented with probiotic (three groups) or probiotic via feed (two groups); the probiotic used consisted of Enterococcus faecium #589, Bifidobacterium animalis #503 and Lactobacillus salivarius #505 at a ratio of 6:3:1. Probiotic supplementation was applied either via drinking water in different inclusion rates (groups W1, W2 and W3) or via feed using uncoated (group FN) or coated strains (group FC). The last group was given the basal diet supplemented with the anticoccidial lasalocid at 75 mg/kg. Each experimental group was given the corresponding diet or drinking water from day 1 to day 42 of age. Throughout the experimental period of 42 days, body weight and feed intake were recorded weekly and feed conversion ratios were calculated. Seven days after infection, the infected control group presented the lowest weight gain values, while probiotics supplied via feed supported growth to a comparable level with that of the lasalocid group. Probiotic groups presented lesion score values and oocyst numbers that were lower than in control infected birds but higher than in the lasalocid group. In the duodenum, jejunum and ileum, the highest villous height values were presented by probiotic groups. In conclusion, a mixture of probiotic substances gave considerable improvement in both growth performance and intestinal health in comparison with infected control birds and fairly similar improvement to an approved anticoccidial during a mixed Eimeria infection.

Bistable charge configuration of donor systems near the GaAs(110) surfaces.

In gated semiconductor devices, the space charge layer that is located under the gate electrode acts as the functional element. With increasing gate voltage, the microscopic process forming this space charge layer involves the subsequent ionization or electron capture of individual dopants within the semiconductor. In this Letter, a scanning tunneling microscope tip is used as a movable gate above the (110) surface of n-doped GaAs. We study the build-up process of the space charge region considering donors and visualize the charge states of individual and multi donor systems. The charge configuration of single donors is determined by the position of the tip and the applied gate voltage. In contrast, a two donor system with interdonor distances smaller than 10 nm shows a more complex behavior. The electrostatic interaction between the donors in combination with the modification of their electronic properties close to the surface results in ionization gaps and bistable charge switching behavior.

[Clavicular fractures in pediatric traumatology]. / Klavikulafrakturen in der Kindertraumatologie.

Clavicle fractures are most common in children. Due to the thick periosteum that provides appositional bone proliferation on the one hand and a high potential of the medial physis for longitudinal growth on the other hand the fractures have an enormous healing potential. Both factors are also responsible for good fracture remodeling. In adolescents, the periosteal tube gets thinner and fracture types correspond to fractures in adults. Most fractures heal with good results after conservative treatment. In this article clavicle fractures in children and adolescents and options for therapy including the rare surgical treatment depending on different fracture localizations and morphologies are discussed.

Dietary plant bioactives for poultry health and productivity.

1. Plants and their biologically active chemical constituents, sometimes called secondary metabolites or bioactives, present numerous opportunities for the improvement of livestock production by inclusion in the diet. 2. Many such plant derived materials have well established therapeutic values in man; however, their potential as feed additives in animal production, particularly of poultry, remains largely unexploited. 3. There is increasing evidence indicating that they can be efficient in controlling diseases, and plant bioactives may also influence production parameters such as feed efficiency and product quality. 4. It has been reported that they may even replicate some of the effects of antibiotic growth promoters, which were banned from use in Europe from 2006. 5. This review assesses the status of plant bioactives in poultry production and their mode of action on avian physiology, particularly in the digestive tract.

In vitro inhibition of Eimeria tenella sporozoite invasion into host cells by probiotics.

The aim was to study the effects of probiotics isolated from the intestinal tract of livestock animals on Eimeria tenella invasion into Madin-Darby bovine kidney (MDBK) cells in vitro. E. tenella sporozoites were purified and labeled with 5(6)-carboxyfluorescein diacetate N-succinimidyl ester before seeding on cell cultures, and invasion was evaluated by fluorescence microscopy. Two protocols (A and B) were used. In protocol A, Enterococcus faecium # 589 or Lactobacillus salivarius subsp. salivarius # 505 were added together with sporozoites to MDBK cell cultures and invasion was evaluated after incubation for approximately 20h. Viable, dead, or spent culture supernatants of probiotics were tested. In protocol B, viable probiotics were incubated with MDBK cells for one hour before sporozoites were added and invasion was evaluated after two more hours of incubation. Parasite invasion of viable, dead, or spent culture supernatant of E. faecium # 589 was assessed. Using protocol A, it was shown that parasite invasion was inhibited by viable (80%) or dead (75%) E. faecium # 589. While inhibition by viable L. salivarius subsp. salivarius # 505 was not valid at the highest concentration and not significant at the other test concentrations, dead cells inhibited parasite invasion up to 45%. Spent culture supernatants of both probiotics had no influence on parasite invasion. Using protocol B, it was shown that viable Bifidobacterium animalis subsp. animalis # 503, E. faecium # 497, E. faecium # 589, L. reuteri # 514, L. salivarius subsp. salivarius # 505, and Bacillus subtilis # 588 inhibited parasite invasion into MDBK cells up to 80%. Anticoccidial activity was strain-specific for E. faecium strains, and the strongest effect was shown by E. faecium # 589. Anticoccidial effects of some of the tested probiotics have already been shown in vivo, which makes them candidates to prevent coccidiosis. These findings have now been confirmed in vitro. The used parasite invasion assay is a fast and inexpensive tool to screen probiotics for prevention of coccidiosis.

Melanocytoma of the iris with rapidly developing secondary glaucoma.

A 28-year-old woman with an upper nasal iris mass developed secondary glaucoma within a few months of presentation. Although the elevated pressure responded to medical therapy, in the interests of a definitive diagnosis as well as prevention of damage to the trabecular meshwork, surgical management was decided upon. Tumor excision was performed through a double-layered sclerolimbal flap. Light and electron microscopic examinations of the tissue revealed a partially necrotic iris melanocytoma. Six months after surgery, the patient's best corrected visual acuity was 20/30 in the affected eye, and the intraocular pressure was 21 mmHg without therapy. The lens remained clear. The differential diagnosis and management of melanocytomas, particularly the role of biopsy, are discussed.

Accommodative effects of aceclidine in the treatment of glaucoma.

In 18 patients, 2% pilocarpine, 2% pilocarpine plus tropicamide 10:1, and 2% aceclidine were tested with respect to the degree of spasm of accommodation induced by these drugs. Aceclidine had the least effect on accommodation, making it the recommended drug for use in patients with glaucoma and considerable remaining accommodation, i.e., most patients under the age of 50 years.

Intraocular fibrous proliferation as an incisional complication in pars plana vitrectomy.

We enucleated an eye of a 39-year-old white man four weeks after partial pars plana vitrectomy was carried out for removal of an amagnetic foreign body which failed. Vitreous clouding complicated the perforating injury. Histological findings included massive ingrowth of fibrous tissue into the vitreous space and along preretinal planes, total retinal detachment with degenerations, and localized proliferations of the pigmentary epithelium. All proliferations originated at the site of the sclerotomy incision.

Photorefractive keratectomy after radial keratotomy.

BACKGROUND: Twenty-three eyes of 22 patients remained undercorrected 5 to 49 months after radial keratotomy, either alone or in combination with transverse keratotomy. METHOD: We attempted to correct the residual myopia ranging from -1.25 to -5.75 diopters (D) (with astigmatism of 0 to 1.25 D) with photorefractive keratectomy. The mean age of patients was 26 years (range 22 to 40 years). RESULTS: After photorefractive keratectomy (follow-up 6 to 17 months) uncorrected visual acuity was equal to or better than 20/20 in 39% (9 eyes), better than 20/25 in 65% (15 eyes), and better than 20/40 in 74% (17 eyes). Spectacle-corrected visual acuity was equal or better than 20/40 in all eyes; one eye (4%) lost two lines of spectacle-corrected visual acuity. Refractive error was within +/- 0.50 D in 48% (11 eyes) and within +/- 1.00 D in 65% (15 eyes). Undercorrections of more than 1.00 D occurred in 22% (5 eyes) and overcorrections of more than 1.00 D occurred in 13% (3 eyes). No or minimal haze was present in 57% (13 eyes), mild haze in 39% (9 eyes) and moderate haze in 4% (1 eye). Final uncorrected visual acuity was better (p = 0.0002) and haze was less (p = 0.003) in the group with less than -3.00 D than in the group with greater than or equal to -3.00 D. CONCLUSION: Photorefractive keratectomy after radial keratotomy is safe but less effective and less predictable in eyes with greater than or equal to -3.00 D compared to those with less than -3.00 D.

Phototherapeutic keratectomy for climatic droplet keratopathy, KKESH Excimer Laser Study Group. King Khaled Eye Specialist Hospital.

BACKGROUND: Phototherapeutic keratectomy (PTK) is an effective treatment for many superficial corneal disorders. The efficacy of PTK for the treatment of climatic droplet keratopathy (CDK) has not been reported. METHODS: We report the results of excimer laser (Summit Technology, Inc, Waltham, Mass) PTK on 75 eyes (67 patients) with "smooth" climatic droplet keratopathy (55 eyes) and "irregular" climatic droplet keratopathy (20 eyes) in whom more than 6 months of follow up are available. RESULTS: PTK was successful in reducing corneal opacification in both smooth (98%) climatic droplet keratopathy and irregular (80%) climatic droplet keratopathy. Achievement of a clear or mildly hazy cornea following PTK was more likely to occur with smooth (80%) climatic droplet keratopathy than irregular (25%) climatic droplet keratopathy (P = 0.01). Eyes with smooth climatic droplet keratopathy were more likely to obtain more than one line of improved uncorrected (56% vs. 25%) or spectacle-corrected visual acuity (61.8% vs. 21.2%) than those with irregular climatic droplet keratopathy (P = 0.03 and 0.005, respectively). Delayed re-epithelialization (longer than 14 days) was more common in irregular CDK (21%) than in smooth CDK (9%), as was the incidence of secondary microbial keratitis (10.0% vs. 1.8%). CONCLUSIONS: PTK is effective in reducing superficial corneal opacification in CDK, although serious complications may occur, especially in advanced irregular CDK.

Trabeculectomy versus trabeculotomy in congenital glaucoma.

Congenital glaucoma is one of the main causes of blindness in children and is more common in Saudi Arabia than in Western countries, perhaps owing to the prevalence of consanguinity with families. Trabeculotomy has given poorer in Saudi Arabia than elsewhere. This study compared the results of trabeculotomy (67% success rate) with trabeculectomy (54% success rate), and reports fewer complications following trabeculotomy.

Management of perforations during epikeratoplasty for keratoconus.

Epikeratoplasty (EKP) in keratoconus generally has few intraoperative complications. Perforations during EKP are rare but may force the surgeon to abandon the procedure. We developed a special suture technique to manage this problem. Several deep mattress sutures are placed by taking shallow bites of the central corneal rim and deep bites of the peripheral corneal rim. This leaves the peripheral corneal rim projecting forward by approximately one third the corneal thickness. Slight stretching of this peripheral corneal rim allows adaptation of the epilenticule to form a smooth tissue plane. This method was used in two patients with significant corneal scarring and led to satisfactory visual results.

Endocapsular closed chamber technique for disc lens implantation.

A simple endocapsular technique for implantation of an 8 mm disc lens is described. Its main features are a scleral three-plane incision, a vertical-stab capsulotomy, cortical hydrodissection, a closed chamber technique during placement of the intraocular lens in the capsular bag, implantation under air and fluid, wherever feasible, and optional anterior capsulectomy with a 27-gauge needle bent at the tip. This technique requires no complicated equipment and allows atraumatic implantation of the disc lens with maximum control of anterior chamber depth.

Pressurized anterior chamber approach to in-the-bag posterior chamber lens insertion.

A new approach to in-the-bag insertion is described. It combines elements of previously used techniques and includes a D-shaped capsulotomy, a posterior chamber intraocular lens with polypropylene loops and one control tip, a Sinskey, reverse Maltzman, or similar hook, and a lens loop injector (a simplified version of the Bailey lens shooter).

Propionibacterium acnes endophthalmitis requiring intraocular lens removal after failure of medical therapy.

A 52-year-old Saudi man developed intraocular inflammation 7 weeks after uneventful phacoemulsification with implantation of a silicone posterior chamber intraocular lens (IOL). Cultures from the aqueous and vitreous were repeatedly negative, but a temporary response to intracameral and intravitreal injection of vancomycin was noted. A series of 6 intraocular injections given over 5 days failed to resolve the inflammation. It did, however, disappear after the IOL was removed. The IOL provided the only positive culture in this case of Propionibacterium acnes endophthalmitis. Nine months later, a posterior chamber poly(methyl methacrylate) IOL was implanted. Eighteen months later, the patient had no recurrences. He regained a visual acuity of 20/30, corresponding to his best postoperative result.

Retrobulbar (intraconal) anesthesia with a curved needle: technique and results.

We report the results of two prospective studies of retrobulbar anesthesia using curved 25 mm and 28 mm needles. These studies were prompted by our experience with the 25 mm needle in more than 13,000 cases of intraconal anesthesia in which one case of postoperative ischemic neuropathy was the only complication. The technique involves the transcutaneous introduction of the curved needle at the middle of the lower lid, following a curved track close to the inferior orbital wall, around the globe, parallel to the plane of the medial orbital wall (i.e., in a strictly sagittal plane lateral to the optical axis in primary gaze). No complications were noted in the prospective studies. Side effects were chemosis in 30% of cases, subconjunctival hemorrhage in 5%, and lid hemorrhage in 2%. Since these comparative studies, we have used the 28 mm needle without significant complications in more than 8,000 cases. This method of retrobulbar anesthesia is superior to peribulbar anesthesia, and because of its safety and reliability, is preferable.

Haptic design for continuous-loop, scleral fixation of posterior chamber lens.

We describe a haptic design for continuous-loop fixation of posterior chamber intraocular lenses (IOLs) to sclera. The haptic ends are broadened to allow two perforations on each haptic through which the sutures are guided. In this manner (satured with continuous loops), a stable four-point fixation is achieved that resists torsional forces, depending only on the mechanical strength of the haptics. Tilt during suture placement can be avoided by inserting the surgical needles and the 27 gauge disposable needles through the sclera at similar angles and distances from the limbus. When tested in a simple experimental model (as well as clinically), the new IOL behaved as predicted. The advantage of this haptic design is a stable, tilt free fixation by a continuous loop that allows the knot to be buried; the disadvantage is that a sophisticated and meticulously executed surgical technique is essential.

Secondary implantation of scleral-fixated intraocular lenses.

PURPOSE: To evaluate the results of a large series of secondary implantations using scleral-fixated posterior chamber intraocular lenses (IOLs). SETTING: Bellevue Eye Hospital, Kiel, Germany. METHODS: This retrospective review comprised 624 consecutive patients who had secondary implantation of a posterior chamber IOL with scleral fixation between 1988 and 1995. All patients had been aphakic for at least 1 year. An ab interno or ab externo suture technique through the ciliary sulcus was used. Visual outcome and complications 1 year after surgery were determined. RESULTS: Best corrected visual acuity improved or remained unchanged in 92.0% of eyes; 8.0% lost one or two lines. Intraocular lens decentration of more than 1.5 mm occurred in 1.9% of eyes. Suture erosion was observed in 17.9%, cystoid macular edema in 5.8%, retinal detachment in 1.4%, and vitreous hemorrhage in 1.0%. Severe uveitis occurred in 0.5%. CONCLUSION: Secondary IOL implantation with scleral fixation was a safe procedure. Although there was a small risk of significant complications, more than 90% of patients regained or improved their preoperative visual acuity.

The torque and tilt gamble.

PURPOSE: To analyze possible suture configurations at the haptics of posterior chamber intraocular lenses (IOLs) and estimate the resulting tilt. SETTING: King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia. METHODS: Using a plastic cylinder with two pairs of holes drilled on opposite sides and an IOL with eyelets in the haptics, we determined possible suture configurations and analyzed them for net torque on the IOL haptics that would result in tilting of the optic. RESULTS: We identified 64 combinations of regular and countless combinations of irregular suture configurations. Among the 16 most likely combinations, only 4 were torque-free (or torque neutral), 2 caused maximum tilt, and 10 induced some tilting. Theoretically, torque could be eliminated by radial suture placement, but this is anatomically undesirable, and by positioning the eyelet perpendicular to the haptic, but this is technically difficult. Longer suture bites tended to lessen the torsion on the haptic but increased the risk of the suture looping around the free end of the haptic. CONCLUSION: Surgeons using scleral fixation of a posterior chamber IOL should be aware of the possibility of inducing tilt and should aim for symmetrical suture configurations at the two haptics.

Toxic endothelial cell destruction from intraocular benzalkonium chloride.

PURPOSE: To present a cluster of cases of corneal edema occurring after phacoemulsification. SETTING: Regional hospital in rural Australia. METHODS: This retrospective case series comprised 12 patients from a single surgical list comprising 19 cases who developed persistent corneal edema after having phacoemulsification. RESULTS: After 6 months, the edema improved in 1 patient. Inadvertent intraocular use of balanced salt solution (BSS) preserved with benzalkonium chloride was found to be the cause of this serious complication. CONCLUSIONS: Benzalkonium chloride in concentrations commonly used extraocularly is highly toxic to the corneal endothelium. Every possible safeguard should be taken to prevent inadvertent intraocular use of such preserved solutions.