Dietary enzyme addition on the growth performance and carcass characteristics of pigs fed diets containing avocado oil cake silage.

Avocado oil cake (AOC) was mixed with dried grape pomace and sugarcane molasses and ensiled for 90 days. A total mixed ration containing 5% AOC silage was formulated and top dressed with Axtra® XB enzyme at 0, 2.5 and 5%. The experimental diets were fed to 24 (8 pigs/diet) Large White × Landrace (LW × LR) cross pigs (± 22-kg live weight). Growth performance data was recorded for 60 days, after which the pigs were adapted to chromic oxide mixed diet for 3 days, whereby faeces were collected for 5 days after to determine nutrient digestion. Following nutrient digestion, pigs were fasted for 12 h, weighed and slaughtered. Carcass samples were collected and analysed for meat quality. Dietary addition of enzyme increased (P < 0.05) dry matter intake and nutrient digestibility, but did not affected (P > 0.05) feed conversion ratio and average daily gain. Carcass characteristics were not affected (P > 0.05); however, small and large intestine weight and length were increased (P < 0.05) with enzyme inclusion in feed. Dietary treatments did not affect (P > 0.05) the colour and cooking quality of the meat. Enzyme addition was worth in the growth performance and nutrient digestion but did not affect the carcass characteristics and meat quality of pigs.

Opsonic monoclonal antibodies enhance phagocytic killing activity and clearance of Mycobacterium tuberculosis from blood in a quantitative qPCR mouse model.

BACKGROUND: Patients with impaired immunity often have rapid progression of tuberculosis (TB) which can lead to highly lethal Mycobacterium tuberculosis (MTB) sepsis. Opsonic monoclonal antibodies (MABs) directed against MTB that enhance phagocytic killing activity and clearance of MTB from blood may be useful to enhance TB immunity. METHODS: BALB/c mice were immunized with ethanol-killed MTB (EK-MTB) and MABs were produced and screened by ELISA for binding to killed and live Mycobacterium smegmatis (SMEG) and MTB. MAB opsonophagocytic killing activity (OPKA) was examined using SMEG with HL60 and U-937 cells and MTB with U-937 cells. Clearance of MTB from blood was evaluated in Institute of Cancer Research (ICR) mice given opsonic anti-MTB MABs or saline (control) 24 h prior to intravenous infusion with 108 CFUs gamma-irradiated MTB (HN878). MTB levels in murine blood collected 0.25, 4 and 24 h post-challenge were assessed by qPCR. MAB binding to peptidoglycan (PGN) was examined by ELISA using PGN cell wall mixture and ultra-pure PGN. RESULTS: Two MABs (GG9 and JG7) bound to killed and live SMEG and MTB (susceptible and resistant), and promoted OPKA with live MTB. MAB JG7 significantly enhanced OPKA of MTB. Both MABs significantly enhanced clearance of killed MTB from murine blood at 4 and 24 h as measured by qPCR. These opsonic MABs bound to PGN, a major cell wall constituent. CONCLUSIONS: Anti-MTB MABs that promote bactericidal phagocytic activity of MTB and enhance clearance of killed MTB from the blood, may offer an immunotherapeutic approach for treatment of MTB bacteremia or sepsis, and augment treatment of multi-drug resistant (MDR) or extensively drug resistant (XDR) TB.

Inhaled microparticles containing clofazimine are efficacious in treatment of experimental tuberculosis in mice.

Inhalable clofazimine-containing dry powder microparticles (CFM-DPI) and native clofazimine (CFM) were evaluated for activity against Mycobacterium tuberculosis in human monocyte-derived macrophage cultures and in mice infected with a low-dose aerosol. Both formulations resulted in 99% killing at 2.5 µg/ml in vitro. In mice, 480 µg and 720 µg CFM-DPI inhaled twice per week over 4 weeks reduced numbers of CFU in the lung by as much as log(10) 2.6; 500 µg oral CFM achieved a log(10) 0.7 reduction.

A fissitunicate ascus mechanism in the Calosphaeriaceae, and novel species of Jattaea and Calosphaeria on Prunus wood.

During a survey of Prunus wood from South Africa, isolations were made of three presumably Calosphaerialean fungi that formed hyphomycetous, phialidic anamorphs in culture. In order to reveal the phylogenetic relationship of these fungi, they were characterised on a morphological and molecular (LSU and ITS rDNA) basis. Two isolates that formed a teleomorph in culture are newly described as Calosphaeria africana sp. nov. Although asci of Calosphaeria are characterised by having non-amyloid apical rings, two functional wall layers were observed in asci of C. africana, which has hitherto not been observed in any member of the Calosphaeriaceae. However, Calosphaeriaceae (Calosphaeriales, Sordariomycetes) are not closely related to other bitunicate fungi like Dothideomycetes, Chaetothyriales and bitunicate lichens. Possession of two separating wall layers is considered to be a result of both inherited abilities and convergent evolution under a strong selection pressure of the environmental conditions that favour an extension of the ascus. The other two species represented a separate lineage within Calosphaeriaceae, and formed phialophora-like anamorphs. By obtaining the teleomorph in culture, one of them could be identified as a species of Jattaea, described here as Jattaea prunicola sp. nov., while the second, which only produced the anamorph, is named as Jattaea mookgoponga sp. nov. These findings suggest that some species of Jattaea are true members of the Calosphaeriaceae, though the phylogenetic relation of the type, J. algeriensis, remains unknown. Furthermore, it also represents the first report of Jattaea on Prunus wood, and from South Africa.

Endovascular treatment of intractable epistaxis--results of a 4-year local audit.

OBJECTIVE: Transcatheter embolisation is an accepted and effective treatment for intractable epistaxis. We analysed our success and complication rates and compared these with results from other published series. DESIGN: Retrospective review. SETTING: Unitas Interventional Unit, Centurion. METHODS: Case record review (57 procedures) and telephonic interviews (36 traceable respondents). OUTCOME MEASURES: A numerical audit of the success and complication rates for embolisation procedures performed during the 4-year period between July 1999 and June 2003. RESULTS: A total of 57 endovascular embolisation procedures were performed for intractable epistaxis in 51 patients during this period. Eight patients (15.7%) developed a re-bleed between 1 and 33 days after embolisation, of whom 5 were reembolised, giving a primary short-term success rate of 86.3% and secondary assisted success rate of 94.1%. Thirty-five of 36 respondents (97.2%) reported no further epistaxis during the long-term follow-up period of 1-47 months. The mortality rate was 0%, the major morbidity rate was 2% (1 stroke) and the minor morbidity rate was 25%. CONCLUSION: Our success and complication rates are acceptable and compare favourably with those reported in other large series.

Intralesional bleomycin injection (IBI) treatment for haemangiomas and congenital vascular malformations.

Successful treatment of vascular anomalies has eluded the physician until now, despite various treatments utilised. Bleomycin has been successfully used in intralesional injection treatment of cystic hygromas and haemangiomas, based specifically on a high sclerosing effect on vascular endothelium. In a prospective study of 95 patients, the effectiveness of intralesional bleomycin injection (IBI) treatment in haemangiomas and vascular malformations was evaluated and documented. Complete resolution or significant improvement occurred in 80% of all patients treated. Complete resolution occurred in 49% of haemangiomas, 32% of venous malformations, and 80% of cystic hygromas. Significant improvement occurred in 38% of haemangiomas, 52% of venous malformations, 13% of cystic hygromas and 50% of lymphatic malformations. Of the six patients who presented with a painful lesion, four experienced complete resolution and two had significant improvement to treatment. Local complications encountered were superficial ulceration occurring in 2 patients, and cellulitis in 1 of the 95 patients. Systemic complications were flu-like symptoms in three patients and partial, transient hair loss in two patients. None of the patients presented with haematological toxic effects or signs of pulmonary involvement (fibrosis, hypertension). IBI is an effective treatment in haemangiomas and vascular malformation lesions, obviating the need for invasive primary surgery or systemic treatment regimens in 80% of cases, and allowing for limited need of secondary surgical or adjunctive procedures in cases with a moderate result.

Acute severe epistaxis due to iatrogenic maxillary pseudoaneurysm. Emergency control of haemorrhage by carotid compression and early recurrence after coil embolization.

SUMMARY: Internal maxillary arterial or branch transection is a potential complication of maxillofacial surgery. We describe one such patient who developed acute massive nasal haemorrhage, an episode of which was controlled clinically just prior to performing endovascular embolization by employing the simple but effective clinical manoeuvre of manual carotid arterial compression. Six weeks later the haemorrhage recurred despite a seemingly adequate embolization of the affected arteries with microcoils and Spongistan due to re-establishment of flow through the coils.

Evaluation of a rapid test for HIV antibodies in saliva and blood.

OBJECTIVE: To test whole blood and saliva for HIV antibodies (anti-HIV) using a rapid test strip capillary flow immunoassay, and to correlate the test strip results with blood specimen results obtained from routine diagnostic anti-HIV assays. DESIGN: A prospective pilot study of selected HIV-positive and HIV-negative individuals, children and medico-legal cases from Gauteng, South Africa. METHODS: Whole blood specimens taken from every individual and medico-legal case (total study population 153) and saliva specimens taken from 76 selected cases were tested for anti-HIV using the respective Hema-Strip HIV-1/2, Sero-Strip HIV-1/2 and Saliva-Strip HIV-1/2 (Saliva Diagnostic Systems Inc.) rapid test strip methodology. All results were correlated with the currently recommended anti-HIV assays. RESULTS: The whole blood test strip results correlated 100% with the traditional diagnostic results. Only two saliva test strip results tested false-negative, both from marasmic and severely dehydrated babies, while the other results were in concordance. All test strip results on postmortem blood and saliva were fully concordant with the diagnostic assay results. CONCLUSION: The anti-HIV test strip methodology for whole blood and saliva specimens is rapid, reliable and easy to perform and interpret. Saliva specimens can be readily collected from any individual, and there is a reduction in hazard risk. Anti-HIV saliva testing using the test strip methodology is recommended for South Africa, particularly in high-risk situations such as the paediatric and forensic medicine settings. A large field study obtaining specimens from different regions in South Africa is advised.

Procedures for developing a simple scoring method based on unsophisticated criteria for screening children for tuberculosis.

OBJECTIVE: To develop a scoring system for screening children for tuberculosis (TB) and for selecting suspects for further investigation in tuberculosis control programmes. Application of the score model, which would not require sophisticated or expensive technology, would be directed towards resource-poor countries with high prevalences of tuberculosis, where health care workers have to deal with diagnostic problems away from district hospitals or diagnostic facilities. DESIGN: Based on contributions from members of an IUATLD task group from 10 countries on the use of diagnostic criteria in childhood tuberculosis, criteria were selected to be used as elements in a score model. Data were collected by standardised questionnaire on 879 subjects aged under 15 years. Of these, 794 were considered probable or confirmed cases of tuberculosis by the diagnosing doctors. From each record, the criteria/procedures used in the diagnosis of probable/confirmed TB and regarded by the doctors as relevant criteria were selected. Bacteriology, histology and chest radiography were used either singly or collectively as the definitive reference (gold standard) against which the more subjective criteria (symptoms, clinical signs, skin test) would be evaluated. The latter criteria cited as relevant were then ranked and further explored for inclusion in the score model. The relative importance of each criterion to every other criterion on the list was expressed as weights, determined by employing a logarithmic least squares method to solve the ratio scale estimation problem which underlies decision-making involving more than one criterion. The resultant values were then assigned to each criterion in the final score model. RESULTS: The five clinical criteria thought to be most relevant as predictors of disease in children were history of contact with a case of tuberculosis, positive skin test, persistent cough, low weight for age, and unexplained/prolonged fever. In selecting the optimal cut-off points for the model at which tuberculosis would be suspected, low sensitivity and specificity (below 70%) but reasonably good positive predictive values (60%-77%) were obtained, depending on age group and epidemiological setting. In low tuberculosis prevalence settings, heavy reliance is placed by the model on a history of contact with a household case of tuberculosis and on a positive skin test, both of which have to be true. For high prevalence settings, more or less equal weighting is assigned to all five elements. Case contact and skin tests are less important, with low body weight, prolonged fever and cough being more indicative of tuberculosis. CONCLUSION: The model provides for epidemiological differences between target populations and should prove successful as a screening tool to select children for further investigation by radiography and bacteriology.

Intravenous immunoglobulin prophylaxis in neonates on artificial ventilation.

The efficacy of the prophylactic use of intravenous immunoglobulin (Ig) was evaluated in a double-blind placebo-controlled trial of 21 pairs of ventilated neonates weighing more than 1,500 g. Each infant received 0.4 g/kg/day of intravenous Ig or a similar volume of placebo daily for 5 days. Criteria used to assess the efficacy of intravenous Ig were the number of infections, the duration of ventilation therapy and time to clinical recovery. There were no significant differences in the treated and placebo groups with regard to the frequency of positive blood cultures (28.6% and 14.3%), endotracheal cultures (57.1% and 66.7%) and abnormal white cell counts (52.4% and 57.1%). On entry to the study there was no significant difference in IgG levels between the treated (974.5 mg/dl; SD 575.3) and placebo groups (818 mg/dl; SD 516.9). However, on day 6 the treated group had a mean level of 1,400.3 mg/dl (SD 426.7) versus 710.9 mg/dl (SD 377.4) in the placebo group (P < 0.05). Clinical improvement occurred within 3 days in both groups. Ventilatory support was required for 11.8 days (SD 8.3) in the treated and 11.8 days (SD 7.3) in the placebo group. Both groups required 3-4 antibiotic treatments over a period of 14-15 days. Two patients died in the treated and 4 in the placebo group, with 1 infant in each group developing bronchopulmonary dysplasia. The patients who recovered did so within 14 days. Analyses of subgroups of patients with different diagnoses revealed no differences except a trend suggesting fewer infections in term babies treated with intravenous Ig. The organisms cultured in the intravenous Ig groups were Pseudomonas, Klebsiella, Escherichia coli and Staphylococcus and in the placebo group Pseudomonas, Klebsiella and Enterobacter. The above has shown that, except for a trend in the older neonates, intravenous Ig is not of prophylactic benefit in ventilated neonates. Newer adjuncts in immunotherapy such as hyperimmune gammaglobulin or monoclonal antibodies may prove of greater value in the treatment of neonatal sepsis.

[Chronic osteomyelitis - a diagnostic dilemma]. / Chroniese osteomiëlitis--'n diagnostiese dilemma.

Infective skeletal lesions can mimic bony tumours. Bony lesions without periosteal reactions in adult patients with normal leucocyte counts will have a different differential diagnosis from that of children with bony lesions and a periosteal reaction. In the latter, osteomyelitis should be distinguished from Ewing's sarcoma and osteogenic sarcoma. Due to the difficult preoperative diagnosis a retrospective study was undertaken which included 14 patients with the histological diagnosis of chronic osteomyelitis but normal leucocyte count and no periosteal reaction. Radiographs showed cavities in 82%, infiltration in 12% and sclerosis in 6% of cases. All patients who underwent skeletal scintigraphy studies showed increased uptake in the lesions. Magnetic resonance showed increased signal intensity in T2 images. Ordinary radiographs are still the most valuable primary investigation for skeletal lesions.

Preservation of myocardial function and biochemistry after blood and oxygenated crystalloid cardioplegia during cardiac arrest.

We compared the ability of blood cardioplegia and oxygenated crystalloid cardioplegic solutions to maintain regional left ventricle contractility and adenosine triphosphate levels after cardiopulmonary bypass. Ten baboons were subjected to 90-minute cardiopulmonary bypass conducted at 28 degrees C. Hemodynamic measurements were made before and after the bypass procedure, and biopsies for high-energy phosphate determinations were performed at different time intervals during and after bypass. The results showed improved maintenance of myocardial contractility (measured with the regional end-systolic pressure-length relationship) with the oxygenated crystalloid solution. Expressed as a percentage of values before bypass, contractility after bypass averaged 81.69% +/- 4.81% and 80.47% +/- 10.05%, respectively, after 10 and 20 minutes using the oxygenated crystalloid cardioplegia. For blood cardioplegia, the corresponding values were 71.9% +/- 8.73% and 64.99% +/- 8.60% (mean +/- standard error of the mean). The 10- and 20-minute postbypass values between the two groups differed significantly (t test, Welch modification: p = 0.0464 and p = 0.0342). Myocardial adenosine triphosphate level was higher immediately after induction of cardiac arrest when blood cardioplegia was used (blood cardioplegia, 6.82 mol.g wet wt-1; crystalloid cardioplegia, 4.95 mol.g wet wt-1; p = 0.0314), but values subsequently equalized.

Bizarre parosteal osteochondromatous proliferation of a phalanx.

A rare proliferative osteochondromatous malformation of a proximal phalanx is described. This malformation may mimic the appearance of a sessile osteochondroma or parosteal osteosarcoma on X-rays and may be mistaken for a low-grade osteosarcoma on histology, with disastrous therapeutic consequences. We found that cryotherapy followed by local excision was adequate to remove the tumour.

Giant colonic diverticulum--a radiological diagnostic problem. A case report.

Giant diverticulum of the colon is a rare condition, mentioned only sporadically in the literature and usually presenting on an abdominal radiograph as an air-filled cyst. This poses an interesting clinical and radiological diagnostic problem. A case is presented and a radiological approach suggested.

Radioiodination of murine anti-alpha-foetoprotein E.9 monoclonal antibody and its F(ab')2 fragment for the diagnosis of hepatocellular carcinoma.

The high incidence of hepatocellular carcinoma amongst certain population groups of Southern Africa made feasible the investigation of a radiolabelled monoclonal anti-alpha-foetoprotein as a radioimmunodiagnostic agent for this disease. This paper reports the preclinical trials with monoclonal anti-alpha-foetoprotein E.9 (anti-AFP) and its F(ab')2 fragment after radiolabelling with 131I. Various radioiodinations were tried. The best results were obtained with the lodogen and Bolton-Hunter methods. 131I from only one of the sources tested gave an 131I-labelled anti-AFP with meaningful immunoreactivity. It was shown by means of gamma-camera scans and monitoring of radioactivity in individual organs that 131I-anti-AFP and the 131I-anti-AFP F(ab')2 fragments did not accumulate abnormally in any organ(s) in healthy animals. The correlation in healthy mice of the biodistribution of 125I human IgG to 131I-anti-AFP, and 125I human IgG to 131I-F(ab')2 was good. Human hepatoma xenografts in athymic mice showed uptake of 131I-anti-AFP and the 131I-F(ab')2 fragment. The uptake of 131I-F(ab')2 was improved by liver background subtraction. There was correlation between circulatory alpha-foetoprotein concentrations and tumour uptake of 131I-F(ab')2 in tumour-bearing athymic mice and a definite relationship was found between tumour size and radiolabelled antibody and the F(ab')2 fragment. After the biological action of the 131I-anti-AFP and the 131I-F(ab')2 fragment was known, sterile pyrogen-free consignments were supplied for clinical trials in humans on a regular basis.

[Digital subtraction angiography]. / Berekende subtraksie-angiografie.

Between 10 February 1983 and 9 November 1984 482 patients were investigated by digital subtraction angiography, mainly for carotid arterial disease and problems associated with transplanted kidneys. The use of abdominal compression and antispasmodics are essential to minimize bowel artefacts for intraabdominal arterial examinations. The apparatus is advantageous for interventional radiologists. Images are immediately seen, can be stored on analogue tape, digitalized and obtained with smaller volumes of contrast medium and without arterial catheterization. Movement artefacts, however, can cause problems.

Comparison between atracurium and alcuronium for muscle relaxation during laparoscopy.

Atracurium 0.3 mg/kg was compared with alcuronium 0.25 mg/kg as the sole muscle relaxant for tracheal intubation and abdominal relaxation for gynaecological laparoscopy in 46 patients during nitrous oxide, oxygen and halothane anaesthesia. Speed of onset, intubation conditions, effect on blood pressure and pulse rate, and ease of reversal were compared. Alcuronium had a significantly faster onset of action than atracurium; intubation conditions were adequate and abdominal relaxation was satisfactory for both drugs. The effect of atracurium was readily reversible within 10 minutes; in contrast alcuronium was significantly more resistant and mean recovery time was 28.03 minutes. Although alcuronium provided good muscle relaxation, it is not suitable for short procedures because of difficulty in reversing its action. Atracurium allowed earlier and more complete reversal of neuromuscular block.

A surface impression and scanning electron microscopic study of porokeratosis of Mibelli.

A silicone rubber impression technique, together with scanning electron microscopy, was used to study the surface detail of porokeratosis of Mibelli. The lesions are propagated by a bud-like spreading of the active edge. The keratotic rim is produced by the condensation of squamous cells from both within and without the lesion.