Effects of dietary supplementation of microencapsulated Enterococcus fecalis and the extract of Camellia oleifera seed on laying performance, egg quality, serum biochemical parameters, and cecal microflora diversity in laying hens.

The aim of this study was to investigate the effects of microencapsulted Enterococcus faecalis (MEF) and the extract of Camellia oleifera seed (ECOS) on laying performance, serum biochemical parameters, and cecal microflora diversity in laying hens. A total of 180 Hy-Line Brown laying hens, 26-wk-old, were randomly allocated to 6 treatments with 10 replicates and 3 hens per replicate. Dietary treatments were as follows: (A) control group, basal diet; (B) basal diet + 100 mg MEF/kg diet (1 × 1010 cfu/g MEF); (C) basal diet + 300 mg ECOS/kg diet; (D) basal diet + 100 mg MEF/kg diet + 300 mg ECOS/kg diet; (E) basal diet + 500 mg ECOS/kg diet; (F) basal diet + 100 mg MEF/kg diet + 500 mg ECOS/kg diet. The results showed that diets supplemented with MEF and ECOS had no significant effects on laying rate, average egg size, average daily feed intake, feed conversion ratio, eggshell thickness, albumen height, and yolk color (P > 0.05), but had significant effects on egg shape index, eggshell strength, and Haugh unit (P < 0.05) during whole feeding phases. Compared to the control group, the serum IgA and IgG levels of birds in Group F significantly increased (P < 0.05). The serum total cholesterol, low-density lipoprotein cholesterol, total triglyceride, and blood urea nitrogen levels of birds in Group D and Group F significantly reduced (P < 0.05), and the high-density lipoprotein cholesterol level of birds in Group D and Group F significantly increased (P < 0.05). At the phylum level, Firmicutes decreased (P < 0.05) and Bacteroidetes increased (P < 0.05) in the birds of Group D. Ruminococcus and Bacteroides were significantly affected by dietary treatments (P < 0.05), and Bacteroides in the birds of Group D significantly increased at the genus level. Therefore, diet supplemented with MEF and ECOS can significantly improve serum biochemical parameters and increase cecal microflora diversity.

The effects of dietary supplementation of microencapsulated and the extract of seed on growth performance, immune functions, and serum biochemical parameters in broiler chickens.

This experiment was conducted to investigate the effects of microencapsulted (MEF) and the extract of seed (ECOS) on growth performance, immune functions, and serum biochemical parameters in broiler chickens. A total of 240 1-d-old male broilers were randomly allotted into 6 treatments with 8 replicates/treatment and 5 broilers in each cage. The dietary treatments included 1) a basal diet without antibiotic (group A), 2) the basal diet + 1 g MEF/kg diet (1 × 10 cfu/g MEF; group B), 3) the basal diet + 300 mg ECOS/kg diet (group C), 4) the basal diet + 300 mg ECOS/kg diet + 1 g MEF/kg diet (group D), 5) the basal diet + 500 mg ECOS/kg diet (group E), and 6) the basal diet + 500 mg ECOS/kg diet + 1 g MEF/kg diet (group F). The feeding experiment included 2 phases: the starter phase from Day 1 through 21 and the grower phase from Day 22 through 42. The results showed that a diet supplemented with MEF and ECOS had no significant effect on ADG, ADFI, feed conversion ratio, and average BW during the whole experimental period ( > 0.05), but group F showed an improving trend in growth performance. Serum IL-2, IgA, and IgG levels and spleen index were significantly affected by dietary treatment ( < 0.05). Serum IgA and IgG levels and spleen index in group F were significantly higher than in the group A ( < 0.05), and the IL-2 level was significantly decreased ( < 0.05) on Days 21 and 42. Compared with the group A, diets supplemented with MEF and ECOS can significantly decrease total cholesterol, low-density lipoprotein cholesterol, triglycerides, and blood urea nitrogen levels ( < 0.05) and increase the high-density lipoprotein cholesterol level on Days 21 and 42. Concentrations of serum biochemical parameters were significantly increased in group F ( < 0.05). In summary, the results indicated that dietary supplementation of MEF and/or ECOS had no significant effect on growth performance but significantly increased spleen index and the levels of serum IgA and IgG and improved serum lipid metabolism. The 1 g MEF/kg diet (1 × 10 cfu/g diet) plus 500 mg ECOS/kg diet was the optimum supplemental dose in this experiment.

Effects of microencapsulated Enterococcus fecalis CG1.0007 on growth performance, antioxidation activity, and intestinal microbiota in broiler chickens.

We performed a series of trials to assess the effect of dietary supplementation with microencapsulated Enterococcus fecalis CG1.0007 on growth performance, antioxidation activity, and intestinal microbiota in Arbor Acres broiler chickens ("broilers"). A total of 150 1-d-old broilers were assigned randomly to 5 feeding treatments (a control group fed the basal diet, 3 groups fed the basal diet plus various concentrations of microencapsulated CG1.0007, and 1 group fed the basal diet plus an antibiotic). Changes in important genera of intestinal bacteria were studied using 16S rRNA gene-based PCR-denaturing gradient gel electrophoresis (DGGE) profiling and real-time quantitative PCR analysis of fecal samples. During the course of the 42-d experimental period, ADG of the birds fed the high and intermediate concentrations of microcapsules were significantly greater (9.90 and 9.50%, respectively) and the ratios of feed to gain fed were significantly lower (4.40 and 4.00%, respectively) compared with the control group. The total antioxidant capacity and the content of malondialdehyde and superoxide dismutase in the microcapsule-treated groups showed significant changes in terms of antioxidation. The numbers of Lactobacillus and Bifidobacterium were significantly greater in the microcapsule-treated groups than in the control group. Cluster analysis indicated that the DGGE bacterial profiles were related to the feeding treatments and revealing the diversity and richness of the intestinal microbiota associated with supplementation of microcapsules. In summary, our results indicate that dietary addition of microencapsulated E. fecalis CG1.0007 enhanced the growth performance of the broilers and improved their health.

Randomised comparison between adrenaline injection alone and adrenaline injection plus heat probe treatment for actively bleeding ulcers.

OBJECTIVE: To compare endoscopic adrenaline injection alone and adrenaline injection plus heat probe for the treatment of actively bleeding peptic ulcers. DESIGN: Randomised prospective study of patients admitted with actively bleeding peptic ulcers. SETTING: One university hospital. SUBJECTS: 276 patients with actively bleeding ulcers detected by endoscopy within 24 hours of admission: 136 patients were randomised to endoscopic adrenaline injection alone and 140 to adrenaline injection plus heat probe treatment. MAIN OUTCOME MEASURES: Initial endoscopic haemostasis; clinical rebleeding; requirement for operation; requirement for blood transfusion; hospital stay, ulcer healing at four weeks; and mortality in hospital. RESULTS: Initial haemostasis was achieved in 131/134 patients (98%) who received adrenaline injection alone and 135/136 patients (99%) who received additional heat probe treatment (P = 0.33). Outcome as measured by clinical rebleeding (12 v 5), requirement for emergency operation (14 v 8), blood transfusion (2 v 3 units), hospital stay (4 v 4 days), ulcer healing at four weeks (79.1% v 74%), and in hospital mortality (7 v 8) were not significantly different in the two groups. In the subgroup of patients with spurting haemorrhage 8/27 (29.6%; 14.5% to 50.3%) patients from the adrenaline injection alone group and 2/31 (6.5%; 1.1% to 22.9%) patients from the dual treatment group required operative intervention. The relative risk of this was lower in the dual treatment group (0.17; 0.03 to 0.87). Hospital stay was significantly shorter in the dual treatment group than the adrenaline injection alone group (4 v 6 days, P = 0.01). CONCLUSION: The addition of heat probe treatment after endoscopic adrenaline injection confers an advantage in ulcers with spurting haemorrhage.

Mesh hernioplasty using a stapler.

BACKGROUND: The recent development of laparoscopic hernioplasty has evoked extensive re-examination of the safety and effectiveness of using synthetic mesh materials in hernia surgery. We have investigated the efficacy of anterior stapling mesh repair in the treatment of inguinal hernia. METHODS: From July 1993 to June 1994, a modified open mesh hernioplasty using staples for anchorage has been performed in 127 patients. RESULTS: The mean age of patients was 61.4 +/- 13.0 years. Over 90% of them were operated on under local anaesthesia. The operation time ranged from 30 to 95 min with a median of 39 min. Only sixteen patients (12.6%) required postoperative parenteral analgesics and the median time for resuming daily activities was 7 days. Apart from two patients with reactionary haemorrhage, there was no other significant complication observed. Only one recurrence was encountered over the 26-month median follow-up period. CONCLUSIONS: We conclude that the modified mesh hernia repair with a stapling device is a feasible, inexpensive and safe procedure that is well tolerated under local anaesthesia by most patients.

Intravenous ciprofloxacin as treatment for patients with acute suppurative cholangitis: a randomized, controlled clinical trial.

One hundred consecutive patients with acute suppurative cholangitis were randomized in a prospective, controlled clinical trial to receive either ciprofloxacin (200 mg bd iv) or triple therapy comprising ceftazidime (1 g bd iv), ampicillin (500 mg qds iv) and metronidazole (500 mg tds iv); 46 and 44 patients in the ciprofloxacin and triple therapy groups respectively were suitable for inclusion in the analysis of efficacy. In two-thirds of the patients biliary obstruction was caused by ductal calculi and in one-third by malignant or benign strictures of the biliary tract. Bacteraemia was documented in 38% of patients in the ciprofloxacin group and in 34% of patients in the triple therapy group, while bile cultures were positive in 87% and 92% of patients in the ciprofloxacin and triple therapy groups respectively. Escherichia coli, Klebsiella spp. and Enterococcus spp. were the most common biliary isolates. Eighty-five per cent of evaluable patients in the ciprofloxacin group and 77% of those in the triple therapy group responded to therapy. The mean durations of fever, septicaemic shock and hospitalization were also similar in the two treatment groups. Six (13%) patients in the ciprofloxacin group and seven (16%) in the triple therapy group required urgent endoscopy or surgery for uncontrolled infection. Recurrence of fever after an initial response was documented in one (2%) patient receiving ciprofloxacin and in three (7%) patients receiving triple therapy. The incidences of mortality were 4% in the ciprofloxacin group and 2% in the triple therapy group. The results of this study suggest that ciprofloxacin alone is adequate empirical therapy for patients with cholangitis.

Selective internal radiation therapy with intra-arterial iodine-131-Lipiodol in inoperable hepatocellular carcinoma.

UNLABELLED: From August 1990 to June 1993, 26 patients with inoperable hepatocellular carcinoma were treated with intra-arterial iodine-131-Lipiodol (131I-L). METHODS: Iodine-131-Lipiodol was given through either an implantable arterial port (9 patients) or during hepatic angiography (17 patients). All 26 patients had multiple lesions, 3 had involved resection margin after surgical resection and 1 had diffuse infiltrative lesions. The median size of the largest tumor among 22 patients with a measurable lesion was 4.5 cm (2-9.5 cm). The end points are tumor response in terms of tumor size, change in serum alpha-fetoprotein level, toxicity of treatment and overall survival. RESULTS: Twenty-three patients received a single treatment of 1.11-2.22 GBq (30-60 mCi)131I-L. Three patients received 2.22-4.44 GBq (60-120 mCi)131I-L in three fractions. Considering both radiological regression and reduction in serum alpha-fetoprotein level as objective response criteria, the overall response rate was 52% (13 out of 25 patients with evaluable disease). Ten out of 15 patients who had raised alpha-fetoprotein levels had more than 50% reduction and 8 patients had more than 90% reduction in alpha-fetoprotein level. Since analysis, 19 patients have died and 7 remain alive, giving a minimum median survival of 6 mo (range 1.2-16.6 mo), with 4 surviving more than 1 yr calculated from the day of treatment. There was only one patient who had late deterioration of liver function compatible with radiation hepatitis. There was no bone marrow toxicity documented in any patients. CONCLUSION: Treatment with intra-arterial 131I-L was well tolerated in patients with inoperable hepatocellular carcinoma and produced an objective response of 52% with median survival of 6 mo. A fractionated dose of 131I-L was feasible and the radiation dose could be escalated safely.

Optochiasmatic tuberculoma causing progressive visual failure: when has medical treatment failed?

A 5 year old girl with tuberculous meningitis developed progressive visual failure during in-patient anti-tuberculous chemotherapy due to an ophthochiasmatic tuberculoma. This was successfully managed by prolonged high-dose corticosteroids and continued anti-tuberculous therapy resulting in complete visual and psychosocial recovery.

Hepatic intra-arterial lipiodol ultrasound guided biopsy in the management of hepatocellular carcinoma.

One hundred and fifty-one consecutive new patients with suspected hepatocellular carcinoma (HCC) were investigated from 1989 to 1990. Ultrasound showed the tumours to be inoperable in 111 patients. Selective hepatic angiography revealed 17 more patients with inoperable HCC. Hepatic intra-arterial lipiodol (HIAL) was injected in the remaining 23 patients. In 16 of them, a clinical decision could be reached basing on the radiological findings. Hepatic intra-arterial lipiodol ultrasound (HIAL/USG) guided biopsy was done in seven patients with suspicious lesions. Histology obtained with this method revealed hyperplastic cirrhotic nodules in four patients (two with suspected HCC and two with suspected secondaries). In another two patients, the suspected lesions were confirmed to be malignant. In the last patient who had received chemotherapy for extensive HCC, HIAL/USG guided biopsy revealed necrotic tissue only. At laparotomy, diffuse infiltrative abnormality was found and repeated biopsy confirmed residual malignancy in the necrotic tumour. We conclude that when there is radiological uncertainty as to the nature and extent of the HCC, HIAL/USG guided biopsy can help the clinician to make important decisions.

Distribution of Lipiodol and evidence for tumor necrosis in hepatocellular carcinoma.

To study the distribution and thromboembolic effect of Ultrafluid Lipiodol, 15 surgically removed hepatocellular carcinomas with selective intraarterial Lipiodol injection 7 to 10 days before surgery and 15 noninjected controls were studied radiologically and histologically. Tissue blocks were processed with an en bloc silver impregnation technique for Lipiodol localization in histologic sections. Lipiodol was distributed evenly in tumors measuring less than 5 cm in diameter and peripherally in tumors measuring 10 cm or more. Lipiodol droplets were mainly extracellular. There was no difference in tumor architecture or in hemorrhage and necrosis scores between Lipiodol-injected cases and negative controls (1.18 versus 0.92). Similarly, in injected cases, no differences were observed between Lipiodol-positive and Lipiodol-negative areas (scores of x-ray Lipiodol-positive versus Lipiodol-negative areas: 1.17 versus 1.36; scores of microscopic Lipiodol-positive versus Lipiodol-negative areas: 1.18 versus 1.14). Lipiodol-negative but hypodense areas examined by x-ray proved to be necrosis or fibrosis with or without viable tumor islands. Lipiodol has no thromboembolic effects. The uneven Lipiodol distribution may account for its failure as a carrier for chemotherapeutic agents in large tumors.

Treatment of inoperable hepatocellular carcinoma by intra-arterial lipiodol and 4'-epidoxorubicin.

A total of 30 patients presenting with inoperable hepatocellular carcinoma (HCC) were treated with intrahepatic arterial Lipiodol (5 ml) and 4'-epidoxorubicin (90 mg/m2) once every 4 weeks. The treatment results included no complete response, 2 partial responses, 6 cases of static disease and 19 cases of progressive disease. The median survival was 18.9 weeks. All patients had died by the time of this writing, with survival duration ranging from 4.1 to 87.3 weeks. Toxicities were minimal and included anaemia and alopecia. As compared with a historic control group that had received the same dose of intravenous 4'-epidoxorubicin, the treatment group showed similar response rates but developed fewer toxicities. There was no significant survival benefit over the control group. We concluded that although this form of treatment had comparable activity and produced fewer side effects, it provided no survival benefit over intravenous treatment. The slight prolongation of survival achieved in the treatment group as compared with the control arm might have been due to case selection.

A radiological-pathological correlation of hepatocellular carcinoma (HCC).

The histological distribution of lipiodol within hepatocellular carcinoma (HCC) was correlated with that seen on computed tomography (CT), arteriography and high resolution plain films of 15 resected specimens. By means of special stains, the arterially administered lipiodol was shown to be maximally distributed at the periphery of large tumours and nodules. The centre of large lesions often remained unopacified. In multinodular tumours some nodules were heavily stained while others contained little or no contrast medium. In small tumours there was a more uniform distribution. In large tumours, those areas where there are large arteries (and slow flow) contained little or no lipiodol. There was also no consistent match of areas of angiographic blush with lipiodol deposition. The lipiodol patterns were poorly shown by CT when compared with high resolution films taken on a mammography unit. We conclude from this study that lipiodol on its own as an embolic agent or as a chemotherapeutic carrier has great limitations because of its peripheral and otherwise haphazard distribution in large tumours. However, such treatments might be more effective in small tumours where a greater concentration of lipiodol is likely. Nevertheless, lipiodol staining of tumours remains a useful diagnostic aid as small HCC can be difficult to visualize both on arteriography and conventional CT.

Transurethral ureterorenoscopic lithotripsy and retrieval of ureteric calculi under local anaesthesia and sedation.

Under strict indications, ureterorenoscopic (URS) lithotripsy was used to treat ureteric calculi in 61 patients under local anaesthesia and sedation in a 2-year period ending November 1988. Assessments of success and discomfort of the procedure were made. Stone retrieval was accomplished in 48 patients (78% success rate) and a mean pain score of 6 was recorded in a scale from 0 to 10. It was concluded that performing URS under local anaesthesia is an acceptable alternative.