Quality of life and defecative function 10 years or longer after posterior sagittal anorectoplasty and laparoscopic-assisted anorectal pull-through for anorectal malformation.

PURPOSE: In our center, patients with anorectal malformation, including males with recto-vesical (RV)/recto-bladder neck (RBN)/recto-prostatic urethral (RU) fistulas, and females with recto-vaginal (RV) fistulas have been treated by posterior sagittal anorectoplasty (PSARP) before 2000, and by laparoscopic-assisted anorectal pull-through (LAARP) thereafter. We would like to compare the quality of life (QOL) and long-term defecative function between these two groups of patients 10 years after reconstructive surgery. METHODS: Patients who underwent LAARP between 2001 and 2005 were compared with historical controls treated with PSARP between 1996 and 2000. Degrees of continence were graded by the Krickenbeck classification and Kelly's score. QOL was assessed by Hirschsprung's disease/Anorectal Malformation Quality of Life (HAQL) questionnaire. Results were compared using Chi-square test and t test. RESULTS: There were 14 LAARP and 7 PSARP patients. All attained voluntary bowel movements. Moderate to severe soiling (Krickenbeck Grade 2 and 3) was found in 3/14 LAARP (21.4%) and 1/7 PSARP (14.3%) patients, p = 1.00. Constipation requiring use of laxatives was present in 3/14 LAARP (28.6%) and 1/7 PSARP (14.3%) patients, p = 0.62. Mean Kelly's scores were 3.79 ± 0.98 (LAARP) and 4.71 ± 1.25 (PSARP), p = 0.12. No patient required Malone antegrade continence enema (MACE). The QOL scores based on the HAQL questionnaire were comparable between the two groups in all areas except social functioning, in which the LAARP patients attained a significantly lower mean score (26.4 vs 71.7, p = 0.0001). CONCLUSION: The 10-year outcome between LAARP and PSARP patients in terms of QOL and defecative function is comparable. Impairment in social functioning in these patients is reflected by the self-reported lower level of functioning.

Combating against methicillin-resistant Staphylococcus aureus - two fatty acids from Purslane (Portulaca oleracea†L.) exhibit synergistic effects with erythromycin.

OBJECTIVES: The aims of this study were to identify the active ingredients from Portulaca oleracea L. (PO) that could provide synergism with antibiotics against methicillin-resistant Staphylococcus aureus (MRSA) and their possible mechanisms of resistance inhibition. METHODS: High-speed counter-current chromatography (HSCCC) coupled with gas chromatography-mass spectrometry and a panel of laboratory MRSA strains were used for checkerboard and efflux inhibitory assays. KEY FINDINGS: Linoleic and oleic acids were identified from HSCCC fraction 18 of PO with synergistic antibacterial activity when combined with erythromycin against RN4220/pUL5054. Ethidium bromide efflux inhibitory studies revealed that linoleic and oleic acids may interfere the activity of MsrA pump. By comparing among a panel of linoleic and oleic acids analogues, unsaturated fatty acids in salt form with cis configuration and an increase in number of double bonds were found to further increase the antibacterial activity when used alone or in combination with antibiotics. CONCLUSION: This study reported for the first time that two active ingredients, namely linoleic and oleic acids, were identified from PO with synergistic antibacterial activity when combined with erythromycin against MRSA RN4220/pUL5054 and possibly act by inhibiting the efflux pumps of the bacteria cells.

The value of the 24-h delayed abdominal radiograph of barium enema in the diagnosis of Hirschsprung's disease.

AIM OF STUDY: The objective of this study is to determine the diagnostic value of the 24-h delayed film for Hirschsprung's disease (HD). Other features of the barium enema were also examined, in particular the correlation between the radiological transition zone (TZ) and the final pathology. METHODS: All patients with suspected HD from 2003 to 2013 who had undergone barium enema and rectal biopsy were reviewed retrospectively to study the correlation between radiological features of barium enema with the final diagnosis as well as severity. RESULTS: A total of 182 patients were admitted for suspected HD during the study period, of which 82 had both investigations done. 68 patients had radiological features suggestive of the disease and ultimately, 12 patients had the disease confirmed with rectal biopsy. Among those without radiological features of HD, 2 patients were found to have the disease. Thus, the sensitivity of the 24-h delayed film was 85.7 % and the specificity was 17.6 %. The positive predictive value (PPV) of this test was 20.6 % and the negative predictive value (NPV) was 85.7 %. Regarding the level of TZ, it was not detected in the barium enema in 7 (50 %) out of the 14 patients. For those with the presence of TZ, 6 (85.7 %) of them correlated well with the intra-operative findings and 4 (57.1 %) of them correlated well with the final histology. CONCLUSION: The 24-h delayed film of barium enema has a high NPV and is useful to rule out HD. However, rectal biopsy is still suggested for disease confirmation given its low PPV. Lastly, once present, the level of radiological TZ is also a useful predictor for the actual disease involvement.

Long-term effects of early-life dietary L-carnitine on lymphoid organs and immune responses in Leghorn-type chickens.

The long-term effects of supplementing Leghorn-type chickens with dietary L-carnitine after hatching for 4 weeks on growth, lymphoid organ weights, humoral and cell-mediated immune responses were assessed in a 12-week study. A commercial starter feed supplemented with 0 (control), 100 (LC) or 1,000 (HC) mg L-carnitine/kg was offered to day-old ISA Brown cockerels for 4 weeks, then all birds were given a commercial pullet grower feed for another 8 weeks. No differences (p > 0.05) in growth rates, feed intake or feed utilisation efficiency existed among the dietary treatments throughout the study. Compared with control birds, HC-fed birds had a lower (p < 0.05) thymus weight relative to bodyweight (BW) at Week 4, but a higher (p < 0.05) relative thymus weight at Week 12. A higher (p < 0.05) serum primary antibody response to sheep red blood cells (SRBC) in HC-fed birds than in the other two groups was also detected at Week 12. Relative spleen or bursa weights and cutaneous responses of toe webs to phytohaemagglutimin (PHA) (an in vivo indicator of cell-mediated immune responses) did not differ (p > 0.05) among dietary treatments at any time. It is concluded that a short-term supply of dietary L-carnitine to a conventional commercial feed after hatching enhanced subsequent humoral immunity in Leghorn-type chickens. Further study is warranted to confirm such a long-term effect.

Long-term effects of early life L-arginine supplementation on growth performance, lymphoid organs and immune responses in Leghorn-type chickens.

The effects of a short-term dietary arginine supplementation after hatching on subsequent growth and the immune system were assessed in growing male Leghorn-type chickens. An arginine-deficient basal diet (67 g/kg) supplemented with 0 (control), 2.7 (LA) or 5.4 (HA) g L-arginine/kg, was offered ad libitum to 1-d-old male ISA Brown chicks for 4 weeks, then all birds were offered ad libitum a commercial pullet grower feed (8.9 g arginine/kg) for another 8 weeks. Supplemented birds had higher growth rates and feed intake than control birds during the 4-week supplementation period, but these effects did not persist into the subsequent periods. When the supplementation ceased at week 4, no differences in lymphoid organ weights relative to body weight (BW), primary serum antibody levels against sheep red blood cells (SRBC) or cutaneous reactivity of toe webs to phytohaemagglutinin (PHA) were detected. LA-fed birds had lower immunoglobulin (Ig) G levels against bovine serum albumin (BSA) than the control at week 4, but this effect did not persist at weeks 8 and 12. No difference in anti-BSA IgM levels was detected among birds at week 4; at week 12, however, the LA-fed birds had a significantly higher anti-BSA IgM level than the control. An increased anti-SRBC antibody level and a reduced relative bursa weight in HA-fed birds were evident at week 8, without any prior effects. It is concluded that short-term supplementary L-arginine had minimal effects on immunity, but some enhancement of SRBC antibody responses in later stages of growth was observed with previous L-arginine administration.

Carry-over effects of dietary yeast RNA as a source of nucleotides on lymphoid organs and immune responses in Leghorn-type chickens.

1. The carry-over effects of supplementing Leghorn-type chickens with yeast RNA as a dietary source of nucleotides for 4 weeks on growth, lymphoid organ weights and immune responses were assessed in a 12-week study. 2. A commercial starter feed supplemented with 0 (control), 5 (LR) or 10 (HR) g yeast RNA/kg was offered to 1-d-old male ISA Brown chicks for 4 weeks, and then all birds were given a commercial pullet grower feed for another 8 weeks. Growth performance, antibody responses to sheep red blood cells (SRBC) and cutaneous reactivity of toe webs to phytohaemagglutinin (PHA)-M were measured at 4-week intervals. 3. Growth rates, feed intake and feed efficiency were not affected by dietary yeast RNA during the supplementary period, but birds previously offered the HR diet grew faster than control birds during weeks 4 to 8.4. LR-fed birds had a higher spleen weight relative to body weight (BW) than control birds at week 4, but this effect was not detected at other times. 5. Serum primary antibody levels against SRBC were not affected by dietary yeast RNA at any time. 6. The toe-web PHA response was significantly higher at week 8 in control birds than in birds previously given the LR diet, although no difference among dietary treatments was observed at other times. 7. It is concluded that the addition of yeast RNA as a source of nucleotides to a commercial diet selectively stimulated the development of the spleen in young birds, but this effect did not persist into a later stage of the bird's life.

Biosynthetic studies on the tropane ring system of the tropane alkaloids from Datura stramonium.

Isotopic labelling experiments have been carried out in Datura stramonium root cultures with the following isotopically labelled precursors; [2H3]- [2-13C, 2H3]-, [1-13C, 18O2]-acetates, 2H2O, [2H3-methyl]-methionine, [2-13C]-phenyllactate, [3-2H]-tropine and [2'-13C, 3-2H]-littorine. The study explored the incorporation of isotope into the tropane ring system of littorine 1 and hyoscyamine 2 and revealed that deuterium from acetate is incorporated only into C-6 and C-7, and not into C-2 and C-4 as previously reported. Oxygen-18 was not retained at a detectable level into the C(3)-O bond from [1-13C, 18O2]-acetate. The intramolecular nature of the rearrangement of littorine 1 to hyoscyamine 2 is revealed again by a labelling study using [2'-13C, 3-2H]-littorine, [2-13C]-phenyllactate and [3-2H]-tropine.

Influence of whey and purified whey proteins on neutrophil functions in sheep.

The effects of ruminant whey and its purified fractions on neutrophil chemotaxis and superoxide production in sheep were studied. Both colostral whey and milk whey were found to inhibit chemotaxis regardless of whether they were autologous or homologous, but the inhibitory effects were abolished by washing neutrophils with culture medium before their use in the chemotaxis assay. Colostral whey and milk whey also inhibited the chemotactic activity of zymosan-activated serum. Whey fractions of various degrees of purity such as lactoferrin, lactoperoxidase, lactoferrin-lactoperoxidase, alpha-lactalbumin, bovine serum albumin and whey protein concentrate were then studied. While none of these proteins showed any effects on chemotaxis, lactoferrin-lactoperoxidase and whey protein concentrate were found to have an enhancing effect on superoxide production in a dose-dependent manner. Our results provide information on the modulatory role of ruminant milk proteins in inflammatory responses and warrant future investigation.

Immunomodulatory activities of whey fractions in efferent prefemoral lymph of sheep.

Studies on the immunomodulatory activities of ruminant milk and colostral whey fractions were undertaken. By comparing with boiled colostral whey in a preliminary experiment, a putative heat-labile immunostimulatory factor for antibody responses was found to be present in ovine colostral whey. Studies were then undertaken in sheep in which the efferent prefemoral lymphatic ducts were cannulated bilaterally, and immune responses in the node were measured following subcutaneous injection in the flank fold of whey protein preparations of various purities. A significant sustained decline of efferent lymphocyte output was observed following injection with autologous crude milk whey or colostral whey preparations, but no changes were observed in interferon-gamma levels in lymph plasma. Two bovine milk whey fractions (lactoperoxidase and lactoferrin) of high purity were compared in bilaterally cannulated sheep. A transient decline over the first 6 h was seen in the efferent lymphocyte output and lymph flow rate after injection of both fractions. A significant difference was seen between the two fractions in interferon-gamma levels in lymph at 6 h after injection. However, no significant changes in the proportion of the various efferent lymphocyte phenotypes were seen following either treatment. Whereas both fractions showed a significant inhibitory effect in a dose-dependent manner on the proliferative response of T lymphocytes, but not B lymphocytes, to mitogenic stimulation in vitro, no similar changes were seen following in vivo stimulation with these two fractions.