Chromium concentrations in ruminant feed ingredients.

Chromium (Cr), in the form of Cr propionate, has been permitted for supplementation to cattle diets in the United States at levels up to 0.50 mg of Cr/kg of DM since 2009. Little is known regarding Cr concentrations naturally present in practical feed ingredients. The present study was conducted to determine Cr concentrations in feed ingredients commonly fed to ruminants. Feed ingredients were collected from dairy farms, feed mills, grain bins, and university research farms. Mean Cr concentrations in whole cereal grains ranged from 0.025 mg/kg of DM for oats to 0.041 mg/kg of DM for wheat. Grinding whole samples of corn, soybeans, and wheat through a stainless steel Wiley mill screen greatly increased analyzed Cr concentrations. Harvested forages had greater Cr concentrations than concentrates, and alfalfa hay or haylage had greater Cr concentrations than grass hay or corn silage. Chromium in alfalfa hay or haylage (n = 13) averaged 0.522 mg/kg of DM, with a range of 0.199 to 0.889 mg/kg of DM. Corn silage (n = 21) averaged 0.220 mg of Cr/kg of DM with a range of 0.105 to 0.441 mg of Cr/kg of DM. By-product feeds ranged from 0.040 mg of Cr/kg of DM for cottonseed hulls to 1.222 mg of Cr/kg of DM for beet pulp. Of the feed ingredients analyzed, feed grade phosphate sources had the greatest Cr concentration (135.0 mg/kg). Most ruminant feedstuffs and feed ingredients had less than 0.50 mg of Cr/kg of DM. Much of the analyzed total Cr in feed ingredients appears to be due to Cr contamination from soil or metal contact during harvesting, processing, or both.

Chromium propionate in broilers: effect on insulin sensitivity.

The objective of this study was to evaluate the effects of dietary chromium (Cr), as chromium propionate, on measures of insulin sensitivity. Liver and muscle glycogen, and plasma glucose and non-esterified fatty acid (NEFA) concentrations were used as indicators of insulin sensitivity. In total, 288 newly hatched male Ross broilers were divided into 4 dietary treatments consisting of 0 (control diet analyzed 0.43 to 0.45 mg Cr/kg), 0.2, 0.4, or 0.6 mg supplemental Cr/kg diet, resulting in 4 treatments with 9 replicate pens per treatment containing eight birds per pen. At d 21, 2 birds per cage were removed based on the greatest deviation from pen mean BW, resulting in each pen containing 6 birds for the final analyses. Final BW were taken on d 40, and on d 42 two birds from each pen were sampled for plasma NEFA, glucose, and muscle and liver glycogen determination at the initiation and termination of a 22 h fast. The remaining 2 fasted birds were sampled after a 30 min refeeding period. No differences were observed in feed intake, BW gain, or feed efficiency on d 21 or d 40. Liver glycogen tended (P=0.10) to be greater in Cr-supplemented chicks in the fed state, and muscle glycogen concentrations tended (P=0.07) to be greater in Cr-supplemented chicks compared with controls following fasting and refeeding. Plasma glucose concentrations were not affected by dietary Cr in the fed, fasted, or refed state. Plasma NEFA levels were not affected by treatment in fed or fasted birds. However, plasma NEFA concentrations were lower (P<0.01) in chicks supplemented with Cr than in controls following fasting and refeeding, suggesting that Cr increased insulin sensitivity. No differences were detected among birds supplemented with 0.2 or 0.4 mg Cr/kg, and among those receiving 0.4 or 0.6 mg Cr/kg. Results of this study indicate that Cr propionate supplementation of a control diet containing 0.43 to 0.45 mg Cr/kg enhanced insulin sensitivity.

Chromium propionate in turkeys: effect on performance and animal safety.

Two hundred eighty-eight male Nicholas Large White turkey poults were used to determine the effect of supplementing turkeys with chromium propionate (Cr Prop) from 1 to 84 d of age on performance and animal safety. Treatments consisted of Cr prop supplemented to provide 0, 0.2, or 1.0 mg Cr/kg diet. One mg of supplemental Cr is 5 times (x) the minimal concentration of Cr Prop that enhanced insulin sensitivity in turkeys. Each treatment consisted of 8 floor pens with 12 poults per pen. Turkeys were individually weighed initially, and at the end of the starter 1 (d 21), starter 2 (d 42), grower 1 (d 63), and grower 2 phase (d 84). On d 85, blood was collected from the wing vein in heparinized tubes from 2 turkeys per pen for plasma chemistry measurements. A separate blood sample was collected from the same turkeys in tubes containing K2EDTA for hematology measurements. Turkey performance was not affected by treatment during the starter 1 phase. Gain was greater (P = 0.024) and feed/gain lower (P = 0.030) for turkeys supplemented with Cr compared with controls during the starter 2 phase. Over the entire 84-d study turkeys supplemented with Cr had greater (P = 0.005) ADG and tended (P = 0.074) to gain more efficiently than controls. Gain (P = 0.180) and feed/gain (P = 0.511) of turkeys supplemented with 0.2 mg Cr/kg did not differ from those receiving 1.0 mg Cr/kg over the entire 84-d study. Feed intake was not affected by treatment. Body weights of turkeys supplemented with Cr were heavier (P = 0.005) than controls by d 84. Chromium supplementation did not affect hematological measurements and had minimal effect on plasma chemistry variables. Results of this study indicates that Cr Prop supplementation can improve turkey performance, and is safe when supplemented to turkey diets at 5x the minimal concentration that enhanced insulin sensitivity.

Chromium propionate in turkeys: effects on insulin sensitivity.

The objective of this study was to evaluate the effects of dietary chromium (Cr), as Cr propionate (Cr Prop), on measures of insulin sensitivity in turkeys. Plasma glucose and nonesterified fatty acid (NEFA), and liver glycogen concentrations were used as indicators of insulin sensitivity. One-day-old Nicholas Large White female poults (n = 336) were randomly assigned to dietary treatments consisting of 0 (control), 0.2, 0.4, or 0.6 mg supplemental Cr/kg diet. Each treatment consisted of 12 replicate cages with 7 turkeys per cage. Final BW were taken on d 34, and on d 35 two birds from each cage were sampled for plasma glucose and NEFA, and liver glycogen determination at the initiation (fed state) and termination (fasted state) of a 24-h fast. Following a 24-h fast, 2 turkeys per cage were refed (refed state) their treatment diet for 4 h, and then harvested. Feed/gain and ADG did not differ between control and Cr-supplemented turkeys over the 34-d study, but feed intake tended (P = 0.071) to be greater for controls than turkeys receiving 0.4 mg Cr/kg diet. Fed turkeys had greater plasma glucose (P = 0.002) and liver glycogen (P = 0.001) concentrations, and lower (P = 0.001) NEFA concentrations than fasted birds. Turkeys refed after fasting had greater (P = 0.001) plasma glucose and liver glycogen concentrations, and lower (P = 0.001) plasma NEFA levels than fed turkeys. Liver glycogen and plasma NEFA concentrations did not differ among control and Cr-supplemented birds in the fed, fasted, or refed state. Plasma glucose concentrations were not affected by treatment in fed or fasted turkeys. Turkeys supplemented with 0.2 or 0.4 mg Cr/kg and refed after fasting had lower (quadratic, P = 0.038) plasma glucose concentrations than controls. Plasma glucose concentrations in refed birds did not differ among Cr-supplemented turkeys. The lower plasma glucose concentration in Cr-supplemented turkeys following refeeding is consistent with Cr enhancing insulin sensitivity.

Research Note: Chromium propionate for turkeys: effect on tissue chromium concentrations and human food safety.

This study was conducted to determine the effect of supplementing turkey diets with chromium propionate (Cr Prop) on Cr concentrations in tissues consumed by humans. Nicholas White male day-old poults were used in this study. Treatments consisted of 0, 0.20, or 1.0 mg supplemental Cr/kg diet. Each treatment consisted of 8 replicate floor pens with 12 poults housed per pen. Diets were fed ad libitum for 84 d. At the end of the study, 2 turkeys per pen were euthanized and samples of liver, breast muscle, kidney, and skin with adhering fat were collected from a similar location in each bird for Cr analysis. Orthogonal contrasts were used to compare the 2 Cr supplemented treatments to the control (0 added Cr) and 0.20 mg Cr to 1.0 mg Cr/kg diet. When expressed on a DM or wet tissue basis, liver (P = 0.001) and muscle (P = 0.015) Cr concentrations were greater in turkeys supplemented with Cr compared with controls. Chromium concentrations in liver were also greater (P = 0.001) in turkeys supplemented with 1.0 mg Cr/kg than those receiving 0.20 mg Cr/kg. Concentrations of Cr in kidney and skin + fat were not affected by treatment. Considering the adequate intake of Cr established for humans, supplementation of Cr Prop at up to 1.0 mg Cr/kg diet would have minimal effect on total Cr intake by humans.

Chromium propionate enhances insulin sensitivity in growing cattle.

Thirty-six Angus and Angus×Simmental heifers, averaging 291 kg, were used to determine the effects of dietary Cr, in the form of Cr propionate (Cr Prop), on glucose metabolism and serum insulin concentrations following glucose administration. Heifers were stratified by body weight (BW) within a breed and randomly assigned to treatments. Treatments consisted of 0, 3, 6, or 9 mg of supplemental Cr/d from Cr Prop. Based on dry matter (DM) intakes, the daily doses of Cr were equivalent to 0.47, 0.94, and 1.42 mg of supplemental Cr/kg of DM. Heifers were individually fed a corn silage-based diet at a level of 2% of BW. Each heifer was also fed 0.45 kg of a ground corn supplement daily that served as a carrier for supplemental Cr. Glucose tolerance tests were performed on d 44 of the study. Glucose was infused via jugular catheters at a level of 0.45 g/kg of BW(0.75) over a course of 1 to 2 min. Blood samples were collected at -10, 0, 5, 10, 15, 30, 45, 60, 90, 120, 150, and 180 min relative to glucose dosing for glucose and insulin determination. Area under the glucose response curve was lower (1,603 vs. 1,964 mg/dL per minute) in heifers supplemented with Cr from 0 to 45 min following glucose challenge. Serum insulin concentrations were lower in Cr-supplemented heifers than in controls following glucose infusion. The molar ratio of insulin to glucose was also lower in Cr-supplemented heifers relative to controls. Serum insulin and serum insulin to glucose ratios did not differ among heifers supplemented with 3, 6, or 9 mg of Cr/d. Results indicate that Cr Prop supplementation increased tissue sensitivity to insulin in growing heifers. Based on insulin sensitivity, Cr requirements (as Cr Prop) of growing heifers can be met by supplementing with 3 mg of Cr/d or 0.47 mg of Cr/kg of DM.

Effects of supplementing dairy cows with chromium propionate on milk and tissue chromium concentrations.

Eight primiparous and 8 multiparous Holstein cows were used to determine the effects of Cr supplementation, in the form of Cr propionate (Cr Prop), on milk and tissue Cr concentrations. Cows were randomly assigned by parity to one of 2 diets: 1) control diet or 2) 2 mg of supplemental Cr/kg of DM. The level of Cr Prop supplemented exceeded by 4-fold the concentration of 0.5 mg of Cr/kg permitted by the FDA. Experimental diets were fed from approximately 30 d prepartum until at least 91 d postpartum, resulting in a minimum of 121 d of exposure to supplemental Cr. The control prepartum and postpartum diets analyzed 0.48 and 0.38 mg of Cr/kg of DM, respectively. Milk samples were obtained from the a.m. milking on d 0 (colostrum), 7, 14, 21, 28, 42, 56, 77, and 90 and on the final day of the study for Cr analysis. Cows were harvested after lactating for a minimum of 91 d and samples of liver, kidney, semitendinosus muscle, and fat were obtained for Cr analysis. Chromium was measured using electrothermal atomic absorption spectrophotometry. Milk Cr concentration averaged 1.7 ng/mL and was affected by day of lactation but not by Cr or a Cr × day interaction. Supplementation of 2 mg of Cr/kg of DM increased kidney Cr by approximately 3-fold and liver Cr concentrations by approximately 2-fold. Chromium concentrations in muscle and fat were not affected by Cr supplementation. In summary, supplementation of Cr Prop at a level of 2 mg of Cr/kg of DM did not affect Cr concentration in milk, muscle, or fat, the major bovine products consumed by humans.

Chromium propionate in broilers: human food and broiler safety.

Chromium propionate (Cr Prop) is approved by the U.S. Food and Drug Administration Center for Veterinary Medicine for supplementation to broiler diets up to 0.20 mg Cr/kg diet. A 49-D study was conducted to: 1) determine the safety of Cr Prop when supplemented at 2 and 10 times (×) the approved feeding level over the normal life span of broilers, and 2) determine the effects of supplementing Cr Prop on Cr concentrations of tissues consumed by humans. On day zero, 216 Ross 708 broilers were stratified by weight within sex and randomly assigned to treatments. Dietary treatments were 0 (control), 0.40, and 2.0 mg supplemental Cr/kg diet from Cr Prop. There were 6 replicate cages each of male and female broilers per treatment. At the end of the study blood was collected for determination of plasma biochemical measurements and tissue samples were collected for Cr analysis. Supplementing 0.40 mg Cr/kg diet (2×) did not adversely affect broiler performance, mortality, plasma biochemical measurements or Cr concentrations in breast muscle, skin with adhering fat, or liver. Chromium propionate supplemented at 2.0 mg Cr/kg (10×) did not affect Cr concentrations in breast muscle or skin with adhering fat, but increased (P < 0.05) liver Cr concentrations. Supplementing Cr Prop at 10× the approved feeding level decreased feed intake and gain in male but not female broilers from days 21 to 49. Results of this study support the safety of Cr Prop in broiler diets, and indicate that Cr Prop supplementation to broiler diets at 2 or 10× the approved feeding level does not present a human health concern.

Testicular cavernous hemangioma associated with testicular torsion - case report and review of literature.

INTRODUCTION: Testicular neoplasms that are derived from connective tissue, blood vessels and musculature are uncommon and intra-testicular tumors of vascular origin are extremely rare; both are benign in nature. Testicular hemangioma is exceedingly rare and typically occurs in patients younger than 20 years, the age in which a primary germ cell tumor of the testis may present, necessitating a radical approach to management with orchidectomy, although potential conservative focal partial surgical excision is desirable. Hemangiomas of the testis have a similar sonographic and magnetic resonance imaging appearance to that of malignant tumors of the testis, especially seminoma. The work has been reported in line with the SCARE criteria. PRESENTATION OF CASE: We present a case of testicular torsion in a 15-year-old male patient who had a painful left testis for 6 days, no vomiting, no fever or dysuria. With clinical suspicion of an old testicular torsion the patient was examined by ultrasound which confirmed the clinical diagnosis. The patient underwent emergency surgical exploration. The left testis was found to be necrotic after a 360° testicular torsion and an orchiectomy was performed. RESULTS: The postoperative course was uneventful. The patient was discharged on day 4 after surgery. Histology showed a complete ischemic infarction of the testicular parenchyma as part of a ruptured intratesticular cavernous hemangioma. DISCUSSION AND CONCLUSION: Cavernous hemangioma is a rare tumor of the testicle in either childhood or adult period. The particularity of the presented case is the possible association of a cavernous intratesticular hemangioma with the torsion of the testis in a teenager. Clinicians and pathologists must be aware of the rare entity of testicular hemangiomas, as clinical examination and imaging studies do not often suffice to arrive at a correct diagnosis.

[Endoscopic investigations in children under 3 years of age at the clinic of paediatric surgery]. / Endoskopické výkony u detí do 3 let na Klinice detské chirurgie.

BACKGROUND: Retrospective study of gastroscopic investigations in children under 3 years of age. METHODS AND RESULTS: Since 1.1.2002 till 31.10.2004 we performed 119 endoscopic investigations in children of this age. 21 patients were excluded because of missed documentation. The average weight of our children was 11.8 kg. (min. 2.8, max 20 kg). In 55 cases suspicion for the oesophageal or gastric corrosion was the reason of investigations. in 24 cases swallowed alien bodies, in 10 patients we performed dilatation of oesophageal stenosis in repeated sessions in 1-6 moths periods. In 4 children we introduced percutaneous endoscopic gastrostomy (PEG), in 3 children ERCP was performed because of cystic dilatation of the bile duct. In I child the supposed hematemesis was the reason of gastroscopy (negative) and in one patient oesophageal varicula were assumed (negative). CONCLUSIONS: Oesophageal or gastric corrosions were assured in 12 cases (Grade 1.-2.:20.2%). 5 alien bodies couldn't be removed because of peristalsis, 1 object because of its dimensions (25% failures). Our dilations were performed in oesophageal stenosis with bougies or balloon dilator. 9 children were first operated for oesophageal atresia (Vogt IIIb), 1 child was after an operation for oesophageal corrosion with perforation.

[Laparoscopic surgical procedures in children with the Hirschprung's disease--initial experience]. / Laparoskopické operace u detí s Hirschprungovou nemocí--první zkusenosti.

Laparoscopically assisted resection of the large intestine in the Hirschprung's disease patients was introduced into practice worldwide in mid 90-ies of the last century. In the Czech Republic this procedure had not been conducted. The aim of this work was to introduce the method in the Czech Republic. In this study the authors present their initial experience with this new method. They have successfully operated three patients with this disorder.

[Extracorporeal membrane oxygenation. Initial experience at an ECMO center. 1]. / Extracorporeal membrane oxygenation (ECMO). První zkusenosti ECMO centra (1. cást).

The authors describe their initial experience, organization, and problems associated with the development of an EMCO centre. Its main activities are those of a neonatal ECMO centre (to a smaller extent paediatric ECMO and ECCO2R-LF PPV of adults) during the first 4 months of its existence. During the period the ECMO centre was contacted in 10 instances. The referring department indicated the ECMO centre correctly in six instances. However, at least in two instances too late and the patients died (during priming of the ECMO circuit or transport could not be implemented because of the critical condition). In two instances, however, the ECMO staff failed as it was unable to ensure a minimum of seven days of safe operation of ECMO and therefore ECMO was not provided. Based on this experience the authors present an organizational model of the ECMO unit which is formed ad hoc when needed and comprises specialists of various professions from the sphere of emergency medicine. The main purpose of the present paper is to inform referring departments on the indications, selection criteria, contraindications of ECMO in neonates and children and to ensure thus not only smooth communication between the ECMO centre and the referring department but in the first place early referral to the ECMO centre at a time when transport is not yet a problem.

[An unusual esophageal stenosis]. / Neobvyklá stenóza jícnu.

In the submitted case-history the authors describe the case of a child operated after delivery on account of oesophageal atresia type Vogt IIIb. After a two-year interval the child returned on account of acute dysphagia and endoscopy revealed oesophageal stenosis caused by a mucosal strangulating bridge. The latter was removed endoscopically and during a check-up examination 6 months later the endoscopic picture was negative.

[Transcutaneous anorectal sphincteromyectomy--possible use in pediatric anorectal surgery]. / Transkutánní anorektální sfinkteromyektomie--moznost vyuzití v detské anorektální chirurgii.

Anorectal sphincteromyectomy (SME) is a simple operation: after accurate localization of the inner anal sphincter from the latter a longitudinal strip 3-4 cm long and 2-4 mm wide is resected, depending on the child s age. In the submitted paper the author describes the surgical method which is used less frequently although it gives comparable results, it is simple and the number of complications is minimal.

[Laparoscopic surgery of the spleen in children]. / Laparoskopické výkony na slezine u detí.

Laparoscopic operations of the spleen, incl. splenectomy, are increasingly accepted worldwide. The most frequent indications for this type of surgical treatment are haematological diseases (some types of haemolytic anaemia, thrombocytopenia, myeloproliferative syndrome). Another indication for surgery is hypersplenism from other causes such as vascular anomalies or isolated thrombosis of the lienal vein. The reason for urgent or planned laparoscopy may be also traumatic damage of the spleen (haemorrhage, pseudocysts). In the submitted work the authors present their experience with 21 patients where a laparoscopic operation of the spleen was performed. Of 21 children four were laparoscopically operated on account of a mesothelial cyst or posttraumatic pseudocyst of the spleen (ratio 1:3). In another 15 children laparoscopoc splenectomy was performed for haematological reasons (11 x spherocytosis, 3 x idiopathic thrombocytopenic purpura, 1 x autoimmune haemolytic anaemia). Twice the operation was indicated on account of isolated thrombosis of the lienal vein. In three instances a concurrently, also laparoscopic cholecystectomy was performed and in two liver biopsy. On operation 3-5 troacars were used and the patient was placed in a supine position. In no instance preoperative embolization of the lienal arteries was performed. On treatment of cystic structures of the spleen the authors made in three instances total resection of a cyst--in the upper pole of the spleen, in case of a central localization, only 2/3 resection and fixation of the omentum. In resections recently coagulation and Argon spraying was used. The spleen was extracted by morcellation in a plastic bag or via a 5 cm left-sided subcostal incision (2x). The median size of the spleen was 14.4 cm (10-20 cm), of cystic formations 7.25 cm (6-8 cm). The mean period of operation in splenectomy was 146 minutes. In two patients a blood transfusion was necessary (1x splenectomy, 1x resection of the lower third of the spleen). As to complications the authors recorded once major haemorrhage after splenectomy--resolved by the use of Endo GIA stapler. Conversion was not necessary in any of the operations. The mean period of hospitalization was 6 days.

[Percutaneous endoscopic gastrostomy in children]. / Perkutánní endoskopická gastrostomie u detí.

AIM: The authors evaluate their experience with percutaneous endoscopic gastrostomy in children at the age of three months to 14 years. COHORT: Forty three patients treated with this method in the years 1995-2002. METHODS: The percutaneous endoscopic gastrostomy is applied in children under general anesthesia. In two patients only it proved to be necessary to convert to open or laparoscopic gastrostomy. RESULTS: Only minor complications were encountered. CONCLUSIONS: It became obvious that percutaneous endoscopic gastrostomy is a suitable method to provide long-term enteral nutrition in children of child age who may not be nourished sufficiently by natural ways.

[Perineal infiltrates after amputation procedures in carcinoma of the rectum]. / Perineální infiltráty po amputacních výkonech pro karcinom rekta.

The authors present their experience with perineal infiltrates amputations on account of rectal carcinoma. In the course of 1986 in the Oncological Research Institute in Brno 58 patients with this diagnosis were hospitalized. After amputations three types of surgical complications were observed: 1. early inflammatory infiltrations, 2. late abscesses and 3. locoregional relapses of the primary tumour. Local relapses were detected first after five months and not later than three years after the radical operation. The authors draw attention to the fact that the first manifestation of the locoregional progress of the disease was a sensation of pressure or pain, which preceded the development of a resistance on the perineum and fever. The extent of tumourous infiltration was assessed by computed tomography. Reduction of locoregional relapses depends according to authors above all on a comprehensive approach to treatment. The usefulness of adjuvant irradiation is obvious. The authors assume that it is important to decide whether to irradiate before or after operation or to combine both methods and whether too combine irradiation with chemotherapy. Due to difficulties of therapeutic influencing of local relapses they emphasize above all the demand of respecting the rules of oncological surgery during the first operation.

[The first 100 laparoscopic procedures in children]. / Prvních 100 laparoskopických výkonu u detí.

Laparoscopic operations (LO) of adults are performed as a routine in many departments, while LO in children are only at their onset. During September 1994 to May 1995 at the Clinic of Paediatric Surgery and Traumatology in Brno the first 100 LO and two thoracoscopic operations were performed. The group is formed by children aged 3 to 17 years. Their mean age was 10.6 years. The number comprised 14 acute operations, the remainder were planned operations. There was no perioperative fatality. Complications included one abscess of the Douglas bag, once the necessity of minilaparotomy on account of minor haemorrhage after resection of Meckel's diverticulum by means of endoGIA and once because the size of the tumour. Early conversion was necessary in two patients.

[The importance of laparoscopy in children]. / Význam laparoskopie u detí.

The authors submit the evaluation of 720 laparoscopic operations performed at the Clinic of Child Surgery and Traumatology in Brno between the end of 1994 and May 1999. The group is formed by children aged 3 weeks to 18 years. The mean age was 8.4 years. The authors recorded once an early and 4 times a late complication. None of the complications were serious and did not threaten the child's health or life. With regard to ever more frequently performed acute laparoscopy the percentage of conversions (2.5%) is higher. The authors emphasize there is practically no age limit for performing this operation (32 infants and toddlers). On the other hand, perfect technical equipment and adequate training of the whole team is necessary.