MRI defecography of the ileal pouch-anal anastomosis-contributes little to the understanding of functional outcome.

PURPOSE: Variability in functional outcome after ileal pouch-anal anastomosis (IPAA) is to a large extent unexplained. The aim of this study was to use MRI to evaluate the morphology, emptying pattern and other pathology that may explain differences in functional outcome between well-functioning and poorly functioning pouch patients. A secondary aim was to establish a reference of normal MRI findings in pelvic pouch patients. METHODS: From a previous study, the best and worst functioning patients undergoing IPAA surgery between 2000 and 2013 had been identified and examined with manovolumetric tests (N = 47). The patients were invited to do a pelvic MRI investigating pouch morphology and emptying patterns, followed by a pouch endoscopy. RESULTS: Forty-three patients underwent MRI examination. We found no significant morphological or dynamic differences between the well-functioning and poorly functioning pouch patients. There was no correlation between urge volume and the volume of the bony pelvis, and no correlation between emptying difficulties or leakage and dynamic MRI findings. Morphological MRI signs of inflammation were present in the majority of patients and were not correlated to histological signs of inflammation. Of the radiological signs of inflammation, only pouch wall thickness correlated to endoscopic pouchitis disease activity index scores. CONCLUSION: It seems MRI does not increase the understanding of factors contributing to functional outcome after ileal pouch-anal anastomosis. Unless there is a clinical suspicion of perianal/peripouch disease or pelvic sepsis, MRI does not add value as a diagnostic tool for pelvic pouch patients. Endoscopy remains the golden standard for diagnosing pouch inflammation.

Restorative proctocolectomy with two different pouch designs: few complications with good function.

AIM: The object of this study was to compare function and quality of life after restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) surgery having two different pouch designs. METHOD: Patients having RPC in an academic unit from 2000 who had had the loop-ileostomy closed by June 2013 were identified from the hospital medical records. They were sent a questionnaire regarding quality of life and interviewed using a pouch function score (PFS) described by Oresland (score 0-16, higher scores denote worse function). RESULTS: One hundred and three patients underwent surgery, of whom 56 had a J-pouch design and 47 a K-pouch design, this being a double-folded Kock pouch without the nipple valve. No patients have had the pouch removed or defunctioned due to failure at a mean of 8 years. The reoperation rate was 11.6%. The mean PFS was 5.43 and 5.27 for J- and K-pouches, respectively (P = 0.766). More patients with a J-pouch reported a social handicap due to poor bowel function (P = 0.041). Patients with a PFS ≥ 8 had a poorer quality of life. A score of ≥ 8 was reported by 16% of K-pouch and 25% of J-pouch patients (P = 0.29). CONCLUSION: RPC is a safe procedure with a low complication rate and good functional outcome. Small improvements in function have an impact on a patient's quality of life. Although the J-pouch is the most commonly used, the K-pouch has some advantages. Other pouch designs deserve further evaluation.

Complications in surgery for Crohn's disease after preoperative antitumour necrosis factor therapy.

BACKGROUND: The use of biological therapy (biologicals) is established in the treatment of Crohn's disease. This study aimed to determine whether preoperative treatment with biologicals is associated with an increased rate of complications following surgery for Crohn's disease with intestinal anastomosis. METHODS: All patients receiving biologicals and undergoing abdominal surgery with anastomosis or strictureplasty were identified at six tertiary referral centres. Demographic data, and preoperative, operative and postoperative details were registered. Patients who were treated with biologicals within 2 months before surgery were compared with a control group who were not. Postoperative complications were classified according to anastomotic, infectious or other complications, and graded according to the Clavien-Dindo classification. RESULTS: Some 111 patients treated with biologicals within 2 months before surgery were compared with 187 patients in the control group. The groups were well matched. There were no differences between the treatment and control groups in the rate of complications of any type (34·2 versus 28·9 per cent respectively; P = 0·402), anastomotic complications (7·2 versus 8·0 per cent; P = 0·976) and non-anastomotic infectious complications (16·2 versus 13·9 per cent; P = 0·586). In univariable regression analysis, biologicals were not associated with an increased risk of any complication (odds ratio (OR) 1·33, 95 per cent confidence interval 0·81 to 2·20), anastomotic complication (OR 0·89, 0·37 to 2·17) or infectious complication (OR 1·09, 0·62 to 1·91). CONCLUSION: Treatment with biologicals within 2 months of surgery for Crohn's disease with intestinal anastomosis was not associated with an increased risk of complications.

Factors in fish modifying methylmercury toxicity and metabolism.

We report here some results of a long-term (19 month) study with cats fed methylmercury (MeHg) in nutritionally balanced diets based on fish. By using either freshwater pike (low in Se) or canned tuna (high in Se) as the major protein source, basal diets with low levels of MeHg were prepared having different Se content, all Se being of natural origin. The basal diets produced no signs of toxicity or pathological changes over the l9-month period. In cats fed basal diets spiked with medium or high levels of MeHg, evidence for delayed onset of toxic effects from the added MeHg was observed with the tuna diets compared to pike diets. In brain, muscle, and blood, the activity of GSH peroxidase, a selenoenzyme, was decreased by Hg. In liver, substantial accumulation of Hg with Se occured (molar Hg/Se ratio approximately 1.4 to 1.8) but GSH peroxidase activity was unaffected. We suggest that the coaccumulation of Hg and Se in liver measures the extent to which MeHg has been metabolically transformed by metabolism to Hg++, and inactivated by deposition as a Hg/Se complex of low bioavailability. The accumulation of Hg and Se in liver was much greater in cats fed tuna compared to pike, out of proportion to the relatively small differences in Hg and Se content of the tuna and pike basal diets. Some mechanisms are described by which selenium, vitamin E, and other factors might facilitate MeHg breakdown to inorganic Hg during long term low level exposure to MeHg.

Molybdenum but not copper counteracts cysteine-induced tibial dyschondroplasia in broiler chicks.

Studies were conducted to evaluate the ability of copper and molybdenum to prevent cysteine-induced tibial dyschondroplasia in broiler chicks. Experiment 1 was a 3 x 3 factorial arrangement of treatments used to investigate the interaction between Cu (0, 150 or 300 mg/kg diet) and Mo (0, 10, or 100 mg/kg diet) on cysteine-induced tibial dyschondroplasia. Molybdenum at both supplemental levels, but not Cu, prevented cysteine-induced tibial dyschondroplasia. In Experiment 2 (a 3 x 3 factorial arrangement of treatments with 0, 5 or 10 g/kg diet of cysteine and 0, 10 or 100 mg/kg diet of Mo), Mo prevented cysteine-induced but not spontaneous tibial dyschondroplasia. Cysteine and Mo did not affect the mechanical properties of the tibiotarsus. In Experiment 3, cysteine (0 or 10 g/kg diet) and Mo (0 or 100 mg/kg diet) were used to study the tissue concentrations of mineral and hepatic sulfite oxidase activity. Supplemental Mo increased Mo concentrations in the plasma and liver. Cysteine prevented these increases; however, cysteine, in the absence of supplemental Mo, did not affect concentrations of Mo in these tissues. Dietary cysteine and/or Mo did not affect tissue levels of Cu. We conclude that Mo prevents cysteine-induced tibial dyschondroplasia and that the induction of tibial dyschondroplasia by cysteine is not related to the Mo and Cu deficiency.

A feather-sexed strain of laying hens was more responsive to dietary supplements of choline and methionine than a vent-sexed strain.

A response surface design was used to study Cho and Met interactions with corn and soybean diets, using two strains of hens. The strains were a feather-sexed line (FS strain), and a vent-sexed line (SS strain). The diets contained 3% meat and bone meal and, on chemical analysis, 15.1% crude protein, .29% Met, .225% Cys, and 1,041 ppm of Cho. Nine diets were fed from 20 to 68 wk of age, using added Met levels ranging from 0 to 500 ppm and added Cho levels ranging from 0 to 1,500 ppm, to fix the design points. The FS strain consumed significantly more feed per day (117 versus 108 g) than the SS strain, but there were no significant differences for the 24 to 68 wk period in egg production, egg weight, or feed per dozen eggs. Three and five combinations of Met and Cho were significant in improving egg production (P less than .05) out of the eight combinations for the SS and FS strains, respectively. The best egg production for the FS strain for the period 24 to 68 wk was observed at 250 ppm Met and 1,500 ppm Cho, or 427 ppm Met and 220 ppm added Cho. The SS strain showed no significant (P greater than .05) dietary responses in egg production between 250 ppm Met and no Cho, or 427 ppm Met and either 220 or 1,280 ppm Cho. The SS strain showed no significant (P greater than .05) dietary response in egg weight to either Cho or Met.(ABSTRACT TRUNCATED AT 250 WORDS)

Wheat middlings as an alternative feedstuff for laying hens.

Three long-term experiments were conducted to evaluate the possibility of using wheat middlings (WM) for laying hens and to study the responses of six strains of commercial laying hens fed WM diet. In Experiment 1,320 layers maintained in floor pens were fed diets containing 45% WM with .25 or .75% salt, or 89% WM with .25% or 1.5% salt. Salt supplementation did not show any beneficial effect on egg production. Hen-day egg production by hens fed the 45% WM diet was significantly higher for hens fed 45% WM than for those fed the 89% WM diet (79 versus 67.5%, 44-wk period). Feed, limestone, and water intakes were increased by the 89% WM diet. Yolk color, Haugh units, hen livability, and reproductive parameters were not different among the dietary treatments. In Experiments 2 and 3, laying hens from six commercial strains (four strains each experiment, 240 hens per strain) were maintained in laying cages in each year, and fed either a corn and soybean meal (CSM) or a 25% WM diet. Results show that neither diet nor strain had effects on hen-day egg production; however, egg weights from Strains A, C, and F were heavier than those from Strains B, D, and E. Feed intakes and feed utilizations were similar among the s trains. The 25% WM diet increased egg weight, feed intake, and feed utilization compared with the CSM diet. Livability of hens was 93.8 to 97.5% and was not affected by either strain or diet. It is concluded that commercial strains of laying hens can be fed diets containing 25 to 45% WM and still have normal hen-day egg production although feed utilization will be poorer.

Feed consumption of egg strain pullets at onset of lay.

An experiment was conducted to investigate the performance of four strains of commercial egg type pullets (A, B, C, and D) from 19 to 30 wk of age. The feed consumption differences during this period as well as feed consumption patterns 10 days prior to and after the first oviposition were of special interest. Two hundred and sixty-four birds (66 birds per strain) were fed a diet formulated to contain 2,750 kcal/kg ME, 17% CP, and 3.4% calcium. Results show that the average age to the first egg and percentage of hen-day egg production were not significantly different among the four strains of birds. However, egg weights of Strain A and C birds were significantly heavier than those of the Strain B and D birds. The birds from Strains B and D had significantly lower body weight than Strain A birds at the end of 18 wk, but body weights were not significantly different at the end of 30 wk. Feed intake per bird per day of pullets from Strains A and C was generally higher than that of those from Strains B and D in the first and second 4-wk period. Some of the consumption differences were significant. Feed intake in the third period (27 to 30 wk) was similar for the four strains of birds. Although different strains showed different feed consumption patterns around the first oviposition, all strains showed a drop on the day of the first oviposition. When the strains were combined, feed consumption was lower on that day than during the 8 days prior to the first oviposition.

Hatching eggs sanitized with chlorine dioxide foam: egg hatchability and bactericidal properties.

The efficacy of chlorine dioxide (ClO2) as an alternative sanitizing agent for hatching eggs was investigated because of the health concerns about formaldehyde fumigation. Hatchability of chicken eggs was reduced when the eggs were dipped in the ClO2 solutions for more than 5 minutes or in concentrations greater than 100 ppm Cl. However, treating hatching eggs with a ClO2 foam or fumigating with formaldehyde had no adverse effect on hatchability compared with untreated control eggs. Sanitizing soiled duck eggs with ClO2 foam improved hatchability by more than 10% and hatch by more than 6% compared with untreated eggs (P less than 0.05). A novel method for assessing bactericidal potential of egg-sanitizing agents was developed. Using this technique, both chlorine dioxide foam and formaldehyde fumigation reduced the number of egg-contaminant bacteria inoculated on sterile chicken eggs compared with the number of bacteria on untreated eggs (P less than 0.05). These findings suggest that sanitizing hatching eggs with ClO2 foam may be a viable alternative to fumigating with formaldehyde.

Water consumption and fecal moisture of laying hens fed wheat middlings and corn-soybean-alfalfa meal diets.

Hens, housed on the floor and fed a diet containing 89% wheat middlings (WM) either as mash or pellets, consumed more feed and water than hens fed corn-soybean meal-alfalfa meal (CSA) diets with either .15, .50, or .75%. NaCl. Moisture content of the hens' feces was not affected by mash or pellet processing of the WM diet. Feeding the .75% NaCl-CSA diet, however, significantly increased fecal moisture beyond that observed with the other treatments. Caged layers fed the WM diet voided more feces (2.6 fold) than did caged layers fed the .50% NaCl-CSA diet, suggesting that wet litter problems observed in the floor pens of birds fed WM were the result of a greater fecal volume voided rather than a higher moisture content per unit of feces.

Alterations in phospholipid composition of egg yolks from laying hens fed choline and methionine-supplemented diets.

A trial was conducted to assess the effects of choline and methionine supplementation of the diets of hens on phospholipid composition of egg yolk. By chemical analysis, the basal diet contained 16.6% protein, 1,041 parts per million (ppm) of choline, and .53% TSAA. The energy level was 2,899 kcal ME/kg diet, with no added fat. A rapid isocratic HPLC procedure using a Waters mu Bond-NH2 column (Waters Associates, Milford, MA) was developed to quantify phospholipid components. Analysis of egg samples at peak production (36 wk of age) showed significant (P less than .05) elevations in total phospholipids, phosphatidylcholine (PC), and the ratio of PC to phosphatidylethanolamine (PE), when choline was added at 500 or 1,000 ppm. Phosphatidylethanolamine, in contrast, showed a decline with choline supplementation. Methionine supplementation (125 to 250 ppm) also caused elevations in the total phospholipid composition of the egg yolk but had only modest effects on PC and PE. There was a significant (P less than .05) correlation between the yolk weight and total phospholipid concentration, PC, and the PC:PE ratio. There was a relationship between phospholipid content and weight of eggs when diets of laying hens were supplemented with choline.

Lack of response of bone mineralization of chicks fed egg yolks from hens on dietary 1,25 dihydroxycholecalciferol.

White Leghorn hens, age 34 wk, fed 0 to 3 micrograms/kg of 1,25 dihydroxycholecalciferol (1,25(OH)2D3) as the only source of dietary vitamin D3 with 2.5 or 3.5% calcium failed to achieve normal embryonic survival and hatchability of their fertile eggs. Improved egg production was observed over a 24-wk period as the level of 1,25(OH)2D3 was increased. Eggs of hens fed the vitamin D-deficient diet showed significantly lower (P less than .01) egg weight and shell strength with a higher percent of soft shell eggs than those of hens fed 1,25(OH)2D3 or vitamin D3. To study the possibility that 1,25(OH)2D3 cannot be transferred into the egg yolk, yolks from the hens receiving varying levels of 1,25(OH)2D3 and vitamin D3 were fed to day-old chicks. A standard vitamin D3 assay was developed and bone ash was determined on fat-free tibial bone. Significantly lower (P less than .01) vitamin D activity per gram of yolk was observed in yolks from hens fed 0 to 3 micrograms of 1,25(OH)2D3 than in yolks of hens fed vitamin D3. These results demonstrate that insufficient 1,25(OH)2D3 is incorporated in the egg yolk to support normal embryonic survival and hatchability. This may be due to a decrease in available receptor sites in the egg yolk or to the inability of 1,25(OH)2D3 to cross the vitelline membrane.

Identification of volatile sulfur derivatives released from feathers of chicks fed diets with various levels of sulfur-containing amino acids.

Physical changes are observed in the feathers of chickens fed diets with high levels of methionine or cysteine. Chicks were fed diets chemically analyzed to contain 21% crude protein, 0.35% methionine and 0.37% cystine (basal) supplemented with DL-methionine [0.063 (control), 0.25 or 1.45%] or L-cysteine (0.203%). At 3 wk of age, the birds were weighed and the feathers scored for softness. Feather strength (i.e., force-displacement curves) was determined on feathers from the pectoral tract. A significant (P less than 0.05) reduction in body weight and an increase in feather softness were seen when chicks fed the control diet and those fed the diet with 1.45% added methionine were compared. Chicks fed the diet supplemented with 0.203% L-cysteine produced the strongest feathers; those fed diets supplemented with 1.45% DL-methionine produced the weakest feathers. Volatile sulfur compounds released from the feathers were trapped as dinitrophenyl (DNP) thioethers and were analyzed by thin-layer chromatography, high pressure liquid chromatography and mass spectrometry. More bound sulfide (P less than 0.05) was recovered from feathers of chickens fed the diet supplemented with 1.45% methionine than from feathers of chickens fed the other diets. The feather softness score was correlated (r = 0.5; P less than 0.05) with bound sulfide. Thus, consumption of a diet with a level of methionine that is approximately three times the requirement resulted in decreased growth, elevated sulfide bound to the feathers and soft, weak feathers.

Critical vitamin supplementation of broiler diets high in alfalfa juice protein.

Three trials were conducted to identify the critical vitamins in the diets of broiler-strain chicks fed alfalfa juice protein concentrate (AJPC) corn-soy diets from 0 to 3 wk of age. Vitamin supplements were added to AJPC diets. Diets were formulated to contain, parts 30/121, 40/128, 50/135, and 60/142 parts AJPC/parts total diet. Parts were used to permit usage of wet materials and still maintain about 90% dry matter. All diets were formulated to contain 20% crude protein, .93% total sulfur-containing amino acids, and 2,940 kcal metabolizable energy/kg diet. Propionic acid was added at .2% to all diets. Feeds were refrigerated (7 C) and fed out daily. The addition of choline, riboflavin, vitamin B12, vitamin A or E, folic acid, or biotin did not increase weight gains. Addition of 3 mg/kg vitamin B6 completely overcame the growth depression caused by the 50-parts AJPC diet and significant (P less than .05) growth increases (13 to 29%) were achieved with vitamin-B6 supplementation to the 60-parts AJPC diet. Depressed immune responses were completely prevented by the addition of 3 mg/kg of vitamin B6. The significant (P less than .05) increases in leg deformities observed in birds fed the 60-parts AJPC diet were also brought back to more typical values in birds fed the diet supplemented with 3 mg/kg vitamin B6. Vitamin K supplementation (.53 mg/kg) to the 60-parts AJPC diet resulted in significant decreases from 15 min in blood clotting times to 3 to 5 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Assessment of softness properties of feathers.

An instrument to be called the "Crimp Meter" was designed and used with a conventional balance to enable the plotting of a force-displacement curve for individual feathers. A comparison of the curves described by different feathers was made by regression analysis. The type of curve described by a feather is characteristic of its tensile properties and its degree of softness. This procedure was employed to objectively confirm the observation that chicks fed toxic levels of methionine (1.45% added) in corn-soybean diets had significantly softer (P less than .001) feathers than those fed nontoxic levels of cysteine (.203% added). The basal diet was analyzed and found to contain .35% methionine and .37% cystine. This device had potential for the down-feather, wool, and fabric industries.

Efficacy of cysteine in replacing methionine in the immune responses of broiler chicks.

Two trials were conducted to compare the effects of supplements of methionine and cysteine on the growth and immune responses of broiler chicks fed corn-soy diets. The basal diet contained 21% crude protein, 3,255 kcal metabolizable energy/kg diet, .35% methionine, .37% cysteine, and .13% choline. Additions to the basal diet were methionine (.063, .25, .85, and 1.45%), or cysteine (.203%), or a combination of methionine (.063%) and cysteine (.153%). Total antibody and 2-mercaptoethanol-resistant antibodies, immunoglobulin G (IgG), were determined in chicks inoculated intraperitoneally at 14 days of age and serially bled at 4, 7, and 10 days postinoculation. Thymus-derived (T)-cell-dependent in vivo mitogen response to phytohemagglutinin-P (PHA-P) was assessed via wing web swelling. The methionine requirement for growth (0 to 3 wk of age) was found to be no more than .413% of the diet (.35% in the basal diet plus .063% added). Addition of 1.45% methionine to the basal diet resulted in significant depression (P less than .05) in growth. The antibody responses generally peaked at 7 days postprimary inoculation. Both methionine and cystine supplementation at low levels resulted in improvement in the cell mediated PHA-P responses as well as in the IgG (T-cell-dependent) responses. High supplemental methionine (1.45%), however, caused significant (P less than .05) depressions in both responses. Equimolar additions of methionine and cysteine (16.8 mmol/kg diet) showed that cysteine was about 84 and 70% as efficacious as methionine in the IgG and the PHA-P stimulation (PHA-I), respectively, in healthy chicks.(ABSTRACT TRUNCATED AT 250 WORDS)

Enhanced immune responses in broiler chicks fed methionine-supplemented diets.

Effects of feeding supplementary methionine and choline on broiler growth and immunity were examined by supplementing a corn-soybean diet that contained 21% crude protein, 3,255 kcal metabolizable energy/kg diet, .35% methionine, .37% cystine, and .13% choline. Methionine (.063, .125, .25%) and choline (.125, .25%) were dietary variables. Sulfate (.055%) was added either alone or along with methionine (.125 or .25%) and choline (.125%). In one study, the .25% methionine diet was supplemented with .121% betaine. Sodium and chloride levels were constant in all the diets. Feed and distilled water were supplied ad libitum. Total antibodies, immunoglobulin (Ig) G (2-mercaptoethanol-resistant antibodies) and IgM (2-mercaptoethanol-sensitive antibodies) were determined in 3-wk-old chicks inoculated intraperitoneally with sheep red blood cells. The thymus-derived (T)-cell-dependent in vivo mitogen response to phytohemagglutinin-P (PHA-P) was assessed via wing web swelling. The methionine requirement for growth (0 to 3 wk of age) was approximately .413% of the diet (.35% in the basal diet plus .063% added). Supplementation of the basal diet with .125% choline stimulated growth to the same extent as did the extra .063% of methionine. Addition of .055% sulfate with .125% choline did not improve the ability of the latter to spare methionine. Supplemental methionine resulted in significant (P less than .05) dose-related increases in total antibody, IgG, and response to the mitogen PHA-P, but not in IgM. There were no effects of choline on the immune variables studied. These results suggest that methionine is required for select components of the antibody response, which effect might be related to T-cell help.

Lighting and sex ratio for breeding ringnecked pheasants in confined housing.

In two trials with breeding pheasants, pheasants were assigned to two male:female sex ratios (1:12 and 1:18) arranged factorially with two lighting regimens (14 or 16 hr of light) in a 24-hr period. In each trial, 1644 or 1680 pheasant hens divided in two replicates were assigned to each experimental treatment and placed in controlled environment housing. Hen mortality, percent culled eggs, total eggs per hen-housed, fertility, hatchability, and usable chicks per hen-housed were determined over a 9-week production period. Although mortality and percent hatch were not affected by either sex ratio or lighting, percent culled eggs increased with increased light (16 hr light) and usable chicks per hen-housed decreased with increased light. Increasing the sex ratio from 1:12 to 1:18 increased egg production but decreased fertility. These data demonstrate that pheasants reared in a controlled environment require less than 16 hr light for maximizing usable chick production per hen-housed and there is a trade-off between fertility and egg production.