Liquid pancreatic enzyme therapy for a patient with short bowel syndrome and chronic pancreatitis in a complicated case of Crohn's disease.

The case of a 45 year old female with multiple complications of Crohn's disease is reported. After multiple resections in the gastrointestinal tract she had been suffering from short bowel syndrome and severe malnutrition. With a special continuous gastric tube feeding system, she was able to maintain her weight for years. In the beginning of 1997 the enteral nutrition was not longer tolerated for an exacerbation of chronic pancreatitis. There was a weight loss, permanent pain and total parenteral nutrition had to be performed. In this situation a new liquid preparation of pancreatic enzymes which had been tested in the laboratory before, was used for continuous enzyme replacement via gastric tube. In combination with this enzyme preparation, enteral nutrition could successfully be started again.

Evaluation of the sustainability of contrasted pig farming systems: economy.

The aim of this paper is to present an efficient tool for evaluating the economy part of the sustainability of pig farming systems. The selected tool IDEA was tested on a sample of farms from 15 contrasted systems in Europe. A statistical analysis was carried out to check the capacity of the indicators to illustrate the variability of the population and to analyze which of these indicators contributed the most towards it. The scores obtained for the farms were consistent with the reality of pig production; the variable distribution showed an important variability of the sample. The principal component analysis and cluster analysis separated the sample into five subgroups, in which the six main indicators significantly differed, which underlines the robustness of the tool. The IDEA method was proven to be easily comprehensible, requiring few initial variables and with an efficient benchmarking system; all six indicators contributed to fully describe a varied and contrasted population.

Evaluation of the sustainability of contrasted pig farming systems: integrated evaluation.

The aim of this paper is to present an approach for an integrated evaluation of the sustainability of pig farming systems, taking into account the three classical pillars: economy, environment and society. Eight sustainability themes were considered: Animal Welfare (AW), Animal Health (AH), Breeding Programmes (BP), Environment (EN), Meat Safety (MS), Market Conformity (MC), Economy (EC) and Working Conditions (WC). A total of 37 primary indicators were identified and used for the evaluation of 15 much contrasted pig farming systems in five EU countries. The results show that the eight themes were not redundant and all contributed to the observed variation between systems. The tool was very robust for highlighting the strengths and weaknesses of the systems along the eight themes that were considered. The number of primary indicators could be reduced from 37 to 18 with limited impact on the strengths/weaknesses profile of the individual systems. Integrating the eight theme evaluations into a single sustainability score is based on hypotheses or presumptions on the relative weights that should be given to the eight themes, which are very dependent on the context and on the purpose of the users of the tool. Therefore, the present paper does not have the ambition to provide a ready-for-use tool, rather to suggest an approach for the integrated evaluation of the sustainability of pig farming systems.

Evaluation of the sustainability of contrasted pig farming systems: the procedure, the evaluated systems and the evaluation tools.

Although a few studies consider the sustainability of animal farming systems along the three classical main pillars (economy, environment and society), most studies on pig farming systems address only one of these pillars. The present paper is the introduction to a series of companion papers presenting the results of a study undertaken within the EU-supported project Q-PorkChains, aiming at building a comprehensive tool for the evaluation of pig farming systems, which is robust to accommodate the large variability of systems existing in Europe. The tool is mostly based on questions to farmers and comprises a total of 37 dimensions distributed along eight themes: Animal Welfare, Animal Health, Breeding Programmes, Environmental Sustainability, Meat Safety, Market Conformity, Economy and Working Conditions. The paper describes the procedure that was used for building the tool, using it on 15 contrasted pig farming systems and analysing the results. The evaluated systems are briefly described and a short overview of the dimensions is provided. Detailed descriptions of the theme-wise tools and results, as well as the results of an integrated evaluation, are available in the companion papers.

Late results after microvascular reconstruction of severe crush and avulsion injuries of the upper extremity.

From 1978 to 1985, a total of 64 patients underwent successful hand and digit replantation/revascularisation for salvage after crush and avulsion trauma to their upper extremities. Forty-seven of them (39 males and 8 females) were followed between 10 and 17 years (mean: 12.6 years). The average age was 33.2 years. In 39 patients, replantations were performed: 37 digits (including seven thumbs), two hands, and three midhands. Eight patients underwent revascularizations in cases of subtotal amputations: two in the midhand, three at the wrist, and three at the lower arm. Concomitant injury to the hand or forearm was a feature of all cases. In 45 percent of the study population, secondary reconstructions were necessary. Outcomes were evaluated using Chen's classification (1981) and showed that 19 percent of the patients were classified grade 1, 49 percent grade II, 28 percent grade III, and 4 percent grade IV. Results demonstrated a greater patient age in the grade III group, and relatively more secondary operations in the grade IV patients.

Growth pattern of the maxillary sinus in the miniature pig (Sus scrofa).

The biological role of the paranasal sinuses is obscure, can be elucidated through a cross-sectional growth study of the maxillary sinus in miniature pigs. The maxillary sinus area was obtained from lateral cephalograms of left skull halves of 103 female miniature pigs of known ages, from newborn to 24 months. Out of several nonlinear models, the growth of the maxillary sinus was best described with the Gompertz model. The first derivative of the Gompertz curve revealed an increase in the growth rates of the maxillary sinus until 4 months, after which sinus growth slowed down. The eruption of the permanent molars did not seem to have a significant influence on this growth pattern. Furthermore, growth in maxillary sinus size in the miniature pig does not follow growth in skull size closely, which showed the highest growth rates in newborn animals. In addition, a correlation analysis revealed that the relationship between maxillary sinus area and different characteristics of the masticatory apparatus (including linear cranial dimensions, and the dry weight of the masseter and zygomatico-mandibularis muscles) were influenced greatly by skull size. These results suggest that the existence of pneumatic cavities within the mammalian skull is not satisfactorily explained solely by an architectural theory. Epigenetic factors are likely to influence the final shape of the maxillary sinus.