Response of broiler chickens in the starter and finisher phases to 3 sources of microbial phytase.

A broiler chicken study was conducted for 42 D to evaluate their responses to 3 commercially available microbial phytases. Growth performance, nutrient digestibility, and bone mineralization at days 21 and 42 posthatching were used as parameters of evaluation. The study was a randomized complete block design with 12 treatments, 8 replicate pens, and 25 birds per pen. Treatments included a positive control (PC), a negative control (NC) with crude protein (CP), nonphytate phosphorus (P), and calcium (Ca) reduced by 18, 1.5, and 1.8 g/kg, respectively; the NC + 4 levels of phytase A (250, 500, 750, 1,000 FTU/kg), 3 levels of phytase B (250, 500, 750 FTU/kg), and 3 levels of phytase C (500, 750, 1,000 FTU/kg). Broilers fed the NC diet had reduced (P < 0.05) performance and digestibility measures at days 21 and 42 relative to the PC. All phytase enzymes improved (P < 0.05) BW, gain, feed efficiency, and tibia ash weight and percent. Inclusion of phytase at the highest levels improved (P < 0.05) tibia ash weight by an average of 18.5 and 22% at days 21 and 42, respectively, over the NC. Phytase A linearly improved (P < 0.05) the apparent ileal digestibility (AID) of DM, Ca, P, copper, and sodium at day 21, and the AID of energy, nitrogen, and all amino acid (AA) digestibility at day 42 posthatching. Phytase B linearly (P < 0.05) improved BW gain and feed efficiency of birds at day 21 and quadratically improved (P < 0.05) the AID of nitrogen and all AA in birds at day 42. Supplementation of birds fed the NC with phytase C linearly improved (P < 0.05) the BW gain, feed intake, feed efficiency, and AID of DM, energy, nitrogen, all AA, and all minerals except manganese at day 42. In conclusion, all 3 phytase products improved the growth performance, nutrient and mineral digestibility, and bone mineralization of birds fed diets deficient in nitrogen, Ca, and P similar to or more than birds fed diet adequate in P and CP.

Effects of formic acid and phytase supplementation on digestibility and use of phosphorus and zinc in growing pigs.

Two studies, arranged according to a 4 × 4 Latin square design, were conducted to assess effects of dietary acidification on fungal 3-phytase (PHY) efficacy in growing pigs. In Exp. 1, effects of supplementing 500 units/kg feed of PHY and 4.7 g/kg HCOOH either alone or in combination on the use of P and Zn in growing pigs fed a pelleted diet based on wheat (Triticum aestivum), barley (Hordeum vulgare), and soybean (Glycine max) meal were investigated. In Exp. 2 the same dietary treatments were fed except that PHY supplementation was increased to 1000 units/kg. In both experiments, PHY supplementation increased (P < 0.05) P digestibility and retention. A PHY × HCOOH supplementation interaction on P balance was observed (P < 0.05), indicating that the combination of the additives may increase P digestibility and retention. Effects of HCOOH and PHY on Zn use followed a similar pattern. Supplementation of 1000 units/kg of PHY further increased P and Zn retention compared to supplementation of 500 units/kg. In conclusion, the present study indicated that HCOOH supplementation to diets with microbial PHY may increase PHY efficacy.

Rehabilitation in patients with peripheral arterial disease.

Rehabilitation is a recommended first-line therapy for patients with peripheral arterial disease (PAD) and consists of supervised exercise training and therapeutic education. Proved benefits are significant: improve pain-free walking distance, functional status and quality of life; reduce cardiovascular risk factors and mortality. At least three sessions weekly are recommended during 3 months. Exercise conditioning (global training and lower limb resistance training) is tailored by the preliminary evaluation of walking ability (free walking test, treadmill tests, 6-min walk test) and of the cardiac tolerance (maximal effort tests). Then the exercise workload is progressively improved. The four main goals of therapeutic education are: smoking cessation, prolonged physical activity, Mediterranean diet and observing pharmacological therapies. The limited compliance of the patients with PAD is often an obstacle for educational needs. The chronic patients with important functional limitations and unchecked risk factors will be preferentially enrolled in such programs. When a revascularization is discussed, rehabilitation can serve as trial treatment. Despite its efficacy, rehabilitation is still underutilized in clinical practice and should be promoted.

[Outcome of early fitting by silicone liner with lock system for dysvascular below-knee amputation: assessment of walking abilities by a specific questionnaire]. / Appareillage précoce par manchon silicone avec attache terminale après amputation vasculaire sous le genou: évaluation par score de marche du devenir fonctionnel.

PURPOSE: To assess by a specific questionnaire the functional outcome of patients with below-the-knee amputation after early prosthetic fitting by the ICEROSS silicone liner, which had demonstrated improvement of stump healing and length of hospital stay. PATIENTS AND METHODS: In this retrospective study, walking ability was assessed by a specific score resulting from answers on a questionnaire. The outcome variables were walking inside and outside, transfer from sitting, climbing stairs, and use of walking aids. Following amputation, the ICEROSS system was used for compression therapy, then for temporary prosthesis. The questionnaire was administered at the fitting stabilized state. RESULTS: Twenty-nine of 51 patients who underwent trans-tibial amputation were included: 5 women (mean age 72.8+/-4.1 years) and 24 men (mean age: 69+/-7.4 years). The mean total score was 14.5/20 (good functional outcome) for the 22 unilateral amputees and 7.2/20 (intermediate result) for the seven bilateral amputees. Previous studies concerning functional outcome with other contact casts (without a silicon liner with a bolt) had shown similar results. CONCLUSION: Despite its beneficial initial effect, early fitting by the ICEROSS system did not improve walking ability at the steady functional state, which is more linked to advanced age and comorbidities.

Quercetin-3-glucoside is transported by the glucose carrier SGLT1 across the brush border membrane of rat small intestine.

In the present study we investigated a possible involvement of the intestinal sodium-dependent glucose transporter (SGLT)1 in the absorption of quercetin-3-glucoside (Q3G). Pieces of rat jejunum or proximal colon were mounted in Ussing-type chambers and incubated under short-circuited conditions. Test flavonols were added to the mucosal or serosal bathing solution (initial concentration, 100 micromol/L) and disappearance from the donor compartment was monitored for 2 h. With jejunal tissue, only 13.6 +/- 3.5% of the initial dose of Q3G was found in the mucosal compartment 2 h after mucosal addition. Simultaneous addition of D-glucose (10 mmol/L) significantly reduced the disappearance of Q3G (remaining concentration, 33.4 +/- 6.9%) as did a Na(+)-free buffer solution containing phloridzin (final mucosal concentration of Q3G, 54.2 +/- 7.7%). In these experiments, disappearance of Q3G was paralleled by the appearance of quercetin in the mucosal solutions. In contrast, D-fructose (10 mmol/L) did not influence the disappearance of Q3G (Na(+)-free conditions). With proximal colon, 78.2 +/- 11.5% of the initial concentration of Q3G was still present in the mucosal solution after 2 h. When added to the serosal side, the concentration of Q3G decreased only slightly (jejunum, 96.1 +/- 2.1%; proximal colon, 90.7 +/- 1.2%). The concentration of rutin did not change after mucosal or serosal addition. Neither transport of intact glycosides nor of free quercetin from the donor into the acceptor compartment was observed under our experimental conditions. Taken together, the results clearly indicate a role of SGLT1 in mucosal uptake of the Q3G.

The in vivo neuromodulatory effects of the herbal medicine ginkgo biloba.

Extracts of Ginkgo biloba leaves are consumed as dietary supplements to counteract chronic, age-related neurological disorders. We have applied high-density oligonucleotide microarrays to define the transcriptional effects in the cortex and hippocampus of mice whose diets were supplemented with the herbal extract. Gene expression analysis focused on the mRNAs that showed a more than 3-fold change in their expression. In the cortex, mRNAs for neuronal tyrosine/threonine phosphatase 1, and microtubule-associated tau were significantly enhanced. Hyperphosphorylated tau is the major constituent of the neurofibrillary tangles in the brains of Alzheimer's disease patients. The expression of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-2, calcium and chloride channels, prolactin, and growth hormone (GH), all of which are associated with brain function, were also up-regulated. In the hippocampus, only transthyretin mRNA was upregulated. Transthyretin plays a role in hormone transport in the brain and possibly a neuroprotective role by amyloid-beta sequestration. This study reveals that diets supplemented with Ginkgo biloba extract have notable neuromodulatory effects in vivo and illustrates the utility of genome-wide expression monitoring to investigate the biological actions of complex extracts.

Interaction of quercetin glucosides with the intestinal sodium/glucose co-transporter (SGLT-1).

Recently it has been postulated that flavonoid glucosides may be absorbed by the small intestine via the SGLT-1. Therefore, we applied an in vitro mucosal uptake method to investigate mucosal uptake of the non-metabolisable glucose analogue methyl-alpha-D-glucopyranoside (MDG) as influenced by quercetin-3-glucoside (isoquercitrin) and quercetin-4'-glucoside (spiraeosid). We found that both glucosides significantly inhibited SGLT-1-mediated MDG uptake whereas the aglycon quercetin or the quercetin-3-rhamnoglucoside (rutin) were ineffective. Calculated apparent kinetic parameters (Km, Vmax) of initial Na+-dependent MDG uptake by the jejunal mucosa indicate a competitive type of inhibition.

Bioavailability and metabolism of the flavonol quercetin in the pig.

During the last years, much data pointing to putative health-promoting effects of dietary plant-derived flavonoids (stemming mainly from epidemiological and in vitro studies) have been published. Our knowledge, however, concerning the systemic availability of these substances after ingestion with food is only sketchy. In the present study, we have investigated the bioavailability of the flavonol quercetin after intravenous and oral application in pigs equipped with a permanent jugular catheter. Each animal received a single intravenous dose of quercetin (0.4 mg/kg body weight) and one week later an oral dose of 50 mg/kg. A single animal additionally received an oral dose of 500 mg/kg one week after the lower oral dose. Blood samples were drawn at defined intervals over a total period of three days following the application of quercetin. Analysis of quercetin and some of its metabolites (isorhamnetin, tamarixetin, kaempferol) in plasma samples were performed by HPLC. The calculated apparent bioavailability of free, unchanged quercetin after intake of 50 mg quercetin/kg body weight was 0.54+/-0.19%. Bioavailability was, however, considerably increased to 8.6+/-3.8% after additionally taking into account conjugated quercetin and further increased to 17.0+/-7.1% by including quercetin's metabolites. Our results further indicate, that the conjugation of orally administered quercetin with glucuronic and sulfuric acid appears to preferentially occur in the intestinal wall.

P-glycoprotein transporters and the gastrointestinal tract: evaluation of the potential in vivo relevance of in vitro data employing talinolol as model compound.

Among the different application routes peroral administration remains the one most widely used. Hence, mechanisms affecting p.o. bioavailability are of particular interest, also in drug development. In recent years, intestinal drug secretion mediated by the multi-drug resistance gene product P-glycoprotein (Pgp) has been discovered as a possible mechanism of low and erratic bioavailability. Due to the saturability of this process, a dose-dependent apparent oral clearance may be observed which decreases upon increasing dose. However, in vivo intestinal secretion might be revealed only in the lower or subtherapeutic dose range. In permeability studies with Caco-2 cell monolayers, the MDR-reversing agent verapamil inhibits secretion of P-glycoprotein substrates and, hence, increases apical-to-basolateral permeability. The aim of the rat studies with talinolol presented here was to test the relevance of the intestinal secretion process as well as the extent of inhibition by verapamil in ex vivo, in situ, and in vivo talinolol/verapamil drug-drug interaction studies. Intestinal secretion of talinolol was detected indirectly in ex vivo studies via transport inhibition with verapamil and directly in in situ intestinal perfusions in rats following a talinolol i.v. bolus. Both i.v. and p.o. verapamil appear to affect the concentration-time profiles of talinolol. Relevant observations with respect to drug absorption are the decreased apparent oral clearance upon verapamil coadministration as well as the decreased tmax and mean absorption times at high verapamil doses. Talinolol may be regarded as a potential model compound for mechanistic studies on Pgp interactions, including permeability as well as binding studies and the involvement of transporters other than Pgp.

Cinnamate uptake by rat small intestine: transport kinetics and transepithelial transfer.

Due to their ubiquitous occurrence in the plant kingdom, plant phenolics, including monomeric cinnamic acids, are ingested by man and animals in variable amounts with their natural diets. Recently, Na(+)-dependent saturable transport of cinnamic acid across the brush-border membrane of rat jejunum has been described. It was the aim of the present study to characterize this mechanism in more detail. We therefore determined the transport kinetics of mucosal uptake of radioactively labelled cinnamic acid under various conditions using a short-term mucosal uptake technique. In addition, the transfer of cinnamic acid across the jejunal wall was investigated using everted intestinal sacs. Investigations of the kinetics of cinnamic acid uptake by the mid-jejunal mucosa revealed the involvement of two transport components, a diffusive Na(+)-independent mechanism and a saturable Na(+)-dependent mechanism. The results obtained with everted sacs provided further evidence of the existence of an active Na+ gradient-driven transport of cinnamic acid across the intestinal epithelium. In the presence of Na+, a significant accumulation of cinnamate occurred inside the serosal compartment and this was strongly inhibited by serosal ouabain. A decrease in the extracellular pH stimulated mucosal cinnamate uptake by increasing the apparent affinity (1/km). This may be attributable to the involvement of a transmembrane H+ gradient in Na(+)-dependent cinnamate transport because the protonophore FCCP caused a significant reduction of cinnamate uptake only in the presence of Na+. The kinetics of cinnamate transport in the absence or presence of a surplus of either unlabelled cinnamate or unlabelled butyrate indicates a reduction in the apparent affinity of the Na(+)-dependent mechanism involved in cinnamate uptake. These results may be explained by a modification of the mechanism by the intracellular pH. Additionally, competitive inhibition of cinnamate uptake by substances structurally related to cinnamic acid may also be involved.

A survey of postoperative elbow immobilization approaches.

A survey of 200 North American burn units was designed to gather data about elbow immobilization positions and methods. Respondents were asked to identify the position of elbow and forearm immobilization after grafting to the upper extremity, the rationale for this, the location of the burn for the immobilization position chosen, who was responsible for immobilizing the patient's elbow after surgery, what type of material was used, and on what day range of motion to the elbow was resumed. Results indicated that elbow immobilization positions varied from full extension to more than 20 degrees of flexion, although full extension and slight flexion were used most, as was the forearm midposition. The rationale for immobilization that was most frequently given was prevention of contractures. Occupational therapists were most likely to be involved in or responsible for elbow immobilization, and thermoplastic materials were used most often. The day that range of motion was resumed also varied but was most frequently postoperative day 5.

Phycomycosis in fifteen dogs and two cats.

Phycomycosis was confirmed by histologic examination of biopsy specimens from 15 dogs and at necropsy in 2 cats. The fungal infections occurred most frequently in young adult dogs (1-3 yr) of the larger breeds. The gastrointestinal tract was the organ most commonly involved. Treatment by surgical excision, amphotericin B, and sodium iodide alone or in combination was attempted in five cases. Mortality was 100%.

[Resection for pulmonary metastases: results and prognosis (author's transl)]. / Ergebnisse der Resektion von Lungenmetastasen

From 1955 to 1975 in 25 patients lung surgery has been carried out because of intrapulmonary metastases of extrapulmonary malignant growth. 6 patients survived longer than 5 years. There was no relationship between survival time and length of the time interval between initial surgery (primary) and second operation (i.e. diagnosis of pulmonary lesion). On the other hand a definite relationship resulted for survival time and the size of the growth. In bad-risk patients surgery for metastatic lung cancer is not indicated, but it is very successful in selected cases.