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1.
Br Poult Sci ; 61(3): 287-293, 2020 Jun.
Article in English | MEDLINE | ID: mdl-31951479

ABSTRACT

1. This study investigated the nutritional value (digestibility of ileal crude protein and amino acids (AAs)) and the AMEN value of legumes (pea, faba bean, yellow lupin, and narrow-leaved lupin) with or without protease. 2. Two hundred, one-day-old, male Ross 308 broiler chickens were randomly allocated to ten groups. Each group received one of five different protein raw materials - either peas, faba beans, yellow lupins or narrow-leaved lupins, with or without protease produced from Bacillus licheniformis. The birds were kept in individual cages. Nutrient digestibility was calculated using the difference method. The total duration of the study was 23 d, and the study involved two phases - accommodation phase (d 1-18) and experimental phase (d 18-23). 3. The effect of protease on response traits was not consistent between the legumes. The enzyme increased the digestibility of some AAs in the pea (arginine, leucine, phenylalanine, histidine, tyrosine, alanine, and proline), faba bean (lysine, arginine, glycine, and asparagine), and yellow lupin diets (lysine, valine, and serine), but this effect was not observed in the narrow-leaved lupin diet. The change in AMEN values due to protease addition was only statistically significant for the pea diet (P < 0.05), whereas in the case of other legume species, the difference was insignificant (P > 0.05). 4. Exogenous protease increased the digestibility of AAs present in pea, faba bean, and yellow lupin seeds but not in narrow-leaved lupin diets. The AMEN value of peas increased with protease supplementation, but no effect of protease was found for the AMEN values of faba bean and both the lupin diets.


Subject(s)
Animal Feed , Animal Nutritional Physiological Phenomena , Bacillus licheniformis , Vicia faba , Animal Feed/analysis , Animals , Chickens , Diet , Digestion , Male , Nutritive Value , Pisum sativum , Peptide Hydrolases
2.
Surg Endosc ; 34(10): 4525-4535, 2020 10.
Article in English | MEDLINE | ID: mdl-31720810

ABSTRACT

BACKGROUND: Minimally invasive surgery requires surgeons to allocate more attention and efforts than open surgery. A surgeon's pool of resource is affected by the multiple occurrences of interruptions and distractions in the operating room. Surgical flow disruption has been addressed from a quantitative perspective. However, little is known on its impact on the surgeons' physiological resources. METHODS: Three physiological markers, heat flux (HF), energy expenditure in metabolic equivalent of tasks and galvanic skin response were recorded using body sensor monitoring during the 21 surgical operations. The three markers, respectively, represent: stress, energy mobilization and task engagement. A total of 8 surgeons with different levels of expertise (expert vs. novice) were observed performing 21 surgical procedures categorized as short versus long. Factors of distractions were time-stamped, and triangulated with physiological markers. Two cases illustrate the impact of surgical flow disruptions on the surgeons. RESULTS: The results indicate that expert surgeons' mental schemata are better organized than novices. Additionally, the physiological markers indicate that novice surgeons display a higher HF at the start (tendency p = .059) and at the end of procedures (p = .001) when compared to experts. However, during longer procedures, expert surgeons have higher HF at the start (p = .041) and at the end (p = .026), than at the start and end of a short procedure. CONCLUSION: Data collected during this pilot study showed that interruptions and disruptions affect novice and expert surgeons differently. Surgical flow disruption appears to be taxing on the surgeons' mental, emotional and physiological resources; as a function of the length and nature of the disruptions. Several training curricula have incorporated the use of virtual reality programs to train surgeons to cope with the new technology and equipment. We recommend integrating interruptions and distractions in virtual reality training programs as these impact the surgeons' pool of resources.


Subject(s)
Surgeons , Clinical Competence , Energy Metabolism , Female , Galvanic Skin Response , Humans , Male , Metabolic Equivalent , Minimally Invasive Surgical Procedures , Operating Rooms , Pilot Projects
3.
Ann Oncol ; 30(8): 1298-1303, 2019 08 01.
Article in English | MEDLINE | ID: mdl-31192355

ABSTRACT

BACKGROUND: This trial evaluated whether preoperative short-course radiotherapy and consolidation chemotherapy (CCT) were superior to chemoradiation in rectal cancers with clinical (c)T4 or fixed cT3. Previously, we reported early results showing no differences in the radical surgery rate (primary end point). In the short-course/CCT group, we observed lower acute toxicity of preoperative treatment and better overall survival (OS). We updated results to determine whether the benefit in OS was sustained and to evaluate late complications. PATIENTS AND METHODS: Patients with cT4 or fixed cT3 rectal cancer were randomized either to preoperative 5 × 5 Gy and three cycles of FOLFOX4 or to chemoradiation (50.4 Gy with bolus 5-Fu, leucovorin and oxaliplatin). RESULTS: Patients (N = 515) were eligible for analysis, 261 in the short-course/CCT group and 254 in the chemoradiation group. The median follow-up was 7.0 years. The difference in OS was insignificant [hazard ratio (HR) 0.90; 95% confidence interval (CI) 0.70-1.15; P = 0.38). However, the difference in early OS favouring short-course/CCT previously reported was observed again, being 9% at 3 years (95% CI 0.5% to 17%). This difference disappeared later; at 8 years OS was 49% in both groups. There was no difference in disease-free survival (HR 0.95; 95% CI 0.75-1.19; P = 0.65) at 8 years 43% versus 41% in the short-course/CCT group versus the chemoradiation group, respectively. The corresponding values for cumulative incidences of local failure and distant metastases did not differ and were HR = 1.08, 95% CI 0.70-1.23, P = 0.60, 35% versus 32% and HR = 1.10, 95% CI 0.68-1.23, P = 0.54, 36% versus 34%, respectively. The rate of late complications was similar (P = 0.66), grade 3+ being 11% versus 9% in the short-course/CCT group versus the chemoradiation group, respectively. CONCLUSION: The superiority of preoperative short-course/CCT over chemoradiation was not demonstrated. CLINICAL TRIAL NUMBER: The trial is registered as ClinicalTrials.gov number NCT00833131.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Dose Fractionation, Radiation , Neoadjuvant Therapy/methods , Neoplasm Recurrence, Local/epidemiology , Rectal Neoplasms/therapy , Adolescent , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Chemoradiotherapy/adverse effects , Chemoradiotherapy/methods , Consolidation Chemotherapy/adverse effects , Consolidation Chemotherapy/methods , Disease-Free Survival , Female , Fluorouracil/administration & dosage , Fluorouracil/adverse effects , Follow-Up Studies , Humans , Incidence , Leucovorin/administration & dosage , Leucovorin/adverse effects , Male , Middle Aged , Neoadjuvant Therapy/adverse effects , Neoplasm Recurrence, Local/prevention & control , Organoplatinum Compounds/administration & dosage , Organoplatinum Compounds/adverse effects , Poland/epidemiology , Proctectomy , Rectal Neoplasms/mortality , Rectal Neoplasms/pathology , Rectum/drug effects , Rectum/pathology , Rectum/radiation effects , Rectum/surgery , Time Factors , Young Adult
4.
Br Poult Sci ; 60(3): 288-296, 2019 Jun.
Article in English | MEDLINE | ID: mdl-30917668

ABSTRACT

1. This study investigated the effect of different levels of seeds of lupin species (Lupinus angustifolius, Lupinus luteus and Lupinus albus) on broiler growth performance, nutrient digestibility and apparent metabolisable energy of poultry diets. 2. A control diet containing corn-soybean meal and test diets containing 50, 100, 150, 200 and 250 g/kg of three lupin species were fed to broiler chickens during a 35-day study period. There were 10 replicate cages of 8 broiler chickens per treatment. 3. Growth performance of the birds fed with yellow and white lupin diets was found to be similar to that of the birds in the control group. The use of narrow-leaved lupin seeds in the diet quadratically decreased the body weight gain of birds and increased feed conversion ratio during all the experimental periods (0-14, 15-35 and overall 0-35 days of age). 4. A significant interaction between lupin species and their inclusion levels for apparent metabolisable energy and apparent ileal digestibility of starch was observed, showing a negative effect of increasing levels of narrow-leaved lupin. Pearson correlation coefficients demonstrated that the presence of raffinose and non-starch polysaccharides is a key factor affecting the nutritive value of lupin, 5. Yellow and white lupins could be utilised as an alternative ingredient for soybean meal in the diet of broiler chickens without any adverse effects on growth performance. The narrow-leaved counterpart diet reduced broiler performance, and hence did not provide a satisfactory outcome.


Subject(s)
Chickens/physiology , Digestion , Lupinus/chemistry , Nutrients/physiology , Nutritive Value , Seeds , Animal Feed/analysis , Animal Nutritional Physiological Phenomena/drug effects , Animals , Chickens/growth & development , Diet/veterinary , Digestion/drug effects , Dose-Response Relationship, Drug , Male , Nutritive Value/drug effects , Random Allocation , Species Specificity
5.
Animal ; 13(8): 1583-1590, 2019 Aug.
Article in English | MEDLINE | ID: mdl-30621798

ABSTRACT

Soybean meal in broiler chicken diets can partly be replaced by faba bean seeds. Unfortunately, high levels of antinutritional factors and resistant starch found in these seeds can have a detrimental impact on both broiler chickens' performance and nutrient digestibility. It is, however, possible to increase the usefulness of faba bean for broiler nutrition by a technological process known as extrusion. In this study, the authors made and attempt to investigate the effect of different forms of faba bean seeds (raw or extruded) on broiler chicken performance, nitrogen-corrected apparent metabolizable energy values (AMEN), nutrient utilization and meat quality, as well as on the excretion of total and free sialic acids. In the trial, the total of 160 1-day-old male broiler chicks of the Ross 308 strain were used. Experimental birds were randomly assigned to two dietary treatments, each containing 10 replication (floor pens); one replication included nine birds. The first group contained 300 g/kg diet of raw faba bean seeds, whereas the second group - 300 g/kg diet of extruded faba bean seeds. The applied extrusion process was found to exert a positive impact and led to a decrease in phytic phosphorus, H, NDF, ADF and resistant starch content in studied faba bean seeds. Experimental birds fed diets containing extruded faba bean seeds were characterized by a lower feed intake (2299 g) and feed conversion ratios (FCRs) (1.52 g/g) in comparison with the other group (feed intake 2466 g; FCR 1.61 g/g). Extrusion of faba bean seeds improved dry matter retention, dietary AMEN value, apparent ileal digestibility of dry matter and starch, as well as most amino acids. In addition, the above-mentioned process resulted in a decrease in the excretion of total and free sialic acids. Extruded faba bean seeds failed to have a significant impact on broiler meat quality. It was concluded that application of extrusion can increase the use of faba bean seeds in broiler chicken nutrition.


Subject(s)
Animal Feed/analysis , Diet/veterinary , Meat/standards , Sialic Acids/metabolism , Vicia faba/chemistry , Amino Acids/metabolism , Animal Nutritional Physiological Phenomena , Animals , Chickens/physiology , Digestion , Energy Metabolism/drug effects , Ileum/metabolism , Male , Random Allocation , Seeds/chemistry , Glycine max/metabolism
6.
Br Poult Sci ; 59(4): 477-484, 2018 Aug.
Article in English | MEDLINE | ID: mdl-29595321

ABSTRACT

1. The aim of this study was to investigate the effect of white lupin (Lupinus albus) meal (WLM) addition on the intestinal viscosity, bird performance and nutrient utilisation of laying hens. 2. The experiment was conducted with 360 laying hens aged 21 weeks fed one of 6 treatments, including a corn-soybean meal control diet (CON) and 5 experimental diets containing 60, 120, 180, 240 and 300 g/kg WLM. 3. A linear increase in feed intake (p < 0.001) was observed with higher levels of WLM from 0 to 300 g/kg. Laying rate decreased quadratically (p < 0.05) and egg weight (at 6th, 12th and 18th weeks of the trial) decreased linearly with WLM inclusion from 0 to 300 g/kg. Birds fed 60 g/kg or more of WLM laid lighter eggs (p < 0.05) than CON hens. When 240 g/kg or more WLM was included into the diet, laying rate was affected negatively (p < 0.05). 4. As WLM increased from 0 to 300 g/kg, apparent metabolisable energy and pre-caecal digestibility of dry matter and crude protein decreased quadratically (p < 0.05). When 300 g/kg of WLM was used, there was a tendency (p < 0.1) to decrease pre-caecal starch digestibility. WLM dose exerted a quadratic effect (p < 0.05) on total sialic acid excretion. As WLM increased, the viscosity of ileal digesta linearly increased (p < 0.05). 5. In the 6th and 12th weeks of the experiment (p < 0.05), eggshell thickness decreased linearly when 240 g/kg of WLM was added. At the 6th, 12th and 18th weeks, a linear decrease in eggshell content was observed (p < 0.05) after WLM addition. 6. In conclusion, the graded inclusion of WLM into laying hens' diets resulted in depressed performance, AMEN and eggshell quality.


Subject(s)
Animal Feed/analysis , Chickens/physiology , Digestion/drug effects , Energy Metabolism/drug effects , Ileum/drug effects , Lupinus/chemistry , Animal Nutritional Physiological Phenomena/drug effects , Animals , Diet/veterinary , Dose-Response Relationship, Drug , Female , Ileum/chemistry , Random Allocation , Viscosity
8.
J Anim Physiol Anim Nutr (Berl) ; 101(5): e216-e224, 2017 Oct.
Article in English | MEDLINE | ID: mdl-27868253

ABSTRACT

The effect of soya bean meal (SBM) substitution in the diet with white lupine (WL) seeds on performances and some parameters of the digestive tract of pigs were studied. The digestibility experiment was performed on 30 pigs using difference method combined with marker method, where one group was offered basal diet and in diet of experimental groups 25% of the basal diet was substituted with SBM or WL meal. The growth experiment was conducted on 48 pigs of approximately 20 kg body weight. The animals from the control group were fed with diet containing SBM, whereas in the experimental groups 50% or 100% of SBM was substituted with WL seeds. At the end of the experiment, eight pigs from each group were euthanized, and digesta and tissues were sampled. The apparent total tract digestibility of crude protein and dry matter was higher (p < 0.05), but crude fibre and ether extract were lower (p < 0.05) in the WL seeds than in SBM. Substituting 50% of SBM in the control diet with WL seeds did not affect significantly pig performance. Total substitution of SBM with WL seeds impacted negatively pigs growth and feed intake (p < 0.05), but it did not affect the length of villi and crypt depth. It also significantly increased ileum digesta viscosity and ammonia concentration in the ileum and caecum digesta. In the ileal digesta of animals offered WL seeds, an increased (p < 0.05) total bacterial and Enterobacteriaceae numbers were found, whereas reduced number of yeast and mould was found in the caecal digesta. The substitution of 50% SBM with WL seeds in the growing pig diet did not affect pigs' results, but the total substitution significantly decreased the performance of pigs and affected intestinal ecology.


Subject(s)
Animal Feed/analysis , Digestion/drug effects , Lupinus/chemistry , Swine/growth & development , Animal Nutritional Physiological Phenomena , Animals , Diet , Digestion/physiology , Gastrointestinal Tract , Male , Glycine max , Swine/physiology
9.
Eur J Surg Oncol ; 42(12): 1859-1865, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27546011

ABSTRACT

BACKGROUND: Whether there is any benefit derived from adding oxaliplatin to fluoropyrimidine-based preoperative chemoradiation is currently unknown in cases of advanced cT3 or cT4 tumours. Our aim was to evaluate this issue by analysing a randomized trial, which compared two schedules of preoperative treatment (chemoradiation vs. 5 × 5 Gy with 3 cycles of consolidation chemotherapy) for cT4 or fixed cT3 rectal cancer. PATIENTS AND METHODS: Delivery of oxaliplatin was mandatory to the first part of the study. For the second part, its delivery in both treatment-assigned groups was left to the discretion of the local investigator. We analysed a subgroup of 272 patients (136 in the oxaliplatin group and 136 in the fluorouracil-only group) from institutions that had omitted oxaliplatin in the second part of the study. RESULTS: Circumferential resection margin negative (CRM-) status rate was 68% in the oxaliplatin group and 70% in the fluorouracil-only group, p = 0.72. The pathological complete response rate (pCR) was correspondingly 14% vs. 7%, p = 0.10. Following multivariable analysis, when comparing the CRM- status in the oxaliplatin group to the fluorouracil-only group, the odds ratio was 0.79 (95 CI 0.35-1.74), p = 0.54; there being no interaction between concomitant chemoradiation and 5 × 5 Gy with consolidation chemotherapy; pinteraction = 0.073. For pCR, the corresponding results were 0.47 (95 CI 0.19-1.16), p = 0.10, pinteraction = 0.84. CONCLUSION: No benefit was found of adding oxaliplatin in terms of CRM nor pCR rates for either concomitant or sequential settings in preoperative radiochemotherapy for very advanced rectal cancer.


Subject(s)
Adenocarcinoma/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemoradiotherapy , Digestive System Surgical Procedures , Neoadjuvant Therapy , Rectal Neoplasms/therapy , Adenocarcinoma/pathology , Aged , Female , Fluorouracil/administration & dosage , Fluorouracil/therapeutic use , Humans , Leucovorin/administration & dosage , Leucovorin/therapeutic use , Male , Middle Aged , Neoplasm Staging , Organoplatinum Compounds/administration & dosage , Organoplatinum Compounds/therapeutic use , Oxaliplatin , Prospective Studies , Rectal Neoplasms/pathology , Treatment Outcome
10.
Br Poult Sci ; 57(3): 364-74, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27025275

ABSTRACT

The aim of this study was to investigate the effect of white lupin (Lupinus albus) meal (WLM) addition on the intestinal viscosity, bird performance, nutrient utilisation and villi morphology of growing broiler chicks. The experiment was conducted with 480 broiler chicks divided into 6 dietary treatments, including a maize-soybean meal control diet (CON) and 5 experimental diets containing 100, 150, 200, 250 and 300 g/kg WLM. During the period from d 0 to 35, birds fed on 200 or higher WLM/kg were characterised by lower body weight gain and feed intake than CON. The use of 150 g of WLM/kg increased feed conversion ratio (FCR) compared to CON treatment. Apparent metabolisable energy corrected to zero N balance (AMEN) and apparent ileal digestibility of dry matter, ether extract, crude protein and starch, linearly decreased as WLM increased from 0 to 300 g/kg. There was a quadratic effect of WLM dose on sialic acid excretion. A strong negative linear correlation was found between the excretion of sialic acid and AMEN. The viscosity of ileal digesta was linearly increased as WLM increased. The effect of WLM dose on ileum villus height (VH) was linear, while that on ileum villus area (VA) was quadratic. Both parameters decreased as WLM increased from 0 to 300 g/kg. In conclusion, the use of over 150 g/kg of WLM in broiler diets depressed performance results. However, depression of nutrient utilisation was only observed when 250 or 300 g/kg of WLM was used.


Subject(s)
Animal Nutritional Physiological Phenomena , Chickens/physiology , Diet/veterinary , Dietary Supplements , Digestion/physiology , Intestines , Lupinus/metabolism , Animal Feed/analysis , Animals , Chickens/anatomy & histology , Chickens/growth & development , Energy Metabolism , Intestines/anatomy & histology , Intestines/physiology , Lupinus/chemistry , Male , Weight Gain
11.
Ann Oncol ; 27(5): 834-42, 2016 05.
Article in English | MEDLINE | ID: mdl-26884592

ABSTRACT

BACKGROUND: Improvements in local control are required when using preoperative chemoradiation for cT4 or advanced cT3 rectal cancer. There is therefore a need to explore more effective schedules. PATIENTS AND METHODS: Patients with fixed cT3 or cT4 cancer were randomized either to 5 × 5 Gy and three cycles of FOLFOX4 (group A) or to 50.4 Gy in 28 fractions combined with two 5-day cycles of bolus 5-Fu 325 mg/m(2)/day and leucovorin 20 mg/m(2)/day during the first and fifth week of irradiation along with five infusions of oxaliplatin 50 mg/m(2) once weekly (group B). The protocol was amended in 2012 to allow oxaliplatin to be then foregone in both groups. RESULTS: Of 541 entered patients, 515 were eligible for analysis; 261 in group A and 254 in group B. Preoperative treatment acute toxicity was lower in group A than group B, P = 0.006; any toxicity being, respectively, 75% versus 83%, grade III-IV 23% versus 21% and toxic deaths 1% versus 3%. R0 resection rates (primary end point) and pathological complete response rates in groups A and B were, respectively, 77% versus 71%, P = 0.07, and 16% versus 12%, P = 0.17. The median follow-up was 35 months. At 3 years, the rates of overall survival and disease-free survival in groups A and B were, respectively, 73% versus 65%, P = 0.046, and 53% versus 52%, P = 0.85, together with the cumulative incidence of local failure and distant metastases being, respectively, 22% versus 21%, P = 0.82, and 30% versus 27%, P = 0.26. Postoperative and late complications rates in group A and group B were, respectively, 29% versus 25%, P = 0.18, and 20% versus 22%, P = 0.54. CONCLUSIONS: No differences were observed in local efficacy between 5 × 5 Gy with consolidation chemotherapy and long-course chemoradiation. Nevertheless, an improved overall survival and lower acute toxicity favours the 5 × 5 Gy schedule with consolidation chemotherapy. CLINICAL TRIAL NUMBER: The trial is registered as ClinicalTrials.gov number NCT00833131.


Subject(s)
Chemoradiotherapy , Organoplatinum Compounds/administration & dosage , Rectal Neoplasms/drug therapy , Rectal Neoplasms/radiotherapy , Aged , Combined Modality Therapy , Consolidation Chemotherapy , Disease-Free Survival , Female , Humans , Male , Middle Aged , Neoplasm Staging , Oxaliplatin , Preoperative Care , Radiotherapy Dosage , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery
12.
Poult Sci ; 95(4): 851-9, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26740137

ABSTRACT

We recently applied four dietary treatments in experiments I and II to determine the effect of protected calcium butyrate (BP) on growth performance and nutrient digestibility in broiler chickens. A group of one-day-old male Ross 308 broiler chicks (total 960, 480 per trial) were used in the study. In experiment I, the basal diets were fed with protected BP inclusion (0.2, 0.3, or 0.4 g/kg of finished feed) (BP) or without (C). In experiment II, 4 different diets were tested: 1) basal diet with no supplementation (C), 2) basal diet supplemented with protected BP (0.3 g/kg) (BP), 3) basal diet supplemented with avilamycin (6 mg/kg, active substance) a common antibiotic growth promoter (AGP) (Av), and 4) basal diet supplemented with the combination of both avilaymicin and BP. In experiment I, considering the entire study period, the use of BP improved feed conversion ratio (P<0.05) irrespective of the dose. Apparent total tract crude fat digestibility and apparent metabolizable energy corrected for nitrogen (AMEN) were improved after BP supplementation (P<0.05). In experiment II, A or AB diets improved (P<0.05) body weight gain compared to the control treatment. The diets Av, BP, and AvB improved (P<0.05) feed conversion ratio compared to the control treatment. Birds from the treatment diet were characterized by having the thickest mucosa (P<0.05). On days 14, 35, and 42, the use of AB diets improved AMENcontent compared to the control treatment (P<0.05). The apparent ileal digestibility of amino acid data showed that Av or AvB treated birds were characterized by higher Asp, Glu, Cys, Gly, and Ala ileal digestibility than the control animals (P<0.05). The use of Av, BP, or AvB increased ileal digestibility of Thr, Ser, and Pro (P<0.05). There is an indication that BP, alone or in combination with avilamycin, improve the digestion and absorptive processes and consequently birds performance results.


Subject(s)
Anti-Bacterial Agents/pharmacology , Butyric Acid/metabolism , Chickens/growth & development , Chickens/metabolism , Oligosaccharides/pharmacology , Animal Feed/analysis , Animal Nutritional Physiological Phenomena/drug effects , Animals , Anti-Bacterial Agents/administration & dosage , Butyric Acid/administration & dosage , Diet/veterinary , Dietary Supplements/analysis , Digestion/drug effects , Ileum/anatomy & histology , Ileum/drug effects , Male , Oligosaccharides/administration & dosage , Random Allocation
13.
Eur J Surg Oncol ; 42(2): 288-96, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26506863

ABSTRACT

BACKGROUND: During an ongoing phase II observational study on watch and wait policy in rectal cancer, a substantial number of patients presented residual lesion after radiotherapy with a clinical benign appearance. This article aims to discuss the clinical significance of such findings. MATERIALS AND METHODS: Main entry criteria were age ≥70 years and small tumour (≤5 cm and ≤60% of circumferential involvement) located in the low rectum. Patients received chemoradiation (50 Gy, 2 Gy per fraction concomitantly with a 5-Fu bolus and leucovorin) or 5 × 5 Gy if considered unfit for chemotherapy. Patients with clinical complete response (cCR) were observed. Those with persistent tumours underwent transanal endoscopic microsurgery [TEM] if the baseline tumour was ≤3 cm and cN0 or total mesorectal excision. RESULTS: The watch and wait procedure was used in 11 out of the total 35 patients (31%) with a cCR; 17 patients (49%) with residual tumours that appeared clinically malignant were referred for TEM or abdominal surgery. In the remaining seven (20%), the residual tumour clinically appeared benign. Of these, there were two invasive cancers, four high-grade dysplasias and one low-grade dysplasia. The five patients with dysplasia, underwent local lesion resection without recurrence within a median of 11 months follow-up. CONCLUSIONS: The majority of lesions that appeared clinically benign after radio(chemo)therapy were also benign on pathological examination. Thus, local excision of such lesions should be considered.


Subject(s)
Adenocarcinoma/pathology , Adenocarcinoma/therapy , Chemoradiotherapy , Rectal Neoplasms/pathology , Rectal Neoplasms/therapy , Watchful Waiting , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Dose Fractionation, Radiation , Female , Fluorouracil/administration & dosage , Humans , Leucovorin/administration & dosage , Male , Neoplasm, Residual , Organ Sparing Treatments , Transanal Endoscopic Microsurgery , Tumor Burden
14.
Phys Rev Lett ; 115(17): 170401, 2015 Oct 23.
Article in English | MEDLINE | ID: mdl-26551092

ABSTRACT

We construct steering inequalities that exhibit unbounded violation. The concept was to exploit the relationship between steering violation and the uncertainty relation. To this end, we apply mutually unbiased bases and anticommuting observables, known to exhibit the strongest uncertainty. In both cases, we are able to procure unbounded violations. Our approach is much more constructive and transparent than the operator space theory approach employed to obtain large violation of Bell inequalities. Importantly, using anticommuting observables we are able to obtain a dichotomic steering inequality with unbounded violation. Thus far, there is no analogous result for Bell inequalities. Interestingly, both the dichotomic inequality and one of our inequalities cannot be directly obtained from existing uncertainty relations, which strongly suggest the existence of an unknown kind of uncertainty relation.

15.
Ann Neurol ; 78(6): 982-994, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26418456

ABSTRACT

OBJECTIVE: Mutations in TPM3, encoding Tpm3.12, cause a clinically and histopathologically diverse group of myopathies characterized by muscle weakness. We report two patients with novel de novo Tpm3.12 single glutamic acid deletions at positions ΔE218 and ΔE224, resulting in a significant hypercontractile phenotype with congenital muscle stiffness, rather than weakness, and respiratory failure in one patient. METHODS: The effect of the Tpm3.12 deletions on the contractile properties in dissected patient myofibers was measured. We used quantitative in vitro motility assay to measure Ca(2+) sensitivity of thin filaments reconstituted with recombinant Tpm3.12 ΔE218 and ΔE224. RESULTS: Contractility studies on permeabilized myofibers demonstrated reduced maximal active tension from both patients with increased Ca(2+) sensitivity and altered cross-bridge cycling kinetics in ΔE224 fibers. In vitro motility studies showed a two-fold increase in Ca(2+) sensitivity of the fraction of filaments motile and the filament sliding velocity concentrations for both mutations. INTERPRETATION: These data indicate that Tpm3.12 deletions ΔE218 and ΔE224 result in increased Ca(2+) sensitivity of the troponin-tropomyosin complex, resulting in abnormally active interaction of the actin and myosin complex. Both mutations are located in the charged motifs of the actin-binding residues of tropomyosin 3, thus disrupting the electrostatic interactions that facilitate accurate tropomyosin binding with actin necessary to prevent the on-state. The mutations destabilize the off-state and result in excessively sensitized excitation-contraction coupling of the contractile apparatus. This work expands the phenotypic spectrum of TPM3-related disease and provides insights into the pathophysiological mechanisms of the actin-tropomyosin complex.


Subject(s)
Muscle Contraction , Muscle Fibers, Skeletal/pathology , Muscular Diseases/genetics , Tropomyosin/genetics , Child, Preschool , Exome , Female , Humans , Male , Muscular Diseases/pathology , Muscular Diseases/physiopathology , Mutation , Phenotype , Respiratory Insufficiency , Sequence Deletion
17.
Tech Coloproctol ; 18(10): 921-8, 2014 Oct.
Article in English | MEDLINE | ID: mdl-24993838

ABSTRACT

BACKGROUND: Despite the findings of several randomized clinical studies, the role of gentamicin collagen implant (GCI) in rectal cancer surgery is unclear. Local pelvic application of GCI following preoperative radiotherapy and total mesorectal excision (TME) was evaluated to determine the risk of surgical site infections (SSI). METHODS: In this single-center trial, 176 patients with rectal cancer after preoperative, short-term radiotherapy (5 × 5 Gy) were randomized either to the study group in which GCI was used or in the control group without GCI. Prior to surgery and intraoperatively five patients were excluded from the study. The remaining 171 patients were analyzed; 86 were in the study group and 85 in the control group. RESULTS: There were no statistically significant differences in the overall rate of early postoperative complications between the study and control group: 25.6 and 34.1 % respectively; p = 0.245, relative risk (RR) 0.750 [95 % confidence interval (CI) 0.471-1.195]. The reoperation rate was similar in both groups: 12.8 versus 9.4 %; p = 0.628; RR 1.359; (95 % CI 0.575-3.212). The total rate of SSI and organ space SSI were 22.2 and 15.8 % without differences between the study and control group. In patients without anastomotic leakage, the risk of organ space SSI was significantly reduced in patients who received GCI: 2.6 versus 13.0 %; p = 0.018. CONCLUSIONS: Application of GCI in the pelvic cavity after short-term preoperative radiotherapy and TME may reduce the risk of organ space SSI but only in the absence of anastomotic leakage.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Gentamicins/therapeutic use , Rectal Neoplasms/surgery , Surgical Wound Infection/prevention & control , Adult , Aged , Aged, 80 and over , Anastomotic Leak/drug therapy , Anastomotic Leak/prevention & control , Anti-Bacterial Agents/administration & dosage , Collagen/administration & dosage , Combined Modality Therapy , Digestive System Surgical Procedures/adverse effects , Digestive System Surgical Procedures/methods , Female , Gentamicins/administration & dosage , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/surgery , Rectal Neoplasms/radiotherapy , Risk Factors , Surgical Wound Infection/complications , Surgical Wound Infection/drug therapy
18.
Poult Sci ; 93(7): 1745-53, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24864284

ABSTRACT

A study was conducted to determine if amylase and protease addition would improve nutrient digestion during the first 2 wk of growth. The experimental treatments included a control corn-soybean meal-based diet and diets supplemented with either amylase or amylase plus protease. No effect of enzyme supplementation was observed on BW gain and feed conversion ratio. This was corroborated by similar ileal starch and protein digestibility values, which averaged 96.8, 96.8, and 96.9% and 83.9, 80.1, and 79.6%, respectively, for the control and for the amylase or amylase plus protease supplemented diets. Total tract digestibility of starch averaged 97.8, 97.7 and 97.7% for the 3 diets and was followed by a similar diet with AMEn values of 3,129, 3,129, and 3,106 kcal/kg. In another study, a 2(3) factorial arrangement of 8 dietary treatments was used to evaluate the effect of corn particle size (conventional or coarse vs. fine) and the addition of a nonstarch polysaccharide enzyme, amylase, or both on growth performance and nutrient utilization of broiler chickens from 1 to 21 d of age. Chickens fed a diet containing a conventionally ground corn (geometric mean diameter of 736 µm) showed higher (P < 0.001) BW gain (808 vs. 750 g/bird) and lower feed conversion ratio (1.27 vs. 1.32) than those consuming a fine corn-containing diet (geometric mean diameter of 482 µm). This was further substantiated by a lower AMEn content (2,852 vs. 2,972 kcal/kg). Addition of amylase had no effect on growth performance of chickens fed a conventional corn-containing diet, but improved BW gain, feed conversion ratio, and diet AMEn in those fed the finely ground corn, possibly due to increased starch digestion in the upper gut. Addition of nonstarch polysaccharide enzymes was effective for both diets, with the most pronounced effects observed in feed conversion ratio for the conventional corn-containing diet (1.27 vs. 1.23) and BW gain (750 vs. 789 g/bird) for the fine corn-containing diet. This was followed by the same magnitude of difference in diet AMEn content, which increased from 2,972 to 3,042 and 2,852 to 3,009 kcal/kg following enzyme addition.


Subject(s)
Chickens/physiology , Diet/veterinary , Dietary Supplements , Peptide Hydrolases/metabolism , Polysaccharides/metabolism , Zea mays/chemistry , alpha-Amylases/metabolism , Animal Feed/analysis , Animal Nutritional Physiological Phenomena , Animals , Chickens/growth & development , Digestion/physiology , Male , Particle Size , Random Allocation
20.
Animal ; 8(6): 912-22, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24674938

ABSTRACT

The aim of the present work was to examine how different fats commonly used in the feed industry affect broiler performance, nutrient digestibility and microbial fermentation in the gastrointestinal tract of broiler chickens challenged with virulent Clostridium perfringens strains. Two experiments were carried out, each including 480-day-old male broilers (Ross 308), which were randomly distributed to eight experimental groups using six replicate pens per treatment and 10 birds per pen. In Experiment 1, birds were fed diets containing soybean oil, palm kernel fatty acid distillers, rendered pork fat and lard. In Experiment 2, birds were fed diets containing rapeseed oil, coconut oil, beef tallow and palm oil. In both experiments, the birds were either not challenged or challenged with a mixture of three C. perfringens type A strains. Irrespective of the fat type present in the diet, C. perfringens did not affect broiler chicken body weight gain (BWG) and mortality in either of the two experiments. The BWG was affected by dietary fat type in both experiments, indicating that the fatty acid composition of the fat source affects broiler growth performance. In particular, the inclusion of animal fats tended to improve final BW to a greater extent compared with the inclusion of unsaturated vegetable oils. In Experiment 2, irrespective of the dietary fat type present in the diet, C. perfringens challenge significantly impaired feed conversion ratio in the period from 14 to 28 days (1.63 v. 1.69) and at 42 days (1.65 v. 1.68). In both experiments apparent metabolizable energy values were affected by dietary fat type. Irrespective of the fat type present in the diet, C. perfringens challenge decreased the digesta pH in the crop and ileum, but had no effect in cecal contents. Moreover, in Experiment 1, total organic acid concentration in the ileum was two to three times lower on soybean oil diets as compared with other treatments, indicating that C. perfringens as well as dietary fat type significantly affects microbiota activity in the broiler chicken gastrointestinal tract.


Subject(s)
Chickens , Clostridium Infections/veterinary , Clostridium perfringens/physiology , Dietary Fats/analysis , Poultry Diseases/immunology , Poultry Diseases/microbiology , Animal Feed , Animals , Clostridium Infections/immunology , Clostridium Infections/microbiology , Diet/veterinary , Fermentation , Gastrointestinal Tract/immunology , Gastrointestinal Tract/metabolism , Gastrointestinal Tract/microbiology , Male , Random Allocation , Weight Gain
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