Effect of feeding fermented liquid feed and fermented grain on gastrointestinal ecology and growth performance in piglets.

To investigate the microbial and nutritional characteristics of dry feed, liquid feed containing fermented liquid cereal grains, and fermented liquid feed, and their effect on gastrointestinal ecology and growth performance, 120 piglets from 40 litters were used and housed in pens with 5 animals in each. The 3 dietary treatments (all nonheated and nonpelleted diets) were: a dry meal diet (DRY); a fermented, liquid cereal grain feed (FLG); and a fermented liquid feed (FLF). The FLG diet was prepared by storing the dietary cereals (barley and wheat) and water (1:2.5, wt/wt) in a closed tank at 20 degrees C and adding the remaining dietary ingredients immediately before feeding. The FLF diet was prepared by storing compound feed and water (1:2.5, wt/wt) in a closed tank at 20 degrees C. Three times daily, 50% of the fermented cereals or compound feed and water stored in the tanks was removed and replaced with an equal amount of fresh cereals or feed and water. On d 14, 1 piglet from each pen was killed and samples from the gastrointestinal tract were obtained. The pH of the fermented cereals was 3.85 (SD = 0.10), that of the FLG diet was 5.00 (SD = 0.18), and the pH of the FLF diet was 4.45 (SD = 0.11). The dietary concentration of lysine (g/16 g of N) pointed to a decreased concentration in the FLF (5.46, SD = 0.08) compared with the DRY (6.01) and FLG (6.21, SD = 0.27) diets, and the concentration of cadaverine was greater in the FLF diet (890 mg/kg, SD = 151.3) than in the DRY (32 mg/kg) or FLG (153 mg/kg, SD = 18.7) diets. Fermenting only the cereal component of the diet (FLG) promoted the growth of yeasts to a greater extent than fermenting the whole diet (FLF). Terminal RFLP profiles of diets and digesta from the stomach and midcolon showed differences among dietary groups. The number of yeasts able to grow at 37 degrees C in the stomach and caudal small intestine was greatest in the FLG group compared with the other 2 dietary groups (P < 0.01). In the cecum and colon, the differences were only significant between piglets fed the FLG and the FLF diets (P < 0.05). The greatest number of yeasts able to grow at 20 degrees C was detected in the animals fed the FLG diet. However, the values were different from the FLF-fed piglets only in the stomach (P < 0.05) and midcolon (P < 0.05). There was a tendency (P < 0.10) for greater ADG of the piglets fed the FLG compared with the FLF diet. Feeding liquid feed containing fermented, liquid cereal grains as a means of avoiding microbial decarboxylation of free amino acids in the feed and increasing feed intake by improving palatability seems promising but requires further investigation.

The effect of breed and parity on curves of body condition during lactation estimated using a non-linear function.

The objectives of this study were to see if the body condition score curve during lactation could be described using a model amenable to biological interpretation, a non-linear function assuming exponential rates of change in body condition with time, and to quantify the effect of breed and parity on curves of body condition during lactation. Three breeds were represented: Danish Holstein (n = 112), Danish Red (n = 97) and Jerseys (n = 8). Cows entered the experiment at the start of first lactation and were studied during consecutive lactations (average number of lactations 2, minimum 1, maximum 3). They remained on the same dietary treatment throughout. Body condition was scored to the nearest half unit on the Danish scale (see Kristensen (1986); derived from the Lowman et al. (1976) system) from 1 to 5 on days: 2, 14, 28, 42, 56, 84, 112, 168, 224 after calving. Additionally, condition score was recorded on the day of drying off the cow, 35, 21, and 7 days before expected calving and finally on the day of calving. All condition scores were made by the trained personal on the research farm, where the same person made 92% of the scores. The temporal patterns in condition score were modelled as consisting of two underlying processes, one related to days from calving, referred to as lactation only, the other to days from (subsequent) conception, referred to as pregnancy. Both processes were assumed to be exponential functions of time. Each process was modelled separately using exponential functions, i.e. one model for lactation only and one for pregnancy, and then a combined model for both lactation only and pregnancy was fitted. The data set contained 467 lactation periods and 378 pregnancy periods. The temporal patterns in condition score of cows kept under stable and sufficient nutritional conditions were successfully described using a two component non-linear function. First lactation cows had shallower curves, they had greater condition scores at the nadir of the curve. Danish Holstein and Jersey were thinner at the end of the mobilisation period having lost more body condition than the Danish Red breed. Although the dairy breeds ended up being thinner there were no significant differences in the rate at which they lost body condition.

Noncytopathogenic bovine viral diarrhea virus (BVDV) reduces cleavage but increases blastocyst yield of in vitro produced embryos.

The growing application of in vitro embryo production systems that utilize slaughterhouse tissues of animals of unknown health status conveys the risk of disease transmission. One pathogen of concern in this regard is bovine viral diarrhea virus (BVDV), and the objective of this study was to investigate the effect of BVDV on in vitro embryonic development. A bovine in vitro embryo production system was experimentally infected with BVDV at 2 stages: prior to in vitro maturation by incubating cumulus-oocyte complexes (COC) with virus (strain Pe515; titer 10(6.2) tissue culture infective dose (TCID)50/mL) or vehicle for 2 h, and then during in vitro culture by the use of BVDV infected granulosa cells. Exposure to BVDV throughout in vitro production reduced cleavage rates (P = 0.01) but increased (P = 0.05) the number of embryos that reached the 8-cell stage when expressed as a percentage of cleaved oocytes. Blastocyst yield was increased by the presence of virus when expressed as a proportion of oocytes (P = 0.0034) or of those cleaved (P < 0.0001). The percentage of total blastocyst yield on Days 7, 8 and 9 for the control and virus treatments was 20, 51, 29 and 29, 41, and 29%, respectively, indicating that the rate of blastocyst development was nonsignificantly faster in the virus-treated group (P = 0.06). These results indicate that the presence of non-cytopathogenic BVDV in an in vitro production system may reduce cleavage rates but allow those cleaved to develop to blastocysts at a higher rate.

The prognosis of patients with alcoholic liver disease. An international randomized, placebo-controlled trial on the effect of malotilate on survival.

The aim of this study was to examine the effect of malotilate on survival in patients with alcoholic liver disease and to determine prognostic variables for survival. Four hundred and seven patients with alcoholic liver diseases, from seven European liver units, entered a randomized placebo-controlled, double-blind trial: 140 patients received malotilate 1500 mg/day, 133 patients received 750 mg/day, and 134 patients received placebo. The patients were included in the study over a period of 3 1/2 years, and the study was closed 1 year after the entry of the last patient. Eighty-four patients died (35, 19, 30 patients in groups 1500 mg/day, 750 mg/day, and placebo, respectively). Survival was slightly better in the 750 mg/day group than in the two other treatment groups, when tested by conventional log-rank tests (p = 0.06). However, a treatment effect was supported by a highly significant (p = 0.006) non-proportionality of the death intensity in patients receiving 750 mg/day against those receiving either 1500 mg/day or placebo. Prognostic variables for survival were evaluated using the multiple Cox regression analysis of clinical and laboratory variables and with or without liver histology variables, as determined at entry into the study. The analysis was stratified for the three treatment regimens. In the analysis including liver histology variables, independent significant prognostic variables were: years of high alcohol intake, prothrombin index, alkaline phosphatases, creatinine, immunoglobulin M, white blood cell count, and liver cell steatosis. In the analysis without liver histology variables, prognostic variables were: years of high alcohol intake, prothrombin index, alkaline phosphatases, creatinine, and immunoglobulin M.

Cardiac function and maximal exercise capacity early after acute myocardial infarction.

The purpose of the study was to assess the relationship between left and right ventricular function measured at rest and maximal exercise capacity in patients with recent acute myocardial infarction (AMI). Forty-three male patients (Killip Class I, n = 36; Killip Class II, n = 7) with a wide range of left ventricular (LV) function and size underwent graded bicycle exercise testing less than 4 weeks after AMI (mean 21 days, 17-27). None of the patients had exercise limiting factors other than dyspnoea and fatigue. Left and right ventricular ejection fractions were determined by a radionuclide ventriculographic method which also allowed determination of absolute LV volumes and actual LV peak filling rate. LV ejection fraction had a weak association to estimated maximal oxygen uptake (VO2 max) (r = 0.37). No association was found between LV size, LV stroke volume, or LV peak filling rate and estimated VO2 max. Similarly, right ventricular ejection fraction showed no correlation to estimated VO2 max. Patients with well preserved LV function had a higher exercise induced increase in systolic blood pressure than patients with reduced LV function, but the increase in systolic blood pressure could not be used to estimate LV function with any reasonable accuracy. We conclude that the maximal exercise capacity of patients with recent AMI is virtually independent of their left and right ventricular function determined at rest, and that exercise testing and radionuclide ventriculography should be regarded as complementary procedures in the evaluation of patients with AMI.

Short-term measurement of linear growth in preterm infants: validation of a hand-held knemometer.

A hand-held electronic knemometer, resembling a pair of callipers, for measuring knee-heel length in preterm infants was developed to improve the accuracy of measuring linear growth velocity in infants. The measuring system is based on a magnetic encoder and has a resolution of 0.01 mm. The knee-heel length is recorded automatically when the pressure applied on the heel reaches a preset value. The result of a measurement sequence is expressed as the average of five sequential readings. The error of one measurement sequence was 0.82 mm, corresponding to a coefficient of variation of 0.8% or 2 d of growth in knee-heel length. It includes the technical error and an error component due to the correlation of the readings within a series. The estimated error on the measurement of the knee-heel growth velocity (expressed as mm/d), measured over a 3-wk period, was 0.04 mm, corresponding to a coefficient of variation of 8%. Longitudinal growth data from 11 healthy preterm infants (birth weight 918-1482 g) are presented. Knee-heel length velocity from birth until day of regained birth weight was similar to the velocity during the following weeks, showing that there was no deceleration of growth immediately after birth. In conclusion, the method is accurate and gentle in measuring linear growth velocity over short periods and can be useful in monitoring the progress of ill infants and in growth studies of preterm and mature infants, in which linear growth is a more relevant short-term outcome than weight gain.

Left ventricular peak filling rate, heart failure and 1-year survival in patients with acute myocardial infarction.

Radionuclide left ventricular (LV) peak filling rate (PFR) was determined in 185 survivors of acute myocardial infarction (AMI) and expressed in units of (1) end-diastolic volume per second (EDV s-1). (2) stroke volume per second (SV s-1), or (3) actual millilitres of blood filled into the left ventricle per second (ml s-1). The purpose of the study was to assess the interrelationship between the three expressions of PFR, and to analyse their significance with regard to signs of congestive heart failure and 1-year survival in patients with AMI. PFR EDV s-1, PFR SV s-1 and PFR ml s-1 had a poor relationship to each other, were all influenced by LV volumes and ejection fraction, and supplied contradictory information with regard to LV filling in patients with heart failure. None of the three expressions of LV peak filling rate had an association to heart failure that was independent of LV volume and ejection fraction. A low PFR EDV s-1 in contrast to a high PFR SV s-1 was associated with a high 1-year cardiac mortality, suggesting that these 'normalized' indices of LV peak filling rate signalled LV size and stroke volume rather than actual LV filling behaviour. No association was present between PFR ml s-1 and 1-year mortality. We conclude that the clinical use of radionuclide LV PFR in patients with AMI may lead to spurious results, unless the influence of LV size and ejection fraction is taken into consideration.

Left ventricular volumes in the recovery phase after myocardial infarction: relation to infarct location, left ventricular function and one-year cardiac mortality.

Absolute left ventricular volumes, normalized to body surface area, were determined by a count-based radionuclide technique in 189 patients with myocardial infarction (MI). All examinations were performed in the second week after MI. Fifty-three percent of the patients had an increased end-diastolic volume index (EDVI) and 72% an increased end-systolic volume index (ESVI). Patients with anterior MI had the same median EDVI as patients with inferoposterior MI, but significantly higher median ESVI and significantly lower median stroke volume index (SVI). SVI was subnormal in 19% of the 189 patients and left ventricular ejection fraction (LVEF) was subnormal in 67%. A non-linear, inverse relationship was present between EDVI and LVEF and between ESVI and LVEF, but LVEF varied greatly for any degree of ventricular dilatation. During a 1-year follow-up period, death from cardiac causes occurred in 29 patients. A strong relationship was present between the degree of ventricular dilatation and 1-year mortality, as well as between the degree of SVI or LVEF reduction and 1-year mortality but, next to clinical heart failure, LVEF was the single most powerful predictor of cardiac death, and various combinations of EDVI, ESVI and SVI did not add more prognostic information to that obtained by heart failure than did LVEF.

Variation in macronutrients in human bank milk: influencing factors and implications for human milk banking.

Protein (P), fat (F), and carbohydrate (C) concentration in expressed human bank milk was determined by infrared analysis of 2,554 samples from 224 mothers. The mean contents of P, F, C, and energy (E, calculated from P, F, and C) were 9.0 g/L, 39.0 g/L, 71.9 g/L, and 696 kcal/L, respectively. There was a large variation in the concentration of energy-yielding macronutrients. The contents of P, F, C, and E in the samples with the highest values (97.5 percentile) were 2.3-, 4.8-, 1.2-, and 2.3-fold, respectively, above the contents in the samples with the lowest values (2.5 percentile). The P content decreased exponentially during the 1st 8 months, followed by an increase during the following months. The F content decreased during the 1st 4 months, followed by an almost linear increase. The possible influence of different maternal characteristics on the macronutrient content of the milk was examined. The main results were as follows: the P and F contents increased slightly with increasing body mass index of the mother, the P content decreased with increasing amounts of milk delivered to the milk bank, and the F content was higher in mothers delivering large amounts of milk. By selecting incoming milk with a high P content, we have developed a "high-protein" milk with a P content of about 12 g/L (true protein) and an E content of about 725 kcal/L. Thus, by continuous monitoring of macronutrient content in human bank milk it is possible to develop a "high-protein" milk with sufficient P and E content to cover the needs of preterm infants with very low birth weights (less than 1,500 g).

Graft-versus-leukaemia activity associated with CMV-seropositive donor, post-transplant CMV infection, young donor age and chronic graft-versus-host disease in bone marrow allograft recipients. The Nordic Bone Marrow Transplantation Group.

Risk factors for post-transplant relapse were analysed retrospectively in 163 patients treated with allogenic bone marrow transplantation for acute myeloid leukaemia (AML), acute lymphoblastic leukaemia (ALL) or lymphoblastic lymphoma in first to fourth remission or during relapse. Multifactorial analysis was performed according to Cox with fixed pretransplant covariates and post-transplant cytomegalovirus (CMV) infection and graft-versus-host (GVHD) as time-dependent covariates. Advanced stage of leukemia at the time of transplantation was an important risk factor for subsequent relapse. Furthermore, the study confirmed a graft-versus-leukaemia (GVL) activity associated with chronic GVHD, including de novo chronic GVHD (intensity factor 0.08, p = 0.004). In a model excluding chronic GVHD, female donor-to-male recipient (a risk factor for GVHD), was associated with decreased post-transplant relapse risk (intensity factor 0.3, p = 0.008), suggesting that an allo-reaction against a minor transplantation antigen (Hy) may mediate antileukaemic activity. A decrease of the relapse risk by a factor 0.18 was observed in recipients with AML as well as ALL when the donor was CMV seropositive (p = 0.0002). This effect was restricted to patients who had laboratory evidence of post-transplant CMV infection. When CMV infection occurred and donor was seropositive the relapse risk was reduced by a factor 0.035. The effect was not mediated through an increased occurrence of grade 2-4 acute or chronic GVHD and could not be explained by a statistical bias due to censoring of patients who died in remission. Rather, donor CMV immunity was associated with GVHD independent GVL activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Prognostic factors in resected stages I and II adenocarcinoma of the lung. A multivariate regression analysis of 137 consecutive patients.

The prognostic factors for survival after radical resection of stages I and II adenocarcinoma of the lung were investigated in 137 consecutive patients. Seventeen variables were investigated by use of Cox's multivariate regression model. Factors predicting a poor prognosis were low status of Karnofsky performance, histologic subtype of solid carcinoma with formation of mucus, and T2 and N1 disease. The staging according to American Joint Committee on Cancer Staging did not provide significant information on survival when the variables describing T and N status were included in the Cox model. The new international staging system carried prognostic information because the new stages I and II are identical with the N0 and N1 groups. Groupings of patients according to the prognostic variables defined in this study allow for more detailed prediction of survival than can be achieved solely by T and N groupings. The prognostic information may be used in the design and interpretation of clinical trials and in the selection of patients who might be considered potential candidates for studies of adjuvant treatment.

Late ventricular dilatation in survivors of acute myocardial infarction.

The purpose of this study was to assess the natural course of left ventricular (LV) volumes in the convalescent phase of acute myocardial infarction (AMI). Fifty-seven patients were examined 2 weeks and approximately 1 year after AMI by a radionuclide method allowing determination of absolute LV volumes. After 1 year the patients had fewer clinical and radiologic signs of heart failure, but median end-diastolic volume index had increased from 92 to 112 ml/m2 (p less than 0.001), median end-systolic volume index from 51 to 65 ml/m2 (p less than 0.001) and median stroke volume index from 39 to 47 ml/m2 (p less than 0.001). Patients with first anterior infarcts had significantly greater increases in end-diastolic volume index, end-systolic volume index and stroke volume index than patients with first inferoposterior infarcts. The increase in LV volumes was significantly greater in patients with clinical manifestations of heart failure than in those without these signs. Notably, changes in LV size had an unpredictable effect on LV ejection fraction.

Prognostic factors in inoperable adenocarcinoma of the lung: a multivariate regression analysis of 259 patients.

The prognostic factors for survival in advanced adenocarcinoma of the lung were investigated in a consecutive series of 259 patients treated with chemotherapy. Twenty-eight pretreatment variables were investigated by use of Cox's multivariate regression model, including histological subtypes and degree of differentiation, the new international staging system for lung cancer, and seven laboratory parameters. Staging of the patients included bone marrow examination but were otherwise nonextensive without routine bone, liver, and brain scans. Factors predicting poor survival were low performance status, stage IV disease, no prior nonradical resection, liver metastases, high values of white blood cell count, and lactate dehydrogenase, and low values of asparatate aminotransaminase. The nonradical resection may not be a prognostic factor because of the resection itself but may rather serve as an indicator for patients having minimal disease spread. Liver metastases were of limited clinical value as a prognostic factor because they were detected in only seven cases in this patient population. A new Cox analysis ignoring the influence of this variable revealed no other variables than those occurring in the former Cox model to be of importance (performance status, stage, surgical resection, WBC, aspartate aminotransaminase, and lactate dehydrogenase). This simplified model appears to be a feasible clinical tool, allowing for prognostic stratification of patients when first the inoperability of the patient is known.

Response to cytostatic treatment in inoperable adenocarcinoma of the lung: critical implications.

The prognostic factors for response to chemotherapy and the prognostic impact of response status on survival, relative to other prognostic variables, were evaluated among 53 responding (9 complete responses; 44 partial responses) and 165 non-responding patients with inoperable adenocarcinoma of the lung (ACL). Multiple logistic regression analysis, including 27 pretreatment variables, revealed that the only significant predictor of response was bidimensionally measurable disease parameter (P = 0.02), followed by brain metastases that were negatively correlated to response, although insignificantly (P = 0.10). Univariate landmark analyses among patients alive at 8, 12, 16 and 24 weeks showed a trend towards better survival for responders compared with non-responders, but did not reach a significant level at any time (P values 0.78, 0.57, 0.23 and 0.12, respectively). Death hazard ratios for responders to non-responders were 0.91, 0.89, 0.79 and 0.73. Multivariate regression analysis among patients alive at 16 weeks demonstrated a significant impact on survival for performance status, non-radical tumour resection, liver metastases and LDH, while the impact of response status in comparison was weak and insignificant. This reflects the unsatisfactory treatment results achieved in inoperable ACL, with the majority of responses being partial, and calls for improvement of the cytostatic treatment currently available.

The fall-off in serum concentration of tetanus antitoxin after primary and booster vaccination.

In 196 randomly selected persons with documented complete primary vaccination against tetanus 12-30 years earlier, antitoxin concentration in serum relative to time since last vaccination was studied. In the group of non-revaccinated persons an exponential decrease in antitoxin concentration with time since primary vaccination was found. 25-30 years after primary vaccination, 28% were unprotected (antitoxin concentration in serum below 0.01 IU/ml). In the group that received a single revaccination earlier, a similar exponential fall in antitoxin concentration was found, but all those revaccinated up to 23 years earlier were still protected. 82 persons who had not been revaccinated earlier were revaccinated. All those revaccinated less than 20 years after primary vaccination attained very high antitoxin concentrations (above 6 IU/ml) corresponding to a duration of immunity of at least 20 years. It was suggested that a revaccination program consisting of a single revaccination in childhood and thereafter every 20 years is sufficient to maintain immunity.