Feeding of Pellets Rich in Digestible Neutral Detergent Fiber to Lactating Cows in an Automatic Milking System

If the milking frequency in an automatic milking system (AMS) is increased, the intake of concentrated pellets in the robot may be raised accordingly. Consumption of a large quantity of starchy grains within a short time can impair the appetite, decrease voluntary visits to the milking stall, and lower intakes of dry matter (DM) and neutral detergent fiber (NDF). Therefore, the hypothesis to be tested in this study was whether conventional starchy pellets fed in the AMS could be replaced with pellets rich in digestible NDF without impairing the cows' motivation to visit a milking stall voluntarily. Fifty-four cows were paired according to age, milk yield, and days in milk, and were fed a basic mixture along the feeding lane (19.9 kg of DM/cow per d), plus a pelleted additive (approximately 5.4 kg of DM/cow per d) that they obtained in the milking stall and in the concentrate self-feeder that they could enter only after passing through the milking stall. The 2 feeding regimens differed only in the composition of the pelleted additive, which, for the control group, contained 49% starchy grain, and for the experimental group contained 25% starchy grain plus soy hulls and gluten feed as replacement for part of the grain and other low-digestible, NDF-rich feeds. Both diets resulted in similar rates of voluntary milkings (3.31 vs. 3.39 visits/cow per d). Average yields of milk and percentages of milk protein were also similar in the 2 groups. The results suggest that an alternative pellet composition can be allocated in the AMS in conjunction with basic mixture in the feeding lane, without any negative effect on appetite, milk yield, milk composition, or milking frequency of the cows. It also opens the opportunity to increase yields of milk and milk solids by increasing the amount of pelleted concentrates that can be allocated to selected high-yielding cows via the AMS, because this can be done while maintaining a high frequency of voluntary milkings.

Follow-up of patients with contrast-induced nephropathy

In this chapter, we review the approach to following the patient after contrast is administered. We first discuss the clinical importance of renal injury for if there were no clinically significant consequences of this renal injury, we would have far less concern for the adequacy of follow-up. We next look at markers of renal injury and what tests are used in clinical practice to define contrast-induced nephropathy (CIN). Finally, we discuss the steps that should be taken in those who do develop CIN to limit the impact of the injury and protect them from future adverse events.

Digestibility in Lactating Cows of Diets Containing Whole Pima Treated with Sodium Hydroxide Versus Akala or Pima Cottonseed

This study examines the effect of NaOH treatment on the nutritive value of Pima cottonseed for lactating cows. Treatment of Pima cottonseed with NaOH increased the extent of dry matter (DM) and neutral detergent fiber in vitro digestibility. Three groups of cows were fed 3 similar total mixed rations (TMR) differing only in the type of cottonseed fed, either whole linted Akala, whole unlinted Pima, or whole Pima treated with 4% NaOH (T-Pima). Dry matter and organic matter (OM) intakes of Akala and Pima TMR were similar and tended to be lower compared with cows fed T-Pima. This was reflected in similar intake of crude protein and lipids by cows fed the 3 TMR. Digestibility of DM, OM, and crude protein were similar in cows fed Pima and T-Pima diets, and slightly higher in cows fed the Akala TMR. Lipid digestibility was highest in cows fed Akala TMR, whereas cellulose and NDF digestibility were lowest in Pima TMR. In the 3 TMR, there was a large gap between the high values of "digestibility of intact seeds" and actual in vivo digestion of DM and OM. Similar yields of milk and milk protein were obtained in cows fed the Akala and Pima TMR, whereas higher yields of milk, milk protein, milk fat, and 4% fat-corrected milk were found in the T-Pima cows. Similar efficiency of DM intake for fat-corrected milk production was achieved by cows fed the 3 TMR.

Interdigitating dendritic cell sarcoma: a report of four paediatric cases and review of the literature

AIMS

To report a series of four paediatric cases of interdigitating dendritic cell sarcoma (IDCS) and add to the known extranodal sites of occurrence for this tumour. Neoplasms derived from interdigitating dendritic cells are rare, with only 33 cases being reported in the literature (Medline search). These tumours usually occur in lymph nodes in the adult population.

METHODS AND RESULTS

The patients were a 10-year-old girl with a large soft tissue mass bulging into the left chest, a 12-year-old girl with a right paraspinal mass, a 21-month-old boy with generalized lymphadenopathy and hepatosplenomegaly and a 6-year-old girl with a large bladder mass. Paraffin blocks and haematoxylin and eosin slides were available in all cases. In addition, immunohistochemistry and electron microscopy were performed. A diagnosis of IDCS was made in all cases.

CONCLUSION

The diagnosis of IDCS can rarely be entertained on clinical information alone. Microscopically, there is a wide spectrum of features. Thus, immunohistochemistry and electron microscopy are crucial in making the diagnosis. The differential diagnosis includes inflammatory pseudotumour, follicular dendritic cell sarcoma, true histiocytic lymphoma, malignant Langerhans cell histiocytosis, anaplastic large-cell lymphoma, melanoma, and a range of sarcomas. IDCS displays aggressive behaviour and approximately half of the patients die of the disease.

Characterization of adhesion and differentiation markers of osteogenic marrow stromal cells

Marrow stroma cells (MSC) play a major role in osteogenesis. The potential of the MSC to differentiate to bone-forming cells relies upon molecular regulation. This study analyzed MBA-15 cells for the expression of genes and proteins that are key regulators of osteoblast differentiation. These cells express Cbfa1 and c-fos transcription factors (TF) of osteoprogenitor proliferating cells. RT-PCR and immunohistochemistry were used to demonstrate the message and protein expression of extracellular matrix proteins that are a prerequisite for matrix formation and mineralization, including alkaline phosphatase (ALP), osteocalcin, osteopontin, biglycan, and bone sialoprotein (BSP). The activity of ALP was correlated at various cell densities with co-expression of osteocalcin or osteopontin. Adhering cells must attach to the appropriate matrix to enable survival and differentiation. Using attachment assays, we demonstrated that MBA-15 cells adhered to collagenous matrix and the effect on survival measured by changes in intracellular calcium (Ca) levels. The cells' adhesion to matrix is mediated via cell surface molecules. We quantified the expression of cells surface molecules that are important players in mediating cell-matrix interaction. Flow cytometry analysis (FACS) was used to determine the expression of CD-31 (36%), and lower levels were identified for CD-62E and CD11b. In summary, the present study demonstrates the expression of molecular markers that are distinctive for the osteoblastic phenotype in MBA-15 marrow stroma cells and have crucial role in cell-matrix interaction, in establishing the cellular osteogenic phenotype and their survival.

Long segment Hirschsprung's disease in the Waardenburg-Shah syndrome

Presentation with signs of bowel obstruction in an infant with Waardenburg syndrome should raise the suspicion of aganglionosis. We report such a case of long segment Hirschsprung's disease associated with Waardenburg syndrome. Long term care of such children is fraught with high morbidity and mortality.

Digestibility by dairy cows of monosaccharide constituents in total mixed rations containing citrus pulp

Ten lactating cows were divided into two groups and individually fed ad libitum one of two experimental total mixed rations (TMR) as follows: 1) a TMR containing 20% corn grain and 10% dry citrus pulp (high corn); and 2) a TMR containing 21% citrus pulp and 9% corn grain (high citrus pulp). Both TMR also contained corn silage (28%), legume haylage (19.5%), extruded full fat soybeans (13.5 to 14%), soybean meal (6.5%), and minerals and vitamins. Voluntary dry matter intake of cows consuming the high corn ration tended to be higher than for cows in the high citrus pulp group (22.2 vs. 20.7 +/- 1.0 kg/cow per day, respectively). Digestibility of NDF was higher for the TMR with high citrus pulp compared with the TMR with higher corn. Across treatments, neutral detergent fiber (NDF) glucose was more digestible than NDF xylose and uronic acids and less digestible than NDF arabinose, galactose, and mannose. Digestibility of total neutral detergent soluble carbohydrates was also higher in the high citrus pulp group (86.8, high citrus pulp vs. 80.3 +/- 1.7%, high corn); with glucose and uronic acids accounting for most of that difference. Consequently, higher total carbohydrate digestibility was obtained in the TMR containing higher citrus pulp compared with the TMR with a higher percentage of corn (77.1 and 72.5 +/- 1.0%, respectively). Slightly lower carbohydrate intake in cows fed higher citrus pulp was compensated by higher digestibility of carbohydrates and protein. Thereby, partial replacement of corn by citrus pulp in TMR of high producing dairy cows improved feed efficiency.

Mental mobilization processes in critical incident stress situations

In this article, the psychological emergency mobilization process that takes place in threat situations is postulated. Mental mobilization is the increased mental capability of the mind in critical situations to process incoming and stored information to enable adaptive survival responses. The processes that are mobilized in the service of survival are enhanced sensory awareness, focused attention, rapid processing of incoming data, and use of previous experience, enhanced memory, altered time perception, and temporary deactivation of emotional reactions. From a clinical standpoint, it is important that the survival value of these processes is understood, as survivors can be helped to feel a sense of accomplishment and empowerment when they are taken through a critical situation in a detailed way and discover that they have been able to function well and survive by use of their stored "experience," rapid processing of information or other aspects of their mental mobilization.

The young dancer

The injuries that are prevalent in and unique to dancers have their origins inextricably linked to faulty technique or poor biomechanics, combined with other risk factors. It is this combination of factors that must be addressed when considering diagnosis, treatment, and rehabilitation. For the dancer to return to full activity with minimal risk of recurrent injury, neuromuscular re-education is mandatory. This process best entails using a team approach, accessing the resources of healthcare professionals and those who train the dancer on a daily basis. In some cases, parents also may need to be involved. Communication, interaction, and mutual understanding among these groups will assist the dancer in regaining and maintaining health.

The effect of nonstructural carbohydrate and addition of full fat extruded soybeans on the concentration of conjugated linoleic acid in the milk fat of dairy cows

Conjugated linoleic acid (CLA), a naturally occurring anticarcinogen found in dairy products, is a byproduct of incomplete ruminal biohydrogenation of unsaturated fatty acids. Our objective was to determine the effect of nonstructural carbohydrate sources, addition of full fat extruded soybeans as a source of unsaturated fatty acids, and possible interactions on the milk fat content of CLA. Cows (n = 20) were assigned to a 4 x 4 Latin square involving two sources of nonstructural carbohydrate, high starch (corn) or high pectin (citrus pulp), with or without addition of extruded soybeans. Milk yield was not affected by nonstructural carbohydrate source, but milk production was increased by 7.8 to 10.5% with dietary additions of extruded soybeans. Milk fat content did not differ between treatments, but fatty acid composition was affected. Cows fed extruded soybean diets had reduced concentrations of C8 to C16 fatty acids and increased concentrations of octadecenoic acids. Diets with extruded soybeans also resulted in more than a doubling in milk fat concentration and yield of CLA. Nonstructural carbohydrate source had only minor effects on CLA, and there was no interaction with extruded soybeans. Milk fat content of trans-C18:1 and CLA were closely related (r2 = 0.77). However, variation among cows was about threefold for each of the diets and rank order of individual cows differed among diets. Overall, we demonstrated that diet modification can be used to alter CLA content of milk fat, but there was substantial individual cow variation for all diets.

Pseudo-aneurysm of the carotid bifurcation secondary to radiation

Pseudoaneurysms of the extracranial carotid vessels have a varied etiopathogenesis. Cases have been attributed to spontaneous rupture, following tonsillectomy or peritonsillar abscesses, trauma, postanastamotic and, rarely, postirradiation, and ECMO. The authors present a case of a pseudoaneurysm involving the carotid artery bifurcation following radiation therapy. A saphenous vein graft was used to establish continuity between the common and the internal carotid arteries. A vascular shunt was used to maintain cerebral perfusion during surgery. This case highlights the technical difficulties encountered in correcting this condition. This case exemplifies the technical difficulties that are encountered in a complicated case such as this. Numerous previous operations and radiotherapy compounded the hazards of the surgical procedure. Although technically challenging, every attempt must be made to resect pseudoaneurysms caused by radiation induced vascular damage.

Surgical treatment for chronic lower-leg compartment syndrome in young female athletes

Our experience in treating chronic lower-leg compartment syndrome suggests that women may be more susceptible to this injury than are men, an observation for which there is support in the literature. Furthermore, when we evaluated the 47 young female athletes (age range, 13 years 11 months to 21 years 10 months) from our practice on whom 78 separate surgeries were performed, we found a lower success rate than those generally reported in studies that combine male and female patients. We suspect, therefore, that for reasons as yet unclear, women may also respond less well than men to operative fasciotomy.