Effect of different ratios of phytogenic feed additives on growth performance, nutrient digestibility, intestinal barrier integrity, and immune response in weaned pigs challenged with a pathogenic Escherichia coli

This study was conducted to investigate the effects of supplementing different ratios of phytogenic feed additives (PFA) to weaned pigs challenged with pathogenic Escherichia coli (E. coli) on growth performance, nutrient digestibility, intestinal barrier integrity, and immune response, and to determine the optimal mixing ratio for PWD prevention. A total of 48 4-week-old weaned pigs with initial body weight of 8.01 ± 0.39 kg were placed in individual metabolic cages, and then randomly assigned to eight treatment groups. The eight treatments were as follows: a basal diet without E. coli challenge (negative control, NC), a basal diet with E. coli challenge (positive control, PC), PC with supplementing 0.1% mixture of 20 % bitter citrus extract (BCE), 10% microencapsulated blend of thymol and carvacrol (MEO), and 70% excipient (T1), PC with supplementing 0.1% mixture of 10% MEO, 20% premixture of grape seed & grape marc extract, green tea, and hops (PGE), and 60% excipient (T2), PC with supplementing 0.1% mixture of 10% BCE, 10% MEO, 10% PGE, and 70% excipient (T3), PC with supplementing 0.1% mixture of 20% BCE, 20% MEO, and 60% excipient (T4), PC with supplementing 0.1 % mixture of 20% MEO, 20% PGE, and 60% excipient (T5), and PC with supplementing 0.1 % mixture of 10% BCE, 20% MEO, 10% PGE, and 60% excipient (T6). The experiments progressed in 16 days, including 5 days before and 11 days after the first E. coli challenge (d 0). In the E. coli challenge treatments, all pigs were orally inoculated by dividing a total of 10 mL of E. coli F 18 for 3 consecutive days from d 0 post-inoculation (PI). Compared with the PC group, the PFA2 and PFA6 groups significantly increased (P < 0.05) feed efficiency and decreased (P < 0.05) diarrhea during the entire period. At d 11 PI, the PFA6 group significantly improved (P < 0.05) gross energy digestibility compared to the PFA1 group. The PFA6 group significantly decreased (P < 0.05) tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) in serum and increased (P < 0.05) the villus height to crypt depth ratio (VH:CD). The PFA2 significantly decreased (P < 0.05) the relative protein expression of calprotectin in the ileum. In conclusion, improvements in growth performance, diarrhea reduction, and immunity enhancement are demonstrated when 10% BCE, 20% MEO, 10% PGE, and 60% excipient are mixed.

Effects of different stocking density and various phytogenic feed additives dosage levels on growing-finishing pigs

This study was to investigate the effects of different phytogenic feed additives (PFA) dosage levels in growing- finishing pigs stressed by high stocking density. A total of 72 mix sexed 12 weeks growing pigs ([Landrace × Yorkshire] × Duroc) with initial body weight (BW) of 49.28 ± 4.58 kg were used for 8 weeks. There were 3 replicate pens in each treatment group, with 3 pigs per pen. The dietary treatment groups consisted of basal diets in animal welfare density (negative control [NC]), basal diet in high stocking density (positive control [PC]), PC + 0.04% essential oil (ES1), PC + 0.08% essential oil (ES2), PC + 0.10% bitter citrus extract & essential oil (CES1), PC + 0.20% bitter citrus extract & essential oil (CES2), PC + 0.05% grape pomace extract (GP1), PC + 0.10% grape pomace extract (GP2). The reduction of space allowance decreased (p < 0.05) average daily gain, feed efficiency, and digestibility of dry matter, crude protein, and gross energy. Also, the fecal score of PC groups increased (p < 0.05) compared with other groups. Basic behaviors (feed intake, standing, lying) were inactive (p < 0.05) and singularity behavior (biting) was increased (p < 0.10) under high stocking density. There was no difference in blood profile. However, the supplementation of PFA alleviated the negative effects such as reduced growth performance, nutrient digestibility, and some increasing stress indicators in th blood (cortisol) and animal behavior (biting). In conclusion, the negative effect of high stocking density was most effectively mitigated by the normal dosage of the mixture of bitter citrus extract and essential oil additive (CES1).

Effect of insect protein and protease on growth performance, blood profiles, fecal microflora and gas emission in growing pig

Two experiments were conducted to determine the effect of Hermetia illucens larvae (HIL) as protein and protease on growth performance, blood profiles, fecal microflora, and gas emission in growing pig. In experiment 1, the seventy-two crossbred growing pigs ([Landrace × Yorkshire] × Duroc) with an initial body weight (BW) of 27.98 ± 2.95 kg were randomly allotted to one of four dietary treatments (3 pigs per pen and 6 replicates pen per treatments). The experimental design was a 2 × 2 factorial arrangement of treatments evaluating two diets (Poultry offal diets and HIL diets) without or with supplementing protease. The poultry offal in basal diet has been replaced by HIL. In experiment 2, the four crossbred growing pigs ([Landrace × Yorkshire] × Duroc) with an initial BW of 28.2 ± 0.1 kg were individually accepted in stainless steel metabolism cages. The dietary treatments included: 1) PO- (PO-; poultry offal diet), 2) PO+ (PO- + 0.05% protease), 3) HIL- (3% PO of PO- diet was replacement 3% HIL), 4) HIL+ (HIL- + 0.05% protease). In experiment 1, From weeks 0 to 2, average daily gain (ADG) and feed efficiency (G:F) were significantly increased in the PO diet group compared with the HIL group. From weeks 2 to 4, ADG and G:F were higher for protease group than for non-protease group. At weeks 2 and 4, the PO diet group had lower blood urea nitrogen (BUN) levels than HIL diet group. In experiment 2, crude protein (CP) and nitrogen (N) retention were decreased by HIL diet at weeks 2 and 4. The fecal microflora and gas emission were not affected by HIL and protease. The HIL diet showed lower CP digestibility than PO diet and total essential amino acids digestibility tended to higher in PO diet than HIL diet. In summary, the present study revealed that replacement of the PO protein with the HIL protein and the additive of protease in growing pig diets during the overall experimental period had no negative effect.

Stimbiotic supplementation modulated intestinal inflammatory response and improved boilers performance in an experimentally-induced necrotic enteritis infection model

Background

Two experiments were conducted to establish an optimal NE challenge model and evaluate the efficacy of stimbiotic (STB) supplementation in necrotic enteritis (NE) challenged broilers. In Exp. 1, a total of 120 Arbor Acres (AA) broilers (45.0 ± 0.21 g) were randomly assigned to 6 treatments in a 3 × 2 factorial arrangement. Vaccine treatments included non-challenge (0), × 10 the recommended dose (× 10) or × 20 the recommended dose (× 20) by the manufacturer. Clostridium perfringens (CP) treatments were non-challenge (No) or 3 mL of 2.2 × 10⁷ CFU CP challenge (Yes). In Exp. 2, a total of 72 AA broilers (40.17 ± 0.27 g) were randomly assigned to 6 treatments in a 3 × 2 factorial arrangement. Dietary treatments included non-additive (CON), 100 mg/kg STB (STB) and 100 mg/kg STB on top of a typical commercial blend including an essential oil, probiotics, and enzyme (CB). Challenge treatments included non-NE challenge (No) and NE challenge (Yes) as established in Exp. 1.

Results

In Exp. 1, CP and vaccine challenge decreased (P < 0.05) body weight (BW), body weight gain (BWG) and feed intake (FI), and increased (P < 0.05) the number of broilers with diarrhea and intestinal lesions. The oral administration of × 20 recommended dose of vaccines coupled with 3 mL of 2.2 × 10⁷ CFU CP resulted in (P < 0.01) a significantly increased incidence of wet litter and intestinal lesions. Thus, this treatment was chosen as the challenge model for the successful inducement of NE in Exp. 2. In Exp. 2, the NE challenge negatively affected (P < 0.01) growth performance, ileal morphology, immunoglobulin contents in blood, caecal microbiota in the caecum, footpad dermatitis, intestinal lesion scores, tumour necrosis factor (TNF-α) and endotoxin in the serum compared with the non-NE challenged birds. The supplementation of STB and CB in diets enhanced (P < 0.05) growth performance, intestinal microbiota, and blood profiles by stimulating ileal morphology (VH and VH:CD) and propionate production in the cecum, and there were no differences in measured variables between STB and CB supplemented birds.

Conclusion

Overall, these results indicate that STB supplementation was able to reduce the inflammatory response and improve the performance of NE challenged birds, and the supplementation of STB alone was as effective as a typical commercial blend containing a number of other additives.

Phytogenic feed additives alleviate pathogenic Escherichia coli-induced intestinal damage through improving barrier integrity and inhibiting inflammation in weaned pigs

Background

This study was conducted to investigate the effects of each phytogenic feed additive (PFA; PFA1, bitter citrus extract; PFA2, a microencapsulated blend of thymol and carvacrol; PFA3, a mixture of bitter citrus extract, thymol, and carvacrol; PFA4, a premixture of grape seed, grape marc extract, green tea, and hops; PFA5, fenugreek seed powder) on the growth performance, nutrient digestibility, intestinal morphology, and immune response in weaned pigs infected with Escherichia coli (E. coli).

Results

A total of 63 4-week-old weaned pigs were placed in individual metabolic cages and assigned to seven treatment groups. The seven treatments were as follows: 1) NC; basal diet without E. coli challenge, 2) PC; basal diet with E. coli challenge, 3) T1; PC + 0.04% PFA1, 4) T2; PC + 0.01% PFA2, 5) T3; PC + 0.10% PFA3, 6) T4; PC + 0.04% PFA4, 7) T5; PC + 0.10% PFA5. The experiments lasted in 21 d, including 7 d before and 14 d after the first E. coli challenge. In the E. coli challenge treatments, all pigs were orally inoculated by dividing a total of 10 mL of E. coli F18 for 3 consecutive days. The PFA-added groups significantly increased (P < 0.05) average daily gain and feed efficiency and decreased (P < 0.05) the fecal score at d 0 to 14 post-inoculation (PI). Tumor necrosis factor α was significantly lower (P < 0.05) in the PFA-added groups except for T1 in d 14 PI compared to the PC treatment. The T3 had a higher (P < 0.05) immunoglobulin G and immunoglobulin A concentration compared to the PC treatment at d 7 PI. Also, T3 showed significantly higher (P < 0.05) villus height:crypt depth and claudin 1 expression in ileal mucosa, and significantly down-regulated (P < 0.05) the expression of calprotectin compared to the PC treatment.

Conclusions

Supplementation of PFA in weaned pigs challenged with E. coli alleviated the negative effects of E. coli and improved growth performance. Among them, the mixed additive of bitter citrus extract, thymol, and carvacrol showed the most effective results, improving immune response, intestinal morphology, and expression of tight junctions.

Effects of different Bacillus licheniformis and Bacillus subtilis ratios on nutrient digestibility, fecal microflora, and gas emissions of growing pigs

The objective of this study was to evaluate the effects of different mixing ratios of Bacillus licheniformis and Bacillus subtilis in diets on nutrient digestibility, fecal microflora, and odor gas emissions of growing pigs. A total of four crossbred ([Landrace × Yorkshire] × Duroc) barrows with average body weight (BW) of 41.2 ± 0.7 kg were randomly allotted four diets over four periods in a 4 × 4 Latin square design. Treatments were as follows: Control (CON, basal diet), CON + 0.2% probiotic complex (L4S6, B. licheniformis and B. subtilis at a 4:6 ratio), CON + 0.2% probiotic complex (L5S5, B. licheniformis and B. subtilis at a 5:5 ratio), CON + 0.2% probiotic complex (L6S4, B. licheniformis and B. subtilis at a 6:4 ratio). Dietary probiotic supplementation showed higher crude protein (CP) digestibility values and lower Escherichia coli counts in fecal samples than the CON group (p < 0.05). There was no significant difference in NH₃ or H₂S emission until day 3. The positive effect of H₂S and NH₃ emissions was detected earlier with the L4S6 and L5S5 compared to the L6S4, which had a lower ratio of B. subtilis. Both the L4S6 and L5S5 probiotic complexes significantly decreased the fecal H₂S and NH₃ emission in days 4 and 6 (p < 0.05). On day 7, all probiotic complexes decreased (p < 0.05) H₂S and NH₃ emissions than the CON group. Our results agreed that the dietary supplementation of Bacillus licheniformis and Bacillus subtilis complexes in growing pigs can significantly improve CP digestibility and reduce fecal E. coli counts, NH₃ and H₂S emissions. Notably, the higher mixing ratio of Bacillus subtilis in probiotic supplementation is more effective in reducing the odor of manure.

Effects of Replacing Medical Zinc Oxide with Different Ratios of Inorganic: Organic Zinc or Reducing Crude Protein Diet with Mixed Feed Additives in Weaned Piglet Diets

One hundred twenty weaned piglets (9.34 ± 0.74 kg) were used in a four-week experiment to investigate the effects of replacing medical ZnO with a different ratio of inorganic and organic zinc (IZ:OZ) or a low-crude-protein diet (LP) with mixed feed additives (MFAs) in the weaned piglets' diet. The dietary treatments included a control (CON), T1 (T1; ZnO 1000 mg/kg), T2 (IZ:OZ 850:150), T3 (IZ:OZ 700:300), T4 (IZ:OZ, 500:500), and T5 (LP with MFAs (0.1% essential oils + 0.08% protease + 0.02% xylanase)). The growth performance was decreased (p < 0.05) in the CON treatment compared with the T4 treatment. The diarrhea incidence was decreased (p < 0.05) in the T4 and the T5 treatment compared with the CON and the T1 treatments. The apparent total tract digestibility (ATTD) of nutrients were increased (p < 0.05) in the T4 and T5 treatments compared with the CON, T1, and T2 treatments. The T4 treatment had a higher (p < 0.05) ATTD of zinc than the T1, T2, and T3 treatments. The fecal microflora was improved (p < 0.05) in the T5 treatment compared with the CON and T3 treatments. In conclusion, IZ:OZ 500:500 could improve growth performance, nutrient digestibility, and zinc utilization while reducing diarrhea incidence in weaned piglets. Moreover, LP with MFA could replace medical ZnO.

Effects of different inorganic:organic zinc ratios or combination of low crude protein diet and feed additives in weaned piglet diets

Thirty-six weaned piglets with an initial body weight (BW) of 8.43 ± 0.40 kg (28 days of age, ([Landrace × Yorkshire] × Duroc) were randomly assigned to 6 treatments for a 2-week feeding trial to determine the effects of different inorganic zinc (IZ), organic zinc (OZ) or combination of low crude protein diet (LP) and Mixed feed additive (MFA) on diarrhea score, nutrient digestibility, zinc utilization, blood profiles, organ weight, and fecal microflora in weaned piglet diet. The pigs were individually placed in 45 × 55 × 45 cm stainless steel metabolism cages in an environmentally controlled room (30 ± 1°C). The dietary treatments included a negative control (NC), positive control (PC; zinc oxide, 1,000 mg/kg), T1 (IZ : OZ, 850 : 150), T2 (IZ : OZ 700 : 300), T3 (IZ : OZ, 500 : 500), and T4 (LP + MFA [0.1% Essential oils + 0.08% Protease + 0.02% Xylanase]). The daily feed allowance was adjusted to 2.7 times the maintenance requirement for digestible energy (2.7 × 110 kcal of DE/kg BW^0.75). This allowance was divided into two equal parts, and the piglets were fed at 08 : 30 and 17 : 30 each day. Water was provided ad libitum through a drinking nipple. The diarrhea score was significantly increased (p < 0.05) in NC treatment compared with other treatments. The apparent total tract digestibility (ATTD) of dry matter (DM), nitrogen (N), and gross energy (GE) was significantly increased (p < 0.05) in the T2 treatment compared with the PC and NC treatments in week 1. In week 2, the ATTD of DM, N, and GE was significantly decreased (p < 0.05) in the NC treatment compared with other treatments. The T3 treatment had significantly higher (p < 0.05) ATTD and apparent ileal digestibility of zinc than the PC and T1 treatments. The Escherichia coli count in feces was significantly decreased in the T4 treatment compared with the NC and T2 treatments. The Lactobacillus count in feces was significantly increased in the T4 and T1 treatment compared with the T2 and T3 treatments. In conclusion, IZ : OZ 500 : 500 levels could improve nutrient digestibility and zinc utilization in weaned piglets, Moreover, MFA in LP diets could be used as a zinc alternative.

Evaluation of pig behavior changes related to temperature, relative humidity, volatile organic compounds, and illuminance

The objective of this study was evaluation of pig behavior changes related to temperature, relative humidity, volatile organic compounds (VOCs), and illuminance. A total of 24 growing pigs ([Yorkshire × Landrace] × Duroc) were used in the experiment. A sensor was installed at a height of 0.5 m in the center of the pig house. In experiment 1, temperature was changed every four days to 18°C (T1), 22°C (T2), 26°C (T3), and then 30°C (T4). In experiment 2, relative humidity was adjusted to 45% (low humidity [LH]), 60% (middle humidity [MH]), and then 75% (high humidity [HH]) for four days. In experiment 3, after cleaning the pig house just before experiment, only minimal ventilation was provided. VOCs and pig behaviors were observed for 7 days without cleaning the pig house. In experiment 4, three light bulbs of 40 W (470 lumens / 45 lx; low illuminance [LI]), 75 W (1,055 lumens / 103 lx; middle illuminance [MI]), and 100 W (1,521 lumens / 146 lx; high illuminance [HI]) were used for four days each. Pig behavior analysis was performed for following criteria : Feed intake, Standing, Lying, Sitting, Drink water, Rooting, Posture transition (lying-standing), Posture transition (standing-lying), Wallowing, and Biting. In experiment 1, feed intake time was lower (p < 0.05) for the T3 than other treatment groups. Standing time was highest (p < 0.05) for the T1 and lowest (p < 0.05) for the T3. Lying time was shorter (p < 0.05) in T1 and T2 compared to T3 and T4. Drinking frequency was higher (p < 0.05) for the T4 than other treatment groups. In experiment 2, the frequency of rooting and wallowing increased (p < 0.05) with increasing humidity. LH showed the lowest (p < 0.05) rooting frequency and HH showed the highest (p < 0.05) rooting frequency. In experiment 3, VOCs concentration did not (p > 0.05) change pig behavior. In experiment 4, lying time was the longest (p < 0.05) at LI and shortest (p < 0.05) at HI. Therefore, pig behavior is heavily influenced by the environment, especially temperature and humidity. However, correlation between pig behavior to VOCs and illuminance seems to be needed more research.

Effect of low protein diets added with protease on growth performance, nutrient digestibility of weaned piglets and growing-finishing pigs

The objective of this study was to evaluate the effects of low protein diets added with protease on growth performance, nutrient digestibility, and blood profiles of weaned piglets and growing-finishing pigs. A total of 96 weaned pigs ([Yorkshire × Landrace] × Duroc) with average body weight (BW) of 6.99 ± 0.21 kg were used in a 20-week experiment. The dietary treatments were arranged in a 2 × 3 factorial design. Treatments were as follows: In phase 1 (1–2 weeks), two protein levels as high protein (HP; 19.0%), low protein (LP; 17.0%), and three protease (PT) levels (PT0, 0%; PT1, 0.3%; and PT2, 0.5%); in phase 2 (3–4 weeks), protein levels (HP, 18.05%; LP, 16.15%) and protease levels (0%, 0.3%, and 0.5%); in phase 3 (5–12 weeks), protein levels (HP, 17.1%; LP, 15.3%) and protease level (0%, 0.15%, and 0.3%); in phase 4 (13–20 weeks), protein levels (HP, 16.15%; LP, 14.45%) and protease level (0%, 0.15%, and 0.3%). At 4 weeks and 20 weeks after treatment, BW was higher (p < 0.050) in the PT2 group than PT0 group. From weeks 0 to 4, average daily gain (ADG) and feed efficiency (G/F) were higher (p = 0.006 and p = 0.014; p = 0.014 and p = 0.044, respectively) in the PT2 group than PT0 and PT1 groups. From weeks 16 to 20, ADG and G/F were higher (p < 0.001 and p = 0.009; p = 0.004 and p = 0.033, respectively) in the PT2 group than PT0 and PT1 groups. Crude protein (CP) digestibility was higher (p = 0.013, p = 0.014, and p = 0.035, respectively) in the low protein (LP) group than high protein (HP) group at weeks 4, 12, and 20. At weeks 4 and 20, the LP diet group had lower (p < 0.001 and p = 0.001, respectively) blood urea nitrogen (BUN) levels than the HP diet group. Therefore, a low CP diet added with protease could increase growth performance and CP digestibility of weaned piglets and growing-finishing pigs.

Predicting body compositions of live finishing pigs based on bioelectrical impedance analysis

The objective of this study was to predict body compositions of live pigs using bioelectrical impedance procedures. In experiment 1, 32 crossbred (Duroc × Landrace × Yorkshire) finishing pigs with an average weight at 84.06 kg were used. In experiment 2, 96 crossbred (Duroc × Landrace × Yorkshire) finishing pigs with an average weight at 88.8 kg were used. A four-terminal body composition analyser was utilized to determine fat percentage. Lean meat percentage and backfat thickness were measured with a lean meat measuring meter. In experiment 1, fat percentage was not significantly correlated with lean meat percentage, although a tendency (p < 0.1) of a negative correlation was found. Backfat thickness was significantly correlated with fat percentage and lean meat percentage (r = 0.745 and r = -0.961, respectively). Coefficients of determination for fat percentage with lean meat percentage, fat percentage with backfat thickness, and backfat thickness with lean meat percentage were 0.503, 0.566, and 0.923, respectively. In experiment 2, fat percentage was significantly correlated with lean meat percentage (r = -0.972). Backfat thickness was also significantly correlated with fat percentage and lean meat percentage (r = 0.935 and r = -0.957, respectively). Results of this study indicate that bioelectrical impedance analysis might be useful for predicting body compositions of live finishing pigs.

Effects of microencapsulated organic acids on growth performance, nutrient digestibility, fecal microbial counts, and blood profiles in weaning pigs

This study was conducted to investigate the efficiency of a microencapsulated mixture of organic acids (MOA) with low protein in piglet feed on growth performance, diarrhea score, nutrient digestibility, fecal microbial counts, and blood profiles in weaning pigs. A total of 80 pigs [(Landrace × Yorkshire) × Duroc; 6.8 ± 0.48 kg] were randomly assigned to four dietary treatment groups: high protein (HP); low protein (LP); MOA1, LP + 0.2% MOA; and MOA2, LP + 0.3% MOA. The MOA2 group had higher average daily weight gains (during days 0–14 and days 0–28), diarrhea score (during days 0–14, during days 14–28 and days 0–28) and greater digestibility of dry matter (days 14 and 28) compared to the LP group (p < 0.05). However, there were no significant differences (p > 0.05) between the pigs fed diets with the MOA1 and MOA2 in blood profiles and fecal microflora. In conclusion, this study indicates that piglets fed 0.3% MOA in low protein diets maintained similar growth performance and nutrient digestibility, but alleviated the incidence of diarrhea compared to piglets fed high protein diets.

Effects of dietary silicate levels on growth performance, nutrient digestibility, fecal microflora, odorous gas emissions, blood characteristics, and foot and mouth disease antibodies in weaning to finishing pigs

The goal of this study was to investigate effects of different levels of silicate supplementation in weaning to finishing pigs. A total of 96 piglets [(Landrace × Yorkshire) × Duroc] with initial body weight of 11.30 ± 0.02 kg were used for 16 wk (six replicate pens with four pigs per pen). Dietary treatment consisted of 0% (CON), 0.1% (T1), 0.5% (T2), and 1.0% (T3) silicate in the basal diet. Inclusion of 0.1% dietary silicate increased (P < 0.05) body weight, average daily gain, and gain-to-feed ratio in 0–16 wk. In addition, inclusion of 0.1% dietary silicate increased (P < 0.05) crude protein digestibility in 8 and 16 wk, whereas it decreased (P < 0.05) Escherichia coli count and ammonia emissions throughout the study period. Additionally, inclusion of dietary silicate increased (linear, P < 0.05) white blood cell in 4 wk, whereas it increased (quadratic, P < 0.05) white blood cell counts in 8 and 16 wk. Blood urea nitrogen decreased (quadratic, P < 0.05), and lymphocyte and foot and mouth antibodies increased (quadratic, P < 0.05) when silicate level increased. In conclusion, supplementation of 0.1% silicate in the diet showed positive effects in weaning to finishing pigs.

Vertebral fracture is associated with myocardial infarction in incident hemodialysis patients: a Korean nationwide population-based study

Chronic kidney disease (CKD)-mineral and bone disorder suggests that fragile bone and vascular disorder might be connected closely in CKD patients. In this study, fracture event was significantly associated with myocardial infarction (MI) in end-stage renal disease patients on hemodialysis (HD), especially for vertebral fractures.

INTRODUCTION

CKD-mineral and bone disorder is characterized by biochemical abnormalities, bone disorders, and vascular calcification. We aimed to verify the association between fracture and MI in CKD patients.

METHODS

Records for incident CKD stage 3 to 5 patients and patients who initiated HD between July 2014 and June 2018 were retrieved from the Korean Health Insurance Review & Assessment Service Database. Fractures were defined using diagnostic codes and were classified into vertebral, femoral, and other site fractures. MI was defined using a combination of MI diagnostic codes and related procedure codes. Multiple logistic regressions and 1:1 propensity score matching analysis were conducted.

RESULTS

A total of 38,935 patients (HD, 11,379; pre-dialysis CKD, 27,556) were included in this study. A total of 5,057 (13.0%) patients experienced fracture, and 1,431 (3.7%) patients had MI. Multiple logistic regression analysis showed that fracture was significantly associated with MI in the HD group (odds ratio (OR) 1.34, P = 0.024), but not in the pre-dialysis CKD group (OR 1.04, P = 0.701). After propensity score matching for age, gender, and diabetes mellitus between patients with and without fracture, fracture still significantly correlated with MI in HD patients (OR 1.47, P = 0.034) but not in patients with pre-dialysis CKD (OR 1.04, P = 0.751). Subgroup analysis by fracture site found that vertebral fracture was associated with MI in HD patients (OR 2.11, P = 0.024), but femoral or other site fractures were not.

CONCLUSION

In HD patients, fracture was significantly associated with MI, especially for vertebral fractures patients.

Effects of different levels of crude protein and protease on nitrogen utilization, nutrient digestibility, and growth performance in growing pigs

This study was conducted to evaluate the effects of different levels of crude protein (CP) and protease on nitrogen (N) utilization, nutrient digestibility, and growth performance in growing pigs. A total of six crossbred ([Landrace × Yorkshire] × Duroc) barrows were individually accepted in 1.2 m × 0.7 m × 0.96 m stainless steel metabolism cages. The pigs (average initial body weight of 27.91 ± 1.84 kg) randomly assigned to six diets with six weeks (6 × 6 Latin square design). The experiment was carried out in an environment with a temperature of 23 ± 1.5°C, a relative humidity of 83 ± 2.3% and a wind speed of 0.25 ± 0.03 m/s. The dietary treatments were arranged in a 2 × 3 factorial design with two levels of CP (15.3% or 17.1%) and three levels of protease (0 ppm, 150 ppm, or 300 ppm). The average daily gain and gain to feed ratio (G:F) tended to increase (p = 0.074) with increasing amounts of protease. The low CP level diet reduced (p < 0.050) urinary and fecal N concentrations, the total N excretion in feces, and increased (p < 0.050) N retention. Different protease levels in the diet did not affect (p > 0.05) at N intake, but supplementation of the diets with 300 ppm protease decreased (p < 0.050) the N concentration in urine and feces and tended to increase (p = 0.061) the percentage of N retention retained of the total N intake. The dietary CP level did not affect (p > 0.050) the apparent total tract digestibility (ATTD) of dry matter, digestible energy (DE), and metabolic energy (ME), but diet supplementation with 300 ppm protease showed higher (p < 0.050) ATTD of DE and ME than in the protease-free diet. Therefore, a low protein diet with protease could improve the utilization of nitrogen, thereby reducing the negative effect of N excretion into the environment while maintaining or increasing growth performance compared to a high protein diet.

Effects of replacing soybean meal with perilla seed meal on growth performance, and meat quality of broilers

The purpose of this study was to evaluate effects of replacing soybean meal with perilla seed meal (PSM) on growth performance, proximate composition of meat, meat quality, and fatty acids composition of meat in broilers. A total of 60 one-day-old chicks of ROSS 308 (initial body weight of 44.8 ± 0.4 g) were randomly allotted to four treatment groups (15 replicate cages with 1 broilers per cage) in a period of 5 weeks. Dietary treatments included control (CON) basal diet (corn-soybean meal-based diets) and test diets in which PSM was included at 0.5% (T1), 1% (T2), or 2% (T3) to gradually replace soybean meal. At the end of experiment, all broilers were slaughtered for collecting breast and thigh meat. At 5 weeks, T2 and T3 treatment groups had higher (p < 0.05) body weights than CON and T1 treatment groups. Weight gain was increased (p < 0.05) in T2 and T3 treatment groups. Feed intake was decreased (p < 0.05) in T3 treatment group. Broilers in T2 treatment group had lower (p < 0.05) feed conversion ratio than those in other treatment groups. In proximate composition of breast meat, there was no significant (p > 0.05) difference in moisture and ash. Fat composition of breast meat was significantly (p < 0.05) increased in T2 and T3 treatment groups. Regarding meat quality, broilers fed T3 diet had higher (p < 0.05) water holding capacity than those fed other diets. Regarding fatty acids composition of thigh meat, broilers fed T3 diet had higher (p < 0.05) linolenic acid than those fed other diets. In conclusion, soybean meal replaced by 2% perilla seed meal in broiler diet can improve growth performance, meat quality, and fatty acids composition of thigh meat in broilers. Perilla seed meal can be a lot of potential alternatives feedstuff for soybean meal in this study.

Effect of replacing corn with soy hulls on nutrient digestibility of growing pigs

The objective of this study was to determine the effect of replacing corn with soy hulls on nutrient digestibility of growing pigs. Three experimental diets were tested using a 3 × 3 Latin square design using three barrows per group (Landrace × Yorkshire × Duroc, average initial body weight of 36.9 ± 4.0 kg) in individual metabolic cages. The dietary treatments were the control (CON) basal diet (corn-soybean meal based diet), whereas in the test diets, soy hulls were included at 5% (H1), 10% (H2), gradually replacing corn. The daily feed allowance was adjusted to 2.7 times the maintenance requirement for digestible energy (DE) (2.7 × 110 kcal of DE/kg BW^0.75). Intake of crude fiber (CF) was different among treatments (p < 0.05). Pigs fed with H2 diet excreted higher concentrations of dry matter (DM), and CF than pigs fed with H1 diet and basal diet (p < 0.05). Pigs fed with H1 and H2 diets excreted higher concentrations of crude protein (CP) than pigs fed with CON diet (p < 0.05). The apparent total tract digestibility (ATTD) of CF from H1 and H2 diets were higher than CON diet (p < 0.05). Pigs fed with H2 diets were significantly lower (p < 0.05) the ATTD of CP than the pigs fed with CON and H1 diets. The current data suggest that 10% inclusion soy hulls can slightly decrease CP digestibility. However, soy hulls considerably increased CF digestibility.It is concluded that 5% soy hulls may be a usable alternative to corn in growing pig diets.

Effects of different standardized ileal digestible lysine: net energy proportion in growing and finishing pigs

This experiment was performed to evaluate the optimal proportion of dietary standardized ileal digestible lysine (SID Lys) to net energy (NE) proportion in growing to finishing pigs. A total of seventy-two pigs were used at phase 1 (initial body weight 37.23 ± 0.23 kilogram, for 42 d) and at phase 2 (initial body weight 54.16 ± 0.20 kilogram, for 77 d). They were arbitrarily assigned to three treatments groups consisting of four duplicates per treatment (six pigs in duplicates, respectively). Diet treatments were as follows: CON = basal diets (phase 1, crude protein (CP): 19.1%; SID Lys: 0.94%; SID Lys: NE proportion: 0.91 g/MJ / phase 2, CP: 17.0%; SID Lys: 0.84%; SID Lys: NE proportion: 0.79 g/MJ), TRT1 (phase 1, CP: 18.0%; SID Lys: 0.92%; SID Lys: NE proportion: 0.89 g/MJ / phase 2, CP: 15.8%; SID Lys: 0.8%; SID Lys: NE proportion: 0.75 g/MJ), TRT2 (phase 1, CP: 17.3%; SID Lys: 0.82%; SID Lys: NE proportion: 0.79 g/MJ / phase 2, CP: 14.8%; SID Lys: 0.7%; SID Lys: NE proportion: 0.65 g/MJ). In phase 1 and 2, growth performance did not meaningfully be affected when SID Lys: NE proportion decreased with reducing CP content. In phase 2, the nitrogen digestibility of CON group in 11 week was higher (p < 0.05) than other treatments. Also, marbling and firmness scores of TRT2 group diets increased (p < 0.05) compared with those of CON group, but dissimilarities of other meat qualities did not be detected among treatments. In conclusion, introduction of NE system can reduce negative problems introduced when dietary CP decreased. Also, 0.79 and 0.65 g/MJ of SID Lys: NE proportion is the optimal Lys: NE proportion to achieve improved pork quality without impairing the growth performance in growing-finishing pigs, respectively.

Effects of exogenous emulsifier supplementation on growth performance, energy digestibility, and meat quality in broilers

This experiment was conducted to investigate the effects of exogenous emulsifier supplementation on growth performance, energy digestibility, and meat quality in broilers. A total of 60 Ross 308 broilers were treated for two weeks. The three dietary treatments were: (CON) basal diet; (T1) basal diet + 0.1% exogenous emulsifier, and (T2) basal diet + 0.2% exogenous emulsifier. In Period 1 (0–7 days), broilers in the T2 group showed significantly higher body weight gain (BWG) (p < 0.05) and broilers in the T1 and T2 treatment groups had significantly lower feed conversion ratios (FCR) (p < 0.05). In Period 2 (8–14 days), broilers in the T2 treatment group had significantly higher feed intake (FI) (p < 0.05). Therefore, in this experiment (from days 0 to 19), BWG and FCR were affected (p < 0.05) by the T1 and T2 treatments. Additionally, the T1 and T2 treatments with added exogenous emulsifier in the broiler feed showed significantly higher energy digestibility (p < 0.05) than the CON treatment. Broilers fed the T2 diet had higher water-holding capacity (WHC) (p < 0.05) and cooking loss than the broilers fed the CON and T1 diets. Moreover, the shearing force in the meat was decreased (p < 0.05) in broilers fed the T2 diet. In conclusion, supplementation with exogenous emulsifier to broiler diets improved growth performance, energy digestibility, and meat quality. The optimal amount of exogenous emulsifier supplementation requires further investigation.

The change of bone mineral density and bone metabolism after gastrectomy for gastric cancer: a meta-analysis

Bone mineral density (BMD) is significantly decreased after gastrectomy in patients with gastric cancer. Calcium malabsorption, secondary hyperparathyroidism, and dominant bone resorption appear to contribute to bone loss in these patients. Patients should undergo early surveillance and nutritional or pharmacologic intensive interventions for bone health.

PURPOSE

Survivorship care, including bone health, has become an important issue in gastric cancer. We performed a meta-analysis of the available observational studies to determine whether and how osteoporosis risk is increased after gastrectomy in patients with gastric cancer.

METHODS

A total of 1204 patients (802 men) from 19 cohort studies were included. We evaluated the prevalence of osteoporosis in postgastrectomy patients, comparing the incidence according to the type of gastrectomy and sex. Additionally, we evaluated changes in bone mineral density (BMD) and bone metabolism-related markers pre- to postoperatively and between patients who underwent gastrectomy and matched controls. Proportion meta-analysis was performed and pooled odds ratios (ORs) were calculated.

RESULTS

The pooled incidence estimate was 36% [95% confidence interval (CI), 32-40]. The incidence of osteoporosis was significantly higher in women than in men (OR = 1.90, p < 0.001) but was similar between partial and total gastrectomy groups (OR = 0.983, p = 0.939). BMD was significantly decreased, and calcium, phosphorous, and parathyroid hormone levels were significantly increased in patients after gastrectomy compared to those before gastrectomy. BMD and calcium and 25OH-vitamin D levels were significantly decreased, and parathyroid hormone and 1,25OH-vitamin D levels were significantly increased in the gastrectomy group compared to that in the control group.

CONCLUSION

We found that BMD is significantly decreased after gastrectomy in patients with gastric cancer. Vitamin D deficiency and secondary hyperparathyroidism are suggested to be common mechanism underlying BMD impairment. After resection, patients should undergo long-term nutritional and bone health surveillance, in addition to their oncological follow-up.

Public Sense of Water Fluoridation as Reflected on Twitter 2009-2017

Though controversial, water fluoridation has been hailed as one of the top-ten public-health achievements of the 20th century in the United States of America. In this article, we aim to investigate the public sense of water fluoridation as reflected on Twitter, using data from 2009 to 2017. To this end, tweets related to water fluoridation were collected using queries such as "fluoridated water or fluoride water," "water fluoridation or fluoridation of water," and hashtags related to water fluoridation. The collected tweets (n = 218,748) were examined through informetric, linguistic (word sentiment, word frequency, and word network analyses), and issue tweet analyses. We found that Twitter users who tweeted about water fluoridation in English between 2009 and 2017 constituted about <0.01% of all users including non-English users. In their tweets, words such as "poison" and "waste" were the strong negative sentiment words most often used. Of the top 30 words most frequently used, words related to information sources on water fluoridation and the safety of water fluoridation appeared more often than words related to its efficacy. Additionally, the words related to information sources on water fluoridation and the safety of water fluoridation were found to be core terms in the sentences of tweet mentions. Our linguistic analyses indicate that Twitter users responded sensitively to words that emphasize negative aspects of fluoridation. This is clearly shown in our issue tweet analysis, where tweet mentions expressing negative opinions about water fluoridation accounted for at least 59.2% of all mentions. By contrast, <15% of tweet mentions were found to be positive. These findings suggest that professionals need to reevaluate the current state of online information about water fluoridation, and improve it in a way so that the public can easily access reliable information sources.

Quantifiable and feasible estrus detection using the ultrasonic sensor array and digital infrared thermography

Detection of estrus is an essential factor as a method of successful breeding in the sow. As increasing the adaption of the information and communication technology (ICT) into swine industry, this study focuses on a possibility and quantification of standing time, vulva and body temperature as methods of estrus detection, comparing each time and temperature in estrus and non-estrus period, and analyzing each success rate of new and existing methods. Ultrasonic sensor array and digital infrared thermography were used to evaluate whether new methods such as standing time and number, and vulva and skin temperature can be replaced, or these methods can be quantifiable in estrus period. Ultrasonic sensor array was installed beside the stall and digital infrared thermography was placed in the rear of sow to collect the dates of sow in estrus and non-estrus period. This study showed total standing time, number and number over 10 minutes, and vulva temperature of the sow in estrus period were increased (p < 0.05) compared with those of sow in non-estrus period, respectively. Detection of estrus using standing time and vulva temperature tended (p = 0.06) to increase the success rate when artificial insemination (AI) was performed. In conclusion, standing time and vulva temperature increased when estrus happened. Success rate of AI of sow using these methods showed an increasing trend. Therefore, existing method using the naked eye can be replaced to new method such as vulvar temperature and standing time when detecting the estrus.

Effects of artificial sweeteners on feed palatability and performance in weaned pigs

In experiment 1, a total of 30 weaning pigs were allotted to three dietary treatments to check the palatability of the dietary feed. Diet treatments were as follows: reference diets = basal diets + 0.05% saccharin (50% Saccharin-natrium), TRT1 = 0.03% saccharin–neotame mix (50% Saccharine-natrium + 2% Neotame), TRT2 = 0.02% neotame (10% Neotame), and TRT3 = 0.02% saccharin–neotame mix (10% Saccharine-natrium + 10% Neotame). TRT2 group was significantly higher than other treatments in palatability (P < 0.05). In experiment 2, a total of 52 weaning pigs were allotted to four dietary treatments. In the average daily gain and average daily feed intake over 1 wk, the TRT2 group was significantly higher than the TRT1 and TRT3 groups (P < 0.05). The concentration of triglyceride in the blood was highest in the TRT1 treated group and the lowest in the TRT2 group (P < 0.05). The Lactobacillus was significantly higher in the TRT2 and TRT3 treatments compared with 0.05% saccharin (50% Saccharine-natrium) (P < 0.05). There was no significant difference in the number of Escherichia coli (P < 0.05). In conclusion, diets supplemented with neotame could improve palatability, and artificial sweeteners can affect nutrient digestibility, blood characteristic, and fecal microbiota.

Effects of microencapsulated complex of organic acids and essential oils on growth performance, nutrient retention, blood profiles, fecal microflora, and lean meat percentage in weaning to finishing pigs

A total of 90 pigs (6.47 ± 0.27 kg; 21 d of age) were used in this 22 wk feeding trial to evaluate the effect of microencapsulated complex of organic acids and essential oils (MOE) on growth performance, nutrient retention, blood profile, fecal microflora, and lean meat percentage in pigs. Pigs were randomly distributed to one of three treatment groups (six replicate pens per treatment, five pigs per pen). Dietary treatments were CON, basal diet; MOE1, basal + 0.1% MOE; and MOE2, basal diet + 0.2% MOE. The average daily gain, average daily feed intake, and feed efficiency ratio were significantly different among treatments (P < 0.05). The apparent total tract digestibility of dry matter was linearly increased (P < 0.05) by MOE2. Red blood cells and immunoglobulin G were significantly different in pigs fed MOE (P < 0.05). The Lactobacillus concentration linearly increased (P < 0.05) in MOE2 treatments compared with other treatments. The meat color (a*, redness) and drip loss decreased linearly (P < 0.05) with increasing level of MOE. In conclusion, MOE supplementation could improve growth performance, nutrient retention, blood profile, fecal microflora, and meat quality in weaning to finishing pigs.

The association between muscle mass deficits and arterial stiffness in middle-aged men

BACKGROUND AND AIMS

Early diagnosis of arteriosclerosis is fundamental for the prevention of cardiovascular morbidity and mortality. The current study was performed to identify major predictors of arteriosclerosis and to assess the association between arterial stiffness as measured by cardio-ankle vascular index (CAVI) and muscle mass deficit (MMD) estimated by bioelectrical impedance analysis (BIA) in middle-aged men.

METHODS AND RESULTS

Data were gathered from 3356 middle-aged men who visited a health promotion center. CAVI was measured as an index of arterial stiffness. Body composition analysis was performed using BIA. MMD was positively associated with CAVI in the regression model. The odds ratios for high-CAVI (≥9.0) rose with MMD grade in a dose-dependent manner after adjusting for age, lifestyle factors and current medication use. The estimated mean CAVI rose as MMD grade increased (P for trend >0.001).

CONCLUSIONS

MMD estimated from BIA was positively associated with arterial stiffness in middle-aged men. These findings show a close interaction between low muscle mass and cardiovascular risk.

The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients

Background

Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents.

Methods

This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic.

Results

Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control.

Conclusion

Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.

Chronologic Trends in Studies on Fluoride Mechanisms of Action

Fluoride has been widely used for the prevention of dental caries since the mid-20th century. The aim of this study was to investigate the chronologic trends in studies on fluoride mechanisms of action against dental caries during the years 1950 to 2015. To this aim, queries such as "fluoride," "fluoride and demineralization," "fluoride and remineralization," "fluoride and (plaque or biofilms)," and "fluoride and (bacteria or microbials)" were submitted to PubMed to collect research article information, including titles, abstracts, publication dates, author affiliations, and publication journals. The article information that PubMed produced was then collected by an automatic web crawler and examined through informetrics and linguistic analyses. We found that the number of articles concerned with fluoride mechanisms of action against dental caries was 6,903 and gradually increased over time during the years 1950 to 2015. They were published by 1,136 journals-most notably, Caries Research and Journal of Dental Research. Of the articles published, those related to bacteria/microbials had a higher percentage (44%) than those dealing with plaque/biofilms, demineralization, and remineralization. With regard to the geographic distribution of authors, Europe and North America accounted for 65% of the articles during the years 1987 to 2015, although the number of authors in Asia sharply increased in recent years. Among the fluoride compounds, NaF was mentioned more frequently than SnF₂, Na₂PO₃F, amine fluoride, and acidulated phosphate fluoride during the years 1986 to 2015. Water fluoridation received the most attention among the various fluoride application methods (toothpastes, mouthwashes, fluoride varnishes, and fluoride gels) during the same period. These results, obtained from employing informetrics and linguistic analyses, suggest that in studies on fluoride mechanisms of action, 1) the unbalanced geographic distribution of articles and 2) the heavy concentration of articles on particular fluoride compounds and application methods should be overcome in future research.

Assessment of Denosumab in Korean Postmenopausal Women with Osteoporosis: Randomized, Double-Blind, Placebo-Controlled Trial with Open-Label Extension

PURPOSE

The efficacy and safety of denosumab was compared with placebo in Korean postmenopausal women with osteoporosis in this phase III study.

MATERIALS AND METHODS

Women aged 60 to 90 years with a T-score of <-2.5 and ≥-4.0 at the lumbar spine or total hip were randomized to a single 60 mg subcutaneous dose of denosumab or placebo for the 6-month double-blind phase. Eligible subjects entered the 6-month open-label extension phase and received a single dose of denosumab 60 mg.

RESULTS

Baseline demographics were similar in the 62 denosumab- and 64 placebo-treated subjects who completed the double-blind phase. Treatment favored denosumab over placebo for the primary endpoint {mean percent change from baseline in lumbar spine bone mineral density (BMD) at Month 6 [3.2% (95% confidence interval 2.1%, 4.4%; p<0.0001)]}; and secondary endpoints (mean percent change from baseline in lumbar spine BMD at Month 1, total hip, femoral neck, and trochanter BMD at Months 1 and 6, and median percent change from baseline in bone turnover markers at Months 1, 3, and 6). Endpoint improvements were sustained over 12 months in the open-label extension (n=119). There were no new or unexpected safety signals.

CONCLUSION

Denosumab was well tolerated and effective in increasing BMD and decreasing bone turnover markers over a 12-month period in Korean postmenopausal women. The findings of this study demonstrate that denosumab has beneficial effects on the measures of osteoporosis in Korean postmenopausal women.

Vitamin D Repletion in Korean Postmenopausal Women with Osteoporosis

PURPOSE

Up to 71% of South Korean postmenopausal women have vitamin D deficiency {serum 25-hydroxyvitamin D [25(OH) D] level <50 nmol/L}. Data on vitamin D supplementation was collected during the screening phase of an efficacy/safety study of denosumab in Korean postmenopausal women with osteoporosis. This report describes the effect of vitamin D supplementation on repletion to 25(OH)D levels ≥50 nmol/L in Korean postmenopausal women with osteoporosis.

MATERIALS AND METHODS

Vitamin D levels of Korean postmenopausal women (60-90 years old) were measured by extracting 25(OH)D₂ and 25(OH)D₃ from serum samples via protein precipitation and using liquid chromatography with tandem mass spectrometry detection. Calibration curves were constructed from the mass chromatograms to obtain total vitamin D levels. Subjects with serum 25(OH)D levels <50 nmol/L were supplemented with 1000 IU of vitamin D tablets during the 2.5-month-long screening period. Dose, frequency, and duration were determined by the investigator. If repletion was achieved (≥50 nmol/L) on retest, subjects were eligible to be rescreened for study entry.

RESULTS

Of 371 subjects screened, 191 (52%) required vitamin D supplementation, and 88% (168 of 191) were successfully repleted. More than half of the subjects (58%) who were successfully repleted received doses of 2000 IU daily. The mean time to successful repletion was 31 days (standard deviation 8.4 days; range 11-48 days).

CONCLUSION

Supplementation with daily median doses of 2000 IU vitamin D successfully repleted 88% of Korean postmenopausal women with osteoporosis within 48 days to a serum vitamin D level of 50 nmol/L.

Clinical Effect of Antioxidant Glasses Containing Extracts of Medicinal Plants in Patients with Dry Eye Disease: A Multi-Center, Prospective, Randomized, Double-Blind, Placebo-Controlled Trial

Purpose

To investigate the clinical efficacy and safety of wearable antioxidant glasses containing extracts of medicinal plants in patients with mild dry eye disease (DED).

Methods

Fifty patients with mild DED were randomly assigned to wear either extracts of antioxidant medicinal plants containing (N = 25) or placebo glasses (N = 25). Patients wore the glasses for 15 min three times daily. The ocular surface disease index (OSDI) score, tear film break up time (BUT), and Schirmer’s test were evaluated and compared within the group and between the groups at baseline, 4 weeks, and 8 weeks after treatment.

Results

OSDI score and tear film BUT were significantly improved in the treatment group at 4 and 8 weeks after wearing glasses (all P < 0.001). Compared to the placebo group, the OSDI scores were significantly lower in the treatment group at 8 weeks (P = 0.007). The results of the Schirmer’s test showed significant improvement in the treatment group at 4 weeks (P = 0.035), however there were no significant differences between the other groups or within the groups. No adverse events were reported during the study.

Conclusions

Antioxidant glasses containing extracts of medicinal plants were effective in improving in DED both subjectively and objectively. Wearing antioxidants glasses might be a safe and adjunctive therapeutic option for DED.

Trial Registration

ISRCTN registry 71217488

Roots extracts of Adenophora triphylla var. japonica improve obesity in 3T3-L1 adipocytes and high-fat diet-induced obese mice

OBJECTIVE

To investigate the anti-obesity activity and the action mechanism of the roots of Adenophora triphylla var. japonica extract (ATE) in high-fat diet (HFD)-induced obese mice and 3T3-L1 adipocytes.

METHODS

The roots of Adenophora triphylla were extracted with 70% ethanol. To demonstrate the compounds, linoleic acid was analyzed by using gas chromatography; and the anti-obesity effects and possible mechanisms of ATE were examined in 3T3-L1 adipocytes and HFD-induced obese mice.

RESULTS

Treatment with ATE inhibited the lipid accumulation without cytotoxicity in 3T3-L1 adipocytes. Furthermore, 200 and 400 mg/kg ATE treatment significantly decreased the body weight gain, white adipose tissues (WATs) weight and plasma triglyceride level, while 100 and 200 mg/kg ATE treatment increased the plasma high-density lipoprotein cholesterol level in the HFD-induced obese mice, as compared with the HFD group. Treatment with 200 and 400 mg/kg ATE also lowered the size of adipocytes in adipose tissue and reduced the lipid accumulation in liver. ATE treatment showed significantly lower expression level of adipogenesis-related proteins, such as peroxisome proliferator-activated receptor γ, fatty acid binding protein (aP2), fatty acid synthase in 3T3-L1 adipocytes; and furthermore, decreased peroxisome proliferator-activated receptor γ, aP2, fatty acid synthase, sterol regulatory element binding protein-1c, and lipoprotein lipase mRNA expression levels in WAT of the HFD-induced obese mice.

CONCLUSIONS

These results suggested that the ATE has an anti-obesity effect, which may be elicited by regulating the expression of adipogenesis and lipogenesis-related genes and proteins in adipocytes and WAT of the HFD-induced obese mice.

Efficacy of the mineral oil and hyaluronic acid mixture eye drops in murine dry eye

Purpose

To investigate the therapeutic effects of mineral oil (MO) and hyaluronic acid (HA) mixture eye drops on the tear film and ocular surface in a mouse model of experimental dry eye (EDE).

Methods

Eye drops consisting of 0.1% HA alone or mixed with 0.1%, 0.5%, or 5.0% MO were applied to desiccating stress-induced murine dry eyes. Tear volume, corneal irregularity score, tear film break-up time (TBUT), and corneal fluorescein staining scores were measured at 5 and 10 days after treatment. Ten days after treatment, goblet cells in the conjunctiva were counted after Periodic acid-Schiff staining.

Results

There was no significant difference in the tear volume between desiccating stress-induced groups. The corneal irregularity score was lower in the 0.5% MO group compared with the EDE and HA groups. The 0.5% and 5.0% MO groups showed a significant improvement in TBUT compared with the EDE group. Mice treated with 0.1% and 0.5% MO mixture eye drops showed a significant improvement in fluorescein staining scores compared with the EDE group and the HA group. The conjunctival goblet cell count was higher in the 0.5% MO group compared with the EDE group and HA group.

Conclusions

The MO and HA mixture eye drops had a beneficial effect on the tear films and ocular surface of murine dry eye. The application of 0.5% MO and 0.1% HA mixture eye drops could improve corneal irregularity, the corneal fluorescein staining score, and conjunctival goblet cell count compared with 0.1% HA eye drops in the treatment of EDE.

Higher order aberrations of the corneal surface after laser subepithelial keratomileusis

PURPOSE

To evaluate the changes of higher order aberrations (HOAs) before and after laser subepithelial keratomileusis (LASEK) and to analyze the influence of tear film instability on HOAs of the corneal surface after LASEK.

METHODS

In this cross-sectional study, 31 patients who underwent LASEK were divided into dry eye (16 patients, 32 eyes) and non-dry eye groups (15 patients, 30 eyes). Uncorrected distance visual acuity, spherical equivalent refraction, ablation depth, tear film parameters and Ocular Surface Disease Index (OSDI) questionnaire scores were evaluated in both groups. Total HOA root mean square (RMS), third-order coma, third-order trefoil and fourth-order spherical aberration (SA) of the corneal surface immediately and at 10 seconds after blinking were measured before and after surgery.

RESULTS

The total HOA RMS, coma, trefoil and SA significantly increased after LASEK compared with preoperative values in both groups. In the dry eye group, total HOA RMS, coma and trefoil significantly increased except for SA at 10 seconds after blinking compared with those measured immediately after blinking. In addition, the changes of total HOA RMS, coma and trefoil were negatively correlated with tear film break-up time (R = -0.420, -0.473 and -0.439, respectively), but positively correlated with OSDI score (R = 0.433, 0.499 and 0.532, respectively). In the non-dry eye group, there were no significant differences between HOAs measured at 10 seconds after blinking and those measured immediately after blinking.

CONCLUSIONS

The HOAs including coma, trefoil and SA significantly increased after LASEK. The tear film instability in the dry eye can be associated with more deterioration of the optical quality after LASEK, due to more significant increase of total HOA RMS, coma and trefoil.

Prevalence of osteoporosis in the Korean population based on Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011

PURPOSE

We analyzed age-related changes of bone mineral density (BMD) and compared with those of U.S and Japanese participants to investigate the prevalence of osteoporosis in Korea.

MATERIALS AND METHODS

The data were collected in the 2008-2011 in Korea National Health and Nutrition Examination Survey (KNHANES) IV and V to select a representative sample of civilian, noninstitutionalized South Korean population. Bone mineral measurements were obtained from 8332 men and 9766 women aged 10 years and older.

RESULTS

BMD in men continued to decline from 3rd decade, however, in women, BMD remained nearly constant until the 4th decade and declined at rapid rate from the 5th decade. The prevalence of osteoporosis in Korea is 7.3% in males and 38.0% in females aged 50 years and older. The prevalence of osteopenia in Korea is 46.5% in males and 48.7% in females, aged 50 years and older. The lumbar spine and femur BMD in Korean females 20 to 49 years of ages was lower than in U.S. and Japan participants.

CONCLUSION

There was obvious gender, and age differences in the BMD based on the 2008-2011 KNHANES IV and V, a nationwide, cross-sectional survey conducted in a South Korean population. We expect to be able to estimate reference data through ongoing KNHANES efforts in near future.

Effect of hypotonic 0.18% sodium hyaluronate eyedrops on inflammation of the ocular surface in experimental dry eye

PURPOSE

To investigate the efficacy of hypotonic 0.18% sodium hyaluronate (SH) eyedrops in a mouse model of experimental dry eye (EDE).

METHODS

EDE was induced in C57BL/6 mice by a subcutaneous scopolamine injection and an air draft. The mice were divided into 4 groups according to topical treatment regimens: EDE control, isotonic 0.5% carboxymethycellulose (CMC), isotonic 0.1% SH, and hypotonic 0.18% SH. Tear volume, corneal smoothness, and corneal staining scores were measured at 5 and 10 days of EDE. Multiplex immunobead assay, immunohistochemistry, and flow cytometry for proinflammatory cytokines, chemokines, and inflammatory molecules were performed at 10 days of EDE.

RESULTS

The 0.18% SH group had a significantly lower corneal smoothness and staining scores than the 0.5% CMC and 0.1% SH groups at 10 days of EDE (P<0.05). The 0.18% SH group showed significantly low levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, monokine induced by interferon-γ, and interferon-γ-inducible protein 10 compared with the other groups (P<0.05). The mean percentages of CD4(+)CXCR3(+), CD40(+), and CD44(+) cells in the conjunctiva were significantly lower in the 0.18% SH group than in the other groups (P<0.05). In addition, the 0.1% SH group showed lower levels of TNF-α and IL-1β and percentages of CD40(+) and CD44(+) cells than the EDE and 0.5% CMC groups.

CONCLUSIONS

Hypotonic 0.18% SH eyedrops are more effective in improving ocular surface irregularity and staining and decreasing inflammatory cytokines, chemokines, and cells on the ocular surface compared with isotonic 0.5% CMC or 0.1% SH eyedrops in the treatment of EDE.

Fabrication of GaAs/Al0.3Ga0.7As multiple quantum well nanostructures on (100) si substrate using a 1-nm InAs relief layer

Nanometer scale thin InAs layer has been incorporated between Si (100) substrate and GaAs/Al0.3Ga0.7As multiple quantum well (MQW) nanostructure in order to reduce the defects generation during the growth of GaAs buffer layer on Si substrate. Observations based on atomic force microscopy (AFM) and transmission electron microscopy (TEM) suggest that initiation and propagation of defect at the Si/GaAs interface could be suppressed by incorporating thin (1 nm in thickness) InAs layer. Consequently, the microstructure and resulting optical properties improved as compared to the MQW structure formed directly on Si substrate without the InAs layer. It was also observed that there exists some limit to the desirable thickness of the InAs layer since the MQW structure having thicker InAs layer (4 nm-thick) showed deteriorated properties.

Costs of illness and quality of life in patients with systemic lupus erythematosus in South Korea

OBJECTIVE

To assess the costs of illness, health-related quality of life (HRQOL) and their associated factors in patients with systemic lupus erythematosus (SLE) in South Korea.

METHOD

Two hundred and one patients with SLE were enrolled at the Rheumatology clinic of Seoul National University Hospital. Direct, indirect and total costs and HRQOL were measured using hospital electronic data and face-to-face interview. Socio-demographic and clinical factors associated with cost of illness and HRQOL were analyzed using multiple regression and multivariate logistic regression.

RESULTS

The average total cost of illness was estimated to be KRW 9.82 million (US $ 8993) per year, of which 41.6% was accounted for by direct costs and 58.4% by indirect costs. In multivariate regression, patients with renal involvement and those with depression incurred an average increment in annual total costs of 37.6% (p = 0.050) and 49.1% (p = 0.024), respectively, and an average increment in annual direct costs of 26.4% (p = 0.050) and 43.3% (p = 0.002), respectively, compared with patients without renal involvement and depression, respectively. In addition, disease damage was positively associated with an average increment in annual total and direct costs (55.3%, p = 0.006; 33.3%, p = 0.013, respectively), and the occurrence of indirect costs (OR 2.21, 1.09-4.88). There was no significant difference in HRQOL between patients with and without renal involvement (0.655 vs. 0.693, p = 0.203) CONCLUSION: Renal involvement, depression, and disease damage were major factors associated with higher total and medical costs for patients with SLE in South Korea. Effective treatment of renal disorders and depression may reduce the high economic burden of SLE.

Analgesic efficacy of caudal dexamethasone combined with ropivacaine in children undergoing orchiopexy

BACKGROUND

Epidural administration of dexamethasone might reduce postoperative pain in adults. We evaluated whether a caudal block of 0.1 mg kg(-1) dexamethasone combined with ropivacaine improves analgesic efficacy in children undergoing day-case orchiopexy.

METHODS

This randomized, double-blind study included 80 children aged 6 months to 5 yr who underwent day-case, unilateral orchiopexy. Patients received either 1.5 ml kg(-1) of 0.15% ropivacaine (Group C) or 1.5 ml kg(-1) of 0.15% ropivacaine in which dexamethasone of 0.1 mg kg(-1) was mixed (Group D) for caudal analgesia. Postoperative pain scores, rescue analgesic consumption, and side-effects were evaluated 48 h after operation.

RESULTS

Postoperative pain scores at 6 and 24 h post-surgery were significantly lower in Group D than in Group C. Furthermore, the number of subjects who remained pain free up to 48 h after operation was significantly greater in Group D [19 of 38 (50%)] than in Group C [four of 37 (10.8%); P<0.001]. The number of subjects who received oral analgesic was significantly lower in Group D [11 of 38 (28.9%)] than in Group C [20 of 37 (54.1%); P=0.027]. Time to first oral analgesic administration after surgery was also significantly longer in Group D than in Group C (P=0.014). Adverse events after surgery including vomiting, fever, wound infection, and wound dehiscence were comparable between the two groups.

CONCLUSIONS

The addition of dexamethasone 0.1 mg kg(-1) to ropivacaine for caudal block can significantly improve analgesic efficacy in children undergoing orchiopexy. Clinical trial registration NCT01604915.

Fast in situ enzymatic gelation of PPO-PEO block copolymer for injectable intraocular lens in vivo

Foldable intraocular lenses (IOLs) have been utilized to substitute natural lens of cataract patients. In this study, we developed a fast, in situ gelable hydrogel requiring no toxic agent as an injectable IOL material. A 4-armed PPO/PEO-phenol conjugate by a non-degradable linker was synthesized to form a hydrogel in situ by horseradish peroxidase. The gelation time and modulus could be controlled, ranging from 20 s to 2 min and from 1 to 43 kPa. The adhesion of human lens epithelial cells on the hydrogel was significantly reduced compared to that on commercial IOLs. The hydrogels were injected into the rabbit eyes to evaluate the in vivo biocompatibility for 8 weeks. Corneal endothelial cell loss and central corneal thickness were comparable with the common IOL implantation procedure. Histologically, the cornea and retina showed the intact structure. The change of refraction after application of pilocarpine was +0.42 D preoperatively and +0.83 D postoperatively, which may indicate the maintenance of accommodation amplitude.

Species-specific challenges in dog cloning

Somatic cell nuclear transfer (SCNT) is now an established procedure used in cloning of several species. SCNT in dogs involves multiple steps including the removal of the nuclear material, injection of a donor cell, fusion, activation of the reconstructed oocytes and finally transfer to a synchronized female recipient. There are therefore many factors that contribute to cloning efficiency. By performing a retrospective analysis of 2005-2012 published papers regarding dog cloning, we define the optimum procedure and summarize the specific feature for dog cloning.

The association between bone mineral density and metabolic syndrome: a Korean population-based study

This study was conducted to investigate the association between the metabolic syndrome (MS), which includes a cluster of major risk factors for cardiovascular diseases, and bone mineral density (BMD) from a population-based study. This cross-sectional study was based on a nationwide representative survey data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008. A total of 3,207 subjects were included from the KNHANES 2008 and composed of men (mean age 48.4 years), premenopausal women (mean age 36.5 years) and postmenopausal women (mean age 64.8 years). The MS was identified according to the new criteria from a joint scientific statement endorsed by major organizations including the National Heart, Lung, and Blood Institute. The mean age of study participants was significantly different according to MS status (58.2 years in the MS group vs. 45.7 years in the non-MS group, P < 0.001). The association between MS and BMD at the lumbar spine and proximal femur was analyzed with adjustment for potential confounders. Although the adjusted BMD at all skeletal sites was not significantly different between participants with and without MS, an increased number of MS components was associated with low adjusted femoral neck (FN) BMD only in men (P = 0.01). After adjusting confounding factors, the triglyceride component of MS was related to low FN BMD in men, but to high BMD at all of the skeletal sites measured in postmenopausal women. The glucose component of MS showed an association with high adjusted BMD at total hip in men. Men with MS had significantly higher odds for pooled osteopenia and osteoporosis (odds ratio: 1.49, 95 % confidence interval: 1.04-2.14). In conclusion, low BMD is associated with MS in Korean men, and the association between the MS component and the BMD is different according to gender.

Achieving recommended low density lipoprotein cholesterol goals and the factors associated with target achievement of hypercholesterolemia patients with rosuvastatin in primary care

OBJECTIVE

Hypercholesterolemia is a major risk factor for cardiovascular disease and requires continuous management. The role of primary physicians in this regard is important, yet the factors associated with successful lipid lowering treatments in primary clinics have not been clearly identified. We aimed to evaluate the rate of successful hypercholesterolemia treatment in Korean primary care, and to identify the factors associated with achieving low density lipoprotein cholesterol (LDL-C) targets.

METHODS

We prospectively recruited and retrospectively assessed 1851 Korean patients with hypercholesterolemia who visited family physicians and were prescribed rosuvastatin for the first time. LDL-C lowering targets, defined according to NCEP ATP III guidelines, were evaluated at 6 months after the first prescription. The factors associated with achieving these targets were also assessed.

RESULTS

Overall, 87.6% of our participants attained their LDL-C goals. In multiple logistic regression analysis, good adherence to medication was strongly associated with the achievement of target LDL-C levels, whereas higher cardiovascular risk factors including diabetes (in both sexes), low high density lipoprotein, and current smoking status (in males), and hypertension (in females) were related to LDL-C target level failures.

CONCLUSION

Our observations of the short period for hypercholesterolemia in Korean primary care has revealed that the rate of achieving target LDL-C levels was high in these patients, whereas patients at higher risk for cardiovascular disease tended to have lower LDL-C achievement outcomes. Primary care physicians should pay more attention to patients showing higher cardiovascular risk and stress the need for good adherence and management regimens in these individuals.