Mannan-based conjugates as a multimodal imaging platform for lymph nodes

We show that mannan-based conjugates possess exceptional features for multimodal imaging because of their biocompatibility, biodegradability and self-targeting properties. Two new mannan conjugates, containing a gadolinium complex and a fluorescent probe, one based only on polysaccharide and the other one comprising polysaccharide with poly(2-methyl-2-oxazoline) grafts, were prepared and simultaneously visualized in vitro and in vivo by magnetic resonance and fluorescence imaging. The synthesis of these mannan-based complexes was based on alkylation with allyl bromide or grafting with poly(2-methyl-2-oxazoline) chains, followed by a thiol-ene click reaction with cysteamine to introduce primary amino groups into their structure. Finally, the obtained conjugates were functionalized with contrast labels using the corresponding N-hydroxysuccinimide esters. When used to detect lymph nodes, the polymers showed better imaging properties than a commercially available contrast agent.

Carbon nanospecies affecting amyloid formation

Carbon nanospecies (fullerenes, carbon nanotubes, nanodiamonds, carbon quantum dots) were tested for amyloidogenicity to estimate their potential as health hazards.

Evolving enzyme technology: impact on commercial poultry nutrition

The use of exogenous enzymes to improve the nutritional value of poultry diets is a relatively new concept. The technology is rapidly evolving, with new enzymes, enzyme combinations, and novel applications being developed as rapidly as regulatory restrictions will allow. Most researchers in the field of poultry nutrition would consider phytase to be the last significant leap forward in terms of enzyme use in the animal feed industry. However, there is a great deal of ongoing research into the next generation of enzymes with a focus on ingredient quality, predictability of response via least-square models, improvements in food safety, effect of bird age, effect of various side activities and enzyme dose, maximisation of net income and reduction in environmental pollution. It is the purpose of the present review article to summarise the current research in the area of feed enzymes for poultry and to speculate on future applications of enzymes and new enzyme technologies that may be of value to the industry in the coming years.

The effect of conditioning temperature and exogenous xylanase addition on the viscosity of wheat-based diets and the performance of broiler chickens

1. A total of 1920 Ross broiler chicks were used in a 6 treatment by 8 replicate growth study to investigate the effect of conditioning temperature and exogenous xylanase addition on diet characteristics and bird performance. 2. Increasing conditioning temperature from 80 to 90 degrees C increased the viscosity of the diets by approximately 6 mPa.s and reduced body weight gain of the broiler chickens by 7%. 3. Furthermore, there was a significant interaction between temperature and the addition of exogenous xylanase, with a proportionately greater positive response to added xylanase in the diets that were pelleted at higher temperatures. 4. Addition of exogenous xylanase also increased the proportion of soluble arabinoxylan in the feed and reduced dietary viscosity, which is likely to be related to the degree of polymerisation of the soluble carbohydrate. 5. These results suggest that conditioning temperature should be considered as a factor when attempting to predict the response of broilers to added xylanase, especially when high-viscosity or 'low-quality' wheat is being used. 6. It can be concluded that pelleting wheat-based diets above 80 degrees C can compromise bird performance and that, if higher temperatures are to be employed, the use of exogenous xylanase is critical to maintain productivity.

Influence of an Escherichia coli-derived phytase on nutrient utilization in broiler starters fed diets containing varying concentrations of phytic acid

The influence of an Escherichia coli-derived phytase, on nutrient utilization was investigated in broilers fed starter diets containing different concentrations of phytate. The study was conducted as a 3 x 4 factorial arrangement of treatments with 3 concentrations of phytic acid (10.4, 11.8, and 13.6 g/kg; equivalent to 2.8, 3.3, and 3.8 g of phytate P/kg) and phytase (0, 500, 750, and 1,000 FTU/kg). One unit of phytase (FTU) is defined as the quantity of enzyme that releases 1 micromol of inorganic phosphorus/min from 0.00015 mol/L of sodium phytate at pH 5.5 at 37 degrees C. The dietary phytic acid concentrations were manipulated by the inclusion of rice bran. Increasing dietary concentrations of phytic acid resulted in reductions (P < 0.01) in AME. Phytase additions tended to increase AME (P = 0.07), regardless of dietary phytate concentrations. Apparent ileal digestibility coefficients of protein and most amino acids were influenced by phytate (P < 0.05 to 0.001) and phytase (P < 0.001). Phytase improved ileal protein and amino acid digestibility at all phytate concentrations, but the trend in responses to increasing phytase additions was different at different phytate concentrations as shown by significant phytate x phytase interactions (P < 0.01 to 0.001). At the lowest phytate concentration, the ileal digestibility coefficients increased with increasing phytase supplementation. At the medium and high phytate concentrations, the greatest responses were observed at 500 FTU/kg of phytase, with little improvement attributable to further additions. Ileal digestibility of P was lowered (P < 0.01) by increasing phytate concentrations and increased (P < 0.001) with increasing additions of phytase. A significant phytate x phytase interaction (P < 0.05) was also observed, where the improvements in P absorption with added phytase were found to be greater at high phytate concentrations. These data demonstrate the anti-nutritive effects of phytic acid and the potential of microbial phytase to improve energy utilization and the availability of P and amino acids in broilers fed starter diets.

A Study on the Interaction of Xylanase and Phytase Enzymes in Wheat-Based Diets Fed to Commercial White and Brown Egg Laying Hens

A trial was conducted to investigate potential interactions between phytase and xylanase enzymes in wheat-based laying diets. Hens (480 ISA-White and 480 ISA-Brown) were distributed into 160 experimental units and fed one of 10 diets containing 75 to 77% wheat from 33 to 64 wk of age with a diet change at 49 wk. Two diets were adequate in P content (0.3 and 0.25% available P in the 2 phases) with or without xylanase (0 or 2,000 U/kg; Avizyme 2300, Danisco Animal Nutrition, Marlborough, Wiltshire, United Kingdom), and 8 diets had reduced P (0.2 and 0.15% available P) with or without xylanase and phytase (0, 300, 500, and 700 ppu/kg; Phyzyme 5000G, Danisco Animal Nutrition). Egg production was higher for ISA-Brown than for ISA-White hens, and ISA-Brown hens were larger. Eggs from ISA-Brown hens had lower albumen height; higher egg, shell, and albumen weights; and lower yolk weight than those from ISA-White hens. Egg production was not affected by the diet. In P-reduced diets without xylanase, phytase significantly increased BW gain in the first period with no change in feed intake or feed efficiency. In P-adequate diets, xylanase increased egg and albumen weight and albumen height. In P-reduced diets with xylanase, increasing levels of phytase increased egg and albumen weight. This trial demonstrated no negative interactions between these enzymes for production traits and no interactions between the diet and strain of hen. These data suggest that poultry producers can use these enzymes individually or together in feed for the Brown and White egg layers used in this study without concern for the strain of hen.

How do patients view the role of the primary care physician in inpatient care?

As hospitalized patients are increasingly cared for by physicians who are not their primary care physicians, discontinuity of care occurs when patients are sickest. We sought to determine hospitalized patients' knowledge, preferences, and satisfaction regarding the involvement of their primary care physician in their inpatient care. We conducted a cross-sectional questionnaire of 73 patients cared for by inpatient physicians and 12 relatives of such patients on an inpatient general medical service in a teaching hospital. Eligible patients were those admitted to the care of an inpatient physician other than their primary care provider (PCP), who stayed in the hospital for >1 day. If these patients were too sick to be interviewed or did not speak English, a relative knowledgeable about their medical care was interviewed. In all, 87% of patients had a primary care physician. Of these, 33% had some contact with their PCP while in the hospital. A total of 66% of respondents were satisfied with the contact they or their relative had with the PCP. Some 61% of respondents knew that communication had occurred between the inpatient and PCP. Respondents generally had positive opinions of their hospital care. However, most agreed that patients receive better care from and have more trust in physicians they have known for a long time, compared with those they have just met. About 50% of respondents believed that a PCP (rather than a separate hospital physician) should inform a patient of a serious diagnosis or discuss choices between medical and surgical management. Patients under the care of an inpatient physician want contact with their PCP and want good communication between the PCP and hospital doctors. Systems should be established to facilitate communication between inpatient and primary care physicians, and between PCPs and patients.

Effects of new vitamin D analogues on parathyroid function in chronically uraemic rats with secondary hyperparathyroidism

BACKGROUND

Treatment with calcitriol or its analogue, alfacalcidol often leads to hypercalcaemia, hyperphosphataemia or both in patients which chronic renal failure and advanced secondary hyperparathyroidism. We tested three new vitamin D analogues (CB 1093, EB 1213, GS 1725) in an attempt to identify potentially non hypercalcaemic compounds, capable of decreasing plasma parathyroid hormone (PTH) concentration.

METHODS

Male Wistar AF rats aged 12-14 weeks were fed a synthetic, phosphate-rich diet and underwent either sham surgery (control) or a standard two-step 5/6th nephrectomy. Four weeks later, renal function was mildly decreased in the latter. Chronic renal failure rats were then divided into six groups, with 8-10 rats in each group. They received daily 1.p. injections, from days 0 to 4, of either placebo, calcitriol, or one of the following three active vitamin D analogues: CB1093, 0.25 micrograms; EB1213, 0.25 or 1.25 micrograms; and GS1725, 0.025 micrograms/kg body weight per day, respectively. Sham-operated rats received no drug. On day 5, arterial blood was sampled and rats were sacrificed.

RESULTS

At predefined dosage schedules, all three compounds significantly decreased plasma immunoreactive PTH levels (except EB1213 at low dose). The decrement was somewhat less marked than that obtained with calcitriol, at the dose of 0.25 micrograms/kg b.w. per day. However, calcitriol induced a marked increase in plasma calcium and phosphate concentrations at that dose, whereas vitamin D analogues led to a more modest increase in plasma calcium level, and none to a worsening of hyperphosphataemia. CB1093 treatment was even associated with a significant decrease in plasma phosphate level.

CONCLUSION

All three calcitriol analogues tested are promising as non-hypercalcaemic agents in the treatment of uraemic secondary hyperparathyroidism. However, more prolonged administration to uraemic rats of calcitriol analogues with slightly modified dosage schedules and of calcitriol with lower non-hypercalcaemic dose is required for an optimal comparison before considering clinical trials.

Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients

Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients. Plasma bone-specific alkaline phosphatase (bAP) has been demonstrated to be more reliable than total alkaline phosphatases (tAP) in providing information about bone turnover in patients with metabolic bone diseases. This study surveyed 42 hemodialysis patients who underwent a systematic transiliac bone biopsy for histomorphometry study. Plasma bAP was determined by using a new immunoassay (Tandem-R Ostase, Hybritech, Liège, Belgium). Plasma bAP values were compared with those of two other plasma markers of bone metabolism, namely tAP and intact parathyroid hormone (iPTH), for the correlations with bone histomorphometric parameters. Patients with high-turnover bone disease (HTBD) (N = 32) had significantly higher plasma bAP levels than patients with normal or low bone turnover (N/LTBD) (N = 10) (66.9 +/- 63.5 ng/mL versus 10.8 +/- 4.2 ng/mL, respectively). Bone formation and resorption were highly correlated in these patients, and plasma bAP levels were positively correlated with bone resorption parameters, including osteoclast surface (r = 0.39, P < 0.0001) and osteoclast number/mm2 (r = 0.36, P < 0.001), and with bone formation parameters, osteoblast surface (r = 0.50, P < 0.005), and bone formation rate (r = 0.91, P < 0.0001). The bone formation rate was better correlated with plasma bAP levels than with either plasma tAP or iPTH concentrations. Plasma bAP level equal or higher than 20 ng/mL, either alone or combined with plasma iPTH of 200 pg/mL, had the highest sensitivity, specificity, and predictability values for the diagnosis of high-turnover bone disease, and formally excluded patients with normal or LTBD. In conclusion, plasma bAP can be measured with a reliable immunoassay in hemodialysis patients. It represents a highly sensitive and specific biochemical marker of skeletal remodeling in these patients. Therefore, both serum iPTH and bAP are complementary in diagnoses of the type of renal osteodystrophy.

Parathyroid hormone (PTH)/PTH-related protein receptor messenger ribonucleic acid expression and PTH response in a rat model of secondary hyperparathyroidism associated with vitamin D deficiency

The aim of the present work was to characterize at the molecular level the mechanism of PTH resistance in a rat model of secondary hyperparathyroidism resulting from vitamin D deprivation. PTH/PTH-related protein (PTHrp) receptor messenger RNA (mRNA) expression, assayed by ribonuclease protection analysis, was studied in the kidney, femoral epi/metaphysis, and diaphysis. In addition, in the kidney, PTH/PTHrp receptor mRNA expression was correlated to receptor function by measuring adenyl cyclase activity in crude renal membranes after stimulation by PTH (10(-10) - 10(-6) M), forskolin (0.1 and 0.2 mM), NaF (5 and 10 mM), and isoproterenol (1 and 10 microM). Four groups of rats were studied to investigate the effects of calcium, PTH, and/or vitamin D status. The first group received a control diet (D+D+). The second group received a diet deficient in vitamin D until death (D-D-). In the two other groups that also received a vitamin D-deficient diet, the hypocalcemia and the hyperparathyroidism were later corrected, by either vitamin D supplementation (D-D+) or lactose and high calcium diet (D-Ca+), 1 week before death. The results revealed a 2-fold decrease in the PTH-induced adenyl cyclase activity of the renal membranes in the D-D- rats compared to those in the three other groups. There was no significant difference in the four groups in adenyl cyclase activity stimulated by forskolin, NaF, and isoproterenol. The decrease in PTH-induced adenyl cyclase activity was associated with an approximately 2-fold increase in PTH/PTHrp receptor mRNA expression in the kidneys of the D-D- rats compared to controls. Normalization of PTH/PTHrp receptor mRNA expression was observed after vitamin D supplementation (D-D+ rats), but not after correction of the hypocalcemia and secondary hyperparathyroidism by oral lactose and calcium supplementation. In the epi/metaphysis, an approximately 2-fold increase in PTH/PTHrp receptor mRNA was also observed in the D-D- rats compared to the controls; this increase was partially corrected upon normalization of the calcemia and PTH levels with either vitamin D (D-D+ group) or lactose/calcium (D-Ca+ group). In the diaphysis, no change in the expression of PTH/PTHrp receptor mRNA was observed in any group.(ABSTRACT TRUNCATED AT 400 WORDS)

Parathyroidectomy does not prevent the renal PTH/PTHrP receptor down-regulation in uremic rats

In a recent study we demonstrated that the PTH/PTHrP receptor (PTH-R) mRNA was markedly down-regulated in the remnant kidney of uremic rats with severe secondary hyperparathyroidism. Among the factors potentially implicated in this down-regulation, to date only PTH has been demonstrated to modulate PTH-R expression. Here, we examined the effect of thyroparathyroidectomy (TPTX) on the renal expression of PTH-R in rats with normal renal function or with chronic renal failure (CRF) induced by 5/6 nephrectomy. Four groups of rats were studied: control, TPTX, CRF, and CRF + TPTX. Moderate-degree renal failure was documented by mean (+/- SD) creatinine clearances (microliter/min/100 g body wt) of 259 +/- 40 and 212 +/- 45 in CRF and CRF + TPTX rats, compared with 646 +/- 123 and 511 +/- 156 in control and TPTX rats, respectively. Plasma phosphorus, calcitriol, and ionized calcium were significantly lower in CRF and CRF + TPTX than in control animals. Plasma ionized calcium and calcitriol were also lower in TPTX than in control rats. Plasma PTH levels (pg/ml) were increased in CRF rats (41.8 +/- 29.4), and markedly decreased in TPTX (10.1 +/- 7.8) and CRF + TPTX (8.0 +/- 3.8) rats compared with control rats (21.7 +/- 7.5). Northern blot analysis showed that the level of the steady-state PTH-R mRNA in the kidney of CRF and CRF + TPTX rats was markedly decreased compared with that of control rats, the ratios of PTH-R mRNA/beta-actin mRNA being 0.28 +/- 0.04 and 0.27 +/- 0.03 versus 0.54 +/- 0.05, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

The renal PTH/PTHrP receptor is down-regulated in rats with chronic renal failure

Hypocalcemia, hyperphosphatemia, and resistance to the action of PTH are well characterized features in the setting of advanced chronic renal failure (CRF). Although the underlying mechanisms are ill-understood, clinical and experimental evidence points to both PTH receptor down-regulation and post-receptor abnormalities in their pathogenesis. In the present study we have examined the effect of advanced CRF in rats on the renal expression of PTH/PTHrP receptor (PTH-R). CRF was created by a standard two-step operation (5/6 nephrectomy). Four weeks thereafter, 19 uremic rats were compared with 23 sham-operated rats. Uremic rats had higher mean (+/- SD) plasma creatinine levels than control rats, 164 +/- 107 microM versus 43 +/- 5 microM, respectively. They also had higher plasma phosphorus and iPTH levels, 4.70 +/- 1.71 mM versus 2.59 +/- 0.37 mM and 561 +/- 336 versus 27 +/- 18 pg/ml, respectively. Mean plasma total calcium and blood ionized calcium were significantly lower in uremic than in control rats, 2.13 +/- 0.06 mM versus 2.61 +/- 0.10 mM and 1.07 +/- 0.11 versus 1.31 +/- 0.06 mM, respectively. Mean plasma calcitriol concentration was also significantly lower in uremic than in control rats, 39.8 +/- 14.6 and 80.4 +/- 15.2 pg/ml, respectively. Nine out of the 19 rats were examined for renal PTH-R gene expression.(ABSTRACT TRUNCATED AT 250 WORDS)

Endoscopic therapy of a congenital oesophageal stricture

A sixteen months old girl with Down's-Syndrome suffered from congenital oesophageal membrane and segmental oesophageal stricture. In the neonatal period, two other associated malformations of the gastrointestinal tract (malrotation of gut and duodenal web) had been operated successfully. The first endoscopic examination of the eosophagus was performed at the age of sixteen months because of increasing dysphagia. A solid membrane in the lower part of the oesophagus was incised by diathermy. The associated segmental stenosis necessitated repeated bougienages. After this treatment the child developed well without clinical signs of dysphagia.

Folic acid nonresponsive homocystinuria due to methylenetetrahydrofolate reductase deficiency

Four siblings from a family with 11 children of Irish ancestry were observed to suffer from an essentially identical clinical illness, consisting of delayed psychomotor development in infancy and childhood, severe mental retardation, and upper motor neuron dysfunction. Death occurred at an early age in three siblings. In cases in which detailed physical examinations were performed, ectopia lentis, marfanoid features, and severe bony deformities were absent. Homocystinuria, homocystinemia, relatively normal concentrations of methionine and cystine in tissue fluids, and absence of methylmalonic aciduria were found. A deficiency of methylenetetrahydrofolate reductase was demonstrated in cultured skin fibroblasts from two siblings. Postmortem examination of two of the three patients who died showed extensive vascular thrombosis. No biochemical improvement was observed in the surviving child following treatment with large doses of folic acid.