Cancer worry is associated with increased use of supportive health care-results from the multinational InCHARGE study

PURPOSE

To assess use of health care following a diagnosis of endometrial, cervical, and ovarian cancer in the Netherlands, Norway, and Denmark. Furthermore, to analyze the association between cancer worry and use of supportive care.

METHODS

An international multicenter cross-sectional questionnaire study was undertaken among female cancer survivors with endometrial, cervical, or ovarian cancer 1-7 years post diagnosis. We investigated different aspects of cancer survivorship and follow-up care. Health care use included information on the use of supportive health care, general practitioner (GP), and follow-up visits to the department of gynecology. Cancer worry was assessed with the Impact of Cancer (IoCv2) questionnaire.

RESULTS

A total of 1433 women completed the questionnaire. Health care use decreased from time of diagnosis and was higher among cervical and ovarian cancer survivors than endometrial cancer survivors. Twenty-five percent of the women with ovarian cancer reported severe cancer worry, in contrast to 10 and 15% of women diagnosed with endometrial and cervical cancer, respectively. Women with severe worry had significantly higher use of supportive care activities. In a multivariable regression analysis, cancer worry remained a significant correlate for use of supportive health care services irrespective of disease severity or prognosis. The strongest association was found for use of a psychologist (OR 2.1 [1.71-2.58]).

CONCLUSION

Cancer worry is associated with increased use of supportive care.

IMPLICATIONS FOR CANCER SURVIVORS

Targeted, timely, and accessible psychological support aimed at severe cancer worry may improve survivorship care and ensure optimal referral of patients in need of additional care.

Early-stage inflammation changes in supraspinatus muscle after rotator cuff tear

BACKGROUND

Rotator cuff (RC) tendon tear leads to impaired shoulder function and pain. The supraspinatus (SS) tendon is most often affected, but the biological response of the SS muscle to SS tendon tear is largely unknown. This study aimed to investigate time-dependent muscle inflammation, degeneration, fatty infiltration, and regeneration in experimental SS tear conditions.

METHODS

Forty-five C57BL/6 mice were subjected to SS tendon tear and allowed to recover for 1, 3, 5, 7, 14, or 28 days. The extent of muscle damage was examined using histologic, flow cytometric, proteomic, and chemiluminescence analyses.

RESULTS

We found that muscle inflammation peaked around day 5 with increased monocyte infiltration and increased cytokine levels in the ipsilateral compared to the contralateral SS muscle. Bioinformatics analysis of proteomics on mice that survived 5 days after RC tendon tear revealed upregulated proteins involved in "neutrophil activation involved in immune response" and "extracellular matrix organization," whereas "skeletal muscle tissue development and contraction" and "respiratory electron transport chain" were among the most downregulated. Histologic analysis of collagen showed increased collagen accumulation and fatty infiltration of the ipsilateral SS over time. Finally, we observed time- and lesion-dependent changes in satellite cell and fibro-adipogenic progenitor populations.

CONCLUSION

Altogether, we demonstrate that the SS muscle shows severe signs of acute inflammation, early degeneration, and fatty infiltration, as well as reduced regenerative potential following SS tendon tear.

Lichen Sclerosis is Associated With a High Rate of Local Failure After Radio(chemo)therapy for Vulvar Cancer

AIMS

Radio(chemo)therapy plays an important role in the treatment of vulvar cancer, either as postoperative treatment or as definitive treatment in patients who present with inoperable disease. Only limited data are available regarding outcome after modern state of the art radio(chemo)therapy and more information regarding prognostic factors are warranted. The aim of this study was to evaluate disease outcomes after radio(chemo)therapy in patients with vulvar cancer with special emphasis on the impact of lichen sclerosis on local control.

MATERIALS AND METHODS

All consecutive patients (n = 109) from the western half of Denmark who were treated with definitive (n = 52) or postoperative (n = 57) radio(chemo)therapy between January 2013 and January 2020 were included. Local control, cause-specific survival and overall survival, as well as morbidity, were analysed using Kaplan-Meier statistics. Prognostic factors for local control were analysed in univariate and multivariate analysis.

RESULTS

At a median follow-up of 35 (4-95) months, 46 (42.0%) patients were diagnosed with recurrence. Eighty per cent of the recurrences were located to the vulva region, leading to a 5-year local control of 58.9% (confidence interval 47.9-69.9). Cause-specific survival was 62.9% (confidence interval 53.1-72.7), whereas overall survival was 58.0% (confidence interval 47.6-68.5). Grade 3-4 morbidity was diagnosed in 10 (9%) patients. Lichen sclerosis (hazard ratio 3.89; confidence interval 1.93-7.79) was an independent risk factors for local recurrence. Patients without lichen sclerosis had a 5-year local control rate of 83.6% (confidence interval 67.2-99.0) and 62.6% (confidence interval 43.2-82.0) after postoperative and definitive radio(chemo)therapy, respectively. In patients with lichen sclerosis, the local control rate was 44.0% (confidence interval 19.3-69.0) and 17.6% (confidence interval 0-30.0) after postoperative and definitive radio(chemo)therapy, respectively.

CONCLUSION

Radio(chemo)therapy plays an important role in the treatment of vulvar cancer. However, despite dose escalation, a substantial proportion of patients experienced local relapse. Pre-existing lichen sclerosis seems to have a significant impact on the risk of recurrence. This should influence surveillance programmes for these patients.

Surgeons' posture and muscle strain during laparoscopic and robotic surgery

Background

It is assumed that conventional laparoscopy (LAP) and robotic-assisted laparoscopic surgery (RALS) differ in terms of the surgeon's comfort. This study compared muscle workload, work posture and perceived physical exertion of surgeons performing LAP or RALS.

Methods

Colorectal surgeons with experience in advanced LAP and RALS performed one of each operation. Bipolar surface electromyography (EMG) recordings were made from forearm, shoulder and neck muscles, and expressed relative to EMG maximum (%EMGmax). The static, median and peak levels of muscle activity were calculated, and an exposure variation analysis undertaken. Postural observations were carried out every 10 min, and ratings of perceived physical exertion before and after surgery were recorded.

Results

The study included 13 surgeons. Surgeons performing LAP showed higher static, median, and peak forearm muscle activity than those undertaking RALS. Muscle activity at peak level was higher during RALS than LAP. Exposure variation analysis demonstrated long-lasting periods of low-level intensity muscle activity in the shoulders for LAP, in the forearms for RALS, and in the neck for both procedures. Postural observations revealed a greater need for a change in work posture when performing LAP compared with RALS. Perceived physical exertion was no different between the surgical modalities.

Conclusion

Minimally invasive surgery requires long-term static muscle activity with a high physical workload for surgeons. RALS is less demanding on posture.

TNF deficiency causes alterations in the spatial organization of neurogenic zones and alters the number of microglia and neurons in the cerebral cortex

BACKGROUND

Although tumor necrosis factor (TNF) inhibitors are used to treat chronic inflammatory diseases, there is little information about how long-term inhibition of TNF affects the homeostatic functions that TNF maintains in the intact CNS.

MATERIALS AND METHODS

To assess whether developmental TNF deficiency causes alterations in the naïve CNS, we estimated the number of proliferating cells, microglia, and neurons in the developing neocortex of E13.5, P7 and adult TNF knock out (TNF^-/-) mice and wildtype (WT) littermates. We also measured changes in gene and protein expression and monoamine levels in adult WT and TNF^-/- mice. To evaluate long-term effects of TNF inhibitors, we treated healthy adult C57BL/6 mice with either saline, the selective soluble TNF inhibitor XPro1595, or the nonselective TNF inhibitor etanercept. We estimated changes in cell number and protein expression after two months of treatment. We assessed the effects of TNF deficiency on cognition by testing adult WT and TNF^-/- mice and mice treated with saline, XPro1595, or etanercept with specific behavioral tasks.

RESULTS

TNF deficiency decreased the number of proliferating cells and microglia and increased the number of neurons. At the same time, TNF deficiency decreased the expression of WNT signaling-related proteins, specifically Collagen Triple Helix Repeat Containing 1 (CTHRC1) and Frizzled receptor 6 (FZD6). In contrast to XPro1595, long-term inhibition of TNF with etanercept in adult C57BL/6 mice decreased the number of BrdU⁺ cells in the granule cell layer of the dentate gyrus. Etanercept, but not XPro1595, also impaired spatial learning and memory in the Barnes maze memory test.

CONCLUSION

TNF deficiency impacts the organization of neurogenic zones and alters the cell composition in brain. Long-term inhibition of TNF with the nonselective TNF inhibitor etanercept, but not the soluble TNF inhibitor XPro1595, decreases neurogenesis in the adult mouse hippocampus and impairs learning and memory after two months of treatment.

Surgeons' muscle load during robotic-assisted laparoscopy performed with a regular office chair and the preferred of two ergonomic chairs: A pilot study

Surgeons work in awkward work postures and have high precision demands - well-known risk factors for musculoskeletal pain. Robotic-assisted laparoscopy is expected to be less demanding compared to conventional laparoscopy; however, studies indicate that robotic-assisted laparoscopy is also associated with poor ergonomics and musculoskeletal pain. The ergonomic condition in the robotic console is partially dependent upon the chair provided, which often is a regular office chair. Our study quantified and compared the muscular load during robotic-assisted laparoscopy using one of two custom built ergonomic chairs and a regular office chair. The results demonstrated no differences that could be considered clinically relevant. Overall, the study showed high levels of static and mean muscular activity, increased perceived physical exertion from pre-to-post surgery, and moderate to high risk for musculoskeletal injuries measured by the Rapid Upper Limb Assessment worksheet. Authors advocate for further investigation in surgeons' ergonomics and physical work demands in robotic surgery.

Patient-initiated follow up affects fear of recurrence and healthcare use: a randomised trial in early-stage endometrial cancer

OBJECTIVE

To test the hypothesis that patient-initiated follow up reduces the fear of cancer recurrence (FCR) and healthcare use when compared with traditional hospital-based follow up.

DESIGN

Pragmatic, multicentre randomised trial.

SETTING

Four Danish departments of gynaecology between May 2013 and May 2016.

POPULATION

One hundred and fifty-six women diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I low-intermediate risk endometrial carcinoma.

METHODS

Women allocated to the control group attended hospital-based follow up consisting of regular outpatient visits for 3 years after primary treatment. Women in the intervention group were instructed in patient-initiated follow up, which included careful instruction in alarm symptoms and options for self-referral rather than a schedule of examinations.

MAIN OUTCOME MEASURES

The primary end point was FCR as measured by the Fear of Cancer Recurrence Inventory (FCRI) after 10 months of follow up. Secondary end points included cancer-related use of primary and secondary health care during the first 10 months after treatment.

RESULTS

In the primary analysis, FCR decreased significantly more in the control group from baseline to 10 months of follow up (difference -5.9, 95% CI -10.9 to -0.9). The majority of this improvement happened after only 3 months of follow up. Women receiving the intervention had fewer examinations at the department compared with the control group (0 versus 2 median visits, P < 0.01) and 58% of these examinations were scheduled because of vaginal bleeding.

CONCLUSIONS

Hospital-based follow up alleviates FCR significantly more than patient-initiated follow up, though the estimated difference was small. Patient-initiated follow up is a feasible, potentially cost-reducing follow-up approach in a population of endometrial cancer survivors with low risk of recurrence. The decision to use patient-initiated follow up should balance these benefits and harms.

TWEETABLE ABSTRACT

Patient-initiated follow up reduces healthcare use but maintains fear of recurrence in endometrial cancer.

PLAIN LANGUAGE SUMMARY

Why and how was the study carried out? Follow up of women with endometrial cancer is resource consuming and previous research suggests that it is not effective. Even though the women benefit from reassurance at follow up, routine examinations may also remind the women of the disease and induce fear of cancer recurrence. Furthermore, routine follow up may delay recurrence diagnosis, because the women do not report their symptoms until the next scheduled visit. In the research explained in this article, patient-initiated follow up was evaluated as an alternative to traditional follow up. The women were randomly assigned to one of two follow-up programmes: regular gynaecological examinations at the department of gynaecology or self-referral with careful instruction in alarm symptoms, that is, patient-initiated follow up. The level of fear of cancer recurrence in the two groups was obtained by questionnaires. Information on healthcare use was obtained by questionnaires and a chart review. What were the main findings? Regular examinations at the department of gynaecology reduced the fear of cancer recurrence significantly more than patient-initiated follow up, though the difference was small. Women who were instructed in alarm symptoms, under self-referral, were able to monitor their symptoms, and this approach significantly reduced the number of examinations at the department of gynaecology. What are the limitations of the work? Participants in the self-referral group knew that they were examined less than other women, and this may have induced fear of cancer recurrence. Similarly, the regular completion of questionnaires regarding fear of cancer recurrence may have reminded the women of the disease and diminished the difference between the two groups. What are the implications for patients Patient-initiated follow up reduced healthcare use but maintained fear of cancer recurrence in women who had survived early-stage endometrial cancer. Future analyses on quality of life and cost-effectiveness are needed to balance the benefits and harms of patient-initiated follow up.

Rehabilitation of women with gynaecological cancer: the association between adult attachment, post-traumatic stress disorder and depression

OBJECTIVE

We hypothesised that being diagnosed with gynaecological cancer influences adult attachment and occurrence of depression and post-traumatic stress disorder (PTSD). The main aim of the study was to assess changes in the attachment dimensions, PTSD and depression from baseline to 5-month post-treatment. Further, we evaluated the association between attachment avoidance/anxiety dimensions and PTSD/depression among women newly diagnosed with ovarian, endometrial, or cervical cancer.

METHODS

Consecutive Danish-speaking women aged 20 to 75 years and treated surgically for primary gynaecological cancer were eligible. All patients were offered a rehabilitation programme consisting of two face-to-face sessions and two phone calls carried out by a nurse. Patients were asked to complete the Revised Adult Attachment Scale, the Harvard Trauma Questionnaire and the Major Depression Inventory at baseline and at 5-month follow-up. In all, 151 women consent to participate in the sessions where 51 fulfilled Revised Adult Attachment Scale questionnaire and contribute with socio-demographic data.

RESULTS

We found significant positive changes within the attachment anxiety dimension among women with ovarian cancer, a significant reduction of PTSD among endometrial cancer patients and insignificant changes in depression among all cancer types. The attachment anxiety dimension significantly increased the odds for PTSD and depression.

CONCLUSIONS

Depression and PTSD were prevalent among ovarian and cervical cancer patients. The adjustment of rehabilitation according to patients' attachment anxiety dimension contains possibilities for indirect impact on PTSD and depression symptoms. Copyright © 2015 John Wiley & Sons, Ltd.

Pulsed dose rate (PDR) brachytherapy as salvage treatment of locally advanced or recurrent gynecologic cancer

PURPOSE

Pulsed dose rate (PDR) brachytherapy is a new treatment option permitting dose distribution optimization in interstitial implants. It possesses the advantage of equipment simplification and radiation protection to the staff, compared to the manually afterloading technique. This study presents the first clinical results from The Finsen Center with PDR-brachytherapy in patients with locally advanced or recurrent gynecologic cancer.

METHODS AND MATERIALS

Between June 1993 and August 1996, 34 patients with gynecologic malignancies (22 pelvic recurrences, 12 primary locally advanced) have been treated with external irradiation, four-field box technique, to 46 Gy/23 fractions, 5 F/week and 192Ir-interstitial PDR-brachytherapy in pulses of 0.6 Gy, one pulse per hour to a total of 30 Gy. The Martinez Universal Perineal Interstitial Template applicator was used for all implantations.

RESULTS

The overall complete response rate was 74%. At median 14 months follow-up (range 3-40) 15 patients were alive with no evidence of disease. Seven of 14 patients with a second recurrence or progressive disease were still alive. The overall 1- and 2-year survival was 71% and 63%, respectively. There was no difference in survival probability when stratifying the patients by primary diagnosis (recurrent vs. primary advanced), relapse locations (central vs. central + pelvic wall mass) or treatment volume. Seventeen chronic grade III complications were observed in 10 patients. Large treatment volumes significantly correlated to severe gastrointestinal complications. Fifteen of 17 chronic grade III complications were observed in patients treated for recurrent disease.

CONCLUSION

PDR-brachytherapy in combination with external irradiation is an effective treatment option for patients with locally advanced or recurrent gynecologic cancer, although substantial toxicity is observed in patients with large treatment volumes and recurrent disease.

Nation-wide Salmonella enterica surveillance and control in Danish slaughter swine herds

A nation-wide Salmonella enterica surveillance and control programme was initiated in Danish finishing herds over the first quarter of 1995. In Denmark, all swine for slaughter are identifiable by a unique herd code. For each herd code, and depending on the herd's annual kill, random samples ranging from four to more than 60 swine are obtained quarterly at the abattoir. A meat sample from each pig is frozen, and meat juice (harvested after thawing) is examined for specific antibodies against S. enterica using an indirect enzyme-linked immunosorbent assay (ELISA). The ELISA combines several S. enterica O-antigens, and allows detection of antibody response after a variety of different S. enterica serovar infections. Results are transferred to a central database, which each month (based on meat-juice tests obtained in the previous 13 weeks) assigns all herds into three S. enterica infection levels: Level 1, in which the S. enterica prevalence is deemed low and acceptable; Level 2, where there is a moderate prevalence of S. enterica seroreactors (from > 50% in the smallest to > 10% in the largest herds); Level 3, in which S. enterica seroreactor prevalence is clearly unsatisfactory (> 50% for most herd sizes). Irrespective of Salmonella level, all herds receive a monthly update on the current results of the S. enterica test results. If a herd is categorized in Level 2 or 3, it must receive an advisory visit by a practising veterinarian and a local swine extension specialist, and certain management hygiene precautions must be taken. If a herd is categorized in Level 3, the finishers from the herd must additionally be slaughtered under special hygiene precautions. This is supervised by the veterinary authorities. During 1995, 604000 samples were tested for S. enterica, corresponding to 3.0% of the total kill. In December 1995, 15522 herds (representing > 90% of the national production) were categorized into one of the three levels: 14551 herds (93.7%) in Level 1; 610 herds (3.9%) in Level 2; 361 herds (2.3%) in Level 3. The proportion of serologically positive meat-juice samples collected during 1995 ranged from a mean of 2.9% in smaller herds (101-200 swine slaughtered per year) to 6.1% in relatively large herds (more than 5000 swine slaughtered per year).

Mulberry heart disease in young pigs without vitamin E and selenium deficiency

Mulberry heart disease persists among young pigs in Denmark although abundant supplies of selenium and vitamin E are added to feedstuffs for sows and pigs. The concentrations of selenium and vitamin E in the liver and heart tissues of young pigs which had died suddenly, and had the characteristic lesions of mulberry heart disease post mortem, were not significantly different from the concentrations found in pigs of the same age which had died suddenly for other reasons. The concentrations of selenium and vitamin E in the livers (0.3 mg/kg and 4 mg/kg, respectively) appeared to be satisfactory in all the pigs examined.

Studies on boar semen. III. Sperm concentration and seminal plasma total solids followed in Danish AI boars through a 10-year-period

Semen samples from 1531 young boars eligible for AI service were examined for normality. Sperm concentration (s.c.) was determined by the hemocytometer technique in 1348 of the samples. Seminal plasma total solids (t.s.) were determined on all samples in order to control whether the semen samples originated from complete ejaculates.

The hemocytometer counts showed an arithmetic mean of 370 × 10⁶/ml with a standard deviation of 188×10⁶/ml. No correlation was found either between s.c. and age or between s.c. and season of the year.

The seminal plasma t.s. showed an arithmetic mean of 4.6% with a standard deviation of 1.35%. No correlation was found between t.s. and s.c. or between t.s. and the age of the boars. Neither was there any association between t.s. and the season of the year.

Values of t.s. below 1.6% combined with aspermia were regarded as the result of incomplete ejaculations and the following retest from such cases gave ejaculates showing normal values concerning s.c. and t.s. A drop in t.s. combined with an admixture of pathological cells to the ejaculate may indicate an inflammatory condition in the vesicular glands.

Serological comparison of type strains of porcine, bovine, and ovine mycoplasmas with atypical colony morphology

The type strains of Mycoplasma hyopneumoniae, M. flocculare, M. dispar, and M. ovipneumoniae, all characterized by nipple-less colonies on solid media, were compared serologically. By indirect hemagglutination and by complement fixation tests they were found to constitute a related group. By crossed immunoelectrophoresis a sharing of common antigens was demonstrated, whereas no cross reactivity was noted by the metabolism inhibition test.

The type strains of Mycoplasma hyorhinis and Mycoplasma bovirhinis were included in the study for comparison. Although some cross reaction was noted, they appeared just moderately related to the nipple-less group as well as to each other.

Hereditary dwarfism in pigs

In a swine production herd dwarfs with extremely short limbs were observed in 3 litters sired by the same boar. Clinical, radiographical, and pathologic-anatomical examinations, showed the affected individuals to be chondrodysplastic dwarfs. Such dwarfism has not been reported previously in pigs. An inbreeding experiment conducted with a dwarf gilt and related boars indicated that the dwarfism was hereditary with a simple autosomal recessive inheritance.

Congenital ascorbic acid deficiency in pigs

In a swine production herd, spontaneous scurvy was observed among piglets 2–3 weeks after weaning. All affected pigs had the same boar as both maternal and paternal grandfather. The affected pigs had only traces of ascorbic acid in blood and tissues as compared to litter mates and other normal pigs. The ratio between the total numbers of normal and affected pigs in the 4 litters concerned was in agreement with a 3:1 segregation, which is characteristic of simple autosomal recessive inheritance in matings between non-affected carriers.

Two affected pigs were restored to normal when given ascorbic acid in the diet. Without vitamin C supplement affected pigs died or had to be euthanized.

Liver microsomes from an affected pig were unable to synthesize ascorbic acid in vitro with 1-gulonolactone as a substrate, unlike microsomes from normal control pigs.

Effect of dietary and injectable vitamin E on the antioxidant status of pigs

An experiment concerning 6 different vitamin E treatments was conducted with 30 young pigs. From 4 to 15 weeks of age the pigs were kept in individual pens and fed a selenium supplemented basal diet consisting mostly of propionic acid treated barley and soybean meal, and containing 4.4 mg vitamin E per kg. The treatments were periods with or without vitamin E supplement (20 mg/kg) or a vitamin E injection (200 mg). Blood samples collected during the period of investigation were examined for vitamin E and for resistance against erythrocyte lipid peroxidation (ELP) in order to evaluate the antioxidant status.

Analysis of variance showed a litter effect on ELP values at all the weekly investigations and a treatment effect from two weeks after the experiment had started. Also the blood vitamin E level was litter dependent and influenced by treatment. Paired comparisons by Student’s t-test showed a delay of 1 to 2 weeks in the effect on ELP of a dietary vitamin E supplement. In contrast, both ELP and vitamin E changed very rapidly (hours) after vitamin E injections.

Independently of the vitamin E treatments there was a rise in ELP within the first 2 or 3 weeks after weaning; this was taken as an index of a reduced antioxidant status during that period.

Procedure for blood glutathione peroxidase determination in cattle and swine

An improved testing system has been developed for direct measurement of glutathione peroxidase activity in heparinized whole blood at 37°C. Without loss in net yield the consumption of reagents has been found to be considerably lower with the new technique than with previously described techniques. Within the range 0–700 mKat/1 the GSH-Px activity in red cells may be measured with a high degree of accuracy and reproducibility without preceding separation and washing. The stability of the enzyme in bovine and porcine whole blood at 22°C, 4°C, and —20°C was determined.

Clinico-pathologic findings in young pigs fed different levels of selenium, vitamin E and antioxidant

A randomized, blocked 2³ factorial experiment was conducted with 48 young pigs. The treatment factors were: 2 levels of selenium (55 and 115 µg/kg), 2 levels of vitamin E (3 and 53 mg/kg) and 2 levels of the antioxidant feed additive Ethoxyquin (0 and 150 mg/kg). All pigs were kept in single pens and fed ad libitum throughout the experimental period of 9 weeks, i.e. from 3 to 12 weeks of age.

Plasma, heart, liver and muscle Se levels as well as whole blood glutathione peroxidase activity (EC 1.11.1.9 GSH-Px) were significantly higher in pigs given a dietary supplement of Se than in pigs given no supplement of Se (P ≤ 0.001). The Se-supplemented pigs showed a tendency to lower mean serum transaminase activity (ASAT and ALAT) than unsupplemented pigs, but the influence was significant (P ≤ 0.05) only for the ALAT activity.

Blood vit. E levels were higher for pigs receiving a supplement of vit. E than for unsupplemented pigs (P ≤ 0.001), and so was the resistance of red blood cells against lipid peroxidation (ELP), as expressed by lower ELP values.

There were no effects of Ethoxyquin supplementation on the biochemical variables included in the study.

The histological examination of heart muscle showed that the score for changes was negatively influenced by both Se and vit. E supplement (P ≤ 0.001) and to some extent also by Ethoxyquin supplement (P ≤ 0.05). The histological picture of m. long dorsi was influenced only by the vit. E supplement (P ≤ 0.01). No histological changes were found in the liver in this study. There were inverse relationships between whole blood GSH-Px defluorescence time and blood Se, and between ELP and whole blood vit. E (P ≤ 0.001).

The influence of sow colostrum trypsin inhibitor on the immunoglobulin absorption in newborn piglets

The influence of sow colostrum trypsin inhibitor (SCTI) on the immunoglobulin absorption from the gut of 16 newborn colostrum-deprived piglets was investigated in a paired feeding experiment.

Three times at 1 h intervals the piglets were fed an experimental diet consisting of sow milk, purified swine serum immunoglobulins containing agglutinins against Bordetella bronchiseptica, and purified SGTI (diet I) or saline (diet II). The serum concentrations of IgG, IgM, IgA, and antibodies for B. bronchiseptica were measured by single radial immunodiffusion and by a tube agglutination procedure and used to evaluate the immunoglobulin absorption. Four and 6 h after the first experimental meal, blood samples from the piglets given SGTI in their diet had a generally higher level of IgG, IgA and aggutinins against B. bronchiseptica than blood samples from the piglets d no SGTI. No real differences were found in the IgM levels. Although the piglets fed no SGTI all showed a considerable immunoglobulin absorption, the SCTI was found to have a statistically significant positive influence on the IgG and IgA absorption.

In vitro evaluation of porcine lymphocyte response to phytohaemagglutinin using a modified "whole blood" technique

The purpose of these investigations was to develop a modified whole blood technique for measuring quantitatively the responsiveness of pig peripheral blood lymphocytes to phytohemagglutinin (PHA) in vitro. Washed blood cells from a fixed volume of blood were suspended in culture medium supplemented with foetal calf serum and stimulated with a pure mitogenic PHA preparation. The stimulation was measured by the incorporation of 3H-thymidine. Data are presented to show the effect of different variables on the culture system. The transformation response was measured at different levels of PHA and the reproducibility of the different responses from repeated investigations was used to evaluate the usefulness of the test. The best reproducibilities of the stimulation response were found at the high PHA concentrations. Also the calculated PHA concentration giving maximum stimulation response had a relatively high reproducibility and indicates that this value is a convenient and reliable alternative measure of the functional capacity of the lymphocytes.

Genetic studies on the in vitro PHA-transformation of porcine blood lymphocytes

The response of pig peripheral blood lymphocytes to phytohaemagglutinin (PHA) was studied by a whole blood technique. The material for study comprised 441 offspring from one generation of a randomly mated Danish Landrace pig herd. The pigs were blood-sampled at a weight of 90 kg. After correlation for influence from other blood cells and for seasonal variation, the heritability of the PHA stimulation responses at different PHA concentrations were estimated. The heritability estimates ranged from 0.15 to 0.53. Also the PHA concentration giving maximum stimulation response, as calculated by a dose response function, was found to vary depending on genetic variation among the pigs with an estimated heritability of 0.38.

Studies on immunoglobulins and trypsin inhibitor in colostrum and milk from sows and in serum of their piglets

The concentrations of IgG, IgM, IgA and the specific sow colostrum trypsin inhibitor (SCTI) were measured by radial immunodiffusion in colostrum and milk samples from sows and in serum samples from their offspring during the suckling period. A clear time dependence was found for all the measured variates in both whey and serum. Statistically significant positive correlations were found between, on the one hand, concentrations of IgG and IgA, but not IgM, in sera from 39 suckling piglets 1 and 3 days old, and, on the other hand, concentrations of the same immunoglobulins and of the trypsin inhibitor in maternal colostrum (n = 7). Multiple regression analyses showed that at day 1 and day 3 the levels of both IgG and IgA in serum samples from the suckling piglets were positively influenced by both the SCTI and the IgG or IgA contents in maternal colostrum.

Glutathione peroxidase activity and erythrocyte lipid peroxidation as indices of selenium and vitamin E status in young pigs

A randomized, blocked 2³ factorial experiment was conducted with 48 pigs from sows fed a diet low in selenium and vitamin E. From 3 to 12 weeks of age the piglets were kept in single pens and fed a basic diet consisting mostly of barley, dried skim milk, soybean meal and dried yeast, and containing 55 µg selenium and 3 mg vitamin E per kg. The treatment factors — i.e. feed supplements — were 2 levels of Se (nil, 60 µg/kg), 2 levels of vitamin E (nil, 50 mg/kg), and 2 levels of the feed antioxidant ethoxyquin (nil, 150 mg/kg). Blood samples, collected at termination of the experiment, were examined for glutathione peroxidase activity (GSH-Px) and resistance against erythrocyte lipid peroxidation (ELP) to evaluate Se and vitamin E status, respectively. Analysis of variance showed the GSH-Px activity to be litter-dependent (P < 0.001) and influenced by selenium supplementation (P < 0.001) but not by the other supplements or by interactions between supplements. Resistance against ELP was influenced only by vitamin E supplementation (P < 0.001). GSH-Px and ELP thus seem to be valuable and simple methods for evaluating, respectively, Se status and vitamin E status in growing pigs.

Immunoglobulins in bovine ostertagiasis

Lowered albumin levels with normal or slightly elevated γ-globulin levels are well known features of various gastro-intestinal disorders in cattle. Thus, this picture is a prominent finding in clinical ostertagiasis, where hypercatabolism of both albumin (Nielsen 1966) and IgG (Nansen 1970) has been demonstrated. The hypercatabolism is explained by gastric loss, and evidence suggests that this takes place as a non-selective loss of protein through the hyperplastic abomasal wall (Murray 1969). The albumin hypercatabolism is not compensated for by an increased synthesis, and thus leads to hypoalbuminaemia also during part of the non-diarrhoeal phase. The IgG hypercatabolism, on the other hand, is compensated for by increased synthesis, which may lead to elevated serum IgG levels, especially in phases without diarrhoea. There seems to be no comparative data available for IgG-1, IgG-2, IgM, and Ig A levels in ostertagiasis. The purpose of the present study was to analyse the influence of ostertagiasis on the serum levels of immunoglobulins, albumin and total protein in young cattle. The study comprised two groups of randomly selected Red Danish calves, approx. % year old. Half the calves (Group A) grazed the same paddock from May to late September and were exposed to heavy infection from August onwards as evidenced by high herbage larval counts, high faecal egg counts, and elevated serum pepsinogen levels (see Table 1). Most of the calves were clinically affected, and in the last part of August and September some had profuse diarrhoea. The other calves (Group B) were moved in mid July to a paddock not grazed earlier that season. Accordingly, these calves were exposed to only a relatively low pasture infection in the second half of the grazing season. None of them showed clinical signs, and pepsinogen levels were only slightly elevated (Table 1).

Utilisation of glucose by Mycoplasma suipneumoniae and Mycoplasma flocculare

The utilisation of glucose by Mycoplasma suipneumoniae and Mycoplasma flocculare was examined by chemical determination of glucose disappearance during growth, and by examination for hexokinase activity in cell preparations. Both species degraded glucose during growth and possessed hexokinase activity as evidence of the presence of a glycolytic pathway. The glucose utilisation capacity was found to be greater for M. flocculare than for M. suipneumoniae.

Enzyme-linked immunosorbent assay (ELISA) for detection of antibodies to Mycobacterium paratuberculosis in cattle

Paratuberculosis may be diagnosed by clinical, bacteriological and immunological methods, but so far only the demonstration of M. paratuberculosis is considered a definite proof of the infection. World-wide use is being made of the complement fixation (CF) test as a valuable immunological test for diagnosis of clinical cases, but its low specificity and sensitivity makes its value problematic in non-clinical cases.

Isolation and immunochemical determination of sow colostrum trypsin inhibitor

Trypsin inhibitor from sow colostrum was isolated by ion exchange chromatography on DEAE-Sephadex A-50 followed by gel filtration chromatography on Sephadex G-100 and affinity chromatography. Antiserum against sow colostrum trypsin inhibitor was produced by immunization with the purified inhibitor, and made specific by absorption with normal porcine serum. The specific antiserum was used for immunoquantitation by single radial immunodiffusion (SRI). In sow colostrum whey, good agreement was found between the results obtained by SRI and the total trypsin-inhibiting activity as determined by radial diffusion in a casein-containing agarose gel (r = 0.97, n = 10). In sow's milk there was only a very low inhibiting activity, and no colostral inhibitor was demonstrable by SRI. Also in baby-pig urine agreement was found between the two methods (r = 0.97, n = 14). In baby-pig serum such an agreement was not seen, undoubtedly becuase of the presence of genuine serum trypsin inhibitors. By the SRI technique it is possible specifically to determine the colostral inhibitor even in the presence of other trypsin inhibitors.

[Glutathione peroxidase and selenium-vitamin E deficiency in pigs (author's transl)]

Glutathione peroxidase activity was measured, by the simple paper-fluorescent method of Board & Peter (1976), in blood samples from growing pigs(8 to 16 weeks old) originating from various production herds. The animals were divided in three different groups (Tables I and II): 1) Clinically normal animals from herds fed a selenium supplemented feed (about 0.1 ppm) (40 pigs, 5 herds). 2) Clinically normal animals from herds fed rations low in selenium feed (18 pigs, 3 herds). 3) Clinically normal pigs from litters fed rations with unknown selenium content and with at least one pig having died from Mulberry heart disease (MHD) or Hepatosis dietetica (HD) (Diagnosed at the State Veterinary Serum Laboratory) (40 pigs, 7 herds). The glutathione peroxidase activity was expressed as the reaction time (min.) corrected for haemoglobin concentration, as shown, in Fig. 1. and Equation A. The activity in whole blood was found significantly higher (P less than 0.001) in Group 1 than that in Group 2. The mean activity in Group 3 was significantly higher than in Group 2 (P less than 0.001) and significantly lower than in Group 1 (P less than 0.001). It is concluded that estimation of glutathione peroxidase activity may be useful in evaluating the "selenium status" in pigs.

A simple method for determination of pepsinogen in bovine serum and plasma

Calf serum pepsinogen can be determined by radial diffusion in a casein-containiing agarose gel prepared at pH 8.2 and afterwards immersed in a BaGla-containing buffer, pH 2.4, whereby the casein is precipitated homogeneously. Serum samples are placed in wells in the gel, and at the low pH pepsinogen present in the samples will be activated and the casein digested, whereby transparent, circular zones are formed in the otherwise opaque gel. The diameter of these zones can be measured directly and used as an expression of the serum pepsinogen level. On analysis of a number of sera from calves with or without ostertagiasis a positive correlation was found between the results obtained by this method and conventional absorption photometry (r = 0.87, n = 55).

Congenital osteogenesis imperfecta in Charollais cattle

An outbreak of an apparently new hereditary bone disease--congenital osteogenesis imperfecta--in six newborn half-sib Charollais calves is described. In many respects the clinical, pathological, radiological and genetical findings resemble the congenital osteogenesis imperfecta seen in man and sheep.