Valve Cannula Research Articles

Comparing Voice Related Quality of Life scores between fenestrated and speaking valve cannula users

Background: Tracheostomy is a procedure that aims to maintain the airway so that air can enter the lungs and bypass the upper airway. Tracheostomy causes physiological changes, especially in terms of communication, which leads to reduced voice-related quality of life. Fenestrated tracheal cannula and speaking valve can assist patients in generating voice.
 Objective: To compare the V-RQOL scores of the fenestrated tracheal cannula and speaking valve users.
 Methods: Analytic observational study using a cross-sectional design. Data collection was done through interviews with the V-RQOL questionnaire guide. The study was conducted in September-December 2022 at the THTBKL Polyclinic of Dr. Mohammad Hoesin Hospital Palembang. Data were analyzed with IBM SPSS 26.
 Results: 42 patients were using tracheal cannula, with 21 patients each with a fenestrated and speaking valve tracheal cannula. Patients with fenestrated tracheal cannula had lower quality of life in the physical, social, and total domains than those in the speaking valve group (poor QoL in the physical domain: 66.67% vs. 9.52%; social domain: 85.71% vs. 57.14%; total domain: 76.19% vs. 4.76%; p<0.001). From the multivariate analysis, the tracheal cannula type influenced the patient's quality of life was (p<0.001). The probability of someone with a fenestrated tracheal cannula will experience a poor QoL is 76.2%, while speaking valve is 4.7%.
 Conclusion: The quality of life of patients with a fenestrated type of tracheal cannula is significantly lower than that of speaking valve tracheal cannula users in both the physical, social, and total domains as measured by the V-RQOL.

Risk Assessment of Aerosol Generation During Vitreoretinal Surgery Using High Speed Imaging Amidst the COVID-19 Pandemic.

PurposeThe purpose of this study was to discuss the propensity of aerosol and droplet generation during vitreoretinal surgery using high speed imaging amidst the coronavirus disease 2019 (COVID-19) pandemic.MethodsIn an experimental set up, various steps of vitreoretinal surgery were performed on enucleated goat eyes. The main outcome measures were visualization, quantification of size, and calculation of aerosol spread.ResultsDuring intravitreal injection, insertion of cannulas, lensectomy, and vitrectomy with both 23 and 25-gauge instruments, with either valved or nonvalved cannulas, aerosols were not visualized which was confirmed on imaging. Although there was no aerosol generation during active fluid air exchange (FAE), there was bubbling and aerosol generation at the exit port of the handle during passive FAE. Under higher air pressure, with reused valved and fresh nonvalved cannulas, aerosol generation showed a trajectory 0.4 to 0.67 m with droplet size of 200 microns. Whereas removing cannulas or suturing under active air infusion (35 mm Hg and above) aerosols were noted.ConclusionsBased on the above experiments, we can formulate guidelines for safe vitrectomy during COVID-19. Some recommendations include the use of valved cannulas, avoiding passive FAE or to direct the exit port away from the surgeon and assistant, and to maintain the air pressure less than or equal to 30 mm Hg.Translational RelevanceIn the setting of the COVID-19 pandemic, the risk from virus laden aerosols, as determined using an experimental setup, appears to be low for commonly performed vitreoretinal surgical procedures.

Assessing visible aerosol generation during vitrectomy in the era of Covid-19.

ObjectiveTo assess visible aerosol generation during simulated vitrectomy surgery.MethodsA model comprising a human cadaveric corneoscleral rim mounted on an artificial anterior chamber was used. Three-port 25 gauge vitrectomy simulated surgery was performed with any visible aerosol production recorded using high-speed 4K camera. The following were assessed: (1) vitrector at maximum cut rate in static and dynamic conditions inside the model, (2) vitrector at air–fluid interface in a physical model, (3) passive fluid–air exchange with a backflush hand piece, (4) valved cannulas under air, and (5) a defective valved cannula under air.ResultsNo visible aerosol or droplets were identified when the vitrector was used within the model. In the physical model, no visible aerosol or droplets were seen when the vitrector was engaged at the air–fluid interface. Droplets were produced from the opening of backflush hand piece during passive fluid–air exchange. No visible aerosol was produced from the intact valved cannulas under air pressure, but droplets were seen at the beginning of fluid–air exchange when the valved cannula was defective.ConclusionsWe found no evidence of visible aerosol generation during simulated vitrectomy surgery with competent valved cannulas. In the physical model, no visible aerosol was generated by the high-speed vitrector despite cutting at the air–fluid interface.

Predicting the standardized ileal protein digestibility of processed soybean meal and rapeseed meal in growing pigs using two in vitro methods1

A study was conducted to compare protein digestibility of processed ingredients using 2 in vitro methods with known standardized ileal digestibility of CP (SIDCP) measured in growing pigs. The SIDCP in soybean meal (SBM), rapeseed meal (RSM), and both ingredients retoasted in the presence of lignosulfonate, resulting in processed SBM (pSBM) and processed RSM (pRSM), was determined in a trial with growing pigs surgically fitted with a steered ileocecal valve cannula. Toasting in the presence of lignosulfonate was performed to induce protein damage. Initial pH and degree of hydrolysis after 10 min (DH10) and 120 min (DH120) were determined using the pH-STAT method. Hydrolysis was performed using trypsin, chymotrypsin, and peptidase at pH 8. Size-exclusion profiles of the resulting peptides after hydrolysis were also determined. Crude protein digestibility was determined using a 2-step enzymatic method, with pepsin at pH 2 and pancreatin at pH 6.8. The SIDCP in SBM, pSBM, RSM, and pRSM were 83.9, 71.6, 74.9, and 64.6%, respectively. Initial pH of ingredient solutions measured at constant N concentration was 6.9, 5.9, 6.1, and 5.5, respectively, and was highly positively correlated to SIDCP (r = 0.99, P A study was conducted to compare protein digestibility of processed ingredients using 2 in vitro methods with known standardized ileal digestibility of CP (SIDCP) measured in growing pigs. The SIDCP in soybean meal (SBM), rapeseed meal (RSM), and both ingredients retoasted in the presence of lignosulfonate, resulting in processed SBM (pSBM) and processed RSM (pRSM), was determined in a trial with growing pigs surgically fitted with a steered ileocecal valve cannula. Toasting in the presence of lignosulfonate was performed to induce protein damage. Initial pH and degree of hydrolysis after 10 min (DH10) and 120 min (DH120) were determined using the pH-STAT method. Hydrolysis was performed using trypsin, chymotrypsin, and peptidase at pH 8. Size-exclusion profiles of the resulting peptides after hydrolysis were also determined. Crude protein digestibility was determined using a 2-step enzymatic method, with pepsin at pH 2 and pancreatin at pH 6.8. The SIDCP in SBM, pSBM, RSM, and pRSM were 83.9, 71.6, 74.9, and 64.6%, respectively. Initial pH of ingredient solutions measured at constant N concentration was 6.9, 5.9, 6.1, and 5.5, respectively, and was highly positively correlated to SIDCP (r = 0.99, P

FLUCTUATION OF INFUSION PRESSURE DURING MICROINCISION VITRECTOMY USING THE CONSTELLATION VISION SYSTEM

To measure fluctuations in infusion pressure and intraocular pressure (IOP) during vitrectomy performed using a flow-based IOP control system. Using 3 vitrectomized porcine eyes, the authors simultaneously measured infusion pressure and IOP during vitreous cutting and aspiration and after extraction of operative instruments in 23-gauge and 25-gauge system. The measurements were performed with the "IOP control" setting turned on or off. The efficacy of valved cannula and a built-in "IOP control limit" module in attenuation of infusion pressure fluctuation was evaluated. At set pressure of 30 mmHg and 60 mmHg, the mean infusion pressure levels were 43.7 mmHg and 78.7 mmHg in the vitreous cutting mode, 67.4 mmHg and 101.2 mmHg in the aspiration mode, and 72.8 mmHg and 115.8 mmHg after extraction of the operative instrument, respectively, when the 23-gauge system was used. Use of valved cannulas effectively attenuated fluctuations in both infusion pressure and IOP. When the IOP control limit setting was "on," the compensatory infusion pressure increase was markedly limited and similar to the set pressure level when the IOP control limit was set at Level 2. Similar results were obtained when a 25-gauge system was used. Infusion pressure increased markedly during vitrectomy using a flow-based IOP control system.

Globe stability during simulated vitrectomy with valved and non-valved trocar cannulas.

PurposeTo compare the effects of valved and non-valved cannulas on intraocular pressure (IOP), fluid leakage, and vitreous incarceration during simulated vitrectomy.MethodsThree-port pars plana incisions were generated in six rubber eyes using 23-, 25-, and 27-gauge valved and non-valved trocar cannulas. The models were filled with air and IOP was measured. Similar procedures were followed for 36 acrylic eyes filled with saline solution. Vitreous incarceration was analyzed in eleven rabbit and twelve porcine cadaver eyes.ResultsIn the air-filled model, IOP loss was 89%–94% when two non-valved cannulas were unoccupied versus 1%–5% when two valved cannulas were unoccupied. In the fluid-filled model, with non-valved cannulas, IOP dropped while fluid leaked from the open ports. With two open ports, the IOP dropped to 20%–30% of set infusion pressure, regardless of infusion pressure and IOP compensation. The IOP was maintained in valved cannulas when one or two ports were left open, regardless of IOP compensation settings. There was no or minimal fluid leakage through open ports at any infusion pressure. Direct microscopic analysis of rabbit eyes showed that vitreous incarceration was significantly greater with 23-gauge non-valved than valved cannulas (P<0.005), and endoscopy of porcine eyes showed that vitreous incarceration was significantly greater with 23-gauge (P<0.05) and 27-gauge (P<0.05) non-valved cannulas. External observation of rabbit eyes showed vitreous prolapse through non-valved, but not valved, cannulas.ConclusionValved cannulas surpassed non-valved cannulas in maintaining IOP, preventing fluid leakage, and reducing vitreous incarceration during simulated vitrectomy.

Estimating equivalency values of microbial phytase for amino acids in growing and finishing pigs fitted with steered ileo-cecal valve cannulas

Ten crossbred barrows (48.3 +/- 2.3 kg of initial BW) fitted with steered ileo-cecal valve cannulas were used to investigate the effects of supplemental microbial phytase on the apparent ileal digestibilities (AID) of AA, Ca, P, N, and DM, and the apparent total tract digestibilities of Ca, P, N, and DM. All diets were corn-soybean meal-based, and contained 0.44% Ca and 0.40% total P. Diets 1, 2, and 3 contained 12.0, 11.1, and 10.2% CP, respectively. Diets 4 and 5 had the same ingredient composition as diet 3, plus 250 and 500 U/kg phytase (Natuphos), respectively. Pigs were randomly allotted to 1 of 5 dietary treatments in a paired 5 x 5 Latin square with an extra period to test for carryover effects. Each 14-d period consisted of a 7-d adjustment followed by a 3-d total collection, a 12-h ileal digesta collection, a 3-d readjustment, and a second 12-h ileal digesta collection. Pigs were housed individually in metabolism pens (1.2 x 1.2 m). Water was supplied ad libitum, and feed was supplied at a level of 9% of the metabolic BW (BW(0.75)) per day in 2 equal daily feedings. As the dietary CP concentration increased, the AID of CP and all AA measured increased linearly (P < 0.05) with the exception of proline. In addition, the apparent total tract digestibilities (grams per day) and retention of N (grams per day) increased linearly (P < 0.01) with increasing CP levels. Supplementing diets with phytase increased the AID of Ca (P < 0.01), P (P < 0.001), CP (P = 0.07), and the AA (P < 0.10) Gly, Ala, Val, Ile, Thr, TSAA, Asp, Glu, Phe, Lys, and Arg. Protein and phytase response equations were generated for those AA affected (P < 0.10) by both CP level and phytase supplementation. Based on these equations, 500 U/kg of phytase can replace 0.52 percentage units of the dietary CP, which includes a 0.03 percentage unit improvement in Lys AID. The results of this study show that supplementing pig diets with microbial phytase improves CP and AA digestibilities in addition to Ca and P digestibilities.

Nutritional value of a corn containing a glutamate dehydrogenase gene for growing pigs.

Eight female PIC Line 42 pigs (initial BW = 47.5 +/- 1.8 kg) were used in a two-period switchback design (n = 4 per treatment per period) to evaluate the nutritional difference between a genetically modified corn and a similar nontransgenic corn. The genetically altered corn (gdhA+) contained a glutamate dehydrogenase gene isolated from Escherichia coli. The non-transgenic corn was the same variety lacking the transgenic cassette, grown at the same two locations. Pigs were surgically fitted with steered ileocecal valve cannulas for collection of ileal digesta. Diets were made up of primarily one of the two corn sources. Dietary AA profiles were adjusted using crystalline AA to match Illinois Ideal Protein Ratios. Pigs were limit-fed at 8% of metabolic body weight (BW0.75) in two equal feedings at 0600 and 1800 daily throughout the experiment. The study consisted of two 15-d periods. Each period consisted of a 7-d acclimation period, a 3-d total collection of feces and urine, two 12-h ileal collections, and a 3-d adjustment period between ileal collections to ensure adequate hydration. Crude protein, leucine, methionine, alanine, aspartic acid, glutamic acid, and tyrosine concentrations were greater (P < 0.05) in the gdhA+ corn than in the nontransgenic variety. The presence of the gene did not alter (P > 0.17) BW gain. Similarly, DM digestibility, fecal N excretion (grams per day), apparent total-tract N digestibility, N balance, net protein utilization, and N retained as percentages of absorbed were not affected (P > or = 0.32) by the gene modification. Apparent ileal AA digestibility values did not differ (P > 0.31) between the two dietary treatments. Results of this study suggest corn that contains the E coli. gene for glutamate dehydrogenase was nutritionally equivalent to the unaltered variety.

Digestibility of carbohydrates in growing pigs: a comparison between the t-cannula and the steered ileo-caecal valve cannula

We compared the determination of ileal and total tract digestibility of carbohydrates in five experimental diets using a double 5 × 5 Latin square design involving a total of 10 cannulated pigs; half of the pigs were equipped with a simple T-cannula and the other half with steered ileo-caecal valve (SICV)-cannula. The diets consisted of nitrogen-free mixture and soya bean meal, sunflower meal, peas or rape seed cake diluted to about 180 g/kg DM protein with the nitrogen-free mixture. There was no significant difference in the digestibility values using the two types of cannulas with regard to organic matter, sugars (sum of glucose, fructose and sucrose), α-galactosides (sum of raffinose, stachyose and verbascose), starch, cellulose, total non-cellulosic polysaccharides (NCP) and insoluble NCP constituents. The digestibility values for the NCP residues arabinose and galactose, however, were estimated higher but with a lower variability with the SICV-cannula compared with the T-cannula. The type of cannula did no influence the estimation of the total tract digestibility for any of the major dietary constituents, but the total tract digestibility was slightly more variable when the pigs were equipped with the SICV-cannula compared with the T-cannula. There was no difference in the ileal digestibility of sugars, α-galactosides, cellulose and the NCP arabinose and uronic acids residues among the experimental diets, while the ileal digestibility of starch and the remaining NCP sugar residues varied between diets. The total tract digestibility was complete for sugars, α-galactosides and starch, whereas the digestibility of the cell wall constituents varied in accordance with the polymeric composition of the cell walls. It was concluded that ileal digesta samples from SICV-cannula are more homogenous than those from the T-cannula. In cases where the precision of each determination is crucial, the SICV-cannula should be the option.

The effects of potassium diformate and its molecular constituents on the apparent ileal and fecal digestibility and retention of nutrients in growing-finishing pigs

Five 43-kg barrows [(Dutch Landrace x Yorkshire) x Yorkshire] were fitted with steered ileocecal valve cannulas to compare the effects of K-diformate (KDF), a specifically conjugated salt vs its molecular constituents, namely, formic acid and K-formate, as acidifiers in lysine-deficient diets on the apparent ileal (ID) and fecal digestibility, retention of nutrients, and manure production. The animals were randomly assigned to five dietary treatments according to a 5 x 5 Latin square design as follows: 1) control-no acidifier; 2) 1% KDF (= 0.65% K-formate + 0.35% formic acid, or 0.7% [HCOO-] + 0.3% [K+]); 3) 0.65% K-formate (= 0.35% [HCOO-] + 0.3% [K+]); 4) 0.35% formic acid (= 0.35% [HCOO-]); and 5) 1.3% K-formate (= 0.7% [HCOO-] + 0.6% [K+]). Diets were formulated with barley, wheat, soybean meal, and canola meal as major ingredients, and provided all nutrients at adequate levels, except for lysine (24% less than estimated requirement). Feeding level was equal to 2.5 x maintenance requirement (MR) for ME (MR = 418 kJ ME x BW(-0.75)), and daily rations were given in two portions after mixing with water in a ratio of 1:2.5. Chromic oxide was used as an indigestible marker. No clinical health problems due to the dietary treatments were observed. Irrespective of the additive, there were no differences (P < or = 0.10) in the ID of DM, OM, CP, or essential amino acids compared to the control, except for phenylalanine (P < or = 0.05). Among nonessential AA, only the ID of tyrosine tended (P = 0.092) to increase (up to 3.9 percentage units). The fecal digestibility of ash and K were greater (P < or = 0.001) in pigs fed supplemental K, irrespective of its source. The greater intake and fecal digestibility of K corresponded with greater (P < or = 0.05) losses of K in urine. Body retention of N, Ca, total P, and K was similar (P > or = 0.10) among treatments. As estimated from a separate nonorthogonal analysis, supplemental K improved (P < or = 0.05) body N by 3.7 percentage units compared to the control. The results of this study do not provide a clear explanation for the improved growth performance reported previously with KDF and its molecular constituents, and further research on their in vivo mode of action will require methodological refinement, especially with regard to the efficiency of AA utilization.

Digestibility of nutrients in growing–finishing pigs is affected by Aspergillus niger phytase, phytate and lactic acid levels : 1. Apparent ileal digestibility of amino acids

In growing–finishing pigs, the effects of microbial phytase, lactic acid and phytate levels in a maize-soybean meal diet on the apparent ileal digestibility (AID) of N and amino acids were studied. The experimental design was a 2×2×2 factorial arrangement plus a positive control treatment. Six crossbred castrates of 37 kg initial BW, fitted with steered ileo-caecal valve cannulas, were used during six collection periods. The dietary treatments consisted of Aspergillus niger phytase (Natuphos ®; 0 or 900 FTU kg −1), Na phytate (0 or 1.5 g P kg −1) and lactic acid (0 or 30 g kg −1). The positive control diet was supplemented with 1.0 g P kg −1 from monocalcium phosphate monohydrate (MCP). Ileal digestible amino acids were supplied at 80% of the Dutch recommended allowances for a 60-kg growing pig. The feeding level was 2.3 times the maintenance requirement for energy (418 kJ ME BW −0.75). Estimates of AID were calculated using Cr 2O 3 as a marker. Results showed that for almost all amino acids there was a significant interaction between Na phytate and phytase. Supplementing Na phytate to the diets without phytase increased the AID of N and amino acids. In general, phytase alone stimulated the AID of N and amino acids in the diets without Na phytate. Supplementing both Na phytate and phytase slightly decreased AID compared with the diets with only one supplement. Lactic acid stimulated the AID of N and amino acids, but a synergistic effect between phytase and lactic acid was not detected. Adding MCP had no effect on the AID of N and amino acids. It was concluded that when diets are supplemented with either phytase or lactic acid, AID of amino acids is improved. However, supplementing both did not result in a further increase in AID.

Digestibility of nutrients in growing–finishing pigs is affected by Aspergillus niger phytase, phytate and lactic acid levels : 2. Apparent total tract digestibility of phosphorus, calcium and magnesium and ileal degradation of phytic acid

In growing–finishing pigs, the effects of supplemental microbial phytase, lactic acid and Na phytate in a maize-soybean meal based diet on the apparent total tract digestibility (ATTD) of ash, total P, Ca and Mg and the ileal degradation (AID) of phytic acid were studied. The experimental design was a 2×2×2 factorial arrangement plus a positive control treatment. Six crossbred castrates of 37 kg initial BW, fitted with steered ileo-caecal valve cannulas were used during six collection periods. The dietary treatments consisted of Aspergillus niger phytase (Natuphos ®; 0 or 900 FTU kg −1), sodium phytate (0 or 1.5 g P kg −1) or lactic acid (0 or 30 g kg −1). The positive control diet was supplemented with 1.0 g P kg −1 from monocalcium phosphate monohydrate (MCP). The feeding level was 2.3 times maintenance requirement for energy (418 kJ MEW −0.75). Estimates of AID and ATTD were calculated using Cr 2O 3 as a marker. The addition of MCP to the diet as the only variable had no effect on the AID of phytic acid and the ATTD of ash, Ca and Mg, but enhanced total P ATTD. Both microbial phytase and lactic acid enhanced the ATTD of ash, Ca and Mg and the AID of phytic acid, but there was no interaction. The ATTD of total P was increased by the combination of microbial phytase and lactic acid to a greater extent than was calculated as the sum of the stimulatory effects of the single additions. It is hypothesized that lactic acid delays gastric emptying, which prolongs the action of phytase in the stomach at its optimum pH. When Na phytate was added to the diets, total P ATTD was enhanced, possibly reflecting efficient phytate hydrolysis by intrinsic phytase.

Effect of microbial enzyme supplementation on energy, amino acid digestibility and performance of pigs fed hulless barley based diets

Two experiments were conducted to investigate the influence of a microbial enzyme preparation on the digestibility and performance of starter-growing pigs fed hulless barley based diets. In the digestibility trial, eight pigs with an average initial body weight of 14.3 ± 0.4 kg initial liveweight were surgically fitted with steered ileo-cecal valve cannulas at the terminal ileum. Two hulless barley varieties (Condor and CDC Buck) were separately used as the dietary energy source (77.6%) with canola meal as the protein supplement (20%). Enzyme supplementation improved (P &lt; 0.05) the ileal dry matter (DM) digestibility by 15.2%, gross energy (GE) by 11.0% and protein by 7.6%. The average apparent ileal digestibility of the indispensable amino acids was improved by 6.9% (P &lt; 0.05), and of nonstarch polysaccharides (NSP) was improved by 90%. The total-tract digestibility of DM was increased by 6.2%, GE by 6% and crude protein (CP) by 9.4% (P &lt; 0.05). Enzyme supplementation tended to enhance digestion in the small intestine instead of the hind-gut as expected. In the growth performance trial, positive responses from enzyme supplementation were observed from both mash and pelleted diets fed to 48 pigs grown from 9 to 60 kg liveweight. The ADG was improved by 8.6% (P &lt; 0.05) and feed conversion by 8.7% (P = 0.09). Pelleting had no adverse effect on enzyme activity. The results demonstrated that the enzyme supplementation improved (P &lt; 0.5) nutrient utilization and performance of pigs fed diets containing hulless barley. Key words: Enzyme, hulless barley, digestibility, performance, swine

Randomized Prospective Study of the Impact of Three Needleless Intravenous Systems on Needlestick Injury Rates

AbstractObjective:To determine the impact of three needleless intravenous systems on needlestick injury rates.Design:Randomized controlled trial.Setting:1,000-bed tertiary-care Midwestern hospital.Participants:Nursing personnel from general medical, general surgical, and intensive-care units.Interventions:From June 1992 through March 1994, a metal blunt cannula (MBC), two-way valve (2-way), and plastic blunt cannula (PBC) were introduced into three study areas, and needlestick injury rates were compared to three control areas using traditional needled devices.Results:24 and 29 needlestick injuries were reported in study and control areas. Intravenous-therapy-related injuries comprised 45.8% and 57.1% of injuries in each area. Thirty-seven percent and 20.7% of study and control area needlestick injuries were considered to pose a high risk of bloodborne infection. The 2-way group had similar rates of total and intravenous-related needlestick injuries compared to control groups. The PBC group had lower rates of total and intravenous-related needlestick injuries per 1,000 patient-days (rate ratios [RR], 0.32 and 0.24; 95°% confidence intervals [CI95], 0.12-0.81 and 0.09-0.61;P=.02 andP=.003, respectively) and per 1,000 productive hours worked (RR, 0.11 and 0.08; CI95, 0.01-0.92 and 0.010.69;P=.03 andP=.005, respectively) compared to controls.Conclusions:Needlestick injuries continued in study areas despite the introduction of needleless devices, and risks of bloodborne pathogen transmission were similar to control areas. The PBC device group noted lower rates of needlestick injuries compared to controls, but there were problems with product acceptance, correct product use, and continued traditional device use in study areas. Low needlestick injury rates make interpretations difficult. Further studies of safety devices are needed and should attempt greater control of worker behavior to aid interpretation.

Apparent ileal digestibility of amino acids in wet wheat protein and soya bean meal for growing pigs

A study was conducted on four castrated male pigs to determine the apparent ileal digestibility (AID) of crude protein (CP) and amino acids in wheat protein (WP), a wet by-product of the starch and gluten industry, and in soya bean meal (SBM). The pigs were fitted with a steered ileo-caecal valve cannula at a liveweight of 35 kg. They were assigned to two semi-purified wheat starch based diets, with either WP or SBM as a sole protein source, and fed according to a three-period reversal design. The diets were formulated to contain 140 g CP/kg DM, 11.3 MJ net energy/kg DM and similar amounts of lysine, methionine and threonine. The CP content and the lysine and threonine contents in CP were lower in WP than in SBM. Nearly half of the DM in WP was starch, and the crude fibre content of the product was very low. The apparent ileal and total tract digestibilities of CP were very similar in both the WP and SBM diets. The AID of methionine was higher in WP (88.2%) than in SBM (84.6%) diets (P

Crambe meal: digestibility in pigs and rats in comparison with rapeseed meal

Seed meals from decorticated Crambe abyssinica (CM) and modern variety rape (RSM) were compared for composition and digestibility. The structural elements of the whole seeds (pericarp, seedcoat and endosperm) were measured through hand-separation. In the digestion trial the decorticated and defatted meals were fed to four pigs (liveweight 35 kg) fitted with ileocaecal valve cannulas. Digestibility data were obtained from a change-over experiment in which both meals were included at 300 g kg −1 in the diet. Then the energy digestibility and nitrogen utilization of the meals were determined in a balance trial with rats. The whole crambe seeds contained 300 g pericarp kg −1. After decortication, the seeds possessed 89 g seedcoat kg −1, significantly lower than in rapeseed (160 g kg −1). Compared with RSM, CM contained a considerably higher level of protein (504 vs. 367 g kg −1) and a lower level of fibre constituents (e.g. 65 vs. 139 g kg −1 for crude fibre). Apparent total-tract digestibilities of gross energy for CM and RSM in pigs were 78.3 and 73.2% ( P < 0.05), of organic matter 78.7 and 73.2% ( P < 0.05), and of protein 76.8 and 79.1%, respectively. However, the apparent ileal digestibility of protein in CM was lower than in RSM (63.0 vs. 71.7%, P < 0.01); that of lysine and cystine was also lower (61.1 and 62.5% for CM vs. 75.3 and 71.2% for RSM, P < 0.01). The difference in protein digestibility was presumably due to overheating of CM during the detoxification treatment. Phosphorus total-tract digestibility was 43.4% for CM and 22.5% for RSM ( P < 0.01). In the balance trial, rats received diets in which all nitrogen originated from either CM or RSM. The results showed that CM had clearly higher apparent energy digestibility than RSM (93.4 vs. 79.6%, P < 0.01). Apparent protein digestibility was similar (78.4 vs. 78.8%). However, the biological value and net protein utilization of CM were low, i.e. 46.8 and 41.7%, compared with 87.1 and 77.6% for RSM ( P < 0.01). The differences were presumably due to the high level of glucosinolates in CM. It is thus concluded that CM is highly digestible, and that there is large scope for enhancement in protein utilization by optimizing the detoxification treatment.

Initial Clinical Experience with a New Temporary Left Ventricular Assist Device

A new, simple left ventricular assist system has been developed and its use in experimental animals has been evaluated. The system achieves ventricular drainage by a transaortic valve cannula and utilizes a new centrifugal pump; the blood access is unique in requiring only a simple end-to-side synthetic graft anastomosis to the ascending aorta. Adequate pulsatility is obtained by concomitant use of an intraaortic balloon pump. This case report documents our initial clinical experience with this system in a postoperative patient with profound left ventricular failure unresponsive to all usual treatment. There was temporary recovery of left ventricular function upon decannulation after five and a half days of assist pumping. Despite the eventual death of the patient, the system functioned adequately, suggesting that it has good potential for use in a small, selected group of patients.