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This experiment was carried out to study the effect of a directly fed exogenous fibrolytic enzyme on intake and digestion of DM, OM, protein, NDF, ADF, and hemicellulose of alfalfa and ryegrass hay by sheep. Four diets were randomly assigned to four ruminally cannulated lambs using a 4 × 4 Latin square design, repeated in time, with a factorial arrangement (2 × 2) of diets: 1) alfalfa hay; 2) alfalfa hay + exogenous fibrolytic enzymes (enzyme); 3) ryegrass hay; and 4) ryegrass hay + enzyme. Lambs consumed more DM and OM from alfalfa than from ryegrass hay (P< 0.001). The ADF intake was not different between the hays, but NDF intake was lower for alfalfa (P< 0.001). For both hays, the enzyme increased intake of DM (P< 0.01), as well as OM and CP (P< 0.05); however, NDF and ADF intake were not changed. Alfalfa hay had higher apparent digestibility of DM, OM, and CP (P< 0.001), but lower digestibility for NDF, ADF, and hemicellulose. The enzyme increased apparent digestibility of CP, hemicellulose (P< 0.05), and NDF (P< 0.10) for alfalfa. Also, for both hays, the enzyme improved N balance because lambs retained more N (P< 0.05). The enzyme increased (P< 0.05) total VFA concentration (3 and 6 h) for both hays. Results from this trial indicate that directly fed exogenous fibrolytic enzymes may change ruminal fermentation, intake, and digestibility of forages with different nutritive value.

The correction of hepatopulmonary syndrome (HPS) after liver transplantation (LT) remains controversial. The aims of our study were to: 1) analyze whether LT reverses HPS; 2) note any relationship between HPS and the systemic hemodynamic disturbance; and 3) note changes in circulating sex hormones and the possible association with pulmonary and systemic hemodynamic changes. Systemic hemodynamic parameters, cardiac output and systemic vascular resistance (SVR), sex hormones, and intrapulmonary vasodilatation assessed by contrast transesophageal echocardiography, and gas exchange abnormalities were investigated in 19 patients with advanced cirrhosis prior to and 6 months (176.8±30 days) after LT. LT was followed by a marked reduction in cardiac output (6.6±1.7 vs3.5±0.5 l/min; plt0.001) and SVR (1039±460 vs1978±294 dyn⊙sec⊙cm−5; plt0.005). Before LT, circulating estradiol and progesterone levels were invariably elevated (66±22 pg/ml and 1.8±1.1 ng/ml, respectively, normal values lt31 pg/ml and 0.35 ng/ml, respectively), and dropped after LT (28±12 pg/ml plt0.001 and 0.38±0.2 ng/ml; plt0.001, respectively). Seventeen of 19 patients had intrapulmonary vasodilatation and increased alveolar-arterial oxygen difference, thereby fulfilling diagnostic criteria for HPS. Patients with HPS presented higher cardiac output (plt0.05), lower SVR (plt0.01), and higher progesterone and estradiol levels than patients without HPS (plt0.05). LT produced normalization of intrapulmonary vasodilatation in all patients. LT normalized hyperdynamic circulation and is a useful therapeutic option in patients with HPS. Normalization of sex hormone levels after LT suggests that they could play a pathogenic role in the development of HPS.

The efficacy of albendazole in hydatid disease is still unclear, because there has been no study that assessed the status of the parasite after treatment. The significance of albendazole- induced echographic changes in the cyst therefore cannot be judged. We did a prospective, controlled, randomised, open study of albendazole in patients with liver hydatid disease, and assessed parasite viability after treatment. 18 patients received no albendazole treatment (controls), 18 received albendazole (10 mg/kg daily) for 1 month (group A), and 19 received the drug for about 3 months (group B). Echography was done before and during treatment; all patients underwent surgery on completion. Parasite (protoscolex viability and development of cysts in mice) and ultrastructure studies were done for all cysts removed. 8 (50%) of cysts in the control group, 13 (72%) in group A, and 16 (94%) in group B were non-viable (p=0·015). Protoscolex and cyst viability were significantly (p=0·039 and p=0·018, respectively) lower in treated patients than in controls. Treatment was also significantly associated with total cyst membrane disintegration. 68% of cysts treated for 3 months showed echographic changes, and only 1 of 20 cysts showing echographic changes during treatment was judged viable. The efficacy of albendazole at a dose of 10 mg/kg daily for 3 months suggests that it is a suitable alternative to surgery in uncomplicated hydatid liver disease, as initial treatment.

Key words: hepatitis B; membranous nephropathy; reversibility; serial biopsy