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Highlights • Rapid improvement observed in a patient with a large cardiac metastasis. • There is today no curative therapeutic option when the tumor is inoperable. • Transcoronary tumor embolization plus moderate targeted radiotherapy should be a new option for tumor control., Purpose Cardiac metastasis is a rare fatal event. An intracavitary right tumor mainly in the ventricle is difficult to manage. Literature reports suggest that cardiac surgery in oligometastatic patients could offer median survival of 1 year. We investigated salvage treatment comprising transcoronary tumor embolization followed 15 days later by cardiac radiotherapy (40.5 Gy/15 fractions). Cases We report two cases of severe right cardiac metastasis with a history of abdominal cancer managed by this salvage treatment following residual cardiac mass after previous cardiac surgery. Conclusion Both symptomatic patients improved progressively and were locally controlled for at least 1 year without toxicity.

Background Dairy products are among the most adulterated food products. Especially the milk fat can be replaced with foreign fats or oils. Because of the current high price of milk fat, it has been replaced by low-cost oils, especially those oils that have the same fatty acid profile as milk fat. This study aims to validate some classic methods (saponification number and iodine number) and the use of modern devices (gas chromatography, reverse phase high performance liquid chromatography and Fourier Transform Infrared) to detect palm oil in milk and to confirm the minimum levels of palm oil added to milk. Five treatments of fresh milk cream and an emulsion of palm oil were used to prepare different levels of palm oil in the final liquid milk. Results The results of this study showed that the values of the saponification number decreased with the increase in the percentages of added palm oil, but there was no decrease from the limits of the Egyptian standards until the addition of 25% palm oil. The iodine number is less sensitive than the saponification number in the detection of palm oil. Butyro refractometer reading is unable to detect the palm oil in milk. The fatty acid profile in milk determined by gas chromatography correlated well with the addition of palm oil. Also, there is a good relationship between the cholesterol and β-sitosterol content measured by reverse phase high performance liquid chromatography and the level of added palm oil. There was no relationship between the behavior of the spectra resulting from Fourier transform infrared spectroscopy and the presence of palm oil. Conclusions Gas Chromatography has potential to be used for the detection of palm oil in milk, the levels of some fatty acids in the milk could be used as an indicator. Also, Reverse Phase High Performance Liquid Chromatography analysis could be used for the same purpose, as the addition of palm oil caused a gradual decrease in the cholesterol percentage and increase in the β-sitosterol content of milk.

This study aimed at improving the antioxidant capacity of fermented camel milk using some single strains of Lactobacillus (Lb. helveticus B-734, Lb. casei subsp. casei B-1922, Lb. paracasei subsp. paracasei B-4560, Lb. rhamnosus B-1445 or Lb. rhamnosus B-442), as well as evaluating the acceptability of the final products. The acidity, proteolysis degree, antioxidant activity, viscosity and organoleptic properties of fermented milk were assessed during 14 days of storage at 4°C. Total phenolic content (TPC), DPPH radical scavenging activity, Ferrous ion chelating ability (FCA) and Ferric reducing antioxidant power (FRAP) assays were used to determine the antioxidant activity of fermented milks. The results indicated that fermented milks differed significantly (P Lb. helveticus had the highest proteolysis degree, while samples with commercial starter culture (control) showed the lowest degree of proteolysis. Fermented milks containing Lactobacillus strains showed higher DPPH radical scavenging activity compared to those samples containing commercial starter culture. By the end of storage, there was a significant improvement (P Lb. paracasei, Lb. rhamnosus B-442 or commercial starter culture had the highest FCA values, while Lb. rhamnosus B-1445 samples recorded the highest value at the end of storage. Lb. helveticus samples had the highest TPC and FRAP values (P 0.0001) between the proteolysis degree and the values of FRAP and TPC. Samples containing Lb. rhamnosus B-442, Lb. rhamnosus B-1445 or commercial starter culture received the highest taste and overall acceptability scores while Lb. helveticus samples were the lowest. It is recommended to use Lb. rhamnosus B-442 and Lb. rhamnosus B-1445 for producing fermented camel milk with high antioxidant activity and acceptability.

The present study aimed to investigate the effect of chickpea as a prebiotic, antioxidant and thickener agent on the probiotic viability and physicochemical properties of stirred bio-yoghurt. Stirred bio-yoghurts were made using probiotic cultures (Bifidobacterium bifidum and a mixture of Bifidobacterium animalis subsp. lactis and Lactobacillus acidophilus) with chickpea flour at different concentrations (1, 2 and 3%). Physicochemical, antioxidant, rheological, microbiological and sensorial properties of stirred bio-yoghurt were evaluated during storage. The obtained results showed that the chickpea flour stimulated the growth of probiotic bacteria. The bacterial counts in bio-yoghurt made using Bifidobacterium bifidum were log 8.28, 8.12, 8.04 and 7.32 CFUg−1 with 3, 2, 1% chickpea flour and control respectively. Stirred bio-yoghurt supplemented with chickpea flour received high values of antioxidant capacity (91, 83 and 76.6%) at concentrations of 3%, 2% and 1% chickpea flour respectively, while control received low value (31.12%). The viscosity of stirred bio-yoghurt was enhanced by chickpea supplementation. The sensory evaluation revealed that samples with 1 and 2% chickpea flour were preferred by panelists in texture and flavour properties. The obtained results concluded that the chickpea flour could replace the skimmed milk powder at concentrations of 1 or 2% to enhance the quality of stirred bio-yoghurt and reduce the production cost.

This study aimed at investigating the impact of adding microbial transglutaminase (MTGase) after rennet addition on some properties of fresh soft cheese made from camel milk. MTGase was added to milk at concentration of 80, 100 and 120 U/L after 20 and 30 min of renneting. The chemical composition, yield, hardness, antioxidant activity and sensory properties of cheese were estimated. Enzymatic protein crosslinking was analyzed by SDS-PAGE. Results revealed that MTGase-treated cheeses were higher in moisture and lower in protein content compared to control. In addition, the concentration of MTGase and time of addition significantly (P 0.05) impacted these parameters. Among treated cheeses, samples with 80 U of MTGase and addition time of 20 min were the highest in total solids and protein content. Adding MTGase significantly (P 0.05) increased the cheese yield, however, increased MTGase concentration at any time of addition did not improve it. The electrophoretic patterns of MTGase-cheese proteins showed a reduction in the intensity of caseins bands and the appearance of new protein fractions with high molecular weights. However, the changes in the intensity of the whey proteins bands were not sufficiently clear as caseins. The cheese hardness was significantly (P 0.05) affected by adding MTGase. Cheese containing 80 U of MTGase had the highest hardness value compared to control and other treated samples. The antioxidant activity of cheese was negatively influenced by adding the enzyme. The use of MTGase enhanced the mouthfeel, texture and overall acceptability of cheese. However, the effect of MTGase concentration and addition time was not significant (P > 0.05) on the sensory attributes. In conclusion, adding MTGase to milk at concentration of 80 U after 20 min of renneting is recommended to improve the yield, textural and some sensory properties of fresh soft cheese made from camel milk.

Social Networks has become one of the most popular platforms to allow users to communicate, and share their interests without being at the same geographical location. With the great and rapid growth of Social Media sites such as Facebook, LinkedIn, Twitter...etc. causes huge amount of user-generated content. Thus, the improvement in the information quality and integrity becomes a great challenge to all social media sites, which allows users to get the desired content or be linked to the best link relation using improved search / link technique. So introducing semantics to social networks will widen up the representation of the social networks.

Camel milk produces watery texture when it is processed to yogurt. Despite the extensive studies on microbial transglutaminase (MTGase) in dairy research, the effect of this enzyme on the properties of yogurt made from camel milk has not been studied. This study aims to investigate the impact of MTGase with and without bovine skimmed milk powder (SMP), whey protein concentrate (WPC),or β-lactoglobulin (β-lg) on physico-chemical, rheological, microstructural, and sensory properties of camel-milk yogurt during 15 days of storage period. MTGase treatment markedly reduced the fermentation time of unfortified and SMP-fortified camel milk. The fortification of camel milk without MTGase failed to give set-type yogurt. The treatment of unfortified milk with MTGase enormously improved the viscosity and the body of yogurt samples. Fortification of MTGase-treated milk impacted positively on the viscosity, the water holding capacity, and the density of the protein matrix in the gel microstructure, which were influenced by the type of dairy ingredients. All MTGase-treated yogurts differed from each other in hardness and adhesiveness values. Electrophoresis results showed that the susceptibility of the individual milk proteins to MTGase varied, and there were differences among the treatments toward the enzyme. SMP-fortified yogurt was the most accepted product. Generally, the addition of MTGase preparation at a concentration of 0.4%, simultaneously with starter culture, to fortified camel milk was considered an effective tool to solve the challenges of producing set-type yogurt from this milk.

This study investigated the effect of purslane (Portulaca oleracea L.) leaves extract on Greek-style yogurt. Purslane extract showed higher antioxidant values and antimicrobial activity against Escherichia coli ATCC25922; Salmonella typhimurium ATCC14028. The fortified of Geek-style yogurt with lyophilized purslane extract 2.2g/L (S1) and 4.4g/L (S2) significantly increased the antioxidant capacity. Greek-style yogurt made with 4.4g/L lyophilized purslane extract received the highest antioxidant capacity and lowest sensory acceptability comparing with control and low dosage of lyophilized purslane extract. DPPH scavenging activity % of S1 and S2 samples had no obvious change during storage period, while, FRAP values were decreased in all treatments after 14 days of storage.The treatment of Geek-style yogurt fortified with 2.2 g/L lyophilized purslane extract was the most preference in sensory acceptability. This study recommended that the increasing of shelf life and antioxidant capacity and stability of all-natural Greek-style yogurt, a dosage of lyophilized purslane extract 2.2g/L should be incorporated. Moreover, the P. oleracea could be used in functional foods as it has some bioactive components.

Purpose Perioperative chemotherapy confers a 3-year progression free survival advantage following resection of colorectal liver metastases (CRLM), but is associated with significant toxicity. Chemoembolisation using drug eluting PVA microspheres loaded with irinotecan (DEBIRI) allows sustained delivery of drug directly to tumour, maximising response whilst minimising systemic exposure. This phase II single arm study examined the safety and feasibility of DEBIRI before resection of CRLM. Methods Patients with resectable CRLM received lobar DEBIRI 1 month prior to surgery, with a radiological endpoint of near stasis. The trial had a primary end-point of tumour resectability (R0 resection). Secondary end-points included safety, pathologic tumour response and overall survival. Results 40 patients received DEBIRI, with a median dose of 103 mg irinotecan (range 64–175 mg). Morbidity was low (2.5%, CTCAE grade 2) with no evidence of systemic chemotoxicity. All patients proceeded to surgery, with 38 undergoing resection (95%, R0 resection rate 74%). 30-day post-operative mortality was 5% (n = 2), with neither death TACE related. 66 lesions were resected, with histologic major or complete pathologic response seen in 77.3% of targeted lesions. At median follow up of 40.6 months, 12 patients (34.3%) had died of recurrent disease with a median overall survival of 50.9 months. Nominal 1, 3 and 5-year OS was 93, 78 & 49% respectively. Conclusions Resection after neoadjuvant DEBIRI for CRLM is feasible and safe. Single treatment with DEBIRI resulted in tumour pathologic response and median overall survival comparable to that seen after systemic neoadjuvant chemotherapy. Registered at clinicaltrials.gov ( NCT00844233 ).

We investigated the effects of milk protein concentrate (MPC) and milk protein concentrate hydrolysate (MPCH) as antioxidant agents in rats. Six groups of healthy (non-diabetic) and type-II diabetic rats were used: (1) healthy rats (control), (2) alloxan-induced rats (diabetic control group), (3) healthy rats treated orally with MPC, (4) diabetic rats treated orally with MPC, (5) healthy rats treated orally with MPCH, and (6) diabetic rats treated orally with MPCH. We concluded that treatment with MPC or MPCH reduced the level of thiobarbituric acid reactive substances in healthy and diabetic rats. Treatment with MPC or MPCH improved activities of antioxidant enzymes (catalase, superoxide dismutase, reduced glutathione, glutathione-S-transferase, and glutathione peroxidase) in healthy and diabetic rats. From the present data, we concluded that both MPC and MPCH contain potent antioxidants and could improve the health of rats or other animals with diabetes mellitus.

Some traditional fermented dairy products like Egyptian Karish cheese and traditional fermented milk (Laban Zeer) are manufactured in farmhouses following traditional techniques using raw milk without heat treatment or addition of selected starter cultures, these products are generally designed as “artisanal”. The representative Karish samples were analyzed for their content of total microbial, Enterobacteriaceae, yeast, molds, Staphylococci coagulase positive, Salmonella spp., Listeria spp., in addition to detection of Bacillus cereus, Listeria monocytogenes, Clostridium perfringens and Campylobacter spp. using classical methods. The physico-chemical properties of collected samples showed that the average of protein, fat, moisture and acidity were in accepted range with that reported in literatures and Egyptian standard. Some lactic acid bacteria (Lactococcus lactis supsp. lactis, Lactobacillus delbrueckii subsp. lactis and Enterococcus feacium) were isolated and identified from fresh karish cheese using classical methods followed by rep-PCR. Lactococcus garvieae was detected in fresh samples using TTGE but could not be detected using classical methods. The results of microbiological analysis showed the presence of high numbers of Enterobacteriaceae that ranged from log10 2.6 cfu/g to log10 3.5 cfu/g, Bacillus ssp. ranged from log10 4.2 cfu/g to log10 5.6 cfu/g, Staphylococci counts are ranged from log10 1.8 cfu/g to log10 2.7 cfu/g, faecal enterococci count ranged from log10 3.5 cfu/g to log10 5.8 cfu/g. Yeasts and molds count ranged from log10 2.7 cfu/g to log10 3.5 cfu/g. B. cereus, L. monocytogenes, C. perfringens, Shigella, Salmonella, Escherichia coli β-glucuronidase positive and Campylobacter spp. were not detected in all the examined samples. The count of undesirable microorganisms indicated the poor hygienic practice of traditional Karish cheese production; starting with using poor quality of raw milk and processing under uncontrolled environments. This would require using clean raw milk, controlled manufacturing steps and selection of the appropriate starter culture for the fermentation. Key words: Karish cheese, microbiological analysis, safety.

Ischemic cholangiopathy (IC) has a known poor prognosis. However, the risks and outcomes of this complication after transcatheter arterial chemoembolization (TACE) in hepatectomized patients are poorly documented. This study aimed to evaluate the incidence of and to identify the predictive factors for IC following TACE for recurrent hepatocellular carcinoma (HCC) after hepatectomy.From a cohort with a total of 486 patients who underwent resection for HCC, we included all consecutive patients who were treated with TACE for recurrent HCC after hepatectomy between 2000 and 2017. IC was defined by the coexistence of biological cholestasis and morphological lesions.A total of 156 patients underwent TACE for the treatment of HCC recurrence after hepatectomy. Of them, eight (5.1%) developed IC. Their prognosis was poor compared with patients without IC (3-year survival 23.4% vs 76.2%; P = 0.008). Two factors, namely, time between hepatectomy and TACE (4.8 months vs. 16.0 months, P = 0.001) and TACE for a remnant liver mobilized during hepatectomy (P = 0.001), were associated with IC. Receiver operating characteristic (ROC) curve analysis showed that 7 months was the more discriminant cutoff for the time period. IC occurred in 33.3% of the patients with the two factors, in 5.0% of those with one factor, and 0% in the absence of any factors.TACE for treating HCC recurrence carries a high risk of IC when performed early after hepatectomy in a previously mobilized liver. Our results might aid in identifying candidates for TACE for recurrent HCC, considering the major effect on patient outcomes.

Milk protein-derived bioactive peptides could be used in human nutrition in both newborns and adults, since they are claimed to be health-improving components that can be used to reduce the risk of disease or to enhance certain physiological functions. This study investigated the effect of oral intake of milk protein concentrate (MPC) and milk protein concentrate hydrolysate (MPCH) on body weight, organ relative weight, and hematological parameters in alloxan-induced diabetes rats. The animals were divided into six major groups after stabilization of diabetes for one week. Diabetic and non-diabetic rats groups were received intra-gastric dose of MPC or MPCH (150mg/kg B.W) for six weeks. Feed treatment by MPC and MPCH significantly (P

The main milk proteins are caseins and whey proteins, some other minor proteins and peptides, are also found in milk. Proteins are vital ingredients for human because they provide all the essential amino acids needed for body and human health. Milk proteins are very important sources of bioactive peptides. The bioactive peptides are inactive within the sequence of the parent protein and can be released by proteolytic enzymes, during gastrointestinal digestion or during milk processing, for example the adding coagulation enzymes and starter culture. Once bioactive peptides are present in the body, these peptides may act as regulatory compounds with hormone-like activity. Furthermore, Bioactive peptides from milk proteins have many biological activities such as antimicrobial, antihypertensive, antithrombotic, antioxidant, mineral binding, and anti-diabetic. Bioactive peptides have potential health and have pharmaceutical applications. Antimicrobial peptides are recognized as an important component of innate immunity, particularly at mucosal surfaces such as the lungs and small intestine that are constantly exposed to a range of potential pathogens. The ability of protein hydrolysates to inhibit deleterious changes caused by lipid oxidation appears to be related to the nature and composition of the different peptide fractions. Milk protein hydrolysate possesses free-radical-scavenging and anti-inflammatory activities have many beneficial effects on the increase of the glucose-induced insulin secretion and reduction in postprandial glycemia. This article is tried through exposure in some detail to review characteristics of some milk protein peptides and its positive effects on human health.

The objective of this study was to evaluate characteristics of processed cheese made from salt Ras cheese whey and young Cheddar containing exopolysaccharide producing cultures (EPS) as compared with those in cheese made from EPS-negative cheeses. Processed cheeses were manufactured using young (1 day) or 1-month-old EPS-positive or EPSnegative Cheddar cheese and replacing the added water by Ras cheese whey or ultrafiltrated (UF) whey. Moisture and fat of processed cheese were standardized to 54% and 23%, respectively. Exopolysaccharide-positive processed cheese was softer, less chewy and gummy than the EPS-negative cheeses. The hardness and chewiness were lower in processed cheeses made from 1-month-old Cheddar than in the corresponding cheeses made from 1-day-old Cheddar cheese. Sensory scores for texture of EPS positive processed cheeses were higher than those of the EPS-negative cheeses. Generally, processed cheese made from replacing all added water with whey received higher scores in flavor and overall than did the corresponding cheeses made without whey. The obtained results are showing promise for application of salt whey in processed cheese making.

Background Early tumour shrinkage has been associated with improved survival in patients receiving cetuximab-based systemic chemotherapy for liver metastases from colorectal cancer (LM-CRC). We tested this hypothesis for previously treated LM-CRC patients receiving cetuximab (500 mg/m 2 ) and triplet hepatic artery infusion (HAI) within European trial OPTILIV. Methods Irinotecan (180 mg/m 2 ), 5-fluorouracil (2800 mg/m 2 ) and oxaliplatin (85 mg/m 2 ) were given as chronomodulated or conventional delivery. Patients were retrospectively categorised as early responders (complete or partial RECIST response after three courses) or non-early responders (late or no response). Prognostic factors were determined using multivariate logistic or Cox regression models. Results Response was assessed in 57 of 64 registered patients (89%), who had previously received one to three prior systemic chemotherapy protocols. An early response occurred at 6 weeks in 16 patients (28%; 9 men, 7 women), aged 33–76 years, with a median of 12 liver metastases (LMs) (2–50), involving five segments (1–8). Ten patients had a late response, and 31 patients had no response. Grade 3–4 fatigue selectively occurred in the non-early responders (0% versus 26%; p = 0.024). Early tumour response was jointly predicted by chronomodulation—odds ratio (OR): 6.0 (1.2–29.8; p = 0.029)—and LM diameter ≤57 mm—OR: 5.3 (1.1–25.0; p = 0.033). Early tumour response predicted for both R0-R1 liver resection—OR: 11.8 (1.4–100.2; p = 0.024) and overall survival—hazard ratio: 0.39 (0.17–0.88; p = 0.023) in multivariate analyses. Conclusions Early tumour response on triplet HAI and systemic cetuximab predicted for complete macroscopic liver resection and prolonged survival for LM-CRC patients within a multicenter conversion-to-resection medicosurgical strategy. Confirmation is warranted for early response on HAI to guide decision making. Protocol numbers : EUDRACT 2007-004632-24 NCT00852228.

Erythrocytapheresis (ER) can improve outcome in patients with sickle cell disease (SCD). A good vascular access is required but frequently it can be difficult to obtain for sickle cell patients. Arterio-venous fistulas (AVFs) have been suggested for ER in SCD supported by limited evidence. We report the largest cohort of ER performed with AVFs from three French SCD reference centers. Data of SCD patients undergoing ER with AVFs in the French SCD reference center were retrospectively collected. The inclusion criteria were: SS or Sβ-Thalassemia and AVF surgery for ER. SCD-related complications, transfusion history, details about AVF surgical procedure, echocardiographic data before and after AVF, AVF-related surgical and hemodynamical complications were collected. Twenty-six patients (mean age 20.5 years, mean follow-up 68 months [11-279]) were included. Twenty-three patients (88.5%) required central vascular access before AVF. Fifteen AVFs (58%) were created on the forearm and 11 (42%) on the arm. Nineteen patients (73%) had stenotic, thrombotic or infectious AVF complications. A total of 0.36 stenosis per 1,000 AVF days, 0.37 thrombosis per 1,000 AVF days and 0.078 infections per 1.000 AVF days were observed. The mean AVF lifespan was 51 months [13-218]. One patient with severe pulmonary hypertension worsened after AVF creation and died. We report the first series of SCD patients with AVF for ER, demonstrating that AVFs could be considered as a potential vascular access for ER. Patients with increased risk for hemodynamic intolerance of AVFs must be carefully identified, so that alternative vascular accesses can be considered. Am. J. Hematol. 92:136-140, 2017. © 2016 Wiley Periodicals, Inc.

The effect of milk protein (MP) and milk protein hydrolysate (MPH) as Anti-diabetic agent were investigated in vivo using six groups of normal and type 2 diabetic rats. The results of this study showed that the treatments of diabetic rats by oral intake of MP or MPH significantly reduced the concentrations of plasma glucose, total lipids of blood plasma, triglycerides, total cholesterol, LDL and VLDL in rat plasma. Also, the treatments of diabetic rats by oral intake of MP or MPH significantly increased the globulin value and HDL, while the concentration of urea, creatinine and bilirubin were reduced. In addition, oral intake of MPH has no affective on acid phosphatase (ACP), alkaline phosphatase (ALP), alanine transaminase (ALT) and aspartate transaminase (AST) activities in blood plasma and liver of normal rats and protective its concentrations in diabetic rats. The present results concluded that MP and MPH could be used as anti-diabetic agents.

The effect of sodium chloride concentration and pH of milk at renneting on the rennet clotting time (RCT) and gel firmness was studied. The results showed that rennet clotting activity and gel firmness decreased with increasing NaCl concentration in milk. The RCT increased as the pH of the salted milk decreased below 6.4. Milk containing 5 and 10 g NaCl/100 g did not coagulate at pH 5.0. The gel firmness increased with decreasing milk pH to 6.2 for unsalted milk. However, the firmness decreased as the pH of milk decreased below 6.2. In case of using salted milk, the firmness decreased as the pH at renneting dropped below 6.4.

Hepatic artery stenosis (HAS) is a rare complication of orthotopic liver transplantation (LT). HAS could evolve into complete thrombosis and lead to graft loss, incurring significant morbidity and mortality. Even though endovascular management by percutaneous transluminal angioplasty ± stenting (PTA) is the primary treatment of HAS, its longterm impact on hepatic artery (HA) patency and graft survival remains unclear. This study aimed to evaluate longterm outcomes of PTA and to define the risk factors of treatment failure. From 2006 to 2012, 30 patients with critical HAS (>50% stenosis of HA) and treated by PTA were identified from 870 adult patients undergoing LT. Seventeen patients were diagnosed by post-LT screening, and 13 patients were symptomatic due to HAS. PTA was completed successfully in 27 (90%) patients with angioplasty plus stenting in 23 and angioplasty alone in 4. The immediate technical success rate was 90%. A major complication that was observed was arterial dissection (1 patient) which eventually necessitated retransplantation. Restenosis was observed in 10 (33%) patients. One-year, 3-year, and 5-year HA patency rates were 68%, 62.8%, and 62.8%, respectively. Overall patient survival was 93.3% at 3 years and 85.3% at 5 years. The 3-year and 5-year liver graft survival rates were 84.7% and 64.5%, respectively. No significant difference was observed in patient and graft survivals between asymptomatic and symptomatic patients after PTA. Similarly, no difference was observed between angioplasty alone and angioplasty plus stenting. In conclusion, endovascular therapy ensures a good 5-year graft survival (64.5%) and patient survival (85.3%) in patients with critical HAS by maintaining HA patency with a low risk of serious morbidity (3.3%). Liver Transplantation 22 923-933 2016 AASLD.

Introduction Erythracytapheresis (ER) can improve outcome in patients with sickle cell disease (SCD). A good vascular access is required but can be difficult to obtain for sickle cells patients. Arterio-venous fistula (AVF) has been suggested for ER in SCD supported by limited evidence. We report the largest cohort of ER performed with AVF from three French sickle cell disease reference centers. Methods Data of SCD patients undergoing ER with AVF in the French SCD reference center were retrospectively collected. The inclusion criteria were: SS or Sβ-Thalassemia and AVF surgery for ER. AVF for hemodialysis were excluded. SCD-related complications, transfusion history, details about AVF surgical procedure, echocardiographic data before and after AVF, AVF-related surgical and hemodynamical complications were collected. Results Twenty-six patients (mean age 20.5 years; median follow-up 68 months [11; 279]) were included. Twenty-three patients (88.5%) required a central vascular access before AVF. Fifteen AVF (58%) were created on the forearm and 11 (42%) on the arm. Nineteen patients (73%) had stenotic, thrombotic or infectious AVF complications. The median AVF lifespan was 34 months [13; 66]. One patient with severe pulmonary hypertension worsened after AVF creation, and died. Conclusions We report the first series of SCD patients with AVF for ER demonstrating AVF could be considered as a potential vascular access for ER. Patients with increased risk for hemodynamic intolerance of AVF must be carefully identified, in order to consider alternative vascular accesses. Disclosures Ribeil: Bluebirdbio: Consultancy; Addmedica: Research Funding.

The effects of microfiltration and pasteurization processes on proteolysis, lipolysis, and flavor development in Domiati cheese during 2 mo of pickling were studied. Cultures of starter lactic acid bacteria isolated from Egyptian dairy products were evaluated in experimental Domiati cheese for flavor development capabilities. In the first trial, raw skim milk was microfiltered and then the protein:fat ratio was standardized using pasteurized cream. Pasteurized milk with same protein:fat ratio was also used in the second trial. The chemical composition of cheeses seemed to be affected by milk treatment—microfiltration or pasteurization—rather than by the culture types. The moisture content was higher and the pH was lower in pasteurized milk cheeses than in microfiltered milk cheeses at d 1 of manufacture. Chemical composition of experimental cheeses was within the legal limits for Domiati cheese in Egypt. Proteolysis and lipolysis during cheese pickling were lower in microfiltered milk cheeses compared with pasteurized milk cheeses. Highly significant variations in free amino acids, free fatty acids, and sensory evaluation were found among the cultures used in Domiati cheesemaking. The cheese made using adjunct culture containing Lactobacillus delbrueckii ssp. lactis , Lactobacillus paracasei ssp. paracasei , Lactobacillus casei , Lactobacillus plantarum , and Enterococcus faecium received high scores in flavor acceptability. Cheeses made from microfiltered milk received a higher score in body and texture compared with cheeses made from pasteurized milk.

In a previous study, exopolysaccharide (EPS)-producing cultures improved textural and functional properties of reduced fat Cheddar cheese. Because base cheese has an impact on the characteristics of process cheese, we hypothesized that the use of EPS-producing cultures in making base reduced fat Cheddar cheese (BRFCC) would allow utilization of more young cheeses in making reduced fat process cheese. The objective of this study was to evaluate characteristics of reduced fat process cheese made from young BRFCC containing EPS as compared with those in cheese made from a 50/50 blend of young and aged EPS-negative cheeses. Reduced fat process cheeses were manufactured using young (2 d) or 1-mo-old EPS-positive or negative BRFCC. Moisture and fat of reduced fat process cheese were standardized to 49 and 21%, respectively. Enzyme modified cheese was incorporated to provide flavor of aged cheese. Exopolysaccharide-positive reduced fat process cheese was softer, less chewy and gummy, and exhibited lower viscoelastic moduli than the EPS-negative cheeses. The hardness, chewiness, and viscoelastic moduli were lower in reduced fat process cheeses made from 1-mo-old BRFCC than in the corresponding cheeses made from 2-d-old BRFCC. This could be because of more extensive proteolysis and lower pH in the former cheeses. Sensory scores for texture of EPS-positive reduced fat process cheeses were higher than those of the EPS-negative cheeses. Panelists did not detect differences in flavor between cheeses made with enzyme modified cheese and aged cheese. No correlations were found between the physical and melting properties of base cheese and process cheese.

The objective was to study the influence of different exopolysaccharide (EPS)-producing and nonproducing lactic cultures on the viscoelastic properties of reduced-fat Cheddar cheese. Changes in the viscoelastic properties were followed over a ripening period of 6 mo. Results showed that the elastic, viscous, and complex moduli were higher in reduced-fat cheeses made with EPS-nonproducing cultures than in full-fat cheese. No differences in the viscoelastic properties were found between young reduced-fat cheese made with a ropy strain of Lactococcus lactis ssp. cremoris (JFR1) and its full-fat counterpart. Interestingly, the changes in viscoelastic moduli in both full-fat cheese and reduced-fat cheese made with JFR1 during ripening followed the same pattern. Whereas the moduli increased during the first month of ripening in those 2 cheeses, a dramatic decrease was observed in all other cheeses. Slopes of the viscoelastic moduli as a function of frequency were lower in the full-fat than in reduced-fat cheeses. The creep test showed that fresh reduced-fat cheese made with JFR1 was less rigid and more deformable than that made with EPS-nonproducing cultures. The creep and recovery properties of young reduced-fat cheese made with JFR1 and the full-fat type were similar. No differences were found in the viscoelastic properties between reduced-fat cheese made with no EPS and those made with EPS-producing adjunct cultures of Streptococcus thermophilus. After 6 mo of ripening, cheeses made with EPS-producing cultures maintained lower elastic and viscous moduli than did those made with no EPS.

The microstructure of reduced- and full-fat Cheddar cheeses made with exopolysaccharide (EPS)-producing and nonproducing cultures was observed using cryo-scanning electron microscopy. Fully hydrated cheese samples were rapidly frozen in liquid nitrogen slush (-207 degrees C) and observed in their frozen hydrated state without the need for fat extraction. Different EPS-producing cultures were used in making reduced-fat Cheddar cheese. Full-fat cheese was made with a commercial EPS-nonproducing starter culture. The cryo-scanning electron micrographs showed that fat globules in the fully hydrated cheese were surrounded by cavities. Serum channels and pores in the protein network were clearly observed. Young (1-wk-old) full-fat cheese contained wide and long fat serum channels, which were formed because of fat coalescence. Such channels were not observed in the reduced-fat cheese. Young reduced-fat cheese made with EPS-nonproducing cultures contained fewer and larger pores than did reduced-fat cheese made with a ropy strain of Lactococcus lactis ssp. cremoris (JFR1), which had higher moisture levels. A 3-dimensional network of EPS was observed in large pores in cheese made with JFR1. Major changes in the size and distribution of pores within the structure of the protein network were observed in all reduced-fat cheeses, except that made with JFR1, as they aged. Changes in porosity were less pronounced in both the full-fat and the reduced-fat cheeses made with JFR1.

Textural, melting, and sensory characteristics of reduced-fat Cheddar cheeses made with exopolysaccharide (EPS)-producing and nonproducing cultures were monitored during ripening. Hardness, gumminess, springiness, and chewiness significantly increased in the cheeses as fat content decreased. Cheese made with EPS-producing cultures was the least affected by fat reduction. No differences in hardness, springiness, and chewiness were found between young reduced fat cheese made with a ropy Lactococcus lactis ssp. cremoris [JFR1; the culture that produced reduced-fat cheese with moisture in the nonfat substance (MNFS) similar to that in its full-fat counterpart] and its full-fat counterpart. Whereas hardness of full-fat cheese and reduced-fat cheese made with JFR1 increased during ripening, a significant decrease in its value was observed in all other cheeses. After 6 mo of ripening, reduced fat cheeses made with all EPS-producing cultures maintained lower values of all texture profile analysis parameters than did those made with no EPS. Fat reduction decreased cheese meltability. However, no differences in meltability were found between the young full-fat cheese and the reduced-fat cheese made with the ropy culture JFR1. Both the aged full- and reduced-fat cheeses made with JFR1 had similar melting patterns. When heated, they both became soft and creamy without losing shape, whereas reduced-fat cheese made with no EPS ran and separated into greasy solids and liquid. No differences were detected by panelists between the textures of the full-fat cheese and reduced-fat cheese made with JFR1, both of which were less rubbery or firm, curdy, and crumbly than all other reduced-fat cheeses.