Optimization of nickel and cobalt biosorption by native Serratia marcescens strains isolated from serpentine deposits using response surface methodology

The treatment of metal-polluted wastes is a challenging issue of environmental concern. Metals can be removed using microbial biomass, and this is an interesting approach towards the design of eco-friendly technologies for liquid waste treatment. The study reported here aimed to optimize nickel and cobalt biosorption from aqueous solutions using three native metal-resistant Serratia marcescens strains. Ni(II) and Co(II) biosorption by S. marcescens strains was found to fit better to Langmuir's model, with maximum uptake capacities of 13.5 mg g^-1 for Ni(II) ions and 19.9 mg g^-1 for Co(II) ions. Different experimental conditions of initial metal concentration, pH, initial biomass, and temperature were optimized using the Plackett-Burman method, and, finally, biomass and metal concentration were studied using the response surface methodology (RSM) to improve biosorption. The optimum uptake capacities for Co(II) ions by the three biosorbents used were obtained for initial metal concentrations of 35-40 mg L^-1 and an initial biomass of 6 mg. For Ni(II) ions, the optimum uptake capacity was achieved with 1 mg of initial biomass for S. marcescens C-1 and C-19, and with 7 mg for S. marcescens C-16, with initial concentrations of 20-50 mg L^-1. The results obtained demonstrate the viability of native S. marcescens strains as biosorbents for Ni(II) and Co(II) removal. This study also contributes to our understanding of the potential uses of serpentine microbial populations for the design of environmental cleanup technologies.

Biosorption of nickel, cobalt, zinc and copper ions by Serratia marcescens strain 16 in mono and multimetallic systems

The metallurgical industry is one of the main sources of heavy metal pollution, which represents a severe threat to life. Metals can be removed from aqueous solutions by using microbial biomasses. This paper analyses the heavy metal biosorption capacity of Serratia marcescens strain 16 in single and multimetallic systems. The results obtained show that Co(II), Ni(II) and Zn(II) biosorption in monometallic systems is two to three times higher than in the presence of bi-metallic and multimetallic solutions. Fourier transform infrared spectroscopy confirmed that carbonyl, carboxyl and hydroxyl were the main functional groups, as well as the amide bands I and II involved in metal uptake, which are present in external structures of the bacterial cell. The results obtained demonstrated the viability of S. marcescens strain 16 as a biosorbent for the design of eco-friendly technologies for the treatment of waste liquor.

Facilitation and plant phenotypic evolution

While antagonistic interactions between plants have been a major topic of eco-evolutionary research, little evidence exists on the evolution of positive plant interactions (i.e., plant facilitation). Here, we first summarize the existing empirical evidence on the role of facilitation as a selection pressure on plants. Then, we develop a theoretical eco-evolutionary framework based on fitness-trait functions and interaction effectiveness that provides predictions for how facilitation-related traits may evolve. As evolution may act at levels beyond the individual (such as groups or species), we discuss the subject of the units of evolutionary selection through facilitation. Finally, we use the proposed formal evolutionary framework for facilitation to identify areas of future research based on the knowledge gaps detected.

Niche differences may explain the geographic distribution of cytotypes in Erysimum mediohispanicum

Polyploidisation has played an important role in plant diversification, and variation in ploidy level may be found not only between species of the same genus, but also within a single species. Although establishing the adaptive significance of polyploidy to explain the geographic distribution of cytotypes is challenging, the occurrence of different cytotypes in different ecological niches may suggest an adaptive role of genome duplication. We studied the adaptive significance of the geographic distribution of cytotypes across the entire distribution range of the endemic Erysimum mediohispanicum (Brassicaceae). For that, we have used climate variables, population elevation and soil properties to model ecological niches for the different cytotypes. In addition, we analysed the effect that ploidy level has on the floral phenotype. We found a clear geographic pattern in the distribution of cytotypes, with diploid individuals occurring in the southernmost part of the distribution range, while tetraploids were found in the northern area. A contact (mosaic) zone between both cytotypes was identified, but diploids and tetraploids occur in sympatry in only one population (although in a highly unbalanced proportion). Gene flow between different cytotypes seems to be negligible, as evident from an almost complete absence of triploids and other minority cytotypes. Niches occupied by both cytotypes showed subtle, but significant differences, even in the contact zone. Precipitation was higher in regions occupied by tetraploid individuals, which present wider corolla tubes and thinner but taller stalks than diploids. Our findings highlight the potential role of polyploidy in the ecological adaptation of E. mediohispanicum to both abiotic factors and biotic interactions.

Flower specialisation: the occluded corolla of snapdragons (Antirrhinum) exhibits two pollinator niches of large long-tongued bees

Flower specialisation of angiosperms includes the occluded corollas of snapdragons (Antirrhinum and some relatives), which have been postulated to be one of the most efficient structures to physical limit access to pollinators. The Iberian Peninsula harbours the highest number of species (18 Iberian of the 20 species of Antirrhinum) that potentially share similar pollinator fauna. Crossing experiments with 18 Iberian species from this study and literature revealed a general pattern of self-incompatibility (SI) - failure in this SI system has been also observed in a few plants - which indicates the need for pollinator agents in Antirrhinum pollination. Field surveys in natural conditions (304 h) found flower visitation (>85%) almost exclusively by 11 species of bee (Anthophora fulvitarsis, Anthophora plumipes, Anthidium sticticum, Apis mellifera, Bombus hortorum, Bombus pascuorum, Bombus ruderatus, Bombus terrestris, Chalicodoma lefebvrei, Chalicodoma pyrenaica and Xylocopa violacea). This result covering the majority of Antirrhinum species suggests that large bees of the two long-tongued bee families (Megachilidae, Apidae) are the major pollinators of Antirrhinum. A bipartite modularity analysis revealed two pollinator systems of long-tongued bees: (i) the long-studied system of bumblebees (Bombus spp.) associated with nine primarily northern species of Antirrhinum; and (ii) a newly proposed pollinator system involving other large bees associated with seven species primarily distributed in southern Mediterranean areas.

Is floral morphology a good predictor of floral visitors to Antirrhineae (snapdragons and relatives)?

The association between plants and flower visitors has been historically proposed as a main factor driving the evolutionary change of both flower and pollinator phenotypes. The considerable diversity in floral morphology within the tribe Antirrhineae has been traditionally related to pollinator types. We used empirical data on the flower visitors from 59 Antirrhineae taxa from the literature and our own field surveys, which provide an opportunity to test whether flower phenotypes are reliable predictors of visitors and pollinator niches. The degree of adjustment between eight key floral traits and actual visitors was explored by testing the predictive value of inferred pollinator syndromes (i.e. suites of floral traits that characterise groups of plant species related to pollination). Actual visitors and inferred pollinator niches (categorisation of visitors' association using a modularity algorithm) were also explored using Linear Discriminant Analysis (LDA). The bee pollinator niche is correctly classified for flowers with dull corolla colour, without nectar guides, as the most important predictor. Both predictive value and statistical classification prove useful in classifying Antirrhineae taxa and the bee pollinator niche, mostly as a consequence of the high proportion of genera and taxa with occluded corollas primarily visited by bees. Our predictive approach rendered a high Positive Predictive Value (PPV) of floral traits in the diagnosis of visitors/pollinator niches. In particular, a high PPV was found for bees as both visitors and forming pollinator niches. In addition, LDA showed that four pollinator niches are well defined based on floral traits. The large number of species visited by bees irrespective of pollinator syndromes leads us to hypothesise their generalist pollinator role, despite the phenotypically specialised flowers of Antirrhineae.

Dye adsorption onto mesoporous materials: pH influence, kinetics and equilibrium in buffered and saline media

Mesoporous materials were used as adsorbents for dye removal in different media: non-ionic, buffered and saline. The mesoporous materials used were commercial (silica gel) as well as as-synthesised materials (SBA-15 and a novel mesoporous carbon). Dye adsorption onto all the materials was very fast and the equilibrium was reached before 1 h. The pH has a significant influence on the adsorption capacity for the siliceous materials since the electrostatic interactions are the driving forces. However, the influence of the pH on the adsorption capacity of the carbonaceous material was lower, since the van der Waals interactions are the driving forces. The ionic strength has a great impact on the siliceous materials adsorption capacity, being their adsorption capacity in a buffered medium six times higher than the corresponding to a non-ionic medium. Nevertheless, ionic strength does not influence on the dye adsorption on the mesoporous carbon. Overall, the as-synthesised carbon material presents a clear potential to treat dye effluents, showing high adsorption capacity (q(e) ≈ 200 mg/g) in all the pH range studied (from 3 to 11); even at low concentrations (C(e) ≈ 10 mg/L) and at short contact times (t(e) < 30 min).

Evolution of pollination niches and floral divergence in the generalist plant Erysimum mediohispanicum

BACKGROUND AND AIMS

How generalist plants diverge in response to pollinator selection without becoming specialized is still unknown. This study explores this question, focusing on the evolution of the pollination system in the pollination generalist Erysimum mediohispanicum (Brassicaceae).

METHODS

Pollinator assemblages were surveyed from 2001 to 2010 in 48 geo-referenced populations covering the entire geographic distribution of E. mediohispanicum. Bipartite modularity, a complex network tool, was used to find the pollination niche of each population. Evolution of the pollination niches and the correlated evolution of floral traits and pollination niches were explored using within-species comparative analyses.

KEY RESULTS

Despite being generalists, the E. mediohispanicum populations studied can be classified into five pollination niches. The boundaries between niches were not sharp, the niches differing among them in the relative frequencies of the floral visitor functional groups. The absence of spatial autocorrelation and phylogenetic signal indicates that the niches were distributed in a phylogeographic mosaic. The ancestral E. mediohispanicum populations presumably belonged to the niche defined by a high number of beetle and ant visits. A correlated evolution was found between pollination niches and some floral traits, suggesting the existence of generalist pollination ecotypes.

CONCLUSIONS

It is conjectured that the geographic variation in pollination niches has contributed to the observed floral divergence in E. mediohispanicum. The process mediating this floral divergence presumably has been adaptive wandering, but the adaptation to the local pollinator faunas has been not universal. The outcome is a landscape where a few populations locally adapted to their pollination environment (generalist pollination ecotypes) coexist with many populations where this local adaptation has failed and where the plant phenotype is not primarily shaped by pollinators.

Height gain at adult-height age in 184 short patients treated with growth hormone from prepubertal age to near adult-height age is not related to GH secretory status at GH therapy onset

BACKGROUND

GH release after stimuli classifies short children as severe idiopathic isolated GH deficiency (IIGHD), mild IIGHD, dissociated GH release (DGHR) and normal GH release (NGHR) and anthropometric birth data as adequate for gestational age (AGA) or small for gestational age (SGA). GH release after stimuli classifies AGA patients as IIGHD or as idiopathic short stature (ISS).

AIM

To compare height gain induced by GH therapy (31.8 ± 3.5 µg/kg/day, 7.7 ± 1.6 years) started at prepubertal age and stopped at near adult-height age.

METHODS

A retrospective longitudinal multicenter study including 184 short patients classified as severe IIGHD n = 25, mild IIGHD n = 75, DGHR n = 55 and NGHR n = 29; or as IIGHD n = 78, ISS n = 57 and SGA n = 49. Height gain was evaluated throughout GH therapy and at adult-height age.

RESULTS

Height-SDS gain at adult-height age was similar among severe IIGHD (1.8 ± 0.8 SDS), mild IIGHD (1.6 ± 0.6 SDS), DGHR (1.7 ± 0.7 SDS) and NGHR (1.6 ± 0.7 SDS), or among IIGHD (1.7 ± 0.7 SDS), ISS (1.7 ± 0.6 SDS) and SGA (1.6 ± 0.8 SD).

CONCLUSION

GH-release stimuli are of little help for deciding on GH therapy in the clinical management of prepubertal children with IIGHD, ISS or SGA.

Effect of VOCs and methane in the biological oxidation of the ferrous ion by an acidophilic consortium

During the elimination of H2S from biogas in an aqueous ferric sulphate solution, volatile organic compounds (VOCs) and methane are absorbed and may have an effect on the subsequent biological regeneration of ferric ion. This study was conducted to investigate the effect of maximum concentrations of methane and some VOCs found in biogas on the ferrous oxidation of an acidophilic microbial consortium (FO consortium). The presence and impact of heterotrophic microorganisms on the activity of the acidophilic consortium was also evaluated. No effect on the ferrous oxidation rate was found with gas concentrations of 1500 mg toluene m(-3), 1400 mg 2-butanol m(-3) or 1250 mg 1,2-dichloroethane m(-3), nor with methane at gas concentrations ranging from 15-25% (v/v). A tenfold increase in VOCs concentrations totally inhibited the microbial activity of the FO consortium and the heterotrophs. The presence of a heterotrophic fungus may promote the autotrophic growth of the FO consortium.

Different strategies for recovering metals from CARON process residue

The capacity of Acidithiobacillus thiooxidans DMS 11478 to recover the heavy metals contained in the residue obtained from the CARON process has been evaluated. Different bioreactor configurations were studied: a two-stage batch system and two semi-continuous systems (stirred-tank reactor leaching and column leaching). In the two-stage system, 46.8% Co, 36.0% Mg, 26.3% Mn and 22.3% Ni were solubilised after 6h of contact between the residue and the bacteria-free bioacid. The results obtained with the stirred-tank reactor and the column were similar: 50% of the Mg and Co and 40% of the Mn and Ni were solubilised after thirty one days. The operation in the column reactor allowed the solid-liquid ratio to be increased and the pH to be kept at low values (<1.0). Recirculation of the leachate in the column had a positive effect on metal removal; at sixty five days (optimum time) the solubilisation levels were as follows: 86% Co, 83% Mg, 72% Mn and Ni, 62% Fe and 23% Cr. The results corroborate the feasibility of the systems studied for the leaching of metals from CARON process residue and these methodologies can be considered viable for the recovery of valuable metals.

Growth hormone secretory status evaluated by growth hormone peak after two pharmacological growth hormone release stimuli did not significantly influence the two-year catch-up growth induced by growth hormone therapy in 318 prepubertal short children with idiopathic growth retardation

BACKGROUND/AIMS

In prepubertal short children with idiopathic growth retardation, growth hormone (GH) peak after GH release stimuli classifies patients as growth hormone- deficient (GHD) or non-GHD. This study compared a 2-year growth response to GH therapy in 318 prepubertal short children.

METHODS

Patients were classified as: severe GHD (GH peaks <5 ng/ml after 2 stimuli; n = 54), mild GHD (GH peaks <10 ng/ml, but one or two between 5 and 10 ng/ml; n = 140), dissociated GH release (GH peak ≥ 10 ng/ml after 1 stimulus and <10 ng/ml after the other; n = 89), and normal GH release (GH peaks ≥ 10 ng/ml after 2 stimuli; n = 35).

RESULTS

Two-year height gain did not differ statistically among the 4 groups: 1.39 ± 0.51 SD, 16.4 ± 2.3 cm; 1.23 ± 0.56 SD, 15.8 ± 2.1 cm; 1.18 ± 0.53 SD, 15.3 ± 2.0 cm, and 1.14 ± 0.53 SD, 15.4 ± 2.0 cm, respectively, as was also the case for bone age gain: 2.5 ± 0.6, 2.4 ± 0.7, 2.6 ± 0.7 and 2.3 ± 0.5 years, respectively.

CONCLUSIONS

Our results suggest that GH release stimuli are of little help for deciding on GH therapy in the clinical management of prepubertal short children with idiopathic growth retardation, while well-defined anthropometric and biochemical criteria may be useful.

Combined strategy for the precipitation of heavy metals and biodegradation of petroleum in industrial wastewaters

The precipitation of chromium(III), copper(II), manganese(II) and zinc(II) by biogenic hydrogen sulfide generated by sulfate-reducing bacteria, Desulfovibrio sp., and the degradation of total petroleum hydrocarbons (TPH) in the presence of heavy metal by Pseudomonas aeruginosa AT18 have been carried out. An anaerobic stirred tank reactor was used to generate hydrogen sulfide with Desulfovibrio sp. culture and the precipitation of more than 95% of each metal was achieved in 24 h (metal solutions contained: 60, 49, 50 and 80 mg L(-1) of chromium, copper, manganese and zinc sulfates). A stirred tank reactor with P. aeruginosa AT18, in the presence of the heavy metal solution and 2% (v/v) of petroleum, led to the degradation of 60% of the total petroleum hydrocarbons and the removal of Cr(III) 99%, Cu(II) 93%, Zn(II) 46% and Mn(II) 88% in the medium through biosorption phenomena. These results enabled the development of an integrated system in which the two processes were combined. The overall aim of the study was achieved, with 84% of TPH degraded and all of the metals completely removed. Work is currently underway aimed at improving this system (decrease in operation time, culture of P. aeruginosa in anaerobic conditions) in an effort to apply this process in the bioremediation of natural media contaminated with heavy metals and petroleum.

[Distal femur fractures. Comparative analysis of two different surgical treatments]

INTRODUCTION

The treatment of distal femur fractures has been a controversial topic and it has recently evolved towards indirect reduction and minimally invasive techniques.

OBJECTIVE

To compare the results of the surgical treatment of distal femur fractures with a plate with screws for condylar compression purposes with the minimally invasive stabilization system.

MATERIAL AND METHODS

Patients with distal femur fractures treated surgically between January 2007 and December 2009 were assessed retrospectively. The following variables were registered from each patient record: age, sex, type of fracture, mechanism of injury, type of implant used, operative time and postoperative bleeding. The Neer scale was used to compare the anatomical, radiologic and functional results of both techniques.

RESULTS

The total number of patients was 52; 32 males and 20 females; mean age was 58 years. A plate with screws was used in 31 patients for condylar compression purposes, and a minimally invasive stabilization system in 21. The cases managed with a minimally invasive stabilization system had a shorter operative time and less intraoperative bleeding. The results of the evaluation using the Neer scale were similar for both modalities.

CONCLUSIONS

The patients with fracture of the distal third of the femur managed with a minimally invasive stabilization system had better outcomes, which were not significant in the Neer scale, mainly due to less pain intensity, early mobilization and less functional repercussions.

Dimethyl sulphide degradation using immobilized Thiobacillus thioparus in a biotrickling filter

Gaseous dimethyl sulphide (DMS) was eliminated in a biotrickling filter with Thiobacillus thioparus grown in polyurethane foam cubes as carrier material. The temperature, pH and empty bed residence time of the gas were maintained at 30 degrees C, 7.0 and 40 s, respectively. In the first 45 days, DMS loads of around 2.0 gDMS m(-3) h(-1) were fed to the BTF to adapt T. thioparus to DMS consumption, attaining close to 100% removal efficiency (RE) on day 46, and the maximum elimination capacity (EC) was 4.0 gDMS m(-3) h(-1) with a RE of 77%. The overall performance was enhanced by adding a nitrogen-enriched (9x) medium but was negatively affected by high superficial liquid velocity (8.18 m h(-1)) and high pH (>7.5). Sulphate concentrations (up to 10 g L(-1)) showed no effect. The system supported shock loads up to 58 gDMS m(-3) h(-1) with increased elimination. With nitrogen-enriched medium and a pH of 7.0 it was possible to increase the EC of DMS up to a maximum of around 23 gDMS m(-3) h(-1) with 65% RE.

[Reversal of acenocoumarol anticoagulation with activated factor VII in massive hemorrhage following rupture of a splenic artery pseudoaneurysm]

A 66-year-old man with a metallic valve and under treatment with acenocoumarol developed hypovolemic shock after rupture of a splenic artery pseudoaneurysm. We managed to reverse anticoagulation within 60 minutes by administering 20 mg of vitamin K and 4.8 mg of activated recombinant factor VII. No thromboembolic adverse events were observed. We discuss the pharmacologic effects of coumarin derivatives and their antagonists, as well as the use of activated factor VII in the reversal of anticoagulation by these drugs.

Removal of hydrogen sulfide and ammonia from gas mixtures by co-immobilized cells using a new configuration of two biotrickling filters

The simultaneous removal of H(2)S and NH(3) was investigated using two biotrickling filters packed with polyurethane foam cubes. One biotrickling filter was inoculated with Thiobacillus thioparus ATCC 23645 for the removal of H(2)S (BTT) and the other filter with Nitrosomonas europaea ATCC 19718 for the removal of NH(3) (BNE). Three different configurations were studied by modification of the gas line and recirculation medium line. The best results were obtained with the BNE biotrickling filter after the co-immobilization of the two bacteria. A removal efficiency of 100% for 230 ppmv of NH(3) and 129 ppmv of H(2)S was reached at an EBRT of 60 seconds. The results obtained show that it is possible to co-immobilize both microorganisms using the same recirculation medium and remove successfully H(2)S and NH(3) from a gas mixture.

[Relationship between methylenetetrahydrofolate reductase polymorphism and homocysteine levels in women with recurrent pregnancy loss: a nutrigenetic perspective]

The objective of this study was to evaluate if there is any difference in the proportion of methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms and the homocysteine levels in a group of women with recurrent pregnancy loss (RPL) and a control group. Ninety-three patients with diagnosis of three or more gestational losses and 206 healthy women with two or more children, were included. After acceptance of informed consent, samples of peripheral blood were taken to determine the genetic polymorphisms of MTHFR C677T and the plasmatic levels of homocysteine. The carriers of the homozygous mutation TT of MTHFR 677T polymorphism were 12.9% (12 of 93) in the group of patients and 14.6% (30 of 206) in the control group; 46.2% (43 of 93) and 40% (83 of 206) in the group of patients and controls respectively, were heterozygous CT for MTHFR gene. The levels of homocysteine were 7.2 micromol/ml in the group of patients and 7.7 mmol/l in controls. There was no relationship between MTHFR gene polymorphisms and the increase of homocysteine levels, nor of these one with RPL. From the nutrigenetics perspective we suggest that studies related to MTHFR polymorphisms and the risk of disease include the levels of folate and B6 and B12 vitamins participating in the tetrahydrofolate cycle for trying to establish a direct relation among the genotype, the level of metabolite and the clinical manifestations. In this regard, we recommend the administration of folic acid in women in search of pregnancy due to the high frequency of heterozygous and homozygous for MTHFR C677T mutation in our population.

Effect of weight loss induced by gastric bypass on proinflammatory interleukin-18, soluble tumour necrosis factor-alpha receptors, C-reactive protein and adiponectin in morbidly obese patients

OBJECTIVE

Interleukin-18 (IL-18) is a potent proinflammatory cytokine whose role in human obesity has recently been suggested. The aim of our study was to analyse in morbidly obese patients undergoing gastric bypass, the relationship of IL-18 with insulin resistance and with proinflammatory cytokines (tumour necrosis factor-alpha receptors, sTNFR), C-reactive protein (CRP) and with adiponectin.

DESIGN

Observational and prospective study.

PATIENTS

Sixty-five morbidly obese patients, aged 45 +/- 8.9 years, were studied before and 12 months after gastric bypass.

MEASUREMENTS

We analysed plasma concentrations of IL-18, sTNFR, CRP and adiponectin.

RESULTS

Plasma concentrations of sTNFR2, IL-18 and CRP were decreased and adiponectin significantly increased after bypass surgery. In the multiple regression analysis, preoperative values of IL-18 remained significantly associated with preoperative triglycerides (beta = 0.47, P = 0.005) and TNFR2 (beta = 0.47, P = 0.004). R(2) for the model = 0.38. Postoperative IL-18 concentrations in the multiple regression analysis were significantly associated with postoperative homeostasis model assessment of insulin resistance (HOMA-IR) (beta = 0.092, P = 0.019) and triglycerides (beta = 0.40, P = 0.036). R(2) for the model = 0.46. IL-18 did not correlate with body mass index, fat mass, fat-free mass or body fat. No relationship was either found between adiponectin and IL-18, TNFR1 and -2 and CRP.

CONCLUSIONS

Massive weight loss induced by gastric bypass reduces IL-18, TNFR2 and CRP. IL-18 might be a marker of the chronic inflammatory process underlying insulin resistance but its lack of association with anthropometric and body composition parameters does not support a major secretion by human adipocytes. IL-18 and sTNFR1 and -2 do not play a main role in the inhibition of the secretion of adiponectin.

Low 25-hydroxyvitamin D concentrations in obese women: their clinical significance and relationship with anthropometric and body composition variables

Obesity is associated with low concentrations of 25-hydroxyvitamin D [25(OH) D]. However, conflicting results have been found regarding the relationship of 25(OH) D with anthropometric and adiposity parameters. The aim of our study was to analyze the association between 25(OH) D and body fat (BF) in a homogeneous cohort of non-obese, obese, and morbidly obese Caucasian women. The study was performed in L'Hospitalet de Llobregat, a city adjacent to Barcelona with a latitude of 41 degrees, 22 minutes, and 5 seconds north.

MATERIALS AND METHODS

Plasma concentrations of 25(OH) D were determined and body composition was evaluated by bioelectrical impedance in a group of 43 women with morbid obesity, 28 non-morbidly obese, and 50 non-obese women matched for age.

RESULTS

Morbidly obese women showed lower 25(OH) D concentrations compared to non-morbidly and non-obese women (37.9+/-16 vs 40.2+/-13 vs 56.7+/-21 nmol/l, p=0.001). Fifty-one percent of morbidly obese women had vitamin D deficiency [25(OH) D<38 nmol/l] compared to 22% of non-obese patients, (p=0.004). In the bivariate correlation analysis 25(OH) D was inversely associated with weight (r=-0.41, p=0.001), body mass index (BMI) (r=-0.432, p=0.001), waist to hip ratio (WHR)(r=-0.40, p=0.001), BF (r=-0.53, p=0001), fat mass (r=-0.44, p=0.0001), fat-free mass (r=-0.35, p=0.001). In the multivariate general linear model analysis, 25(OH) D was associated with season of examination (p=0.001) and was negatively associated with BF (beta=-0.75, p=0.001), after adjusting for age, BMI, and WHR.

CONCLUSIONS

25(OH) D concentrations are associated with body composition variables especially by BF, independently of seasonal variability. Therefore, body adiposity should be considered when assessing vitamin D requirements in obese patients.

Adipose tissue expression of the glycerol channel aquaporin-7 gene is altered in severe obesity but not in type 2 diabetes

CONTEXT

Aquaporin-7 is required for efflux of glycerol from adipocytes and influences whole-body glucose homeostasis in animal studies.

OBJECTIVE

Our objective was to test the hypothesis that AQP7 gene expression levels may be affected by presence of obesity and type 2 diabetes in humans.

DESIGN

The obesity study cohort consisted of 12 lean, 22 nonseverely obese, and 13 severely obese subjects. The type 2 diabetes study cohort consisted of 17 lean and 39 obese type 2 diabetic patients. Circulating levels of plasma soluble proteins monocyte chemoattractant protein-1, TNF receptors 1 and 2, and IL-6 and glycerol were measured. The sc adipose tissue gene expression of AQP7, MCP-1, IL-6, TNFalpha, PPARgamma, and SREBP1c genes was measured by real-time PCR. AQP7 gene mutation analysis was performed.

RESULTS

Severely obese women showed lower AQP7 expression levels compared with lean and nonseverely obese (P < 0.001). Moreover, circulating glycerol concentration was lower in severely obese subjects, but no correlation with AQP7 adipose tissue expression was observed. AQP7 expression was negatively related with proinflammatory genes (for monocyte chemoattractant protein-1, r = -0.203 and P = 0.044; for TNFalpha, r = -0.209 and P = 0.036). Concerning adipogenic factors, AQP7 expression levels were found to be positively determined by PPARgamma mRNA expression levels (r = 0.265; P = 0.012). AQP7 expression did not show differences regarding the presence of type 2 diabetes.

CONCLUSION

Expression of AQP7 is down-regulated in women with severe obesity. The expression of this glycerol channel is not affected by type 2 diabetes.

Interstitial stereotactic radiosurgery of pilocytic astrocytomas in paediatric patients

OBJECTIVE

To evaluate the clinical presentation, tumour response, clinical improvement and complications in 12 children and young people with a pilocytic astrocytoma, WHO I grade 1, who were treated with interstitial radiosurgery using Iodine-125 seed implants.

PATIENTS AND METHODS

Retrospective analysis of 12 patients aged under 18 years (mean 8.4 years, ranging from 8 months to 17 years of age) with a pilocytic astrocytoma treated between 1993 and 2006. Iodine-125 seeds were used as temporary implants with low-dose rate (<or=10 cGy/h) and a calculated reference dose of 60 and 100 Gy to the outer ring of the tumour.

RESULTS

There was no perioperative mortality. Two patients worsened transiently, but thereafter each patient improved clinically. Eleven out of 12 tumours shrank after the treatment. The mean volume of the tumours before implantation was 17.9 cm(3). and was reduced to 60% of this volume at 6 months, to 26.5% at 12 months, to 8% at 24 months, and was less than 1% at 30-36 months One patient underwent a reimplantation to treat a recurrence 3 years after the initial treatment. Ten patients were alive 2 years after the first intervention. In the longest surving patient, there was no evidence of progression after 13.4 years of follow up.

IL-18: relationship with anthropometry, body composition parameters, leptin and arterial hypertension

OBJECTIVE

Interleukin-18 (IL-18) is a potent pro-inflammatory cytokine with potential atherogenic properties whose role in human obesity has been recently suggested. The aim of our study was to analyze the physiologic distribution of IL-18 among sexes and all decades of the adult life in a healthy population randomly selected and to study its relationship with anthropometric, body composition measurements and leptin concentrations. We also studied the relationship of IL-18 with smoking and arterial hypertension, known risk factors implicated in atherogenesis.

MATERIALS AND METHODS

One hundred and thirty four men and 127 healthy women were included in the study. Plasma concentrations of IL-18 and leptin were determined in all subjects. Body composition was evaluated by bioelectrical impedanciometry.

RESULTS

IL-18 was distributed similarly in men and women and throughout decades. No significant differences were found in IL-18 between obese and normal-weight men and women according to their body mass index and body fat content. Higher IL-18 concentrations were found in subjects with arterial hypertension. In the bivariate correlation analysis only waist to hip ratio correlated weakly with IL-18 in the whole population (r=0.12, p=0.04). In the multiple regression analysis the relationship between IL-18 and waist to hip ratio lost significance after adjusting for age, sex and body mass index. However, IL-18 remained associated with arterial hypertension (adjusted r2=0.25, p=0.023).

CONCLUSIONS

The lack of correlation between IL-18 with anthropometric, body composition variables and leptin in our healthy population argues against a role of this cytokine in obesity. Moreover, our findings suggest the implication of this interleukin in the atherogenic process induced by arterial hypertension.

Toxic effects of dissolved heavy metals on Desulfovibrio vulgaris and Desulfovibrio sp. strains

Biological treatment of metal-containing wastewaters with sulphate-reducing bacteria (SRB) is an attractive technique for the bioremediation of this kind of medium. In order to design a suitable engineering process to address this environmental problem, it is crucial to understand the inhibitory effect of dissolved heavy metals on these bacteria. Batch studies were carried out to evaluate the toxic effects of several heavy metal ions [Cr(III), Cu(II), Mn(II), Ni(II) and Zn(II)] on two cultures of SRB (Desulfovibrio vulgaris and Desulfovibrio sp.). The experimental data indicate that SRB show different responses to each metal. At the highest metal concentration tolerated for each metal, the precipitation levels for D. vulgaris were as follows: 24.7%-15 ppm Cr(III), 45%-4 ppm Cu(II), 60%-10 ppm Mn(II), 96%-8.5 ppm Ni(II) and 9%-20 ppm Zn(II). The corresponding values for Desulfovibrio sp. were: 25.5%-15 ppm Cr(III), 71%-4 ppm Cu(II), 66.2%-10 ppm Mn(II), 96.1%-8.5 ppm Ni(II) and 93%-20 ppm Zn(II). Results obtained in batch studies will be taken into account for the subsequent design of a sulphate-reducing bioreactor to reduce levels of heavy metals present in different types of contaminated media.

Expression of TWEAK and its receptor Fn14 in human subcutaneous adipose tissue. Relationship with other inflammatory cytokines in obesity

TWEAK, a cytokine of the TNF family, has been found to be expressed under different inflammatory conditions but no data is available concerning the expression of this cytokine and its receptor (Fn14) in human obesity. In the present work we have evaluated the expression of many pro-inflammatory TNF system cytokines (TNF-alpha, TWEAK and their respective receptors, TNFR1, TNFR2 and Fn14) in human adipose tissue of 84 subjects some with different degree of obesity and type 2 diabetes, and its relation with inflammation by also measuring the expression of macrophage marker CD68. We detected expression of TWEAK and Fn14 in isolated mature adipocytes and in the stromovascular fraction. Additionally, we found that LPS upregulates the expression of both genes on THP-1 human monocytic cell line. TWEAK was expressed in adipose tissue of all studied subjects with no differences between obesity group, and was associated with Fn14 expression in morbid obese, mainly in women with type 2 diabetes. The data obtained here also showed that TNF-alpha and TNFR2 mRNAs were significantly more expressed in subcutaneous adipose tissue of subjects with morbid obesity compared to obese and non-obese subjects. In contrast, TNFR1 gene expression was negatively associated with BMI. Our results suggest that the expression of TNF-derived pro-inflammatory cytokines are increased in severe obesity, where macrophage infiltrate could modulate the inflammatory environment through activation of its receptors.

Reference values of thyroid volume in a healthy, non-iodine-deficient Spanish population

Our aim was to assess reference values of thyroid volume by ultrasonography in healthy adult subjects. We conducted an epidemiological cross-sectional study where 880 subjects were randomly selected from the town census of L'Hospitalet de Llobregat after being invited to participate in our study directly by mail and phone call. We made a clinical history of each subject and determined serum thyrotropin, antiperoxidase antibodies, urinary iodine excretion and thyroid volume by ultrasonography. Subjects with thyroid disease were excluded. We finally studied 268 representative subjects. The reference thyroid volume was median 7.31 ml, mean 8.22 ml (Confidence Interval: 7.75 - 8.69 ml). In men: median 9.19 ml, mean 9.87 ml (CI: 9.09 - 10.65 ml); in women: median 6.19 ml, mean 6.57 ml (CI: 6.22 - 9.92 ml) (p < 0.0001). We grouped the subjects into decades, and found that thyroid volume was different (p = 0.0034) in males because the younger group had lower volume. We did not find any differences among age groups in women. The mean of the urinary iodine excretion was 154.23 microg/l. We have determined reference values of thyroid volume measured by ultrasonography in our iodine non-deficient population and prepared tables that distribute thyroid volume by sex and age.

Relationship between 25-(OH) D3, the IGF-I system, leptin, anthropometric and body composition variables in a healthy, randomly selected population

OBJECTIVE

This study prompted us to investigate the relationship between 25-(OH) D (3) and the IGF-I system, leptin, sex, age, anthropometric and body composition variables in healthy adults. We hypothesised that these variables would regulate 25-(OH) D (3) concentrations.

DESIGN

We included 253 subjects--126 men and 127 women. Body mass index (BMI) and body composition was determined, along with serum leptin, total IGF-I, free IGF-I, IGFBP3 and plasma 25-(OH) D (3) concentrations.

RESULTS

25-(OH) D (3) deficiency was observed in 69 subjects. There was a difference between 25-(OH) D (3) values and season (summer vs. winter). We observed similar 25-(OH) D (3) concentrations in men to those in women. The differential characteristics in subjects without 25-(OH) D (3) deficiency were lower BMI, fat mass and body fat and higher free IGF-I. We observed that leptin increased in the last decades and IGF-I system decreased by decade in both men and women. In subjects without 25-(OH) D (3) deficiency, there was a correlation between free IGF-I and 25-(OH) D (3) in men, and a negative correlation between 25-(OH) D (3) and age, BMI, fat mass and leptin and a positive correlation with total IGF-I in women. The multivariate linear regression analysis explained 37.8 % of 25-(OH) D (3) variability in men and 39 % in women, and only season and free IGF-I made an independent contribution to 25-(OH) D (3) in men, and season and fat mass in women.

CONCLUSION

These data suggest that free IGF-I in men and fat mass in women could regulate 25-(OH) D (3) concentrations.

Thyroid volume as measured by ultrasonography in patients With type 1 diabetes mellitus without thyroid dysfunction

The aim of this cross-sectional study was to assess and compare thyroid volume and its derminants in a cohort of type 1 diabetes mellitus (DM1) and compare the results to a healthy control group. We studied 65 DM1 patients treated with an intensive insulin regimen and 65 matched controls. In all participants we evaluated weight, height, BMI, waist-hip ratio, body surface area and body composition variables determined by using a bioelectrical impedance analyser. Thyroid size was estimated by ultrasonography. We determined basal TSH, anti-thyroid antibodies and urinary iodine excretion. Body weight, height, BMI and body surface area were similar in DM1 patients and in controls. Fat-free mass was higher in both male and female DM1 patients than in controls (64.4 +/- 6.9 vs. 60.4 +/- 8.2 kg, p=0.03 and 48.3 +/- 5.7 vs. 45.4 +/- 6, p=0.04, respectively), and fat mass was lower in male DM1 patients than in controls (9.7 +/- 7 vs. 14.2 +/- 8.1 kg, p=0.01). Thyroid volume was greater in both male and female DM1 patients than in controls (11.12 +/- 2.87 vs. 9.63 +/- 2.27 ml, p=0.0001 and 9.5 +/- 2.3 vs. 7.7 +/- 2 ml, p=0.002, respectively). Urinary iodine excretion was similar in the two groups. In both DM1 patients and controls, thyroid volume correlated with weight, height, BMI, waist-hip ratio, body surface area, fat-free mass and the multivariate linear regression analysis with thyroid volume as the dependent variable showed that fat-free mass in either group was the only significant determinant of thyroid volume. We conclude that DM1 patients had larger thyroid volume compared with healthy controls with similar anthropometry; body composition is different in DM1 patients and that the anthropometric and body composition variables, especially fat-free mass and body surface area, predict thyroid volume either in DM1 patients or in healthy controls.

Early elimination of cyclosporine in kidney transplant recipients receiving sirolimus prevents progression of chronic pathologic allograft lesions

Cyclosporine elimination in a regimen including sirolimus has been shown to be a safe and effective approach to improve graft function. Nevertheless, it is still unknown whether the functional benefit of CyA withdrawal coincides with a subsequent reduction in histologic lesions of chronic damage or development of chronic allograft nephropathy. This consideration would forecast a reduction in the rate of long-term graft loss. We analyzed 114 graft biopsies from a subgroup of 57 patients that had been included in a randomized study to eliminate CyA at 3 months posttransplant from a regimen including sirolimus either in group A CyA + SRL vs group B of SRL with CyA elimination at 3 months. Every patient had two biopsies, one at transplantation and another at 1 year. The biopsy reading was performed in a blinded manner by a central pathologist using the Banff 1997 and the CADI classifications. A significantly lower rate of progression of tubular and interstitial chronic lesions between basal and 1-year biopsies was observed for group B patients. In addition, the incidence of new cases of chronic allograft nephropathy during the first year was significantly lower in the group in which CyA had been eliminated at 3 months posttransplant. We conclude that early elimination of CyA in the first months posttransplant, when SRL is used as the main immunosuppressant, reduces the appearance or worsening of chronic histologic lesions, probably as a consequence of long-term CyA toxicity prevention.

Ultrasonographic thyroid volume as a reliable prognostic index of radioiodine-131 treatment outcome in Graves' disease hyperthyroidism

OBJECTIVE

We studied the relationship between thyroid volume, thyroid function and immunological markers of Graves' disease (GD) to determine prognostic factors of treatment response to low-dose radioiodine-131 (131I).

MATERIAL AND METHODS

A prospective study of 40 patients with GD hyperthyroidism treated with 131I (141 +/- 85MBq) and 10 GD patients who went spontaneously into remission (controls). Free T4, total T3 and basal TSH levels, TSH-receptor antibodies (TRAb) and anti-thyroid peroxidase antibodies (TPOAb) were studied. Thyroid volume was determined by ultrasonography. Logistic regression models were used to predict the probability of final thyroid status. Receiver-operating characteristics (ROC) curves and Hosmer Lemeshow tests were used to evaluate the final statistical models.

RESULTS

Of 40 patients treated with 131I, 16 became euthyroid, 12 hyperthyroid and 12 hypothyroid at 12 months. Median thyroid volume was reduced from 24.8 ml before to 8.5 ml at 12 months (p<0.001). In 10 control patients, the median reduction was from 16.6 ml to 11.3 ml (p=0.029). Thyroid volume reduction was lower in the hyperthyroid than in the euthyroid group, but higher in the hypothyroid group. Thyroid volume at baseline and at 3 months predicted hyperthyroidism outcome with a cut-off of 45 ml and 24.4 ml, respectively (odds ratio 1.074, p=0.003, ROC curve 0.78 and odds ratio 1.182, p=0.012, ROC curve 0.86 respectively). Thyroid volume at 6 months differentiated the hyperthyroid group with a cut-off of 17 ml. Thyroid volume at 3 and 6 months with a cut-off of 8.5 ml and 9.3 ml respectively, predicts permanent hypothyroidism outcome (odds ratio 0.768 and 0.685, p=0.012 and p=0.008, ROC curve 0.89 and 0.88, respectively). Changes in thyroid echogenicity and TRAb and TPOAb levels did not show any predictive value in the follow-up after 131I therapeutic outcome.

CONCLUSION

The study shows that the ultrasonographic thyroid volume at 3 and 6 months after low-dose 131I treatment for GD hyperthyroidism could be a reliable prognostic factor of thyroid function outcome in the first year after treatment, and also reveals that the changes in the thyroid echogenicity and in the immunological markers of GD have no prognostic value.

The clinical utility of the prostate specific membrane antigen reverse-transcription/polymerase chain reaction to detect circulating prostate cells: an analysis in healthy men and women

OBJECTIVE

To evaluate the overall specificity of nested reverse transcriptase-polymerase chain reaction (RT-PCR) to detect prostate-specific membrane antigen (PSM) mRNA in peripheral blood samples of healthy donors.

SUBJECTS AND METHODS

Peripheral blood samples were taken from 60 healthy blood-donors (30 men and 30 women aged < 50 years) and analysed for PSM-mRNA using nested RT-PCR (in 'hot-start' conditions and confirmed using nested EcoRI restriction enzyme). Intron-spanning primer pairs specific for human PSM were deduced from the GenBank sequence (M99487) using gene software. The outer primer pair for PSM was: fwd: 1368 5'-TCACCGGGACTCATGGGTGT-3'; reverse: 1860 5'-GCCTGAAGCAATTCCAAGTCGG-3'. Inner primer pair for PSM was: fwd: 1480 5'-AAGGAAGGGTGGAGACCTAG-3'; reverse: 5-ACTGAACTCTGGGGAAGGAC-3'. The integrity of cDNAs was checked using primer pairs specific for the housekeeping gene beta-actin. The specificity and false-positive rate were calculated assuming that the underlying prostate cancer incidence was nil.

RESULTS

The first PCR was negative for all samples (100% specificity; 0% false-positive rate). The nested PCR detected 23 positive samples (23/60, 38%) with an overall specificity of 62% (false positive rate, 38%).

CONCLUSION

Nested RT-PCR of PSM-mRNA in peripheral blood is highly unspecific. Its clinical utility in the management of prostate cancer must be low. Further development is needed of quantitative RT-PCR, primers that identify prostatic PSM or another prostate-specific marker gene to differentiate PSM mRNA from circulating prostate cells and from non-prostatic tissues.

Pituitary-thyroid axis, thyroid volume and leptin in healthy adults

OBJECTIVE

Patients with thyroid diseases usually have disturbances relating to body weight and thermogenesis. On the other hand, leptin is involved in the regulation of body weight, food intake and thermogenesis. Some studies have investigated the relationship between leptin and dysthyroid states, but the complex interactions between leptin and pituitary-thyroid axis have led to controversial results.

DESIGN

The aims of this cross-sectional study were to investigate the relationship among basal TSH, ultrasonographic thyroid volume and leptin in a group of 268 healthy adults randomly selected from our city, L'Hospitalet de Llobregat, Barcelona, an area free of iodine deficiency. In this euthyroid group, we determined basal TSH, thyroid autoantibodies, leptin concentrations, and thyroid volume by ultrasonography, body anthropometry, and body composition.

RESULTS

All subjects were free of goitre and were negative for anti-thyroid antibodies. Basal TSH concentrations were 1.49 +/- 0.8 mU/l in males and 1.67 +/- 0.83 mU/l in females (p = 0.6). Anti-thyroid antibodies were negative in all cases; leptin concentrations were 6.1 +/- 4 ng/ml in males and 16.8 +/- 11.7 ng/ml in females (p = 0.0001). Thyroid volume was 9.8 +/- 4.6 ml in males and 6.5 +/- 2 ml in females (p = 0.001). There were significant correlations among leptin concentrations and anthropometric and body composition variables in both sexes, without correlation with TSH concentrations. There was no significant correlation between anthropometric and body composition variables and thyroid volume in males but there was a correlation in females. In females, there was a positive correlation between leptin and thyroid volume (r = 0.181, p = 0.038). In males, there was a negative correlation between TSH concentrations and thyroid volume (r = - 0.271, p = 0.002).

CONCLUSIONS

We did not find any correlation between leptin levels and pituitary-thyroid axis in this control population. The correlation between leptin and thyroid volume in females is probably a consequence that leptin and thyroid volume are regulated in parallel by variables relating to anthropometry and body composition.

Body composition assessment in type 1 diabetes mellitus patients over 15 years old

BACKGROUND

The aim of the present study was to assess the anthropometric characteristics and body composition in type 1 diabetic patients and compare the results with a randomly selected control population.

MATERIAL AND METHODS

We studied 75 type 1 diabetic patients, 43 male and 32 female, recruited from consecutive diagnosed type 1 diabetic patients attending the Endocrine Unit and treated with a intensive insulin regimen, and 93 control subjects, 44 males and 49 females representative of the census of this city. We performed a dietary recall in patients and determined anthropometric characteristics, both in patients and controls, body weight, height, body-mass index, waist-hip ratio and body composition parameters: total body water, free-fat mass, body free-fat mass, fat mass and body fat by bioelectrical impedance analyser.

RESULTS

In diabetic male patients, we observed lower waist-hip ratio than in controls, 0.84 +/- 0.06 vs. 0.88 +/- 0.07, p = 0.021, higher free-fat mass in female diabetic patients, 48.5 +/- 5.6 vs. 45.6 +/- 5.9 kg, p = 0.03, lower fat mass in male diabetic patients, 9.5 +/- 6.9 vs. 14.6 +/- 8.5 kg, p = 0.003. We did not find any correlation among the parameters of body composition and dietary macronutrient intake in patients.

CONCLUSIONS

The present study exposes the differences in anthropometric characteristics and body composition in type 1 diabetes mellitus, especially lower waist-hip ratio in male, higher free-fat mass in female and lower fat mass in male.

[Prognostic factors of thyroid function following surgical therapy in Graves-Basedow's disease]

BACKGROUND

The goals of this work are to describe late thyroid function and to determine predictive factors of permanent hypothyroidism following surgery in Graves-Basedow's disease.

PATIENTS AND METHOD

From 1979 to 1999, 107 patients with hyperthyroidism due to Graves-Basedow's disease underwent subtotal thyroidectomy. We performed life-table analysis and calculated the cumulative incidence of hypothyroidism by means of the Kaplan-Meier's method. Survival (euthyroidism)within patients groups was compared using the Mantel-Cox method. Variables influencing long-term thyroid function were determined by estimating the Odds ratio with a logistic regression model.

RESULTS

The probability of euthyroidism among all 107 patients at 240 months was 51.4%.Age, gender, duration of both hyperthyroidism and antithyroid therapy and weight of resected thyroid tissue did not influence the eventual outcome. The weight of thyroid remnant was 5.4 (1.5)g and the conditional logistic regression analysis showed that weight of thyroid remnant was the only variable influencing long-term thyroid function. Hyperthyroidism relapsed in 5 patients.

CONCLUSIONS

In our experience,surgery represents a definitive alternative treatment with a risk of hypothyroidism within the first 2 years of 43.9%. The weight of thyroid remnant is the only variable influencing long-term thyroid function.

Leptin in type 2 diabetic or myotonic dystrophic women

BACKGROUND

Insulin resistance is an important determinant of circulating leptin concentrations in humans, but its independent contribution on plasma leptin levels are controversial. In the present study, we characterized plasma leptin levels and their regulation in women with 2 different insulin resistance states: type 2 diabetes and myotonic dystrophy disease, and in controls.

MATERIAL AND METHODS

We studied 3 groups of women: 21 type 2 diabetic patients, 20 myotonic dystrophic patients and a control group of 20 normoglycemic subjects, matched in age and body mass index. Body composition, fasting glucose and insulin, IGF-I, IGF-binding protein-3 and leptin were studied. Body composition was measured using a bioelectrical impedance analyser. Insulin sensitivity (in percentage) was modeled according to a computer-based homeostasis model assessment model. Data are expressed in mean +/- SEM.

RESULTS

In both groups of patients, glucose concentrations were higher in type 2 diabetic patients than in myotonic dystrophic patients, and insulin concentrations and insulin sensitivity were similar in the 2 groups of patients (82.4 +/- 18.6% in type 2 diabetic patients vs. 69.7 +/- 9.7% in myotonic dystrophic patients, p = 0.2) and lower than in controls. Serum leptin and leptin/fat mass ratio were higher in myotonic dystrophic patients than in type 2 diabetic patients (30 +/- 4.9 ng/ml vs. 17.7 +/- 2.6 ng/ml, p = 0.03 and 2.32 +/- 0.69 ng/ml/kg vs. 1.07 +/- 0.2 ng/ml/kg, p = 0.02, respectively) or those found in controls. In type 2 diabetic patients, leptin concentrations were correlated with body mass index and body fat, and in myotonic dystrophic patients leptin concentrations were correlated with age, body mass index, fasting insulin and lower insulin sensitivity, whereas leptin concentrations were not correlated with body fat.

CONCLUSIONS

These findings suggest that leptin concentrations and regulation in myotonic dystrophic patients are different from type 2 diabetes.

Water metabolism disturbances at different stages of primary thyroid failure

The aim of the present study was to study salt and water metabolism in thyroid deficiency. We performed an oral water loading test (OWL) and a hypertonic 5% saline infusion test (HSI) in 16 patients with overt primary hypothyroidism before replacement treatment (PRE group) and after, in eight patients with subclinical hypothyroidism (SUB group) and in 16 normal individuals (CG group). In the PRE group, a lower free water clearance was detected in the OWL (P < 0.022), with lower plasma osmolality (OWL: P < 0.005; HSI: P < 0.001) and arginine vasopressin (AVP) (OWL: P < 0.001; HSI: P < 0.001) than the CG group, across both tests; they normalized with the replacement treatment. The same plasma abnormalities were detected in the SUB group with the HSI. Although the AVP and thirst thresholds did not differ between the groups, the lag between them was lower in the PRE (4.1+/-3.2 mOsm/kg) and SUB group (2.6+/-2.1 mOsm/kg) than in the CG group (13.3+/-9.2 mOsm/kg) (P < 0.05). There were no differences in atrial natriuretic hormone (ANH), plasma renin activity (PRA) and plasma aldosterone among the groups. These results indicate that plasma hypo-osmolality and low levels of AVP are present in primary hypothyroidism, and indeed are already present in the subclinical phase of the disease. An overlap between the thresholds of thirst and AVP seem to play a role in these abnormalities, but ANH, PRA and plasma aldosterone do not appear to contribute.

Determinants of thyroid volume as measured by ultrasonography in healthy adults randomly selected

OBJECTIVES

The relationship between thyroid volume and anthropometric characteristics is a matter of controversy. The aim of this study was to investigate thyroid volume and its determinants in healthy adult subjects from a noniodine-deficient area.

DESIGN AND PATIENTS

Of the 280 000 inhabitants of the city, served by L'Hospitalet de Llobregat, we randomly selected 880 subjects from the census of the city. The participation rate in the study was 44%; after application of several exclusion criteria, a further 28 subjects were excluded because of previously diagnosed thyroid disease. We finally studied 268 subjects representative of the census of the city: 134 male and 134 female, without thyroid disease. We determined the anthropometric characteristics, body mass index, waist-hip ratio, body surface area; body composition by bioelectrical impedance analyser; thyroid volume by ultrasonography; basal TSH, antithyroid antibodies and urinary iodine excretion.

RESULTS

Thyroid volume in our population was higher in males (9.19 ml, CI 9.09-10.65) than in females (6.19 ml, CI 6.02-6.92), P = 0.001. Significant correlations were found among thyroid volume and body weight (r = 0.39, P = 0.0001), height (r = 0.44, P = 0.0001), body mass index (r = 0.13, P = 0.02), waist-hip ratio (r = 0.38, P = 0.0001), body surface area (r = 0.48, P = 0.0001), total body water (r = 0.14, P = 0.02), free fat mass (r = 0.47, P = 0.0001), fat mass (r = 0.37, P = 0.001) and body fat (r = 0.32, P = 0.001). Negative correlation was found between thyroid volume and basal TSH (r = -0.26, P = 0.001). No correlations were found among thyroid volume and iodine excretion, previous pregnancies in women, cigarette smoking and alcohol consumption. In a multiple regression analysis with thyroid volume as the dependent variable, body surface area was demonstrated to account for the 44% of variation of thyroid volume (P = 0.0001).

CONCLUSION

It is important to know the reference values of the thyroid volume in a population free of iodine deficiency and its determinants. Body surface area accounts for much of the variation of thyroid volume. Age, gender, anthropometric variables, body composition variables and biological variables, do not significantly influence the thyroid volume when considered as possible additions to this baseline model.

Serum leptin concentrations in patients with short-bowel syndrome

BACKGROUND

Short-bowel syndrome is a state of severe malabsorption resulting from absence or removal of the small bowel for several causes. A number of short-bowel patients develop hyperphagia. Leptin, a protein secreted from adipose tissue, signals the amount of energy stores to the brain.

OBJECTIVE

To study body composition and leptin regulation in short-bowel patients and to determine whether or not leptin concentrations are linked with hyperphagia.

DESIGN

We studied 25 short-bowel patients (remnant bowel less than 150 cm) and 31 controls and 10 oral nutrition. Fifteen patients received total parenteral nutrition and 10 oral nutrition. Anthropometric measurements, body composition (by bioelectrical impedance), and cholesterol, triacylglycerol and leptin concentrations were studied in all subjects.

RESULTS

There were no differences between short-bowel patients and controls in anthropometric variables, body composition, or leptin concentrations. Leptin concentrations were higher in short-bowel women than men (9.21+/-8.54 vs. 3.22+/-1.86 ng/ml, P=0.01). Leptin concentrations correlated positively with age (r=0.4, P=0.045), body mass index (r=0.52, P=0.007), fat mass (r=0.67, P=0.001) and body fat (r=0.68, P=0.0001); there were no correlations with other body composition parameters. We found no correlations between parenteral or oral nutrition and body composition parameters, or between leptin concentrations and the presence of hyperphagia. Logistic regression analysis showed that body fat correctly identified leptin concentrations in 60% of patients.

CONCLUSIONS

Body composition, leptin concentrations and leptin regulation in patients with short-bowel syndrome are similar to those of controls. Leptin concentrations do not correlate with hyperphagia in short bowel-patients.

Immobilisation of Thiobacillus ferrooxidans cells on nickel alloy fibre for ferrous sulfate oxidation

The immobilisation of the iron-oxidising bacteria Thiobacillus ferrooxidans on nickel alloy fibre as support is described. This matrix showed promise for application in iron oxidation under strongly acidic conditions. The influence on the colonisation process of T. ferrooxidans exerted by the initial pH of the medium and by temperature has also been studied. Results showed that immobilisation of T. ferrooxidans cells was affected by changes of temperature between 30 degrees C and 40 degrees C and in pH from 1.4 to 2.0.

Hypothyroidism after iodine-131 or surgical therapy for Graves' disease hyperthyroidism

BACKGROUND

The aim of this work was to describe late permanent hypothyroidism after iodine-131 or surgery, and to seek predictive factors of hypothyroidism for the two treatments.

MATERIAL

From 1979 to 1994, 462 patients with Graves' disease hyperthyroidism underwent definitive treatment. Three hundred and fifty-five patients were treated with low calculated doses of iodine-131, and 107 patients with subtotal thyroidectomy. Life-table analysis was performed and the cumulative incidence of hypothyroidism was calculated by Kaplan-Meier's method, and survival (euthyroidism) within the groups was compared by the Mantel-Cox method.

RESULTS

Of the 355 patients treated with one dose of 6.6 1.9 mCi of iodine-131, 246 became euthyroid after one dose, and 109 needed 2 or more doses. Twenty-two patients received one or more doses higher than 10 mCi. The probability of euthyroidism at 145 months after low-dose was 10. 19% and age, sex, pretreatment with antithyroid drugs, previous subtotal surgery did not influence the final outcome. Of the 107 surgically treated patients the probability of euthyroidism at 144 months was 56.1%. Age, sex, duration of hyperthyroidism, duration of antithyroid treatment, weight of thyroid resected, did not influence the final outcome. The weight of the thyroid remnant was 5.4 1.5 g and the multivariate statistical model by conditional logistic regression showed that the weight of thyroid remnant was the only variable that influenced long-term thyroid function.

CONCLUSIONS

There is no ideal dose of iodine-131 that would correct hyperthyroidism in Graveś disease without risk of hypothyroidism. Surgery is an alternative definitive treatment with a risk of hypothyroidism within the 2 first years, and a cumulative risk of hypothyroidism lower than with iodine-131.

Effects of long-term treatment with GH in the bone mineral density of adults with hypopituitarism and GH deficiency and after discontinuation of GH replacement

BACKGROUND

Only few previous studies have assessed the effects of long-term growth hormone (GH) replacement therapy on bone mineral density (BMD) in adult patients with GH deficiency. The aim of this study was to investigate the effects of long-term GH therapy on bone metabolism and BMD.

MATERIAL AND METHODS

At the start of the study, 20 adults with GH deficiency were randomized to receive either GH, 0.25 IU x kg per week, or placebo. After 6 months, patients in the placebo group were switched to GH therapy, and they received GH for a further 18 months. Of the 20 patients, 14 were male and 6 female with GH deficiency of adult-onset. The mean age of the patients at the start of the study was 40.3+/-10.9 years and the duration of GH deficiency was 10.6+/-6.4 years. Patients deficient in pituitary hormones other than GH had been receiving stable replacement doses of appropriate hormones for at least 6 months before the start of the study. Rates of bone metabolism were assessed by measuring calcium, phosphate, alkaline phosphatase, calciuria, phosphaturia and osteocalcin. BMD was measured by dual X-ray absorptiometry. Body composition was calculated from measurements of bioelectrical impedance.

RESULTS

Before GH treatment, BMD in the femoral neck was lower in patients than in controls. The rate of bone resorption markers increased significantly after 6 months and remained stable during the whole treatment period. BMD significantly increased in L2-L4 after 12 months of treatment with an increase of Z-score. The total BMD increase was 4.5+/-6.5%. BMD in the femoral neck increased after 12 months with an increase of Z-score after 18 months. The total increase was 10.4+/-18%. The total BMD increase was not different among patients with or without basal osteopenia. In both groups BMD in L2-L4 and in the femoral neck remained stable after 12 months without GH treatment. Sex, age, BMI and the time in which GH deficiency started, before or after the end of the peak of BMD, did not correlate with BMD. The BMD values and their response to GH treatment did not correlate with other associated deficiencies, and we did not find differences among BMD increase and GH dose, levels of insulin-growth factor-I, insulin growth factor binding protein-3, and parameters of body composition.

CONCLUSIONS

The results of the study support previous ones that BMD is subnormal in adults with GH deficiency; that GH replacement therapy stimulates bone turnover with initial biochemical changes; and that in the long term, this stimulation results in a significant augmentation in BMD that continues to increase after 2 years and remains stable after 12 months of GH withdrawal.