Arabidopsis nonresponding to oxylipins locus NOXY7 encodes a yeast GCN1 homolog that mediates noncanonical translation regulation and stress adaptation

Stress adaptation and translational regulation was studied using noxy7 (nonresponding to oxylipins7) from a series of Arabidopsis thaliana mutants. We identified the noxy7 mutation in At1g64790, which encodes a homolog of the yeast translational regulator General Control Nonderepressible1 (GCN1) that activates the GCN2 kinase; GCN2 in turn phosphorylates the α subunit of the translation initiation factor eIF2. This regulatory circuit is conserved in yeast and mammals, in which phosphorylated eIF2α (P-eIF2α) facilitates stress adaptation by inhibiting protein synthesis. In phenotypic and de novo protein synthesis studies with Arabidopsis mutants, we found that NOXY7/GCN1 and GCN2 mediate P-eIF2α formation and adaptation to amino acid deprivation; however, P-eIF2α formation is not linked to general protein synthesis arrest. Additional evidence suggested that NOXY7/GCN1 but not GCN2 regulates adaptation to mitochondrial dysfunction, high boron concentration, and activation of plant immunity to infection by Pseudomonas syringae pv tomato (Pst). In these responses, NOXY7/GCN1 acts with GCN20 to regulate translation in a noncanonical pathway independently of GCN2 and P-eIF2α. These results show the lesser functional relevance of GCN2 and P-eIF2α in plants relative to other eukaryotes and highlight the prominent role of NOXY7/GCN1 and GCN20 in regulation of translation and stress adaptation in plants.

One-step electrodeposition of Pd–CeO2 on high pore density foams for environmental catalytic processes

Electrodeposited Pd–CeO₂ on high pore density foams shows high activity and stability for environmental processes and outstanding mass transport properties.

Giant retroperitoneal sarcoma: case report

OBJECTIVE

To report a new case of giant retroperitoneal mass with silent beginning.

METHODS

We present the case of a 36 year old man with a giant retroperitoneal liposarcoma 35 × 15 cm in size. The only symptom was a one month history of minimal abdominal pain.

CONCLUSION

Liposarcoma is the most frequent retroperitoneal mass. In most of the cases clinical symptoms are silent, being this the reason why diagnosis is late and the size is large. The best image options are CT scan or MRI but final diagnosis is based on pathology results. Its treatment is surgery and relapse is very usual.

Effectiveness of chondroitin sulphate in patients with concomitant knee osteoarthritis and psoriasis: a randomized, double-blind, placebo-controlled study

OBJECTIVE

The aim of the trial was to assess the efficacy of chondroitin sulphate (CS) on symptomatic knee osteoarthritis (OA) associated to psoriasis.

METHODS

In this randomized, double-blind, placebo (PBO)-controlled clinical trial 129 patients with symptomatic knee OA and concomitant psoriasis were randomized into two groups receiving 800 mg daily of CS or PBO for 3 months. The primary efficacy outcome for knee OA was the Huskisson's visual analogue scale (VAS) and for psoriasis was the Psoriasis Area and Severity Index (PASI). Additionally, other secondary efficacy criteria for both conditions were assessed.

RESULTS

After 3 months of treatment, CS was more effective than PBO, relieving pain VAS (CS -26.9+/-24.8 vs PBO -14.23+/-20.8mm, P<0.01), decreasing the Lequesne index (CS -4.8+/-3.4 vs PBO -3.3+/-3.5, P<0.05) and reducing the number of patients using acetaminophen as rescue medication (CS 43% vs PBO 64%, P<0.05). Regarding PASI, Overall Lesion Severity Scale and Physician's Global Assessment of Change no statistically significant changes were detected in front of PBO. However, CS improved plantar psoriasis compared to PBO (CS 87% vs PBO 27%, P<0.05). Quality of life improved significantly in CS-treated patients according to the Short Form-36 health survey and the Dermatology Life Quality Index (DLQI). CS tolerability was excellent. Adverse events were infrequent and evenly distributed among groups. The incidence of psoriatic flares did not increase after treatments.

CONCLUSIONS

This study confirms the efficacy and safety of CS as a symptomatic slow-acting drug in patients with knee OA and shows that CS improves plantar psoriasis. The use of CS could represent a special benefit in patients with both pathologies since non-steroidal anti-inflammatory drugs have been reported to induce or exacerbate psoriasis.

[Effect of gastric bypass on the metabolic syndrome and on cardiovascular risk]

BACKGROUND

Obesity is associated with increased morbimortality cardiovascular. Individual with metabolic syndrome (MS) are a high risk of developing cardiovascular disease (CVD). The aim of this study was to determine the prevalence of the MS in morbidly obese patients enrolling in a bariatric surgery program and to evaluate the impact of weigh loss induced by gastric bypass on the MS and on the predicted 10-year cardiovascular risk.

MATERIAL AND METHODS

We studied 46 morbidly obese patients who underwent laparoscopic gastric bypass and were followed for 2 years. MS was defined following the IDF 2005 criteria and the insulin resistance (IR) was calculated by using HOMA index. Risk assessment for estimating 10-year ECV risk was carried out according to Framingham score.

RESULTS

Before surgery, 67.2% of patients had IR and 60,9% met the definition of the MS. 17.3% of patients had an elevated cardiovascular risk category. 2 years after gastric bypass, the percentage of excess body weight lost was 72%. All patients restored their HOMA index and only 1 patient (3.6%) had MS. Resolution of hypertension, disglucemia and dislipemia has been observed in 85%, 93.8% and 95.6% of patients. Estimated cardiovascular risk decreased from 4.5% at baseline to 1% at 2 years after surgery.

CONCLUSIONS

SM is common in morbidly obese patients. Bypass gastric is associated with an improvement or resolution in cardiovascular risk factors and IR and result in a significant reduction in MS prevalence and of predicted 10-year cardiovascular risk.

Reconstruction of an extensive perineal defect using two modified V-Y flaps based on perforators from the gluteus maximus muscle

SUMMARY

We report the case of a women with severe perineal defect secondary to a perianal cancer that required reconstruction from the posterior wall of the urinary bladder to the coccyx, and which laterally surpassed both ischial tuberosities. For this reconstructive work, we used two V-Y advanced flaps taken from the gluteal region. On the basis of these flaps, we modified the final position in the advance of the lateral ends, crossing the tips of each flap over each other to provide a greater volume of tissue in the central area, with no signs of vascular injury. We believe that the use of V-Y flaps, based on the perforating arteries of the gluteus maximus, allows the reconstruction of especially extensive defects in the perineal region. The technique is rapid and easy perform, and produces acceptable clinical outcome and minimum morbidity.

A porous PCL scaffold promotes the human chondrocytes redifferentiation and hyaline-specific extracellular matrix protein synthesis

The redifferentiation, proliferation, and hyaline-specific extracellular matrix (ECM) protein synthesis of chondrocytes cultured in a polycaprolactone (PCL) scaffold were analyzed. Gene expression of the type II collagen and aggrecan was assessed by real-time PCR in cells from PCL scaffolds, monolayer, and pellet cultures. The proliferative activity was assessed using Ki-67 immunodetection, and the chondrocytic differentiation was evaluated using S-100 immunodetection. The synthesis and deposition into scaffold pores of type II collagen and glycosaminoglycan were analyzed by immunohistochemistry and Alcian blue staining, respectively. All parameters were assessed throughout 28 days of cultures maintained in either fetal bovine serum-containing medium (FCM) or Insulin-Transferrin-Selenium-containing medium (ICM). Expression of the type II collagen gene was lower in FCM cultures than in ICM cultures for all culture systems (p < 0.05). Moreover, PCL scaffolds cultured in ICM were able to induce collagen gene expression more efficiently than pellet and monolayer cultures. Aggrecan gene expression did not vary significantly between mediums and three-dimensional system cultures, but in ICM cultures, the monolayer cultures had significantly higher levels of aggrecan gene expression than did either the PCL or pellet cultures. Chondrocytes cultured in PCL scaffolds or pellets with FCM did not proliferate to a great extent but did maintain their differentiated phenotype for 28 days. Levels of cartilage ECM protein synthesis and deposition into the scaffold pores were similar among PCL and pellet cultures grown in FCM and in ICM. In conclusion, chondrocytes seeded into PCL scaffolds, cultured in ICM, efficiently maintained their differentiated phenotype and were able to synthesize cartilage-specific ECM proteins.

Unilateral dichotomy of nipple (intraareolar polythelia) and areola: report of a case and surgical correction

An unusual case of intraareolar polythelia with two nipples is presented. The dichotomy affected not only the nipple, but also the areola. No other breast malformation existed. Surgical correction was performed by transposition flaps sutured to one another in the center of the areola. The anatomic and functional results were satisfactory.

Reconstruction of chest wall defects after resection of large neoplasms: ten-year experience

We review our experience in the treatment of complex large chest-wall defects needing a multidisciplinary approach due to primary or secondary neoplasms. Non-small cell lung cancer with chest-wall invasion cases are excluded. Fifteen patients underwent whole thickness resection of the chest wall due to lesions affecting at least three ribs, sternum, clavicle or thoracic spine and the surrounding soft tissue. Previously operated breast cancer and sarcoma were the most frequent diagnoses. Partial or total sternectomy plus rib resection was performed in 8 patients. Immediate closure of the defects was performed in all cases: 12 with single prosthesis placement and 3 with a rigid one of methylmethacrylate. Coverage was achieved using myocutaneous flaps in most cases and, in one case, using the greater omentum that supported a free split-thickness skin graft. No 30-days mortality was recorded. Three patients had a post-operative complication. Mean hospital stay was 11.7+/-9 days. All cases of primary tumours were alive at the time of review (range: 6-126 months). In conclusion, resection and immediate reconstruction of large chest wall defects can be accomplished without operative mortality and low morbidity whenever close cooperation between plastic and thoracic teams exists.

Chondroitin sulfate and hyaluronic acid (500-730 kda) inhibit stromelysin-1 synthesis in human osteoarthritic chondrocytes

Chondroitin sulfate (CS) and 500-730 kDa hyaluronic acid (HA) are symptomatic slow-acting drugs for the treatment of osteoarthritis (OA). In addition, a growing body of evidence suggests a role for CS and this specific HA as modifiers of the course of OA. The therapeutic efficacy of CS and HA lies in their different mechanisms of action. Stromelysin-1 (metalloprotease-3 [MMP-3]) is a cartilage proteolytic enzyme, which induces cartilage destruction and acts as a mediator of the inflammatory response. However, there are few studies evaluating the in vitro effect of CS and HA on MMP-3 synthesis in human chondrocyte cultures from OA patients. Thus, the aim of the present study was to analyze the effect of CS and HA (500-730 kDa) on MMP-3 synthesis induced by interleukin-1beta (IL-1beta) in chondrocytes from patients with hip OA. Chondrocyte cultures were incubated for 48 h with IL-1beta (2.5 ng/ml) in the absence or presence of different HA 500-730 kDa (Hyalgan, Bioibérica Farma, Barcelona, Spain) concentrations, or alternatively, CS (Condro.san, Bioibérica Farma) at concentrations of 10, 50, 100, 150, 200 and 1,000 microg/ml. The results revealed that both CS and HA (500-730 kDa) inhibited MMP-3 synthesis induced by IL-1beta in human OA chondrocytes. Specifically, CS and HA (500-730 kDa) reduced MMP-3 expression levels at all tested concentrations. Therefore, our study provides new data on the mechanism of action of these drugs, which could help to explain their clinical efficacy in OA patients.

Effect of dietary conjugated linoleic acid (CLA) on metabolism of isotope-labeled oleic, linoleic, and CLA isomers in women

The purpose of this study was to investigate the effect of dietary CLA on accretion of 9c-18:1, 9c,12c-18:2, 10t,12c-18:2, and 9c,11t-18:2 and conversion of these FA to their desaturated, elongated, and chain-shortened metabolites. The subjects were six healthy adult women who had consumed normal diets supplemented with 6 g/d of sunflower oil or 3.9 g/d of CLA for 63 d. A mixture of 10t,2c-18:2-d4, 9c,11t-18:2-d6, 9c-18:1-d8, and 9c,12c-18:2-d2, as their ethyl esters, was fed to each subject, and nine blood samples were drawn over a 48-h period. The results show that dietary CLA supplementation had no effect on the metabolism of the deuterium-labeled FA. These metabolic results were consistent with the general lack of a CLA diet effect on a variety of physiological responses previously reported for these women. The 2H-CLA isomers were metabolically different. The relative percent differences between the accumulation of 9c,11t-18:2-d6 and 10t,12c-18:2-d4 in plasma lipid classes ranged from 9 to 73%. The largest differences were a fourfold higher incorporation of 10t,12c-18:2-d4 than 9c,11t-18:2-d6 in 1-acyl PC and a two- to threefold higher incorporation of 9c,11t-18:2-d6 than 10t,12c-18:2-d4 in cholesterol esters. Compared to 9c-18:1-d8 and 9c,12c-18:2-d2, the 10t,12c-18:2-d4 and 9c,11t-18:2-d6 isomers were 20-25% less well absorbed. Relative to 9c-18:1, incorporation of the CLA isomers into 2-acyl PC and cholesterol ester was 39-84% lower and incorporation of 10t,12c-18:2 was 50% higher in 1-acyl PC. This pattern of selective incorporation and discrimination is similar to the pattern generally observed for trans and cis 18:1 positional isomers. Elongated and desaturated CLA metabolites were detected. The concentration of 6c,10t,12c-18:3-d4 in plasma TG was equal to 6.8% of the 10t,12c-18:2-d4 present, and TG was the only lipid fraction that contained a CLA metabolite present at concentrations sufficient for reliable quantification. In conclusion, no effect of dietary CLA was observed, absorption of CLA was less than that of 9c-18:1, CLA positional isomers were metabolically different, and conversion of CLA isomers to desaturated and elongated metabolites was low.

Elevated levels of small, low-density lipoprotein with high affinity for arterial matrix components in patients with rheumatoid arthritis: possible contribution of phospholipase A2 to this atherogenic profile

OBJECTIVE

This work studied the presence of inflammatory and atherogenic lipoprotein markers that could explain the high incidence of cardiovascular disease (CVD) reported in rheumatoid arthritis (RA) patients.

METHODS

Inflammatory markers were 1) soluble adhesion molecules (intercellular adhesion molecule [ICAM] and vascular cell adhesion molecule [VCAM]), 2) C-reactive protein (CRP), 3) fibrinogen (Fb), 4) cytokines (interferon-gamma [IFNgamma], tumor necrosis factor alpha [TNFalpha]), and 5) secretory group IIA phospholipase A2 (sPLA2-IIA). Atherogenic lipoprotein markers were 1) the size distribution of plasma lipoprotein subclasses, and 2) the binding affinity of low-density lipoprotein (LDL) to chondroitin 6-sulfate glycosaminoglycan (GAG).

RESULTS

RA patients (n = 31) and matched controls (n = 28) had similar plasma concentrations of total cholesterol, triglycerides, Apo B, Apo A-I, very low-density lipoprotein, intermediate-density lipoprotein, and high-density lipoprotein (HDL). RA patients had significantly higher plasma levels of sPLA2-IIA, ICAM, CRP, Fb, TNFalpha, and IFNgamma compared with controls. RA patients also had significantly higher levels of small, dense LDL-1 (P < 0.05) and lower levels of small HDL-2 particles (P < 0.001) compared with controls. In addition, LDL from RA patients had a significantly higher binding affinity (Kd) to GAG (mean +/- SD Kd 204+/-22.4 nM Apo B) than did LDL from control subjects (Kd 312+/-36 nM Apo B) (P < 0.05). This Kd value showed a significant negative correlation with the plasma levels of LDL-1 (r = -0.566, P < or = 0.004). In RA patients, a significant positive correlation was obtained between sPLA2-IIA and CRP, ICAM, and LDL-1. HDL-2 showed a negative correlation with sPLA2-IIA.

CONCLUSION

These atherogenic lipoprotein factors combined with the presence of chronic inflammation may contribute to the high CVD-related mortality in RA patients.

Ease of ventilation through the cuffed oropharyngeal airway (COPA), the laryngeal mask airway and the face mask in a cardiopulmonary resuscitation training manikin

The aim of this study was to compare ease of ventilation of a cardiopulmonary resuscitation manikin using a cuffed oropharyngeal airway (COPA), a laryngeal mask airway (LMA) and a face mask, by two groups of people with different levels of earlier experience in cardiopulmonary resuscitation (CPR). Enrolled were, 108 people identified as experienced (54), or inexperienced (54), in CPR. Training equipment included a manikin, a COPA (n=10), an LMA (n=4), a face mask (n=4) and self-inflating bag-valve device. The same investigator explained the theoretical use and practice of the three techniques with the subjects in groups of three. The variables recorded were the number of attempts needed to achieve correct placement (and a tidal volume of 200 ml, was achieved), the insertion time for the COPA and the LMA, and the average time taken to achieve the first ten correct ventilations. The face mask and LMA required fewer attempts for correct placement than did the COPA. The LMA also took less time to insert than the COPA. The face mask required a significantly shorter total time with all attempts and the mean time of placement and time to achieve ten correct ventilations was shorter than with either the LMA or the COPA (P=0.0001). We conclude that the face mask offers an easier and quicker way to provide ventilation for CPR manikins than does the COPA or the LMA. Earlier experience affects the ease of insertion of the LMA and the total time needed to achieve effective ventilation.

Dietary supplementation with conjugated linoleic acid increased its concentration in human peripheral blood mononuclear cells, but did not alter their function

The purpose of this study was to examine if conjugated linoleic acid (CLA) supplementation of diets would alter fatty acid (FA) composition and function of peripheral blood mononuclear cells (PBMC). Seventeen women, 20-41 yr, participated in a 93-d study conducted at the Metabolic Research Unit. The same diet (19, 30, and 51% energy from protein, fat, and carbohydrate, respectively) was fed to all subjects throughout the study. Seven subjects (control group) supplemented their diet with six daily capsules (1 g each) of placebo oil (sunflower) for 93 d. For the other 10 subjects (CLA group), the supplement was changed to an equivalent amount of Tonalin capsules for the last 63 d of the study. Tonalin provided 3.9 g/d of a mixture of CLA isomers (trans-10,cis-12, 22.6%; cis-11,trans-13, 23.6%; cis-9,trans-11, 17.6%; trans-8,cis-10, 16.6%; other isomers 19.6%), and 2.1 g/d of other FA. PBMC isolated on study days 30 and 90 were used to assess intracellular cytokines by flow cytometry, secreted cytokines, and eicosanoid by enzyme-linked immonosorbent assay, and FA composition by gas-liquid chromatography. After supplementation, total CLA concentration increased from 0.012 to 0.97% (P < 0.0001) in PBMC lipids, but it did not significantly alter the concentration of other FA. CLA supplementation did not alter the in vitro secretion of prostaglandin E2, leukotriene B4, interleukin-1beta (IL-1beta), or tumor necrosis factor alpha (TNFalpha) by PBMC simulated with lipopolysaccharide, and the secretion of IL-2 by PBMC stimulated with phytohemagglutinin. Nor did it alter the percentage T cells producing IL-2, interferon gamma, and percentage of monocytes producing TNFalpha. The intracellular concentration of these cytokines was also not altered. None of the variables tested changed in the control group. Our results show that CLA supplementation increased its concentration in PBMC lipids, but did not alter their functions.

The effect of conjugated linoleic acid on platelet function, platelet fatty acid composition, and blood coagulation in humans

Despite extensive research on conjugated linoleic acid (CLA) showing multiple beneficial effects in animal models, little is known about the role of dietary CLA in human health. To investigate if the beneficial effects of CLA seen in animal models are relevant to humans, we conducted a study with 17 healthy female volunteers who lived in the Metabolic Research Unit of the Western Human Nutrition Research Center for 93 d. This paper reports only the results from this study that are related to the effects of CLA supplementation on blood coagulation, platelet function, and platelet fatty acid composition. Throughout the study, the subjects were fed a low-fat diet (30 en% fat, 19 en% protein, and 51 en% carbohydrate) consisting of natural foods with the recommended dietary allowances for all known nutrients. After a 30-d stabilization period, subjects were randomly assigned to either an intervention group (n = 10) whose diet was supplemented with 3.9 g/d of CLA or a control group (n = 7) who received an equivalent amount of sunflower oil consisting of 72.6% linoleic acid with no detectable CLA. Platelet aggregation was measured in platelet-rich plasma using adenosine diphosphate, collagen, and arachidonic acid agonists. No statistical difference was detected between the amount of agonist required to produce 50% aggregation of platelet-rich plasma before and after the subjects consumed the CLA, with the exception of a decrease in response to collagen. This decrease was found in both control and intervention groups with no significant difference between the groups, suggesting that both linoleic acid (sunflower oil) and CLA might have similar effects on platelet function. The prothrombin time, activated partial thromboplastin time, and the antithrombin III levels in the subjects were determined. Again, there was no statistically significant difference in these three parameters when pre- and post-CLA consumption values were compared. The in vivo bleeding times were also unaffected by CLA supplementation (10.4 + 2.8 min pre- and 10.2 + 1.6 min postconsumption). Platelet fatty acid composition was not markedly influenced by the consumption of dietary CLA, although there was a small increase in the amount of the 9 cis,11 trans-18:2 isomer normally present in platelets after feeding CLA for 63 days. In addition, small amounts of the 8 trans,10 cis-18:2 and the 10 trans,12 cis-18:2 isomers were detected in the platelets along with traces of some of the other isomers. Thus, when compared to sunflower oil, the blood-clotting parameters and in vitro platelet aggregation showed that adding 3.9 g/d of dietary CLA to a typical Western diet for 63 d produces no observable physiological change in blood coagulation and platelet function in healthy adult females. Short-term consumption of CLA does not seem to exhibit antithrombotic properties in humans.

The effect of conjugated linoleic acid on plasma lipoproteins and tissue fatty acid composition in humans

Conjugated linoleic acid (CLA) has been suggested by some animal studies to possess antiatherogenic properties. To determine, in humans, the effect of dietary CLA on blood lipids, lipoproteins, and tissue fatty acid composition, we conducted a 93-d study with 17 healthy female volunteers at the Metabolic Research Unit of the Western Human Nutrition Research Center. Throughout the study, subjects were fed a low-fat diet [30 energy percent (en%) fat, 19 en% protein, and 51 en% carbohydrate] that consisted of natural foods with the recommended dietary allowances for all known nutrients. After a 30-d stabilization period, subjects were randomly assigned to either an intervention group (n = 10) supplemented daily with capsules containing 3.9 g of CLA or a control group (n = 7) that received an equivalent amount of sunflower oil. The CLA capsules (CLA 65%) contained four major cis/trans geometric isomers (11.4% 9 cis-,11 trans-18:2; 10.8% 8 trans-,10 cis-18:2; 15.3% 11 cis-,13 trans-18:2; and 14.7% 10 trans-,12 cis-18:2) and their corresponding cis/cis (6.74% total) and trans/trans (5.99% total) varieties in smaller amounts. Fasting blood was drawn on study days 30 (end of the stabilization period), 60 (midpoint of the intervention period), and 93 (end of the intervention period). Adipose tissue samples were taken on days 30 and 93. CLA supplementation for 63 d did not change the levels of plasma cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and triglycerides. The weight percentage of CLA in plasma increased from 0.28 +/- 0.06 to 1.09 +/- 0.31 (n = 10, P < 0.05) after the supplementation. The 9 cis-,11 trans-isomer was the most prominent variety followed by the 11 cis-,13 trans- and 10 trans-,12 cis-isomers in lesser amounts. CLA in adipose tissue was not influenced by the supplementation (0.79 +/- 0.18 to 0.83 +/- 0.19 wt%) (n = 10) and the 9 cis-,11 trans-variety was the only isomer present. Thus, contrary to findings from some animal studies, CLA does not seem to offer health benefits, in the short term, regarding the prevention of atherosclerosis in humans. CLA supplementation for 2 mon did not alter the blood cholesterol or lipoprotein levels of healthy, normolipidemic subjects. The supplementation did increase CLA in the plasma but only 4.23% of the ingested CLA was present in the plasma at any given time. No adverse effect of CLA supplementation was detected in this study.

Comparison of octreotide acetate LAR and lanreotide SR in patients with acromegaly

BACKGROUND AND OBJECTIVE

The most effective option for the medical treatment of patients with acromegaly is the use of somatostatin analogues. Long-acting depot formulations for intramuscular injection of two somatostatin analogues have recently become available: octreotide acetate LAR (Sandostatin LAR, Novartis Pharma AG) and lanreotide SR (Somatuline, Ipsen Biotech). We wished to compare efficacy of octreotide LAR and lanreotide SR in acromegalic patients.

PATIENTS AND METHODS

A group of 125 patients with acromegaly (67 females; mean age, 47 years; 59 patients had previous pituitary irradiation) from 26 medical centres in France, Spain and Germany were studied. Before the study, all patients had been treated with intramuscular injections of lanreotide SR (mean duration, 26 months) at a dose of 30 mg which was injected every 10 days in 64 and every 14 days in 61 patients, respectively. All patients were switched from lanreotide SR to intramuscular injections of 20 mg of octreotide LAR once monthly for three months. In order to obtain efficacy and safety data of lanreotide SR under study conditions, it was decided to randomly assign at day 1, in a 3 : 1 ratio, the time point of the treatment switch; 27 of the patients were randomly assigned to continue the lanreotide SR treatment for the first 3 months of the study (group A); they were on octreotide LAR 20 mg from month 4-6. The other 98 patients were assigned to be switched to treatment with octreotide LAR 20 mg at day 1 (group B). In group B patients, octreotide LAR treatment was continued until month 6, with an adjustment of the dose based on GH levels obtained at month 3.

RESULTS

The mean GH concentration decreased from 9.6 +/- 1.3 mU/l at the last evaluation on lanreotide SR to 6.8 +/- 1.0 mU/l after three injections of octreotide LAR (P < 0.001). The percentages of patients with mean GH values < or = 6.5 mU/l (2.5 microg/l) and < or = 2.6 mU/l (1.0 microg/l) at the last evaluation on lanreotide SR were 54% and 14%, and these values increased after 3 months treatment with octreotide LAR to 68% and 35% (P < 0.001), respectively. IGF-I levels were normal in 48% at the last evaluation on lanreotide SR and in 65% after 3 months on octreotide LAR (P < 0.001). Patients with pre-study pituitary irradiation had lower mean GH and IGF-I concentrations. But the effects of the treatment change did not differ between the irradiated and the nonirradiated patients. In general both drugs were well tolerated.

CONCLUSION

Octreotide LAR 20 mg administered once monthly was more effective than lanreotide SR 30 mg administered 2 or 3 times monthly in reducing GH and IGF-I in patients with acromegaly.

Dietary conjugated linoleic acid did not alter immune status in young healthy women

The purpose of this study was to examine whether conjugated linoleic acid (CLA) supplementation in human diets would enhance indices of immune status as reported by others for animal models. Seventeen women, 20-41 yr, participated in a 93-d study conducted in two cohorts of 9 and 8 women at the Metabolic Research Unit of Western Human Nutrition Research Center. Seven subjects were fed the basal diet (19, 30, and 51% energy from protein, fat, and carbohydrate, respectively) throughout the study. The remaining 10 subjects were fed the basal diet for the first 30 d, followed by 3.9 g CLA (Tonalin)/d for the next 63 d. CLA made up 65% of the fatty acids in the Tonalin capsules, with the following isomeric composition: t10, c12, 22.6%; c11, t13, 23.6%; c9, t11, 17.6%; t8, c10, 16.6%; and other isomers 19.6%. Most indices of immune response were tested at weekly intervals, three times at the end of each period (stabilization/intervention); delayed-type hypersensitivity (DTH) to a panel of six recall antigens was tested on study day 30 and 90; all subjects were immunized on study day 65 with an influenza vaccine, and antibody titers were examined in the sera collected on day 65 and 92. None of the indices of immune status tested (number of circulating white blood cells, granulocytes, monocytes, lymphocytes, and their subsets, lymphocytes proliferation in response to phytohemagglutinin, and influenza vaccine, serum influenza antibody titers, and DTH response) were altered during the study in either dietary group. Thus, in contrast to the reports with animal models, CLA feeding to young healthy women did not alter any of the indices of immune status tested. These data suggest that short-term CLA supplementation in healthy volunteers is safe, but it does not have any added benefit to their immune status.

Conjugated linoleic acid supplementation in humans: effects on body composition and energy expenditure

Recent animal studies have demonstrated that dietary conjugated linoleic acid (CLA) reduces body fat and that this decrease may be due to a change in energy expenditure. The present study examined the effect of CLA supplementation on body composition and energy expenditure in healthy, adult women. Seventeen women were fed either a CLA capsule (3 g/d) or a sunflower oil placebo for 64 d following a baseline period of 30 d. The subjects were confined to a metabolic suite for the entire 94 d study where diet and activity were controlled and held constant. Change in fat-free mass, fat mass, and percentage body fat were unaffected by CLA supplementation (0.18+/-0.43 vs. 0.09+/-0.35 kg; 0.01+/-0.64 vs. -0.19+/-0.53 kg; 0.05+/-0.62 vs. -0.67+/-0.51%, placebo vs. CLA, respectively). Likewise, body weight was not significantly different in the placebo vs. the CLA group (0.48+/-0.55 vs. -0.24+/-0.46 kg change). Energy expenditure (kcal/min), fat oxidation, and respiratory exchange ratio were measured once during the baseline period and during weeks 4 and 8 of the intervention period. At all three times, measurements were taken while resting and walking. CLA had no significant effect on energy expenditure, fat oxidation, or respiratory exchange ratio at rest or during exercise. When dietary intake was controlled, 64 d of CLA supplementation at 3 g/d had no significant effect on body composition or energy expenditure in adult women, which contrasts with previous findings in animals.

Conjugated linoleic acid supplementation in humans: effects on circulating leptin concentrations and appetite

Conjugated linoleic acid (CLA) has been demonstrated to reduce body fat in animals. However, the mechanism by which this reduction occurs is unknown. Leptin may mediate the effect of CLA to decrease body fat. We assessed the effects of 64 d of CLA supplementation (3 g/d) on circulating leptin, insulin, glucose, and lactate concentrations in healthy women. Appetite was assessed as a physiological correlate of changes in circulating leptin levels. Analysis of plasma leptin concentrations adjusted for adiposity by using fat mass as a covariate showed that CLA supplementation significantly decreased circulating leptin concentrations in the absence of any changes of fat mass. Mean leptin levels decreased over the first 7 wk and then returned to baseline levels over the last 2 wk of the study in the CLA-treated group. Appetite parameters measured at around the time when the greatest decreases in leptin levels were observed showed no significant differences between supplementation and baseline determinations in the CLA-supplemented group or between the CLA and placebo-supplemented groups. There was a nonsignificant trend for mean insulin levels to increase toward the end of the supplementation period in CLA-treated subjects. CLA did not affect plasma glucose and lactate over the treatment period. Thus, 64 d of CLA supplementation in women produced a transient decrease in leptin levels but did not alter appetite. CLA did not affect these parameters in a manner that promoted decreases of adiposity.

Analysis of indirect signs of microprolactinoma at MR imaging

OBJECTIVE

To evaluate the diagnostic reliability/value of microprolactinoma indirect signs at MRI.

METHODS AND MATERIAL

A prospective study was carried out over 3 years on 26 women with microprolactinoma (MiP group) and 106 healthy female volunteers as a control group. Size, glandular morphology, pituitary stalk inclination and sellar bony floor erosion were measured and a comparative statistical analysis between both groups was performed.

RESULTS

Patients from the MiP group showed a significantly bigger glandular size than women in the control group, although the glandular morphology did not present significant differences between both groups. Only 5% of normal glands measured over 7.5 mm in height and none of them reached 9 mm, while up to 42.3% of the MiP group scored over 7.5 mm and 19.2% over 9 mm. Mean stalk inclination for the MiP group was 4.6 +/- 3.1 degrees and 3.5 +/- 2.7 degrees for the control group with no significant differences. Five microprolactinomas were located on the glandular midline, 11 on the left side and ten on the right side. No relationship between the microadenoma location inside the gland and stalk inclination was found. From 21 microprolactinomas with eccentric location, 17 coincided with the sellar floor excavation; eccentric excavation presented significant differences between both groups, but not the central excavation.

CONCLUSION

From all indirect sings of microprolactinoma analyzed in this study, only a gland height over 9 mm, and an eccentric sellar excavation of at least 3 mm are reliable signs to support its diagnosis.

Comparison of oral and intraperitoneal iron supplementation in anaemic rats: a re-evaluation of the mucosal block theory of iron absorption

To evaluate the extent to which daily oral Fe supplements may block Fe absorption from a subsequent dose, we compared effects of oral and intraperitoneal (i.p.) Fe supplementation on Fe status in anaemic rats (haemoglobin (Hb) 90 g/l). A ligated duodenal loop technique was used to assess the effects of the Fe supplements administered either orally or i.p. at different frequencies on Fe absorption from a subsequent test dose. Anaemic Sprague-Dawley rats were assigned to seven groups of eight rats each and received either oral or i.p. Fe supplements for 3 d as follows: (1) 4 mg oral supplement daily (three doses in 3 d); (2) 4 mg oral supplement once (one dose on day 1, low-Fe dose on days 2 and 3); (3) 12 mg oral supplement once (one dose on day 1, low-Fe dose on days 2 and 3); (4) 3.2 mg i.p. supplement daily (three doses in 3 d); (5) 3.2 mg i.p. supplement once (one dose on day 1); (6) 9.6 mg i.p. supplement once (one dose on day 1); (7) low-Fe diet (control). The effectiveness of the supplements in treating Fe deficiency on each of the two test-factors, i.e. route of administration and frequency of dose, was assessed by determining Hb-Fe gain and liver-Fe stores after the 3 d test period. Oral supplementation was as effective as i.p. in improving the Fe status of the anaemic animals. However, a 15 min absorption of a radio-Fe test dose from a ligated loop in i.p.-supplemented groups was significantly higher (11.68 (SD 1.70)%, 17.49 (SD 4.59)%, 16.71 (SD 3.39)%) than in orally supplemented groups (3.24 (SD 1.35)%, 2.45 (SD 1.05)%, 1.80 (SD 0.35)%) despite equal body Fe stores. No significant difference in intestinal Fe absorption efficiency was detected within the oral groups but those supplemented only once were more effective than or as effective as the group receiving daily supplements for 3 d in improving Fe status as indicated by Hb-regeneration efficiency. We conclude that there is a mucosal block with the administration of oral Fe supplements but the extent of this blocking effect during oral Fe supplementation is not as dramatic as currently thought in the context of the poor efficacy of daily Fe supplementation programmes.