Depressive traits are associated with a reduced effect of choice on intentional binding

A sense of agency (SoA) over wilful actions is thought to be dependent on the level of choice and the nature of the outcome. In a preregistered study, we manipulated choice and valence of outcome to assess the relationship between SoA across the depression and psychosis continuum. Participants (N = 151) completed a Libet Clock task, in which they had either a free or forced choice to press one of two buttons and received either a rewarding or punishing outcome. Participants also completed questionnaires on depressive and psychosis-like traits. Rewarding outcomes increased intentional binding. The evidence favoured no effect of choice on average, but this was influenced by inter-individual differences. Individuals reporting more depressive traits had less of a difference in intentional binding between free and forced choice conditions. We show that implicit SoA is sensitive to outcome valence and the effect of choice differs across the depression continuum.

[Update on toxoplasmosis in poultry farming]

INTRODUCTION

Toxoplasmosis is a worldwide occurring zoonosis caused by the obligate intracellular parasite Toxoplasma gondii (T. gondii). All warm-blooded species, including humans, serve as intermediate hosts. Definitive hosts are exclusively cats. Farm poultry can become infected with oocysts from contaminated feed or directly from the ground, or by pecking of e.g. infected rodents. Outdoor or free-range housing of poultry increases the risk of infection with length of time. Poulty meat must be seen as a potential source of infection for humans with the increasing popularity of humane animal husbandry practices in poultry farming. This short literature review attempts to assess the current epidemiological situation in farmed poultry and to assess the possible relevance of toxoplasmosis of poultry meat and poultry meat products for human consumption.

Biomimetic reconstruction of the hematopoietic stem cell niche for in vitro amplification of human hematopoietic stem cells

Hematopoietic stem cell transplantation is successfully applied since the late 1950s; however, its efficacy still needs to be increased. A promising strategy is to transplant high numbers of pluripotent hematopoietic stem cells (HSCs). Therefore, an improved ex vivo culture system that supports proliferation and maintains HSC pluripotency would override possible limitations in cell numbers gained from donors. To model the natural HSC niche in vitro, we optimized the HSC medium composition with a panel of cytokines and valproic acid and used an artificial 3D bone marrow-like scaffold made of polydimethylsiloxane (PDMS). This 3D scaffold offered a suitable platform to amplify human HSCs in vitro and, simultaneously, to support their viability, multipotency and ability for self-renewal. Silicon oxide-covering of PDMS structures further improved amplification of CD34+ cells, although the conservation of naïve HSCs was better on non-covered 3D PDMS. Finally, we found that HSC cultivated on non-covered 3D PDMS generated most pluripotent colonies within colony forming unit assays. In conclusion, by combining biological and biotechnological approaches, we optimized in vitro HSCs culture conditions, resulting in improved amplification, multipotency maintenance and vitality of HSCs.

Associations between physical activity and bone structure in older adults: does the use of self-reported versus objective assessments of physical activity influence the relationship?

Associations of current and previous physical activity (PA) with bone health are unclear. In postmenopausal women with low bone mineral density (BMD), current PA was positively associated with femoral neck BMD and microarchitecture. Past PA was positively associated with tibial microarchitecture. PA appears beneficial for bone health throughout the lifespan.

INTRODUCTION

To compare associations of current and past self-reported bone-specific physical activity, and current accelerometer-determined physical activity (PA), with bone structure (bone mineral density [BMD] and microarchitecture) in postmenopausal women with osteopenia or osteoporosis.

METHODS

Fifty community-dwelling postmenopausal women (mean age 64.4 ± 7.7) with hip or spine BMD T-score < - 1.0 SD were recruited for an exercise intervention. At baseline, current, past and total Bone-specific Physical Questionnaire (BPAQ) scores were self-reported, and percentages of sedentary, light and moderate to vigorous PA (MVPA) were objectively determined by accelerometer measurements. Bone structure was assessed by lumbar spine and hip dual-energy X-ray absorptiometry (DXA), 3D modelling algorithms (3D-SHAPER) of hip DXA scans and distal tibial high-resolution peripheral quantitative computed tomography (HR-pQCT) scans.

RESULTS

Current BPAQ scores and MVPA were significantly positively associated with femoral neck areal BMD (β = 0.315, p = 0.031 and β = 0.311, p = 0.042, respectively) following multivariable adjustments. MVPA was also positively associated with femoral cortical surface BMD (β = 0.333, p = 0.028) and mean cortical thickness (β = 0.374, p = 0.013). Past and total BPAQ scores demonstrated positive associations with tibial trabecular number (β = 0.391, p = 0.008 and β = 0.381, p = 0.010, respectively), and negative associations with trabecular separation (β = - 0.396, p = 0.006 and β = - 0.380, p = 0.009, respectively) and distribution (β = - 0.411, p = 0.004 and β = - 0.396, p = 0.006, respectively). Current BPAQ score was positively associated with tibial cortical periosteal perimeter (β = 0.278, p = 0.014).

CONCLUSION

BPAQ scores were most consistently associated with tibial bone parameters in older women, with past PA having lasting benefits for trabecular microarchitecture, and current PA positively associated with cortical bone.

Post-discharge oral antimicrobial use among hospitalized patients across an integrated national healthcare network

OBJECTIVES

Antimicrobial stewardship programmes have focused on reducing inappropriate inpatient antimicrobial prescribing, but several small studies have found a large portion of antimicrobial exposure occurs immediately after hospital discharge. In this study, we describe the prescribing of oral antimicrobials at hospital discharge across an integrated national healthcare system. At the hospital level, we also compare total inpatient antimicrobial use and post-discharge oral antimicrobial use.

METHODS

This retrospective cross-sectional study used national administrative data to identify all acute-care admissions during 2014-2016 within the Veterans Health Administration (VHA). We evaluated inpatient days of therapy (DOT) and post-discharge DOT, defined as oral outpatient antimicrobials dispensed at the time of hospital discharge. At the hospital level, inpatient DOT/100 admissions were compared with post-discharge DOT/100 admissions using Spearman's rank-order correlation.

RESULTS

There were 1 681 701 acute-care admissions across 122 hospitals, and 335 369 (19.9%) were prescribed an oral antimicrobial at discharge. Fluoroquinolones (38.3%) were the most common post-discharge antimicrobial. At the hospital level, median inpatient antimicrobial use was 331.3 (interquartile range (IQR) 284.9-367.9) DOT/100 admissions and median post-discharge use was 209.5 (IQR 181.5-239.6) DOT/100 admissions. Thirty-nine per cent of the total duration of antimicrobial exposure occurred after discharge. At the hospital-level, the metrics of inpatient DOT/100 admissions and post-discharge DOT/100 admissions were weakly positively correlated with rho=0.44 (p < 0.001).

CONCLUSIONS

A large proportion of antimicrobial exposure among hospitalized patients occurred immediately following discharge. Antimicrobial-prescribing at hospital discharge provides an opportunity for antimicrobial stewardship. Hospital-level stewardship metrics need to include both inpatient and post-discharge antimicrobial-prescribing to provide a comprehensive assessment of hospital-associated antimicrobial use.

I just lost it! Fear and anger reduce the sense of agency: a study using intentional binding

Two recent studies have demonstrated that increases in arousal states lead to an increase people's sense of agency, i.e., the subjective experience of controlling one's own voluntary actions (Minohara et al. in Front Psychol 7:1165, 2016; Wen et al. in Conscious Cogn 36:87-95, 2015). We here extend these findings by showing that arousal states with negative emotional valence, such as fear and anger, decrease sense of agency. Anger and fear are negative emotional states. Anecdotally, they are often invoked as reasons for losing control, and neuroscientific evidence confirms important effects on the brain's action control systems. Surprisingly, the subjective experience of acting in anger or fear has scarcely been investigated experimentally. Thus, the legal notion that these intense emotions may undermine normal voluntary control over actions and outcomes (the 'Loss of Control', a partial defence for murder) lacks any clear evidence base. In three laboratory experiments, we measured sense of agency using an implicit measure based on time perception (the "intentional binding" paradigm). These actions occurred in either an emotionally neutral condition, or in a fearful (experiments 1 and 2) or angry state (experiment 3). In line with our hypotheses, fear or anger reduced the subjective sense of control over an action outcome, even though the objective causal link between action and outcome remained the same. This gap between the objective facts of agency, and a reduced subjective experience of agency under emotional conditions, has important implications for society and law.

SNP panel development for genetic management of wild and domesticated white bass (Morone chrysops)

White bass (Morone chrysops), striped bass and their interspecific hybrid are important game fishes, whereas the hybrid striped bass is an important aquaculture species in the US. Numerous state, federal and private hatcheries, therefore, rear these species for stocking purposes as well as for food fish. Although striped bass populations (both wild and domesticated) have been extensively evaluated, relatively little effort has been directed toward the study and improvement of white bass. In this study, we developed SNP resources to examine the genetic relationships among a long-term domesticated white bass line and five potential founder stocks for selective breeding collected from drainages in Arkansas, Texas and Alabama. Using genotyping-by-sequencing, we generated 13 872 genome-wide SNP loci across the six populations. Stringent filtering of SNP-calling parameters identified 426 informative SNP loci. Population genetic and structure analyses using these loci revealed only moderate genetic differentiation between populations (global F_st  = 0.083) and indicated two major genetic clusters. A final 57-SNP assay was successfully designed and validated using the MassARRAY system. The developed SNP panel assigned 96 additional genotyped individuals to their population of origin with 100% accuracy. The SNP resources developed in this study should facilitate ongoing efforts in selective breeding and conservation of white bass.

Major trauma in older persons

Background

Globally, populations are ageing, creating challenges for trauma system design. Despite this, little is known about causes of injury and long-term outcomes in older injured patients. This study aims to describe temporal trends in the incidence, causes and functional outcomes of major trauma in older adults.

Methods

The population-based Victorian State Trauma Registry was used to identify patients with major trauma aged 65 years and older with a date of injury between 1 January 2007 and 31 December 2016. Temporal trends in population-based incidence rates were evaluated. Functional outcome was measured using the Glasgow Outcome Scale - Extended.

Results

There were 9250 older adults with major trauma during the study period. Low falls were the most common mechanism of injury (62·5 per cent), followed by transport-related events (22·2 per cent) and high falls (9·5 per cent). The number of patients with major trauma aged 65 years and older more than doubled from 2007 to 2016, and the incidence increased by 4·3 per cent per year (incidence rate ratio 1·043, 95 per cent c.i. 1·035 to 1·050; P < 0·001). At 12 months after injury, 41·8 per cent of older adults with major trauma had died, and 52·2 per cent of those who survived to hospital discharge were not living independently.

Conclusions

The number and proportion of older adults with major trauma are increasing rapidly and this will impact on trauma system design. Given the poor long-term outcomes, there needs to be greater emphasis on ensuring that appropriate interventions are targeted to the right patients and enhanced efforts in primary prevention.

Transforming growth factor-β1 and tumor necrosis factor-α concentration in serum during disturbed lymph flow from a liver in rats

In the last decades an increasing attention has been devoted to the role of lymphatic system in pathomechanism. The disturbed lymph flow from a liver contributes to liver fibrogenesis and probably to hepatocirrhosis. Cytokines play a major role in the development of hepatic fibrosis, the wound-healing response of the liver to chronic injury. Cytokines in hepatic fibrogenesis may be pro- or antifibrogenic. Transforming growth factor-β1 (TGF-β1) is pro-fibrogenic cytokine and plays a key role in liver fibrogenesis. Interferon-γ (INF-γ) is anti-fibrogenic by downregulating hepatic stellate cell activation. We described the negative correlation between tumor necrosis factor-α (TNF-α) and IFN-γ concentration in serum during disturbed lymph flow from a liver of rats. TNF-α plays a antifibrogenic role in liver fibrogenesis too. Male Albino Wistar rats weighing 250 - 300 grams were selected for the experiment. The animals were kept in stable condition and were fed a standard diet with no fluid restriction. The rats were divided into 3 groups: group B - mechanical insufficiency was obtained by ligation of hepatic trunc, group K - underwent sham operation, group 0 - rats not subjected to any surgery. The animals were sacrificed for experiment in 1, 3, 7, 14, 21, 28, 35, 56 and 103 day after operation. During experiment TGF-β1 and TNF-α concentration in serum were assayed. We observed a positive correlation between TGF-β1 and TNF-α concentration in serum. During disturbed lymph flow from the liver TNF-α plays probably a antifibrogenic role in liver fibrogenesis.

A unified approach to fast teller queues and ATM

This paper examines a problem of importance to the telecommunications industry. In the design of modern ATM switches, it is necessary to use simulation to estimate the probability that a queue within the switch exceeds a given large value. Since these are extremely small probabilities, importance sampling methods must be used. Here we obtain a change of measure for a broad class of models with direct applicability to ATM switches.

We consider a model with A independent sources of cells where each source is modeled by a Markov renewal point process with batch arrivals. We do not assume the sources are necessarily identically distributed, nor that batch sizes are independent of the state of the Markov process. These arrivals join a queue served by multiple independent servers, each with service times also modeled as a Markov renewal process. We only discuss a time-slotted system. The queue is viewed as the additive component of a Markov additive chain subject to the constraint that the additive component remains non-negative. We apply the theory in McDonald (1999) to obtain the asymptotics of the tail of the distribution of the queue size in steady state plus the asymptotics of the mean time between large deviations of the queue size.

Eosinophil activities modulate the immune/inflammatory character of allergic respiratory responses in mice

BACKGROUND

The importance and specific role(s) of eosinophils in modulating the immune/inflammatory phenotype of allergic pulmonary disease remain to be defined. Established animal models assessing the role(s) of eosinophils as contributors and/or causative agents of disease have relied on congenitally deficient mice where the developmental consequences of eosinophil depletion are unknown.

METHODS

We developed a novel conditional eosinophil-deficient strain of mice (iPHIL) through a gene knock-in strategy inserting the human diphtheria toxin (DT) receptor (DTR) into the endogenous eosinophil peroxidase genomic locus.

RESULTS

Expression of DTR rendered resistant mouse eosinophil progenitors sensitive to DT without affecting any other cell types. The presence of eosinophils was shown to be unnecessary during the sensitization phase of either ovalbumin (OVA) or house dust mite (HDM) acute asthma models. However, eosinophil ablation during airway challenge led to a predominantly neutrophilic phenotype (>15% neutrophils) accompanied by allergen-induced histopathologies and airway hyper-responsiveness in response to methacholine indistinguishable from eosinophilic wild-type mice. Moreover, the iPHIL neutrophilic airway phenotype was shown to be a steroid-resistant allergic respiratory variant that was reversible upon the restoration of peripheral eosinophils.

CONCLUSIONS

Eosinophil contributions to allergic immune/inflammatory responses appear to be limited to the airway challenge and not to the sensitization phase of allergen provocation models. The reversible steroid-resistant character of the iPHIL neutrophilic airway variant suggests underappreciated mechanisms by which eosinophils shape the character of allergic respiratory responses.

Preparation of reference stocks suitable for evaluation of alternative NAT-based mycoplasma detection methods

AIMS

The aim of this study was to optimize conditions for preparation and cryopreservation of mycoplasma reference materials suitable to evaluate alternative nucleic acid testing (NAT)-based assays and to compare their limits of detection (LODs) with those of conventional culture-based methods.

METHODS AND RESULTS

Acholeplasma laidlawii, Mycoplasma gallisepticum and Mycoplasma arginini stocks with low ratios of genomic copies to colony forming units (12, 8 and 4, respectively) harvested in early stationary phases of growth were preserved with different cryoprotective agents (CPAs) under slow (1°C min(-1)), moderate (8°C min(-1)), fast (13°C min(-1)) and 'snapshot' (60°C min(-1)) cooling rates. Depending on mycoplasma species, increasing the cooling rate from slow to snapshot enhanced cell survival up to 5-fold. The addition of 10% (v/v) dimethyl sulfoxide (DMSO) and 15% (v/v) glycerol significantly improved cell survival of all tested strains. Cryoprotected stocks maintained high and stable titres for at least 1 year during storage at -80°C. Sonication of cell cultures prior to cryopreservation enhanced cell dispersion and reduced of GC/CFU ratios.

CONCLUSIONS

It is feasible to prepare stable reference stocks of cryopreserved mycoplasma cells suitable to reliably compare NAT- and culture-based mycoplasma testing methods.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study describes experimental results demonstrating the preparation and storage of highly viable and dispersed mycoplasma reference stocks suitable for comparing alternative NAT-and conventional culture-based mycoplasma detection methods.

Up-regulation of Neuropeptide Y Receptors in the Hypothalamus of Monosodium Glutamate-lesioned Sprague-Dawley Rats

Monosodium-glutamate (MSG) is neurotoxic for brain regions devoid of blood-brain barrier when it is injected at high doses during the neonatal period. Neuropeptide Y (NPY) neurons in the arcuate nucleus are particularly sensitive to MSG treatment. But, despite of the large decrease of this potent orexigenic peptide, feeding behavior is only slightly affected. We hypothesized that the hypothalamic NPY receptor system might be modified in these rats. The present study characterizes hypothalamic NPY and NPY receptors in normal and MSG-treated rats. MSG-treated rats were lighter (p < 0.01) and ate 17% less than the control rats (p < 0.01). NPY levels in the mediobasal and mediodorsal hypothalamus were reduced in MSG-treated rats compared to normal rats (-26% and -43%, p < 0.05 and p < 0.01, respectively). Combined hypothalamic Y1 and Y5 NPY receptor density was increased in MSG-treated rats compared to normal rats (+25%, p < 0.04), but affinity remained unaltered. Blockade with a selective Y1 antagonist showed that the Y1 receptor subtype represented more than 90% of the combined Y1 and Y5 receptor populations. The up-regulation of the NPY receptors is an element necessary to maintain food intake at a sufficient level to allow survival and growth of the lesioned rats.

[Health-related quality of life of people with severe traumatic injury: a longitudinal study using the SF-36 health survey]

Even though 85 percent of those who have been severely injured in an accident in Germany survive, complex and serious long-term consequences are still a major problem not only for health and care insurance providers but also for the accident victims themselves because their quality of life is affected permanently. Therefore the aim of the current study is to identify factors that significantly improve the quality of life after a severe traumatic injury and to investigate whether the support by a reintegration service has a positive effect on the victims' quality of life. The sample consisted of severely injured accident victims who were supported by a reintegration service. The data collection comprised three data points. At every data point the SF-36 questionnaire was used to assess the participants' quality of life. The results indicate that an individual medical-vocational support by a reintegration service has the potential to significantly and stably improve the physical aspects of quality of life, even if the accident dates back several years. Furthermore it appears to be important to support the independence of the accident victims because assistance by a third person correlates with a lower degree of physical quality of life, regardless of severity or type of injury. Moreover it becomes clear that it is important to pay more attention to the treatment of psychological consequences of severe accidents.

Electrocardiographic changes in workers occupationally exposed to lead

BACKGROUND

The significance of heavy metals in pathogenesis of the circulatory system diseases remains unresolved. The aim of the study was to evaluate electrocardiographic changes in workers occupationally exposed to lead without clinical presentation of cardiac involvement.

METHODS

A group of 60 smelters and refiners and 45 healthy men, as a control group, were enrolled. Twelve-lead electrocardiogram (ECG) and 24-hour Holter monitoring were performed. Further analysis included heart rate variability (HRV) in time and frequency domains and heart rate turbulence (HRT).

RESULTS

Analysis of 12-lead ECG recordings revealed various pathologies in 27 out of 60 men occupationally exposed to lead. Twenty-four-hour ECG Holter monitoring showed the higher mean heart rate in copper smelters than in healthy subjects (85.8 ± 14.1 bpm vs 72.6 ± 9.2 bpm; P < 0.05) and more premature supraventricular and ventricular contractions (298 ± 235 vs 27 ± 45; P < 0.05 and 152 ± 138 vs 18 ± 18; P < 0.05, respectively). The majority of time domain and frequency domain HRV parameters were significantly lower, and the LF:HF ratio was higher when compared with the control group. Turbulence onset was abnormal in six copper smelters and turbulence slope in five men exposed to lead.

CONCLUSIONS

Electrocardiographic evaluation showed that various heart rhythm disorders were more frequent in metallurgists, as compared to the control group, and the decreased HRV and abnormal parameters of HRT were observed. Noninvasive electrocardiographic evaluation could be a valuable method of the early prediction of cardiovascular disorders in men occupationally exposed to lead.

Orai1 contributes to the establishment of an apoptosis-resistant phenotype in prostate cancer cells

The molecular nature of calcium (Ca²⁺)-dependent mechanisms and the ion channels having a major role in the apoptosis of cancer cells remain a subject of debate. Here, we show that the recently identified Orai1 protein represents the major molecular component of endogenous store-operated Ca²⁺ entry (SOCE) in human prostate cancer (PCa) cells, and constitutes the principal source of Ca²⁺ influx used by the cell to trigger apoptosis. The downregulation of Orai1, and consequently SOCE, protects the cells from diverse apoptosis-inducing pathways, such as those induced by thapsigargin (Tg), tumor necrosis factor α, and cisplatin/oxaliplatin. The transfection of functional Orai1 mutants, such as R91W, a selectivity mutant, and L273S, a coiled-coil mutant, into the cells significantly decreased both SOCE and the rate of Tg-induced apoptosis. This suggests that the functional coupling of STIM1 to Orai1, as well as Orai1 Ca²⁺-selectivity as a channel, is required for its pro-apoptotic effects. We have also shown that the apoptosis resistance of androgen-independent PCa cells is associated with the downregulation of Orai1 expression as well as SOCE. Orai1 rescue, following Orai1 transfection of steroid-deprived cells, re-established the store-operated channel current and restored the normal rate of apoptosis. Thus, Orai1 has a pivotal role in the triggering of apoptosis, irrespective of apoptosis-inducing stimuli, and in the establishment of an apoptosis-resistant phenotype in PCa cells.

Primate-specific RFPL1 gene controls cell-cycle progression through cyclin B1/Cdc2 degradation

Ret finger protein-like 1 (RFPL1) is a primate-specific target gene of Pax6, a key transcription factor for pancreas, eye and neocortex development. However, its cellular activity remains elusive. In this article, we report that Pax6-elicited expression of the human (h)RFPL1 gene in HeLa cells can be enhanced by in vivo p53 binding to its promoter and therefore investigated the hypothesis that hRFPL1 regulates cell-cycle progression. Upon expression in these cells, hRFPL1 decreased cell number through a kinase-dependent mechanism as PKC activates and Cdc2 inhibits hRFPL1 activity. hRFPL1 antiproliferative activity led to an increased cell population in G(2)/M phase and specific cyclin B1 and Cdc2 downregulations, which were precluded by a proteasome inhibitor. Specifically, cytoplasm-localized hRFPL1 prevented cyclin B1 and Cdc2 accumulation during interphase. Consequently, cells showed a delayed entry into mitosis and cell-cycle lengthening resulting from a threefold increase in G(2) phase duration. Given previous reports that RFPL1 is expressed during cell differentiation, its impact on cell-cycle lengthening therefore provides novel insights into primate-specific development.

Dietary modulation of ghrelin and leptin and gorging behavior after weight loss in the obese Zucker rat

In this study, we measured ghrelin and leptin in obese Zucker rats after weight loss induced by calorie restriction using either a low-fat (LF) or high-energy palatable (HEPa) diet. After weight loss, the animals were refed lab chow and offered one hour-palatable test meals on the second and fifteenth days of refeeding. Both LF and HEPa rats lost 10% of their initial body weight (P<0.0001). Plasma ghrelin increased with calorie restriction in both groups (P<0.002) with a tendency to a higher increase in the HEPa group while plasma leptin decreased only in the LF group (P<0.01). Both groups ate the same quantity of chow during refeeding and both groups gorged on palatable diet during test meals at a very high constant intensity in HEPa rats. After one week of refeeding, ghrelin levels remained elevated in HEPa rats (+33.2%; P<0.001) while returning to baseline in LF rats. Plasma leptin remained low in LF rats. We conclude that weight loss on a palatable diet is possible if total energy intake is controlled. After stopping restriction, when a palatable diet is available, observed gorging might be dependent on specific ghrelin and leptin changes.

[13C2]oxalate absorption in children with idiopathic calcium oxalate urolithiasis or primary hyperoxaluria

Intestinal oxalate absorption is an important part of oxalate metabolism influencing its urinary excretion and its measurement can be a valuable diagnostic tool in hyperoxaluric disorders. In this study, we use [(13)C(2)]oxalate absorption under standardized dietary conditions to assess intestinal oxalate absorption and its impact on urinary oxalate excretion. Tests were conducted in age-matched pediatric patients that included 60 with idiopathic calcium oxalate urolithiasis, 13 with primary hyperoxaluria, and 35 healthy children. In the idiopathic stone formers, median oxalate absorption was significantly higher than that in the controls or in patients with primary disease. From standardized values obtained in control patients, oxalate hyperabsorption was detected in 23 patients with idiopathic disease but not in any patients with primary hyperoxaluria; therefore, a significant correlation between intestinal absorption and urinary excretion was found only in those with the idiopathic disease. We have shown that increased intestinal oxalate absorption is an important risk factor of idiopathic calcium oxalate urolithiasis. In contrast, low intestinal oxalate absorption in patients with primary hyperoxaluria indicates that only foods with excessive oxalate content be restricted from their diet.

Neuropeptide Y in normal eating and in genetic and dietary-induced obesity

Neuropeptide Y (NPY) is one the most potent orexigenic peptides found in the brain. It stimulates food intake with a preferential effect on carbohydrate intake. It decreases latency to eat, increases motivation to eat and delays satiety by augmenting meal size. The effects on feeding are mediated through at least two receptors, the Y1 and Y5 receptors. The NPY system for feeding regulation is mostly located in the hypothalamus. It is formed of the arcuate nucleus (ARC), where the peptide is synthesized, and the paraventricular (PVN), dorsomedial (DMN) and ventromedial (VMN) nuclei and perifornical area where it is active. This activity is modulated by the hindbrain and limbic structures. It is dependent on energy availability, e.g. upregulation with food deprivation or restriction, and return to baseline with refeeding. It is also sensitive to diet composition with variable effects of carbohydrates and fats. Leptin signalling and glucose sensing which are directly linked to diet type are the most important factors involved in its regulation. Absence of leptin signalling in obesity models due to gene mutation either at the receptor level, as in the Zucker rat, the Koletsky rat or the db/db mouse, or at the peptide level, as in ob/ob mouse, is associated with increased mRNA abundance, peptide content and/or release in the ARC or PVN. Other genetic obesity models, such as the Otsuka-Long-Evans-Tokushima Fatty rat, the agouti mouse or the tubby mouse, are characterized by a diminution in NPY expression in the ARC nucleus and by a significant increase in the DMN. Further studies are necessary to determine the exact role of NPY in these latter models. Long-term exposure to high-fat or high-energy palatable diets leads to the development of adiposity and is associated with a decrease in hypothalamic NPY content or expression, consistent with the existence of a counter-regulatory mechanism to diminish energy intake and limit obesity development. On the other hand, an overactive NPY system (increased mRNA expression in the ARC associated with an upregulation of the receptors) is characteristic of rats or rodent strains sensitive to dietary-induced obesity. Finally, NPY appears to play an important role in body weight and feeding regulation, and while it does not constitute the only target for drug treatment of obesity, it may nevertheless provide a useful target in conjunction with others.

Oxalobacter formigenes: a potential tool for the treatment of primary hyperoxaluria type 1

Primary hyperoxaluria is characterized by severe urolithiasis, nephrocalcinosis, and early renal failure. As treatment options are scarce, we aimed for a new therapeutic tool using colonic degradation of endogenous oxalate by Oxalobactor formigenes. Oxalobacter was orally administered for 4 weeks as frozen paste (IxOC-2) or as enteric-coated capsules (IxOC-3). Nine patients (five with normal renal function, one after liver-kidney transplantation, and three with renal failure) completed the IxOC-2 study. Seven patients (six with normal renal function and one after liver-kidney transplantation) completed the IxOC-3 study. Urinary oxalate or plasma oxalate in renal failure was determined at baseline, weekly during treatment and for a 2-week follow-up. The patients who showed >20% reduction both at the end of weeks 3 and 4 were considered as responders. Under IxOC-2, three out of five patients with normal renal function showed a 22-48% reduction of urinary oxalate. In addition, two renal failure patients experienced a significant reduction in plasma oxalate and amelioration of clinical symptoms. Under IxOC-3 treatment, four out of six patients with normal renal function responded with a reduction of urinary oxalate ranging from 38.5 to 92%. Although all subjects under IxOC-2 and 4 patients under IxOC-3 showed detectable levels of O. formigenes in stool during treatment, fecal recovery dropped directly at follow up, indicating only transient gastrointestinal-tract colonization. The preliminary data indicate that O. formigenes is safe, leads to a significant reduction of either urinary or plasma oxalate, and is a potential new treatment option for primary hyperoxaluria.

Angiogenic and coagulation-fibrinolysis factors in non Hodgkin's lymphoma

High serum VEGF and bFGF levels are independent prognostic factors of poor prognosis in NHL patients. There is growing evidence that both angiogenesis and haemostatic aberrancies are integral parts of the pathobiology of cancer growth and dissemination. The purpose of the study was: (a) to analyze relations of VEGF and bFGF serum levels, fibrinogen and D-dimer plasma levels with lymphoma Ann Arbor Staging System (AASS) and International Prognostic Index (IPI) and, (b) to evaluate correlations between serum levels of angiogenic cytokines and plasma levels of coagulation-fibrinolysis factors in 52 previously untreated NHL patients included to the study. The control group consisted of 23 healthy volunteers. Serum VEGF, bFGF and plasma D-dimer levels were measured by enzyme-linked immunosorbent assay (ELISA). Plasma levels of fibrinogen were determined on Behring Coagulation System (BCS) equipment. In lymphoma group serum VEGF and bFGF levels were significantly higher than in the control. Differences in concentrations of VEGF, bFGF between II, III and IV stage of disease acc. AASS were not statistically significant. Plasma levels of fibrinogen and D-dimer were elevated in lymphoma patients when compared with the control. Fibrinogen plasma levels were similar in all stages. The D-dimer level was significantly higher in patients with IV stage in comparison to stage II and III. Statistically significant differences of VEGF and bFGF serum levels were observed only between intermediate/high and high risk groups acc. IPI. Fibrinogen plasma levels were significantly higher in high risk group than in low risk group. D-dimer plasma levels were significantly higher in high risk group than in low risk group and low/intermediate group. We observed positive correlation between serum level of VEGF and plasma level of fibrinogen, and between serum level of bFGF and plasma level of fibrinogen. There was also negative correlation between serum level of VEGF and plasma level of D-dimer, and between serum level of bFGF and plasma level of D- dimer. Our study indicates that D-dimer level, but not VEGF, bFGF and fibrinogen correlates with AASS and IPI in NHL patients. Significant correlations between levels of VEGF/bFGF and fibrinogen/D-dimer suggest specific interactions between angiogenic and coagulation-fibrinolysis system.

[New image of occupational medicine--current problems, future solutions]

Current problems in occupational medicine result mainly from the situation in which existing structures are not appropriately adapted to the changes in economy, work market structures and social and demographic trends, which rapidly appeared within the last decade. The Act of Occupational Medicine Service in force precisely defines the duties of occupational medicine services. However, although the legal powers seem clear and detailed, the possibility of real actions is not put in order and encounters many barriers. The changes in structures of economy, enterprises and work market result in the situation in which despite the obligatory preventive examination system, there is a large group of people that are not subject to them. Care of workers in bigger companies or institutions is also the source of problems concerning mainly the examination range, but also the identification of new threats connected with ergonomics, psychological or biological factors; their limiting, monitoring and prevention. A broad issue of provided service qualities is closely connected with the problems mentioned above. Another question is defining the quality control system, the execution of post-control suggestions and the possibility of applying possible sanctions. A significant task is also to modify the examining and specialisation acquirement system. In the creation of the new image of occupational medicine in Poland the most significant issue is to correct the current legal grounds by introducing new standards of health protection for working people, enable to provide high- quality services, create the conditions for functioning of multidiscipline teams preventively caring of working people, being a guarantee of health and economic benefits for the society.

Diagnosis and metaphylaxis of stone disease. Consensus concept of the National Working Committee on Stone Disease for the upcoming German Urolithiasis Guideline

This review draws the recent state of the art in metabolic diagnosis and metaphylaxis of stone disease. It is the basis for the consensus approval with the other medical societies and institutions in Germany involved in the guideline process of the new "Urolithiasis Guideline". The German Working Committee on Stone Disease reviewed critically the current literature in the field of urolithiasis-including the existing German and EAU-Guidelines as well as the Conference Book of the First International Consultation on Stone Disease. As far as possible the references were rated according to the EBM criteria. On this basis the expert group discussed all pathways and statements regarding the management of stone disease. The present review coincides with the consented guideline draft of the German Working Committee on Stone Disease. Occurrence of stone disease in the western world increases seriously. Modern lifestyle, dietary habits and overweight-problems of the affluent societies-emerge to be the important promoters of the "stone-boom" in the new millennium. This even affects children, whose stone prevalence is otherwise significantly less than that of adults. Criteria for the high risk group of stone formers were clearly defined. A diagnostic standard is formulated for the basic and the elaborate metabolic evaluation of a stone patient. Approximately 75% of all stone patients could anticipate stone recurrence with elementary reorientation of their lifestyle and dietary habits, summarized as general metaphylaxis. About 25% of the stone formers require additional pharmacological intervention to normalize their individual biochemical risk, precisely compiled for each stone type as specific metaphylaxis.

Persistent alterations in neuropeptide Y release in the paraventricular nucleus of rats subjected to dietary manipulation during early life

The aim of the present experiment was to determine the influence of nutritional manipulations during early life on feeding regulatory mechanisms. For this purpose, neuropeptide Y (NPY) release in the hypothalamic paraventricular nucleus was measured in male offspring born to dams fed either on a control (C) diet, on a high-carbohydrate (HC) diet or on a high-fat (HF) diet during gestation and lactation periods. In addition, we examined the development of dietary preferences in these rats. NPY release was measured in vivo through the push-pull technique after a stimulation with 2-deoxy-glucose (2DG), a blocker of carbohydrate metabolism. NPY release was significantly enhanced in the HC rats after 2DG (+89% vs. control and +54% vs. HF rats; P < 0.01). In a two-bottle choice test, a clear preference for carbohydrate (62% vs. 38%; P < 0.01) was present as early as 30 days of age in control rats. The establishment of this preference in HC and HF rats was delayed by 2 and 3 months, respectively. Therefore, each type of dietary manipulation during early life has left a specific imprint in the offspring. The change in reactivity of the NPY system to glucopenia persisted in adulthood. When combined with the early changes in the dietary preferences, this can lead to adverse effects on body weight when abundant and palatable food is offered. These data support the hypothesis of an intrauterine and perinatal programming of the central regulatory mechanisms and reinforce the necessity of a preventive approach for the treatment of obesity and related metabolic disorders.

[Coexistence of pneumoconiosis with myelodysplastic syndrome in a coal miner occupationally exposed to coal dust]

Pneumoconiosis is the most common occupational disease of the respiratory system. The aim of this paper is presentation of case of pneumoconiosis coexisting with myelodysplastic syndrome in a former coal miner occupationally exposed to coal dust. In a mineral coal miner, aged 56 year, with a 15-year duration of work underneath, suffering from pneumoconiosis, pancytopenia was detected. He was admitted to the hospital, where myelodysplastic syndrome was diagnosed. The patient's condition was gradually worsening, even though chemotherapy was applied, he died from thrombocytopenia manifested by bleeding from the digestive tract in a relatively short time since diagnosis. The presented case seems to be interesting not only in view of possible development of pneumoconiosis as a result of occupational exposure to coal dust, typical in this case, but also in view of the occurrence of clonal disease of blood several years after cessation of exposure.