Psychological Factors Influencing Consumer Intentions to Consume Cultured Meat, Fish and Dairy

This study investigates the structure of factors that influence consumer intentions to both try and to consume cultured proteins, and their intentions to substitute vegan, vegetarian and omnivore diets with these alternative protein sources. Comprehensive survey data (N=3,862) was collected from three Nordic countries (Denmark, Finland, and Norway) and analysed using confirmatory factor analysis and structural equation modelling. Theoretically, this article draws from behavioural models of environmental psychology, identity theory, and attitude theory. Results indicate that beliefs about the necessity of an industry producing cultured proteins and impacts of cultured proteins on the global economy are significant predictors of consumer intentions. Moreover, participants who exhibited high levels of general and food innovativeness were more likely to express positive intentions to consume cultured proteins. Social norms influenced consumer intentions: Individuals surrounded by positive attitudes and intentions toward cultured proteins within their social networks were more inclined to want to consume these products. The predictor variables in the final model accounted for between 39% and 66% of the variance in the different cultured proteins related intentions. Understanding consumer intentions better can inform targeted communication strategies aimed at promoting the advantages of cultured proteins and facilitating its adoption.

Enzalutamide and abiraterone in the treatment of patients with metastatic castration-resistant prostate cancer treated previously with chemotherapy

BACKGROUND

The evaluation of treatment outcomes and toxicity in patients with metastatic castration-resistant prostate cancer (mCRPC) treated by enzalutamide or abiraterone after previous docetaxel.

PATIENTS AND METHODS

We analyzed 66 patients with mCRPC treated by enzalutamide (55 patients) or abiraterone (11 patients) after previous therapy with docetaxel. The median follow-up was 31.2 months. Enzalutamide and abiraterone were administered in daily doses of 160 mg and 1,000 mg per day, respectively. The progression free survival (PFS) and overall survival (OS) were estimated by Kaplan-Meier analysis. The prognostic influence of the factors on OS was evaluated by regression analysis.

RESULTS

The progression was observed in 55 (83%) patients, and mPFS was 12.1 (95% CI 7.7-16.4) months. In total, 43 patients died, and he median OS was 21.9 (95% CI 12.2-31.7) months. In the regression analysis, we observed statistical favorable influence of the following factors on OS: PSA decrease ≥ 50%, in patients with early decrease of prostatic specific antigen (PSA) ≥ 50% in 3 months after initiation of enzalutamide or abiraterone treatment, in patients with visceral metastatic sites, in patients treated with only one regimen of previous chemotherapy and in those without anemia. We observed the toxicity grades 3-4 in 45.5% and 36.3% patients treated with enzalutamide and abiraterone, respectively.

CONCLUSION

Our analysis demonstrated efficacy and good tolerance in patients with mCRPC treated with enzalutamide and abiraterone after previous docetaxel therapy.

BepiColombo mission confirms stagnation region of Venus and reveals its large extent

The second Venus flyby of the BepiColombo mission offer a unique opportunity to make a complete tour of one of the few gas-dynamics dominated interaction regions between the supersonic solar wind and a Solar System object. The spacecraft pass through the full Venusian magnetosheath following the plasma streamlines, and cross the subsolar stagnation region during very stable solar wind conditions as observed upstream by the neighboring Solar Orbiter mission. These rare multipoint synergistic observations and stable conditions experimentally confirm what was previously predicted for the barely-explored stagnation region close to solar minimum. Here, we show that this region has a large extend, up to an altitude of 1900 km, and the estimated low energy transfer near the subsolar point confirm that the atmosphere of Venus, despite being non-magnetized and less conductive due to lower ultraviolet flux at solar minimum, is capable of withstanding the solar wind under low dynamic pressure.

Building bridges between natural and social science disciplines: a standardized methodology to combine data on ecosystem quality trends

Despite a growing interest in interdisciplinary research, systematic ways of how to integrate data from different disciplines are still scarce. We argue that successful resource management relies on two key data sources: natural science data, which represents ecosystem structure and processes, and social science data, which describes people's perceptions and understanding. Both are vital, mutually complementing information sources that can underpin the development of feasible and effective policies and management interventions. To harvest the added value of combined knowledge, a uniform scaling system is needed. In this paper, we propose a standardized methodology to connect and explore different types of quantitative data from the natural and social sciences reflecting temporal trends in ecosystem quality. We demonstrate this methodology with different types of data such as fisheries stocks and mangrove cover on the one hand and community's perceptions on the other. The example data are collected from three United Nations Educational Scientific and Cultural Organization (UNESCO) Biosphere reserves and one marine park in Southeast Asia. To easily identify patterns of convergence or divergence among the datasets, we propose heat maps using colour codes and icons for language- and education-independent understandability. Finally, we discuss the limitations as well as potential implications for resource management and the accompanying communication strategies.

This article is part of the theme issue ‘Nurturing resilient marine ecosystems’.

Temporal trends in the characteristics, treatment and clinical outcomes of conservatively managed patients with non-ST elevation acute coronary syndrome: ACSIS registry 2000–2016

Background

Despite advances in percutaneous coronary interventions (PCI), a sub group of acute coronary syndrome (ACS) patients are still managed medically by a conservative approach. We sought to characterize a contemporary, large-scale, real-world cohort of ACS patients treated conservatively via pharmacological management, without PCI.

Methods

Data from the ACS Israeli Survey (ACSIS) accrued between 2000–2016, encompassing all consecutive patients admitted to cardiology wards with an ACS diagnosis. Examined were 3543 conservatively managed patients with non-ST elevation ACS (NSTE-ACS). Patients with ST elevation MI or those referred to bypass surgery were excluded. Primary endpoints were 30-day major adverse cardiovascular events (MACE) and 1-year mortality. The study cohort was divided to 4 time-periods.

Results

Over 2 decades, medically managed NSTE-ACS patients remained of similar age (67±13y, p=0.78), but had more atherosclerotic risk-factors and comorbidities. During time, patients were more often referred to diagnostic angiography and treated with statins, ACE-I/ARBs, and P2Y12 inhibitors (p<0.001 for each). Over time, there were less in-hospital complications such as kidney injury and heart failure. The rate of 30-day MACE decreased (from 20.7% to 10.3%, earliest to latest period, p<0.001). Compared with the earliest period, the latest period was associated with a reduction in 1-year mortality (14.7% to 11.6%; adjusted HR 0.65, 95% CI 0.47–0.90).

Conclusions

Over two decades, in medically managed NSTE-ACS patients, short term prognosis has significantly improved while 1-year mortality demonstrated improvement only recently, likely due to incremental benefits of medical management. Further studies are needed to examine treatment modalities in these unique ACS patients.

Funding Acknowledgement

Type of funding sources: None. Kaplan Meier survival curvesTrends in management and Angiographies

[Docetaxel-Cabazitaxel-Enzalutamide Versus Docetaxel-Enzalutamide in Patients with Metastatic Castration-resistant Prostate Cancer]

AIM

The aim of this retrospective study was to compare the efficacy of the sequence docetaxel-cabazitaxel-enzalutamide vs. docetaxel-enzalutamide in patients with metastatic castration-resistant prostate cancer.

PATIENTS AND METHODS

Of the cohort of 35 patients, 11 were treated with the sequence docetaxel-cabazitaxel-enzalutamide and 24 were treated with the sequence docetaxel-enzalutamide. The doses were as follows: docetaxel, 75 mg/m2; cabazitaxel, 25 mg/m2; and enzalutamide, 160 mg/day. Overall survival (OS) was defined as the interval between the initial dose of docetaxel and death or the date of the last control for survivors (censored). OS was assessed using the Kaplan-Meier method, and the two arms were compared using the log-rank test. The significance level for all statistical tests was set at α = 0.05.

RESULTS

The median OS of patients treated with the sequence docetaxel-cabazitaxel-enzalutamide was 28.8 months, vs. 24.4 months in patients treated with the sequence docetaxel-enzalutamide. No statistically significance differences in OS were found between the two arms (HR 0.678, 95% CI 0.264-1.744; p = 0.418). Grade 3-4 toxicity was observed for each drug, as follows: docetaxel: fatigue and peripheral neuropathy in six patients, nausea in three patients, and diarrhea and neutropenia in one patient; cabazitaxel: anemia in two patients and neutropenia in one patient; and enzalutamide: anemia in six patients, thrombocytopenia in two patients, and cerebral hemorrhage in one patient.

CONCLUSION

No statistically significant differences in OS were found between the sequences docetaxel-cabazitaxel-enzalutamide and docetaxel-enzalutamide.Key words: prostate cancer - metastasis - chemotherapy - targeted hormonal treatment The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 13. 2. 2017Accepted: 20. 3. 2017.

[Enzalutamide and Abiraterone in the Treatment of Metastatic Castration-resistant Prostate Cancer after Chemotherapy]

AIM

Enzalutamide and abiraterone represent new therapeutical options in the treatment of metastatic castration-resistant prostate cancer (mCRPC). The aim of the presented study was retrospective analysis of clinical experience and efficacy of enzalutamide or abiraterone in the postchemo indication in patients with mCRPC.

PATIENTS AND METHODS

A total of 32 mCRPC patients were evaluated. All patients received one or more lines of chemotherapy. Twenty-three patients were treated by enzalutamide, nine patients were treated by abiraterone. We defined two parameters: over all survival and progression-free survival.

RESULTS

The median follow-up was 6.5 months. A total of 10 patients treated by enzalutamide progressed (43.47%) and eight patients died (34.78%). A total of five patients treated by abiraterone progressed (55.56%) and one patient died (11.11%). We did not observe any statistical difference in over all survival (HR 0.2362, 95% CI 0.0295- 1.8942; p = 0.102) and in progression-free survival (HR 0.9853, 95% CI 0.2934- 3.308; p = 0.939) between enzalutamide and abirateron.

CONCLUSION

Our retrospective study demonstrated similar efficacy of enzalutamide and abiraterone in mCRPC patients previously treated by chemotherapy.

The prognostic significance of epidermal growth factor receptor expression in patients with anal carcinoma

The aim of the present retrospective study was to evaluate the prognostic significance of epidermal growth factor receptor (EGFR) expression in patients treated with radiotherapy or concomitant chemoradiotherapy for squamous cell anal cancer (SCAC)Patients and methods: A total of 17 patients with SCAC (clinical stages I-III) were studies. All patients were treated with radiotherapy (total dose range 40 - 68 Gy), 13 patients received concomitant chemotherapy (7 patients mitomycin/5-fluorouracil, 5 patients cisplatine/5-fluorouracil, 1 patient cisplatine weekly). EGFR expression in the pretreatment biopsieswas assessed with imunohistochemistry.Patients with EGFR expression had significantly shorter progression free survival (PFS) (p=0.0109; HR 9.38, 95% CI 1.75 - 50.35) and overall survival (OS) (p=0.0351; HR 7.11, 95% CI 1.4 - 36.13) than patients without expression EGFR. The 4-year PFS in patients with increased EGFR expression was only 28.57% (95% CI 17.07 - 62.04%) compared to 87.5% (95% CI 64.58 - 100%) in patients without EGFR expression. The 4-year OS in patients with increased EGFR expression was only 50.0% (95% CI 15.35 - 84.65%) compared to 87.5% (95% CI 64.58 - 100.0%) in patients without EGFR expression.Patients with expression EGFR had significantly shorter PFS and OS compared with patients without EGFR expression.

[The Possibility of Epidermal Growth Factor Receptor Inhibition in Anal Cancer]

Anal cancer is a relatively rare tumour. In local and locally advanced disease, concomitant chemoradiation based on mitomycin C and 5-fluorouracil, remains golden standard of treatment. However, this treatment is associated with significant morbidity. With the developing of molecular biology, new treatment strategies can be investigated. Epidermal growth factor receptor (EGFR) expression in anal cancer is observed in 55-100% of cases. Some studies demonstrated that KRAS mutations, mechanism marker of resistance to antiEGFR therapy, are rare in anal cancer. This paper presents current view on the possibilities of antiEGFR therapy in locally advanced and metastatic anal cancer.

[Influence of preoperative chemoradiotherapy on changes of epidermal growth factor receptor expression in patients treated by preoperative chemoradiotherapy for local advanced rectal carcinoma]

AIM

The aim of this retrospective study was to determine the prognostic impact of expression of epidermal growth factor receptor (EGFR) changes during neoadjuvant chemoradiotherapy in patients with locally advanced rectal adenocarcinoma.

MATERIAL AND METHODS

One hundred and three patients with locally advanced rectal adenocarcinoma of stage II and III were evaluated. All patients were administered the total dose of 44 --  50.4 Gy. Concomitantly, the patients received capecitabine in the dose 825 mg/ m² in two daily oral administrations or 5- fluorouracil in the dose 200 mg/ m² in continuous infusion. Surgery was indicated at intervals of 4-8 weeks from chemoradiotherapy completion. EGFR expression in the pretreatment biopsies and in resected specimens was assessed with immunohistochemistry.

RESULTS

All of 103 patients received radiotherapy without interruption up to the total planned dose. Downstaging was described in 64 patients. Six patients had complete pathologic remission. Recurrence occurred in 49 patients. Local recurrence was found in 22 patients, generalization of disease was reported in 27 patients. A total of 51 patients died. Increased EGFR expression was found in 26 patients. The statistically significantly shorter overall survival (p < 0.001) and disease-free survival (p < 0.001) was found in patients with increased expression of EGFR compared with patients where no increase in the expression of EGFR was observed during neoadjuvant chemoradiotherapy.

CONCLUSIONS

The overexpression of EGFR during neoadjuvant chemoradiotherapy for locally advanced rectal adenocarcinoma is associated with significant shorter overall survival and disease-free survival.

Primary cilia in gastrointestinal stromal tumors

The primary cilium is a solitary, sensory, non-motile microtubule-based structure that arises from the centrosome and is projected from the surface of most human cells. The objective of the current pilot study was to conduct an investigation of presence and frequency of cilia in gastrointestinal stromal tumors (GIST).The presence of primary cilia in GIST was evaluated in 9 patients, including 8 primary tumors and 1 liver metastasis. In 2 patients the presence of primary cilia was evaluated not only in the primary tumor, but also in recurrence: in 1 patient in recurrence without previous treatment with imatinib and in 1 patient in recurrence after treatment with imatinib. The primary cilia of GIST cells were immunofluorescently stained with primary monoclonal anti-acetylated tubulin alpha antibody and cell nuclei with DAPI.We observed 9985 nuclei of cells of GISTs and 425 primary cilia in total. The median of frequency of primary cilia in cells of GISTs in all examined samples was 4.26%, in primary tumors was 4.32% and in metastases was 3.64%, respectively. This pilot study provides the evidence of the presence of primary cilia in GISTs in different organs. Primary cilia were identified in all examined cases of GIST, including primary tumors, metastases and recurrent lesions without and with previous treatment with imatinib.

[The combination of neoadjuvant chemoradiotherapy and epidermal growth factor receptor inhibitors in the treatment of rectal adenocarcinoma]

Rectal adenocarcinoma, in contrast to colorectal carcinoma, is typical of its high local reccurence rate. Radiotherapy is proved to reduce the incidence of recurrences. Neoadjuvant chemoradiotherapy demonstrated better treatment results than adjuvant chemoradiotherapy. Standard cytotoxic agents involved in combination therapy are 5- flurouracil or capecitabin. Epidermal growth factor receptor (EGFR) is supposed to play an important role in cell- cycle regulation, proliferation, differentiation, and surviving of normal epithelial tissues. EGFR overexpression in patients with rectal adenocarcinoma is associated with radioresistance of malignant tissues, lower rates of patological complete response after neoadjuvant chemoradiation and generally poor survival. There are many clinical studies describing combination of neoadjuvant chemoradiotherapy with EGFR inhibitors, however, this regimen has not gained an acceptance as a standard of treatmentment.

[Primary cilia of cells of cardiovascular apparatus]

The primary cilium is a mechanosensory, solitary, non-motile microtubule-based structure that in the quiescent phase of the cell cycle projects from the surface of the majority of human cells, including embryonal, stem and mesenchymal cells, fibroblasts, myoblasts, cardiomyocytes, vascular smooth muscle and endothelial cells. Primary cilia are in increased frequency also present on the surface of endothelial cells in atherosclerotic predilection sites, lipoid streaks and dots and atheromatous plaques. The primary cilium is formed from the mother centriole. Primary cilia are currently studied in mechanobiology of cardiovascular apparatus and their role in cell migration, cell cycle control and atherogenesis. The aim of this paper is to provide a review of the current knowledge on the primary cilia of cells of cardiovascular apparatus.

[Three-dimensional visualization for preoperative planning and evaluation in head and neck surgery]

There are a lot of diagnostic possibilities for the preoperative planning in head and neck surgery. So far, no study was performed to evaluate if there is an advantage of three-dimensional visualization compared to conventional computed tomography yet. Additionally, there are no specifications for such a visualization prior surgery in head and neck surgery. This work describes different possibilities for segmentation and three-dimensional visualization for preoperative planning in head and neck surgery and tumor volumetry compared to conventional computed tomography. We describe new techniques and specifications for three-dimensional visualization.

[Communal health promotion in child and adolescent health services -- report on the experience with a organisational model for setting up an interdisciplinary network in a socially important area]

This report focusses on health promotion for children adolescents und families and on the aspects of organisation and resources. In 1991 the Public Youth Health Care (KJGD), a community health service for children und adolescents, set up a multi-professional "district committee" of distributors in leading positions in a socially important area (social workers, school teachers, kindergarten teachers, councillors, medical personnel, architects and town planners etc.). Medical examinations of all school beginners and children with special educational needs formed the basis of the social paediatric observations and data. Until 2003 the author was responsible for the management and coordination of this local interdisciplinary district committee of leading representatives from local social and educational organisations as well as town councillors who created a local multi-professional network. The district health reports of the discussions in the district committee including the different professional aspects of health promotion were passed on to the local politician actively involved in the discussions with specialists and invested in social and health promotion projects. Social paediatric issues and preventative strategies became part of the work in social and educational organisations in the area und the city. A healthy environment for children und families was promoted. For the KJGD the conceptual work with distributors in leading positions led to initiatives for communal health promotion making time-saving use of existing resources.

[Not Available]

Allogeneic stem cell transplantation (alloSCT) is increasingly used in the treatment of hematological disorders. In order to demonstrate the national development of alloSCT as well as the effect of the foundation of local transplant centers, data of all alloSCT performed on patients living in Mecklenburg-Vorpommern (MV) during 1991 and 2000 were evaluated regarding date and location of the alloSCT, diagnosis and age of the patient as well as donor type. AlloSCT in patients from MV increased 6 fold from 1991 n=5 to 2000 n=30. Because of the lack of local transplant centers during the period between 1991 and 1997, alloSCT of patients from MV were exclusively performed in other locations, whereas in 2000 only 2 of 30 alloSCT were performed in transplants centers outside MV. With the establishment of local centers, the gap between the numbers of alloSCT between MV and Germany was closed (1991 Germany 4,17/Million inhabitants, MV 2,67/Million inhabitants, 2000 Germany 17,4/Million inhabitants, MV 16,7/Million inhabitants). The increase in the number of alloSCT was mainly due to an increased use of unrelated stem cell donors which increased from n=0 in 1991 to 12 out of 30 in 2000. Another important factor was the increase in the age limit with a mean age of 32 years in 1991 and 43 years in 2000 (upper range 60 years).

CONCLUSION

The data reflect the dramatic increase in alloSCT during the last decade caused by factors listed above. In addition, the development of the numbers of transplants of patients in MV supports the need for local transplant centers, since with the opening of local transplant centers the difference of the frequency of alloSCT between Germany and MV was completely eradicated.

Variable phenotype associated with Ser505Asn-activating thyrotropin-receptor germline mutation

Constitutively activating thyrotropin-receptor (TSHR) germline mutations have been identified as a molecular cause of hereditary nonautoimmune hyperthyroidism. To date, seven cases of familial and six cases of sporadic nonautoimmune hyperthyroidism have been described associated with 13 different TSHR germline mutations, with a variable clinical course. We report the case of a 12.3-year-old girl with a history of thyrotoxicosis since the age of 11 months who developed diffuse thyroid hyperplasia at the age of 4.5 years. The patient has required continuous moderate-dose antithyroid medication, to maintain euthyroidism. There were no clinical signs of autoimmune thyroid disease and autoantibodies were negative. An activating germline mutation in the TSHR gene was suspected and was found in TSHR exon 10 (Ser505Asn) but was absent in the girl's mother. This same mutation, was first reported in a patient with severe intrauterine hyperthyroidism with early and progressive goiter development. Our patient had a significantly less severe clinical course with later onset compared to the original patient with the same TSHR germline mutation.

[Persistent Lactobacillus casei subspecies rhamnosus bacteremia in a 14 year old girl with acute myeloid leukemia. A case report]

The present clinical observation is related to a 14-year-old girl suffering from acute myeloid leukemia. The clinical course was complicated by episodes of severe enterocolitis, E. coli- septicemia, pancreatitis and pneumonia. In the course of continued cytostatic and antibiotic treatment a persistent asymptomatic Lactobacillus casei subsp. rhamnosus-bacteremia became detectable by a total of 18 blood cultures. Microbial cultures of the faeces revealed colony-forming unites of this germ in orders of 10(9)/g. Antibiotic eradication attempts according to the resistogram were not successful. The Lactobacillus-bacteremia disappeared only after 13 months when the cytostatic therapy was terminated. An adjuvant influence of the Lactobacillus infection on the outcome of the underlying disease cannot be excluded.

Heterogeneity and clonality among isolates of Mycobacterium kansasii: implications for epidemiological and pathogenicity studies

The reservoir and transmission route of Mycobacterium kansasii are largely unknown. In addition, culturing of M. kansasii from human sources is not proof of disease because it may represent colonization rather than infection. Unfortunately, investigation of the epidemiology and pathogenicity of M. kansasii is complicated by evidence of heterogeneity within the species. A comprehensive study by detailed genotypic analysis of a large collection of M. kansasii isolates (n = 276) from various geographical sources within Europe was conducted. Five defined subtypes of M. kansasii were identified; of these subtypes, type I represents the most common isolate from humans. Although phylogenetic analysis confirmed its relationship to the other M. kansasii types, significant sequence divergence was found at the 16S-23S intergenic spacer. Analysis of the chromosomal polymorphism of type I demonstrated a marked clonal structure for this particular organism. Because M. kansasii is becoming a significant pathogen among immunodeficient hosts, future epidemiological and pathogenicity studies should take into consideration both the heterogeneity within the species and the apparent clonality of the most prevalent M. kansasii isolates infecting humans.

Evaluation of oro-coecal transit time: a comparison of the lactose-[13C, 15N]ureide 13CO2- and the lactulose H2-breath test in humans

OBJECTIVE

The lactulose H2-breath test is the most widely used non-invasive approach for evaluation of orocoecal transit time (OCTT). In the present study, doubly-labelled lactose-[13C, 15N]ureide (DLLU) was synthesized to investigate the OCTT in comparison to the conventional lactulose H2-breath test. Additionally the bacterial breakdown rate (BBR) and rate of elimination and the metabolic pathways of the cleavage products of DLLU (13CO2, [15N]urea, and 15NH3) were investigated.

DESIGN AND SUBJECTS

In a first study, DLLU was administered as a single oral-pulse-labelling (dosage: one gram) either without and after pretreatment of five grams of unlabelled lactoseureide (LU) on the day prior to the study to twelve healthy adult volunteers after breakfast. Breath and urine were collected in one and two hour-intervals, respectively, over a one-day period. 13C-enrichment in breath as well as 15N-enrichment in urine fractions were measured by continuous flow-isotope ratio mass spectrometry (CF-IRMS). In a second study, lactulose was administered to the same subjects (dosage: ten grams). Breath was collected in quarter, half and one hour-intervals over a ten hour-period. Hydrogen concentration in breath was analysed using an electrochemical detector.

RESULTS

The comparison of the lactose-[13C]ureide 13CO2-breath test and the lactulose H2-breath test showed that the mean increase of the 13C-enrichment in CO2 occurred 1.18 h later than the mean increase of H2 in breath. The resulting OCTTs derived from the two methods were 3.02 +/- 1.4 and 1.84 +/- 0.5 h (P < 0.05) and the corresponding BRs were 9.63 +/- 3.4 and 6.07 +/- 1.7 h (P < 0.01), respectively. The 15N-enrichment of urinary urea and ammonia without and after pretreatment with LU started between two and three hours after DLLU-administration. The cumulative percentage urinary excretion of the 15N- and 13C-tracer was 29.9% and 13.6% respectively, and was slightly increased after LU-pretreatment to 32.1% and 14.6% of the dose administered. A total of 35.2% of the 13C was found to be exhaled and remained approximately constant after LU-pretreatment (36.2%).

CONCLUSIONS

The use of the lactulose H2-breath test for evaluation of the OCTT showed a statistically significant shortening of 1.18 h in comparison to the lactose-[13C]ureide 13CO2-breath test in healthy adults. The most important limitations of the lactulose H2-breath test are its low specificity and sensitivity due to dose-dependent accelerations of OCTT, interfering H2-rise from malabsorbed dietary fibre and H2-non-producers. In contrast, our lactose-[13C]ureide 13CO2-breath test was confirmed to avoid these disadvantages and to yield reliable results. This test is recommended especially if higher sensitivity and specificity is required, if IRMS-technique is available and if lactulose H2-tests lead to insufficient results.

Mycobacterium conspicuum sp. nov., a new species isolated from patients with disseminated infections

A new type of slowly growing, nonphotochromogenic mycobacterium was recovered from two patients with disseminated disease. The growth characteristics, acid fastness, acids were consistent with those for Mycobacterium species. The results of biochemical investigations, lipid analyses, and comparative 16S rRNA sequencing showed that these isolates represent a new slowly growing Mycobacterium species which is named Mycobacterium conspicuum.

Design considerations of form birefringent microstructures

Diffraction characteristics of high-spatial-frequency (HSF) gratings are evaluated for application to polarization-selective computer-generated holograms by the use of two different approaches: second-order effective-medium theory (EMT) and rigorous coupled-wave analysis (RCWA). The reflectivities and the phase differences for TE- and TM-polarized waves are investigated in terms of various input parameters, and results obtained with second-order EMT and RCWA are compared. It is shown that although the reflection characteristics can be accurately modeled with the second-order EMT, the phase difference created by form birefringence for TE- and TM-polarized waves requires the use of a more rigorous, RCWA approach. The design of HSF gratings in terms of their form birefringence and reflectivity properties is discussed in conjunction with polarization-selective computer-generated holograms. A specific design optimization example furnishes a grating profile that provides a trade-off between the largest form birefrin gence and the lowest reflectivities.

Blue rubber-bleb-nevus syndrome with predominant urinary bladder hemangiomatosis

In a 2-year-old girl a blue rubber-bleb-nevus syndrome is described. Apart from cutaneous hemangiomas, pronounced hemangiomas of the urinary bladder were diagnosed and treated by laser surgery. The features of the disorder are discussed as a special clinical condition within the framework of this syndrome.

Stimulation of nitrogen and whole-body protein metabolism in growth hormone-deficient children by recombinant human growth hormone: relationship to growth

The effect of a mammalian-cell-derived recombinant human growth hormone (rhGH) on nitrogen and whole-body protein metabolism was assessed in 12 children with complete growth hormone (GH) deficiency. All the patients received single oral doses of 15N-glycine (95 atom % 15N), 20 mg/kg body weight, prior to and following 7 days of treatment with rhGH, 1.7 IU/m2 body surface area (BSA) per day, administered subcutaneously. Prior to rhGH, mean urinary 15N-nitrogen excretion was 42.8 +/- 8% of the administered dose, which fell significantly to 22.8 +/- 7% during rhGH administration (p < 0.0001). Stimulation of protein metabolism by rhGH resulted in a protein net gain rate of 1.1 +/- 0.4 g/kg/day, which was significantly higher than the 0.6 +/- 0.5 g/kg/day rate seen prior to rhGH (p < 0.001). In patients subsequently placed on daily subcutaneous injections of rhGH 1.7 IU/m2 BSA, mean height velocity standard deviation score (HV SDS) for chronological age significantly increased from -3.8 +/- 2.6 to +8.5 +/- 3.1 and +3.3 +/- 2.2, during the 1st and 2nd years of treatment, respectively. However, there was no correlation between the long-term response to rhGH treatment and the short-term changes in nitrogen or protein metabolism in GH-deficient children.

Replacement of lysine 269 by arginine in Escherichia coli tryptophan indole-lyase affects the formation and breakdown of quinonoid complexes

Lysine 269 in Escherichia coli tryptophan indole-lyase (tryptophanase) has been changed to arginine by site-directed mutagenesis. The resultant K269R mutant enzyme exhibits kcat values about 10% those of the wild-type enzyme with S-(o-nitrophenyl)-L-cysteine, L-tryptophan, and S-benzyl-L-cysteine, while kcat/Km values are reduced to 2% or less. The pH profile of kcat/Km for S-benzyl-L-cysteine for the mutant enzyme exhibits two pK alpha values which are too close to separate, with an average value of 7.6, while the wild-type enzyme exhibits pK alpha values of 6.0 and 7.8. The pK alpha for the interconversion of the 335 and 412 nm forms of the K269R enzyme is 8.3, while the wild-type enzyme exhibits a pK alpha of 7.4. Steady-state kinetic isotope effects on the reaction of [alpha-2H]S-benzyl-L-cysteine with the K269R mutant enzyme (Dkcat = 2.0; D(kcat/Km) = 3.9) are larger than those of the wild-type enzyme (Dkcat = 1.4; D(kcat/Km) = 2.9). Rapid scanning stopped-flow kinetic studies demonstrate that the K269R mutant enzyme does not accumulate quinonoid intermediates with L-alanine, L-tryptophan, or S-methyl-L-cysteine, but does form quinonoid absorption peaks in complexes with S-benzyl-L-cysteine and oxidolyl-L-alanine, whereas wild-type enzyme forms prominent quinonoid bands with all these amino acids. Single wavelength stopped-flow kinetic studies demonstrate that the alpha-deprotonation of S-benzyl-L-cysteine is 6-fold slower in the K269R mutant enzyme, while the intrinsic deuterium kinetic isotope effect is less for the K269R enzyme (Dk = 4.2) than for the wild-type (Dk = 7.9). The decay of the K269R quinonoid intermediate in the presence of benzimidazole is 7.1-fold slower than that of the wild-type enzyme. These results demonstrate that Lys-269 plays a significant role in the conformational changes or electrostatic effects obligatory to the formation and decomposition of the quinonoid intermediate, although it is not an essential basic residue.

[Complete remission of type I diabetes mellitus in infancy following cytomegalovirus infection]

A case of total remission of insulin-dependent Diabetes mellitus in an infant after one year of the disease is described. At time of onset an infection with cytomegalovirus was detected. It is suggested that the protective HLA genes DR2, DQw1 of the patient are responsible for the very rarely seen course of the disease.

[Ullrich-Turner syndrome and anorexia nervosa--an association?]

It is reported about the clinical progress of a 15 years old girl suffering from anorexia nervosa with Ulrich-Turner's syndrome. Etiological aspects are discussed. It is derived from calculations that there is a suspicious fact of an association of both disorders.

[Sonography as an aid in the early diagnosis of herpes simplex encephalitis]

In 3 infants with meningoencephalitis caused by Herpes simplex viruses the findings of cerebral sonography corresponded with those of computerized tomography and electroencephalography. The therapeutic success of antiviral chemotherapeutics depends very much on their application at an early stage of the disease, which can be recognized by cerebral sonography.

Astrocytes synthesize and secrete alpha 2-macroglobulin: differences between the regulation of alpha 2-macroglobulin synthesis in rat liver and brain

alpha 2-Macroglobulin (alpha 2M) is an important proteinase inhibitor both in the blood and in the interstitial space of many mammalian species. Recently, occurrence of alpha 2M in human and fetal rat brain has been reported. However, its cellular origin remained obscure. Here it will be shown that astroglial cells cultured from newborn rats synthesize and secrete alpha 2M. In addition to astrocyte primary cultures a rat astrocytoma cell line, C6-cells, also synthesize and secrete alpha 2M. In contrast to hepatocytes of the adult rat, where alpha 2M is expressed as an acute-phase protein and where glucocorticoids and monocyte-derived factors are required for its synthesis, alpha 2M synthesis in astrocytes of newborn rats is independent from both. It is therefore concluded that expression of alpha 2M is differently regulated in the liver of the adult rat and fetal or neonatal brain.

Evidence for colonic absorption of protein nitrogen in infants

The absorption of protein nitrogen by the colon was assessed in 6 infants with colostomy by giving 15N yeast protein in a dosage of 5-20 mg 15N/kg (92.4 atom-% 15N). The absorption of 15N ranged between 87.1 and 98.1% of the administered dose, and the retention in the protein pool ranged between 79.0 and 94.2%. The incorporation of 15N in the plasma proteins was demonstrated by 15N excess values between 0.02 and 0.10 atom-%. The results suggest that the colon can assimilate proteins when insufficient absorption of protein nitrogen in the small intestine occurs. The breakdown of protein is thought to result from the action of colonic flora.

15N tracer techniques for the differential diagnosis of dwarfism and prediction of growth hormone action in children

[15N]Glycine in a single oral dose was used to study nitrogen turnover in 18 short children, aged 3-14 yr. On the basis of their serum GH responses to insulin-induced hypoglycemia, the patients were divided into 3 groups: complete GH deficiency (GHD; n = 5); partial GH deficiency (pGHD; n = 6), and children with constitutional growth delay and familial short stature (CGD/FSS; n = 7). The mean 48-h renal excretion of 15N by patients with GHD was 66.09 +/- 14.12% (+/- SD) of the tracer dose. This decreased to 27.64 +/- 5.33% after two injections of 10 IU/m2 GH (P less than 0.001). 15N excretion by patients with pGHD was 47.19 +/- 13.42%, and it decreased after GH injection to 22.69 +/- 4.58% (P less than 0.005). Patients with CGD/FSS had 15N excretion of 37.27 +/- 5.68%, and it did not change in response to GH. The mean protein synthesis rate in GHD patients was extremely low, and it increased after GH injection from 0.99 +/- 0.46 to 3.53 +/- 0.43 g/kg X day. In pGHD patients the protein synthesis rate increased from 2.62 +/- 0.84 to 4.50 +/- 1.09 g/kg X day. The CGD/FSS patients had no change in protein synthesis rate after GH. Our results suggest that studies of the metabolism of [15N]glycine might be of value in predicting responsiveness to GH therapy.

[The dose dependence of 15N-incorporation in organ proteins of newborn rats after pulse labeling with different tracers]

A short-chain 15N-peptide mixture characterized by an average chain length of 2.3 was obtained when 15N-labeled yeast protein has hydrolyzed enzymatically by thermitase from Thermoactinomyces vulgaris. Fifteen newborn Wistar-rats were given a single pulse of [15N]glycine. [15N]H4Cl and [15N]yeast protein-thermitasehydrolysate (YPTH) in a dosage of 50 mg 15N excess kg-1 by gastric tube. In comparison with [15N]glycine the 15N-incorporation rates of brain, muscle and liver were approximately 150% higher after [15N]YPTH-application. Uniform labeling, high 15N-enrichment, almost complete absorption, avoidance of imbalances and the low price make this tracer substance superior to other tracers conventionally used for organ labeling.

Blood level, distribution, metabolite pattern and excretion of [14C]alinidine in mice and rats

Following oral and intravenous administration the absorption, distribution, metabolite pattern and excretion of [14C]alinidine, a drug with specific bradycardic efficacy, was studied in mice and rats. [14C]alinidine was rapidly and extensively absorbed. The distribution of radio-labelled drug over the entire animal body was rapid as indicated by blood level curves as well as by whole body autoradiography. In both species radioactive compounds were eliminated from blood with half-lives ranging from 5.6 h to 7.4 h. More than 50% of the renally excreted radioactivity was a uniform substance behaving in in TLC and HPLC experiments like the drug administered. From rat urine this compound could be identified as [14C]alinidine using mass spectrometry. In mice and rats no definite substance with clonidine-like chromatographic properties was found. Biliary excretion was demonstrated in both species. The renal portion of the total radioactivity elimination was 67.2-70.1% of the dose administered in mice and 68.1-85.1% in rats. Total excretion was 85.1-101.3% of radioactivity given and was complete 3-4 days after [14C]alinidine administration. No significant differences in pharmacokinetic behavior in mice and rats could be found.

Blood level, distribution, excretion, and metabolite pattern of [14C]-brotizolam in the rat, dog, and rhesus monkey

Following oral and intravenous administration the absorption, distribution, metabolite pattern and excretion of 14C-labeled brotizolam (2-bromo-4-(2-chlorophenyl)-9-methyl-6H-thieno[3,2-f]-1,2,4-triazolo [4,3-a]-1,4-diazepine, We 941, Lendormin), a new hypnotic, was studied in rats, dogs, and rhesus monkeys. Given orally to these species, [14C]-brotizolam was rapidly and extensively absorbed. The distribution of the radiolabeled drug was very fast indicated by blood level curves as well as by rat whole body autoradiography. [14C]-Brotizolam and its metabolites crossed the placenta; they also occurred in the milk of rats. In all species studied radioactivity was eliminated from blood with very similar half-lives ranging from 14.8 to 20.8 h. The renal portion of the total radioactivity elimination increased from 5.5% of the dose given to rats to 33.5% in rhesus monkeys and to 51.4% in dogs. Total excretion was complete 3 to 4 days after [14C]-brotizolam administration. Biliary excretion also occurred. In the species studied thin layer chromatographic separation of the biliarily and renally excreted radioactivity indicated a similar but not the same pattern of 2 to 3 major metabolites which were mostly totally conjugated. Unchanged [14C]-brotizolam was only excreted in minor quantities, if at all.

15N-tracer-kinetic studies on the nitrogen metabolism of very small preterm infants on a diet of mother's milk

Protein synthesis and breakdown, nitrogen flux and other parameters of nitrogen metabolism were measured in five male preterm infants with a mean gestational age of 30.4 +/- 1.95 complete weeks of gestation and a mean body weight of 1592 +/- 517 g. The infants were fed on mothers' milk; the measurements were made at a post-conceptional age of 31.6 +/- 1.9 weeks of gestation (Ia) and were repeated at 34.4 +/- 1.9 weeks of gestation (Ib). [15N]-glycine (95 atom per cent) was used as a tracer, administered as a single enteral dose of 20 mg/kg. Whole-body protein parameters were calculated from an assumed three-pool model. The results were compared with data from moderately small preterm (II) and full-term (III) infants measured at post-conceptional ages of 36.1 +/- 1.4 and 48.0 +/- 2.8 weeks respectively. Protein synthesis rates tended to decrease with increasing post-conceptional age: 14.3 +/- 4.5 g/kg/d (Ia); 11.8 +/- 2.9 g/kg/d (Ib); 7.9 +/- 2.7 g/kg/d (II); and 7.7 +/- 1.4 g/kg/d (III). Protein breakdown and nitrogen flux showed the same trends. Possible consequences for the appropriate nutrition of very small preterm infants are discussed.

15N-tracer investigations into the nitrogen metabolism of preterm infants fed mother's milk and a formula diet

Protein synthesis, protein breakdown, protein-N turnover, and other parameters describing the nitrogen metabolism were measured in five male preterm infants. The weight of the subjects at birth was 2,064 +/- 107 g and the measurements were performed at age 16.0 +/- 4.5 days in the case of the mother's milk diet and 27.4 +/- 6.8 days in the case of the formula diet containing 1.8% protein. The parameters were measured by means of the 15N-tracer technique using [15N]glycine (95 atom %) applied in a single oral dose of 20 mg/kg as a tracer. The three-pool model proposed by Winkler and Faust was used to calculate the whole body protein parameters. No difference in net protein gain, protein synthesis, protein breakdown, or the other protein metabolism parameters were recorded despite the different protein inputs. Renal nitrogen excretion and the rate of endogenous urea N excretion were significantly higher for the formula diet than for the mother's milk diet. The protein synthesis rate of 7.9 g X kg-1 X day-1 was, as has previously been observed, higher than in other age groups. The protein metabolism of the preterm infant older than 33 weeks of gestational age does not benefit from a formula diet based on cow's milk that is richer in protein than mother's milk.

Evaluation of different 15N-tracer substances for calculation of whole body protein parameters in infants

The validity of using different 15N-tracer substances to measure whole body protein parameters, i.e., protein synthesis, protein breakdown, net protein gain, protein turnover, metabolic pool, and reutilization, was assessed by comparing the results obtained with: [15N]glycine, a mixture of 10 15N-labeled amino acids, and a 15N-labeled chicken egg protein in two infants, 9 and 12 weeks old, who were fed human milk. The tracer substances were fed orally as a single dose corresponding to a 15N-excess quantity of 0.2 mmol X kg-1 body weight. 15N Excretion in the urine was measured cumulatively by emission spectrometry, and the data on the protein metabolism were calculated by means of a three-pool model. All three tests yielded consistent net protein gains. The protein synthesis, protein breakdown, protein turnover, and nitrogen reutilization values produced by the [15N]glycine tracer study were higher than those produced by application of the 15N-amino acid mixture and the 15N-labeled egg protein. However, in our opinion, this discrepancy does not justify the replacement of [15N]glycine by expensive 15N-amino acid mixtures as tracer substances.