Protein quality and quantity influence free amino acid levels in the brain and serum of rats during lactation

Diets containing 11 or 21% protein supplied by wheat, wheat + lysine + threonine or casein + methionine were fed to pregnant rats from conception until d 4 or 8 of lactation. Dams then were decapitated, serum was collected and brains and left inguinal-abdominal mammary glands were quickly excised and weighed. Serum and brains were frozen in liquid nitrogen and stored at -70 degrees C. Free amino acids in either serum or brain were not significantly different on d 8 as compared with d 4 of lactation. Increasing dietary protein quality or quantity increased concentrations of most essential amino acids in serum and brain. Changes in the concentrations of nonessential amino acids in serum or brain associated with increases in protein quality or quantity were variable. For all 16 amino acids measured, brain free amino acids were highly correlated with serum levels. In this experiment, pup growth varied from 0.3 g/d for the offspring of dams fed 11% wheat to 1.4 g/d for the offspring of dams fed 21% wheat + lysine + threonine. Concentrations of lysine and threonine in the brain were more than twice as high under the latter as compared with the former condition, but differences in all other amino acids among the dietary groups were small, ranging from -20% for glycine to +21% for leucine and isoleucine.     

Variability of body density and body impedance at different frequencies.

Body density and body impedance at 15 selected frequencies ranging from 1 to 1350 kHz were determined in 13 subjects on four consecutive days of the week. Bioelectrical impedance at the same frequencies was also determined in 11 subjects on the same day of the week during four consecutive weeks. Day-to-day variability of body density and body impedance and week-to-week variability of body impedance were studied. Statistical analyses did not reveal significant day- or week-effects in variabilities. The mean within-person variation in body density between days was 0.0019 kg/l (CV 0.2%). Mean within-person variation in body impedance between days was 57 ohms (CV 8.7%) at 1 kHz. At 5, 50 and 100 kHz the within-person variation between days was 16 ohms (CV 2.4%), 12 ohms (CV 2.1%) and 11 ohms (CV 2.0%), respectively. Mean within-person variation between weeks was 44 ohms (CV 2.4%) at 1, 5, 50 and 100 kHz, respectively. Overall the within-subject variability in impedance at all frequencies was higher in females. The larger mean within-person variation in impedance at 1 kHz could only partly be explained by variation in body weight and may be a real error in the measurement. Electrodes with a larger surface area reduced the variability to values comparable with those at higher frequencies. The day-to-day variation in impedance at higher frequencies causes an error in calculated FFM, which is about two times larger compared to the estimated error in FFM by body density.     

Repair of large midline incisional hernias with polypropylene mesh: Comparison of three operative techniques

Polypropylene mesh is widely used for the reconstruction of incisional hernias that cannot be closed primarily. Several techniques have been advocated to implant the mesh. The objective of this study was to evaluate, retrospectively, early and late results of three different techniques, onlay, inlay, and underlay. The records of 53 consecutive patients with a large midline incisional hernia — 25 women and 28 men, mean age 60.4 (range 28–94) — were reviewed. Polypropylene mesh was implanted using the onlay technique in 13 patients, inlay in 23 patients, and underlay in 17 patients. Either the greater omentum or a polyglactin mesh was interponated between the mesh and the viscera. The records of these 53 patients were reviewed with respect to: size and cause of the hernia, pre- and postoperative mortality and morbidity, with special attention to wound complications. Patients were invited to attend the outpatient clinic at least 12 months after implantation of the mesh for physical examination of the abdominal wall. Postoperative complications occurred in 14 (26.4%) patients. The onlay technique had significantly more complications, as compared to both other techniques. Reherniation occurred in 15 (28.3%) patients. The reherniation rate of the inlay technique was significantly higher than after the underlay technique (44% vs 12%, P=0.03) and tended to be higher than the onlay technique (44% vs 23%, P=0.22). Repair of large midline incisional hernias with the use of a polypropylene mesh carries a high risk of complications and has a high reherniation rate. The underlay technique seems to be the better technique.     

Testicular dysgenesis and mental retardation in two incompletely masculinized XY-siblings.

Aberrations of fetal sexual development were studied in two retarded phenotypic female 46,XY dysgonadal sisters from a consanguineous marriage. Endocrine evaluation revealed an inadequate response of plasma-testosterone to human chorionic gonadotropin (hCG) stimulation and a normal response to adrenocorticotropic hormone (ACTH) administration. At exploratory laparotomy dysgenetic testes and remnants of the Müllerian and of the Wolffian duct were found. Loss of testicular function, resulting in male pseudohermaphroditism (MPH), can occur at different times during intrauterine development, resulting in a variety of clinical manifestations. A thorough evaluation is warranted in all patients in order to reach a correct diagnosis which is of importance for appropriate gender assignment and genetic counseling.     

Clinical efficacy of Sinemet CR 50/200 versus Sinemet 25/100 in patients with fluctuating Parkinson's disease. An open, and a double-blind, double-dummy, multicenter treatment evaluation. The Dutch Sinemet CR Study Group.

In a multicenter study we selected 84 patients with fluctuating Parkinson's disease in order to evaluate the effects of controlled-release Sinemet 50/200 (=CR) versus standard Sinemet 25/100 (=STD) in an open-label 8-week titration period, followed by a double-blind, double-dummy 24-week treatment period. In contrast with previous double-blind studies, the efficacy of Sinemet CR proved to be significantly superior to that of Sinemet-STD according to NYUPDS and NUDS rating scales. This higher efficacy of Sinemet CR was not achieved at the expense of safety and/or tolerability. Actual total daily levodopa dosage in patients treated with Sinemet CR was increased by 33%; however, the plasma level of this dosage is calculated to be similar to that of the previous dosage of Sinemet-STD (bio-availability of Sinemet CR is 71%). Mean numbers of daily doses, off-hours, and off-periods were decreased significantly during Sinemet CR treatment. Although all other variables suggest that the number of on-hours had to be increased, statistical significance could not be reached in this respect.     

Gallbladder sensitivity to cholecystokinin in coeliac disease. Correlation of gallbladder contraction with plasma cholecystokinin-like immunoreactivity during infusion of cerulein.

The present study was undertaken to determine whether alterations in the gallbladder sensitivity to cholecystokinin (CCK), apart from a reduced endogenous CCK secretion, contribute to the abnormally decreased postprandial gallbladder contraction in patients with coeliac disease. Gallbladder emptying, measured by cholescintigraphy, and plasma CCK levels, measured by radioimmunoassay, were studied during infusion of graded doses of the CCK analog cerulein in six coeliac patients with subtotal villous atrophy, six coeliac patients on a gluten-free diet with normal villous architecture, and nine control subjects. Both in the patients and in the controls infusion of stepwise increasing doses of cerulein, in the range of 1-16 ng.kg-1.h-1, induced dose-related changes in plasma CCK-like immunoreactivity (CCK-LI) (r = 0.99; p less than 0.001) and gallbladder emptying (r greater than 0.97; p less than 0.01-p less than 0.001). Plasma CCK-LI and gallbladder responses were not significantly different among untreated coeliac patients, treated coeliac patients, and controls. Gallbladder sensitivity to cerulein in untreated and treated coeliac patients was not significantly different from that in controls. It is concluded that the abnormally decreased gallbladder contraction in coeliac patients is the result of a reduced endogenous CCK secretion and not of a lack of end-organ responsiveness to CCK.