Comparison of yogurt, soybean, casein, and amino acid–based diets in children with persistent diarrhea

Although previous studies have shown successful treatment of persistent diarrhea (PD) with the use of yogurt-based diets, some recent ones speculate the need of special formulas for the nutritional management of PD complicated cases. In the present study, we tested the hypothesis that the consumption of 3 lactose-free diets, with different degrees of complexity, is associated with lower stool output and shorter duration of diarrhea when compared with the use of a yogurt-based one on the nutritional management of PD. A total of 154 male infants, aged between 1 and 30 months, with PD and with or without dehydration, were randomly assigned to 1 of 4 treatment groups. Throughout the study, the patients were placed in a metabolic unit; their body weights and intakes of oral rehydration solution, water, and formula diets, in addition to outputs of stool, urine, and vomit, were measured and recorded at 24-hour intervals. Four different diets were used in this study: diet 1, yogurt-based formula; diet 2, soy-based formula; diet 3, hydrolyzed protein-based formula; and diet 4, amino acid–based formula. Throughout the study, only these formula diets were fed to the children. The data showed that children fed the yogurt-based diet (diet 1) or the amino acid–based diet (diet 4) had a significant reduction in stool output and in the duration of diarrhea. The use of an inexpensive and worldwide-available yogurt-based diet is recommended as the first choice for the nutritional management of mild to moderate PD. For the few complicated PD cases, when available, a more complex amino acid–based diet should be reserved for the nutritional management of these unresponsive and severe presentations. Soy-based or casein-based diets do not offer any specific advantage or benefits and do not seem to have a place in the management of PD.     

Predominance of null mutations in ataxia-telangiectasia

Ataxia-telangiectasia (A-T) is an autosomal recessive disorder involving cerebellar degeneration, immunodeficiency, chromosomal instability, radiosensitivity and cancer predisposition. The responsible gene, ATM, was recently identified by positional cloning and found to encode a putative 350 kDa protein with a Pl 3-kinase-like domain, presumably involved in mediating cell cycle arrest in response to radiation-induced DNA damage. The nature and location of A-T mutations should provide insight into the function of the ATM protein and the molecular basis of this pleiotropic disease. Of 44 A-T mutations identified by us to date, 39 (89%) are expected to inactivate the ATM protein by truncating it, by abolishing correct initiation or termination of translation, or by deleting large segments. Additional mutations are four smaller in-frame deletions and insertions, and one substitution of a highly conserved amino acid at the Pl 3-kinase domain. The emerging profile of mutations causing A-T is thus dominated by those expected to completely inactivate the ATM protein. ATM mutations with milder effects may result in phenotypes related, but not identical, to A-T.      

High throughput parallel analysis of hundreds of patient samples for more than 100 mutations in multiple disease genes

As more mutations are identified in genes of known sequence, there is a crucial need in the areas of medical genetics and genome analysis for rapid, accurate and cost-effective methods of mutation detection. We have developed a multiplex allele-specific diagnostic assay (MASDA) for analysis of large numbers of samples (> 500) simultaneously for a large number of known mutations (> 100) in a single assay. MASDA utilizes oligonucleotide hybridization to interrogate DNA sequences. Multiplex DNA samples are immobilized on a solid support and a single hybridization is performed with a pool of allele-specific oligonucleotide (ASO) probes. Any probes complementary to specific mutations present in a given sample are in effect affinity purified from the pool by the target DNA. Sequence-specific band patterns (fingerprints), generated by chemical or enzymatic sequencing of the bound ASO(s), easily identify the specific mutation(s). Using this design, in a single diagnostic assay, we tested samples for 66 cystic fibrosis (CF) mutations, 14 beta-thalassemia mutations, two sickle cell anemia (SCA) mutations, three Tay-Sachs mutations, eight Gaucher mutations, four mutations in Canavan disease, four mutations in Fanconi anemia, and five mutations in BRCA1. Each mutation was correctly identified. Finally, in a blinded study of 106 of these mutations in > 500 patients, all mutations were properly identified. There were no false positives or false negatives. The MASDA assay is capable of detecting point mutations as well as small insertion or deletion mutations. This technology is amenable to automation and is suitable for immediate utilization for high-throughput genetic diagnostics in clinical and research laboratories.      

Preliminary observations on polar body extrusion and pronuclear formation in human oocytes using time-lapse video cinematography

In this study, we have used time-lapse video cinematography to study fertilization in 50 human oocytes that had undergone intracytoplasmic sperm injection (ICSI). Time-lapse recording commenced shortly after ICSI and proceeded for 17-20 h. Oocytes were cultured in an environmental chamber which was maintained under standard culture conditions. Overall, 38 oocytes (76%) were fertilized normally, and the fertilization rate and embryo quality were not significantly different from 487 sibling oocytes cultured in a conventional incubator. Normal fertilization followed a defined course of events, although the timing of these events varied markedly between oocytes. In 35 of the 38 fertilized oocytes (92%), there were circular waves of granulation within the ooplasm which had a periodicity of 20-53 min. The sperm head decondensed during this granulation phase. The second polar body was then extruded, and this was followed by the central formation of the male pronucleus. The female pronucleus formed in the cytoplasm adjacent to the second polar body at the same time as, or slightly after, the male pronucleus, and was subsequently drawn towards the male pronucleus until the two abutted. Both pronuclei then increased in size, the nucleoli moved around within the pronuclei and some nucleoli coalesced. During pronuclear growth, the organelles contracted from the cortex towards the centre of the oocyte, leaving a clear cortical zone. The oocyte decreased in diameter from 112 to 106 microm (P < 0.0001) during the course of the observation period. The female pronucleus was significantly smaller in diameter than the male pronucleus (24.1 and 22.4 microm respectively, P = 0.008) and contained fewer nucleoli (4.2 and 7.0 respectively, P < 0.0001). After time-lapse recording, oocytes were cultured for 48 h prior to embryo transfer or cryopreservation. Embryo quality was related to fertilization events and periodicity of the cytoplasmic wave, and it was found that good quality embryos arose from oocytes that had more uniform timing from injection to pronuclear abuttal and tended to have a longer cytoplasmic wave. In conclusion, we have shown that time-lapse video cinematography is an excellent tool for studying fertilization and early embryo development, and have demonstrated that human fertilization comprises numerous complex dynamic events.      

A comparison of the Fishbein and Ajzen and the Triandis attitudinal models for the prediction of exercise intention and behavior

The main purpose of the study was to compare the efficiency of the Fishbein and Ajzen and the Triandis models to predict (1) the intention to participate regularly in some physical activities during free time within a 3-week period and (2) the exercise behavior within these 3 weeks among a group of 166 subjects, aged 22 to 65 years. Our results show that the Triandis model was as efficient as the Fishbein and Ajzen model in predicting the exercise behavior. However, the results obtained from the Triandis model demonstrate the importance of the habit of exercising in predicting the exercise behavior. Moreover, the Triandis model was superior to the Fishbein and Ajzen model in explaining behavioral intention. Of particular interest was the salience of the affective, social, and personal belief components of the Triandis model. In addition, from a practical perspective, this comparative study showed that (1) to exercise regularly is perceived as hard work, and (2) individuals believe that it is their own responsibility to exercise or not to exercise.     

Black and white females' perceptions of ideal body size and social norms

Different cultural norms and standards for appropriate female body size might contribute to the disparity in obesity rates between black and white adult females (46.0% and 24.6% respectively). The purpose of this study was to measure adolescents' perceptions of ideal size and social norms regarding female body size as well as adolescents' perceptions of significant others' evaluation and expectations of the adolescents' body size. Subjects included 437 adolescent girls (247 white and 190 black) aged 13 to 19 (x = 14.9, SD = .979) from six randomly selected public schools. The subjects, heights and weights were measured. Responses to a body image questionnaire and a series of nine female body drawings (arranged ordinally, 1 to 9, from thinnest to heaviest) were analyzed using the General Linear Model and Logistic Regression. The female body size considered ideal by black females was significantly larger than the size selected as ideal by white females (x = 3.47 and x = 3.13 respectively, p < 0.001). Black females were two times more likely than white females to describe themselves as thinner than other girls their age (O.R. = 2.01, 95% C.I. 1.34, 3.01) and seven times as likely to say that they were not overweight (O.R. = 7.08, 95% C.I. 3.72, 13.45). White females wanted to be a smaller size than they currently were and felt encouraged by significant others to lose weight or reduce their size. Black females did not indicate as great a desire as whites to be smaller and they tended to feel that their size was considered satisfactory by significant others. Only subjects from the low SES group perceived that significant others wanted them to gain weight. The differences between black and white subjects' beliefs and perceptions about body size norms may explain, in part, why heavier body weights persist in some cultural groups.     

Preoperative and postoperative assessment of laparoscopic inguinal hernia repair by dynamic MRI

RATIONALE AND OBJECTIVES: To determine the value of dynamic MRI for seroma detection, hernia recurrence, and mesh placement in patients after laparoscopic inguinal hernia repair. METHODS: Thirteen inguinal hernias in 10 consecutive patients were evaluated before and after surgery by using an MRI protocol consisting of coronal T1-weighted (fast field echo) and T2-weighted (turbo spin-echo) images and two sequences obtained during straining (turbo field echo gradient technique). All patients underwent a transabdominal preperitoneal laparoscopic inguinal hernia repair. MRI scans were reviewed for the presence of postoperative fluid collections, recurrent hernia, and mesh localization. RESULTS: In all patients, an inguinal hernia was identified on the preoperative MRI and was absent on the postoperative MRI. In all patients treated laparoscopically, the mesh and its position were clearly identified. Three small fluid collections were found on the postoperative MRI scans. CONCLUSIONS: Dynamic MRI can demonstrate small, postoperative fluid collections and a sufficient hernioplasty by showing the proper position of the mesh and the absence of a hernia.