Marine phospholipids: The current understanding of their oxidation mechanisms and potential uses for food fortification.

There is a growing interest in using marine phospholipids (PL) as ingredient for food fortification due to their numerous health benefits. However, the use of marine PL for food fortification is a challenge due to the complex nature of the degradation products that are formed during the handling and storage of marine PL. For example, nonenzymatic browning reactions may occur between lipid oxidation products and primary amine group from phosphatidylethanolamine or amino acid residues that are present in marine PL. Therefore, marine PL contain products from nonenzymatic browning and lipid oxidation reactions, namely, Strecker aldehydes, pyrroles, oxypolymers, and other impurities that may positively or negatively affect the oxidative stability and quality of marine PL. This review was undertaken to provide the industry and academia with an overview of the current understanding of the quality changes taking place in PL during their production and their storage as well as with regards to their utilization for food fortification.

Impact of primary amine group from aminophospholipids and amino acids on marine phospholipids stability: non-enzymatic browning and lipid oxidation.

The main objective of this study was to investigate the oxidative stability and non-enzymatic browning reactions of marine PL in the presence or in the absence of primary amine group from aminophospholipids and amino acids. Marine phospholipids liposomal dispersions were prepared from two authentic standards (phosphatidylcholine and phosphatidylethanolamine) and two purified PL from marine sources with and without addition of amino acids (leucine, methionine and lysine). Samples were incubated at 60°C for 0, 2, 4 and 6days. Non-enzymatic browning reactions were investigated through measurement of (i) Strecker derived volatiles, (ii) yellowness index (YI), (iii) hydrophobic and (iv) hydrophilic pyrroles content. The oxidative stability of the samples was assessed through measurement of secondary lipid derived volatile oxidation products. The result showed that the presence of PE and amino acids caused the formation of pyrroles, generated Strecker derived volatiles, decreased the YI development and lowered lipid oxidation. The lower degree of lipid oxidation in liposomal dispersions containing amino acids might be attributed to antioxidative properties of pyrroles or amino acids.

Oxidative degradation and non-enzymatic browning due to the interaction between oxidised lipids and primary amine groups in different marine PL emulsions.

Due to the beneficial health effects of marine phospholipids (PL) there is an increasing industrial interest in using them for nutritional applications including emulsified foods. This study was undertaken to investigate both oxidative and hydrolytic stability of marine PL emulsions in relation to the chemical composition of the marine PL used. Moreover, non-enzymatic browning reactions were also investigated. Emulsions were prepared by high pressure homogenizer using different concentrations and sources of marine PL. In some formulations, fish oil was added in order to study the effect of increasing levels of triglycerides in the emulsions. The oxidative and hydrolytic stability of emulsions was investigated through measurement of peroxide value, free fatty acids, and (31)P NMR during storage at 2°C for up to 32 days. The oxidative stability of marine PL emulsions during storage was further investigated through the measurement of secondary volatile compounds by solid-phase microextraction (SPME) and dynamic headspace (DHS) connected to gas chromatography (GC-MS). Non-enzymatic browning reactions were investigated through the measurement of Strecker derived volatiles, colour changes and pyrrole content. The results suggested that the oxidative stability of marine PL emulsions was significantly influenced by the chemical composition and the concentration of marine PL used to prepare them. Emulsions with good oxidative stability could be prepared from marine PL of high purity and high content of PL and antioxidant and low TAG content.

Oxidative stability of marine phospholipids in the liposomal form and their applications.

Marine phospholipids (MPL) have attracted a great deal of attention recently as they are considered to have a better bioavailability, a better resistance towards oxidation and a higher content of eicosapentaenoic (EPA) and docosahexaenoic acids (DHA) than oily triglycerides (fish oil) from the same source. Due to their tight intermolecular packing conformation at the sn-2 position and their synergism with α-tocopherol present in MPL extracts, they can form stable liposomes which are attractive ingredients for food or feed applications. However, MPL are still susceptible to oxidation as they contain large amounts polyunsaturated fatty acids and application of MPL in food and aquaculture industries is therefore a great challenge for researchers. Hence, knowledge on the oxidative stability of MPL and the behavior of MPL in food and feed systems is an important issue. For this reason, this review was undertaken to provide the industry and academia with an overview of (1) the stability of MPL in different forms and their potential as liposomal material, and (2) the current applications and future prospects of MPL in both food and aquaculture industries with special emphasis on MPL in the liposomal form.

A biomechanical evaluation of the relative load change in the joints of the wrist with ulnar shortening: a 'handbag' model.

The wrist joint is loaded not only while applying a proximally directed load but also, less obviously, while carrying a handbag. Ulnar shortening reduces pressure and relieves pain in the ulnocarpal joint. The present study evaluated the pressure distribution in the wrist joints with ulnar shortening and lengthening when applying traction to the flexed fingers while the fingers were loaded and unloaded. The compressive forces in the loaded wrist were distributed with 67% across the radiocarpal joint and 33% across the ulnocarpal joint. Shortening the ulna by 3 mm increased load in the radius to 80%. Lengthening of the ulna by 1 mm increased its load to 55%. The load share of the distal radioulnar joint was constant even when the ulna was shortened 3-4 mm. It seems advisable to shorten the ulna by 3 mm, since the increased load in the related joints are constant within a range of -2 to -4 mm.

Influence of fish oil supplementation on in vivo and in vitro oxidation resistance of low-density lipoprotein in type 2 diabetes.

OBJECTIVE: Fish oil supplement has been proposed as a non-pharmacological strategy to correct the atherogenic lipid profile associated with type 2 diabetes mellitus. However, fish oil may have deleterious effects on lipid peroxidation and glycemic control. DESIGN: In this study, 44 type 2 diabetic patients were randomized to vitamin E standardized (53.6 mg/day) supplementation (capsules) with 4 g daily of either fish oil (n=23) or corn oil (n=21) for 8 weeks preceded by a 4 week run-in period of corn oil supplementation. LDL was isolated by density gradient ultracentrifugation and oxidized in vitro with Cu(2+). As a marker of in vivo oxidation malondialdehyde concentration in LDL (LDL-MDA) was measured. RESULTS: Fish oil reduced both mean lag time (before, 57.8; after, 48.8 min, P<0.001) and mean propagation rate (before, 0.018 DeltaOD/min; after, 0.015 DeltaOD/min, P<0.001), whereas corn oil had no influence on lag time and propagation rate. The changes in lag time and propagation rate differed significantly between fish oil and corn oil treatment. LDL-MDA changes differed borderline significantly between groups (FO, 110.4 pmol/mg protein; CO, 6.7 pmol/mg protein; P=0.057). Fish oil supplementation had no influence on glycemic control as assessed from HbA(1c) and fasting blood glucose. CONCLUSION: According to our findings, fish oil supplementation leads to increased in vivo oxidation and increased in vitro oxidation susceptibility of LDL particles. More studies are needed to clarify the clinical importance of this finding.

Arthroscopy of the proximal interphalangeal joints of the finger.

Cadaveric studies were carried out to evaluate the technique, portals and possible indications for arthroscopy of the proximal interphalangeal joints of the finger. We suggest horizontal placement of the hand instead of using a traction tower, as it is important to be able to flex the joint freely. The recommended arthroscopic portals are either between the central slip and the lateral bands of the extensor mechanism or between the lateral band and the collateral ligament. A blunt technique of introduction is used to avoid iatrogenic cartilage damage and possible digital nerve injury.

Winchester syndrome.

Winchester syndrome was first described in 1969 and since then nine patients have been reported in the literature. The syndrome is characterized by short stature, coarse face, corneal opacities, generalized osteolysis and progressive painful arthropathy with joint stiffness and contractures of distal phalanges in combination with skin changes. The etiology is unknown. Parental consanguinity supports autosomal inheritance. The diagnosis is based on clinical and radiological manifestations. We describe a case in a 7-year-old Pakistani boy.

Repeated digital nerve block for pain control after tenolysis.

We describe a way of achieving immediate painfree mobilisation after tenolysis or tenosynovectomy in Zone II. Bupivacaine is instilled along the flexor tendon sheath through a thin percutaneous catheter with an antibacterial filter.

Effect of meal fat quality on oxidation resistance of postprandial VLDL and LDL particles and plasma triacylglycerol level.

This study was performed to examine the postprandial effects of meals containing dietary fats, with their natural fatty acid composition and tocopherol content, on the plasma triacylglycerols (TG) and tocopherols and on the resistance of VLDL and LDL to oxidation. On six separate days eighteen healthy male subjects were given low-fat meals (LF) or the LF meals enriched with sunflower oil (SO), rapeseed oil (RO), olive oil (OO), palm oil (PO), or butter (B) in a crossover design. The fat-rich meals all resulted in similar postprandial TG responses while the LF test meal did not increase plasma TG level. The postprandial plasma fatty acid profile changed to resemble the fatty acid composition of the ingested test fat. The alpha-tocopherol:gamma-tocopherol ratios in postprandial plasma and VLDL samples were greater than in the test fats. We found that the resistance of VLDL particles to oxidation in the postprandial state as assessed from lag time was increased after the PO-rich meal as compared with the SO-rich meal (p = 0.018), and the propagation rate was greater after the SO- and RO-rich meals compared with the others (p < 0.001). The resistance of LDL particles to oxidation was unaffected by the meals. In postprandial VLDL samples, the content of alpha-tocopherol was greater after the OO- and SO-rich meals compared with the meal rich in PO (P = 0.034 and 0.042 respectively). The gamma-tocopherol content of VLDL was highest after RO-meal as compared with all other test meals (P = 0.0019), and higher after SO as compared with B (P = 0.0148). Large individual differences were noted. In conclusion, meals enriched with different fats lead to the formation of VLDL particles with varying resistance to oxidation.

Hyperextension injury to the PIP joint or to the MP joint of the thumb--a clinical study.

We present a prospective study of the diagnosis and clinical course of 60 patients with 57 pure hyperextension injuries to the proximal interphalangeal (PIP) joint of the long fingers (fingers 2-5) and seven injuries to the metacarpophalangeal (MP) joint of the thumb. Thirty four of the injuries (57%) were related to ball sports, and the ulnar fingers of the non-dominant hand were usually affected. There were 24 avulsion fractures at the site of the insertion of the volar plate on to the middle phalanx. Twelve (20%) initially presented with hyperextension instability, and this was usually associated with an avulsion fracture. Thirty four of the patients (57%) had symptoms for less than one month, while 10 (17%) complained of symptoms six months after the injury. Severe complications such as daily pain and stiffness were encountered in three cases. The triad sign (pain on extreme flexion and extension) was of no use as a diagnostic or prognostic factor, nor did the radiographic stress-view help to identify acute instability of the joint.

[Ultrasonically guided gastroscopically assisted percutaneous internal drainage of pancreatic pseudocysts]. / Ultralydvejledt gastroskopiassisteret perkutan intern draenage af pancreaspseudocyster.

Non-surgical procedures are increasingly being used for drainage of pancreatic pseudocysts. We describe the results of placement of a double pigtail cystogastric stent under ultrasonographic and gastroscopic guidance. The stent was placed in 22 of 25 pseudocysts. There was no mortality associated with the procedure and the total complication rate was 20%. The cysts resolved in all patients and 87% reported reduction of abdominal pain. The median stent-time was 347 days and there were no cyst recurrences or complications during that time. After removal of the stent four out of 19 patients had recurrences. After placement of a second stent in these four patients there were no recurrences. Treatment with a cystogastric stent is comparable to surgical cystogastrostomy as regards to results and has fewer complications.

Prediction of hormone responsiveness by mammographic parenchymal pattern in advanced primary breast cancer.

Ninety-two women with advanced, unilateral breast cancer were classified according to the Wolfe and Nottingham classifications of mammographic parenchymal pattern (MPP). Both classifications of MPP were significantly correlated to the estrogen receptor (ER) status of the breast carcinoma, but could not be used for prediction of response to hormonal therapy. Age distribution was significantly different among Wolfe types as well as between ER groups, but a multiple regression analysis showed that both age and Wolfe pattern were significant and independent predictors of the ER status.

Renal candida infections. Diagnosis by ultrasonography.

Sonographic features of renal candidiasis are nonspecific. Ultrasonically guided aspiration and culture is a quick and easy way to reach the exact diagnosis. We describe one case of parenchymal and one case of pelvic candidiasis diagnosed by percutaneous aspiration.

Mammographic features of sclerosing adenosis presenting as a tumour.

A re-examination study was made of 18 cases of histologically verified adenosis tumour from 12 different hospitals in Denmark. Four mammographic appearances could be identified. No pathognomonic sign or appearance could be identified. The median age of the patients was 42 years. The mean diameter of the 'tumour' was 2.1 cm. The diagnostic problem of malignant and benign breast disease is discussed.

Relation between mammographic findings and hormonal receptor content in breast cancer.

A comparative investigation of 85 patients with unilateral primary breast cancer was performed to elucidate a possible correlation between the mammographic appearance of the cancer and the content of hormonal receptors (estrogen and progesterone). The mammographic appearance was divided into five types: (1) spiculated; (2) structural changes in the parenchyma (density); (3) calcifications; (4) circumscribed; and (5) not visible on mammogram. The hormonal content was found to be high in types 1 and 2, low in 3 and 4, and intermediate in 5. Statistically significant difference in the estrogen receptor content was found between 1 and 3; 1 and 3 + 4; 1 and 3 + 4 + 5. In progesterone receptor content, a statistically significant difference was found between 1 and 3 + 4. The results concerning estrogen receptor content within each cancer type, except type 2, are comparable to those of a Swedish study. No correlation was found between Wolfe's parenchymal patterns and hormonal receptor content, which contradicts a recent English study. Reasons for this discrepancy are discussed.

Cerebrovascular disease in Utah, 1968--1971.

Utah mortality rates for cerebrovascular disease (ICD numbers 430--438) are 13% below U.S. rates. About 70% of Utahns are members of the Church of Jesus Christ of Latter-day Saints, commonly called Mormons of LDS, which proscribes use of tobacco and alcohol. Other studies on this group have found significantly lower occurrence of many cancers and ischemic heart disease. We tested the hypothesis that Utah's lower cerebrovascular disease (CBVD) mortality was contributed by the LDS population. We classified by religion all CBVD deaths (2,521) (except subarachnoid hemorrhage and cerebral embolism) occurring in the state in 1968--1971. No significant difference was found between LDS and non-LDS, but both groups had mortality rates below U.S. expectation. Although recent studies have reported smoking to be a risk factor for CBVD, we found no consistent difference between the LDS and non-LDS, even in the younger age groups. The results do not support the hypothesis that tobacco is an important etiologic agent in CBVD mortality.