High hydrostatic pressure induced extraction and selective transfer of ß-phosvitin from the egg yolk granule to plasma fractions.

Egg yolk phosvitin is of particular interest due to its functional and biological properties. Recently, it was demonstrated that high hydrostatic pressure (HHP) (400 MPa for 5 min) induced the transfer of folic acid and phosvitin from the egg yolk granule to the plasma fraction. A granule fraction (Gin) produced by egg yolk centrifugation was pressure-treated at 400 and 600 MPa for 5 and 10 min, and centrifuged to generate granule fractions (GP1 to GP4) and plasmas (PP1 to PP4). Iron and phosphorus contents were also increased in PP1 to PP4 fractions, confirming the transfer of phosvitins from pressure-treated granule to plasma. Pressurization drastically improved phosvitin recovery in PP fractions, specifically at 600 MPa for 10 min, which had the highest value of phosvitin/100 mg of dry plasma at 33.3 ± 4.39 mg. Consequently, HHP represents an alternative approach for phosvitin transfer and recovery in the egg yolk soluble fraction.

Recent Developments in Folate Nutrition.

The term folate (vitamin B9) refers to a group of water-soluble compounds that are nutritionally essential for the support of optimal human health and development. Folates participate in numerous one-carbon transfer reactions, including the methylation of important biomolecules (lipids, amino acids, DNA). A deficiency of folate leads to pathological outcomes including anemia and impairments in reproductive health and fetal development. Due to the linkage of impaired folate status with an increased prevalence of neural tube defects (NTDs) in babies, several jurisdictions required the fortification of the food supply with folic acid, a synthetic and stable form of folate. Data from the postfortification era have provided strong evidence for the reduction of NTDs due to folic acid fortification. However, concern is now growing with respect to the amount of synthetic folic acid within the human food supply. Excess folic acid intake has been linked to a masking of vitamin B12 deficiency, and concerns regarding the promotion of folate-sensitive cancers, including colorectal cancer. New strategies to ensure the supply of optimal folate to at-risk populations may be needed, including the use of biofortification approaches, in order to address recent concerns.

Effect of Freezing, Thermal Pasteurization, and Hydrostatic Pressure on Fractionation and Folate Recovery in Egg Yolk.

In this study, the impact of pasteurization and freezing of raw material, as performed at a commercial scale, on egg yolk fractionation and folate recovery was assessed. Freezing induced denaturation of the lipoproteins in egg yolk, which prevented further fractionation of the yolk. Thermal pasteurization of egg yolk at 61.1 °C for 3.5 min as well as high hydrostatic pressure (HHP) treatment (400 MPa for 5 min) did not change (p < 0.05) the composition of egg yolk or yolk fractions after their recovery by centrifugation. Expressed as dry matter, folate in pasteurized yolk was measured to be 599 µg/100 g, while its concentration reached 1969.7 µg/100 g for pasteurized granule and 1902.5 µg/100 g for HHP-treated granule. Folate was not detected in plasma, emphasizing the complete separation of yolk folate into granule. Further, we studied the effect of HHP on different dilutions of egg yolk, which were then fractionated. Egg yolk was diluted with water at different concentrations (0.1, 1.0, 10, 25, and 50%), HHP-treated at 400 MPa for 5 min, and centrifuged. Characterization of the compositions of the separated granule and plasma followed. Folate was stable under the HHP conditions used. However, HHP caused separation of folate from the yolk structure into water-soluble plasma. After HHP processing, the amount of folate detected in the plasma fraction was significantly (p < 0.05) higher (1434.9 µg/100 g) in the 25% diluted samples but was significantly (p < 0.05) lower in HHP-treated granule samples. Native sodium dodecyl sulfate-polyacrylamide gel electrophoresis results showed that phosvitin, α-livetin, and apovitellenin VIa were the proteins most resistant to HHP. This study confirms that dilution of egg yolk before HHP treatment can significantly (p < 0.05) change the composition of granule and plasma fractions after centrifugal fractionation of egg yolk.

The use of high hydrostatic pressure to generate folate-enriched extracts from the granule fraction of hen's egg yolk.

The present work characterized the effects of pre-treatments on the protein profile and microstructure of granule fractions from egg yolk. The granule microstructure was studied using confocal laser scanning microscopy (CLSM). The protein profiles of the pre-treated granule and the corresponding plasma fraction were studied using 2D gel electrophoresis techniques. Further, we explored the potential for using high hydrostatic pressure (HHP) to promote disintegration of the granule structure. The CLSM micrographs provided evidence of the substantial disintegration of granules due to HHP (600MPa/5min). Results from high performance liquid chromatography (HPLC) analysis indicated high concentrations of folate in the plasma fractions (230µg/g dry matter) separated from the HHP-treated granule. Sodium Dodecyl Sulphate-Polyacrylamide Gel Electrophoresis (SDS-PAGE) analysis revealed the localization of phosvitin in the plasma fraction, which correlated with higher folate concentrations. The results demonstrate that phosvitin and folate were stable under the HHP conditions applied in this study. These findings provide evidence of a putative interaction between phosvitin and folate, and offer an improved model for the structure of granule.

Effects of High Hydrostatic Pressure Processing on Hen Egg Compounds and Egg Products.

High hydrostatic pressure (HHP), used alone or with other processes, is an emerging technology increasingly used in the food industry to improve microbial safety, and the functionality and bioactive properties of food products. HHP provides a way to reduce energy requirements for food processing and may contribute to improved energy efficiency in the food industry. Hen egg is used by the food industry to formulate many food products. To improve the microbiological safety of egg and egg-derived products, HHP processing is an attractive alternative to heat- pasteurization and a potential technology. However, HHP treatment induces structural modifications of egg components (such as proteins) which could positively or negatively affect the physicochemical and functional properties of egg-derived products. Improving our knowledge regarding the potential of HHP in the egg industry will add value to the final food products and increase profitability for egg producers and the food industry.

Epicardial adipose tissue volume as a marker of coronary artery disease severity in patients with diabetes independent of coronary artery calcium: findings from the CTRAD study.

AIMS: The association between epicardial adipose tissue (EAT) volume and coronary artery disease (CAD) severity was evaluated, independent of traditional risk factors and coronary artery calcium (CAC) scores, in patients with diabetes type 2 (DM-2) using cardiac computed tomography angiography (CTA). METHODS: A multivariate analysis was utilized to assess for an independent association after calculating EAT volume, CAD severity, and calcium scores in 92 patients with DM-II from the CTRAD study. We graded CAD severity as none (normal coronaries), mild-moderate (<70% stenosis), and severe (70% or greater stenosis). RESULTS: A total of 39 (42.3%) asymptomatic patients with diabetes did not have CAD; 30.4% had mild/moderate CAD; and 27.1% had severe CAD. Mean EAT volume was highest in patients with severe CAD (143.14 cm(3)) as compared to mild/moderate CAD (112.7 cm(3)), and no CAD (107.5 cm(3)) (p = 0.003). After adjustment of clinical risk factors, notably, CAC score, multivariate regression analysis showed EAT volume was an independent predictor of CAD severity in this sample (odds ratio 11.2, 95% confidence interval 1.7-73.8, p = 0.01). CONCLUSIONS: Increasing EAT volume in asymptomatic patients with DM-II is associated with presence of severe CAD, independent of BMI and CAC, as well as traditional risk factors.

Comparison of epicardial adipose tissue volume and coronary artery disease severity in asymptomatic adults with versus without diabetes mellitus.

Epicardial adipose tissue (EAT) has been shown to have important effects on the development of coronary artery disease (CAD) through local paracrine influences on the vascular bed. We compared a cohort of asymptomatic patients with type II diabetes mellitus (DM) without known CAD to an age- and gender-matched group of asymptomatic patients without DM from the CTRAD (Cardiac CT's Role in Asymptomatic Patients with DM-II) study in which patients underwent a cardiac computed tomography angiogram, for early detection of CAD. Mean EAT volumes of 118.6 ± 43.0 and 70.0 ± 44.0 cm(3) were found in the DM and non-DM groups, respectively. When stratified by the presence and severity of CAD, it was found that in the DM (p = 0.003) and non-DM groups (p <0.001), there was a statistically significant increase in EAT volume as the patients were found to have increasingly severe CAD. After adjusting for age, race, gender, DM, hypertension, insulin use, body mass index, and coronary artery calcium (CAC) score, the presence of >120 cm(3) of EAT was found to be highly correlated with the presence of significant CAD (adjusted odds ratio 4.47, 95% confidence interval 1.35 to 14.82). We found that not only is EAT volume an independent predictor of CAD but that an increasing volume of EAT predicted increasing severity of CAD even after adjustment for CAC score.

Patient characteristics and comorbidities associated with cerebrovascular accident following acute myocardial infarction in the United States.

BACKGROUND: Although cerebrovascular accident (CVA) is a relatively infrequent complication of acute myocardial infarction (AMI), the occurrence of CVA in patients with AMI is associated with increased morbidity and mortality. We wanted to assess post-AMI CVA rate in the United States and identify the associated patient characteristics, comorbidities, type of AMI, and utilization of invasive procedures. METHODS: This is an observational study from the Nationwide Inpatient Sample, 2006-2008. Using multivariate regression models, we assessed predictive risk factors for post-AMI CVA among patients admitted for AMI. RESULTS: Among the 1,924,413 patients admitted for AMI, the overall rate of CVA was 2% (ischemic stroke: 1.47%, transient ischemic attack [TIA]: 0.35% and hemorrhagic stroke: 0.21%). In this sample of AMI patient, higher incidence of CVA was associated with: CHF (adjusted odds ratio [AOR] 1.71; 95% confidence interval [CI], 1.58-1.84,), age over 65 AOR, 1.65; 95% CI, 1.60-1.70, alcohol abuse AOR, 1.60; 95% CI, 1.49-1.73, cocaine use AOR, 1.48; 95% CI, 1.29-1.70, atrial fibrillation AOR, 1.43; 95% CI, 1.39-1.46, Black race AOR, 1.35; 95% CI, 1.30-1.40, female gender AOR, 1.32; 95% CI, 1.29-1.35, peripheral vascular disease [PVD] AOR, 1.26; 95% CI, 1.22-1.30, coronary artery bypass graft (CABG) AOR, 1.22; 95% CI, 1.17-1.27, P<0.0001, STEMI AOR, 1.17; 95% CI, 1.14-1.20 and teaching hospitals AOR, 1.09; 95% CI, 1.06-1.12. CONCLUSION: Female gender, older age (age≥65), black ethnicity, comorbidities including CHF, PVD, atrial fibrillation as well as STEMI and undergoing CABG were associated with the highest risk of CVA post-AMI.

Can vitamin D supplementation improve the severity of congestive heart failure?

The aim of the present study was to investigate whether vitamin D supplementation could improve biochemical findings and functional capacity of patients with heart failure (HF). One hundred patients with New York Heart Association (NYHA) class I through III HF were included in this prospective study and their 25-hydroxyvitamin D levels were evaluated. Only 6% of the participants had a sufficient serum concentration of 25(OH) D >30 nmol/L. Patients with insufficient or deficient serum levels of 25(OH) D (<30 ng/mL and <20 ng/mL, respectively) received oral vitamin D3 (cholecalciferol) for a total period of 4 months. Vitamin D supplementation increased mean serum concentration of 25(OH) D from 12.63±7.60 nmol/L to 54.49±18.01 nmol/L (P<.001). After vitamin D supplementation, the serum level of pro-brain natriuretic peptide markedly decreased (P<.001). Cholecalciferol significantly decreased high-sensitivity C-reactive protein level (P<.001). Restoration of serum 25(OH) D level was also associated with substantial improvement in NYHA class (P<.001) and 6-minute walk distance (P<.001).

Comparison of laparoscopic versus open appendectomy for acute nonperforated and perforated appendicitis in the obese population.

BACKGROUND: Use of laparoscopic appendectomy (LA) has been increasing in obese patients. We evaluated the outcomes of LA compared with open appendectomy (OA) in obese patients. METHODS: By using the Nationwide Inpatient Sample database, clinical data of obese patients who underwent LA and OA for suspected acute appendicitis (perforated or nonperforated) from 2006 to 2008 were examined. RESULTS: A total of 42,426 obese patients underwent an appendectomy during this period. In acute nonperforated cases, LA had a lower overall complication rate (7.17% vs 11.72%; P < .01), mortality rate (.09% vs .23%; P < .01), mean hospital charges ($25,193 vs $26,380; P = .04), and shorter mean length of stay (2.0 vs 3.1 d; P < .01) compared with OA. Similarly, in perforated cases, LA was associated with a lower overall complication rate (22.34% vs 34.65%; P < .01), mortality rate (.0% vs .50%; P < .01), mean hospital charges ($36,843 vs $43,901; P < .01), and a shorter mean length of stay (4.4 vs 6.5 d; P < .01) compared with OA. CONCLUSIONS: LA can be performed safely with superior outcomes compared with OA in obese patients and should be considered the procedure of choice for perforated and nonperforated appendicitis in these patients.

Diffusion-weighted imaging of the abdomen at 3 T: image quality comparison with 1.5-T magnet using 3 different imaging sequences.

OBJECTIVE: This study aimed to perform comparisons between diffusion-weighted imaging (DWI) sequences at 3 T with 1.5 T. METHODS: Thirteen healthy volunteers underwent abdominal DWI on both 3- and 1.5-T magnets using 3 sequences including breath hold without parallel imaging (PI), breath hold with PI, and free breathing with PI at b50 and b1000. Artifacts and subjective image quality scores, signal intensity, and apparent diffusion coefficient were compared. RESULTS: For breath hold without PI, higher artifact was noted at 3 T b50 compared with 1.5 T (P < 0.0001). For b50 and b1000 breath hold with PI, artifacts were not different between the magnets, but image quality was better at 3 T (P = 0.04 and P = 0.02, respectively). For b50 and b1000 free breathing sequences, artifact and image quality scores were significantly better at 1.5 T. For breath hold acquisitions, the signal-to-noise ratio of gallbladder, kidneys, and pancreas was generally higher and that of the liver was lower on 3 T. Imaging at 3 T showed significantly higher image quality and lower artifacts for breath hold with PI compared with free breathing. Most apparent diffusion coefficients were not significantly different between the 2 magnets (P > 0.05). CONCLUSIONS: Three-tesla magnets can provide good images using breath hold with PI sequence.

Plasma homocysteine level in patients with Behcet's disease with or without thrombosis.

AIM: To find the possible role of plasma homocysteine level as a contributing factor in venous and arterial thrombosis in patients with Behcet's disease (BD). METHODS: In a case control study, two groups of BD patients were included: 47 with thrombosis and 49 without thrombosis. All patients fulfilled the International Study Group Criteria for BD and the confirming diagnostic procedures for vascular thrombosis were either Doppler sonography or angiography. Forty-nine controls were selected by consecutive sampling among age and sex matched healthy subjects. Plasma homocysteine level was measured by ELISA in all. The clinical and laboratory characteristics of the disease were compared between the two groups of BD patients. Comparisons were done by ANOVA and Chi square tests; correlations were analyzed with Pearson test. RESULTS: The mean plasma homocysteine level was significantly higher in BD patients (14.9±13.9 µMol/L) than in healthy controls (9.9±6.7 µMol/L), P<0.02. The difference was also significant when comparing the three groups by ANOVA: BD patients with thrombosis (24.2±13.2 µMol/L), BD patients without thrombosis (5.9±7.0 µMol/L), and healthy controls (P<0.0001). We found no correlation between plasma homocysteine level and any organ involvement other than thrombosis. The mean plasma homocysteine level was lower in HLA-B51 positive BD patients (11.6±12.1 vs. 21.7±16.3 µMol/L, P<0.05), but the difference was not significant in those with thrombosis (20.9±13.2 vs. 29.5±12.7 µMol/L, P=0.18). CONCLUSION: Hyperhomocysteinaemia may be an independent risk factor for vascular thrombosis in patients with BD. This is the first study showing a negative correlation between HLA-B51 and plasma homocysteine level.

Nailfold capillaroscopy in Behçet's disease, analysis of 128 patients.

The aims of this study were to find the characteristics and prevalence of nailfold capillary changes in a large series of patients with Behçet's disease (BD) and to analyze their possible relation to other clinical characteristics of the disease. We performed nailfold capillaroscopy in 128 randomly selected patients fulfilling the international classification criteria for BD. Capillaroscopy was done in eight fingers with a x3.2 microscopy. All patients were questioned for history of Raynaud's phenomenon, ischemic ulcers, smoking, and hypertension. A computerized form including demographic, clinical, and para-clinical features was used to collect data. Univariate and multivariate logistic regressions were used to analyze the relation between capillaroscopic findings and disease characteristics. Odds ratio and a confidence interval at 95% (CI) were calculated for each item. The mean age of the patients was 37 +/- 10 years, and the male to female ratio was 1.56:1. Capillaroscopy was abnormal in 51 patients (40%, CI 8.5). Enlarged capillaries were seen in 33 patients (26%, CI 7.6), hemorrhages in 21 (16%, CI 6.4), and capillary loss only in one patient. In univariate logistic regression analysis, the presence of enlarged capillaries was associated with lower age at disease onset (OR = 0.9, CI 0.9-1; p = 0.04), hypertension (OR = 4.2, CI 1.5-11.4; p = 0.006), superficial phlebitis (OR = 5.5, CI 1.2-24.4; p = 0.03), and negative pathergy test (OR = 0.4, CI 0.2-0.9; p = 0.04). The presence of hemorrhages tended to be associated with articular symptoms (p = 0.05). Multivariate analysis also confirmed the association of enlarged capillaries with lower age at disease onset (p = 0.01), hypertension (p = 0.001), and superficial phlebitis (p = 0.03). Nailfold abnormalities, mainly enlarged capillaries, are frequent in patients with BD. Our results suggest that these abnormalities may be related to other vascular features of the disease such as superficial phlebitis, but it does not seem to confer special risk for any other specific clinical symptom of the disease.