[Migraine in children and adolescents-brain and muscle? : Another example of why children are not small adults]. / Migräne im Kindes- und Jugendalter ­ Gehirn und Muskel? : Warum Kinder einmal mehr keine kleinen Erwachsenen sind.

Migraine as primary headache is a life-long disease which is relevant for the quality of life and is based on complex genetics. It often starts in childhood with symptoms typical for the specific age. These show different nuances compared to the migraine symptoms in adults, for example, regarding (bilateral/unilateral) localization of the acute migraine headache. Only over the course of years-during adolescence and young adulthood-do the more specific symptoms as defined by the International Classification of Headache Disorders (ICHD 3 beta) develop. In this article we focus on the clinical specifics of children and adolescents with migraine. We elaborately refer to the trigeminocervical complex (TCC) because it forms a conceptual bridge for the understanding of migraine, for psychoeducation, and for therapeutic options. We pragmatically discuss options and limits of treatments.

Hepatitis E: an emerging infectious disease in Germany?

Increased frequencies of HEV infections have been reported in several industrialized countries. We suggest that this finding might be explained by a better awareness of the disease and not by an increased incidence. Although reported HEV infections increased more than 6-fold in Germany in recent years, the seroprevalence remained unchanged (2 %).

Differentiation-regulated serine phosphorylation of STAT1 promotes GAF activation in macrophages.

Gamma interferon (IFN-gamma), a macrophage-activating cytokine, modulates gene expression through the activity of a transcription factor designated IFN-gamma activation factor (GAF). GAF is formed after phosphorylation on tyrosine and dimerization of the 91-kDa protein STAT1. We have recently reported that differentiation of the promonocytic cell line U937 into monocytes increases the amount of cellular GAF after IFN-gamma treatment and at the same time increases the phosphorylation of STAT1. Here we show that activation of the JAK family kinases, which are instrumental in mediating STAT1 phosphorylation on tyrosine, did not increase upon monocytic U937 differentiation. Consistent with this finding, levels of STAT1 tyrosine phosphorylation were virtually identical in promonocytic and monocytic U937 cells. Analysis of STAT1 phosphoamino acids and mapping of phosphopeptides showed an IFN-gamma-dependent increase in Ser phosphorylation in differentiated cells. Analyses of STAT1 isoforms by two-dimensional gel electrophoresis demonstrated a differentiation-induced shift toward more acidic isoforms. All isoforms were equally sensitive to subsequent tyrosine phosphorylation, as indicated by a sodium dodecyl sulfate-polyacrylamide gel electrophoresis mobility shift typical for tyrosine-phosphorylated STAT1. Consistent with the importance of Ser phosphorylation for high-affinity binding to the IFN-gamma activation site sequence, phosphatase 2A treatment strongly reduced the formation of IFN-gamma activation site-GAF complexes in an electrophoretic mobility shift assay. Our data indicate that the activity of GAF is modulated by STAT1 serine kinases/phosphatases and suggest that this mechanism is employed in the developmental control of macrophage responsiveness to IFN-gamma.

Mineral- and trace element concentrations in human breast milk, placenta, maternal blood, and the blood of the newborn.

The concentrations of the essential trace elements Cu, Fe, and Zn, and of the mineral elements Ca, K, Mg, and P during the perinatal period in human placenta and in the blood of the mother and the newborn (cord blood) were determined. Breast milk (colostrum and transitory milk) was also included to permit correlations between the different compartments. No correlations were found. The uptake by nutrition and the body-pools of the mother and their mobilization for these elements seem to be sufficiently high for an adequate supply of the fetus and the milk in the geographical region of Munich (Bavaria, FRG) under these investigations. Differences in the mineral-and trace element concentrations of colostrum and transitory milk for the elements P and Zn and to a lesser extent for Ca and Mg were observed. Additionally, breast milk samples from different geographical regions in Bavaria were investigated. Results for the heavy metals Cd, Hg, and Pb, and for the essential trace element Se are also presented for these samples, and can be seen as a reflection of the overall environmental and dietary influences during pregnancy in these geographical regions. ICP (Inductively Coupled Plasma)-emission spectrometry was used for the determination of the elements Cu, Fe, Zn, Ca, K, Mg, and P. For the additionally given elements in the milk-samples anodic stripping voltammetry (DPASV) (Cd, Pb), hydride atomic absorption spectrometry (AAS) (Se), and cold vapor AAS (Hg) were applied.

Effect of Mn and Fe on the reactivity of sulfated zirconia toward H2 and n-butane: a diffuse reflectance IR spectroscopic investigation.

Sulfated zirconia (SZ) and sulfated zirconia promoted with 2 wt % manganese (MnSZ) or iron (FeSZ), all active in n-butane isomerization, were investigated using diffuse reflectance Fourier transform IR spectroscopy (DRIFTS). By adsorption of H(2) at 77 K or of n-butane at room temperature, it was found that the promoters neither enhance the Lewis nor the Brønsted acid strength. SZ and promoted SZ do not exhibit higher acid strength than zeolites. In a batch experiment using 70 hPa of H(2), SZ did not react at 473 K. Reaction of H(2) with MnSZ produced water (band at 5242 cm(-1)) and a decrease in the sulfate groups (multiple bands). Heating of SZ in 10 hPa n-butane to 573 K caused total reduction of sulfate to H(2)S (2583, 2570 cm(-1)) and partial and total oxidation of butane to olefinic species (3062 cm(-1)), CO(2), and water. MnSZ and FeSZ reacted with n-butane already at 373 K; products of skeletal isomerization (methyne CH vibration at 2910 cm(-1)) were detected and sulfate groups were consumed. Rather than increasing the acidity, the promoters enhance the oxidation potential of sulfate and facilitate alkane activation via oxidative dehydrogenation.

HPV 16 DNA in autopsy material of a metastatic cervical carcinoma.

Human papillomavirus (HPV) DNA has been regularly detected in primary cervical carcinomas and in some metastatic lesions. Using Southern blot hybridization on autopsy material we found HPV 16 DNA in a primary cervical carcinoma and in multiple metastases therefrom.

[The influence of pregnancy on the venous return from the lower extremities (author's transl)]. / Einfluss der Gravidität auf die venöse Drainagefunktion der unteren Extremitäten

Determination of intravenous pressure in the lower extremities revealed in 77 pregnant women a marked insufficiency of the venous drainage. In the last third of pregnancy the capacity of the venous drainage is reduced by approximately 30 per cent. Determination two to five days post partum showed a significant improvement but not yet complete normalization. The causes of the insufficiency of the venous drainage are hormonal influences, dilating the vessels, which are still active post partum. The insufficient venous return is a major factor in the genesis of varicosity during pregnancy. The disturbance of venous return by the large uterus will result in an increase of static venous pressure on the average of 10 mm Hg. In the upright position this is a qualitatively as well as quantitatively individually variable phenomenon. There ist no relation between the increase in static venous pressure and the occurrence of varicosity.

[Breech presentation and its significance (author's transl)]. / Die Beckenendlage und ihre Behandlung

From 1959 to 1975, 1060 (3.6%) breech presentations were found among 29,463 infants. The breech deliveries from May 1, 1959 to December 31, 1965 were compared with those from January 1, 1966 to December 31, 1975. Among the 3.6% breech deliveries there were 47% male and 53% female. There were more primigravida breech deliveries in both groups. The mean age of the mothers was 25.4 years for primigravidas and 29.4 years for multiparas. There was a maternal mortality of 0.2% (2 cases) in breech delivery. 29% of the breech deliveries were premature deliveries. There was a strickingly high incidence of frank and full breech deliveries among all patients. Knee presentations were rare. Delivery was primarily accomplished with the Bracht manoeuver in over 80% of the cases. Complete breech extractions decreased and the incidence of Caesarean Sections rose from 6% in the first group to 21% in the second group of patients. During the past 3 years the Caesarean Section rate was approximately 30%. Perinatal complications in the breech deliveries compare well to those reported in the literature. Of 750 mature infants (70.8%), 12 died (1.6%). Discounting children with congenital malformations and intrauterine stillbirth there remained 5 deaths from breech deliveries (0.7%). Of 1032 breech deliveries with a birth weight of 1000 grams or over, 74 infants (over all perinatal mortality 7.2%) died. 110 infants of all breech deliveries had a birth weight of less than 2500 grams (prematurity rate 29.2%). Of 102 cases of perinatal mortality in breech deliveries including those below 1000 grams 90 (88.2%) were premature. Of those 90 premature deaths, 28 infants were less than 1000 grams. 25 infants showed fetal congenital abnormalities. The corrected perinatal mortality of the premature deliveries was therefore 11.9%. The rate of birth trauma was 6.3% in the first group and 2.7% in the second group.

[Behavior modification and obesity (author's transl)]. / Verhaltenstherapie und Ubergewicht.

Good results were obtained treating 49 obese patients with an elaborated selfcontrol behavior modification program. This program was an addition to the normal program of the obesity clinic of the 2. Medizinische Klinik der Universität Düsseldorf. The normal program contains some principles of behavior modification but less accentuated. After the initial 12 weeks of controlled training patients tried to reduce weight further decreasing external control. Only few patients were able to loose additional pounds during this period of 8 weeks. At the end of the initial 12 weeks patients had asked for another control before the vacational season, but only 10 out of 49 appeared at the control sessions 9 months after the program's start. If an additional behavior modification program is considered for incorporation into an already existing weight reduction clinic, additional costs and expected results have to be checked. Durative success of behavior modification techniques in weight loss programs has still to be submitted to proof.

[Trace elements in the human placenta (author's transl)]. / Spurenelemente in der menschlichen Plazenta

The determination of the mentioned elements was carried out by the neutron activation analysis with lollowing radio-chemical separation. The comparison of trace elements in the human placenta from different regions of Bavaria showed a high concentration of Sb, Br, La and Co in Munich. This fact is explained by the environmental pollution of the large city. Placentas from the Bavarian forest contained a higher amount of Ce and Hg. Cer is contained in the rock of this region. The increase in Hg from that region is unexplained.

[Determination of aluminium in blood-serum by inductively coupled plasma (ICP)-spectroscopy (author's transl)]. / Direktbestimmung von Aluminium in Serumprobel mittels Inductively Coupled Plasma (ICP)-Emissionsspektralanalyse.

The application of ICP emission spectroscopy for the direct determination of aluminium in blood serum was investigated and the method with all important parameters is described. The well known matrix interferences in atomic absorption spectroscopy do not exist in ICP spectroscopy, due to the very high excitation temperature of the sample of about 8000 K. It is therefore possible to perform very sensitive and reproducible measurements.

A novel interferon-alpha-regulated, DNA-binding protein participates in the regulation of the IFP53/tryptophanyl-tRNA synthetase gene.

We have investigated the transcriptional response of the IFP53/tryptophanyl-tRNA synthetase gene to interferon-alpha (IFN-alpha). A single gamma-interferon activation site (GAS) in proximity to the transcription start sites was found to mediate the response of the IFP53 gene to IFN-alpha. This DNA element bound two distinct protein factors, alpha-interferon activation factor 1 (AAF1) and AAF2, which were rapidly activated in the cytoplasm of IFN-alpha-treated HeLa cells. AAF1, like the gamma-interferon activation factor, bound to the GAS from different IFN-responsive promoters and contained the 91-kDa ISGF3 protein (p91). However, in complexes with the IFP53 or Ly6A/E GAS, p91 was the only ISGF3 protein, whereas in the case of the GBP GAS, the 48-kDa protein (p48) was also present. AAF2 was found to preferentially bind to the IFP53 GAS, but not at all to the GBP GAS, and contained no ISGF3 protein. Therefore, GAS-binding regulatory factors in the IFN-alpha response can either consist of proteins found in ISGF3 or be formed by distinct proteins that are similarly linked to IFN-alpha-induced signal transduction.

Constitutive STAT1 tyrosine phosphorylation in U937 monocytes overexpressing the TYK2 protein tyrosine kinase does not induce gene transcription.

Janus kinase (JAK) family protein tyrosine kinases are constituents of a signaling path leading to tyrosine phosphorylation and activation of signal transducer and activator of transcription (STAT) family transcription factors. IFN-alpha activates two JAK family protein tyrosine kinases (TYK2 and JAK1) and two STAT family proteins (STAT1 and STAT2). We have generated a line of U937 promonocytes expressing a tyk2 transgene. 12-O-Tetradecanoylphorbol-13-acetate-mediated differentiation into monocytes resulted in transgene induction and both overexpression and constitutive activation of the kinase. TYK2 protein in the transgenic line was found predominantly in a membrane fraction. Coprecipitation experiments demonstrated an association of constitutively tyrosine-phosphorylated TYK2 with the IFN-alpha receptor 1 chain. TYK2 activity led to an IFN-alpha-independent appearance of tyrosine-phosphorylated STAT1 but not STAT2 or JAK1 proteins. Consistent with this, TYK2 activity also caused constitutive activation of the IFN-alpha-responsive transcription factor IFN-alpha activation factor, a dimer of tyrosine-phosphorylated STAT1, but not of the IFN-alpha-responsive transcription factor IFN-stimulated gene factor 3, a heterotrimer of tyrosine-phosphorylated STAT1 and STAT2 in association with a M(r) 48,000 DNA-binding subunit. Expression of STAT1 target genes was not observed in TYK2-overexpressing cells. Our results suggest that in addition to activated TYK2, there is a requirement for additional, IFN-alpha-dependent signals for the phosphorylation of STAT2 and the generation of IFN-stimulated gene factor 3 as well as for the conversion of tyrosine-phosphorylated STAT1 into transcriptionally active IFN-alpha activation factor.