Human pharmacokinetic profile of 1,25-dihydroxyvitamin D3-glycoside of herbal origin.

A natural form of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), the active metabolite of vitamin D, was identified in glycosylated form in Solanum glaucophyllum (SG). Solbone P, an extract of SG with high and homogenous content of glycosylated 1,25(OH)2D3, was chemically characterized and produced under GMP conditions. Three different doses of glycosylated 1,25(OH)2D3 were given as single oral dose to 16 healthy volunteers in a first-in-man trial. The oral pharmacokinetic properties of 1,25(OH)2D3 of SG origin were established and the subjects were monitored until day 28 for safety reasons. This included regular monitoring of vital signs, electrocardiogram (ECG) data, calcium, phosphate and creatinine values. Subjects were exposed to up to the equivalent of a 40-fold level of the recommended human daily dose for synthetic 1,25(OH)2D3 (0.5µg/subject/day) without experiencing any untoward effects. When compared with the historically established pharmacokinetics profile of synthetic 1,25(OH)2D3, glycosylated 1,25(OH)2D3 of herbal origin exhibited delayed absorption characteristics. The phenomenon is species independent, as similar pharmacokinetic patterns were observed in rats and chickens. This modified release pattern may be attributed to the glycosylation of herbal 1,25(OH)2D3 because de-glycosylation by ubiquitous intestinal enzymes prior to intestinal uptake of the unmodified 1,25(OH)2D3 is the rate-limiting step. The major relevance of this finding is that the human pharmacokinetic profile of glycosylated 1,25(OH)2D3 of herbal origin is reminiscent of a delayed release formulation of free 1,25(OH)2D3, resulting in a wider therapeutic window, a potentially longer therapeutic effectiveness, and thus, a better pharmacologic tolerance. This article is part of a Special Issue entitled '16th Vitamin D Workshop'.

First Report of Colletotrichum acutatum sensu lato Causing Anthracnose on Gooseberry Fruits in the Czech Republic.

Gooseberry (Ribes uva-crispa L.) is a commonly grown fruit tree or bush in the Czech Republic. Colletotrichum acutatum J. H. Simmonds is a polyphagous fungal plant pathogen. This pathogen has been reported causing anthracnose on strawberry in the Czech Republic (2), and recently it has become an important pathogen on the fruits of apple and tomato (4). In 2012, anthracnose symptoms were noticed on fruits of gooseberry (locality Pribyslavice, near Brno). The symptoms on fruit surfaces were round, brown, shriveled, sunken spots of 1.2 to 2.0 cm, with orange conidial masses on the spots. The pathogen was isolated from symptomatic fruits on PDA and cultured at 25 ± 2°C. The color of colonies varied with age from white to gray with occurrence of orange conidial masses. Conidia were colorless and fusiform, size 13 to 17 × 4 to 5 µm (n = 100). The morphological characteristics classified the pathogen as a Colletotrichum sp. To fulfill Koch's postulates, 25 disinfested healthy gooseberry fruits were pinpricked by sterile needle and 10 µl of spore suspension (1 × 105 conidia ml-1) was inoculated by pipetting into the wound. Control fruits were treated with sterile distilled water. The fruits were transferred to a growth cabinet and maintained at a temperature of 25 ± 2°C, relative humidity 70 ± 5%. Similar anthracnose symptoms were observed on all of gooseberry fruits a week after inoculation, whereas no symptoms appeared on control fruits. The pathogen was reisolated from infected fruits. Species determination of the isolates was confirmed by PCR. Specific primers designed in region ITS1, the 5.8S RNA gene, and region ITS2 of the pathogen DNA were selected. Specific primers CaInt2 and ITS4 were used to identify C. acutatum (3), and primers CgInt and ITS4 were used to determine C. gloeosporioides isolate CCM 177 (1), which was used as a control. Our isolates yielded PCR products (size 490 bp) only with primers designed for C. acutatum. The C. gloeosporioides isolate yielded PCR product (size 450 bp) only with CgInt and ITS4 primers. PCR products were sequenced and identified with the BLAST program. The sequence of the gooseberry fruit isolates (Accession No. JX843763 and JX843764) matched with 100% similarity to the C. acutatum sequences in GenBank. To our knowledge, this is the first report of C. acutatum sensu lato on gooseberry fruits in the Czech Republic. This pathogen can endanger the production of gooseberry fruits in this region. References: (1) P. R. Mills et al. FEMS Microbiol. Lett., 98:137, 1992. (2) D. Novotný et al. Plant Dis. 91:1516, 2007. (3) S. Sreenivasaprasad et al. Plant Pathol. 45:650, 1996. (4) J. Víchová et al. Plant Dis. 96:769, 2012.

First Report of Colletotrichum acutatum on Tomato and Apple Fruits in the Czech Republic.

Apple (Malus domestica Borkh.) is a fruit traditionally grown in the Czech Republic, and tomatoes (Solanum lycopersicum Mill.), too, are widely raised in this region. Colletotrichum acutatum J. H. Simmonds is a polyphagous fungal plant pathogen. Earlier, this pathogen caused disease on strawberry in the Czech Republic (2), and now it has become an important pathogen on safflower (4). During the 2010 harvest, anthracnose symptoms were noticed on the fruits of apple and tomato. Infected apples fruits (localities Velká Bítes and Znojmo) and tomatoes (localities Velká Bítes and Zabcice) were collected. Typical symptoms on fruit surfaces were round, brown, shriveled and sunken spots, 1.2 to 2.0 cm, with orange conidial masses appearing on the spots. A fungus was isolated from each host on potato dextrose agar and cultured at 25 ± 2°C for 10 days. Mycelium was superficial, partly immersed, and white to gray with occurrence of orange conidial masses. Conidia of the tomato and apple isolates were colorless and fusiform. The size of conidia from the apple and tomato isolates, respectively, ranged from 11 to 15 × 2.5 to 3.5 µm and 11 to 16 × 2.5 to 4 µm. Morphological characteristics suggested that the isolated fungi was a Colletotrichum sp. To fulfill Koch's postulates, healthy tomato and apple fruits were disinfected with 3% sodium hypochlorite for 2 min and rinsed in sterile distilled water. Fruits were pinpricked with a sterile needle and 10 µl of a spore suspension (1 × 105 conidia ml-1) was inoculated by pipetting into the wound. Control fruits were treated with sterile distilled water. The fruits were transferred to a growth cabinet and maintained at a temperature of 25 ± 2°C, relative humidity of 70 ± 5%, and a photoperiod of 12 h. Similar disease symptoms as in the collected fruits were observed on tomato fruits at 7 days and apple fruits at 20 days after inoculation, while no symptoms appeared on control fruits. The pathogen was reisolated from infected fruits. Species determination of the isolates was confirmed by PCR. Specific primers designed in region ITS1, the 5.8S RNA gene, and region ITS2 of the pathogen DNA were selected. Specific primers CaInt2 and ITS4 were used to identify C. acutatum (3), and primers CgInt and ITS4 were used to determine C. gloeosporioides isolate CCM 177 (1), which was used as a control. Our isolates yielded PCR products (490 bp) only with primers designed for C. acutatum. The C. gloeosporioides isolate yielded a PCR product (450 bp) only with CgInt and ITS4 primers. PCR products were sequenced and identified with the BLAST program. The sequence of the tomato fruit isolate (Accession No. JN676199) and apple fruit isolate (Accession No. JN676198) matched with 100% similarity to the C. acutatum sequences in GenBank. The control isolate of C. gloeosporioides matched 100% to sequences AJ749682 and AJ749692. To our knowledge, this is the first report of C. acutatum on tomato and apple fruits in the Czech Republic. This pathogen can endanger the production and storage of apples and tomatoes in this region. References: (1) P. R. Mills et al. FEMS Microbiol. Lett. 98:137, 1992. (2) D. Novotný et al. Plant Dis. 91:1516, 2007. (3) S. Sreenivasaprasad et al. Plant Pathol. 45:650, 1996. (4) J. Víchová et al. Plant Dis. 95:79, 2011.

Colletotrichum simmondsii Causing Anthracnose on Safflower in the Czech Republic.

Safflower (Carthamus tinctorius L.) is an oil crop that is suitable for dry growing conditions in the Czech Republic. Most of the Czech production is used as bird feed. Typical anthracnose symptoms were observed at one safflower field in the Moravia Region of the Czech Republic during the 2005 growing season. Since then, the disease has become widespread with 100% yield losses observed in several locations in 2009. Symptoms consisted of circular spots on leaves and stem blight characterized by dark-colored stem lesions bearing salmon-colored conidia masses in acervuli. A fungus was isolated from symptomatic safflower plants (cv. Sabina) on potato dextrose agar and incubated at 25°C as described by Kwon et al. (3). The color of fungal colonies changed from white to gray with age with salmon-orange pigmentation on the reverse side of plates. Similar observations had been reported by Jelev et al. (1). Conidia were colorless, fusiform, and measured 10 to 17 µm (mean 13.59) × 4 to 8 µm (mean 5.98). Morphology suggested a Colletotrichum sp. To fulfill Koch' postulates, safflower plants at the BBCH 12 growth stage (second leaf fully expanded) were spray inoculated with a conidia suspension (1 × 105 conidia/ml). Growth chamber conditions were temperature 20 ± 1°C, relative humidity 70 ± 5%, with a 16-h photoperiod. Control plants were treated with sterile distilled water. Typical anthracnose symptoms were observed 1 week after inoculation. Control plants were symptomless. The pathogen was reisolated from infected stems and leaves. PCR with primers CaInt2 and ITS4 was used to confirm the identification of a Colletotrichum sp. Reaction products obtained with these primers were approximately 500 bp long. The ribosomal DNA internal transcribed spacer region containing ITS1, 5.8S, and ITS2 of the isolate from safflower was sequenced and identified with the BLASTn program. The sequence matches with 100% similarity to the sequence of the Glomerella acutata teleomorph of Colletotrichum acutatum (GenBank Accession No. AB548282) and 100% similarity to C. simmondsii (GenBank Accession No. GU183359). C. acutatum and C. simmondsii can be distinguished from each other by pigment color (4), with the safflower isolate matching the description of C. simmondsii. Kim et al. (2) recorded C. acutatum on safflower fields in the Euiseong area of Korea in 1997. To our knowledge, this is the first report of C. simmondsii causing safflower anthracnose in the Czech Republic. References: (1) Z. J. Jelev et al. Plant Dis. 92:172, 2008. (2) W. G. Kim et al. Plant Pathol. J. 15:62, 1999. (3) J. H. Kwon et al. Plant Pathol. J. 15:172, 1999. (4) R. G. Shivas and Y. P. Tan. Fungal Divers. 39:111, 2009.

Soil [N] modulates soil C cycling in CO2-fumigated tree stands: a meta-analysis.

Under elevated atmospheric CO(2) concentrations, soil carbon (C) inputs are typically enhanced, suggesting larger soil C sequestration potential. However, soil C losses also increase and progressive nitrogen (N) limitation to plant growth may reduce the CO(2) effect on soil C inputs with time. We compiled a data set from 131 manipulation experiments, and used meta-analysis to test the hypotheses that: (1) elevated atmospheric CO(2) stimulates soil C inputs more than C losses, resulting in increasing soil C stocks; and (2) that these responses are modulated by N. Our results confirm that elevated CO(2) induces a C allocation shift towards below-ground biomass compartments. However, the increased soil C inputs were offset by increased heterotrophic respiration (Rh), such that soil C content was not affected by elevated CO(2). Soil N concentration strongly interacted with CO(2) fumigation: the effect of elevated CO(2) on fine root biomass and -production and on microbial activity increased with increasing soil N concentration, while the effect on soil C content decreased with increasing soil N concentration. These results suggest that both plant growth and microbial activity responses to elevated CO(2) are modulated by N availability, and that it is essential to account for soil N concentration in C cycling analyses.

Variability of Bean yellow mosaic virus isolates in the Czech Republic.

Three isolates of Bean yellow mosaic virus (BYMV) from the Czech Republic originating from gladiolus plants were examined according to their biological and molecular characteristics. Partial sequence of coat protein-nuclear inclusion protein b (CP-NIb) coding region (768 bp) of these isolates were determined and compared with the corresponding sequences of different BYMV isolates obtained from GeneBank. Phylogenetic analysis showed that the Czech BYMV isolates were distributed across the three groups of phylogenetic tree. Their placement was not dependent on the geography or host plant.

Photocycle dynamics of the E149A mutant of cryptochrome 3 from Arabidopsis thaliana.

The E149A mutant of the cryDASH member cryptochrome 3 (cry3) from Arabidopsis thaliana was characterized in vitro by optical absorption and emission spectroscopic studies. The mutant protein non-covalently binds the chromophore flavin adenine dinucleotide (FAD). In contrast to the wild-type protein it does not bind N5,N10-methenyl-5,6,7,8-tetrahydrofolate (MTHF). Thus, the photo-dynamics caused by FAD is accessible without the intervening coupling with MTHF. In dark adapted cry3-E149A, FAD is present in the oxidized form (FAD(ox)), semiquinone form (FADH(.)), and anionic hydroquinone form (FAD(red)H(-)). Blue-light photo-excitation of previously unexposed cry3-E149A transfers FAD(ox) to the anionic semiquinone form (FAD()(-)) with a quantum efficiency of about 2% and a back recovery time of about 10s (photocycle I). Prolonged photo-excitation leads to an irreversible protein re-conformation with structure modification of the U-shaped FAD and enabling proton transfer. Thus, a change in the photocycle dynamics occurs with photo-conversion of FAD(ox) to FADH(.), FADH(.) to FAD(red)H(-), and thermal back equilibration in the dark (photocycle II). The photocycle dynamics of cry3-E149A is compared with the photocycle behaviour of wild-type cry3 and other photo-sensory cryptochromes.

Genetic and biological diversity of the Pea seed-borne mosaic virus isolates occurring in Czech Republic.

Eight isolates of the Pea seed-borne mosaic virus (PSbMV) from the Czech Republic were studied regarding their biological and molecular characteristics. Molecular characterization using RT-PCR was done on the 5'(Nter)NIb-CP-UTR3' region amplified using universal CPUP/P9502 primer pair and the newly designed PSB8812/PSB944, and PSB8800/PSB9440 primer pairs, respectively. Sequential and phylogenetic analysis of CP-UTR3' region from all isolates showed that the available Czech and GenBank PSbMV isolates were distributed into 4 clusters in agreement with their diversification and according to their biological characteristics (i.e. pathotype). The molecular data were confirmed by biological testing on different pea cultivars. The Czech isolates were distributed into two pathotypes, the P-1 (7 isolates) and P-4 (1 isolate).

Higher content of C18:1 trans fatty acids in early human milk fat of Roma breast-feeding women.

AIM: The purpose of our study was to determine the content of trans fatty acids in early human breast milk as an indicator of dietary exposure in a sample of Roma breast-feeding women and in a sample of women from the general Czech population. METHODS: We collected samples of early human milk from 43 Prague women from the general population and 21 Roma women. After lipid extraction, the fatty acids were converted into methyl esters (FAMEs). Finally, gas chromatography with flame ionization detector (GC-FID) analysis on a CP-Sil 88 column was used to determine C18:1 trans monoenic fatty acid levels and total trans isomers fatty acid levels in human milk. RESULTS: A significantly higher content of C18:1 trans fatty acid isomers was detected in human milk fat from Roma mothers than in women of the general population (2.73 vs. 2.09%, p < 0.05). Both groups monitored did not differ in the representation of total fatty acid trans isomers. Differences in the frequency of consumption of certain TFA sources (butter, fried crisps) were established. CONCLUSIONS: The study proved a higher fatty acid trans isomers content in Roma breast-feeding mothers in the Czech Republic, and this is probably related to their bad eating habits.

Absorption and fluorescence spectroscopic characterization of cryptochrome 3 from Arabidopsis thaliana.

The blue light photoreceptor cryptochrome 3 (cry3) from Arabidopsis thaliana was characterized at room temperature in vitro in aqueous solution by optical absorption and emission spectroscopic studies. The protein non-covalently binds the chromophores flavin adenine dinucleotide (FAD) and N5,N10-methenyl-5,6,7,8-tetrahydrofolate (MTHF). In the dark-adapted state of cry3, the bound FAD is present in the oxidized form (FAD(ox), ca. 38.5%), in the semiquinone form (FADH., ca. 5%), and in the fully reduced neutral form (FAD(red)H2) or fully reduced anionic form (FAD(red)H-, ca. 55%). Some amount of FAD (ca. 1.5%) in the oxidized state remains unbound probably caused by chromophore release and/or denaturation. Förster-type energy transfer from MTHF to FAD(ox) is observed. Photo-excitation reversibly modifies the protein conformation causing a slight rise of the MTHF absorption strength and an increase of the MTHF fluorescence efficiency (efficient protein conformation photo-cycle). Additionally there occurs reversible reduction of bound FAD(ox) to FAD(red)H2 (or FAD(red)H-, FAD(ox) photo-cycle of moderate efficiency), reversible reduction of FADH. to FAD(red)H2 (or FAD(red)H-, FADH. photo-cycle of high efficiency), and modification of re-oxidable FAD(red)H2 (or FAD(red)H-) to permanent FAD(red)H2 (or FAD(red)H-) with low quantum efficiency. Photo-excitation of MTHF causes the reversible formation of a MTHF species (MTHF', MTHF photo-cycle, moderate quantum efficiency) with slow recovery to the initial dark state, and also the formation of an irreversible photoproduct (MTHF'').

Iodine saturation of Roma neonates in prague is not at an optimum level.

AIM: The purpose of our study was to determine urinary iodine as an indicator of iodine supplementation in Roma (Gypsy) neonates compared to majority population neonates. METHODS: The groups studied were formed by 30 full-term Roma neonates and 151 majority population neonates. Iodine was determined from samples of urine collected on the 4th day after delivery, after alkaline ashing, using the Sandell-Kolthoff method. RESULTS: The median of urinary iodine in Roma neonates was 92.15 microg/l urine and in neonates from majority population mothers it was 109.20 microg/l urine. The mean of urinary iodine in Roma neonates was 114.55 microg/l urine (SD 71.68 microg/l) and in neonates from majority population mothers it was 141.86 microg/l urine (SD 87.42 microg/l). The difference was not statistically significant. Majority population mothers more frequently consumed nutrition supplements containing iodine as well as fish. CONCLUSIONS: Compared to older data, supplementation of neonates with iodine is higher. However, it does not reach optimum levels. The urinary iodine median in Roma neonates lies in the mild iodine deficiency band.

Chloride transport in the vegetative mycelia of filamentous fungus Trichoderma viride.

The influx of chlorides into Trichoderma viride vegetative submerged mycelium was measured by means of the radionuclide (36)Cl(-). It was found that the (36)Cl(-) influx was time-dependent (the steady-state was established with t(1/2 )= 25 min at 25 degrees C), pH-dependent (with pH optimum between 4-5.5), temperature-dependent (at about 15 degrees C), and concentration-dependent (K(M)(Cl(-))) = 47.6 +/- 4.2 micromol x l(-1); J(max) = 11.5 +/- 0.7 pmol(Cl(-)) x min(-1). mg(dry mass) (-1)). The (36)Cl(-) influx was inhibited by Br(-) but not F(-), I(-), SO(4)(2-), HPO(3)(2-) and HCO(3)(-). The presence of vanadate (P-type ATPase inhibitor) moderately stimulated the (36)Cl(-) influx but the presence valinomycin (electrogenic K(+) ionophore), salicylate (known to release Ca(2+) from Trichoderma viride internal stores) were without effect on the (36)Cl(-) influx. The results suggest that the (36)Cl(-) influx is mediated by a carrier and that the transport is electroneutral, probably Cl(-)/OH(-) antiport.

Copper complexes with bioactive ligands. Part II--Antifungal activity.

Antifungal activity of new copper(II) complexes of 2-methylthionicotinate (2-MeSNic) of the composition Cu(2-MeSNic)2(MeNia)(2).4H2O (where MeNia is N-methylnicotinamide), and Cu(2-MeSNic)2(Nia)(2).2H2O (where Nia is nicotinamide) and Cu(2-MeSNic)2L2 (where L is isonicotinamide, iNia, or ethyl nicotinate, EtNic) were tested on various strains of filamentous fungi by the macrodilution method. Most sensitive against copper(II) adducts with bioactive ligands were Rhizopus oryzae and Microsporum gypseum (IC50 1.5-2.3 mmol/L). The adducts with Nia, MeNia and EtNic at 5 mmol/L induced morphological changes in growing hyphae of Botrytis cinerea, mainly their intensive branching attached to release of cytoplasm with partial growth inhibition. Inhibition of sporulation (> 90%) of Alternaria alternata by Cu(2-MeSNic)2.H2O was observed as a change in the color of the colonies. The highest resistance was marked by B. cinerea and Fusarium moniliforme (average IC50 values 4.25 and 3.13 mmol/L, respectively). The presence of all bioactive ligands in copper(II) complexes caused an increase in the inhibition effect against model fungi (except significant inhibition activity of EtNic on R. oryzae).

Copper complexes with bioactive ligands Part I--Antimicrobial activity.

Biological properties of new copper(II) complexes of 2-methylthionicotinate (2-MeSNic) of composition Cu(2-MeSNic)2(MeNia)(2).4H2O (where MeNia is N-methyl-nicotinamide), Cu(2-MeSNic)2(Nia)(2).2H2O (where Nia is nicotinamide) and Cu(2-MeSNic)2L2 (where L is isonicotinamide (iNia) or ethyl nicotinate (EtNic)) are reported. Gram(-)-bacteria (Escherichia coli) are more resistant against Cu(II) complexes than Gram(+)-bacteria (Staphylococcus aureus)--significant antistaphylococcal activity was found with Cu(2-MeSNic)2(MeNia)(2).4H2O (IC50 1.3 mmol/L). Candida parapsilosis was most inhibited by Cu(2-MeSNic)2.H2O and Cu(2-MeSNic)2(MeNia)(2).4H2O (IC50 1.4 mmol/L and 1.5 mmol/L, respectively). Biosynthesis of nucleic acids influenced by Cu(2-MeSNic)2(Nia)(2).2H2O indicated by incorporation of 14C-adenine (IC50(Ade) 0.31 mmol/L) is more sensitive than biosynthesis of proteins indicated by incorporation of 14C-leucine (IC50(Leu) 9.94 mmol/L). Cu(II) complexes with expressed antimicrobial activity showed no mutagenic activity.

What's new with tumor markers for colorectal cancer?

BACKGROUND/AIMS: Many tumor markers have been utilized in the follow-up care of colorectal cancer patients. No marker, however, has proven reliably accurate in detecting recurrent disease. METHODS: The strengths and weaknesses of currently available tumor markers are reviewed, with attention to related cost and efficacy. RESULTS: Tumor antigens, enzymes, and genetic markers have been used as tumor markers. CEA and CA 19.9 are the most widely utilized; however, genetic markers are the most promising for the future. CONCLUSIONS: Currently available markers have significant limitations. Development of genetic markers may greatly enhance our ability to predict prognosis and the need for adjuvant therapy. Marker-guided therapy may play an increasing role in this disease.

Limited utility of preoperative studies in preparation for colostomy closure.

Numerous diagnostic and therapeutic practices are used in an attempt to reduce the morbidity of colostomy closures. Our principal aim was to evaluate the role of preoperative studies, specifically barium enemas and endoscopic examinations, performed before colostomy closures. Additionally, we wished to identify other practices involved in the perioperative management of patients undergoing colostomy closure that influenced morbidity. The records of 100 consecutive patients who underwent elective colostomy closure at University of Louisville Hospital between January 1989 and July 1995 were reviewed. Wound infection was the most common complication (12%). Various bowel preparations were equivalent in efficacy and did not influence the complication rate. Intermittent wound irrigation with antibiotics for 3 days postoperatively, via subcutaneous drains, was associated with a low incidence of incision infection. Preoperative barium enema or sigmoidoscopy were often performed but rarely useful. Performing these examinations merely increased hospital cost without a corresponding decline in morbidity.

Birth weight of neonates as an indicator of morbidity and mortality in adult age and factors which influence it.

In 28 neonates born by spontaneous delivery to healthy mothers with a normal course of gestation venous umbilical blood was examined to assess the immunoreactive insulin concentration. Moreover, the birth weight of the neonates was recorded, the weight increment of the mother during pregnancy and the body mass index at the end of gestation. By means of a questionnaire and the computer programme Progana the dietary intake of the mothers at the end of pregnancy was assessed and compared with recommended allowances. The assembled data were evaluated statistically by assessment of the correlation coefficient. The investigation revealed that the birth weight of the neonates in the group does not correlate with the immunoreactive insulin concentration in umbilical venous blood. Although the dietary intake of the mothers at the end of pregnancy is not ideal (fat and cholesterol intake predominates over carbohydrate and protein intake), it does not correlate with the birth weight of the neonates nor with the immunoreactive insulin concentration in umbilical venous blood. From these results the conclusion is drawn that neonates with a low birth weight do not have a higher plasma insulin concentration after delivery and that the mother's diet at the end of pregnancy does not influence the birth weight and insulin level in neonates.

Laparoscopic repair of lumbar hernias.

BACKGROUND: Lumbar hernias are rare defects in the posterolateral abdominal wall that may be congenital or acquired. Repairing these defects is difficult by virtue of their location and the inherent weakness of the surrounding tissues. We report a series of seven patients who had their lumbar hernias repaired laparoscopically at two institutions. STUDY DESIGN: We retrospectively reviewed all lumbar hernias repaired laparoscopically in our institutions within the last 16 months (August 1996 to November 1997). Postoperative followup was 1-15 months. RESULTS: Seven patients underwent laparoscopic repair. Five hernias were acquired defects and two were congenital. One to three defects were found per patient. The average size of the hernia defect was 77.8 cm2. We used a polypropylene or a polytetrafluoroethylene mesh in all patients; the average size of the mesh used was 336.4 cm2. The average length of hospital stay was 1.7 days. One patient returned with an abscess over the mesh, which necessitated removal of the graft. Otherwise, there were no complications, and the remaining six patients had no recurrences after followup of 1-14 months. CONCLUSIONS: The laparoscopic approach is safe and effective for repairing lumbar hernias. Advantages of this approach include excellent operative visualization, decreased hospital stay postoperatively, and a solid repair without recurrence during shortterm followup.

The natural resistance-associated macrophage protein gene is associated with Crohn's disease.

BACKGROUND: Identification of the genes causing inflammatory bowel disease (IBD) would enhance the understanding of and the treatment options for this disease. A hyperreactive immune response toward the intestinal flora has been implicated in the pathology of IBD. The natural resistance-associated macrophage protein (NRAMP) gene is believed to regulate macrophage function, especially the ability to fight intracellular pathogens. Genetic differences of NRAMP might, therefore, be associated with IBD. METHODS: Two DNA markers (D2S434 and D2S1323) near NRAMP were polymerase chain reaction (PCR) amplified and genotyped with DNA from 103 patients with Crohn's disease, 85 patients with ulcerative colitis, and 98 control subjects. Clinical data were obtained for all patients. Comparisons were made by chi-squared analysis. Disease association with significant haplotypes was expressed as odds ratio. RESULTS: Allele and genotype distributions were similar for both markers among all groups. Haplotype frequencies were different among Crohn's disease and control groups (p = 0.024). Two individual haplotypes of the patients with Crohn's disease were significant compared with control subjects: DA (p = 0.023; odds ratio, 0.5; 95% confidence interval, 0.3 to 0.9) and EA (p = 0.001; odds ratio, 3.5; 95% confidence interval, 1.6 to 3.2). The haplotype distribution was different within three age-of-onset groups of patients with Crohn's disease (p = 0.05). CONCLUSIONS: This study is the first to report an association between the NRAMP gene and Crohn's disease.