An easy-to-use semiquantitative food record validated for energy intake by using doubly labelled water technique.

BACKGROUND: Estimating dietary intake is important for both epidemiological and clinical studies, but often lacks accuracy. OBJECTIVE: To investigate the accuracy and validity of energy intake estimated by an easy-to-use semiquantitative food record (EI(SQFR)) compared to total energy expenditure (TEE) estimated by doubly labelled water technique (EE(DLW)). DESIGN: TEE was measured in 29 nonobese subjects using the doubly labelled water method over a period of 14 days. Within this period, subjects reported their food consumption by a newly developed semiquantitative food record for 4 consecutive days. Energy intake was calculated using the German Food Code and Nutrition Data Base BLS II.3. RESULTS: A good correlation was observed between EI(SQFR) and EE(DLW) (r = 0.685, P < 0.001). The mean difference between EI(SQFR) and EE(DLW) was -1.7+/-2.6 MJ/day (-14+/-21%, P = 0.002). An underestimation of EI(SQFR) <10% was observed in nine subjects (31%), of 10-20% in six subjects (21%), and of >20% in nine subjects (31%). In five subjects (17%), an overestimation of EI(SQFR) was observed. CONCLUSIONS: The easy-to-use semiquantitative food record provided good estimates of EI in free-living and nonobese adults without prior detailed verbal instructions. The presented food record has limitations regarding accuracy at the individual level.

Heat shock response is associated with protection against acute interstitial pancreatitis in rats.

We recently reported that hyperthermia induces pancreatic expression of heat shock proteins (HSPs), particularly HSP70 isoforms, and protects against cerulein pancreatitis. We have now studied whether a double hyperthermia amplifies these effects and whether hyperthermia also protects against dibutyltin dichloride (DBTC)-induced pancreatitis. A further aim was to examine whether hyperthermia induces changes in transforming growth factor-beta1 (TGF-beta1). Following pretreatment without or with a single or double hyperthermia, pancreatitis was induced by application of cerulein or DBTC. Pancreatic HSP and TGF-beta1 expression were studied by immunoblotting. Pancreas injury was assessed by light microscopy and serum pancreatic enzyme activity. Hyperthermia as well as DBTC induced HSP72, whereas cerulein did not. A double hyperthermia led to a further increase in HSP72 compared to a single heat stress. In both models, hyperthermia significantly reduced pancreatic injury. Although a double hyperthermia slightly decreased the severity of cerulein pancreatitis compared to a single heat treatment, an improved pancreas protection against DBTC cytotoxicity was not achieved. We also found that hyperthermia induces the expression of TGF-beta1. In conclusion, hyperthermia preconditioning exerts protective effects against two pathophysiologically different types of pancreatitis by a mechanism that involves the up-regulation of HSP70 isoforms as well as TGF-beta1.

Increased cytosolic Ca2+ amplifies oxygen radical-induced alterations of the ultrastructure and the energy metabolism of isolated rat pancreatic acinar cells.

BACKGROUND: Oxygen radicals have been implicated as important mediators in the early pathogenesis of acute pancreatitis, but the mechanism by which they produce pancreatic tissue injury remains unclear. We have, therefore, investigated the effects of oxygen radicals on isolated rat pancreatic acinar cells as to the ultrastructure, cytosolic Ca2+ concentration and energy metabolism. METHODS: Acinar cells were exposed to an oxygen radical-generating system consisting of xanthine oxidase, hypoxanthine and chelated iron ions. Cell injury was assessed by LDH release and electron microscopy. Cytosolic Ca2+ levels and mitochondrial membrane potential were determined by flow cytometry; adenine nucleotide concentrations by HPLC. Mitochondrial dehydrogenase activity was measured by spectrophotometric assay. RESULTS: Oxygen radicals damaged the plasma membrane as shown by a 6-fold LDH increase in the incubation medium within 180 min. At the ultrastructural level, mitochondria were the most susceptible to oxidative stress. In correlation to the pronounced mitochondrial damage, the mitochondrial dehydrogenase activity declined by 70%, whereas the mitochondrial membrane potential was enhanced by 27% after 120 min. Together this may cause the 85% decrease in the ATP concentration and the corresponding increase in ADP/AMP observed in parallel. In addition, an immediate 26% increase in cytosolic Ca2+ was found, a change which could be inhibited by BAPTA, reducing cellular damage. CONCLUSION: Cytosolic Ca2+ synergizes with oxygen radicals causing alterations of the ultrastructure and energy metabolism of acinar cells which might contribute to the cellular changes found in early stages of acute pancreatitis.

[Comparison of gastric emptying, blood glucose, and oro-cecal transit times after a conventional morning meal and a Kollath breakfast]. / Vergleichende Messungen von Magenentleerung, Blutglukose und orozökaler Transitzeit nach einer konventionellen Morgenmahlzeit und einem Kollath-Frühstück.

Blood glucose kinetics and intestinal transit times were investigated in 12 adult volunteers aged 28 to 52 years after ingestion of a conventional morning meal made up of white flour rolls, butter, marmalade, and coffee with sugar as compared with an isocaloric Kollath-breakfast consisting of whole wheat flakes as a basis. For estimation of gastric emptying time the sodium-[13C]acetate breath test technique was used. Oro-coecal transit time and gastric emptying were determined by simultaneous administration of lactose-[13C]ureide and consecutive drawings of breath samples in intervals of 15, 30, and 60 min through 12 h. The 13CO2-excess of the breath test samples was measured by continuous flow isotope ratio mass spectrometry. The postprandial rise in blood glucose following the ingestion of the Kollath-breakfast was lower as compared with the conventional morning meal, showing significant differences between the 90 min values and the area below the blood glucose curve. The half time of gastric emptying was not different between the two breakfast versions (1.7 vs. 1.6 h). The oro-coecal transit time averaged out at 4.2 h after the Kollath-breakfast and 5.3 h following the conventional morning meal. Likewise, there were no significant differences in the coecal retention time nor in the cumulative percentage of 13CO2-exhalation between the two breakfast versions. Concerning the blood glucose kinetics the differences in the nutritional physiology between the breakfast based on whole wheat flakes and the conventional breakfast as claimed by Kollath were only detectable in outlines in our study. Gastric emptying time showed no differences between the two breakfast versions.

Evaluation of oro-coecal transit time: a comparison of the lactose-[13C, 15N]ureide 13CO2- and the lactulose H2-breath test in humans.

OBJECTIVE: The lactulose H2-breath test is the most widely used non-invasive approach for evaluation of orocoecal transit time (OCTT). In the present study, doubly-labelled lactose-[13C, 15N]ureide (DLLU) was synthesized to investigate the OCTT in comparison to the conventional lactulose H2-breath test. Additionally the bacterial breakdown rate (BBR) and rate of elimination and the metabolic pathways of the cleavage products of DLLU (13CO2, [15N]urea, and 15NH3) were investigated. DESIGN AND SUBJECTS: In a first study, DLLU was administered as a single oral-pulse-labelling (dosage: one gram) either without and after pretreatment of five grams of unlabelled lactoseureide (LU) on the day prior to the study to twelve healthy adult volunteers after breakfast. Breath and urine were collected in one and two hour-intervals, respectively, over a one-day period. 13C-enrichment in breath as well as 15N-enrichment in urine fractions were measured by continuous flow-isotope ratio mass spectrometry (CF-IRMS). In a second study, lactulose was administered to the same subjects (dosage: ten grams). Breath was collected in quarter, half and one hour-intervals over a ten hour-period. Hydrogen concentration in breath was analysed using an electrochemical detector. RESULTS: The comparison of the lactose-[13C]ureide 13CO2-breath test and the lactulose H2-breath test showed that the mean increase of the 13C-enrichment in CO2 occurred 1.18 h later than the mean increase of H2 in breath. The resulting OCTTs derived from the two methods were 3.02 +/- 1.4 and 1.84 +/- 0.5 h (P < 0.05) and the corresponding BRs were 9.63 +/- 3.4 and 6.07 +/- 1.7 h (P < 0.01), respectively. The 15N-enrichment of urinary urea and ammonia without and after pretreatment with LU started between two and three hours after DLLU-administration. The cumulative percentage urinary excretion of the 15N- and 13C-tracer was 29.9% and 13.6% respectively, and was slightly increased after LU-pretreatment to 32.1% and 14.6% of the dose administered. A total of 35.2% of the 13C was found to be exhaled and remained approximately constant after LU-pretreatment (36.2%). CONCLUSIONS: The use of the lactulose H2-breath test for evaluation of the OCTT showed a statistically significant shortening of 1.18 h in comparison to the lactose-[13C]ureide 13CO2-breath test in healthy adults. The most important limitations of the lactulose H2-breath test are its low specificity and sensitivity due to dose-dependent accelerations of OCTT, interfering H2-rise from malabsorbed dietary fibre and H2-non-producers. In contrast, our lactose-[13C]ureide 13CO2-breath test was confirmed to avoid these disadvantages and to yield reliable results. This test is recommended especially if higher sensitivity and specificity is required, if IRMS-technique is available and if lactulose H2-tests lead to insufficient results.

Tracer kinetic studies on a methionine-supplemented soy-based infant formula using 1-13C- and 15N-methionine as tracers.

A tracer-kinetic study using 1-13C- and 15N-labeled L-methionine was conducted in order to measure the retention rate of free methionine added to commercially-produced soy-based infant formulas. Twelve male infants, fed on a soy formula, received a single-pulse labeling by oral administration of L-1-13C-methionine (5 mg/kg) and L-15N-methionine (10 mg/kg). The abundance of expired 13C-labeled CO2 was measured up to 7 h after administration at 15-, 30-, and 60-min intervals. Additionally, enrichment of total 15N and 15N in urinary ammonia were determined up to 48 h after administration. Retention rates of the labeled carboxyl group amounted to an average of 91.2% (SD 4.1) of the intake. A similar retention rate was measured for the 15N-label of methionine (90.0%, SD 4.3). The data point at the efficacy of methionine supplementation of soy-based infant formulas.

Enhancement of lysozyme trypsin-mediated decay of intestinal bifidobacteria and lactobacilli.

Lysozyme-mediated lysis of Bifidobacteria and Lactobacilli was studied in in vitro tests using the agar gel plate and turbidometric Micrococcus luteus (lysodeikticus) procedure as a standard. Suspensions of the strains Bifidobacterium infantis, B. infantis liberorum, B. breve, B. longum, B. ssp, and Lactobacillus acidophilus proved to be resistant to egg white lysozyme and human milk lysozyme when incubated at 37 degrees C in concentrations of 5, 50, and 500 mg lysozyme/L, respectively, through 30 and 60 min. Heat treatment at 100 degrees C for 1 h and pretreatment with ether, acetone, ascorbic acid, and hydrogen peroxide failed to incline the bacteria to the lytic effects of lysozyme. Consecutive incubation of the lysozyme-pretreated bacteria with trypsin resulted in a significantly enhanced bacteriolysis in all strains of bacteria, with the exception of B. longum. The mode of action of lysozyme and proteolytic enzymes on Bifidobacteria and Lactobacilli offers an explanation for the release of microbial building blocks and their colonic absorption and retention in the breast-fed baby.

Laparoscopic cholecystectomy in a young girl.

Laparoscopic cholecystectomy is now a widely used procedure in adults. However, reports on this procedure in infants and young children are rare. This paper reports a successful laparoscopic cholecystectomy in a young girl.

A screening method for the evaluation of selenium status.

A screening test for the estimation of the Se content in whole blood was developed. Blood was administered on to filter paper, dried at room temperature and circles of 28 mm circumference cut out. The blood volume corresponding to the stained circle amounted to 17.0 +/- 1.4 microL. The Se content was estimated by atomic absorption spectrophotometry + hydride generation technique after stepwise digestion of the blood stained filter papers. Precision (within-run 6.3%) and recovery rate (102%) were good. The screening test was used for samples from Magnesia, an area on the east coast of Greece, and Ningxia, a rural area in northeast China. The blood Se content was significantly lower in Greek mothers after birth than in Chinese mothers. Greek newborns had higher blood Se than their mothers. Greek infants showed a drastic decline in the blood Se values within the airst 4 months of life. The screening method showed good practicability in testing the blood Se content in samples from different areas of the world.