Peptide Lv Promotes Trafficking and Membrane Insertion of KCa3.1 through the MEK1-ERK and PI3K-Akt Signaling Pathways

Peptide Lv is a small endogenous secretory peptide that is proangiogenic through hyperpolarizing vascular endothelial cells (ECs) by enhancing the current densities of KCa3.1 channels. However, it is unclear how peptide Lv enhances these currents. One way to enhance the current densities of ion channels is to promote its trafficking and insertion into the plasma membrane. We hypothesized that peptide Lv-elicited KCa3.1 augmentation occurs through activating the mitogen-activated protein kinase kinase 1 (MEK1)-extracellular signal-regulated kinase (ERK) and phosphoinositide 3-kinase (PI3K)-protein kinase B (Akt) signaling pathways, which are known to mediate ion channel trafficking and membrane insertion in neurons. To test this hypothesis, we employed patch-clamp electrophysiological recordings and cell-surface biotinylation assays on ECs treated with peptide Lv and pharmaceutical inhibitors of ERK and Akt. Blocking ERK or Akt activation diminished peptide Lv-elicited EC hyperpolarization and increase in KCa3.1 current densities. Blocking PI3K or Akt activation decreased the level of plasma membrane-bound, but not the total amount of KCa3.1 protein in ECs. Therefore, the peptide Lv-elicited EC hyperpolarization and KCa3.1 augmentation occurred in part through channel trafficking and insertion mediated by MEK1-ERK and PI3K-Akt activation. These results demonstrate the molecular mechanisms of how peptide Lv promotes EC-mediated angiogenesis.

Comparative life cycle assessment (LCA) of pork using different protein sources in pig feed

Abstract. Feed production is the main contributor to a subset of environmental impacts of pork production. In this context, this study is concerned with the substitution of soy products in pig diets in order to reduce these impacts. The aim of this study was to assess three alternative diets in gestating and lactating sows as well as growing and finishing pigs in order to reduce the amount of soy products used as ingredients. In the three alternative scenarios soy proteins were compensated for by either using a combination of different feedstuffs (e.g. rapeseed meal, fava beans, and synthetic amino acids) (LOW), maximising the use of legumes (mainly fava beans) (LEG) and increasing the amount of synthetic amino acids (AA). These alternative scenarios were compared with standard diets (ST) and formulated in order to reduce the crude-protein content of the diet while maintaining the same performance of the pigs. Each of the resulting 16 diets was then assessed with respect to global warming, eutrophication, acidification, and land use, both when accounting and not accounting for emissions due to land use change. The analysis per kilogram of feed showed that the ST diets performed best with regard to global warming, eutrophication, and acidification. When emissions from land use and land use change were added, ST and AA diets appeared to have the least impact. In contrast, the assessment of scenarios per kilogram of pork highlighted that the AA scenario contributed the least in all impact categories. In conclusion, it is possible to partly replace soybean products by using synthetic amino acids in order to minimise the environmental impacts of the pork supply chain.

Ruminal degradation of quercetin and its influence on fermentation in ruminants

The aim of the present study was to investigate the ruminal degradation of the flavonol quercetin and to determine its potential antimicrobial effects on ruminal fermentation in cows. Ruminal degradation of quercetin (0 or 100μmol/L, respectively) as well as its influence on ruminal gas production (0, 50, or 100μmol of quercetin equivalents/L, respectively, either applied as aglycone or as its glucorhamnoside rutin) using concentrate, grass hay, and straw as substrates were investigated in vitro using the Hohenheim gas test. Additionally, the influence of quercetin on ruminal concentrations of volatile fatty acids and their molar ratio in rumen-fistulated, nonlactating cows (n=5) after intraruminal application of quercetin as aglycone or as rutin (0, 10, or 50mg of quercetin equivalents/kg of BW, respectively) was evaluated. Quercetin was rapidly and extensively degraded, whereby the disappearance of quercetin was accompanied by the simultaneous appearance of 2metabolites 3,4-dihydroxyphenylacetic acid and 4-methylcatechol. In vitro total gas and methane production were not reduced by the addition of quercetin aglycone or rutin, respectively, using concentrate, grass hay, and straw as substrates. As expected, however, effects of the substrates used were detected on total gas and methane production. Highest gas production was found with concentrate, whereas values obtained with grass hay and straw were lower. Relative methane production was highest with grass hay compared with concentrate and straw (27.1 vs. 25.0 and 25.5%). After intraruminal application of the quercetin aglycone or rutin, respectively, neither total concentration nor the molar ratio of volatile fatty acids in the rumen fluid were influenced. Results of the present study show that quercetin underlies rapid ruminal degradation, whereby 3,4-dihydroxyphenylacetic acid and 4-methylcatechol are the main metabolites, whereas the latter one most likely is formed by dehydroxylation from 3,4-dihydroxyphenylacetic acid. Regarding antimicrobial effects of quercetin, results obtained indicate that fermentation processes in the forestomachs are not substantially influenced by quercetin or rutin, respectively. With regard to potential health-promoting effects of quercetin, its application in cows, especially in the form of the better available rutin, might not be accompanied by negative effects on ruminal fermentation.

Effects of formic acid and phytase supplementation on digestibility and use of phosphorus and zinc in growing pigs

Two studies, arranged according to a 4 × 4 Latin square design, were conducted to assess effects of dietary acidification on fungal 3-phytase (PHY) efficacy in growing pigs. In Exp. 1, effects of supplementing 500 units/kg feed of PHY and 4.7 g/kg HCOOH either alone or in combination on the use of P and Zn in growing pigs fed a pelleted diet based on wheat (Triticum aestivum), barley (Hordeum vulgare), and soybean (Glycine max) meal were investigated. In Exp. 2 the same dietary treatments were fed except that PHY supplementation was increased to 1000 units/kg. In both experiments, PHY supplementation increased (P < 0.05) P digestibility and retention. A PHY × HCOOH supplementation interaction on P balance was observed (P < 0.05), indicating that the combination of the additives may increase P digestibility and retention. Effects of HCOOH and PHY on Zn use followed a similar pattern. Supplementation of 1000 units/kg of PHY further increased P and Zn retention compared to supplementation of 500 units/kg. In conclusion, the present study indicated that HCOOH supplementation to diets with microbial PHY may increase PHY efficacy.

Bioavailability of the flavonol quercetin in cows after intraruminal application of quercetin aglycone and rutin

The bioavailability of quercetin has been intensively investigated in monogastric species, but knowledge about its bioavailability in ruminants does not exist. Thus, the aim of the present study was to determine the bioavailability of quercetin in nonlactating cows equipped with indwelling catheters placed in one jugular vein after intraruminal and additionally after i.v. application, respectively. Quercetin was administered intraruminally in equimolar amounts, either in the aglycone form or as its glucorhamnoside rutin, each at 2 dosages [10 and 50 mg of quercetin/kg of body weight (BW)]. In a second trial, 0.8 mg of quercetin aglycone/kg of BW was applied i.v. Blood samples were drawn 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, and 24 h after intraruminal application and every 5 min (first hour), every 10 min(second hour), and at 3 and 6h after i.v. bolus application, respectively. Quercetin and quercetin metabolites with an intact flavonol structure (isorhamnetin, tamarixetin, and kaempferol) in plasma samples were analyzed by HPLC with fluorescence detection. After intraruminal application of quercetin and rutin, respectively, quercetin and its methylated (isorhamnetin, tamarixetin) and dehydroxylated (kaempferol) derivatives were present in plasma mainly as conjugated forms, whereas free quercetin and its derivatives were scarcely detected. For rutin, the relative bioavailability of total flavonols (sum of conjugated and nonconjugated quercetin and its conjugated and nonconjugated derivatives after intake of 50 mg/kg of BW) was 767.3% compared with quercetin aglycone (100%). Absolute bioavailability of total flavonols was only 0.1 and 0.5% after quercetin aglycone and rutin applications, respectively. Our data demonstrate that bioavailability of quercetin from rutin is substantially higher compared with that from quercetin aglycone in cows after intraruminal (or oral) application, unlike in monogastric species.

Effects of live yeast cell supplementation to high concentrate diets on the toxicokinetics of ochratoxin A in sheep

Previous studies have indicated that high concentrate feeding reduces the ruminal degradation of the mycotoxin ochratoxin A (OA) to the less-toxic ochratoxin alpha (Oalpha) in ruminants. This is due to a pH-induced decrease in ruminal protozoa and subsequent increasing transfer of OA into the systemic circulation. The present study investigated whether stabilization of rumen pH by the live yeast cell supplementation to high concentrate diets affects the toxicokinetics of OA in sheep. Sheep were fed diets consisting of 70% concentrates and 30% grass silage (dry matter basis) supplemented without or with live yeast cells (Saccharomyces cerevisiae CNCM I-1077). After an adaptation period of 3 weeks, animals were given a single dose of OA (2.46 mg) in the form of contaminated wheat. Even though live yeast cells accelerated the recovery of ruminal pH from the decrease in pH induced by feeding, no effect on ruminal degradability and systemic availability of OA was recorded. Based on in vitro studies, live yeast cells and extracts of live yeast cell walls have been suggested as a mycotoxin-binding agent. However, supplementation with live yeast cells had no effect on the excretion pattern of OA in sheep, indicating that binding of OA to yeast components may be limited in ruminants. With respect to the toxicokinetics of OA, our results are in agreement with earlier results demonstrating that the hydrolysis of OA in the gastrointestinal tract of sheep is substantially less than previously described, especially if OA is ingested in combination with concentrate-rich diets. Our study demonstrates that feeding a live yeast cells product, registered as a feed additive for improving zootechnical performance, had no impact on the toxicokinetics of OA under the chosen conditions.

Basic motor capacity in relation to object manipulation and general manual ability in young children with spastic cerebral palsy

OBJECTIVE

Limited resources in terms of elementary functions may be a limiting factor for functional activities. The objective of the study was to examine basic hand motor capacities in young children with bilateral spastic cerebral palsy (BSCP) and to compare with deficits in functional activities.

METHOD

Eighty-eight children with BSCP, 3-6 years of age, manipulated a grip object (200g) equipped with a uniaxial force sensor. Basic motor capacity was assessed based upon (1) maximal grip strength and (2) production of fast repetitive grip force changes (FFC) while holding the object on the table. Subjects' performance on this task was compared to the grip force amplitude and force rate assessed while the subject was lifting the same object. Results were compared between different degrees of manual ability according to the Manual Ability Classification System (MACS).

RESULTS

In children with BSCP, even in high-functioning children with MACS 1, fast grip force changes and grip strength were 2 SDs and more below the mean of controls. Differences increased from MACS 2 to 4 but not between MACS 1 and 2. During lifting children with BSCP used considerable proportions of their maximum grip strength (40-90%) and of their grip force rates during 70% vs. 86%. In some children with low manual abilities (MACS 3/4), grip force rates during lifting were higher than during FFC.

CONCLUSION

In children with BSCP, basic motor capacity may influence manual ability, particularly in children with MACS 3 and 4. In some of these children, the underlying processes during lifting may also differ qualitatively.

Pyridoxine-dependent epilepsy: normal outcome in a patient with late diagnosis after prolonged status epilepticus causing cortical blindness

We report on a male proband with pyridoxine-dependent epilepsy (PDE) and neonatal seizure onset. At the age of 31 months, a prolonged status epilepticus led to severe neurological regression with cortical blindness, loss of speech and muscular hypotonia with slow recovery over the following 3 months. At 33 months of age pyridoxine therapy was initiated with excellent response and the boy remained seizure-free on pyridoxine monotherapy, except for two occasions with seizure recurrence 10 days after accidental pyridoxine withdrawal. alpha-aminoadipic semialdehyde dehydrogenase (antiquitin) deficiency was indicated by elevated pipecolic acid concentrations in plasma and alpha-aminoadipic semialdehyde excretion in urine. Molecular analysis of the antiquitin gene revealed a novel missense mutation c.57insA, while the mutation of the other allele remained unidentified so far. Despite the delay in diagnosis and prolonged status epilepticus, neuropsychological evaluations at the ages of 11 and 18 years demonstrated full-scale IQ of 93 and 92, respectively, with better verbal IQ (103 and 101) than performance IQ (85 and 82).

[Validation of a screening questionnaire for activities of daily living (M-ADL) in handicapped children]

BACKGROUND

The issue to what extent acitivities of daily living are impaired becomes increasingly relevant for social integration and for the indication and evaluation of therapies in children with developmental disorders and handicaps. The study presents the validation of a screening questionnaire for activities in children (M-ADL).

PATIENTS

The validity of the M-ADL was examined in 2 studies with 3-7-year old children with the full spectrum of severity of cerebral palsy. In study I, the concurrent validity with the Pediatric Evaluation of Disability Inventory (PEDI) has been studied in 33 children. In study II, the predictive validity was evaluated by comparing 63 handicapped children with a stratified sample of 217 normal children of the same age.

METHOD

The scales of the M-ADL covered eating/drinking, self care at home, toileting, manual ability (summarised as "self care") and mobility. In section A, a general estimation from 0 (full support) to 10 (independent) and in section B a rating based on preset graded scales is given. The correlation of the two ratings has been taken to estimate the criterion validity. Further, the subjective bias of the rater has been estimated by comparison of the absolute values in both sections between the groups.

RESULTS

The M-ADL domains showed a very good concurrent validity with those of the PEDI (r=.78-r=.92). The sensitivity and specificity were excellent, particularly for ratings in section B. The criterion validity was high (mobility domain r=.76, self care domain r=.82). Comparison of the subjective bias showed that parents of CP children over-estimated the activities level of their children compared with controls showing the same values in both sections (group differences, t-test: 95% CI for mobility 0.47-1.46, p<0.001, self care 0.91-1.48, p<0.001).

CONCLUSIONS

The M-ADL is a valid standardised instrument of functional independence in handicapped children, which needs little time and requires no special training for the examiner. In addition to other ADL measures, manual ability, e.g. playing, doing handicrafts, using a pen, is rated. Further, a subjective bias of the raters can be estimated. The instrument may serve as a tool for quick information on the level of activities according to the International Classification of Functioning, Disability and Health (ICF).

[Measurement of activities of daily living in children--standardisation of a screening questionnaire]

BACKGROUND

Especially at preschool age, but also at school age, it is a major issue to what extent developmental problems are relevant for activities of daily living. This should be important for the prescription of therapeutic interventions. Previous instruments require training and/or they are time-consuming (e. g. interviews, direct observation and testing) or they are not suitable for the target group. The objective of the presented screening questionnaire for parents and professionals is a quick and standardised instrument for the status of everyday activities, particular in children with physical and mental delays or handicaps. The study examines the interrater and the retest reliability.

PATIENTS AND METHODS

A questionnaire (M-ADL) with the subscales eating and drinking, hand skill in everyday life, toiletting and mobility was tested. The ratings were carried out on two levels: first, a global rating from 0 to 10 had to be given on each subscale. Secondly, a rating based on a defined scale had to be given. The average time for evaluation is about 5 minutes. We examined 28 children with cerebral palsy for the test-retest-reliability, and 48 children for the interrater reliability. The children had all types of cerebral palsy and all degrees of severity rated according to the Gross Motor Function Classification Scale cerebral palsy.

RESULTS

The M-ADL total scores showed an excellent interrater reliability (r=0.84 to r=0.89) and test-retest-reliability (r=0.91 to r=0.97). Each subscale had a good reliability (at least r=0.73).

CONCLUSION

The M-ADL is a reliable, economic measure for activities of daily living for children with physical and mental delays or handicaps. The instrument may serve as a tool for quick information on the level of activities according to the International Classification of Functioning (ICF).

Identifying early treatment failure on category I therapy for pulmonary tuberculosis in Lima Ciudad, Peru

SETTING

Ambulatory, public tuberculosis treatment facilities, central Lima, Peru.

OBJECTIVE

To identify risk factors for failure on directly observed Category I therapy.

DESIGN

Case-control study. All failures of Category I (2HREZ/4H2R2) therapy in 2000 (2.9% of smear-positive TB patients) were included as cases; two controls per case were matched on health center and approximate time of treatment initiation.

RESULTS

The study included 38 cases and 76 controls, all new smear-positive, pulmonary TB patients treated with Category I therapy in central Lima in 2000. Neither treatment irregularity nor incidence of adverse events predicted failure in the study group. Mean baseline body mass index was lower in cases than in controls (P = 0.06). Cases gained less weight during therapy (P = 0.01). Smear positivity at 2 months of therapy was strongly associated with failure (OR 11.7; 95%CI 2.4-57.5). No controls had positive smears at or after 3 months of therapy (OR [corrected] 144.9; 95%CI 8.4-2500). Nearly 75% of cases with isolates tested for susceptibility to first-line drugs had multidrug-resistant TB (MDR-TB).

CONCLUSION

A large proportion of failures on Category I therapy can be identified early. As three-quarters of patients with susceptibility results have MDR-TB, early referral for culture and drug susceptibility testing is critical for prompt initiation of appropriate therapy and improved outcomes.

Effect of fumaric acid supplementation and dietary buffering capacity on the concentration of microbial metabolites in ileal digesta of young pigs

Experiments were conducted to determine the effect of different levels of fumaric acid supplementation to diets with a low or high buffer capacity on the concentrations of microbial metabolites and lipopolysaccharides, as an indicator of gram negative bacteria in ileal digesta of young pigs. In two experiments, 12 pigs each were weaned at 14 d of age and fitted with a simple T-cannula at the distal ileum between 15 and 17 d of age. In experiment 1, the pigs were fed wheat–soybean meal diets without or with inclusion of 1, 2 or 3% fumaric acid according to a balanced two-period changeover design. In experiment 2, the same diets were fed, except that the dietary buffering capacity was increased by inclusion of 3% sodium bicarbonate to all diets. The pigs were fed three times daily, equal amounts at 8 h intervals. The diets were supplied at a rate of 5% (wt/wt) of body weight. The inclusion of fumaric acid to the diet with a low buffering capacity (exp. 1) decreased (P < 0.05) the concentrations of lactic acid, ammonia, spermidine and lipopolysaccharides in ileal digesta. Supplementation of fumaric acid to a diet with a high buffering capacity (exp. 2) did not affect (P > 0.05) the concentrations of fermentation products in ileal digesta, but there was a decrease (P < 0.05) in the concentration of lipopolysaccharides. Furthermore, in both experiments, the concentration of most fermentation products decreased (P < 0.05) with increasing age after weaning. These results give further evidence that supplementation of fumaric acid to diets for young pigs during the first 3–4 wk after weaning reduces the metabolic activity and the concentrations of bacteria in the gastrointestinal tract. The magnitude of this effect, however, is dependent on the buffering capacity and the inclusion level of fumaric acid in the diets. Key words: Pigs, fumaric acid, buffering capacity, microbial metabolites, ileal digesta, lipopolysaccharides

Human development of grip force modulation relating to cyclic movement-induced inertial loads

The present study examines the development of grip force modulation relating to self-induced loads during repetitive vertical arm movements at different frequencies with a hand-held object. One hundred and thirty-four 3- to 6-year-old children and 16 adults were asked to move a lightweight object up and down at increasing rates from 0.5 Hz up to individual maximal arm movement rates (> 2.5 Hz). Grip forces were measured by a uni-axial force transducer and the inertial forces (tangential forces) were calculated from the measurements by accelerometers within the object. Generally, the quality of anticipatory grip force control improved from movement frequencies of 1 Hz to 2.5 Hz and decreased above 2.5 Hz. At movement frequencies below 1 Hz, the phase lag between grip and load force cycles was longer in children than in adults (children: median = 17 ms; adults: median = 0 ms); however, there were no significant differences between the age groups above 1.5 Hz. The grip-to-load force ratio and the grip force modulation were not significantly different from the adults up to 2.5 Hz. The fine coupling of grip and load forces (precise temporal and gain control) showed age effects among the 3- to 6-year-old children, mainly between 3- and 4-year-olds, and in adults extremely good coupling at medium arm movement frequencies. However, concerning the pure temporal coordination of grip and inertial forces, there were only differences between the 3-year-old children and the other groups at arm movement frequencies above 2.5 Hz. The results show that, during cyclic movements with hand-held loads, temporal control is well established at the age of 4 years whereas the fine gain control needs a longer time to develop. The anticipatory control is dependent on the arm movement frequency and, therefore, how rapidly the inertial loads change. The high level of anticipatory control during self-induced repetitive actions in children of 3-6 years of age is interpreted as an early developing ability to predict precisely cyclic self-induced inertial loads of hand-held objects when the object properties are known by proprioception. The timing, which is possibly related to cerebellar functions, is, to some extent, developed earlier than the gain control, which may be associated with cortical functions.

Human motor development and hand laterality: a kinematic analysis of drawing movements

This study examines the developmental profiles of basic 'open-loop' drawing movements on the non-dominant hand (ND) in comparison with the dominant hand (D). Fifty-three right-handed children aged 7-14 years and 15 adults aged 27-43 years were examined. Each subject drew lines and circles of different sizes at maximum velocity with a pressure-sensitive pen on a computer graphics tablet. Small lines were drawn at 90 degrees to the axis of the forearm (lines using wrist movements (LWM)) and along the axis of the forearm (lines using elbow movements (LEM)). Larger lines were drawn at 90 degrees to the axis of the forearm (LEM). At both extremities, the movement frequencies of the proximally generated drawing movements increased in a parallel fashion at different levels. In LWM, the right-left-differences (RLD) were high in 7- to 8-year-old children; until puberty, the ND hand reached almost the performance of the D hand. In contrast, the RLD of the LFM increased at the same time. As adulthood approaches, frequencies of all drawings increased further while the LWM on the ND side remained stable. In adults, there were similar RLD for all line drawings involving predominantly flexion and extension movements. When drawing circles, the RLD were highest, though stable in all age groups. Hand laterality of pen use changes over time; these changes are dependent on complexity (combined/sequential cf. flexion-extension muscle activation) and on topography (proximal cf. distal movements). Distinct developmental profiles of motoneuronal populations of the cortex may be responsible for the distinct hand laterality effects and the decreasing variability of motor patterns. The drawing abilities and developmental changes on the untrained ND hand indicate that effector-specific practice plays a minor role.

Development of externally guided grip force modulation in man

We examined the development of externally guided changes of grip force with respect to force rate and direction of force change. Sixty-nine children, 3-6 years of age, and 17 adults produced increasing or decreasing isometric forces on a small cylindrical sensor using a pinch grip with visual feedback. Force changes were instructed with a visual tracking task. Ramp-like paradigms with both force increase and force decrease and two different target force rates were used (0.5 N/s, 1.25 N/s). Precision of force tracking showed clear age effects and was influenced by the required force rates and directions of force change. In adults, tracking errors were much more dependent on target force rate and direction than in children. Up to four years of age, the children tended to overshoot the target force change in a 'jump and wait' manner in all conditions except for fast target force decreases. Older children tended to overshoot only in the condition with slow target force decrease. Adults showed close undershooting in all conditions when following the target. Adults used either a continuous 'following' strategy or a 'see and catch-up' strategy. The distinct effects on tracking errors suggest an age-related change of strategies from a feedforward strategy with intermittent use of sensorimotor feedback towards a fairly parallel and well-integrated feedback and feedforward processing. A critical age appears to be around five to six years. We suggest that these age effects may reflect distinct developmental velocities of neuronal subpopulations of the cortex and of the cerebello-cortical connections.

Effect of fumaric acid and dietary buffering capacity on ileal and fecal amino acid digestibilities in early-weaned pigs

Experiments were conducted to determine the effect of fumaric acid supplementation and buffering capacity of the diet on ileal and fecal digestibilities of CP, GE, and amino acids in early-weaned pigs. In two experiments, 12 pigs each were weaned at 14 d of age and fitted with a simple T-cannula at the distal ileum between 15 and 17 d of age. In both experiments, the pigs were fed four diets, based on wheat and soybean meal without (control) or with 1, 2, or 3% fumaric acid according to a balanced two-period change-over design. In Exp. 2, the buffering capacity of the diets was increased by supplementation of 3% sodium bicarbonate. The pigs were fed three times daily: equal amounts at 8-h intervals. The diets were supplied at a rate of 5% (wt/wt) of body weight. The inclusion of fumaric acid to the diet with a low buffering capacity increased (P < .05) the ileal digestibilities of CP, GE, and the majority of amino acids. The highest responses were found at an inclusion level of 2% fumaric acid. The improvements in apparent ileal amino acid digestibilities ranged from 4.9 to 12.8 percentage units. Supplementation of fumaric acid to a diet with a high buffering capacity led only to numerical increases in ileal digestibilities of CP, GE, and amino acids. In both studies, fumaric acid supplementation had no effect (P > .05) on the fecal digestibilities of CP, GE, and amino acids, except histidine. A high buffering capacity of the diet decreased the ileal amino acid digestibilities by 1 to 10 percentage units compared with diets with the low buffering capacities. In both experiments, ileal and fecal digestibilities were higher (P < .05) in Period 2 (on d 24 after weaning) than in Period 1 (on d 11 after weaning). A positive correlation (P < .05) between ileal digestibilities and fumaric acid supplementation to the diets with the low buffering capacities was observed in Period 1 (on d 11 after weaning), but not in Period 2 (on d 24 after weaning). No relationship (P > .05) between ileal digestibilities and fumaric acid supplementation to the diets with a high buffering capacity could be established. In conclusion, supplementation of fumaric acid to starter diets during the first 3 to 4 wk after weaning increases the ileal digestibilities of GE, CP, and amino acids.

Effects of age on distally and proximally generated drawing movements: a kinematic analysis of school children and adults

The effects of age on basic fine motor functions were assessed using a kinematic analysis of simple repetitive drawing movements in a sample of 53 right-handed children aged 7 to 14 years 11 months and 16 adults aged 27 to 54 years with no detectable abnormality with neurological examination. Lines, circles, and half-circles were drawn at a self-chosen and maximum velocity with a pressure-sensitive pen on a computer graphics tablet. Patterns generated by finger, wrist, and arm movements, and those generated by combined finger-wrist movements with and without a change in the drawing direction were analysed. The frequencies of all movement patterns increased until adulthood: 0.1 Hz per year for half-circles, 0.15 to 0.2 Hz per year for circles and lines generated by arm and wrist movements. The greatest increase (0.35 Hz per year) was observed for lines produced by finger movements. Differences in movement frequencies between finger versus wrist or arm movements when drawing lines decreased from about 3 Hz in 7- to 8-year-olds to 0.5 to 1 Hz in adolescents. In adults the difference between maximum finger, wrist, and arm movement frequencies decreased to almost zero. In contrast, the differences in movement patterns with and without change in direction remained stable until adulthood. Based on these results it is hypothesized that the differential effects of finger and more proximally generated movements on age reflect maturation of distinct neuronal sites of the corticostriatal-cerebellar circuit rather than acquisition of motor skills or myelinization of corticospinal pathways.

Externally guided control of static grip forces by visual feedback-age and task effects in 3-6-year old children and in adults

This study has been devised to examine the visual feedback control of static grip force levels by pinch and by hand grip during pre-school age and in adults. 69 3-6-year old children and 17 adults were asked to establish and hold grip force levels defined by a visual target and feedback on the dominant and non-dominant hand by hand grip and by pinch grip. From 3 to 6 years of age, the time needed to establish requested grip force levels decreased by a third and the precision increased two-fold for hand grip but four-fold for pinch grip; in contrast to younger children, 5-6-year olds showed a marked superiority of 60% for the pinch grip compared to hand grip, decreasing to about 40% in adults. In the case of pinch grip, all individuals had worse results on higher force levels (children: 50%, adults: 32%). The young children generally tended to use too much force. Older children and adults were better by 75% under the condition of visual feedback vs. internal proprioceptive control (after withdrawing visual feedback). In contrast to previous findings in anticipatory grip force regulation, externally guided force regulation begins to develop during late nursery age. Specific developmental effects were found for grip style and for the ability to use visual feedback and to change from external to internal (proprioceptive) control, and to a lesser extent for force magnitude but not for hand laterality and gender. The findings are interpreted by different developmental velocities of motor areas which are responsible for force regulation mechanisms and for grip style.

[Clinical value of Doppler ultrasound controlled puncture of the inguinal vessels with the "Smart Needle" within the scope of heart catheter examination]

Due to the increasing number of diagnostic heart catheterizations, especially in elderly patients, as well as the increase of percutaneous transluminal coronary angioplasties, we are confronted with a rise in peripheral complications evolving from difficulties in the procedure of the puncture of the femoral artery or vene. The development of greater hematomas in the area of the puncture, the formation of arterio-venous fistulas and aneurysma spuria are the foremost complications. It was the aim of the study to investigate in as far an improved puncture technique could reduce the rate of peripheral complications. In this comparative study the vessel punctures were carried out by the conventional Judkins puncture technique and a new method using a special puncture needle. (Smart Needle" R), with an integrated ultrasonic sound device. In this study 114 patients--age 23 to 82 years--undergoing heart catheterization (91 diagnostics, 23 PTCAs) were examined. In all cases a puncture of the arterial and venous femoral vessel was done. 50 patients received a puncture via "Smart Needle" and the remaining 64 patients were punctured conventionally. In contrast to the group of patients receiving conventional puncture of the femoral artery, where in 72% more than one try was needed, in all patients of the "Smart Needle" group the first puncture was successive. Concerning the puncture of the venous vessels no significant difference between the two groups was observed. This difference between arterial and venous puncture outcome results from the difference between arterial and venous flow signals detected by the ultrasonic sound device. As to the bleeding complications hematomas following to "Smart Needle" puncture occurred less frequently-in 25%--and were significantly smaller than in the conventional group where hematomas were seen in 46%. The number of patients with hematomas with diameters of more than 5 cm was twice as high in the conventionaly punctured group (28%) than in the "Smart Needle" group (14%). However, patients suffering from arterial hypertension or hemostatic disorders showed an increased risk of vascular complications. In regard to the cost-benefit relation an indication for the use of the new technique is to be seen especially in overweight patients and patients suffering to aortic stenosis or cardiogenic shock.

Ambulatory monitoring of children's activity

One of the difficulties in clinical assessment is how to obtain accurate data in the "real world". This paper describes the Dynaport ADL Monitor, an accelerometry-based system for ambulatory monitoring of the activities of daily living (ADL). In previous studies the monitor has proved a success with adults. To validate the system for use with children, 9 h of various activities conducted by nine children were measured and videotaped at the same time. All postures and activities were divided into one of five main categories: standing, sitting, lying, locomotion and swing/seesaw. The video pictures were evaluated by an observer. Independent of this, the acceleration signals were translated by the DynaPort ADL monitor software, and were compared to the video pictures. Minimal and maximal validity percentages were calculated for each of the main classes, for each individual measurement and overall. To estimate monitoring performance the 10 sets of measurements are regarded as representative samples of children's daily activity. The overall minimal and maximal validity are 73.15 +/- 1.96 x 4.48 and 91.31 +/- 1.96 x 1.75 weighed standard deviation.

[Effect of an oligo-antigen diet on the behavior of hyperkinetic children]

The influence of an oligoantigenic diet on different dimensions of the behavior of 21 children diagnosed as having attention-deficit hyperactivity disorder (ADHD) was examined. Treatment effects were assessed with three subjective measures (two questionnaires and an interview) and three objective measures (two attention tests and actometer). The study was divided into three phases: baseline, diet and provocation, each lasting three weeks. A crossover design was used. A significant effect was found for the subjective measures, but not for the objective measures. The results are discussed in terms of possible types of effects, e. g. rater effects and environmental effects. It may be that the oligoantigenic diet influences only certain dimensions of hyperactivity.

Reduced risk of liver-function-test abnormalities and new gallstone formation with weight loss on 3350-kJ (800-kcal) formula diets

Weight loss in obese subjects ingesting very-low-energy (VLE; < 2510 kJ/d), low-fat (< or = 1 g/d) formula diets is associated with liver-function-test abnormalities and gallstone formation. It is unknown whether these abnormalities develop during treatment with diets higher in energy and fat. We prospectively studied liver-function tests and gallstone formation in 73 obese patients ingesting approximately 3500 kJ and 15-25 g fat daily for 10 wk. Two of 53 patients completing the protocol developed ultrasonographic gallstones during weight loss, a rate substantially lower than that observed with VLE diets. Trend analysis demonstrated significant increases in AST and ALT activities, but changes were less than those observed with VLE diets. Patients who developed gallstones had a significantly greater weight loss rate and larger increases in AST and ALT than did nonstone-forming patients. These results suggest that the risk of developing hepatobiliary abnormalities with dieting is lowered when subjects ingest greater amounts of energy and fat than that administered in earlier VLE-diet studies. Our results also highlight potential risk factors and markers of new gallstone formation.

Influence of blood sampling from venipunctures and catheter systems on serial determinations of prothrombin activation fragment 1 + 2 and thrombin-antithrombin III complex

To evaluate the influence of different blood sampling techniques on test results of thrombin-antithrombin III complex (TAT) and prothrombin fragment 1 + 2 (F1 + 2) serial determinations were performed. In six groups of nonrandomized patients (ten patients each) the concentrations of the coagulation markers of blood samples from central catheters (internal jugular, caval, Shaldon, pulmonary artery) and peripheral cannulas (17G and 18G) were compared with those of blood samples obtained simultaneously from direct venipunctures of the contralateral arm. Medians and 25th-75th percentiles of TAT and F1 + 2 concentrations of plasmas obtained from central catheters were not different from those taken from venipunctures. When delta mean values (catheter - venipuncture) were calculated negative results were obtained, indicating lower concentrations measured from blood sampled through central catheters with the exception of blood that taken from Shaldon catheters. Only for TAT concentrations significantly were lower values measured in blood samples taken from internal jugular catheters when compared with blood samples obtained from direct venipunctures. Significantly higher TAT concentrations were determined in blood samples obtained from Shaldon catheters. For both coagulation markers correlations were found between concentrations in blood samples from central catheters and venipunctures. In blood samples taken from peripheral venous cannulas only F1 + 2 concentrations correlated with the concentrations found in samples from direct venipuncture. In contrast to F1 + 2, TAT concentrations measured from blood samples via peripheral cannulas were determined significantly higher than those taken from direct venipunctures.(ABSTRACT TRUNCATED AT 250 WORDS)

[Subgroups of hyperkinetic disorders--explorative studies with reference to questionnaires and immunologic parameters]

In this paper, the main questions examined are: 1. The relationship between clinically diagnosed hyperkinetic syndrome (HKS) and 3 questionnaires for parents (Child Behavior Checklist (CBCL) by Achenbach and Edelbrock, Enzephalopathie-Fragebogen by Meyer-Probst and 10-Item scale by Conners). 2. The relationship between the clinical psychiatric diagnosis and the questionnaires and allergological parameters. In order to answer these questions, a sample of 122 psychiatric patients with "extraversive" behavior disturbances (HKS: N = 104, other "extraversive" disorders, mainly conduct disorders (EVD): N = 18) was examined prospectively and sequentially. The preliminary results are: a) The children with HKS, the children with EVD and the children with HKS and conduct disorder could be differentiated by several subscales (Especially by "introversive" symptoms) of the CBCL and the Fragebogen by Meyer-Probst. The Conners scale showed significant differences between the groups on only one item. b) The children with HKS, especially those without conduct disorder, had two to three times as many allergies as the children with HKS and conduct disorders or those with EVD.