The non-invasive 13C-methionine breath test detects hepatic mitochondrial dysfunction as a marker of disease activity in non-alcoholic steatohepatitis

<p>Abstract</p> <p>Introduction</p> <p>Mitochondrial dysfunction plays a central role in the general pathogenesis of non-alcoholic fatty liver disease (NAFLD), increasing the risk of developing steatosis and subsequent hepatocellular inflammation. We aimed to assess hepatic mitochondrial function by a non-invasive ¹³C-methionine breath test (MeBT) in patients with histologically proven NAFLD.</p> <p>Methods</p> <p>118 NAFLD-patients and 18 healthy controls were examined by MeBT. Liver biopsy specimens were evaluated according to the NASH scoring system.</p> <p>Results</p> <p>Higher grades of NASH activity and fibrosis were independently associated with a significant decrease in cumulative ¹³C-exhalation (expressed as cPDR(%)). cPDR_1.5hwas markedly declined in patients with NASH and NASH cirrhosis compared to patients with simple steatosis or borderline diagnosis (cPDR1.5h: 3.24 ± 1.12% and 1.32 ± 0.94% vs. 6.36 ± 0.56% and 4.80 ± 0.88% respectively; p < 0.001). ¹³C-exhalation further declined in the presence of advanced fibrosis which was correlated with NASH activity (r = 0.36). The area under the ROC curve (AUROC) for NASH diagnosis was estimated to be 0.87 in the total cohort and 0.83 in patients with no or mild fibrosis (F0-1).</p> <p>Conclusion</p> <p>The ¹³C-methionine breath test indicates mitochondrial dysfunction in non-alcoholic fatty liver disease and predicts higher stages of disease activity. It may, therefore, be a valuable diagnostic addition for longitudinal monitoring of hepatic (mitochondrial) function in non-alcoholic fatty liver disease.</p

Hepatic mitochondrial dysfunction in Friedreich Ataxia

<p>Abstract</p> <p>Background</p> <p>Mitochondrial dysfunction due to respiratory chain impairment is a key feature in pathogenesis of Friedreich ataxia. Friedreich ataxia affects the nervous system, heart and pancreas.</p> <p>Methods</p> <p>We assessed hepatic mitochondrial function by ¹³C-methionine-breath-test in 16 Friedreich ataxia patients and matched healthy controls.</p> <p>Results</p> <p>Patients exhaled significantly smaller amounts of ¹³CO₂over 90 minutes. Maximal exhaled percentage dose of ¹³CO₂recovery was reduced compared to controls.</p> <p>Conclusions</p> <p>¹³C-methionine-breath-test indicates subclinical hepatic mitochondrial dysfunction in Friedreich ataxia but did not correlate with GAA repeat lengths, disease duration or disease severity.</p

Migration Patterns, Use of Stopover Areas, and Austral Summer Movements of Swainson\u27s Hawks

From 1995 to 1998, we tracked movements of adult Swainson’s Hawks (Buteo swainsoni), using satellite telemetry to characterize migration, important stopover areas, and movements in the austral summer. We tagged 46 hawks from July to September on their nesting grounds in seven U.S. states and two Canadian provinces. Swainson’s Hawks followed three basic routes south on a broad front, converged along the east coast of central Mexico, and followed a concentrated corridor to a communal area in central Argentina for the austral summer. North of 20°N, southward and northward tracks differed little for individuals from east of the continental divide but differed greatly (up to 1700 km) for individuals from west of the continental divide. Hawks left the breeding grounds mid-August to mid-October; departure dates did not differ by location, year, or sex. Southbound migration lasted 42 to 98 days, northbound migration 51 to 82 days. Southbound, 36% of the Swainson’s Hawks departed the nesting grounds nearly 3 weeks earlier than the other radio-marked hawks and made stopovers 9.0–26.0 days long in seven separate areas, mainly in the southern Great Plains, southern Arizona and New Mexico, and northcentral Mexico. The birds stayed in their nonbreeding range for 76 to 128 days. All used a core area in central Argentina within 23% of the 738 800-km2 austral summer range, where they frequently moved long distances (up to 1600 km). Conservation of Swainson’s Hawks must be an international effort that considers habitats used during nesting and non-nesting seasons, including migration stopovers

PPI-Delayed Diagnosis of Gastrinoma: Oncologic Victim of Pharmacologic Success

Functional neuroendocrine tumors are often low-grade malignant neoplasms that can be cured by surgery if detected early, and such detection may in turn be accelerated by the recognition of neuropeptide hypersecretion syndromes. Uniquely, however, relief of peptic symptoms induced by hypergastrinemia is now available from acid-suppressive drugs such as proton-pump inhibitors (PPIs). Here we describe a clinical case in which time to diagnosis from the onset of peptic symptoms was delayed more than 10 years, in part reflecting symptom masking by continuous prescription of the PPI omeprazole. We propose diagnostic criteria for this under-recognized new clinical syndrome, and recommend that physicians routinely measure serum gastrin levels in persistent cases of PPI-dependent dyspepsia unassociated with H. pylori

Systematic review and meta-analysis on the adverse events of rimonabant treatment: Considerations for its potential use in hepatology

<p>Abstract</p> <p>Background</p> <p>The cannabinoid-1 receptor blockers have been proposed in the management of obesity and obesity-related liver diseases (fatty liver as NAFLD or NASH). Due to increasing number of patients to be potentially treated and the need to assess the advantage of this treatment in terms of risk/benefit, we analyze the side events reported during the treatment with rimonabant by a systematic review and meta-analysis of all randomized controlled studies.</p> <p>Methods</p> <p>All published randomized controlled trials using rimonabant <it>versus </it>placebo in adult subjects were retrieved. Relative risks (RR) with 95% confidence interval for relevant adverse events and number needed to harm was calculated.</p> <p>Results</p> <p>Nine trials (n = 9635) were considered. Rimonabant 20 mg was associated with an increased risk of adverse event (RR 1.35; 95%CI 1.17-1.56), increased discontinuation rate (RR 1.79; 95%CI 1.35-2.38), psychiatric (RR 2.35; 95%CI 1.66-3.34), and nervous system adverse events (RR 2.35; 95%CI 1.49-3.70). The number needed to harm for psychiatric adverse events is 30.</p> <p>Conclusion</p> <p>Rimonabant is associated with an increased risk of adverse events. Despite of an increasing interest for its use on fatty liver, the security profile and efficacy it is needs to be carefully assessed before its recommendation. At present the use of rimonabant on fatty liver cannot be recommended.</p

Rowland ghost suppression in high efficiency spectrometer gratings fabricated by e-beam lithography

In this paper we report different methods to improve the stray light performance of binary spectrometer gratings fabricated by electron beam lithography. In particular, we report the optimization concerns about spurious stray light peaks, also known as "Rowland ghosts". As already known these Rowland ghosts arise from a non-optimized stitching process of special subareas needed in order to fabricate large area gratings. One approach to reduce the impact of the stitching errors is the technique of "multi-pass-exposure" (MPE). Furthermore, the potential of a direct improvement of the stitching accuracy via special calibration parameters is examined. In both cases the effects on the stray light performance were determined by angle resolved scattering measurements. The achieved results show that specific calibration parameters of an e-beam writer have a strong influence on the strength of the Rowland ghosts and that their recalibration combined with an adapted writing regime reduces the peaks significantly

Investigation and optimization of Rowland ghosts in high efficiency spectrometer gratings fabricated by e-beam lithography

Any violation of the periodicity of a perfect grating will result in diffuse scattering. In the particular case of a periodic violation the generated stray light shows deterministic, also periodic features that arise as distinct peaks in the stray light spectra, especially so-called Rowland ghosts. In this paper the characteristics of the spurious Rowland ghosts in binary spectrometer gratings are investigated and the potential of a randomization technique in order to suppress the Rowland ghosts is analyzed. Especially in sequential fabrication technologies, e.g. electron beam lithography, the Rowland ghosts originate in a segmentation process that is necessary in order to write large scale gratings. Hence several subareas are subsequentially exposed and stitched together leading to the final full size grating. Due to this stitching approach the subareas induce secondary periodic structures and thus generate the spurious Rowland ghosts in the order of magnitude of <10-4 compared to the useful diffraction order. A randomization of this segmentation process is investigated both theoretically in rigorous simulations and experimentally by fabricating a purposely designed optical grating. As approach for the randomization in experiment we applied a special multi-pass-exposure. Here the sample is exposed multiple times with an accordingly shifted and dose-reduced subarea in each pass. The achieved simulation results show that a randomization of the subareas effectively reduces the Rowland ghosts. Furthermore the applied randomization technique during grating fabrication was able to suppress one kind of Rowland ghosts completely

Advanced photomask fabrication by e-beam lithography for mask aligner applications

Photomasks contain geometric information that will be transferred to substrates or pre-structured surfaces. Conventional mask aligner lithography in the sense of shadow printing of the photomask suffers from limited achievable resolution. Photomask and substrate are typically separated by an air gap causing diffraction effects and hence affecting the minimum structure size. Even though contact lithography offers a resolution in the wavelengthscale, yield problems and contamination of the photomask are its drawbacks. Using proximity lithography, these problems can be avoided since it profits from a contact-free exposure process. To overcome the resolution limitation of the shadow printing mode more advanced diffraction based photo masks need to be used