Protein restriction in children with chronic renal failure

The progressive nature of renal functional impairment has been recognized for a long time (Mitch 1976, Rutherford 1977). Once glomerularfiltration rate has decreased to 25 ml!min/1.73m' progression to end stage renal disease is inevitable and independent of the primary renal disease (Leumann 1978, Arbus 1981, Warshaw 1982, Warshaw 1985, Claris-Appiani 1986, Fine 1991, Norwick 1991). Based on the assumption that renal functional deterioration is related to renal workload, Addis suggested in 1948 to decrease protein intake in patients with chronic renal failure (Addis 1917, Addis 1948). His aim was not to reduce uremic symptoms (fatigue, thirst, stunted growth, itching) but rather to prevent an increase in the "workload" of surviving nephrons of diseased kidneys in order to prevent further loss of renal function. This concept was supported by the early finding in rats that renal mass increases with long-term feeding of protein (MacKay 1928). This interesting idea lead to widespread advocation of protein restricted diets for children with chronic renal failure. Notwithstanding theoretical ideas and evidence from animal studies there are no prospective randomized controlled studies in children

Hoe een Franse ingenieur over de Abdij van Middelburg in 1812 oordeelde

In 1810 the province of Zealand became a part of the great French empire and was officially named 'Département des Souches de l'Escaut' (Departement of the Mouthes of the Scheldt) with Middelburg as its capital. A prefecture had to be set up here and the old seat of the former centre of government, the Abbey in Middelburg, was considered the best site for it. Napoleon attached great value to architectural provisions (mainly for military purposes) because of the strategic importance of this department. However, there was no local architect to meet the new requirements and who could cooperate with the French experts at their level. Paris immediately understood the necessity of sending an all-round architect to Middelburg. Special emphasis was laid on military demands and those of the Navy in particular. Nicolas Jean-Baptiste Anselin was appointed on 1 March 1812. At the Ecole Polytechnic in Paris he had received the best architectural education the French empire could offer in the beginning of the 19th century. The original centre of government in the former Province of Zealand in no way answered the needs of a rational modern administration, and offices in accordance with them. The representative function and the high standing of the department were also of importance. Anselin was commissioned to reconstruct the Abbey, then still an example of mediaeval architecture, so as to make it suitable to serve as a palace for the prefect on the one hand and as the administrative centre of the prefecture on the other. His designs and the accompanying reports, sent to Paris by the prefect, were based on the newest French ideas on architecture and his ideas are reflected in his writings on the subject. Indeed, the subtitle of this very article is borrowed from one of his statements. The designs were for the extensive Abbeycomplex to be updated as much as possible, in accordance with the ideas of Anselin's teacher Durand. The enterprise was never realised after all because of the short duration of the Napoleon government. Nevertheless from the architectural point of view it is important to get acquainted with the new ideas that inspired it

Defect dynamics in growing bacterial colonies

Colonies of rod-shaped bacteria constitute a system of colloidal active matter with nematic properties. As a single initial bacterium multiplies through repeated divisions, the resulting colony quickly loses long-range orientational order, but retains locally ordered domains. At the boundaries of these domains, topological defects emerge, that themselves move around randomly as the colony grows. In both experiments and simulations, we find that these defects are created at a rate that corresponds to the exponential growth of the colony, resulting in a stable defect density. We also characterize the geometric and topological properties of bacterial colonies, from which we find that the aspect ratio of the rod-shaped particles is the main regulator of both the correlation length and the defect density. Moreover, we find that the defect dynamics are well described by a Gamma distribution, which is due to repeated divisions and subsequent re-orientations of the bacteria

Reduced oxygen concentration during human IVF culture improves embryo utilization and cumulative pregnancy rates per cycle

STUDY QUESTION: Do different oxygen levels during human IVF embryo culture affect embryo utilization, cumulative IVF success rates per cycle and neonatal birthweight?SUMMARY ANSWER: After 2 days of culture, a lower oxygen level (5%) leads to more good-quality embryos and more embryos that can be cryopreserved, and thereby to a higher cumulative live birth rate per cycle when compared to embryo culture in 20% oxygen, while birthweights are similar.WHAT IS KNOWN ALREADY: Several studies have compared IVF outcome parameters after embryo culture in a more physiological level of 5% oxygen and the atmospheric level of 20%. Although there is consensus that embryo development improves in 5% oxygen, effects on pregnancy and live birth rates are mainly seen in blastocyst, but not cleavage-stage transfers. A major drawback of these studies is that only fresh embryo transfers were included, not taking additional frozen-thawed transfers from these cycles into account. This might have underestimated the effects of oxygen level, especially in cleavage-stage embryo transfers. Furthermore, little is known about the effect of oxygen level during culture on birthweight.STUDY DESIGN, SIZE, DURATION: This is a cohort study in 871 consecutive patients who had an IVF cycle between January 2012 and December 2013, and 5-7 years follow-up to allow transfer of frozen-thawed embryos. Based on daily availability of positions in the incubators, all oocytes and embryos of one cycle were allocated to one of the three incubators with traditional ambient oxygen levels (6% CO2 and 20% O2 in air), or to a fourth incubator that was adjusted to have low oxygen levels of 5% (6% CO2, 5% O2 and 89% N2). Embryos were cultured under 5 or 20% oxygen until Day 2 or 3, when embryos were transferred or cryopreserved, respectively. Clinical and other laboratory procedures were similar in both groups.PARTICIPANTS/MATERIALS, SETTING, METHODS: To compare embryo characteristics and (cumulative) pregnancy outcomes between the two oxygen groups, for each patient only the first cycle in the study period was included in the analysis, resulting in 195 cycles in the 5% group (1627 oocytes) and 676 in the 20% oxygen group (5448 oocytes). Embryo characteristics were analysed per cycle and per embryo and were corrected for maternal age, cycle rank order, fertilization method (IVF or ICSI) and cause of subfertility. Perinatal data from the resulting singletons (n = 124 after fresh and 45 after frozen-thawed embryo transfer) were collected from delivery reports from the hospitals or midwife practices.MAIN RESULTS AND THE ROLE OF CHANCE: In the 5% oxygen group, there were significantly more embryos of good quality (45.8 versus 30.9% in the 20% group, adjusted odds ratio (OR) [95% CI] = 1.9 [1.6-2.4]). This did not result in higher live birth rates per cycle, but after fresh transfers more good-quality spare embryos could be cryopreserved (46.1 versus 29.7%, adjusted OR [95% CI] = 2.0 [1.7-2.5]). After a follow-up period of 5-7 years, in which 82.4% of the cryopreserved embryos from the 5% oxygen group and 85.4% from the 20% oxygen group were thawed, the percentage of patients with at least one live birth resulting from the study cycle was significantly higher in the low oxygen group (adjusted OR [95% CI] = 1.5 [1.01-2.2]). In 124 live born singletons from fresh embryo transfers and in 45 from transfers of cryopreserved embryos, birthweight was similar in both oxygen groups after correction for confounding factors.LIMITATIONS, REASONS FOR CAUTION: This is a retrospective study, and treatment allocation was not randomised. The study was not powered for a predefined birthweight difference. With the number of live births in our study, small differences in birthweight might not have been detected. The selection of embryos to be cryopreserved was based on embryo morphology criteria that might be different in other clinics.WIDER IMPLICATIONS OF THE FINDINGS: Improved embryo utilization by more cryopreservation leading to higher cumulative live birth rates per cycle favours the use of 5% instead of 20% oxygen during human IVF embryo culture. This study also demonstrates that for comparison of different IVF treatment regimens, the cumulative outcome, including transfers of fresh and frozen-thawed embryos, is to be preferred instead of analysis of fresh embryo transfers only.STUDY FUNDING/COMPETING INTEREST(S): No external funding was received for this study. None of the authors has a conflict of interest to declare.</p

Fluorescence in situ hybridization-based approaches for detection of 12p overrepresentation, in particular i(12p), in cell lines of human testicular germ cell tumors of adults

Overrepresentation of the short arm of chromosome 12 is frequently detected in human testicular germ cell tumors of adolescents and adults (TGCT). This overrepresentation mostly results from the formation of an isochromosome i(12p). Whether the overrepresentation consistently involves the complete 12p arm including the centromere is still unclear. We studied five TGCT-derived cell line

A 1H NMR comparative study of human adult and fetal hemoglobins

AbstractThe affinities of the individual subunits in human adult and fetal hemoglobins to azide ion have been determined from the combined analysis of NMR and optical titration data. Structural and functional non-equivalence of the constituent subunits, i.e. α and β subunits in human adult hemoglobin and α and γ subunits in human fetal hemoglobin, has been confirmed. The function of the α subunits, which are common to both hemoglobins, is essentially identical in these hemoglobins and, in spite of the substitutions of 39 amino acid residues between β and γ subunits, they exhibit similar azide ion affinities. The present study also demonstrates that the NMR spectral comparison between the two proteins provides signal assignments to the individual subunits in intact tetramer

Comparative genomic hybridization of germ cell tumors of the adult testis: Confirmation of karyotypic findings and identification of a 12p- amplicon

Comparative genomic hybridization (CGH) was carried out on 15 primary testicular germ cell tumors (TGCT) of adolescents and adults and two metastatic residual tumors after chemotherapeutic treatment. The results were compared with karyotypic data obtained form the same tumor specimens after direct harvesting of metaphases or short-term in vitro culture. Both techniques revealed that the most consistent abnormality in primary TGCT is gain of 12p-sequences. Although in most cases over-representation of the complete short arm was observed, CGH revealed a specific amplification of 12p11.1-p12.1 region in two independent primary tumors. In addition, loss of (parts of) chromosome 13 (always involving q31-qter), and gain of (parts of) chromosome 7 (mostly involving q11), (parts of) chromosome 8, and the X chromosome were detected in more than 25% of the tumors by this latter technique. Loss of 6q15-q21 in both re