[Molecular medicine: pathobiochemistry as the key to personalized treatment of inherited diseases]. / Molekulare Medizin: Pathobiochemie als Schlüssel zur personalisierten Therapie vererbter Krankheiten.

Genetic defects are often still regarded as a life-long fate, which one has to cope with. It is true that in many cases an inherited disposition may lead to a severe disease; however, it is also true that the number of genetic defects with a treatment option is continuously increasing and in some of them the onset of disease symptoms can even be totally prevented. Knowledge of the precise molecular pathomechanism is often the basis for a treatment concept. Genome-wide sequencing has tremendously increased the possibility to identify a genetic defect and its broad application has meanwhile made a decisive contribution in routine diagnostics. After identifying a genetic alteration, it is still necessary to investigate the pathobiochemical consequences on the cellular and systemic level. This can be a time-consuming process since not all functional consequences can be immediately recognized. In the case of metabolic defects the treatment strategy can either be a supplementation of missing products or a removal of toxic substrates. The residual function of affected pathways can also often be improved. Recently, the direct correction of the affected genetic defects has become a treatment option for a selected number of diseases. As the first symptoms of disease usually occur early in life, pediatrics has a pioneering role in developing treatment strategies.

Bulky extramedullary hematopoiesis is not a rare complication of congenital dyserythropoietic anemia.

Bulky extramedullary hematopoiesis, usually detected in the thorax by imaging techniques, is a well-known complication in many types of congenital anemias. Here, we describe 12 cases of congenital dyserythropoietic anemia with extramedullary hematopoiesis which was always located in the paravertebral space of the thoracic spine and in other paraspinal regions in a few cases. All bulks were originally detected in chest radiographs and confirmed by imaging techniques such as computed tomography and/or magnetic resonance imaging. In some cases, thoracotomy was performed for suspected malignancy. Although the true prevalence is not known, paravertebral masses in patients with CDA of any type are not uncommon and should be the first differential diagnosis considered when masses adjacent to the spine are detected in this disorder.

Influence of storage conditions and shotshell wounding on the hygienic condition of hunted, uneviscerated pheasant (Phasianus colchicus).

The effects of shot wounds on the hygienic conditions of pheasants (particularly those in the body cavity) were studied. Slaughtered (n = 33) and hunted pheasants (31 specimens with, and 33 specimens without shots in the body cavity) were stored uneviscerated at 0 and 4 degrees C. Specimens were taken at d 0, 3, 7, and 14. Hunted pheasants differed from slaughtered pheasants with respect to muscular hemorrhages and blood and fecal matter in the body cavity but also with regard to the presence of Escherichia coli in breast and thigh muscles. In addition, a higher thigh muscle pH (P < 0.05) was noted in hunted pheasants, with no significant (P > 0.05) increase observed during storage. Concentrations of biogenic amines in muscle tissue remained below the determination limit of 1 mg/kg for 90% of samples analyzed, with the maximum concentration for the remaining 10% of samples reaching 5.7 mg/kg, indicating a low incidence of contaminant bacteria. The observed changes in pH values and levels of biogenic amines failed to correlate with the presence or absence of shot lesions in the body cavity or abdominal region. Total aerobic counts increased significantly during storage, but the absolute numbers were consistently below 10(6) log(10) cfu/g. Although E. coli were <1 log(10) cfu/g in muscles of hunted pheasants on d 3 at 4 degrees C, counts of up to 3.7 log(10) cfu/g on d 7 at 4 degrees C indicated a loss of hygienic quality. Therefore, it is recommended that hunted, uneviscerated pheasants be stored 3 d at 4 degrees C, but not longer than 7 d after the hunt.

Carcass and meat quality traits of wild boar (Sus scrofas. L.) with 2n=36 karyotype compared to those of phenotypically similar crossbreeds (2n=37 and 2n=38) raised under same farming conditions. 1. Carcass quantity and meat dressing.

The aim of this study was to compare wild boar (chromosomal number 2n=36) to phenotypically similar animals of 2n=37 and 2n=38 chromosomes (crossbreeds) with respect to live weight, carcass yield, meat yield, fat and weight of inner organs. All animals were born and raised on the same farm and slaughtered at 39 weeks. The final live weight of wild boar 2n=36 was significantly lower (47.2kg) as compared to crossbreeds (80.0kg). Animals 2n=36 had more carcass yields (65.5%) than 2n=37 karyotype (64.9%) and 2n=38 (64.4%). Wild boar had the highest yields for the cuts with bones and boneless cuts compared to crossbreeds. Therefore, variations in karyotype are accompanied by differences in some carcass quantitative traits, i.e., 2n=36 grow and fatten slower than crossbreeds 2n=37 and 2n=38.

Modified-atmosphere storage under subatmospheric pressure and beef quality: II. Color, drip, cooking loss, sarcomere length, and tenderness.

Beef has a requirement for refrigerated storage up to 14 d to achieve adequate aging and a tender product. To achieve this aging with little spoilage and no surface drying, vacuum packaging is attractive, because it is inherently simple and offers a clear indication to the packer when the process has failed or there is risk of spoilage. However, there is increasing pressure on the meat industry to limit the use of packaging materials in view of their cost and the cost involved in their recovery and recycling. The purpose of this report was to evaluate an alternative storage system in containers using modified atmospheres at reduced pressure (approximately 25 kPa). The quality of the meat for both container- and vacuum-packed treatments was measured during chilled storage for up to 3 wk. Storage time had the most significant effect on quality characteristics, irrespective of the packaging method. Storage in containers under a 70%N2:30%CO2 gas mixture gave characteristics similar to beef stored under vacuum. Storage in containers under 100% CO2 produced less drip loss than under 70%N2:30%CO2, but generally container storage produced 3 times as much drip loss as vacuum packaging. Shear force of the LM was unaffected by the type of packaging, and at d 2 after slaughter (i.e., before the storage trial was begun), sarcomere lengths of muscles intended for container storage were similar to those destined for vacuum storage. During the packaging treatment, the comparison between the storage systems was always done within 1 animal using one carcass-half for container storage and the other half for vacuum packaging; all bulls were shackled from the left hindleg during bleeding. The majority of the muscles from the left sides had lower shear force values than those from the right sides at the earlier storage times (2 and 9 d after slaughter) but had similar values after longer storage (16 and 23 d after slaughter). This is the first report that shackling beef carcasses from the left side can result in more tender meat in the LM from that side. The increased tenderness in the LM from the shackled side probably resulted from an early decrease in pH and an increase in calpain activity after mechanical strain of the muscles on the shackled side. This effect of shackling should be taken into account when designing systematic comparisons of tenderness in beef.

Comparison of roflumilast, an oral anti-inflammatory, with beclomethasone dipropionate in the treatment of persistent asthma.

BACKGROUND: Roflumilast is an oral, once-daily phosphodiesterase 4 inhibitor with anti-inflammatory activity in development for the treatment of asthma. Roflumilast was compared with inhaled beclomethasone dipropionate (BDP) in patients with asthma. METHODS: In a double blind, double-dummy, randomized, noninferiority study, 499 patients (forced expiratory volume in 1 s [FEV1] = 50-85% predicted) received roflumilast 500 microg once daily or BDP 200 microg twice daily (400 microg/day) for 12 weeks. Lung function and adverse events were monitored. RESULTS: Roflumilast and BDP significantly improved FEV1 by 12% (270 +/- 30 ml) and 14% (320 +/- 30 ml), respectively (P < 0.0001 vs baseline). Roflumilast and BDP also significantly improved forced vital capacity (FVC) (P < 0.0001 vs baseline). There were no significant differences between roflumilast and BDP with regard to improvement in FEV1 and FVC. Roflumilast and BDP showed small improvements in median asthma symptom scores (-0.82 and -1.00, respectively) and reduced rescue medication use (-1.00 and -1.15 median puffs/day, respectively; P < 0.0001 vs baseline). These small differences between roflumilast and BDP were not considered clinically relevant. Both agents were well tolerated. CONCLUSIONS: Once daily, oral roflumilast 500 microg was comparable with inhaled twice-daily BDP (400 microg/day) in improving pulmonary function and asthma symptoms, and reducing rescue medication use in patients with asthma.

Comparison of the safety of drug delivery via HFA- and CFC-metered dose inhalers in CAO.

The objective of this study was to compare the long-term safety of a fixed combination of fenoterol hydrobromide (50 microg) and ipratropium bromide (20 microg) delivered using a metered dose inhaler (MDI) formulated with a non-chlorinated propellant, hydrofluoroalkanel34a (HFA-MDI), with delivery using the conventional chlorofluorocarbon propellant (CFC-MDI, Berodual/Bronchodual). The study was designed according to Safety Assessment of Marketed Medicines (SAMM) guidelines, to reflect as far as possible the use of MDls under normal prescribing conditions. Two thousand and twenty-seven patients with chronic airways obstruction (CAO) were enrolled from 99 centres in France, 95 centres in Germany and 24 centres in Italy. Following a 2-week run-in period, patients were randomized on a 2:1 basis (1,348 patients to HFA-MDI, 679 patients to CFC-MDI) to receive a flexible dose regimen of the combination (2 puffs, 2-4 times a day, as prescribed by the investigator) during a 12-week open label phase. The overall incidence of adverse events was comparable between both groups. In addition, the incidence of respiratory side effects was also similar, with CAO exacerbations or bronchitis the most frequently recorded events. The safety profile of the HFA formulation was comparable to those of the marketed CFC-MDIs used in Germany and France/Italy. No clinically significant differences were detected between HFA134a or CFC driven inhalers on the switch from CFC- to HFA-MDI (2 weeks before randomisation versus 2 weeks after randomization). There was a trend for taste complaints to be reported more frequently by patients in the HFA-MDI group (0.7% before randomization versus 3.4% after randomization). This, however, was an expected finding as the HFA134a formulation does have a different taste to the CFC formulation. No difference between formulations was observed in the incidences of coughing or paradoxical bronchospasm. The incidence of falls in FEV1 >15% within 15 min following inhalation at each of the clinic visits was 1.2% for both CFC- and HFA-MDIs. In conclusion, administration of a fenoterol/ipratropium bromide combination via hydrofluoroalkane-metered dose inhaler is as safe as delivery by the currently available chlorofluorocarbon-metered dose inhaler, in an extended population of patients with CAO under normal prescribing conditions.