Serum retinoic acid and atopy among children of different ethnic origin living in Germany.

We hypothesized that higher provitamin A carotenoid serum levels may be associated with higher concentrations of all-trans retinoic acid (ATRA) and atopy. Concentration of ATRA was measured by high-performance liquid chromatography in sera from German domestic and Turkish migrants' children. ATRA serum levels were significantly higher in German children if compared with Turkish children and correlated with those of ß-carotene (rs = 0.692) and other provitamin A carotenoids. They did not differ significantly between atopic and nonatopic individuals. Serum levels of ATRA are related to those of provitamin A carotenoids but are not directly related to atopy in the present study.

Serum carotenoids and atopy among children of different ethnic origin living in Germany.

The manifestation of atopy in early life is thought to be influenced by the diet. We hypothesized that the previously reported lower prevalence of atopy among Turkish immigrant children in Germany might be related to a different pattern of serum carotenoids. Serum carotenoid concentrations were measured in pre-school children of different ethnic origin from Berlin, D. German children (D, N = 49) were compared to Turkish children with well (TR-D, N = 32) or weak cultural adaptation (TR-TR, N = 41). Serum levels of pro-vitamin A carotenoids (α- and ß-carotene, ß-cryptoxanthin) and non-pro-vitamin A carotenoids (lutein, zeaxanthin, lycopene) were measured by high performance liquid chromatography. Serum IgE to common inhalant allergens was measured by immunoassay. Median levels of pro-vitamin A carotenoids were lower in Turkish children if compared to German children: D 135 µg/L, TR-D 100 µg/L (p = 0.025), TR-TR 82 µg/L (p = 0.001). By contrast, median levels of non-pro-vitamin A carotenoids were not higher in German children. The ratio of pro-vitamin A to non-pro-vitamin A carotenoid median levels was highest among D (2.05), lower among TR-D (1.32; p = 0.001) and lowest among TR-TR (1.26; p < 0.001)). A higher ratio was not significantly associated with atopy (atopic 1.79, non-atopic 1.36; p = 0.067). Pro-vitamin A carotenoids are higher in children originating from a cultural population with a higher prevalence of atopy, but atopy seems not to be directly related to the current carotenoid serum levels in children at school age. The distinct pattern of carotenoid levels among Turkish migrant and German children indicates changed nutrition patterns with acculturation.

Long-term evaluation of donor site morbidity after free fibula transfer.

Our aim was to evaluate the long-term morbidity at the donor site after harvest of free fibular flaps. From a total of 165 patients, we were able to examine (not randomly) 62 donor regions in 57 patients (33 men and 24 women) 2-167 months (mean 45 months) after fibular transfer. Patients' individual risk factors and any disturbances of healing, and dysfunction of the toes, were recorded. The Kitaoka ankle-hindfoot score was used for evaluation of functional impairment. Thirteen donor regions displayed prolonged wound healing, eight of which needed revision of the wounds. Eight (14%) had abnormalities of gait. The median Kitaoka ankle-hindfoot score was 93 (range: 14-100). In 17 patients (27%) after a follow-up period of 4 months, hammer and claw toes and deficits in dorsal extension of the hallux were assessed. Thirty patients (48%) had sensory deficits of the calf and toes. Neither the risk factors recorded nor the factors that indicated disturbance of wound healing or deformities of the toe were significantly associated with the development of functional impairment. In more than three-quarters of the cases healing was uneventful, but in a small number the morbidity at the donor site was severe, forcing the patient to use walking aids. We were not able to identify any risk factors for the development of long-term malfunction.