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Introduction: The number of children born underweight (low birth weight, LBW) is increasing despite extensive prevention and screening programmes. The cost is high for the health system, and affected children are burdened with health predictors that can affect them negatively throughout their lives. This study investigates to what extent socioeconomic factors, in addition to known medical causes and the health behaviour of pregnant women, influence LBW. Materials and Methods: In this case-control study 131 mothers of singletons with a birth weight ≤ 2500 g (cases) and 323 mothers of normal birth weight babies (controls) were interviewed with respect to socioeconomic status, health behaviour and stress in the workplace. Medical data were collected by specialist staff using a questionnaire. Results: Independent of medical diagnosis and health behaviour, women with lower level education (OR [95 % CI] = 2.24 [1.12; 4.51]) and those who were not working (OR [95 % CI] = 1.82 [1.10; 3.00]) were more likely to have an LBW baby. No effect was shown for immigrant background (OR [95 % CI] = 1.14 [0.59; 2.21]) or stress in the workplace (OR [95 % CI] = 1.17 [0.90; 1.51]). Discussion and Conclusion: These results show that the association between social and health inequalities starts from before birth. In order to reduce the rising number of babies born underweight, socioeconomic determinants in the care and supervision of pregnant women should systematically receive more attention to enable appropriate early preventive strategies to be implemented.

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BACKGROUND: Despite the well-known link between social support and health as well as quality of life only a few scientifically meaningful studies have been carried out to actively promote social support. In the +P Project (post-hospital lay support for patients) elderly people in need of support after a stay in hospital are accompanied in their daily life by volunteers. The qualitative research part in the study evaluates conditions which led to the adoption of the support by the volunteers and how the elderly people experienced this companionship. METHODS: The analysis followed the grounded theory method. In a theoretical sampling nine accompanied people were identified and participated in narrative interviews regarding their experience of the voluntary support. RESULTS: In addition to personality traits of the elderly and perceived seriousness of the project the interpersonal relationship was important for the adoption of the companionship. Key factors were the perceived similarity between the older people and their supporters as well as confidence in the volunteers and their skills. The support contributed to facilitating and enriching the daily life of the elderly and even friendships with the volunteers developed. CONCLUSIONS: The results indicate that volunteers can help to compensate a lack of social support for the elderly. The results confirm theoretical models of coping with age and disease-related losses and models of social relations in old age. At the same time this study underpins political recommendations to strengthen community engagement to promote social networks for older people.

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BACKGROUND: Individual health behaviour counts as an important factor for health status. A healthier lifestyle substantially contributes to better health. People burdened with lower health and with lower socio-economic status could benefit notably. So far it is not known exhaustively to what extent education and social status contribute to changes in health behaviour and which motifs play a decisive role. METHODS: Based on cross-sectional data from the seventh wave of the "Gesundheitsmonitor", Bertelsmann Foundation, (n=1 436), the influence of social status and education on health behaviour and changes in behaviour was analysed. RESULTS: Specific health behaviour correlates with level of education and socio-economic status. In contrast, regarding health behaviour changes in the last 12 months prior to survey, no social class- or education-specific effect was found. Age, health status as well as fears and wishes in relation to health seem to be important causalities for changes of health-related behaviour. CONCLUSION: Interventions to foster healthy lifestyles should include class differences in specific health-related behaviour and personal reasons for behavioural changes.

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This phase II study evaluated docetaxel-5-fluorouracil (5-FU) in locally recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN). Patients were divided into 2 cohorts--those previously treated with chemotherapy and those nonpretreated--that received docetaxel 75 mg/m2 (day 1) plus 5-FU 1,000 mg/m2/day (days 1-5 every 3 weeks). Of 63 patients entered, 20 (31.7%) were pretreated and 43 (68.3%) were nonpretreated. Fifty-nine patients (93.7%) had received prior radiotherapy. After inclusion of 20 patients, the 5-FU dose was reduced to 750 mg/m2/day due to unacceptable toxicity. The overall response rate (ORR) was 20.6% on radiologic review (22.2%, investigator assessment). Pretreated patients achieved an ORR of 25.0% versus 18.6% for nonpretreated patients. This unexpected finding was partly attributed to differences in patient characteristics between the groups. Overall major grade 3 to 4 toxicities comprised neutropenia (66.6%), febrile neutropenia (31.7%), and mucositis (31.7%). Grade 3 to 4 toxicities were lower at the reduced 5-FU dose (750 mg/m2/day): Febrile neutropenia declined from 40.0% to 27.9%; mucositis declined from 55.0% to 20.9%. Three treatment-related deaths occurred (2 with 5-FU 750 mg/m2/day, 1 with 5-FU 1,000 mg/m2/day). Docetaxel-5-FU appears active in locally recurrent and/or metastatic SCCHN with acceptable toxicity at the dose of 5-FU 750 mg/m2.

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The production of biologicals is subject to strict governmental regulations. These are drawn up in current good manufacturing practices (cGMP), a.o. by the U.S. Food and Drug Administration. To implement cGMP in a production facility, plant automation becomes an essential tool. For this purpose Manufacturing Execution Systems (MES) have been developed that control all operations inside a production facility. The introduction of these recipe-driven control systems that follow ISA S88 standards for batch processes has made it possible to implement cGMP regulations in the control strategy of biological production processes. Next to this, an MES offers additional features such as stock management, planning and routing tools, process-dependent control, implementation of software sensors and predictive models, application of historical data and on-line statistical techniques for trend analysis and detection of instrumentation failures. This paper focuses on the development of new production strategies in which cGMP guidelines are an essential part.

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The processes that participate in clearing increases in [K+]o produced by active neurons include KCl uptake, Na pump stimulation, and spatial buffering. The latter process requires glial cells to carry: 1) inward K+ currents in regions where K+ is elevated at a glial membrane potential more negative than EK; and 2) outward K+ currents at normal K+ and glial membrane potential more positive than EK (Orkand et al: J Neurophysiol 29:788, 1966). Techniques for isolation and culturing glial cells brought new possibilities for studying ionic channels involved in spatial buffering. However, they raised the question of the extent to which the properties of ionic channels are changed due to the process of culturing when glial cells are exposed to an artificial environment and deprived of direct interaction with neurons. We studied potassium currents in glial cells from the frog optic nerve that were cultured for 1-8 days. At 24-48 h, cells exhibited an inwardly rectifying Cs+ blocked current (IK(IN)) that increased in amplitude and shifted its threshold of activation to EK when [K+]o was increased from 3 to 6 or 10 mM. IK(IN), diminished after 3 days in culture and virtually disappeared after 5 days. At 24-48 h, a potassium delayed rectifier current (IKD) was relatively small but became large at 3 days, and was practically the only current present after 5 days. IKD was activated at -8.5 +/- 0.58 mV(SE, n = 48) and 58 +/- 2.2% (SE, n = 48) blocked by 20 mM tetraethylammonium. The results of this study support the idea that the inward rectifying potassium channels (Kir) are responsible for carrying K+ into glial cells whenever [K+]o increases. However, the delayed rectifier potassium channels (KD) cannot provide the pathway for outward K+ current during spatial buffering, and another mechanism must be involved in this process. Our study provides further evidence that culture conditions can greatly influence functional expression of ionic channels in glial cells.

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Using the whole-cell patch-clamp technique, the effects of serotonin (5-HT) and increased acidity to produce membrane currents and to modify high threshold voltage-dependent calcium currents were studied in isolated dorsal root ganglion (DRG) cells of the frog maintained in short-term culture. DRG cells were classified by morphology into two types: (1) cells with a large number of dark rusty brown granules, and (2) cells devoid of these granules or with few scattered pale granules. Fast application of 5-HT (10-30 microM) induced a rapidly desensitizing inward current with a reversal potential at about 0 mV in 38 of 50 granule-containing neurons (76%) which was never observed (0/35) in "clear" neurons. This current was blocked by 10 nM (+)-tubocurarine. In addition, a small noninactivating outward current was also observed in most DRG neurons during 5-HT superfusion. A sudden decrease of pH from 7.4 to 6 or 5.8 induced a fast inactivating inward current of 100-300 pA in 74% of the "clear" neurons and only 24% of the granule-containing neurons. Small noninactivating membrane currents induced by lowering pH were observed in all neurons. Both 5-HT and increased extracellular H+ reduced the magnitude of high threshold calcium currents in all DRG neurons. It is suggested that the 5-HT receptors are expressed on a morphologically distinct population of neurons while the cells with channels responsible for the fast inactivating proton-induced current cannot be related to any distinct morphological cell type.

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The Batch Control System for Vaccines (BCSV), a new Man Machine Interface (MMI) for the control of cultivations in bioreactors, was developed according to SP-88. SP-88 is the ISA standard for Batch Control Systems. Among others, SP-88 supplied the concept of recipes, which organize and specify the monitoring and control requirements for manufacturing. Process optimisation and compliance to GMP rules and regulations were the main objectives for this development.The most important features of the BCSV interface include: - implementation at production, pilot and R & D scale to assure easy transfer of knowledge and experience at the various stage of process development; - independency of underlying hardware to ensure similar "look and feel" for different pieces of equipment; - in-house development and maintenance of recipes to have maximum control over applications; - interactive communication between operator and BCSV during recipe execution. GMP compliance was assured not only by considering governing sets of GMP regulations, but also by taking up the interface in a overall Information & Automation strategy and by setting up a QA strategy for the entire life cycle of the system.

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To study the distribution of oxidative capacity in muscle fibers, mitochondrial volume density and the oxidative capacity of isolated mitochondria were evaluated. Mitochondria were isolated from the subsarcolemmal and interfibrillar areas of the soleus (a muscle largely made up of slow oxidative fibers) and the gastrocnemius medial head (a muscle largely made up of fast glycolytic fibers) of the rat, and their oxidative capacities were evaluated using NADH- and FADH-generating substrates. In the soleus muscle, the subsarcolemmal mitochondria showed a lower oxidative capacity than interfibrillar mitochondria when NADH-generating substrates were used. This difference was not observed when FADH-generating substrates were used. In the gastrocnemius, there were no differences in the oxidative capacity of the subsarcolemmal and the interfibrillar mitochondria. Additionally, citrate synthase activity was found to be lower in mitochondria isolated from the subsarcolemmal area of the soleus than in the other mitochondrial preparations. These findings indicate that the difference in oxidative capacity of the isolated mitochondria is not related to differences in the inner mitochondrial membranes. Mitochondrial volume density was evaluated using electron micrographs of the subsarcolemmal and interfibrillar areas of slow oxidative fibers from the soleus and fast glycolytic fibers from the gastrocnemius. In the slow oxidative fibers, mitochondrial volume density in the subsarcolemmal area was four times higher than in the interfibrillar area. In the fast glycolytic fibers, mitochondrial volume densities in the subsarcolemmal and interfibrillar areas did not differ from that of the interfibrillar area of the slow oxidative fibers. The oxidative capacity of the tissue, calculated by multiplying the mitochondrial oxidative capacities by the mitochondrial volume densities, was 2-4 times higher in the subsarcolemmal areas of the soleus fibers than in the other areas studied. This was true in spite of the fact that the oxidative capacity of the subsarcolemmal mitochondria of the slow oxidative fibers was lower than those of the other mitochondrial populations studied. These results indicate that the difference in oxidative capacity between slow oxidative fibers and fast glycolytic fibers is the result of the much greater mitochondrial volume density in the subsarcolemmal area of the slow oxidative fibers.

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The effects of decreasing extracellular pH from 7.4 to 6.0 or 5.8 on whole cell membrane currents induced by GABA (10-100 microM) were studied in dorsal root ganglion (DRG) neurons of the frog in short-term culture using the whole cell patch-clamp technique. In 45 of 50 cells the GABA currents were the same at both normal and reduced pH. In the remaining 5 cells, acidification increased the response. The reversal potential for the current, about +5 mV, was the same at reduced and normal pH. These results contrast with the effect of the same pH reduction which markedly reduces the current resulting from glutamate activation of receptors on central neurons (Traynelis and Cull-Candy 1990, Vyklický Jr. et al. 1990, Tang et al. 1990). These findings suggest that acidification under pathophysiological conditions plays a protective role in preventing excessive excitation not only by decreasing glutamate responses but also by leaving the inhibitory GABAA responses intact.

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Earlier clinical trials demonstrated the anti-hypertensive effect of amlodipine, a new calcium channel blocker of the dihydropyridine type. In the present comparative study, we investigated the anti-hypertensive effect of amlodipine in comparison with a combination of nifedipine and mefruside. In both groups, the anti-hypertensive effect was comparable. Normalization of the supine diastolic blood pressure was observed in 72.3% of patients treated with amlodipine and in 66.6% of those patients in the combination group. Both drugs were generally well tolerated, with a somewhat higher incidence of side effects being observed in the combination group. The study shows that amlodipine monotherapy in mild-to-moderate hypertension is equally as effective as combination therapy with nifedipine/mefruside, with amlodipine being superior in terms of tolerability.

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The effects of isoprenaline administration (300 micrograms/kg for 5 weeks) on rat soleus muscle capillarity and glycolytic and oxidative capacities were evaluated. The treatment resulted in ventricular hypertrophy. The activities of lactic dehydrogenase, pyruvate kinase, citrate synthase, and cytochrome c oxidase in soleus muscle homogenates were not different between control and isoprenaline-injected animals. Capillaries were visualized in muscle cross sections treated to demonstrate ATPase activity after acid preincubation. Capillary density was higher in the experimental (873 +/- 38 capillaries/mm2) than in the control (713 +/- 33 capillaries/mm2) animals. Capillary to fiber ratio was also higher in the experimental (2.47 +/- 0.10) than in control (2.09 +/- 0.08) animals, but fiber cross-sectional area was not changed by the treatment (2836 +/- 87 microns2 in controls and 2951 +/- 136 microns2 in experimental). A plot of capillary to fiber ratio vs. fiber cross-sectional area showed that at a given fiber cross-sectional area the value of capillary to fiber ratio of the treated animals was higher than that of the controls. This indicates that treatment resulted in the proliferation of microvessels. The results suggest that prolonged beta-adrenergic stimulation results in the development of new capillaries but that this is not accompanied by increases in the oxidative capacity of the soleus muscle of the rat.

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In 68 of 1152 patients older than 65 years an acute ulcus duodeni could be stated by endoscopy. This is 5,9% of the examined patients. Among this group there was a remarkably great number of patients who belonged to the age group between 70 and 80 years. The anamnesis of 42 patients indicated complaints for several years, whereas 26 patients showed symptoms only for a few weeks. The size of the acute ulceration was mostly below 1,0 cm. A determined relation between the size of the ulceration, the patients age and the duration of their anamnesis could not be found. In 12 patients an acute ulcus ventriculi could be proved simultaneously. In 15 cases acute bleeding was the initial symptom of the ulceration. Healing of the ulcera took between 4 weeks and 3 months. The conservative therapeutical steps were not standardized. Stationary and ambulant patients did not show any difference in the time of healing. It was remarkable that the consumption of alcohol and especially of cigarettes was relatively high.

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The activity of glucan synthetase increased dramatically during encystment of Polysphondylium pallidum cells. The majority of activity was present in purified plasma membranes. Activity, measured as glucose incorporation from UDPG into NaOH-insoluble glucan, increased 30-40 fold in the membranes. Increases in activity within the cells preceded plasma membrane increases and the enzyme appeared to be rapidly transported to the plasma membrane. Intracellular activity was relatively low. When cells were incubated with UDPG and when phloretin was included to inhibit glucose uptake, no NaOH-insoluble glucan was synthesized. Hence, the UDPG-binding site was not exposed at the cell-surface. When the NaOH-insoluble glucan was digested with endo-ß-1,4-glucanase the products were cellobiose and glucose. The glucan could also be precipitated from Schweizer's reagent with acetic acid. These results suggest that the glucan contained predominantly ß-1,4-linkages and may be cellulose. Experiments with cycloheximide confirmed that protein synthesis was required for encystment. Labeling of cells with [1-(14)C]-acetate showed that the synthesis of certain plasma membrane proteins was developmentally regulated. A number of proteins (e.g., myosin heavy chains and actin) were synthesized during the lag phase and their synthesis was subsequently reduced or ceased altogether. Immediately prior to the commencement of cyst wall formation seven new plasma membrane proteins were synthesized. These proteins were not detected intracellularly, indicating rapid transfer to the plasma membrane. The possible relationship between the seven developmentally regulated proteins and a postulated "multi-enzyme-complex" involved in cellulose synthesis is discussed. Their synthesis may be related to the increase in particles in the outer leaflet of the plasma membrane observed during encystment with freeze-etching (G.W. Erdos and H.R. Hohl, 1980, Cytobios, 29, 7-16).

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Using the diaminobenzidine (DAB) reaction catalase activity could be demonstrated histochemically in cytoplasmic structures of Phytophthora palmivora bearing general ultrastructural features of microbodies. These socalled U-bodies sediment together with the catalase activity in Ficoll-Sorbitol-Sucrose gradients following prior purification by differential centrifugation.

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