Biomedical subjects

M Kersting

Publications and source records attributed to M Kersting.

At least 37 records · Page 2Linked to original sources

PubMed2000

Differential frequencies of p16(INK4a) promoter hypermethylation, p53 mutation, and K-ras mutation in exfoliative material mark the development of lung cancer in symptomatic chronic smokers.

PURPOSE: The aim of this study was to investigate the frequency of three (epi)genetic alterations (p53 and K-ras mutations and p16(INK4a) promoter hypermethylation) in symptomatic chronic smokers compared with patients with lung cancer and to evaluate the use of exfoliative material for such analyses. PATIENTS AND METHODS: Fifty-one patients with histologically confirmed lung cancer and 25 chronic smokers (> 20 pack-years) were investigated for mutations in the K-ras (codon 12) and p53 (codons 248, 249, and 273) genes and for allelic hypermethylation of the p16(INK4a) gene. DNA was isolated from sputum and bilateral bronchial lavage, and brushings were taken at bronchoscopy. RESULTS: Forty-one genetic lesions were detected within exfoliative material from the group of 51 patients with lung cancer and 10 lesions in the chronic smoker group. K-ras mutations occurred exclusively in the lung cancer group, whereas p53 mutations and p16(INK4a) promoter hypermethylation were also found in chronic smokers. Three of eight chronic smokers who harbored an (epi)genetic alteration were subsequently diagnosed with lung cancer. Analysis of sputum yielded information equivalent to that of samples obtained during bronchoscopy. CONCLUSION: p16(INK4a) promoter hypermethylation and p53 mutations can occur in chronic smokers before any clinical evidence of neoplasia and may be indicative of an increased risk of developing lung cancer or of early disease. K-ras mutations occur exclusively in the presence of clinically detectable neoplastic transformation. Molecular analysis of sputum for such markers may provide an effective means of screening chronic smokers to enable earlier detection and therapeutic intervention of lung cancer.

Aged↗

PubMed2000

Vitamin intake of 1- to 18-year-old German children and adolescents in the light of various recommendations.

Data on the vitamin intake during childhood and adolescence are rare in Europe. Here, age and sex specific percentiles of the absolute intakes and relative densities (per MJ) of retinol, carotenoids, vitamins A, E, C, B1, B2, B6, niacin and folate in a sample of 627 subjects between the age of 1 and 18 years are reported and compared to the actual recommendations from Germany, the EC and the USA. The evaluation of the intakes clearly depends on the reference value chosen. In total, the vitamin intake can be assessed to range between satisfactory and generous with the exception of folate which ranged consistently below the references.

Adolescent↗

PubMed2000

Ten-year trends in vitamin and mineral intake from fortified food in German children and adolescents.

OBJECTIVE: We investigated time trends in consumption patterns, and energy and nutrient intakes (protein, fat, carbohydrates, added sugars, vitamins A, E, C, B1, B2 and B6, niacin, folate, calcium and iron) from fortified food in children and adolescents between 1987 and 1996 in Germany. DESIGN: Mixed longitudinal survey (DONALD study) with 3 d weighed dietary records (n=2062 from 594 subjects), one subject per family per year chosen by random. SETTING: Dortmund (Western Germany) district cohort. SUBJECTS: 285 males, 309 females; mean age 6 y (2-13 y). RESULTS: Almost all children and adolescents consumed fortified food irrespective of the year studied. With the exception of vitamin E, significant time trends in the proportions of nutrient intakes from fortification were observed. The fortification of food with vitamins A, C, B1, B2 and B6 and niacin raised the already adequate intakes from non-fortified food (100% to 150% of reference intake values) by 20-50%. The fortification of food with vitamin E and folate raised the low intakes from non-fortified food (about 50% of reference intake values) to about 80% (folate) and 100% (vitamin E) of the references. Fortification of food with calcium and iron was not significant (<10%), but while total intake of calcium was adequate, total intake of iron remained critical. CONCLUSIONS: Since the nutrient intake of the population of children and adolescents studied is adequate with respect to vitamins A, C, B1, B2 and B6, niacin and calcium, fortification seems inefficient, while fortification of food with vitamin E and folate, but not iron, improves an inadequate intake. SPONSORSHIP: The DONALD study is supported by the German Federal Ministry of Health and the North-Rhine-Westphalian Ministry of Science and Research. European Journal of Clinical Nutrition (2000) 54, 81-86

Adolescent↗

PubMed2000

[Value of the ERGOS work simulator as a component of functional capacity assessment in disability evaluation].

The use of assessment instruments in evaluating functional capacity is an important element in the process of social-medical judgement of whether a person will likely be able to reintegrate into working life. Standardized work processes are used in simulating occupational reality over several hours, with all the requirements involved, and the performance found is contrasted with the requirements to be expected at a workplace. Time-tested in the U.S. for more than 20 years and applied throughout Germany for some two years now, the ERGOS work simulation system is presented in the article, using a case example for more detailed description. Using five different work stations, performance data are collected for job tasks such as carrying, working in kneeling position or overhead, and subjected to computer-based comparison with the job requirements information contained in relevant databases. This enables computerized identification of excessive demands, and hence may point to a need for further rehabilitative action. An important feature is objective assessment, as subjective information on the basis of observation or reports of painfulness are raised separately, hence do not influence the findings of the work simulation performed.

Computer Simulation↗

PubMed2000

[Value of the Susan Isernhangen Evaluation of Functional Capacity Scale in medical and occupational rehabilitation].

In Germany, Susan Isernhagen's Functional Capacity Evaluation (FCE) system has increasingly come into use over the last few years at the interface between medical and vocational rehabilitation. With implementation of these work-related tests of functional capacity it is possible to obtain valid statements concerning the further vocational prognosis. Along with evaluative testing by experts from different disciplines, the further steps towards integration occur on a well-founded basis. Therapies may thus be adjusted to the requirements of work, either at the former workplace or a new one, or possibly of a vocational (re-)training measure. Also, it is possible to directly deal with work-related issues in the report given at the end of rehabilitation, to initiate preliminary integrative steps in order to achieve a seamless, job retention-focussed transition back into work life. Work is simulated at different levels of loading capacity, the functional deficits of the rehabilitees are addressed in a specific, job-related manner, so as to enable an early return to work after rehabilitation.

Disability Evaluation↗

PubMed2000

Multiple primary tumors as an indicator for p16INK4a germline mutations in pancreatic cancer patients?

Multiple primary tumors in pancreatic cancer patients might indicate a genetic predisposition to the development of malignancies. In this study we evaluated whether the mutation rate of the TP53 and p16INK4a genes of pancreatic cancers differs in pancreatic cancer patients with and without multiple primaries. Furthermore, we investigated whether pancreatic cancer patients with multiple primaries carry germline mutations in either p16INK4a, TP53, or BRCA2 tumor suppressor genes to detect a genetic alteration that predisposes to the development of different primaries. Fourteen (23%) of 60 pancreatic cancer patients developed histologically verified additional primaries during their lifetimes. Normal constitutional and tumor DNA of the 14 patients with a positive cancer history, but negative family history, were analyzed for p16INK4a, TP53, and BRCA2 mutations by single-strand conformational variant (SSCV) analysis and direct sequencing. Hypermethylation of the p16INK4a promoter region in pancreatic cancers was identified by methylation-specific polymerase chain reaction (PCR; MSP). Four of 14 pancreatic carcinomas carried somatic intragenic p16INK4a mutations, and another four tumors revealed hypermethylation of the p16INK4a promoter region. Somatic intragenic TP53 mutations were identified in six of 14 tumors. None of the pancreatic cancer patients carried TP53 or BRCA2 germline mutations. In contrast, one of 14 pancreatic cancer patients with multiple primaries carried the p16INK4a mutation A68V in his germline. This mutation was localized in the conserved second ankyrin repeat of p16INK4a and did not occur in 100 control patients. The frequency of somatic TP53 and p16INK4a mutations in pancreatic cancer is similar in patients with and without multiple primaries. TP53 and BRCA2 germline mutations seem not to be significantly associated with the occurrence of multiple primaries in pancreatic cancer patients. However, p16INK4a germline mutations might be causative for tumor development in some pancreatic cancer patients with multiple primaries. The genetic investigation of patients with accumulation of different cancers even without a positive family history may be a new approach for the understanding of the relation of different cancers.

Adult↗

PubMed2000

Low frequency of p16(INK4a) alterations in insulinomas.

BACKGROUND/AIMS: The molecular mechanisms contributing to the tumorigenesis of insulinomas are poorly understood. Disruption of the cell cycle due to inactivation of the p16(INK4a) tumor-suppressor gene was identified in a variety of human tumors, including gastrinomas and nonfunctioning endocrine pancreatic carcinomas. In this study the role of p16(INK4a) in the tumorigenesis of insulinomas was evaluated. METHODS: Seventeen insulinomas (14 benign, 3 malignant) were analyzed for genetic alterations in the p16(INK4a) tumor-suppressor gene by SSCP, PCR-based deletion and methylation-specific assays. p16 expression was determined by immunohistochemistry. RESULTS: One malignant insulinoma showed a homozygous deletion of p16(INK4a) and another two benign insulinomas revealed aberrant methylation of the p16(INK4a) promoter region. All three tumors lacked p16 expression according to immunohistochemistry. None of the insulinomas carried intragenic p16(INK4a) mutations. In total, 17% of insulinomas had p16(INK4a) alterations. CONCLUSIONS: The p16(INK4a) tumor-suppressor gene contributes to tumorigenesis in only a small subset of insulinomas.

Cell Cycle↗

PubMed2000

Vitamin and mineral supplements for the use of children on the German market: products, nutrients, dosages.

A market survey of vitamin and mineral supplements was carried out considering various points of purchase. 37 of 146 producers offered a total of 110 supplements marketed 'directly' (42%) or 'indirectly' (58%) for the use of children. These products contained 31 different nutrients, vitamins more frequently than minerals. The number of nutrients per product ranged from 1 (23%) to over 10 (13%), maximum 26. In most cases, the daily dosage recommended by producers reached from 100 to 200% of the reference doses for nutrition labelling for vitamins and from 50 to 100% for minerals. In total, the findings point to an abundance of products, nutrients and dosages in the German market supply of vitamin and mineral supplements for the use of children.

Adolescent↗

PubMed1999

Development of scores to measure the effects of nutrition counselling on the overall diet: A pilot study in children and adolescents.

An intervention study by documented dietary counselling was carried out in a sample of 9 children and adolescents (12-15 years) living in a full-time institution in Dortmund. Three weighed dietary records were collected over 3-7 days, one before and one after each of two individual nutrition counselling sessions, which were based on the recommended intake of food groups defined by the Optimized Mixed Diet (OMD), a quantitative preventive dietary conception for children and adolescents. As univariate dietary parameters (e.g., cholesterol intake), which are often used to show the effectiveness of nutrition counselling, do not take into account the multivariate complexitiy of nutrition, we developed 3 multivariate scores to measure the effectiveness of nutrition counselling. They are defined as: Recommended Food group change Score (RFS): Average change in the amounts of the deviations (%) from the reference food groups values (OMD = 100 %) before and after counselling taking into account the aim (eat mor/less) of the counselling session, exclusively based on the food groups addressed during counselling. Total Food group change Score (TFS): Average change in the amounts of the deviations (%) from the reference food group values (OMD = 100 %) before and after counselling based on all food groups consumed. Nutrient Improvement Score (NIS): Average change in the negative deviations (%) of 8 vitamins and 8 minerals from the German reference values for nutrient intake (Deutsche Gesellschaft für Ernährung (DGE) = 100 %) before and after counselling. On average, the intakes of the food groups mentioned during the first counselling session improved considerably (RFS = +36 %), the change in the intake of all food groups was small (TFS = +6 %) and the nutrient intakes did not improve (NIS = 0 %). From the second counselling session the values of the RFS was +10 %, of the TFS was +6% and of the NIS +3 %. This means that the success of counselling on one dietary criterion does not guarantee success on others. Our food and nutrient based scores together with a detailed food intake assessment give an example of multivariate measurements of nutrition counselling outcomes.

Adolescent↗

PubMed1999

Vitamin intake of 3- to 36-month-old German infants and children--results of the DONALD-Study.

Infants and young children are a vulnerable group with regard to nutrition. However, there is a lack of information about the dietary composition of healthy German infants and children. Therefore, the intake of vitamins (A, C, E, B1, B2, B6, folate, niacin) was assessed in 354 healthy German infants and children aged 3 to 36 months from 3-day-weighed diet records and compared with German, European and US reference values. Intake of all B-vitamins (B1, B2, B6, folate, niacin) increased during the first 3 years of life, whereas intake of vitamin E decreased. Intake of vitamin A and C varied between age groups. The highest levels of the nutrient densities of most vitamins were found at the end of the first year of life. Depending on the reference values chosen, the vitamin supply of the study population ranged between sufficient and very good. The reported satisfactory intake of vitamins in infants and young children in this study gives rise to the question of whether the current extent of fortification of commercial infant food in Germany is necessary.

Breast Feeding↗

PubMed1999

Consumption of fortified food between 1985 and 1996 in 2- to 14-year-old German children and adolescents.

Since the 1980s, fortified food plays an increasing role in food marketing in Germany. However, there is a lack of data concerning fortified food consumption. We therefore evaluated dietary information of the DONALD Study. A total of 2251 3-days weighed records between 1986 and 1996 from 637 different subjects aged between 2 and 14 years (mean: 6.6 years) were evaluated. Food products were defined as fortified if enriched at least with one of the following nutrients: vitamin A (including provitamin A carotenoids), E, B1, B2, B6, C, niacin, folate, calcium, magnesium, potassium, iron or phosphate. Products were grouped in 'Diary products', 'Cereals', 'Beverages', 'Instant Beverages', 'Sweets/biscuits', 'Fats/oils', and 'Beikost' (i.e. dietetic food intended for infants and young children under 4 years). Over the last 11 years almost all children and adolescents consumed fortified food products. Excluding the food group 'Fats/oils' the proportion of consumers of fortified food increased by about 20% between 1986 and 1996. During the same period the consumption rate increased up to five-fold for the food group 'Beverages' and fourfold for 'Cereals'. Since 1988, a relatively constant consumption ratio of 62-68 different fortified products per 100 consumers has been found. 'Beverages' showed the highest food-group-specific diversity. In Germany, vitamins are more often used than minerals to fortify food, whereas vitamin C is the most frequent added nutrient. We found some interesting time trends in the use of vitamins and minerals for fortification with a continuous increase in the use of vitamin C and E. Only vitamin A showed a decrease in use during the study period. Finally, we found a decreasing number of consumers of all fortified products at the end of the study period.

Adolescent↗

PubMed1999

Fruit juice consumption and the prevalence of obesity and short stature in german preschool children: results of the DONALD Study. Dortmund Nutritional and Anthropometrical Longitudinally Designed.

BACKGROUND: In recent years, a possible association between excessive consumption of fruit juice (> or =12 fl oz per day) and short stature and/or obesity has been discussed. The association among the consumption of fruit juice, anthropometric indices, and the overall diet was examined during a 3-year period in a sample of healthy preschool children participating in the Dortmund Nutritional and Anthropometrical Longitudinally Designed (DONALD) Study. METHODS: Two hundred five children were examined annually at the ages of 3, 4, and 5 years. Dietary intake was calculated from 3-day weighed diet records. Height was measured using a stadiometer. Weight was measured using an electronic scale. RESULTS: Five children consumed excessive fruit juice continually in all three records, 10 children in two records, and 23 children in one record. None of the five children with repeatedly excessive fruit juice consumption was obese or short. Growth velocity, body mass index, and height standard deviation score were not correlated with fruit juice consumption. Consumption of fruit juice was inversely correlated with the consumption of all other beverages and the total consumption of all other food. The intake of protein, fat, and carbohydrates of children consuming excessive fruit juice was closer to the international dietary preventive guidelines than the intake of children consuming low amounts of fruit juice. CONCLUSIONS: In the study sample, even repeatedly excessive fruit juice consumption had no influence on anthropometric indices. The results do not justify a general warning or a general promotion regarding high fruit juice consumption in preschool children's diets.

Animals↗

PubMed1999

Macronutrient intake of 3- to 36-month-old German infants and children: results of the DONALD Study. Dortmund Nutritional and Anthropometric Longitudinally Designed Study.

The intake of macronutrients (protein, fat, fatty acids, carbohydrates, added sugars, fiber) was assessed in 354 healthy German infants and children aged 3-36 months from 3-day weighed diet records. The intake of protein ranged between 7 and 14% of energy intake. Fat intake decreased from 3 months (breast-fed boys and girls, 48%; formula-fed boys/girls, 41/44%) to 12 months (boys/girls, 33/36%) due to the increasing consumption of commercial weaning foods, and then increased again up to 36 months (boys/girls, 40/43%). Intake of added sugars decreased during the first 12 months and then increased again, but only slightly exceeded the limit of 10%. Intake of dietary fiber was highest at the age of 1 year (boys/girls, 2.7/2.3 g/MJ). The macronutrient intake was in accordance with other German and European surveys, but deviated considerably from the respective recommendations.

Age Factors↗

PubMed1998

Energy intake of 1 to 18 year old German children and adolescents.

In a sample of 695 healthy well-nourished German children and adolescents covering the total age range from 1 to 18 years, 3d weighed diet records were collected and measurements of body height and weight were taken. 10% non-plausible records (reported energy intake (EI):estimated basal metabolic rate (BMR) < Cut off 1.06) were excluded from further analysis. The rate of non-plausible records was low in the childhood age groups (2-6%), higher in the male (10%), and highest in the female adolescents (30%). Recalculation of age and sex specific cut offs based on assumed light physical activity levels (PAL) reduced the exclusion rate to 6.5% (total) and 20% (female adolescents). The reported energy intake of the total sample based on plausible records (n = 627, EI:BMR > or = 1.06) was close to the new estimations of energy requirements assuming light physical activity which are proposed for the revision of the current FAO/WHO energy requirements. The sample was of normal height and weight compared to the Netherlands growth references. For a definite interpretation of the low reported energy intake in the context of health promoting physical activity patterns of children and adolescents more scientific evidence should be available.

Adolescent↗

PubMed1998

Underreporting of energy intake in 1 to 18 year old German children and adolescents.

It is generally accepted that self-reported food intakes underestimate habitual energy intake (underreporting). Underreporting is often addressed by computing the ratio of measured energy intake to predicted basal metabolic rate (EI:BMR). We used this ratio to study differences between not plausible records (NPR) and plausible records (PR) according to recalculated cut-off values for EI:BMR ratios (< 0.97 to 1.07; age- and sex-dependent) in cross-sectional data of 1,032 3d weighed diet records of 1 to 18 year old children and adolescents. Underreporting (in 5% of total subjects) was age and sex dependent: about 1% in the 1 to 5 year old children, 2% (3%) in the 6 to 13 year old males (females) and 12% (20%) in the adolescent males (females), respectively. To analyse differences between subgroups with PR vs. NPR we therefore concentrated on the 14 to 18 year olds. Male (female) subjects with NPR vs. PR had a 40% lower total EI: 7.4 MJ/d (5.3 MJ/d) vs. 11.5 MJ/d (8.0 MJ/d), respectively. In both sexes with NPR vs. PR, EI per meal was lower. Females with NPR vs. PR had a higher body mass index (kg:m2), recorded fewer meals per day, and had a shorter time span between the first and last meal per day. Furthermore, females with NPR vs. PR had higher intakes per MJ of water, protein, fiber, sodium, iron, niacin, zinc, and protein in percent of total EI, but a lower intake of added sugars per MJ. Males with NPR vs. PR answered significantly more often that they usually eat more, had a higher water intake per MJ, and a higher Ca:P. The observed differences between groups with PR and NPR indicate different food habits or dietary recording behavior. Therefore, validity in dietary studies cannot be achieved by simply excluding underreporters.

Adolescent↗

PubMed1998

Macronutrient intake of 1 to 18 year old German children and adolescents.

In a sample of 627 healthy German children and adolescents between the age of 1 and 18 years the intake of macronutrients (protein, fat, carbohydrates) and their specific subgroups (animal protein, saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA), cholesterol, added sugars, dietary fiber) were assessed from 3d weighed diet records. The medians of the nutrient intake (% of energy) were 13% protein (2/3 animal), 38% fat, 49% carbohydrates, 17% SFA, 16% MUFA, 5% PUFA, 12% added sugars and (per MJ) 34 mg cholesterol, 1.9 g dietary fiber. The macronutrient patterns were almost uniform across the age and sex groups with the exception of lower fat, PUFA, and sugar intakes in the 1 year olds. The findings were almost in accordance with former and current dietary surveys in Germany and neighboring countries. Several findings, particularly the high SFA and low fiber intake, differed considerably from the diet for the prevention of the chronic diseases related to nutrition in western societies which is recommended for this age range. Based on the findings of this study, a preventive dietary concept for German children and adolescents was proposed.

Adolescent↗

PubMed1998

Measured consumption of commercial infant food products in German infants: results from the DONALD study. Dortmund Nutritional and Anthropometrical Longitudinally Designed.

BACKGROUND: Commercial food products intended for infants form an important part of the diet. Such products are defined as special dietetic food by food legislation. However, quantitative consumption data in the context of the current European Community (EC) food regulations have not been available up to now. METHODS: Six hundred eighty 3-day weighed diet records from 3-, 6-, 9-, and 12-month-old infants involved in the DONALD (Dortmund Nutritional and Anthropometrical Longitudinally Designed) Study were evaluated regarding overall and individual consumption of commercial infant food (CIF). Here, CIF was allocated to the food categories of the current EC directives. RESULTS: Four hundred eighteen varieties of infant food were recorded. The total CIF (formulae; beikost [any food or drink other than breast milk or infant and follow-on formulae]) reached percentages of the total food intake (including breast milk) of 51% (47%; 4%), 62% (33%; 29%), 53% (20%; 32%), and 37% (13%; 24%) at the ages of 3, 6, 9 and 12 months, respectively. Approximately 55% (95%) of the 3-month-old infants (range, 6-12 months) consumed some sort of CIF, but the highest amounts were observed at 6 months and the highest numbers of consumers at 9 months. Depending on the definition of "high consumers" of CIF, the individual consumption quantities (in grams per kilogram per day) differed by a maximum of 60% but high consumers were always found in the 6-month-old group. CONCLUSION: The high proportions of CIF in the diet during a critical developmental period call for a guaranteed high nutritional and safety quality of CIF and for realistic data on consumption patterns.

Breast Feeding↗

PubMed1998

Energy intake and growth of 3- to 36-month-old German infants and children.

Recently, new estimations of the energy requirements of infants and children were proposed as a basis of new FAO/ WHO energy requirements. We have compared the energy intake of 354 healthy, well-nourished infants taking part in the Dortmund Nutritional and Anthropometric Longitudinal Designed Study (3-day-weighted diet records) with these new estimated energy requirements. The energy intake of breast-fed and formula-fed infants and the energy intake of the 1- to 3-year-old children in the study population corresponded well with the new estimated energy requirements, although these were considerably lower than the 1985 FAO/WHO energy requirements. Breast-feeding rates were lower and the introduction of beikost was earlier than the current recommendations. Height and weight, which were taken as global indicators of the adequacy of the energy intake, were in good accordance with The Netherlands' third nationwide survey. Our data indicate that the new estimations of energy requirement seem to be more appropriate than the 1985 FAO/WHO energy requirements.

Body Height↗