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This review article describes the scientific evidence for the relationship between birth weight and insulin resistance. Most studies demonstrate that low birth weight is closely connected to insulin resistance and later development of diabetes type II in adulthood. For this reason it is important for clinicians to focus on the personal history of the patient's birth weight. In patients with low birth weight, primary measures should be taken to prevent the development or progress of insulin resistance, and late consequences like diabetes and atherosclerotic complications.

Tabun (O-ethyl-N,N-dimethyl phosphoramidocyanidate) belongs to highly toxic organophosphorus compounds misused as chemical warfare agents for military as well as terroristic purposes. It differs from other highly toxic organophosphates by its chemical structure and by the fact that tabun-inhibited acetylcholinesterase is extraordinarily difficult to reactivate. The potency of trimedoxime and other commonly used oximes (pralidoxime, obidoxime, the oxime HI-6) to reactivate tabun-inhibited acetylcholinesterase and to eliminate tabun-induced acute effects was evaluated using in vitro and in vivo methods. In vitro calculated kinetic parameters of reactivation of tabun-inhibited acetylcholinesterase from rat brain homogenate and in vivo determined percentage of reactivation of tabun-inhibited blood and tissue acetylcholinesterase in poisoned rats show that trimedoxime seems to be the most efficacious reactivator in the case of tabun poisonings. Trimedoxime was also found to be the most efficacious oxime in the elimination of acute lethal toxic effecs in tabunpoisoned rats and mice. The oxime HI-6, so efficacious against soman, does not seem to be sufficiently effective oxime to reactivate tabun-inhibited acetylcholinesterase and to counteract acute lethal effects of tabun.

In this report, we present the case of a 64-year-old woman who sustained a Burch-Schneider cage fracture. Prior to this event, she underwent repeated acetabular reconstructions, but in the end prosthesis removal was performed as a salvage procedure. We believe that the primary cause of the fracture was metal fatigue facilitated by intraoperative re-contouring of the flange, as well as reuse of the cage. Based on this case we caution against repetitive or excessive flange bending during implantation of Burch-Schneider cages and do not recommend their reuse.

The mechanism of intoxication with organophosphorus compounds, including highly toxic nerve agents, is based on the formation of irreversibly inhibited acetylcholinesterase (AChE; EC 3.1.1.7) that could be followed by a generalized cholinergic crisis. Nerve agent poisoning is conventionally treated using a combination of a cholinolytic drug (atropine mostly) to counteract the accumulation of acetylcholine at muscarinic receptors and AChE reactivators (pralidoxime or obidoxime) to reactivate inhibited AChE. At the Department of Toxicology, the strategy of the development of new more potent AChE reactivators consists of several steps: description of the nerve agent intoxication mechanism on the molecular basis (molecular design), prediction of the biological active structure of AChE reactivators (artificial neural networks), their synthesis, in vitro evaluation of their potencies (potentiometric titration and Ellman's method), in vivo studies (therapeutic index, LD₅₀ of newly synthesized reactivators, reactivation in different tissues, neuroprotective efficacy).

The aim of the study was to determine the prevalence of risk factors for cardiovascular diseases among physicians at a teaching hospital. In total, 203 men and 167 women were included in the study. The participants filled in a questionnaire; their height, weight, blood pressure, serum cholesterol and glucose levels were added. 19.2 % males and 13.8 % females were smokers, hypertension was diagnosed in 10 % of males and in 6.6 % of females, 52.2 % males and 17.4 % females were overweight, 37 % males and 43.1 % females had hypercholesterolemia. The above findings suggest that Czech physicians have more favourable values of all the studied cardiovascular diseases risk factors than the general Czech population. However, Czech physicians smoke more than those in other countries and their level of cardiovascular diseases risk factors is unsatisfactory and calls for further intensive prevention. Preliminary outcomes of the study repeated after two years show no positive trends as well as physicians' low willingness to actively participate in lowering cardiovascular diseases risk factors.

Myrrh and opopanax has been used throughout history in incense and as a perfume. Since Bible times it has been used for the treatment of wounds. The first attempts to identify content compounds were almost 100 years ago. In this review we discuss the present state of knowledge in the chemistry of substances of Commiphora spp.

Cyclosporine A (CyA) is a standard component of immunosuppressive regimens. It is a critical-dose drug for which a minor change in absorption can have important clinical consequences. The aim of the study was to compare the pharmacokinetics and safety of the new generic CyA formulation, Equoral® capsules, after a switch from original formulation, Neoral® capsules, in seventy stable adult renal transplant recipients. The extent and rate of pharmacokinetic parameters for bioequivalence were compared in a non-randomized, steady-state clinical study with fixed non-replicate study design. Pharmacokinetic analysis of CyA have shown that both the rate and extent of absorption of Equoral® does not differ significantly from that of Neoral®. At identical dosing, the new formulation was found to have geometric means of C_max 717 ng/ml and AUCτ 3108 ng/ml.h, while corresponding results of comparator were 725 ng/ml and AUCτ 3039 ng/ml.h, respectively. The 90 % confidence intervals of C_max and AUCτ were within 80- 125 % interval of the mean values. The results suggest that Equoral® capsules can be used as an alternative treatment to Neoral® capsules in CyA regimen.

Peroxisome proliferator-activated receptors (PPARs) are subgroups of nuclear hormonal receptors of transcripting factors mostly found in adipose tissue. They are described as important regulators of lipid and saccharide metabolism including insulin sensitivity; therefore they are taken as marker of metabolic syndrome. Their synthetic ligands could be used as drugs for insulin resistance and type 2 diabetes mellitus.

Cathepsin D is peptidase belonging to the family of aspartic peptidases. Its mostly described function is intracellular catabolism in lysosomal compartments, other physiological effect include hormone and antigen processing. For almost two decades, there have been an increasing number of data describing additional roles imparted by cathepsin D and its pro-enzyme, resulting in cathepsin D being a specific biomarker of some diseases. These roles in pathological conditions, namely elevated levels in certain tumor tissues, seem to be connected to another, yet not fully understood functionality. However, despite numerous studies, the mechanisms of cathepsin D and its precursor's actions are still not completely understood. From results discussed in this article it might be concluded that cathepsin D in its zymogen status has additional function, which is rather dependent on a "ligand-like" function then on proteolytic activity.

The anti-arrhythmic effect was tested on the model of aconitine-induced arrhythmia. The experiment was performed in vivo with 31 male Wistar laboratory rats. Group A was first administered aconitine and, after the onset of the first sinus rhythm disorders, the 44Bu compound was administered. Group B was first administered the 44Bu compound and only after that the aconitine. The control group was administered aconitine and saline as a replacement of the tested compound. In group A, there was a decrease in the ventricular fibrillation occurrence from 100 % to 8 % (p < 0.001) after the administration of the 44Bu compound. In the B group, the onsets of all monitored arrhythmia types were delayed by an average of 15.6 min. Ventricular rhythm occurrence was decreased from 100 to 20 %, as well as ventricular fibrillations, from 100 to 0 % (p < 0.001).

Heat shock proteins (hsp's) are among the most conserved proteins in evolution. They have been identified as important pathogen-related antigens as well as autoantigens suitable for construction of novel vaccines. The high evolutionary homology of hsp's has raised the question about the safety of such vaccines. Experimental and clinical observations have confirmed that hsp proteins are involved in the regulation of some autoimmune disease such as autoimmune arthritis, type 1 diabetes mellitus, atherosclerosis, multiple sclerosis, and other autoimmune reactions. It has been shown in experimental animals that some hsp proteins (especially hsp60, hsp70, and hsp10) can either induce or prevent autoimmune reactions depending on the circumstances. This article discusses the involvement of hsp proteins in the etiology of autoimmune diseases and it presents promising experimental data on the effects of immunization with hsp proteins in the prevention and therapy of autoimmune diseases.

In this work, the ability of four newly synthesized oximes - K005 (1,3-bis(2-hydroxyiminomethylpyridinium) propane dibromide), K027 (1-(4-hydroxyiminomethylpyridinium)-3-(4-carbamoylpyridinium) propane dibromide), K033 (1,4-bis(2-hydroxyiminomethylpyridinium) butane dibromide) and K048 (1-(4-hydroxyiminomethylpyridinium)-4-(4- carbamoylpyridinium) butane dibromide) to reactivate acetylcholinesterase (AChE, EC 3.1.1.7) inhibited by nerve agents is summarized. Reactivation potency of these compouds was tested using standard in vitro reactivation test. Tabun, sarin, cyclosarin and VX agent were used as appropriate testing nerve agents. Rat brain AChE was used as a source of the enzyme. Efficacies of new reactivators to reactivate tabun-, sarin-, cyclosarin- and VX-inhibited AChE were compared with the currently used AChE reactivators (pralidoxime, obidoxime and HI-6). Oxime K048 seems to be promising reactivator of tabun-inhibited AChE. Its reactivation potency is significantly higher than that of HI-6 and pralidoxime and comparable with the potency of obidoxime. The best reactivator of sarin-inhibited AChE seems to be oxime HI-6. None of the new AChE reactivators reached comparable reactivation potency. The same results were obtained for cyclosarin-inhibited AChE. However, oxime K033 is also potent reactivator of AChE inhibited by this nerve agent. In the case of VX inhibition, obidoxime and new oximes K027 and K048 seem to be the best AChE reactivators. None from the currently tested AChE reactivators is able to reactivate AChE inhibited by all nerve agents used and, therefore, the search for new potential broad spectrum AChE reactivators is needed.

The effect of two phenolic compounds vanillin (4-hydroxy-3-methoxybenzaldehyde) and lignin on the development of drug/antibiotic resistance in Salmonella typhimurium was studied. Using the modified Ames test we have shown that vanillin alone has negligible effect on spontaneous mutability to ciprofloxacin and gentamicin resistance. At the tested concentrations vanillin reduces the toxicity of 4-nitroquinoline-N-oxide (4NQO) and reduces the ability of this compound to induce mutations leading to ciprofloxacin but not to gentamicin resistance. Lignin at higher concentrations increases mutagenicity to ciprofloxacin resistance and possess considerable inhibition effect on the spontaneous and 4NQO induced mutability to gentamicin resistance.

Mineralization and ossification in the human costal cartilages were studied radiologically. The aim of our study was to evaluate differences between males and females with respect to patterns of costal cartilage calcification and also with respect to ageing. Material for this study consists of 1044 chest and abdominal radiograms of the Czech population from the Department of Radiology (537 males and 507 females). Further radiograms of 18 chest plates were obtained at routine necropsy of cadavers. The radiograms were examined for pattern of ossification of the costal cartilage. The first rib cartilages were not considered because there are no sex differences. The lower ribs exhibit sexual dimorphism. Mineralization and ossification changes appear at the end of puberty and their occurrence increases with age. The sexual difference in pattern of human costal cartilages is statistically significant and thus highly predictive of sex determination.

Prosthetic joint infection (PJI) diagnosis includes several classes of verification. Among them, only a few have a stronger independent value, namely intraarticular purulence and communicating fistulas. Other diagnostic methods require careful test combinations, analysis, and interpretation. Molecular based techniques using the polymerase chain reaction (PCR) seem to be a promising PJI diagnostic modality due to its excellent sensitivity, specificity, positive predictive value, and speed. Most of the recent reviewers are in agreement that molecular diagnosis has enough potential for future application in orthopaedics even if there are only a few heterogeneous studies fully supporting this concept. Conversely, at least one study has been published with significantly worse results (sensitivity and specificity less than 0.75). The lack of supporting evidence in the published studies may be closely related to varying PCR laboratory procedures, inappropriate reference standards, and other methodological shortcomings among research centers. It is not yet justifiable to firmly include molecular methods into the present PJI diagnostic schemes. The orthopaedic community must await the results of well-organized ongoing studies before considering inclusion of molecular diagnostics as a PJI diagnostic method. The aim of this paper was to make a survey of current PJI molecular diagnostic techniques in orhopaedics.

The human glucocorticoid receptor (hGR) plays a pivotal role in cellular processes such as development, differentiation, homeostasis, immune response and in regulation of xenobiotic metabolism. It has been demonstrated recently that colchicine inhibits hGR transcriptional activity in primary cultures of human hepatocytes by a mechanism involving impairment of hGR nucleo-cytoplasmic shuttling. In the present work, we investigated the role of the nuclear factor kappa B (NFκB) and c-jun-N-terminal kinase (JNK), the functional hGR antagonists, in this process. We found that microtubule disarray caused by colchicine, vincristine or nocodazole does not activate NFκB in human hepatocytes as revealed by p50 and p65 subunits nuclear translocation. On the other hand, we demonstrate that JNK mediates hGR transcriptional inhibition by microtubules disarray, because a specific inhibitor of JNK, 1,9-pyrazoloanthrone (SP600125), partially blocked tyrosine aminotransferase mRNA suppression due to colchicine treatment. In conclusion, JNK is at least partly involved in hGR transcriptional inhibition by colchicine in human hepatocytes, while NFκB involvement is doubtful.

Chewing the leaves of the khat shrub is common in certain countries of East Africa and Arabian Peninsula mainly Yemen. It has been established that a khat plant leaves contain an active psycho-stimulant substance known as cathinone that is similar in structure and pharmacological activity to amphetamine in affecting the CNS. Intoxication with khat is self-limiting but chronic consumption can cause certain health disturbances in the user and also lead to social and economic damage to the individual and the community. In recent years, several cases of intoxication have been observed outside the area of its use. In this view, the khat habit, its health effects and socioeconomic aspects are described with the political issue they imply.

Event-related potentials (ERPs) to word stimuli were registered in 20 twenty-one-year-old students (7 males and 13 females) of the Faculty of Medicine of Palacký University. In an ideal case in the first 800 ms after the onset of stimulus ERP consists of three clear positive and four negative waves. The amplitude of some waves of ERPs shows a high degree of inter-individual variability. It was also revealed that the latency and amplitude of some ERPs waves to word stimuli depends on the gender and on the site of the registration electrode on the scalp of the subject. Latencies of components LP2 and LN4 in all electrodes are shorter in females than in males, component LN2 behaves reversely - its latency is shorter in males. On the other hand, the amplitude of dependent variables BP2, BN2 and PV1 is in most electrodes higher in females than in males - except for the amplitude of components BP4 and BN1.

The aim of our study was to assess the accuracy and limitations of ultrasound guided fine-needle aspiration cytology (FNAC) of thyroid nodules. Methods: The usg-FNAC results of 245 patients with thyroid nodules, who afterwards underwent thyroid surgery or who died, and autopsies were carried out, and compared retrospectively with cytologic results. Patients with malignant cytologic conclusion without histological confirmation after surgery or autopsy were excluded from the study (9 persons). The usg-FNAC results were divided as follows: group 1: diagnosis of malignancy (n = 30), group 2: suspicion of malignancy (n = 28), group 3: benign (n = 126), group 4: inconclusive (n = 29). Results: Assuming the cytologic results of group 1 and group 2 were interpreted as being malignant and those of group 3 as being benign, the sensitivity, specificity and accuracy of usg-FNAC were 90 %, 85 % and 86 % respectively. Comparing the cytologic conclusions between a group of patients with follicular lesions and a subgroup of other lesions a statistically significant difference (p < 0,01) between both subgroups using Fisher's test was found. Sensitivity, specificity and diagnostic accuracy in subgroup of follicular lesions were low (71 %, 63 %, 67 %), while in the subgroup of other lesions were high (94 %, 86 %, 88 %). FNAC can specify the nature of focal lesion with high sensitivity, specificity and diagnostic accuracy in the cases of non-follicular lesions. Histological evaluation is required to specification of the nature in cases in which cytology is indicative of follicular proliferation.

The results of the multivariate analysis of variance confirmed statistically significant differences in latency and amplitude of some ERPs waves to nouns and ERPs to verbs. ERPs to nouns differ from ERPs to verbs by a significantly longer latency and greater amplitude of some waves. A comparison of the characteristics of ERPs to nouns and ERPs to verbs separately in males and females produced basically identical results; in females, however, there are much fewer significant differences than in males. Interaction between the site of the recording electrode and features of ERPs to words of different word classes however could not be demonstrated.

This review article presents kidney cancer epidemiology as well as main environmental and life style risk factors.

The present findings show the existence of significant differences in latency and amplitude of some waves of ERPs to three subclasses of nouns or verbs. Latency LP3 of ERPs to action verbs was shorter than latency of the same wave to abstract verbs. In nouns the relation was a similar (manipulable objects versus abstract ones). The amplitude of early positive components (P1, P2) and BN3 wave also depended on semantic attributes of nouns and verbs. Some waves of ERPs to motion verbs in our experiment had significantly higher amplitude than the same waves of ERPs to nonmanipulable objects. Also revealed was interaction between some ERP features and the subject's gender. It was primarily the amplitude of BP2, the size of which depended on gender in all cases - BP2 amplitude was significantly higher in females then in males. In the other components (BP1, BP4, BN2 and BN4) there were fewer significant differences and if they do occurred, then their amplitude was higher in males than in females. In some cases, gender also affected latency of waves LP2, LN1 and LN4 of ERPs to the same noun or verb subclass - latencies of these waves were shorter in females.

OLOMOUC, 2 – 4 OCTOBER 2003

Adiponectin (ADP) is an adipocytokin with many antiatherogenic properties; its decreased level is associated with numerous atherogenic diseases and syndromes (e.g. diabetes mellitus (DM), dyslipidemia, endothelial dysfunction, hypertension, and obesity). Decreased ADP values in blood may be an independent risk factor of atherosclerotic (ATS) complications. Aim of the study: 1) Do persons with type 2 diabetes have lower ADP values than individuals without DM but with a high risk of ATS complications? 2) Do ADP values differ between persons with well controlled and persons with uncontrolled type 2 diabetes? We examined 109 patients of the Metabolic Center of Hospital Šternberk. Out of them, 58 had type 2 diabetes, others were individuals with variously expressed risk factors of early atherosclerosis (obesity, hypertension, age, fa-mily history, smoking, dyslipidemia, etc.). In all persons under this study the following parameters were determined in peripheral venous blood: adiponectin, resistin, leptin, ObRe, cholesterol, HDL-cholesterol, triacylglycerols, glucose, HbA1c, creatinine, urea, ALT, AST, CRP, homocysteine, thrombocyte aggregation after CPG induction. The whole group was divided according to the presence of type 2DM into two subgroups; persons with diabetes were divided into the well controlled and uncontrolled subgroups. All data obtained were processed statistically using the software SPSS for Windows and Medcalc. The adiponectin/BMI index correlated negatively with HbA1c value (correlation coefficient -0.37, p = 0.00053), triacylglycerols (-0.4, p = 0.000001), P-glucose (-0.3, p = 0.0017), uricemia (-0.35, p = 0.0007) and positively with HDL-cholesterol value (0.6, p=0.00001). Women had higher adiponectin values than men. Persons with hypertension and with diabetes mellitus, individuals with atherogenic lipotype or persons with inflammation signs had lower values than individuals without these diseases and syndromes. Persons with wellcontrolled diabetes mellitus had higher values than persons with uncontrolled diabetes (medians of the adiponectin/BMI index 9.7 vs. 6.7, p < 0.01).Persons with type 2 diabetes mellitus have lower ADP values than persons with a high ATS risk without diabetes mellitus. Persons with wellcontrolled diabetes mellitus (DM) and with satisfactory compensation have significantly higher ADP levels (independently of other metabolic parameters of DM control). ADP may be a new marker of metabolic control in persons with a high risk of atherosclerotic complications.

Intracellular levels of phosphorylation are regulated by the coordinated action of protein kinases and phosphatases. Disregulation of this balance can lead to cellular transformation. Here we review knowledge of the mechanisms of one protein phosphatase, the tumour suppressor PTEN/MMAC/TEP 1 apropos its role in tumorigenesis and signal transduction. PTEN plays an important role in the phosphatidyl-inositol-3-kinase (PI3-K) pathway by catalyzing degradation of phosphatidylinositol-(3,4,5)-triphosphate generated by PI3-K. This inhibits downstream targets mainly protein kinase B (PKB/Akt), cell survival and proliferation. PTEN contributes to cell cycle regulation by blockade of cells entering the S phase of the cell cycle, and by upregulation of p27^Kip1 which is recruited into the cyclin E/cdk2 complex. PTEN also modulates cell migration and motility by regulation of the extracellular signal-related kinase - mitogen activated protein kinase (ERK-MAPK) pathway and by dephosphorylation of focal adhesion kinase (FAK). We also emphasize the increasingly important role that PTEN has from an evolutionary point of view. A number of PTEN functions have been elucidated but more information is needed for utilization in clinical application and potential cancer therapy.

Objective: Evaluation of long-term results of percutaneous treatment of central vein stenoses or occlusions in patients with haemodialysis shunt. Materials and Methods: In 26 patients with haemodialysis shunts and confirmed central vein stenosis or occlusion, 28 primary percuta-neous transluminal angioplasties (PTA) and 5 repeated PTAs (re-PTA) were performed; in three patients a stent was implanted - primary in one patient and due to early restenosis after PTA in two patients. To maintain stent patency, 10 re-PTA were performed. Results: The technical success rate of primary interventions was 96 % (100 % in stenoses and 50 % in occlusions). Primary post-PTA patency rate was 70 % at 3 months, 60 % at 6 months and 30 % at 12 months. Conclusion: PTA with possible stent implantation is a first-choice method in the treatment of stenoses and occlusions of the central venous system. Despite the relatively frequent re-interventions, endovascular treatment is capable to preserve long-term function of the dialysis shunt. Abbreviations: a-v - arterio-venous; CVS - central venous system; PTA - percutaneous transluminal angioplasty; re-PTA - repeated PTA.

In spite of its incidence decreasing to 1% nowadays, prosthesis-related infection remains a research, diagnostic, therapeutic and cost-related problem. It can be defined as a presence of bacteria in the artificial joint space, which is significantly associated with evident laboratory and/or tissue markers, and clinical signs of running infection. We believe that the more precise understanding of pathogenesis, the more effective preventative and therapeutic measures, and the lower infection rate. The implants are colonized by airborne, skin-, and/ or surgeon-related bacteria during surgery despite being operated in closely respected operating regime. Some prosthetic characteristics are advantageous and may play important roles in the process of bacterial adherence. After successful attachment on the biomaterial surface bacteria multiply and physiologically transform into a "biofilm" community, making them much more resistant to antibiotic therapy and host immunity. Bacterial resistance is a complex phenomenon influenced by intrinsic and extrinsic factors, including the cell configuration in the biofilm community. So the cure of periprosthetic sepsis without removing of all foreign bodies and necrotic bone fragments is often ineffective. Acute hematogenous sepsis is suggestive of a distortion of a previously aseptic joint space by invasion of bacteria through the vessels.

In epidemiological studies there exists the evidence of relationship between socio-economic status (SES) and health. The suspicious cause of these differences is life-style. The aim of the presented study was to identify the relationship between SES, demographic characteristics and the life-style in an industrial region. A structured questionnaire was distributed to a random sample of some 3,000 aged 25-70 and collected by postal delivery. The SES and demographic factors being analysed were sex, age, education, marital status and economic situation of the family in the relationship with a wide range of information on life style. The data was analysed using the chi-square test and logistic regression. The total number of analysed questionnaires was 634. The lowest response-rate was in the group with the basic education. Significant differences were found by sex in education (less women with university degree) and household income (more women in the lowest income category, men in the highest one). A detail analysis of the aggregated variables (adjusted for all SES variables) found: passivity and contentment were in adverse correlation with the level of education and economic situation; psychical well-being was correlated with family status and economic situation, risk behaviour was correlated with all SES factors except sex and education. Among the analysed factors economical situation of respondents, family and education were the most significant determinants of the differences in life-style.

The molecular basis for the transition of carcinoma of the prostate from androgen-dependent to androgen-independent growth is largely unknown. Currently for example, it is not clear whether the androgen-independent phenotype is a result of selection of a subgroup of genetically distinct prostate tumour cells which are already hormone-resistant or a genetic adaptation of prostate tumour cells to the hormone therapy itself. It has also been established that prostate tumour transformation is a result of homeostatic control defects, a line of thinking directed toward elucidating the apoptotic profile of prostate tumour cells that may be important in determining prognosis, response to therapy and illness progression. Main consideration in this part of rewiev is given to the role of Bcl-2 and members of the Bcl-2 family, and tumour suppressor gene p53.

Smallanthus sonchifolius (yacon) and Lepidium meyenii (maca) were the traditional crops of the original population of Peru where they are also still used in folk medicine. These plants are little known in Europe and Northern America although at least yacon can be cultivated in the climatic conditions of these regions. This article deals with the botany and the composition, the structure of main constituents, biological activity of these plants and the cultivation of yacon in the Czech Republic. The potential of yacon tubers to treat hyperglycemia, kidney problems and for skin rejuvenation and the antihyperglycemic and cytoprotective activity of its leaves seems to be related mostly to its oligofructan and phenolic content, respectively. Maca alkaloids, steroids, glucosinolates, isothicyanates and macamides are probably responsible for its aptitude to act as a fertility enhancer, aphrodisiac, adaptogen, immunostimulant, anabolic and to influence hormonal balance. Yacon and maca are already on the European market as prospective functional foods and dietary supplements, mainly for use in certain risk groups of the population, e.g. seniors, diabetics, postmenopausal women etc.