Parentage analysis by endonuclease shattering of hypervariable DNA

Single-locus DNA probes for tandem repeat sequences are now used in conjunction with particular endonucleases to characterize heritable restriction fragment lengths in parentage tests. Southern blots of this type, however, demonstrate only two attributes of an allele: its length and the presence of nucleotide sequences that are complementary to the probe. Not all restriction fragments of the same apparent length that react with the same probe are identical. Differences between comigrating fragments can be detected by the selection of a restriction enzyme that recognizes sites in a subset of the repeat sequences, and the information content of these loci is therefore increased. This report describes a paternity case in which two brothers appeared, after DNA phenotyping using Hinf I, to be the father. A second phenotyping using Hae III excluded one of the brothers.     

Effects of medium- and long-chain triglycerides on sleep and thermoregulatory processes in neonates

Sleep processes and body temperature regulation of neonates are never taken into account in the evaluation of nutrients, although these functions are implicated in the regulation of energy metabolism and are influenced by the nutritional state and its metabolic consequences. Medium-chain triglycerides (MCT) are currently used in paediatric units during the first weeks of because they are considered to be a rapid source of energy, easy to assimilate for growing premature infants, whose digestive function is immature. However, no study has described the thermic effect of these nutrients on body temperature regulation and sleep. The present study aimed at analysing the influence of three feeding formulas with different content of MCT on sleep processes and on thermoregulation of neonates fed until desired intake was reached. Whatever the thermal conditions (thermal equilibrium or cool environment), the MCT-fed groups had higher body temperatures and than groups fed without MCT, for whom total sleep time was reduced at thermal equilibrium. In this group, the large amount of quiet sleep seems to favour a strategy of conserving energy . Higher energy expenditure in MCT-fed groups is not harmful to growth rate since nutritional efficiency is even better reflected by a larger body mass gain. The thermic effect of MCT contributes to lessening the vulnerability of neonates exposed to low incubator temperatures.     

Carvedilol for children and adolescents with heart failure: a randomized controlled trial

Context  Although -blockers improve symptoms and survival in adults with heart failure, little is known about these medications in children and adolescents. Objective  To prospectively evaluate the effects of carvedilol in children and adolescents with symptomatic systemic ventricular systolic dysfunction. Design, Setting, and Participants  A multicenter, randomized, double-blind, placebo-controlled study of 161 children and adolescents with symptomatic systolic heart failure from 26 US centers. In addition to treatment with conventional heart failure medications, patients were assigned to receive placebo or carvedilol. Enrollment began in June 2000 and the last dose was given in May 2005 (each patient received medication for 8 months). Interventions  Patients were randomized in a 1:1:1 ratio to twice-daily dosing with placebo, low-dose carvedilol (0.2 mg/kg per dose if weight <62.5 kg or 12.5 mg per dose if weight 62.5 kg), or high-dose carvedilol (0.4 mg/kg per dose if weight <62.5 kg or 25 mg per dose if weight 62.5 kg) and were stratified according to whether each patient's systemic ventricle was a left ventricle or not. Main Outcome Measures  The primary outcome was a composite measure of heart failure outcomes in patients receiving carvedilol (low- and high-dose combined) vs placebo. Secondary efficacy variables included individual components of this composite, echocardiographic measures, and plasma b-type natriuretic peptide levels. Results  There was no statistically significant difference between groups for the composite end point based on the percentage of patients who improved, worsened, or were unchanged. Among 54 patients assigned to placebo, 30 improved (56%), 16 worsened (30%), and 8 were unchanged (15%); among 103 patients assigned to carvedilol, 58 improved (56%), 25 worsened (24%), and 20 were unchanged (19%). The rates of worsening were lower than expected. The odds ratio for worsened outcome for patients in the combined carvedilol group vs the placebo group was 0.79 (95% CI, 0.36-1.59; P = .47). A prespecified subgroup analysis noted significant interaction between treatment and ventricular morphology (P = .02), indicating a possible differential effect of treatment between patients with a systemic left ventricle (beneficial trend) and those whose systemic ventricle was not a left ventricle (nonbeneficial trend). Conclusions  These preliminary results suggest that carvedilol does not significantly improve clinical heart failure outcomes in children and adolescents with symptomatic systolic heart failure. However, given the lower than expected event rates, the trial may have been underpowered. There may be a differential effect of carvedilol in children and adolescents based on ventricular morphology. Trial Registration  clinicaltrials.gov Identifier: NCT00052026      

Ventricular remodeling in children with left ventricular dysfunction secondary to various cardiomyopathies

The ventricular remodeling that occurs in adults with left ventricular (LV) dysfunction is characterized by a change in LV shape from an ellipse to more of a sphere and is associated with increased functional mitral regurgitation (MR), decreased exercise tolerance, and poor outcome. There are limited data on the occurrence and importance of LV remodeling in children with LV dysfunction. The purposes of this study were to evaluate in children with LV dysfunction (1) LV shape, (2) changes in LV shape as LV function improves, and (3) the relation between LV shape and functional MR. Children with LV dysfunction were identified and compared with controls. Patient demographics, treatment, and outcomes were noted. Echocardiograms were reviewed for LV function and shape (sphericity index). The echos of a subset of children whose LV ejection fractions (LVEFs) increased by >10% over a follow-up of >6 months were analyzed for changes in sphericity, mitral annulus size, and the degree of MR. Twenty-five children with LV dysfunction were compared with 37 age-matched controls. LV remodeling to a more spherical shape was inversely related to LVEF but was not associated with clinical outcome. In a subset of patients (n = 17) whose LVEFs improved, the reversal of remodeling (decrease in sphericity index) was associated with a decrease in MR and mitral annulus size. In conclusion, LV remodeling occurs in children with LV dysfunction. The reversal of this remodeling with a decrease in the degree of MR and the size of the mitral annulus occurs as systolic function improves.     

Regrowth of the rat biliary tree after 70% partial hepatectomy is coupled to increased secretin-induced ductal secretion

BACKGROUND & AIMS: After partial hepatectomy, liver regeneration occurs with the return of hepatocyte mass to normal, Limited data exist regarding the renewal of the biliary tree after partial hepatectomy. This study tested the hypothesis that, after partial hepatectomy, the biliary tree regenerates by proliferation of the remaining cholangiocytes, leading to an increase in secretin-induced ductal bile secretion. METHODS: After 70% partial hepatectomy, cholangiocyte proliferation was assessed in situ by morphometric analysis and In vitro by measurement of 3H-thymidine incorporation. Ductal secretion was estimated by measurement of secretin receptor gene expression and adenosine 3',5'-cyclic monophosphate (cAMP) levels in vitro and by the effect of secretin on ductal bile secretion in vivo. RESULTS: DNA synthesis was undetectable in control cholangiocytes, increased and peaked at day 3 after partial hepatectomy, and returned to normal by day 28. Morphometric analysis showed regrowth of the biliary tree beginning at day 1 with restoration by day 10. The expression of secretin receptor gene and secretin-induced cAMP levels and secretin- induced bicarbonate-rich choleresis increased during the period of bile duct renewal. CONCLUSIONS: After partial hepatectomy, the increase in secretin-induced ductal bile secretion observed during bile duct renewal results from proliferation of remaining cholangiocytes. (Gastroenterology 1996 Dec;111(6):1633-44)