NUTRITION IN LOW-BIRTH-WEIGHT INFANTS: II. Repeated Intravenous Injections of Fat Emulsion

Abstract. Gustafson, A., Kjellmer, I., Olegård, R. and Victorin, L. (Department of Paediatrics, Children's Hospital, and of Medicine I, Sahlgren's Hospital, Goteborg, Sweden). Nutrition in low-birth-weight infants. II. Repeated intravenous injections of fat emulsion. Acta Paediat Scand, 63: 177, 1974.–The elimination of an exogenous fat emulsion from the blood stream after repeated intravenous injections was investigated in two groups of low-birth-weight infants: 11 appropriate-for-date (AFD) pre-term babies and 8 light-for-date (LFD) pre- and full-term infants. During a period with six injections hourly of 0.15 g fat/kg 'b.w. the total lipids of plasma increased only moderately in the AFD group, from 264 to 351 mg/100 ml, while in the LFD group a progressive rise of total lipids occurred from 244 to 466 mg/100 ml. The plasma turbidity increased correspondingly more in the LFD than in the AFD group. In 5 LFD babies, where a progressive accumulation of total lipids occurred with each injection of fat emulsion, heparin was given intravenously after eight fat injections. The plasma was rapidly cleared of fat although fat injections were continued. It is concluded that AFD infants are able to hydrolyse fat emulsions given at an hourly rate of 0.15 g/kg b.w., while this amount of fat to LFD babies will cause an accumulation of plasma lipds unless heparin is supplied simultaneously.     

QUANTITATION OF SOME AMINO-TERMINAL RESIDUES IN PROTEINS USING 3H-LABELLED DANSYL CHLORIDE AND 14C-LABELLED AMINO ACIDS

A method for quantitation of amino-terminal residues in proteins is presented. The method is a modification of a double isotope-labelling technique, using ³H-labelled dansyl chloride and ¹⁴C-labelled amino acids as internal standards. The method is demonstrated on human fibrinogen, horse myoglobin and on mouse myoloma IgA. A linear relationship between the ratio ³H/¹⁴C in the separated amino-terminal amino acid of the protein and the amount of protein added in the labelling mixture was obtained with standard deviations of ±7.4%, ±3.4% and ±10.3%, respectively. An application of the method is demonstrated by measuring the increase in amino-terminal glycine in fibrinogen following the proteolytic action of thrombin. The method seems to be useful when 0.1 nmol or more of protein is used.     

THE INFLUENCE OF DIFFERENT ENVIRONMENTAL TEMPERATURES ON PULMONARY GAS EXCHANGE and BLOOD GAS CHANGES AFTER BIRTH

Abstract. Tunell, R. (Department of Paediatrics, Karolinska Sjukhuset, Stockholm, Sweden). The influence of different environmental temperatures on pulmonary gas exchange and blood gas changes after birth. Acta Paediatr Scand, 64:57, 1975.–The oxygen uptake (V_o2) and respiratory exchange ratio (R) was determined during the first 20 min and at one and at 2 hours after birth in 16 healthy full-term newborn infants studied in different environmental temperatures. Arterial blood gases and acid-base balance were determined on repeated blood samples from the abdominal aorta. The infants were grouped in a “warm” group (n= 10) where efforts were made to avoid cooling after birth, and a “cold” group (n=6) where a decrease in rectal temperature to a mean value of 35.4^oC at 2 hours occurred. Irrespective of environmental temperature, V_o2 was approximately 10 ml/kg min during the first 8 min after birth, thereafter decreasing to about 6–7 ml/kg min. During the first 8 min the main increase in P_a02 occurred and about 2 ml/kg min of the V₀ was accounted for by changes in oxygen stores after birth. At 16–20 min and at 60 min after birth a negative relationship was found between V_o2 and P_ao2 During the period 8–120 min after birth a close relationship was found between V_o2 and the degree of muscular activity. Within 4–16 min after birth, R values above 1.0 were regularly found simultaneously with the main decrease in P_aco2. In infants kept “cold” a tendency to hyperventilate was found, probably elicited by cold stimuli. The rapid drop in deep body temperature regularly seen after birth could thus not be explained by a limited ability to increase pulmonary gas exchange. A high degree of evaporative heat loss, a relatively low “basal” metabolic rate and a limited response in “non-shivering thermogenesis” seem to be the main reasons for the heat loss after birth.     

Factors Contributing to Left Ventricular Diastolic Dysfunction in Long-term Type I Diabetic Subjects

ABSTRACT Although non-invasive studies in type I diabetic subjects indicate left ventricular (LV) diastolic dysfunction, the contribution of borderline or mild hypertension to such changes is obscure. Thus, digitized M-mode echocardiograms were obtained in 32 (18 men) young (<50 years) normotensive controls and 32 (21 men) long-term (≥12 years) type I diabetics with blood pressures ranging from normal to hypertensive. All diabetics were without clinical heart disease, none were previously treated for hypertension or using cardioactive drugs. Heart rate, systolic and diastolic blood pressures were higher in diabetic than control subjects. Their LV end-diastolic dimension was smaller, whereas wall thickness, LV mass index and fractional shortening were similar to controls. In diabetics, however, the normalized peak filling rate was decreased and the rapid filling period fraction of diastole increased. In multivariate analysis, diabetes and LV mass independently and inversely influenced the normalized peak filling rate, while fractional shortening did so positively. Furthermore, diabetes and systolic blood pressure independently influenced the rapid filling period fraction of diastole. This study is the first to demonstrate systolic blood pressure and LV mass as independent contributors to subclinical LV diastolic abnormalities in diabetics. These findings may therefore indicate the need to treat even mild hypertension in diabetics in an effort to delay the development of cardiopathy.     

Evaluation of a New Chemotherapeutic Agent in Patients with "Advanced Refractory" Acute Leukemia. Studies of 6-Azauracil

6-Azauracil was studied in patients with "advanced" acute leukemia, refractory to standard chemotherapy. Under the conditions of the study thiscompound was found to have no significant antileukemic activity. As a result,these data have defined the natural history of this phase of acute leukemia. Asignificant proportion (30 per cent) of these patients showed objective hematologic improvement even in the absence of effective specific therapy, whichmight be ascribed to a prospective new agent. The median survival from theonset of the study of this group of patients was two months, and survivalpatterns for adults and children were similar.

Submitted on December 23, 1959 Accepted on February 20, 1960     

Validation and clinical feasibility of nitrogen washin/washout functional residual capacity measurements in children

Background: The functional residual capacity (FRC) is an important parameter in pediatric respiratory monitoring but it is difficult to assess in the clinical setting. We have introduced a modified N₂ washout method utilizing a change of F_IO₂ of 0.1 for FRC measurement in adult respiratory monitoring. This study validated the algorithm in a pediatric lung model and investigated the stability and feasibility in a pediatric peri‐operative and intensive care setting. Methods: The lung model was ventilated in combinations of ventilatory modes, CO₂ production, model FRC and respiratory rates. Sixteen children from 10 days to 5 years were studied peri‐operatively with controlled ventilation using a Mapleson D system and in the intensive care unit using a Servo‐i ventilator in a supported spontaneous mode. FRC was measured during stable metabolic, respiratory and circulatory periods at positive end expiratory pressure of 3–4 and 7–8 cmH₂O. Results: In the model and in the clinical setting, we found an excellent agreement between washout and washin measurements of FRC as well as acceptable coefficients of repeatability. Conclusion: FRC was satisfactorily measured by a modified N₂ algorithm and may be included as a monitoring variable in pediatric respiratory care. Pediatric FRC monitoring demands strictly stable conditions as measurements are performed close to the limits of the monitor's specifications.     

Dietary habits for non-smoking females living with smokers or non-smokers

Background: To investigate whether dietary habits among non-smokingfemales were different between those living with smokers andnon-smokers in two countries. Methods: A questionnaire was sentto 5,000 females in Sweden and Switzerland. After selectionregarding smoking habits, a questionnaire on life style factorsand diet was distributed. Results: Females living with smokersshowed strong tendencies to be overrepresented among those withless frequent consumption of vegetables, fruit and fibre-richfood and in Switzerland among those with a more less frequentconsumption of alcohol. Conclusions: The results suggest thatnon-smoking females living with smokers or non-smokers differin their dietary habits. Some smokers' habits represent riskfactors for disease and should be controlled for in studieson environmental tobacco smoke.