The association between AB blood group and neonatal disease.

BACKGROUND: Numerous studies have examined the association between ABO blood groups and adult disease states, but very few have studied the neonatal population. The objective of this study was to determine the relationship between AB blood group and the occurrence of common neonatal disorders such as neutropenia at birth, sepsis, respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and patent ductus arteriosus (PDA) compared to all other blood groups. METHODS: We performed a retrospective review on 3,981 infants born at 22 0/7 to 42 6/7 weeks' gestational age and compared the relative risk of neonatal diseases in infants with AB blood group to that of infants with all other blood groups (A, B, and O). RESULTS: When compared to all other blood groups, AB infants demonstrated an increased risk for developing negative clinical outcomes. AB blood group was significantly associated with a 14-89% increased risk of neutropenia at birth, sepsis, RDS, and ROP. Risks for IVH and PDA were not significant. CONCLUSION: We hypothesize that the phenotypic expression of A and B antigens, rather than the antigens themselves, in the AB group may reveal an enhanced susceptibility to injury at the endothelial level resulting in an increased risk for disease development.

Role of breast magnetic resonance imaging in difficult diagnostic situations.

In some patients with breast disease, mammography and ultrasonography can provide only limited diagnostic information. Magnetic resonance imaging of the breast has high sensitivity and specificity and can play a significant diagnostic role in problem situations. Patients who are most likely to benefit are those with (i) axillary adenopathy of unknown primary origin, (ii) possible tumour recurrence after surgery or radiotherapy, (iii) lesions overlying implants, or (iv) those requiring staging of lobular or multifocal carcinoma.

Digestibility of cocoa butter and corn oil in human subjects: a preliminary study.

The comparative absorption of cocoa butter (25.5% C16:0, 34.4% C18:0, 34.4% C18:1, 3.4% C18:2) and corn oil (11.4% C16:0, 2.0% C18:0, 26.4% C18:1, 60.0% C18:2) was assessed in six healthy male subjects. During 3-d experimental diet periods, free-living subjects consumed either cocoa butter or corn oil as virtually the sole source of dietary fat, provided at 40% of the total energy intake in the form of specially formulated cookies. Fat absorption was determined by quantifying total fecal lipid excretion over the 3-d period. Total fecal lipid and fecal fatty acids were determined. The percentage of fat excreted was significantly higher (p less than or equal to 0.001) when subjects consumed the cocoa butter (10.8 +/- 3.2%) vs the corn oil (3.5 +/- 1.0%) diet. These results indicate that the digestibility of cocoa butter is significantly less than corn oil and may explain, in part, previous reports of a neutral effect of dietary cocoa butter on plasma cholesterol concentrations.

Effect of choline deficiency on lung phospholipid concentrations in the rat.

Lung surfactant and nonsurfactant phospholipid concentrations were analyzed in relation to choline status in male rats fed a choline-deficient (CD) or choline-supplemented (CS) diet over an 8-d period. On the first day plasma choline concentrations were significantly lower (11.5 +/- 0.9 micron) in rats fed the CD diet than in those fed the CS diet (16.1 +/- 1.2 microM). This relationship continued for the duration of the study. Hepatic phosphatidylcholine/phosphatidylethanolamine (PC/PE) ratios were significantly lower after d 1 of the CD diet, further decreased on d 2 (1.09 +/- 0.04) and remained low through d 8. Only on d 4 were lung surfactant PC and total phospholipid concentrations lower in rats fed the CD diet than in those fed the CS diet. The composition of surfactant, determined by the ratio of PC to total phospholipids, did not change. On both d 4 and d 8 the PC/PE ratios in the nonsurfactant fraction were lower in rats fed the CD diet than in those fed the CS diet. This shift in PC/PE ratio in the lung is similar to the PC/PE shift in the liver associated with dietary choline deficiency. The altered lung phospholipid concentrations in the nonsurfactant (residual) fraction on d 4 and d 8 suggest an adaptation in the lung's phospholipid metabolism to replenish the physiologically essential surfactant PC.

Measurement of free choline concentrations in maternal and neonatal blood by micropyrolysis gas chromatography.

The development of a micropyrolysis gas chromatographic technique for the determination of free choline in plasma and erythrocytes is reported as a means to clinically assess choline status. A micropyrolyzer syringe unit was fabricated and the method was standardized through repeated trials with a single plasma specimen. The interassay coefficient of variance was 1.3% for the standardized trials on plasma and erythrocytes. Choline status was assessed in control women, mothers and premature infants at birth and up to 14 days of life. At birth, plasma choline levels in the infants (32.2 +/- 5.5 mumol/l) were significantly higher than those in the mothers (12.9 +/- 2.6 mumol/l) and the control women (16.9 +/- 1.6 mumol/l). The infant's plasma choline concentrations had decreased significantly by 7 days of life and remained at the lower level at day 14, independent of the nutritional intervention administered.

Lung surfactant phospholipids as related to hydration and choline status of fasted rats.

Hydration status and choline nutrition were evaluated relative to the concentration of lung surfactant phosphatidylcholine (PC) in fasted rats. Rats deprived of food for 72 h showed lower voluntary water consumption and consistently lower levels of both PC and total phospholipid (TPL) present in isolated pulmonary surfactant than ad libitum-fed controls, although the ratio of surfactant PC to TPL and the residual PC and TPL concentrations were not different. Higher hematocrit values observed in the fasted animals were not altered by the administration of water or saline by orogastric tube nor was the low surfactant PC level corrected by fluid therapy. Evidence of choline deficiency was demonstrated in the fasted rats as there was a significant shift in hepatic PC:phosphatidylethanolamine; however, plasma choline levels did not change. The administration to fasted animals of up to 2.4 mmol of choline chloride via the drinking water (containing 60 mM choline) or an orogastric tube did not affect the plasma choline concentrations or the production of lung surfactant PC.

Relationship between the severity of experimental diabetes and altered lung phospholipid metabolism.

Glucose intolerance was induced in rats by iv infusion of streptozotocin (STZ) in doses of 30, 40, 50, and 100 mg/kg. Serum glucose concentrations were elevated versus controls and weight gains were reduced in a dose-dependent fashion up to 50 mg/kg. Urine outputs and blood urea nitrogen (BUN) values were higher than control values in the animals treated with 40 and 50 mg/kg and serum albumin concentrations were decreased after infusion with 50 mg STZ/kg. Lung phosphatidylcholine (PC) concentrations and dry-to-wet weight ratios were unchanged by STZ treatment, while lung protein and disaturated phosphatidylcholine (DSPC) concentrations were depressed in the 50-mg/kg group. Animals surviving treatment with 100 mg/kg demonstrated increased fasting blood glucose levels, BUN values, and 48-hr urine outputs, and decreased lung protein levels. However, these alterations were less than those found in the 50-mg/kg animals. Pulmonary concentrations of PC, DSPC, and lung dry-to-wet weight ratios were unchanged. It was found advantageous to express the results relative to fasting blood glucose levels. This demonstrated that urine output and BUN values increased and weight gain decreased with rising glucose concentrations, but serum albumin decreased only in moderate and severe hyperglycemia. Fasting glucose concentrations greater than 400 mg/dl were associated with reduced lung DSPC and protein levels, while pulmonary PC and dry-to-wet weight ratios demonstrated no change with increasing hyperglycemia.

Lipids of human milk and infant formulas: a review.

The amount of human milk ingested by the nursing infant is about 600 ml per day. The average lipid content of the mature ranges from 3.2 to 3.5% and the amount does not appear to be influenced by diet. About 98% of the lipid is triacylglycerol in which most of the secondary ester is palmitic acid, a unique structure possibly responsible for the relatively high absorbability of the fat. Small quantities of other lipids are present. Amounts of cholesterol reported, range from 200 to 564 mg per 100 g of lipid. While 167 fatty acids have been positively and tentatively identified as being present in human milk lipids, the major fatty acids are palmitic, stearic, oleic, and linoleic. The composition can be changed by diet, which linoleic acid contents of from 1.0 to 45.0% having been found. The "average" linoleic acid is about 10% and this amount is apparently adequate for the essential fatty acid requirements of the infant. The quantity of vitamin E also appears to be satisfactory. The hypothesis that a cholesterol challenge to the breast fed infant would enable the adult to more efficiently metabolize the sterol does not seem to be supported by available evidence, primarily, because the cholesterol content of human milks varies so markedly; 26 to 52 mg per 8 ounces. The compositions of most infant formulas currently in use in the United States are presented for comparison and convenience and a few possible problems associated with their consumption are discussed. We have suggested several areas where, in our opinion, additional research would provide useful information.

Glycerol ester hydrolase activity in the pulp of unerupted calves' teeth.

The pulp from unerupted calves' teeth was found to contain low levels of glycerol ester hydrolase activity. Solutions in Tris buffer cleared tributyrylglycerol agar and hydrolyzed emulsified olive oil. The average quantity of free fatty acids released in five assays with olive oil was: 2.8, S.D.+/-1.4. Specific activities were: 0.25, S.D.+/-0.13, mkatals/kg protein.