Retained foreign body: associations with elevated lead levels, pica, and duodenal anomaly.

A 14-month-old girl presented with elevated lead levels and a metallic foreign body was detected on abdominal radiograph. Subsequent evaluation, performed after the child failed to pass the foreign body with cathartics, revealed a bezoar proximal to a partial duodenal obstruction. The metallic foreign body was later removed and found to contain lead, however, the patient has subsequently had recurrent elevations of lead levels with episodes of pica. This case reiterates the need to evaluate children with retained foreign bodies for lead poisoning due to associated pica. In addition, retained foreign bodies should point to possible congenital anomaly of the duodenum causing partial obstruction.

Short-term exposure to high dietary cholesterol in early life: arterial changes and response after normalization of plasma cholesterol.

Elevated serum cholesterol is an established risk factor for the development of atherosclerosis but the effect of high dietary cholesterol in early life on subsequent arterial response to atherogenic diet in adult life is unknown. Weanling rabbits were exposed for 6 wk to a diet containing 0.25% cholesterol, allowed to recover for 9 wk (at least 3 wk after normalization of plasma cholesterol), and subsequently rechallenged with cholesterol to determine atherogenic response. Enhanced activity of acyl-CoA-cholesterol-acyl-transferase in aorta induced by cholesterol feeding persisted even after normalization of serum cholesterol. When rechallenged with cholesterol for 3 mo, these animals displayed significantly (p less than 0.05) increased development of aortic atherosclerosis and accumulation of cholesterol esters when compared with control animals. Exposure to cholesterol in early life appears to cause persistent changes in cholesterol ester synthetic enzyme activity in aorta after normalization of plasma cholesterol and these residual effects might increase aortic response to subsequent cholesterol challenge in adult life.

Human breast milk stimulates bile acid secretion by fetal rabbit liver in organ culture.

Fetal livers from rabbits at 30 days of gestation were grown in organ culture and the effect of human milk added to the culture medium on the ability of liver to excrete bile acids (cholylglycine) was examined. Human breast milk promoted a concentration related increase in cholylglycine accumulation in the medium. The factor(s) present in milk responsible for this effect appear to be non-protein in nature and is associated with the floating lipid fraction. Furthermore, milk enhances the integrity of liver explants, as established by light microscopy.