Specialized formulas and feedings for infants with malabsorption or formula intolerance.

The composition of specialized formulas for infants who experience malabsorption or formula intolerance is described in detail. The limited studies of efficacy, as well as a rationale for selecting an appropriate formula for infants with malabsorption or formula intolerance, are discussed. Infants with symptoms of diarrhea or emesis may have intolerance to milk lactose or milk protein.

Effect of a maternal fast on the urea cycle enzymes of the ovine fetus.

Activities of five urea cycle enzymes were measured in maternal and fetal sheep liver during the normal fed state and following 5 days of fasting. Six ewes and 10 fetuses were studied in both the fed and fasted periods at 132 days gestation (term: 147 days) for liver protein and enzyme levels. Results indicated that protein content increased during fasting in both the maternal and fetal liver.

Necrotizing fasciitis of the scalp in neonates.

Two premature infants with acute necrotizing fasciitis of the scalp are reported. In both cases the infection most likely arose from infiltrations of intravenous fluids into the subcutaneous region of the scalp. Aggressive surgical debridement, as well as antibiotic therapy, resulted in healing in both infants.

Properties of biomaterials.

Metallic biomaterials, including iron-, cobalt-, and titanium-based systems, have a long history of applications for surgical implant devices. The mechanical properties of these alloys (modulus, strength, and ductility) have been used to make devices to replace skeletal structures with long-term in vivo stabilities. In addition, the passive surface oxide layers have provided chemical inertness within biologic environments.

Corrosion and ion transfer from porous metallic alloys to tissues.

Investigations on porous and nonporous alloys currently available for surgical implant device stabilization through tissue ingrowth have shown microstructures that are characteristic of the thermal processing history of the device and alloy with differences between the nonporous and porous devices of the same nominal chemical analysis, in vitro corrosion potentials that are similar for porous and nonporous alloys and corrosion rates that are approximately proportional to the increases in relative surface areas (X 2 to X 10); local tissue interactions at the cellular level that are specific to the type and amount of elemental constituents present at the interface; and no direct correlations between the local cellular responses (fibroblasts) and the potential for hypersensitivity and other systemically mediated responses. Evaluations of the available published literature and available information on device retrievals and analyses support the opinion that no quantitative, statistically based epidemiologic studies have yet established significant correlations between selected metallic ions and major types of tissue lesions. However, with the changes in surface area and basic surface chemistry for existing alloy systems, research on the long-term tissue responses should be emphasized.

Biomaterials, biocompatibility, and peri-implant considerations.

There are series of tests recommended for evaluation of dental implants. These materials and instrumentation coupled with the publications reviewed here that deal with animal experimentation and implant experience in humans provide an outline of data that have made tissue response to dental implants more clearly delineated. However, there are several specific aspects of cellular response that remain to be illuminated and correlated with clinical and radiographic signs.

Cyclic axial loading of spinal implants.

The performance characteristics of Harrington distraction rods were evaluated and compared with paired wired L-rods when subjected to cyclic axial compression loading. Twelve fresh frozen swine spines with intact facet joints and anterior and posterior ligamentous complexes were instrumented and tested in a specially designed pneumatic testing device. Nine spines were displaced 2.

Compressive strength measurement and microstructure studies of hydroxyapatite cones.

Compressive strength measurement and microstructure studies of standard, diamond bur-ground, and fracture surfaces of durapatite cones were reported. The compressive strength measurements of durapatite cones were variable and strongly dependent on the test method. The fracture force ranged from 1090 to 3692 N and the calculated compressive strengths ranged from 113 (16,333 psi) to 389 mN/m2 (56,462 psi).

Indomethacin therapy on the first day of life in infants with very low birth weight.

To investigate the optimal timing for treatment of small premature infants, we performed a double-blind, controlled trial of indomethacin therapy on the first day of life in 104 infants weighing between 700 and 1300 gm. Infants were given indomethacin or placebo at a mean age of 15 hours. Eleven of the 56 infants given placebo developed large left-to-right shunts through a patent ductus arteriosus.

Lactation and phenylketonuria.

Many young women who were diagnosed as having phenylketonuria (PKU) during routine neonatal screening and effectively treated during childhood are now of childbearing age. Recent reports suggest that maternal dietary therapy instituted before conception may improve the likelihood of a successful pregnancy and normal offspring. However, it is not known whether the intake of phenylalanine (phe) should be restricted during lactation.

Evaluation of a subcutaneously implanted hydroxylapatite-avitene mixture in rabbits.

Avitene, a microfibrillar collagen hemostatic agent was mixed with hydroxylapatite and implanted subcutaneously along the inferior border of the mandible in ten rabbits. This mixture clearly enhanced surgical manipulation of the implants. Radiographic and histologic examination of the implant sites at one, three, and six months showed an acceptable host response with no apparent alteration of the favorable characteristics of hydroxylapatite implants.

Neonatal intracranial hemorrhage and complicating hydrocephalus.

Real-time ultrasound studies of the head were performed on 96 infants weighing 1500 g or less. This population represented all such infants admitted within the first 72 hours of life to a neonatal intensive care unit over a 9-month period. Intracranial subependymal/intraventricular hemorrhage occurred in 22 (23%) of the infants.

Changes in ovine fetal hindlimb amino acid metabolism during maternal fasting.

The flux of various substrates across the ovine fetal and maternal hindlimbs was measured in the fed state and after 5 days of maternal fasting. Whole blood concentrations of glucose, oxygen, ammonia, and six amino acids (glutamate, glutamine, alanine, valine, isoleucine, and leucine) were determined in the fetal and maternal femoral artery and distal inferior vena cava in 15 chronic animal preparations. During fasting the fetal arterial glucose concentration fell by 40% (from 0.

Fetal and maternal amino acid concentrations during fasting in the ewe.

The present investigation was undertaken to quantitate the whole-blood amino acid concentrations of the mother and fetus over an extended period of fasting using a chronic sheep preparation. Fetal amino acid levels generally increased or remained relatively high during the fast (e.g.

Evaluation of the gasless abdomen in the newborn and young infant with metrizamide.

The finding of a gasless abdomen on the abdominal radiograph of an infant over 12 hr old is usually abnormal and may reflect a serious pathologic disorder. Accurate diagnosis is important to plan appropriate therapy. A careful review of the clinical history and the plain chest and abdominal radiographs will often permit an accurate diagnosis to be made.