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Biomedical subjects

G Kohn

Publications and source records attributed to G Kohn.

At least 19 recordsLinked to original sources

Effect of type of early infant feeding on fatty acid composition of plasma lipid classes in full-term infants during the second 6 months of life.

BACKGROUND: Previously, the authors found significantly higher arachidonic and docosahexaenoic acid values in plasma lipids in 2-month-old full-term infants fed human milk than in those receiving formula. This is the report of data obtained in full-term infants during the second half of the first year of life. METHODS: Healthy, full-term infants fed human milk (n = 12) or formula without preformed long-chain polyunsaturated fatty acids (n = 12) were investigated. Fatty acid composition of plasma lipid classes was determined by high-resolution capillary gas-liquid chromatography. RESULTS: Linoleic acid acid values in plasma phospholipids (18.5 [3.94] vs. 20.79 [4.34]) and gamma-linolenic acid values in plasma cholesteryl esters (0.17 [0.09] vs. 0.27 [0.20]) and triacylglycerols (0.27 [0.18] vs. 0.46 [0.27]) were significantly (P < 0.05) lower in breast-fed infants than in those receiving formula. Data are percentage weight by weight shown as median (range from 1st to 3rd quartile) for breast-fed vs. formula fed infants, respectively. In contrast, arachidonic acid values in plasma phospholipids (10.05 [2.90] vs. 7.03 [1.87]; P < 0.01), cholesteryl esters (7.54 [3.58] vs. 4.09 [1.81]; P < 0.05), and triacylglycerols (1.28 [0.84] vs. 0.80 [0.39]; P < 0.05), as well as docosahexaenoic acid values in plasma phospholipids (1.92 [0.36] vs. 1.02 [0.31]; P < 0.001), cholesteryl esters (0.39 [0.13] vs. 0.15 [0.13]; P < 0.001), and triacylglycerols (0.17 [0.17] vs. 0.09 [0.04]; P < 0.01) were significantly higher in infants fed human milk than in those receiving formula. CONCLUSION: Healthy, full-term infants fed formula without preformed dietary long-chain polyunsaturated fatty acids are unable to match the arachidonic and docosahexaenoic acid status of breast-fed infants even during the second half of the first year of life.

Cholesterol Esters↗

[3-13C] gamma-linolenic acid: a new probe for 13C nuclear magnetic resonance studies of arachidonic acid synthesis in the suckling rat.

Our objective was to develop a suitable probe to study metabolism of polyunsaturated fatty acids by 13C nuclear magnetic resonance (NMR) in the suckling rat pup. [3-13C] gamma-Linolenic acid was chemically synthesized, and a 20 mg (Experiment 1) or 5 mg (Experiment 2) dose was injected into the stomachs of 6-10-day-old suckling rat pups that were then killed over a 192 h (8 d) time course. 13C NMR showed that 13C in gamma-linolenate peaked in liver total lipids by 12-h post-dosing and that [5-13C]-arachidonic acid peaked in both brain and liver total lipids 48-96 h post-dosing. 13C enrichment in brain gamma-linolenic acid was not detected by NMR, but gas chromatography-combustion-isotope ratio mass spectrometry showed that its mass enrichment in brain phospholipids at 48-96 h post-dosing was 1-2% of that in brain arachidonic acid. 13C was present in liver and brain cholesterol and in perchloric acid-extractable water-soluble metabolites in the brain, liver and carcass. We conclude that low but measurable amounts of exogenous gamma-linolenic acid do access the suckling rat brain in vivo. The slow time course of [5-13C] arachidonic acid appearance in the brain suggests most of it was probably transported there after synthesis elsewhere, probably in the liver. Some carbon from gamma-linolenic acid is also incorporated into lipid products other than n-6 long-chain polyunsaturated fatty acids.

Animals↗

Docosahexaenoic and arachidonic acid absorption in preterm infants fed LCP-free or LCP-supplemented formula in comparison to infants fed fortified breast milk.

The absorption of long-chain polyunsaturated fatty acids (LCP) with particular respect to docosahexaenoic (DHA) and arachidonic acid (AA) has been studied in 39 very-low-birth-weight infants appropriate for gestational age after a 10-day feeding period. The infants were fed either a LCP-supplemented formula (n = 11), or a LCP-free formula (n = 11) or breast milk fortified with protein and carbohydrates to have similar protein and energy intakes as in the formula-fed infants (n = 17). Total fat content and fatty acid profile were measured in the human milk, the two formulas, and in the stool samples. After a 10-day feeding period, the fecal excretions of total fat, DHA and AA were measured during a 3-day balance period. The total fat apparent absorption rates were similar in all groups (84.1, 82.1 and 80.6% of intake, respectively). The DHA and AA intakes were significantly (p < 0.01) higher in the group fed the fortified breast milk than in the group fed the LCP-supplemented formula (DHA: 75.5 +/- 12.4 vs. 50.2 +/- 4.2 mg/72 h; AA: 45.5 +/- 5.8 vs. 30.2 +/- 2.7 mg/72 h). There was a tendency for lower apparent absorption rates for both LCPs studied in the group fed fortified breast milk when compared to the group fed LCP-supplemented formula (AA: 70.6 +/- 10.9 vs. 73.0 +/- 8.7% of intake, DHA: 69.0 +/- 10.6 vs. 74.2 +/- 9.5% of intakes, but the differences were not significant. As consequence of the different intakes, the net absorption of the two studied LCP fatty acids were significantly (p < 0.01) higher in the breast milk group than in the group fed the LCP-supplemented formula (DHA: 52.6 +/- 6.1 vs. 36.8 +/- 4.5 mg/72 h; AA: 31.4 +/- 3.1 vs. 22.4 +/- 2.3 mg/72 h). The data demonstrate that DHA and AA are absorbed from the studied LCP-supplemented formula at least as effectively as from human milk. The net absorption of these LCP depend on the amount of dietary intake, and seems to be influenced by the dietary LCP source.

Arachidonic Acid↗

[In vivo investigations of stress susceptibility in pigs by means of magnetic resonance spectroscopy].

31P nuclear magnetic resonance spectroscopy was performed on 19 to 55 kg weighing pigs of different MHS genotypes to study the changes of phosphorus components (inorganic phosphate --Pi, phosphocreatine--PCr and adenosine triphosphate--ATP) of muscle metabolism as well as intramuscular pH under application of halothane. Aim of the present study was to observe the changes in energy metabolism and to perform a comparison with also measured blood parameters. Both, NN and Nn pigs did not show any changes during halothane exposure in phosphorus spectra, but in all animals a partially metabolically compensated respiratoric acidosis was found. In all MHS positive pigs a rapid fall of PCr and a corresponding raise of Pi levels in muscle was observed.

Adenosine Triphosphate↗

Influence of the derivatization procedure on the results of the gaschromatographic fatty acid analysis of human milk and infant formulae.

Many different analytical procedures for fatty acid analysis of infant formulae and human milk are described. The objective was to study possible pitfalls in the use of different acid-catalyzed procedures compared to a base-catalyzed procedure based on sodium-methoxide in methanol. The influence of the different methods on the relative fatty acid composition (wt% of total fatty acids) and the total fatty acid recovery rate (expressed as % of total lipids) was studied in two experimental LCP-containing formulae and a human milk sample. MeOH/HCl-procedures were found to result in an incomplete transesterification of triglycerides, if an additional nonpolar solvent like toluene or hexane is not added and a water-free preparation is not guaranteed. In infant formulae the low transesterification of triglycerides (up to only 37%) could result in an 100%-overestimation of the relative amount of LCP, if these fatty acids primarily derive from phospholipids. This is the case in infant formulae containing egg lipids as raw materials. In formula containing fish oils and in human milk the efficacy of esterification results in incorrect absolute amounts of fatty acids, but has no remarkable effect on the relative fatty acid distribution. This is due to the fact that in these samples LCP are primarily bound to triglycerides. Furthermore, in formulae based on butterfat the derivatization procedure should be designed in such a way that losses of short-chain fatty acids due to evaporation steps can be avoided. The procedure based on sodium methoxide was found to result in a satisfactory (about 90%) conversion of formula lipids and a reliable content of all individual fatty acids. Due to a possibly high amount of free fatty acids in human milk, which are not methylated by sodium-methoxide, caution is expressed about the use of this reagent for fatty acid analysis of mothers milk. It is concluded that accurate fatty acid analysis of infant formulae and human milk requires a careful and quantitative derivatization of both polar and nonpolar lipid classes. Sodium methoxide seems to be a reliable and time-saving method for routine fatty acid analysis of infant formulae, which should be validated by interlaboratory comparison. Anhydrous procedures based on methanolic hydrogen chloride including an additional nonpolar solvent are also suitable for infant formulae but seem to be preferable for human milk samples.

Chromatography, Gas↗

Docosahexaenoic and arachidonic acid content of serum and red blood cell membrane phospholipids of preterm infants fed breast milk, standard formula or formula supplemented with n-3 and n-6 long-chain polyunsaturated fatty acids.

UNLABELLED: The contents of docosahexaenoic (DHA) and arachidonic acid (AA) of plasma and red blood cell membrane phospholipids were studied in 41 very low birth weight infants fed either breast milk (n = 18), a standard formula without long-chain polyunsaturated fatty acids with 20 or 22 carbon atoms (LCP) but with alpha-linolenic acid and linoleic acid (n = 11) or a formula additionally supplemented with n-3 and n-6 LCP in relations typical for human milk (n = 12) after 2, 6, and 10 weeks of feeding. The content of DHA and AA in plasma phospholipids declined in the infants fed the LCP-free formula but remained more or less constant during the whole feeding period in those infants fed breast milk as well as in those fed the LCP-supplemented formula. The differences between the group fed the LCP-free standard formula and the two groups fed LCP-containing diets became significant during the first 2 weeks of feeding. In contrast, there were no differences between the group fed breast milk and the group fed the supplemented formula during the study period. Similar effects could be observed regarding the composition of red blood cell membrane phospholipids, but the differences between the infants fed the LCP-free standard formula and the two other groups with LCP-containing diets were significant only for AA. The data indicate that very low birth weight infants are unable to synthesize LCP from alpha-linolenic acid and linoleic acid in sufficient amounts to prevent a decline of LCP in plasma and red blood cell phospholipids. Additionally, the data show, that supplementation of formulas with n-3 and n-6 LCP in amounts typical for human milk fat results in similar fatty acid profiles of plasma and red blood cell membrane phospholipids as found during breast milk feeding. CONCLUSION: Supplementation of formula with long-chain polyunsaturated fatty acids improves the LCP status of very low birth weight infants.

Arachidonic Acids↗

Pitfalls in the design and manufacture of infant formulae.

The composition of modern infant formulae is basically oriented on the "golden standard" human milk and influenced by several official regulations and recommendations (EC, ESPGAN, etc.). This article will focus on two recent improvements in the field of long-chain polyunsaturated fatty acids (LCPs) and protein hydrolysates. The addition of LCPs for preterm formulae was recommended recently by ESPGAN (the European Society for Pediatric Gastroenterology and Nutrition). Our research has focused on this problem for many years and we have found a good source of LCPs using specially prepared egg-yolk lipids. Others have used fish oils and run into the problem of growth retardation. Therefore, the possible sources of LCPs have to be discussed very critically and the alternatives will be shown. Also, new developments like the use of single-cell oils will be discussed. Second, the use of protein hydrolysates have been introduced for the so-called hypoantigenic or hypoallergenic formulae. Hypoantigenic formulae for preventive use have to be differentiated clearly from hypoallergenic formulae for treatment of proved cows' milk protein allergy. The problems of designing suitable hydrolysates that are low in antigenicity and good in taste will be outlined. The determination of the molecular weight distribution by gel chromatography will be compared critically with the newer techniques. The ELISA technique for testing the antigenicity is recommended before any in vivo evaluation. So far, the anaphylactic guinea-pig model is the most sensitive in vivo testing method. Summing up, modern infant formulae manufacture is much more dependent on modern laboratory techniques, which have to be chosen critically and must be adapted to the newest state of the art.

Fatty Acids, Unsaturated↗

Diet and the essential fatty acid status of term infants.

Long-chain polyunsaturated fatty acids with 20 and 22 carbon atoms (LCPs) seem to play an important role during the rapid development of the infant brain in the late fetal and early postnatal period. These LCPs are integral constituents of biological membranes and they are involved in the regulation of functional properties like fluidity, permeability and activity of membrane-bound enzymes. Human milk contains LCPs in an amount of 0.5-3 wt% of total fatty acids, whereas commercially available infant formulae are almost free of them. Recently, several clinical trials, primarily with preterm infants, have reported that the content of LCPs in the blood and a functional parameter like visual acuity correlate with the content of LCPs in the diet. In this clinical trial we studied the effect of different diets on the fatty acid pattern of plasma and erythrocyte lipids of healthy term infants during the first 3 months of life. Breast-fed infants were compared with formula-fed babies who received a commercially available formula without LCPs or a new experimental formula enriched with LCPs that was similar to human milk. The results indicate that the introduction of milk feeding leads to marked differences in the blood lipid composition during the first months of life, independent of the feeding regimen. Secondly, the supplementation of a formula with LCPs seems to result in a blood lipid composition similar to infants fed with human milk. This supports the hypothesis that the newborn term infant has a limited desaturating capacity and depends on an exogenous supply of LCPs during the first months of life.

Arachidonic Acid↗

The dilemma of a low rate of chromosomal mosaicism found in fetal blood sampling.

We report a case in which mosaicism of trisomy 13 was detected in 4/10 cells (40 per cent) in amniotic fluid cell cultures, followed by a low rate of mosaicism (1/160 cells) detected in a fetal blood sample. This finding presents a dilemma both for the genetic counsellor and for the parents in determining whether or not to terminate the pregnancy.

Adult↗

Placental insufficiency as a possible cause of low maternal serum human chorionic gonadotropin and low maternal serum unconjugated estriol levels in triploidy.

We report three cases in which triploidy (69,XXX) was detected by amniocentesis performed for very low maternal serum human chorionic gonadotropin levels. All three cases also had low maternal serum unconjugated estriol levels. We suggest placental insufficiency as the cause of the very low human chorionic gonadotropin because of histologic observations and because a known marker for placental insufficiency, estriol, was also very low.

Abortion, Therapeutic↗

Specific molecular prenatal diagnosis for the CTG mutation in myotonic dystrophy.

The results of DNA analysis for the specific mutation of myotonic dystrophy are reported in eight pregnancies (two studied retrospectively) in six families. Four results were normal; in the other four, large DNA expansions were found, comparable to the range seen in severely affected children with congenital onset of the disorder. The results agreed with those obtained by linked DNA markers in the six cases where they were available. We conclude that specific molecular prenatal diagnosis of myotonic dystrophy is feasible, and that an abnormal result may also give a guide to possible severity, though this should be interpreted with caution until greater experience is available.

Base Sequence↗

Nevus flammeus. Discordance in monozygotic twins.

Nevus flammeus has been described as an inherited vascular anomaly. We report two cases of nevus flammeus, each appearing in one of two monozygotic twins. This finding supports the idea that nevus flammeus results from embryologic mishap rather than genetic transmission.

Adolescent↗

Establishment of a human T-acute lymphoblastic leukemia cell line with a (16;20) chromosome translocation.

A new T-cell line, Loucy, was established from the peripheral blood of a patient with T-cell acute lymphoblastic leukemia (T-ALL). The surface marker analysis of the cell line is OKT3+, OKT4+, THB4+, J5 +/-, OKT6-, TdT-, and HLA-DR-, indicating stage IV in T-cell lineage. Karyotype analysis revealed 45,X,5q-,t(16;20)(p12;q13). The translocation between chromosomes 16 and 20 has not been previously detected in ALL. This cell line may be of value in evaluating the role of t(16;20) in the etiology of T-ALL.

Antigens, Surface↗