I. Tamir

The effect of chronic anticonvulsant therapy on serum lipids and lipoproteins in epileptic children

We measured serum lipids and lipoproteins in 33 epileptic children who were treated with phenobarbital, valproate, and carbamazepine. High-density lipoprotein cholesterol (HDL-c) was significantly higher in the epileptic children than in two control groups: healthy nonepileptic children, and epileptic children before starting anticonvulsant therapy. Our findings indicate that anticonvulsant drugs should be added to the list of substances that affect serum HDL-c.

Serum lipids and lipoprotein concentrations during the acute phase of myocardial infarction.

The concentrations of serum lipids and lipoprotein cholesterol were measured serially during the acute phase (14 days) following myocardial infarction (MI) in 13 male survivors. All patients were re-examined at least two months after discharge from hospital. A significant increase in serum triglyceride (TG) concentration occurred during the acute phase, with values returning to baseline two months after recovery. No changes in the concentrations of the other lipids or lipoprotein cholesterol were observed.

Serum lipids and lipoprotein concentrations in young quadriplegic patients

Serum lipids and lipoproteins were investigated in 10 young quadriplegic patients. All received intermittently a liquid formula diet via a naso-gastric tube, consisting of 2900 calories/day. The polyunsaturated/saturated fatty acids ratio was 1.1 : 1. Their mean body weight was 70% of the ideal body weight. The results were compared to a control group receiving a diet containing 2600 calories per day, and the polyunsaturated/saturated fatty acids ratio was 0.9 : 1. Their mean body weight was 95% of the ideal body weight. In the quadriplegic group the serum HDL-cholesterol levels and linoleic acid content of cholesterol ester were reduced. Similar findings have been observed in patients with coronary disease.

Changes in amniotic fluid lecithin-sphingomyelin ratio following maternal dexamethasone administration.

The effect of dexamethasone on amniotic fluid lecithin-sphingomyelin (L/S) ratio was measured in 15 fetuses of 34 weeks or less of gestation. Six of the patients presented with premature rupture of the membranes. A rise in the L/S ratio is mature levels (two or more) was observed 24 hours to 11 days after the start of treatment in 12 patients. In 2 patients (one second twin and one anencephalic fetus), no rise in L/S ratio occurred. Of 12 cases whch ended in premature delivery (29 to 35 weeks) only one infant, a second twin delivered at the thirtieth week with a posttreatment L/S ration o1.4 weighing 1,240 grams, developed severe respiratory distress syndrome and died. Tt is suggested that dexamethasome accelerates fetal lung maturation by increasing surfactant synthesis or release, and this may be achieved as early as the twenty-eighth week of pregnancy.

The amniotic fluid foam test, L/S ratio, and total phospholipids in the evaluation of fetal lung maturity

The results of the L/S ratio, TPL (total phospholipids) concentration, and the FT (foam test) from 126 amniotic fluid samples (105 of which were obtained less than 48 hours before delivery) between weeks 26 and 43 of gestation were compared in evaluating fetal lung maturity. A perfect correlation between an L/S ratio of 2 or more and TPL of 2.8 mg./100 ml. or more and pulmonary maturity was found. L/S ratio of 1.4 or less and TPL of 1.5 mg./100 ml. or less were associated in all cases with RDS. The intermediate zone between these values, where pulmonary maturity could not be predicted, contained 3.8 per cent of the cases when L/S ratio is evaluated compared to 21.9 per cent by TPL assessment. The intermediate and positive FT were associated in all cases with fetal lung maturity and mature values of L/S ratio and TPL; the negative FT cases (36 out of 105) were associated with a wide range of TPL and L/S ratio values including immature, intermediate, and mature values. No RDS occurred in cases in which the FT was positive or intermediate. It is concluded that the FT is highly valuable as a screening test. If positive or intermediate, the risk of RDS is very small; when negative, the sample should be subjected to chemical analysis.

Behaviour of serum lipids in children with hepatitis A.

Abstract Serum lipids were estimated in 10 children during the acute phase of hepatitis A and following recovery. Two to 4 days after the appearance of the first symptoms a significant increase in serum lipids (total cholesterol, triglycerides and total phospholipids) was found in all children. This increased concentration persisted throughout the active phase regardless of other liver function tests which showed a gradual improvement. 30 days after the start of the disease all serum lipids returned to normal levels. In serum triglyceride fatty acids a gradual decline in the relative linoleic acid concentration was seen. This may be due to faulty absorption of fat or to increased utilization of carbohydrates during recovery. In the major phospholipid fractions an increase in lecithin and a decrease in lysolecithin was seen in most children. This may indicate a defect in the hydrolysis of lecithin to lysolecithin.

Dynamics and composition of serum lipids in hyperlipoproteinemias

The microviscosity of serum lipids in patients with hyperlipoproteinemia and normal donors was determined by monitoring the degree of fluorescence polarization of the fluorescent probe 1,6-diphenyl-1,3,5-hexatrine (DPH). Determination of serum lipids--serum total cholesterol, serum triglycerides, and serum phospholipids--revealed that an increase in the ratio of cholesterol/triglyceride + phospholipid is accompanied by an increase in the degree of fluorescence polarization and an increase in the microviscosity values. Similar results were obtained with sonicated liposomes prepared from serum lipids extracts. This correlation between dynamics and composition of serum lipids was further supported by results obtained with an artificial model system of sonicated lipids dispersions. The results have shown that high microviscosity values are characteristic in patients with high levels of serum cholesterol, and that low microviscosity values are characteristic in patients with high levels of serum triglycerides. It is suggested therefore that this technique may serve as a basis for a rapid screening test for hyperlipoproteinemias.

Changes in plasma free fatty acid concentration following oral lactose tolerance tests as a test for lactose absorption in infants and children.

Changes in blood glucose and plasma free fatty acid (FFA) following oral lactose tolerance tests (LTT) were measured in three groups of children. In three out of seventeen infants with secondary lactose intolerance, only a small increase (less than 25 mg/100 ml) in glucose was found, but a normal decline (more than 50% of fasting value) in FFA concentration occurred. Resumption of milk feeding proved that they were not intolerant to lactose. Six infants (37%) without lactose intolerance who were on a normal lactose-containing diet showed only small increases in glucose; five of them showed a normal decline in plasma FFA. Nine out of thirteen children with no symptoms following oral LTT failed to show an increase in blood glucose, while in only one there was a decline of less than 50% in FFA concentration. Our results suggest that measurement of plasma FFA following oral LTT may be a more reliable test for cleavage and absorption of lactose than LTT alone, but for the final evaluation of this test a study of larger groups is obviously needed.