Samuel Karelitz

Clinical effects of two different levels of protein intake on low-birth-weight infants.

A controlled clinical trial was carried out to evaluate the effects of two different levels of protein intake on 304 infants with birth weights below 2,000 grams; the diets contained either 3.0 to 3.6 or 6.0 to 7.2 Gm. per kilogram per day of protein. The infants fed the higher intake had more fever, lethargy, and poor nipple feeding, but they had higher plasma protein levels and less edema than infants fed the lower intake.

The cry thresholds of normal infants and those with brain damage: An aid in the early diagnosis of severe brain damage

A standardized program of successive painful stimuli was applied to nearly 300 children with the expectation that the vocal responses of normal subjects and of those with diffuse brain damage would differ significantly. Infants with diffuse brain damage require more stimulation to produce a standard 1 minute crying response than do normal infants. The efficiency of the technique varies between 74 and 83 per cent, depending upon the age level studied. Other criteria, e.g., shorter periods of crying, patterns of crying, etc., are being explored, particularly for infants under 4 days of age, in the hope of increasing the predictice efficiency of the method.

Frequency spectra of the cries of normal infants and those with Down’s Syndrome

Samples of tape recorded crying obtained from four male mongoloid infants six months of age, and four normal infants matched for age and sex were fed into the Panoramic Sonic Analyzer in order to survey the frequency (c. p. s.) content of the cries. While the frequency ranges did not differ for the two groups, the cries of the normal infants were richer in spectral content, more active, less variable in sound level and more homogeneous as a group than those of the mongoloid infants.

The lacrimal proteins in Down's syndrome (Mongolism)

The tears of 54 of 60 subjects with Mongolism whose ages ranged from 2 weeks to 44 years contained the protein fractions described for serum in addition to lysozyme. The presence of the alpha-1 globulin in 54 of the 60 Mongoloids which is normally present only in tears from full-term infants younger than 7 days and premature infants variably up to 30 days is especially noteworthy. The immunoelectrophoresis of Mongoloid lacrimal proteins with antiserum antibody revealed the presence of many immunologically distinct moieties. Comparison with the tears of 67 others suffering from a variety of ailments showed that 90 per cent of the subjects with Mongolism produced this characteristic lacrimal protein pattern against less than 10 per cent of the others.

Electrophoresis andimmunoelectrophoresis of neonatal tears

Tears which occurred during the neonatal period were examined by cellulose acetate electrophoresis and immunoelectrophoresis. All neonatal tears contained lysozyme. The infants who wept within 36 hours of birth cried with tears which showed, in addition to the enzyme, proteins similar to those of serum, particularly alpha-1 globulin. Full-term infants, 1 1/2 to 7 days of age, and premature infants, 1 1/2 to 30 days of age, showed an intermediate pattern. Older full-term infants, children, and adults produced tears characterized by the absence of alpha-1 globulin, a paucity of alpha-2 globulins, and a marked diminution of other globulins. Immunoelectrophoretic studies, carried out with antiserum antibodies, confirmed the complexity of protein fractions in the very young by the presence of multiple precipitin arcs.

Radiographic study of gastric emptying in premature infants

Radiographic methods were used in this study of the gastric emptying times of 148 premature infants. Three groups were fed either milk formula, glucose water, or distilled water. In the group fed milk formula significant emptying began at 4 to 5 hours, and the median time for the group was 5 to 6 hours. In the group fed glucose water, significant emptying began at 3 to 4 hours, and the median time was 4 to 5 hours. In the group fed distilled water, results were similar to those of the latter group. These data differ from those reported in the literature for fullterm infants.

Lacrimation in the neonatal and early infancy period of premature and full-term infants

Observations were made upon 1,326 full-term and 202 premature infants to determine when and under what circumstances overflow tears occur in infancy. The time of appearance of tears in premature infants ranged from 35 minutes of age to the eighty-eighth day; in 60 per cent the tears appeared before 30 days of age. In full-term infants, overflow tears were noted as early as 5 1/2 hours of age, and in 166, or 13.2 per cent, tearing appeared in the first 4 1/2 days of life. Tearing occurred with crying when the infants were fed, received injections, or were circumcised; tearing occurred occasionally without crying with feeding, gagging, sneezing, etc.

The effect of stimulus intensity on induced crying activity in the neonate

Cinical observation indicated not only that infants are more responsive to a more intense painful stimulus, but that there are individual differences in the degrees to which their reactions are heightened. A systematic analysis of this differential in responsivity may provide an additional diagnostic parameter in the study of differences in crying behavior between normal infants and those with brain damage.