The influence of oral insulin on the development of autoimmune diabetes in NOD mice fed a hypoallergenic diet

BACKGROUND

Autoimmune diabetes can be prevented in animal models by hypoallergenic diets. Moreover, in animal models, oral administration of insulin can suppress the development of autoimmune diabetes and clinical trials on prevention of human Type 1 diabetes by oral administration of insulin are already taking place. However, it has been reported that autoimmune diabetes can be induced by oral administration of an auto-antigen (insulin), and great caution is therefore warranted when applying the oral tolerance approach to prevent Type 1 diabetes.

AIM

To evaluate the effect of orally administered insulin on the development of autoimmune diabetes in non-obese diabetic mice fed a hypoallergenic diet.

METHODS

Four groups of mice were fed regular mouse chow (group 1, control mice), hypoallergenic diet, using the hydrolyzed infant formula Pregistimil (group 2), and Pregistimil with oral insulin (4 U/l of drinking water, group 3; and 8 U/l of drinking water, group 4).

RESULTS

At 210 days of age, 11/20 (55%) mice in group 1 developed diabetes. In contrast, none of the mice from the Pregistimil-fed groups (0/16, 0/14, 0/17) developed the disease (p<0.001). The incidence of infiltrated islets and the severity of insulitis, at age 90 days, was significantly lower in mice fed with the hypoallegenic diet than in controls (p=0.028).

CONCLUSIONS

In NOD mice fed a diet that prevents the development of diabetes, oral insulin supplementation appears to be safe, since it does not promote the development of clinical diabetes.

Dopa reaction of fetal melanocytes before and after skin transplantation on to nude mice

We have previously demonstrated that human fetal epidermal melanocytes are dopa-negative. The present study was conducted to test the hypothesis that human fetal melanocytes can be activated to produce melanin under conditions differing from their natural in utero environment. To address this question, dopa staining activity of fetal epidermal sheets, obtained from seven aborted fetuses with estimated gestational ages of 13-20 weeks, was evaluated before and after engraftment on to nude mice. Dopa staining became positive 7 days post-engraftment. The intensity of the dopa reaction and the mean number of melanocytes increased by day 14 post-engraftment, and these changes were even greater by day 30. These observations indicate that human fetal melanocytes, potentially capable of synthesizing melanin under conditions differing from their normal in utero environment, are either inhibited, or not stimulated to do so.

Use of saliva in home monitoring of carbamazepine levels

Total carbamazepine (CBZ) levels in serum of 61 epileptic children were compared with saliva levels. Both resting and stimulated saliva was analyzed. The salivary levels were 38.6% of serum CBZ levels. A highly significant correlation was noted (r = 0.89, p < 0.001). Stimulation had no effect on saliva CBZ levels (r = 0.97). Salivary and serum CBZ levels were not affected by storing the samples for 7 days at room temperature. The data indicate that salivary CBZ may provide a reliable alternative monitoring method to Tegretol therapy, especially in children, in whom blood sampling is difficult. Furthermore, the samples may be collected at home and delivered to the laboratory by mail.

Cholestatic pruritus: effect of phototherapy on pruritus and excretion of bile acids in urine

Pruritus associated with hepatic cholestasis may cause significant morbidity and its correlation to retention of bile acids in skin is inconsistent. Available treatment modalities are only partially effective and can have several adverse effects. Phototherapy has recently been reported to improve cholestatic pruritus, but has not been evaluated previously in children, and its mechanism is still unclear. We report the outcome of multiple Daylite phototherapy treatments over two years in a seven-year-old child with chronic hepatic cholestasis that was resistant to other therapeutic modalities. Bile acid levels in urine were used as markers of effectiveness in parallel with clinical response. Night phototherapy alone increased the bile acids/creatinine ratio in urine from 1.54 +/- 0.04 mumol/mg at baseline to 2.07 +/- 0.29 mumol/mg. Continuous phototherapy combined with night diuresis raised the ratio further to 2.28 +/- 0.55 mumol/mg. Night diuresis alone had no effect. Continuous phototherapy combined with night diuresis raised the bile acids/creatinine ratio by 44% on the first day and by 61% on the second day, but declined to baseline on the third day of treatment. A marked clinical improvement was noted for one week following two days of phototherapy. This schedule has been repeatedly effective in improving pruritus for approximately one year and may be due to the ability of phototherapy to enhance excretion of bile acids and other possible pruritogens into urine.

High dose intravenous gamma-globulin in intractable epilepsy of childhood

Eight children aged between 1.3 and 13 years suffering from epilepsy refractory to conventional anticonvulsive therapy were treated with high dose intravenous gamma globulin (200 mg/kg, 3 times per week, repeated after 3 weeks). Immunological studies after therapy showed normal results. In four children, clinical and EEG findings markedly improved. In one other case a partial response was noted. No improvement was observed in the remaining three cases. We confirm that although the mechanism is still obscure, high doses of i.v. gammaglobulin may have a beneficial effect in a significant number of children with intractable epilepsy.

Effect of urine and urine components on the chemiluminescent response of bacteria-stimulated polymorphonuclear leukocytes

The role of polymorphonuclear leukocytes (PMN) found in urine during infectious episodes is still unknown. Opsonophagocytosis of Escherichia coli by normal blood PMN in the presence of urine was measured using a chemiluminescence (CL) assay. PMN were challenged by a type I fimbriated E. coli strain shown to elicit a CL response through attachment to the mannose-containing receptors on the leukocytes. In the presence of urine the CL response decreased significantly. Urine osmolality due to inorganic salts partially caused this decrease. A higher inhibitory effect was elicited by urea. Under otherwise similar conditions, the presence of an additional CL-inhibiting factor, most probably a protein, was detected in urine; however, its identity has not yet been defined. In vitro and in vivo urine dilution improved PMN function. No difference in effect on CL response was found between urine obtained from 25 children with recurrent urinary tract infections and urine from 15 age-matched controls.

Dopa reaction test in hair bulbs of fetuses and its application to the prenatal diagnosis of albinism

No information is available on the amount of tyrosinase normally present in fetuses. A dopa reaction test in hair bulbs from the scalp of normal fetuses obtained after abortion showed that tyrosinase is present in fetuses as early as 17 weeks. Only faint activity was detected in skin specimens other than from the scalp. This assay can serve as a quick and reliable method for the prenatal diagnosis of tyrosinase-negative albinism.

Neurosecretory dysfunction of growth hormone secretion in thalassemia major

The growth retardation of children with thalassemia major is multifactorial. Along the endocrine axis of growth hormone (GH), serum somatomedin has been shown to be deficient and GH response to GH-releasing hormone impaired, while GH response to provocative stimuli is normal. We studied the spontaneous secretion of GH in seven patients with thalassemia major and growth retardation. Three of the patients were hypothyroid, and the other four were euthyroid. Spontaneous secretion of GH in all seven patients was subnormal: the number of pulses, the mean pulse amplitude, and the integrated concentration of GH were all lower than in 14 age- and sex-matched (10 pubertal and 4 prepubertal) control subjects. GH response to provocative stimuli was normal in the euthyroid patients. This pattern of response corresponds with the definition of neurosecretory dysfunction of GH secretion. It is concluded that the growth retardation of patients with thalassemia major is partly due to neurosecretory dysfunction of GH secretion.

Serum lipoprotein profile in children with celiac disease

Jejunal mucosa is responsible for the absorption of triglycerides and the production of lipoproteins [chylomicrons, very-low-density lipoprotein (VLDL), high-density lipoprotein (HDL)] and apolipoproteins (B-48, A-I, A-II, A-IV, C-II). Mucosal damage is known to cause fat malabsorption and probably also affects the serum lipid profile. To determine lipoprotein production in states of enterocyte dysfunction, we compared the serum lipid profiles in a group of 12 children with untreated celiac disease (flat jejunal mucosa) with the profiles in a control group of 10 children suffering from other intestinal diseases. Statistically significant differences were found in the following parameters (celiac versus control): plasma levels of triglycerides (70 versus 119 mg/dl), cholesterol content in LDL (107 versus 67.7 mg/dl), protein content in VLDL (6 versus 10 mg/dl), and level of apoprotein A-I (112 versus 140 mg/dl). No significant differences were found between the two groups in the serum levels of total cholesterol, the cholesterol content in VLDL and HDL, the protein content in LDL and HDL, and the level of apoprotein B. Following institution of a gluten-free diet, the lipoprotein profile reverted to normal. These data suggest that the changes in the serum lipoprotein profile in celiac disease are secondary to alterations in enterocyte function and not only a reflection of fat malabsorption.

Johanson-Blizzard syndrome: clinical spectrum and further delineation of the syndrome

We report on 2 patients with Johanson Blizzard syndrome and review the literature, in an attempt to further characterize the clinical spectrum of this disorder.

Saethre-Chotzen syndrome associated with defective neutrophil chemotaxis

An 11-month-old male infant with Saethre-Chotzen syndrome and recurrent respiratory infections is described. Persistent extremely high leukocytosis warranted evaluation of neutrophil functions. It was found that the opsonophagocytic activity was normal, but neutrophil chemotaxis was markedly decreased. Further studies pointed to an intracellular neutrophil defect causing this motility dysfunction.

Effect of an intravenous gammaglobulin preparation on the opsonophagocytic activity of preterm serum against coagulase-negative staphylococci

Recent reports have described cases of septicaemia caused by coagulase-negative staphylococci in preterm neonates, mainly due to the use of artificial intravenous devices. It was of interest to examine if intravenous immunoglobulin therapy, known to be effective in group B streptococcal infections of neonates, had a similar beneficial effect in coagulase-negative staphylococcal infections. Opsonophagocytosis of coagulase-negative staphylococci by normal polymorphonuclear leukocytes in the presence of cord blood serum supplemented with the commercial IgG preparation 'Sandoglobulin' was investigated, using luminol-dependent chemiluminescence. It was found that with two different coagulase-negative staphylococcal strains, Sandoglobulin had a concentration-dependent enhancing effect on the chemiluminescent response. This effect was demonstrated in the presence of native as well as inactivated cord blood serum and in the presence of sera from preterm infants (28-33 weeks). It is concluded that intravenous Sandoglobulin therapy may be effective in the treatment of preterm infants with severe coagulase-negative staphylococcal infections.

[Kawasaki disease associated with Epstein-Barr virus]

We describe a 14-month-old child who for 3 weeks had high fever and developed lesions of the mucous membranes, enlarged lymph nodes, and an erythematous rash. Kawasaki disease was diagnosed and there was clear evidence for infection with Epstein-Barr virus. Thus it is possible that this virus is one of the etiological factors in the development of Kawasaki disease.

Defective leukocyte fungicidal activity in end-organ resistance to 1,25-dihydroxyvitamin D

Recent studies have shown 1,25(OH)2D3 receptor-mediated modulation of leukocyte proliferation, differentiation, and function. We examined the phagocytosis and killing of microorganisms by neutrophils and monocytes from five patients of three families with hereditary resistance to 1,25(OH)2D3. Phagocytosis of microorganisms by patients' neutrophils and monocytes was normal. However, defective neutrophil killing activity toward Candida albicans (30-40% of controls) was found in all patients. The killing of Staphylococcus aureus was normal. The neutrophil chemiluminescence, nitroblue tetrazolium (NBT) dye reduction, and the generation of superoxide ions and hydrogen peroxide by neutrophils and monocytes after induction by either soluble stimuli or zymozan particles, did not differ from those in controls. The neutrophil myeloperoxidase activity was also normal. Monocytes obtained from two patients of different families before long-term calcium infusion therapy and after they became normocalcemic, demonstrated a similar impaired fungicidal activity toward Saccharomyces cerevisiae, indicating that hypocalcemia itself was not the cause of the killing defect. However, the addition of the Ca+2 ionophore A23187 (1 microM) to the test medium restored the monocyte fungicidal activity to normal. As patients' neutrophil cytosolic free calcium concentration was similar to that in controls, it is suggested that 1,25-(OH)2D3 exerts its effect on leukocyte function by a putative receptor-mediated regulation of subcellular calcium localization which may be important for fungicidal activity.

Humoral and cellular immune dysfunction in a patient with Bloom's syndrome and recurrent infections

Immunological evaluation of a patient with Bloom's syndrome (BS) who suffered from recurrent bacterial and fungal infections, revealed low serum levels of IgG and high levels of IgM accompanied by an elevated proportion of surface membrane IgM positive B-lymphocytes and a decreased proportion of IgG positive B-cells. In vitro IgG secretion was also reduced whereas IgM production was normal. Although proportions of T-cell subsets were normal and proliferative responses to T-cell mitogens were adequate, a defective regulatory T-cell function for the generation of IgG was observed. Natural killer (NK) cell activity against K562 tumor cells was also decreased in this patient. The findings in this patient may suggest a maturation arrest of lymphocytes at an early developmental stage, and this may explain in part the increased susceptibility to infections.

Immunological studies in children with type I diabetes mellitus and their healthy relatives: in vitro antigen stimulated IgM production, T-cell subsets and islet-cell antibodies

Several defects in immunoregulation have been described in patients with insulin dependent diabetes mellitus (IDDM). We have looked at immunoregulatory T-cell subsets autoantibodies and in vitro IgM production in IDDM patients and their healthy first degree relatives. The proportions of total T-cells (OKT11+), helper/inducer (OKT4+), suppressor/cytotoxic T-cells (OKT8+) and OKT4/OKT8 ratio were normal in 8 patients as well as in their 26 family members and in 40 age-matched controls. Anti islet-cell antibodies (ICA) were found in sera of 6 out of 17 patients (35%) in 1 out of 62 (1.6%) family members and in none of the age-matched healthy controls. A significant increase of in vitro IgM production was found in 8 patients (130 +/- 10 PFC/10(6) cultured cells, mean +/- S.E.) as compared to 21 healthy controls (57 +/- 5.0) (p less than 0.01). In vitro IgM production by B-cells of 22 family members was also increased compared to controls (83 +/- 8.0) (p greater than 0.05). This increased antibody production is characteristic for clinical states associated with impaired immunoregulation, and reflects perturbation of immunoregulatory mechanisms in IDDM.

Psychosexual outcome of assigned females and males with 46,XX virilizing congenital adrenal hyperplasia

Seven genotypic female (46,XX) patients with congenital adrenal hyperplasia, four reared as girls and three reared as boys were evaluated at 16-26 years of age with psychological interviews and testing. A small penis in the three young men produced a practical and psychological barrier that severely injured their personality. In spite of some degree of pre-adolescent tomboyism and a somewhat injured body image, the girls adjusted to their feminine gender identity. It is concluded that in cases of both early and late diagnosis, the genotypic female sex should be preferred.

Defective humoral and cellular immune functions associated with veno-occlusive disease of the liver

We describe veno-occlusive disease of the liver associated with humoral and cellular immune defects in two siblings. Another child, with aplastic anemia, died before the age of 1 year. No consanguinity was found in the family. Both infants had lymphopenia and hypogammaglobulinemia; the surviving infant has defective in vitro immunoglobulin production after stimulation of lymphocytes with pokeweed mitogen, increased proportions of OKT8 positive cells, defective proliferative responses to phytomitogens, and decreased help for immunoglobulin production. A therapeutic trial with cimetidine, an H2 receptor antagonist, has not changed the immunologic status of the surviving child.

Intralipid effects on preterm neonate serum: chemoattractant and opsonizing capacities

The effects of Intralipid (IL) administration of preterm infants have been investigated. For this purpose, adult neutrophils were stimulated by infant sera collected before and after IL treatment. A definite decrease (p less than 0.0005) in chemoattractant capacity of zymosan-activated serum was observed after IL. On the other hand, no difference in the opsinizing abilities of untreated versus treated sera could be demonstrated by measuring the chemiluminescence responses to serum-opsonized zymosan. This study emphasized the need of caution in the use of IL treatment for preterm infants.

Bacterial meningitis in infants two to six weeks old

We reviewed our experience with bacterial meningitis in older neonates (2 to 6 weeks of age) during a five-year period. Seventeen patients with bacterial meningitis were diagnosed and treated. Bacteria recovered from the cerebral spinal fluid (CSF) included pneumococci (29%), E. coli and meningococci (23% each), group B streptococci (12%), Enterobacter and H. influenzae (6% each). There were no cases of Listeria monocytogenes. The mean duration of symptoms before admission was 3.1 days. The mortality rate was high (30%), and 36% of the patients had significant neurologic residua. Our study shows that this specific age group is different from newborns or older infants. Therefore, the initial selection of antibiotics for the treatment of meningitis in this age group should include antibiotics that are effective across this spectrum of potential pathogens.

Complete recovery of pure red cell aplasia by intramuscular gammaglobulin therapy in a child with hypoparathyroidism

A 10-year-old girl with multiple endocrinopathies, hypoparathyroidism, and pernicious anemia subsequently developed pure red cell aplasia, which responded only temporarily to cytotoxic therapy. Because of transfusion dependency, resistance to steroids, plasmapheresis, and Cytoxan, she was given injections of intramuscular gammaglobulin. The injections caused a prompt and sustained rise in the child's erythropoiesis.

Requirement of mineralocorticoid in congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency

Marginal salt loss occurs in patients with congenital adrenal hyperplasia due to 11 beta-hydroxylase (11-OHase) deficiency treated with dexamethasone and is accompanied by increased PRA. The present study was undertaken to evaluate the effect of the stimulated renin-angiotensin system on pituitary-adrenal suppression. Seven patients with 11-OHase deficiency were subjected to a series of treatments with dexamethasone, cortisol, and combined cortisol and 9 alpha-fluorohydrocortisone. The latter combination suppressed PRA and sodium excretion, and produced better control of the pituitary-adrenal axis, as measured by plasma ACTA and serum 11-deoxycortisol. We conclude that in children with 11-OHase deficiency, PRA needs to be monitored, and when it is elevated, mineralocorticoid replacement is indicated.

Transient hypogammaglobulinemia of infancy with severe bacterial infections and persistent IgA deficiency

A 1-year-old boy who had had recurrent episodes of sepsis was found to have transient hypogammaglobulinemia of infancy and was treated with gammaglobulin supplements. He subsequently remained IgA deficient and a regulatory T cell imbalance was found.

Transient immunoregulatory perturbation during the acute phase of rheumatic fever

An abnormal immune response directed at streptococcal antigen is currently thought to be involved in the development of autoimmune phenomena in rheumatic fever (RF). We studied T-cell subsets using the OKT monoclonal antibodies in 13 patients with newly-diagnosed RF. No difference was found in the total number of T cells or in the proportion of helper T cells (OKT4+) at the acute phase (56.6 +/- 6.9) as compared to the recovery phase (55.2 +/- 9.2). However, a significantly decreased proportion of suppressor T cells (OKT8+) was observed during the acute phase (17.2 +/- 6) as compared to the recovery phase (26.4 +/- 5.3) (p less than 0.001). The T4/T8 ratio was significantly higher during the initial phase (3.65 +/- 1.04) and returned to normal later (2.12 +/- 0.39) (p less than 0.002). The results of our study indicate that in the acute phase of RF many patients had low levels of suppressor T cells which return to normal after recovery. Thus, reduced proportion of suppressor T cells might be an indicator for the active phase of RF. Decreased suppressor cell activity may also be involved in the development of autoimmune phenomena in RF.

Role of the immune system in the etiology of rheumatic fever

In order to summarize all the data regarding the immunological findings in RF we have elaborated the following theory about the pathogenesis of RF (fig. 1). The disease will develop only after repeated beta-hemolytic group A streptococcal throat infection in susceptible individuals. In these people, who have a specific immune response to repeated streptococcal infection due to their DR region, a decrease in suppressor activity will develop. This will lead to an increased specific humoral and cellular immune response to streptococcal antigen which cross-reacts with specific human tissue as the heart or the brain. Alternatively or concomitantly specific autoantibodies against these tissues are made. These antibodies together with the cellular response will cause the clinical manifestation seen in RF. This is only a proposed theory and still much more work has to be done to solve the enigma regarding the pathogenesis of RF.

Hypocalcaemia induced by glucocorticoids in a child with hypoparathyroidism treated with 1-alpha-hydroxyvitamin D3

Glucocorticoids tend to lower the intestinal absorption of calcium, leading to a negative calcium balance. A 7-year-old girl with hypoparathyroidism was maintained as normocalcaemic on 1-alpha-hydroxyvitamin D3 (1 alpha D3) and calcium gluconate lactate. During an episode of aplastic anaemia she was treated with prednisolone, with a subsequent dramatic fall of serum calcium despite 1 alpha D3 treatment and serum 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in the high-normal range. Glucocorticoids seem to have interfered directly with cellular events responsible for intestinal absorption of calcium.

Calcitriol-resistant rickets with alopecia

Four children of two kindred had alopecia associated with severe rickets, resistant to treatment, and caused by defective cytoplasmic and nuclear receptors for the active vitamin D metabolite calcitriol (1,25-dihydroxyvitamin D3). Scalp biopsy specimen revealed a normal number and light microscopic features of the hair and hair follicles. Calcitriol-resistant rickets should be added to the list of inherited disorders of hair growth, and the association of rickets with alopecia needs to be considered in the differential diagnosis of hair loss.

Hyperbaric oxygenation in peripheral ischaemic lesions in infants

Acute peripheral arterial occlusion may lead to gangrene, with loss of parts of arms and legs. Three infants with disseminated intravascular clotting developed dark red discoloration of the tips of fingers and toes which progressed proximally. Repeated hyperbaric oxygenation treatments caused regression of the demarcation line and further progression of necrosis stopped.

Comparison of the effects of amphetamine and a fluorinated analogue on locomotion and exploratory activity in the mouse

(+)-Amphetamine (AM) and its fluorinated analogue (+)-2-amino-3-fluoro-1-phenylpropane (fluoroamphetamine, FAM) were compared with regard to their effects on locomotor and exploratory activity in mice. Both drugs caused a reduction in spontaneous exploration, but this effect was more marked with FAM than with AM at 1 h after injection. Both compounds increased locomotor activity 10 min after injection, but FAM had sedative effects after 1 h, while AM continued to be stimulatory.

Salt loss in congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency

Nine patients with 11 beta-hydroxylase deficiency had 13 episodes of gastroenteritis requiring hospital admission and fluid administration. Eight episodes were accompanied by hyponatraemia and salt loss. The salt losing patients were treated with excessive glucocorticoid and those with normal serum sodium concentrations were treated with inadequate glucocorticoid. Excessive glucocorticoid suppressed deoxycorticosteroid secretion, resulting in salt loss.

Immunofluorescent antigluten antibody test. Titer and profile of gluten antibodies in celiac disease

Circulating antibodies to gluten fractions have been detected in most patients with celiac disease during gluten ingestion. The various detection techniques, however, are rather complex and inadequate for routine clinical use. Recently, a new indirect immunofluorescent method, named the antigluten antibody (AGA) test, has been developed. To establish the reliability of the test we compared six groups of patients: (1) 15 patients with biopsy-proved celiac disease of whom 13 had positive test results (the other two had already been receiving a gluten-free diet for two to three weeks); (2) 13 malnourished patients without celiac disease who had damaged mucosa, of whom only two had positive test results; (3) 21 patients with celiac symptomatology but normal mucosa, of whom four had positive test results; (4) 42 patients with other intestinal tract diseases, of whom seven had positive test results; (5) 28 patients with extraintestinal diseases, of whom only two had positive test results; and (6) 26 patients with autoimmune diseases, of whom five had positive test results. All patients with celiac disease who had positive test results and who were receiving a gluten-containing diet had titers of 1:40 to 1:80 in the IgG class, while all other patients with positive AGA test results had a low titer of 1:10 to 1:40, in the IgM class mainly. We conclude that the AGA test is an effective screening tool for patients with celiac disease and may serve as a practical index of dietary gluten avoidance.

Systemic carnitine deficiency exacerbated by a strict vegetarian diet

A 12-year old boy suffered episodes of vomiting, lethargy, and hypoglycaemia from the age of 1 year. Adhering to a vegetarian diet caused an increase in frequency and severity of the attacks. It was found that he was suffering from systemic carnitine deficiency that responded promptly to treatment with L-carnitine.

Caffeine stimulates growth hormone secretion by cultured rat pituitary cells

To study the effect of caffeine on growth hormone secretion a culture system of dispersed rat anterior pituitary cells was employed. The cells were incubated overnight in medium 199 containing 10(-5) to 10(-1) M caffeine. The medium was then collected and assayed for rat growth hormone content. A dose dependent stimulatory effect of caffeine on growth hormone secretion into the culture medium was observed. It is concluded that caffeine, like other xanthine phosphodiesterase inhibitors stimulates growth hormone secretion by a direct effect on pituitary cells.

Composition of whole unstimulated saliva of human infants

Whole unstimulated saliva of 168 infants aged 3 days to 12 months was analysed. The concentration of Ca, Mg and Cl was higher in the saliva of infants than in adults. The concentration of phosphate, IgA, amylase and pH was lower in infants; Na, K and total protein did not differ significantly. A wide range of all the concentrations was observed in the saliva of infants. No significant difference was found between the salivary composition of male versus female or of breast-fed as compared to bottle-fed infants. No difference before and after eruption of teeth was detected. Significant differences between different age groups were observed in the concentrations of Na, K, Cl, phosphate, protein, amylase and pH. No significant differences were found in Ca, Mg and IgA concentrations within the first year. A negative correlation between the age of the infants and the concentrations of Na, K, Cl and total protein was observed. A positive correlation was found for phosphate and amylase as a function of age.

Epstein-Barr virus and infectious mononucleosis in children

The presence of IgG antibodies to Epstein-Barr virus (EBV) has been investigated in two groups of children aged 3 to 35 months. The test group consisted of 31 children from an institution in which a high incidence of suspected infectious mononucleosis (IMN) was found. The control group comprised 54 children, aged 1 to 26 months, with noninfectious diseases. In the test group, 29 of the 31 children were positive for IgG anti-EBV antibodies in the serum, whereas only 5 children were positive in the control group. None of the children in the test group had detectable heterophile antibodies, and most of them did not show the typical symptoms of IMN. The reliability of diagnosing IMN in early childhood, by means of detection of anti-EBV serum antibody levels, is discussed.

Growth enhancement induced by prolonged L-dopa administration in rats

To follow growth of rats, in which growth hormone secretion has been chronically stimulated, L-Dopa (5 mg/kg) was injected subcutaneously twice daily for 70 days to growing rats. A control group, matched for sex and sibship, pair fed with the treatment group was given saline injections. At 10-day intervals, the rats were weighed and measured. At 90 days of age the rats were ether anesthesized, bled for growth hormone determination, and internal viscera weighed. Weight gain and length in the L-Dopa-treated group was found to be significantly greater. A mean weight gain of 6% and 12% in the male and female rats, respectively, and a mean length gain of 5% in both male and female rats was observed at 90 days of age. The thymus, thyroid, adrenals, uterus, and gonads all tended to be heavier in the L-Dopa-treated group. Significantly heavier kidneys were found in the L-Dopa group. Serum growth hormone was found to be 8.44 +/- 1.4(SE) ng/ml in the L-Dopa group and 4.6 +/- 0.9 ng/ml in the control group. It is concluded that the continuous administration of L-Dopa produces an increase of circulating serum growth hormone levels, and this in turn enhances growth.