Analysis of Milk-Based Infant Formula. Phase IV. Iodide, Linoleic Acid, and Vitamins D and K: U.S. Food and Drug Administration-Infant Formula Council: Collaborative Study

In 1982, the U.S. Food and Drug Administration, the Infant Formula Council and its member companies, contract laboratories, and other government laboratories began a study of analytical methods for the nutrients listed in the Infant Formula Act of 1980. Phases I, II, III, and V have been completed. The present report provides data on Phase IV, in which 13 laboratories collaboratively studied an ion-selective electrode method for analyzing iodide, a gas chromatographic method for linoleic acid, and 2 liquid chromatographic (LC) methods each for vitamins D and K. Data were insufficient to evaluate one each of the LC methods studied for vitamins K and D. The relative standard deviations (RSD) are sufficient for the nutrient levels found in infant formula. RSDs (%) for repeatability (RSDr) and reproducibility (RSDR), respectively, were as follows: iodide, 4.0-11.4 and 13.5-18.2; linoleic acid, 1.0-1.6 and 3.5-5.1; vitamin K1, 3.2-16.0 and 6.2-19.4; and vitamin D3,4.2 and 35.0. The recommendation to adopt the method for vitamin D was supported by the results of a ministudy. All laboratories were capable of using these methods with little training. The methods for determination of iodide, linoleic acid, and vitamins D and K in ready-to-feed milkbased infant formula have been adopted first action by AOAC International.

The effect of postoperative radiation therapy on pharyngoesophageal reconstruction with free jejunal interposition

Free tissue transfer of a jejunal segment was undertaken for laryngopharyngoesophageal reconstruction in 20 patients who received postoperative irradiation therapy. Treatment consisted of 1.8- to 2-Gy-fractions, the average total dose was 55.57 Gy (range, 40 to 66 Gy). Anastomotic strictures (six) were encountered early in the series and associated with stapled anastomoses. Hand-sewing the jejunoesophagostomy eliminated the problem. Enteric cutaneous fistula, bowel necrosis, and hemorrhagic enteritis were not observed. We conclude that the application of postoperative irradiation therapy to patients requiring jejunal interposition grafts is feasible.

The expression of alpha vascular smooth-muscle actin in salivary gland tumors

In an attempt to determine if both pleomorphic adenomas and adenoid cystic carcinomas are derived from myoepithelial cells, 23 pleomorphic adenomas, 22 adenoid cystic carcinomas, and 17 normal salivary glands were examined immunohistochemically by using monoclonal antibodies directed against actin (HUC1-1, 1A4), keratin (AE-1, 34 beta E 12), and vimentin (V9). In normal salivary glands, the myoepithelial cells demonstrated a positive reaction to the monoclonal antibodies against actin and only rarely reacted with those against vimentin. No reaction to those against keratin was noted. In pleomorphic adenomas, cells that histologically resembled myoepithelial cells displayed a positive reaction to HUC1-1 in 60.9% and to 1A4 in 65.2%. In adenoid cystic carcinoma, 59.1% of cases demonstrated a positive reaction to both HUC1-1 and 1A4. These results supported the hypothesis that the majority of pleomorphic adenomas and adenoid cystic carcinomas arise from cells of myoepithelial origin.

The syndrome of spontaneous iliac arteriovenous fistula: a distinct clinical and pathophysiologic entity

While the development of a spontaneous iliac arteriovenous fistula is an uncommon complication of arteriosclerotic aneurysmal disease, its association with a distinct clinical syndrome allows timely operative intervention for this potentially life-threatening event. A review of cases reported in the literature reveals a triad of symptoms consistently associated with the presence of a spontaneous iliac arteriovenous fistula: high-output cardiac failure of precipitous onset, a pulsatile abdominal mass accompanied by a thrill and bruit, and unilateral lower-extremity ischemia or venous engorgement. Survival may be anticipated if an aggressive diagnostic and operative approach is employed.