, R. (1973). Archives ofDisease in Childhood, 48, 885. Metabolic and hormonal effects of glucagon infusion in erythroblastotic infants. 10 or 50 ,g glucagon was added to the bottle of donor blood, preserved with acid citrate and dextrose, used for exchange transfusion of erythroblastotic infants. The effects of the glucagon infusion on plasma glucose, insulin, growth hormone (GH), and glucagon were measured during the transfusion and for 60 minutes thereafter, and were compared with transfusions in which no addition was made to the donor blood. Both doses of glucagon produced similar effects: higher mean plasma glucose and insulin levels during the transfusion, but no significant change in plasma growth hormone levels. Transfusion with glucagonenriched blood had no effect on the net balance of glucose or growth hormone, but caused a negative insulin balance twice as big as that occurring in the control group.At the end of the control transfusions the mean plasma glucagon was 248 pg/ml and this did not change significantly in the next 60 minutes. When 10 or 50 Xug glucagon was added to the donor blood the end-transfusion mean plasma glucagon concentrations were 1302 and 3975 pg/ml, respectively. Glucagon disappeared rapidly from plasma for 5 to 10 minutes and then more slowly at the rate of 0 * 5 to 1 0 % per minute for the next 50 minutes. The range of glucose disappearance rates in the 60 minutes after transfusion (0 -40-2 13 %/min) was similar in all three groups, but the infants receiving glucagon-enriched blood had higher blood glucose levels for a given glucose disappearance rate. In each group there was a highly significant negative correlation between the 60-minute plasma glucose level and the glucose disappearance rate.

In mothers receiving hexose infusions at the time of delivery (14) the mean (±SE) plasma concentration of glucose was 99±7 mg/100 ml, insulin 32±6 ,uU/ml, glucagon 183±17 pg/ml. These levels were similar to those occurring in mothers who did not have an i.v. infusion, permitting pooling of the two groups for further analysis.The 't' test for paired data was used for statistical comparison of plasma concentrations of metabolite or hormones. The mean (±SE) difference between maternal and umbilical venous plasma glucose was 22 ±3 mg/100 ml, and between umbilical vein and artery 8 ±1 mg/100 ml. The mean (±SE) maternal venous plasma insulin level was 10 ±3 [U/ml higher than that in the umbilical

. (1972). Archives of Disease in Childhood, 47, 537. Effects of fetal exposure to diazoxide in man. Four infants were born to women treated with oral diazoxide for the last 19 to 69 days of pregnancy. Maternal plasma levels of diazoxide in the 5 days before delivery were related to the intake of the drug and varied between 11 and 43 ,ug/ml. At delivery the umbilical plasma diazoxide level was lower than that in the mother and was 6 5 to 25 stg/ml. At the age of 24 hours the plasma diazoxide level in the infants had not altered appreciably. Diazoxide was present in the amniotic fluid and was excreted in the urine in the first week of life. Urinary diazoxide excretion was greatest on days 2 and 3 and had fallen to low or undetectable levels by days 6 and 7.No effect of diazoxide was noted on the blood pressure or blood sugar levels of the infants in the first 24 hours. The glucose tolerance of 2 of the infants was normal at 24 hours, but that of the other 2, whose mothers had diabetes, was impaired. Each of the infants developed alopecia and one had hypertrichosis lanuginosa. Abnormal hair growth was first noted at the age of 1 week and persisted when the infants were last seen at the ages of 5 months to 1 year. The bone age of 3 was normal at a chronological age of 5 to 7 months but the fourth, when aged 1 year, had retarded ossification in the wrist. No abnormalities were detected in blood counts, immunoglobulin levels, or ocular development.Diazoxide is a hypotensive benzothiadiazine that also causes hyperglycaemia due, in part, to inhibition of insulin secretion. Though the drug is little used in the conventional treatment of hypertension because of its side effects, recent reports indicate that it may play a useful role in hypertensive nephropathy and malignant hypertension (Pohl and Thurston, 1971;Mroczek et al., 1971). Diazoxide has also been used, with good effect, in the treatment of hypoglycaemic syndromes in childhood (Drash et al., 1968).The present report concerns the outcome of 4 pregnancies in which women with severe preeclamptic toxaemia and hypertension were treated with oral diazoxide for periods ranging between 19 and 69 days up to the time of delivery. The successful treatment of the pregnant woman is the subject of a separate report (Pohl et al., 1972). As nothing was known of the placental permeability to the drug or of its metabolism by the fetus, careful study of the newborn infant was essential for the well-being of the baby and offered a chance to answer some of the simpler questions on the perinatal pharmacology of diazoxide.

Aplastic anemia is usually associated with hemorrhagic stroke. Here, we report a case of ischemic stroke secondary to aplastic anemia in a 28-year-old male who presented with sudden-onset right hemiplegia and aphasia when he was not on any immunosuppression for five months. His laboratory findings showed pancytopenia, and his peripheral blood smear showed no atypical cells. Magnetic resonance imaging of the brain with magnetic resonance angiography (MRA) of the neck and brain vessels revealed an infarct in the left cerebral hemisphere in the middle cerebral artery territory, and no significant stenosis or aneurysm was observed on MRA. The patient was managed conservatively and discharged in stable condition.

and Lund. Since neonatal gramnegative infections seem to incresse at the w e time as breastfeeding diminishes,the role of brewt milk in the newborns defence system nee& eralnation.We have studied the presence of antimicrobial factors in colostrmn and breast milk-specific(E.coli antibodies of the classes XgA,IgM and I@) and unBpecific(1ac-toperoxidase, lactoferrin and complement). l.Lactoperoxidase,uhich fa present in high concentration6 in cows aillc,was demonstrated only in low quantities in breast milk.This might be compeneated by the high concentrationa re found in the newborn's ealiva. 2 . Specific c.coli 0-antibodies of the I@-class were demonstrated irr -breast milk and were probably of local production since they were not present in the serum of the mother.In contrast IgG-and Ign-E.co1i antibodies were present in lower concentrations in breast milk than In serum.The IgA-antibodies paas along the GI-tmct end appear in faeces with retained agglutinating capacity.3.Tbe relation between the maternal and infantile E.coli strains is studied. Whether or not the specific E.coli antibodies in breast milk influence the selection of the E.coii strains colonizing the infant's bowel is under investigation. 1 n c r e a s i n g l y . t h e b u t t e r f a t o f i n f a n t m i l k f o r m u l a e i s b e i n g r e p l a c e d by m i x t u r e s o f v e g e t a b l e o i l s . I n t h i s r e p o r t t h e a b s o r p t i o n o f l i p i d s and c a l c i u m has been d e t e r m i n e d i n s i x l o w b i r t h w e i g h t i n f a n t s f e d 3 e x p e r i m e n t a l f i l l e d -m i l k f o r m u l a e d i f f e r i n g o n l y i n t h e i r t o t a l f a t c o n t e n t . d t o t h e f a t -c o n t e n t o f each m i l k and t o t h e c o m p o s i t i o n o f t h e c o n s t i t u e n t 1 i p i d s . A marked i nv e r s e r e l a t i o n s h i p b e t w e e n a b s o r p t i o n and c h a i n l e n g t h o f s a t u r a t e d f a t t y a c i d s i s d e s c r i b e d .A b s o r p t i o n o f a s i n g l e (C18) f a t t y a c i d i s r e l a t e d t o t h e d e g r e e o f u n s a t u r a t i o n . The f i n d i n g s a r e d i s c u s s e d i n r e l a t i o n t o t h e e l a b o r a t i o n o f new i n f a n t m i l k f o r m u l a e f o r l o w b i r t h w e i g h t i n f a n t s .E. H e i n z e . H. S c h a t z , C. N i e r l e , E.F. P f e i f f e r , Oepts. o f P e d ia t r i c s and I n t e r n a l M e d i c i n e . U n i v . o f Ulm, 79 Ulm/ Oonau . Germany I n a d u l t r a t i s l e t s o f Langerhans g l u c o s e i s an i m p o r t a n t s t i m u l u s f o r i n s u l i n b i o s y n t h e s i s and r el e a s e . I n c o n t r a s t f e t a l i s l e t s s e c r e t e o n l y s m a l l amounts o f i n s u l i n when c h a l l e n g e d a c u t e l y w i t h g l uc o s e w h i l e t h e b i o s y n t h e s i s has n o t been e v a l u a t e d , T h e r e f o r e t h e i n c o r p o r a t i o n o f H 3 -l e u c i n e i n t o p r oi n s u l i n and i n s u l i n was s t u d i e d i n E l -d a y o l d f e...