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Biomedical subjects

G G Graham

Publications and source records attributed to G G Graham.

At least 145 records · Page 8Linked to original sources
PubMed1978

Fasting plasma free amino acids of infants and children consuming cow milk proteins.

We have analyzed the fasting plasma aminograms of 165 infants and small children. Mean age was 17 months (range, 3-42 months). The majority had been consuming a diet in which all protein was supplied by calcium caseinate, the remainder a modified cow milk formula. Protein provided less than 6.4% of energy for 8 children, 6.4%-7% of energy for 81 children, 8% of energy for 42 children and greater than 8% of energy for 34. Only the values for the concentrations of total essential amino acids, valine, and taurine at less than 6.4% of energy as protein were significantly lower than corresponding values at higher intakes of protein. Analysis of the remainder of the data revealed no significant differences in either absolute concentrations or molar fractions among differing levels or sources of protein intake. Interindividual variation in concentrations of amino acids was greater than that resulting from changes in the level of intake of high quality protein when 6.4% or more of energy was provided as protein.

Amino Acids↗
PubMed1977

Multiple drug interactions with phenytoin.

A 49-year-old female with chronic alcoholism and epilepsy, treated with phenytoin, began to convulse when treatment with disulfiram (an inhibitor of phenytoin metabolism) was discontinued. The patient at this stage was resistant to the large doses of phenytoin, apparently owing to induction of the metabolism of this drug by chronic alcohol intake. Later, a small (30%) increase in dose resulted in about a tenfold increase in plasma concentration of phenytoin and severe toxicity. The final dose of phenytoin required to maintain the plasma level within the therapeutic range suggested that the enzyme induction had decreased. The value of monitoring plasma concentrations of phenytoin is emphasized.

Alcoholism↗
PubMed1977

Wheat-based diets: effect of short-term consumption on serum cholesterol and triglyceride levels in infants.

The effect of consumption of wheat-based diets on serum cholesterol and triglyceride levels was studied in eight previously malnourished children. While consuming a control diet of casein, soy-cottonseed oil blend, and a mixture of sucrose and starch, the serum cholesterol level was 169 +/- 42 mg/dl (mean +/- SD). This decreased significantly (P less than .001) to 108 +/- 30 mg/dl after nine days' consumption of an isoenergetic-isonitrogenous diet in which whole wheat or white flour provided all the protein and +/- 50% of carbohydrate, and remained at this level for the 27-day dietary period. On changing again to the casein-based diet, the serum cholesterol level rose within nine days to 154 +/- 42 mg/dl. There was no similar diet-related change in serum triglyceride values. None of the known mechanisms whereby diet affects serum cholesterol adequately explains these findings.

Body Weight↗
PubMed1977

Patterns of plasma concentrations and urinary excretion of salicylate in rheumatoid arthritis.

Intersubject differences in the volume of distribution, whole body clearance, and steady-state plasma concentrations of salicylic acid (SA) were studied in a series of patients with rheumatoid arthritis and healthy control subjects. The measurement of the plasma concentration of SA 12 hr after an oral dose of 1.2 gm aspirin appears predictive of the success of long-term dosage of aspirin. Concentrations below 5 microgram/ml in this single-dose test were associated with failure to achieve therapeutic plasma concentrations of SA (above 150 microgram/ml during long-term therapy with approximately 4.8 gm aspirin per day. Conversely, plasma concentrations above 10 microgram/ml in the single-dose test were associated with levels above 150 microgram/ml during long-term therapy. The volume of distribution of SA correlated poorly with body weight (r = 0.51, p less than 0.01) and did not correlate significantly with plasma albumin levels. Corticosteroids appear to induce the metabolism of SA and most subjects dosed with oral corticosteroids and aspirin 4.8 gm/day did not attain plasma levels of SA above 150 microgram/ml. The clearance of SA was greater in male than in female patients. The difference appears to be of clinical significance since fewer men than women achieved therapeutic plasma concentrations of SA.

Adolescent↗
PubMed1977

Symptomatic nonparasitic liver cysts.

Based on our experience with four cases of liver cysts and review of the literature, the following conclusions are reached: (1) Diagnosis can be established with routine and special radiologic studies. (2) Laparotomy is indicated for patients with symptoms or uncertain diagnosis. (3) Surgical management should be guided by cyst size, location, and content. (4) Definitive surgical treatment is indicated only for cysts larger than 10 cm.

Aged↗
PubMed1977

The effects of enteric coating of aspirin tablets on occult gastrointestinal blood loss.

The effect of enteric coating of aspirin tablets on the gastrointestinal blood loss associated with high dose aspirin therapy was investigated in 12 patients with rheumatoid arthritis. Occult blood loss was measured after labelling the patients' red blood cells with Cr51. Three salicylate preparations were used: enteric coated tablets of aspirin ("Rhusal", G.P. Laboratories, 7 x 650 mg per day), uncoated tablet cores of aspirin from the same batch (7 x 650 mg per day) and enteric coated tablets of sodium salicylate (7 x 600 mg and 1 x 300 mg per day). Daily blood loss during a salicylate-free period was (0.7 +/- 0.15 ml, mean +/- SE). Blood loss was significantly increased during dosage with all three salicylate preparations. Daily blood loss during dosage with the uncoated tablets of aspirin (5.3 +/- 0.3 ml) was significantly greater than during dosage with the enteric coated tablets of aspirin (2.3 +/- 0.3 ml) and enteric coated tablets of sodium salicylate (2.1 +/- 0.4 ml). The bioavailability of the salicylate preparations was studied in seven of the 12 patients. Mean plasma salicylate concentration two hours after the second daily dose during dosage with the enteric coated tablets of aspirin was 118 +/- 15 microgram/ml compared to 131 +/- 16 microgram/ml during dosage with the uncoated tablets. Urinary recoveries of the daily dosage of aspirin in the two formulations were also similar.

Aged↗
PubMed1977

Effect of the level of dietary protein intake on fat absorption in children.

The quantity and quality of protein in the diet affect both nitrogen balance and energy utilization in man. One possible mechanism is by a direct effect on the process of fat digestion and absorption. The effect on fat absorption of feeding diets providing 0%, 6.4%, or 12.5% of energy as protein was assessed in nine children. Liquid diets were prepared by high speed blending of calcium caseinate, a soy-cottonsed oil blend (80:20), sucrose, water, vitamins, and a mineral mixture and fed by bottle five times per day. Diets varied in the amount of protein and were fed to maintain constant the intakes of fat and carbohydrate. All children began by consuming the diet providing 6.4% of energy as protein for a period of 6 days: 3 days of adaptation, 3-day dietary periods and metabolic collections followed in one of two sequences: 12.5%, 0%, 6.4% energy as protein in five children; 0%, 12.5%, 6.4% energy as protein in four. Mean fat excretion during the two 6.4% periods did not differ significantly (initial 14.5 +/- 6% of intake; final, 11.7 +/- 5.0% of intake). Fat excretion was significantly greater during the period when no protein was consumed (23.9 +/- 7.7% of intake) than during either the period in which protein provided 6.4% of energy (P less than 0.01) or during that in which protein provided 12.5% of energy (10.0 +/- 2.6% of intake, P less than 0.001). The difference between the 6.4% and 12.5% periods did not attain significance (P = 0.10). Fecal fat expressed as a percentage of fecal dry weight was significantly greater during periods when the diet contained no protein than during periods in which protein provided either 6.4% (P less than 0.05) or 12.5% (P less than 0.01) of energy. Additional studies were carried out in a similar fashion in six children consuming diets in which protein provided 5%, 9.6%, and 15% of energy. All six possible dietary sequences were used. At these intakes fat excretion did not vary significantly with protein intake.

Dietary Proteins↗
PubMed1976

Growth of previously well-nourished infants in poor homes.

Twenty-six infants from very poor families were assured adequate diets in protected environments to average age 17.6 months. Ten female infants' mean length reached the tenth percentile and sixteen males' the 25th; female infants' mean weight nearly reached the 50th and males', the 75th. "Norms" in similar environments are near the third percentile for length and the tenth for weight, from infancy through childhood. Six months after returning to original homes there was no further growth in length or head circumference and a mean weight loss of 800 gm, thus declining to environmental norms. Growth followed these patterns until 4 to 8 years of age. Head circumference paralleled linear growth. In very poor environments, nearly maximal growth during the first two years of life apparently does not protect against the characteristic stunting, which may represent an appropriate adaptation.

Body Weight↗
PubMed1976

Growth and nitrogen retention of children consuming all of the day's protein intake in one meal.

To ascertain that linear growth and weight gain continue while consuming a diet in which all the day's protein is given in one meal, six children (ages: 8.5 to 25 months, weight: 6 to 8 kg) who were convalescing from malnutrition were placed on such a diet for 60 to 67 days. All diets provided 125 to 150 kcal and 2.0 to 2.5 g protein/kg/day, recalculated weekly. Energy was evenly divided among five feedings but the entire day's protein was given at the third meal. Increases in height age relative to increases in chronological age were appropriate for the stage of recovery. Height quotient (height age/chronological age times 100) increased during the study in four children and remained constant in two. Increases in weight age were greater than corresponding increases in chronological age. Nine-day control periods prior to and after the growth study allowed comparative N balances, which confirmed previous findings that apparent N retention from the unevenly distributed protein (32 +/- 10% of intake) was less, although not significantly so, than that from the control diet (34 +/- 15% of intake). Fecal facts were elevated during the study period (18 +/- 7.5% of intake) relative to the control period values (9 +/- 3.9% of intake) in all but one child.

Body Height↗
PubMed1976

Evaluation of isoosmotic tube feeding formula in the diets of convalescent malnourished infants and children.

The quality of the protein in a complete tube feeding formula intended for use in adults was evaluated in convalescent malnourished children. The casein-soy protein isolate blend was found to be similar to casein by comparative nitrogen balance studies carried out in five children, with protein providing 6.4% of calories. Three- and four-hour postprandial plasma free amino acid determinations at the same level of protein intake did not show the drop of plasma free methionine or of the methionine/total essential amino acid molar fraction characteristically seen when this amino acid is first limiting for protein synthesis. Three additional children were fed the formula, altered only by the addition of water, for periods of up to 3.6 months to test the tolerance to and completeness of the diet. No untoward effects nor signs of specific nutrient deficiency were encountered. Linear growth was appropriate for the stage of recuperation. The failure to achieve a normal (greater than 3.8 g/dl) serum albumin concentration in two of the three children may have been due to their rapid weight gain. Although it is intended for the adult, our results indicate that the formula could meet the nutritional requirements of infants and children.

Amino Acids↗
PubMed1976

Postprandial glucose, insulin, free fatty acid and growth hormone responses in children consuming all the day's protein in one meal.

BLOOD GLUCOSE, INSULIN (IRI), growth hormone, and plasma free fatty acids (FFA) were determined in six children consuming a diet of uneven distribution of protein relative to energy (study period). Preprandial and postprandial samples surrounding the 8 AM protein-free feeding and the 3 PM feeding containing all the day's protein were compared with values obtained in the same children similarly sampled while consuming an isonitrogenous isoenergetic diet of even protein distribution (control period). After the 8 AM feeding during the study period there was a mean maximal rise of blood glucose at 30 min of 51 mg/dl compared with a rise of 16 mg/dl during the control period. Glucose remained significantly elevated above fasting values at 120 min during the study but not the control period. IRI response after the 8 AM feeding was significantly greater and suppression of FFA was more marked during the study than during the control period. Glucose concentration 30 min after the 3 PM feeding was significantly lower during the study period than during the control period. A peak value occurred at 60 min during the study period which was equal to the 30 min peak control value. Despite the slower elevation of blood glucose during the study period, IRI rose at 30 min, possibly related to a larger influx of amino acids from the protein-containing meal. FFA rose at 30 and 60 min and were then suppressed by the slowly rising blood glucose. Growth hormone after both meals while consuming both diets was variable but considered normal. The qualitative changes in glucose-IRI-FFA responses were for the most part attributable to differences in the test meals and suggested little long-term adaptation to the uneven protein distribution diet.

Adaptation, Physiological↗
PubMed1976

Plasma amino acids of infants consuming soybean proteins with and without added methionine.

Fasting plasma free amino acids were determined in 54 convalescent malnourished infants: seven infants while consuming a diet based on isolated soybean protein, containing 4.0% to 5.3% of dietary metabolizable energy (calories) as protein (A), 20 at 6.4% to 6.7% protein calories (B), 23 at 6.4% to 6.7% protein calories with added DL-methionine (C), and four with 8.0% to 12.3% protein calories (D). There were no differences in total amino acid concentration (TAA) among the four groups; the molar fraction of essential amino acids (EAA:TAA) was lower for group A; there were no differences among the four groups in Lys:EAA or 1/2 cystine:EAA ratios or in Met concentration. Met:EAA was higher in C than B, with considerable overlap of individual values. In 10 of 13 infants who were represented in both B and C, Met concentration and Met:EAA ratio were higher in group C. Fasting plasma AA levels are not consistently reliable for field or clinical assessment of dietary Met adequacy. Fasting and postprandial (3- and 4-hour) plasma AA were determined in 29 infants: in 12 the preceding diet and the test meal were both Met-deficient with less than 6.7% protein calories (E), in five the preceding diet was milk-based but the test meal was Met-deficient at less than 6.7% (F), in five the preceding diet and test meal were based on isolated soybean protein at less than 6.7% with DL-Met added (G), and in seven the test meal was soy-based with greater than 9.0% protein calories (H). Plasma Met concentration and Met:EAA fell significantly at 3 and 4 hours in groups E and F, but not in groups G and H, suggesting that a postprandial fall in Met:EAA ratio can be used to identify dietary Met deficiency in field situations.

Amino Acids↗
PubMed1976

Evaluation of an enteric coated aspirin preparation.

The bioavailability and gastrointestinal site of release of enteric coated aspirin tablets ("Rhusal", G.P. Laboratories) were investigated following dosage with single tablets. A delay of one to more than eight hours was observed between dosage and the appearance of salicylate in plasma or saliva. This delay was decreased by pretreatment with metoclopramide. No aspirin or salicylate was detected in gastric aspirates. The mean urinary recovery of salicylate was equivalent to 92% of the administered dose. All these tests were consistent with the designed function of the enteric coating. The time course of concentrations of salicylate in saliva rather than in plasma was confirmed as a useful technique for the evaluation of different formulations of aspirin. The acceleration of gastric emptying by metoclopramide is a useful technique for the evaluation of enteric coated tablets.

Adult↗
PubMed1976

Metabolic and hormonal responses to a protein-glucose meal in normal infants and in marasmus and marasmic kwashiorkor.

Blood sugar and plasma free fatty acids (FFA), immunoreactive insulin (IRI), and growth hormone (GH) responses to a protein-glucose meal were determined in normal infants and those with marasmus and marasmic kwashiorkor. Among the normal subjects, fasting blood sugar (BS), peak BS and IRI, and the IRI/BS ratio tended to decrease as age increased. Peak IRI was at least 13muU/ml above fasting in 21 of 24 infants. Fasting GH levels were high 38.5 +/- 13.6 (SD) and 26.3 +/- 14.0 ng/ml, in the two youngest groups (under 1 year) and were comparable with those of the late newborn period. They were slightly lower, 20.8 +/- 22.1, in those 12.5-18.5 months of age. Suppressions of FFA and subsequent rebounds were in close temporal relation to BS and IRI peaks and lows, but not the GH levels. GH was promptly suppressed by the meal, and in most infants secondary elevations were seen. Untreated marasmic infants had normal or low BS, correspondingly normal or low IRI, markedly elevated FFA (1,821 +/- 588 muEq/liter), and GH levels comparable with those of the control subjects. There was some delay in BS elevation and disappearance and poor insulin release after the meal, with only two of nine having elevations of at least 13 muU /ml The BS elevations and IRI responses, however, were adequate to block FFA release. GH levels were poorly suppressed by the meal but some infants had further elevations, possibly in response to protein. After partial rehabilitation, fasting BS and FFA and BS elevations after the meal were normal. A slight improvement in insulin release was apparent. Fasting GH levels and responses to the meal were normal. Fasting, minimally treated children with marasmic kwashiorkor (MK) had normal or low BS, normal or low IRI, normal FFA, and probably normal GH levels. There was considerable delay in BS elevation, moderately delayed glucose disappearance, and very poor or unmeasurable insulin release after the test meal; FFA and GH were poorly suppressed. After partial rehabilitation, fasting BS was normal, FFA levels were (630 +/- 163 muEq/l), IRI was still low, BS elevations and disappearance improved. IRI responses modestly improved, and GH responses were normal.

Age Factors↗