Plasma ammonia levels in preterm infants receiving parenteral nutrition with crystalline L-amino acids.
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Biomedical subjects
Publications and source records attributed to M Shohat.
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In an attempt to better define the changes affecting the temporal bone that might predispose achondroplastic dwarfs to otitis media, nine achondroplastic subjects who were evaluated for hearing loss underwent high-resolution CT scanning of the temporal bone. Comparisons were made with 10 nonachondroplastic subjects. A number of morphologic changes were seen, including (1) poor development of mastoid air cells, (2) foreshortening of the carotid canals, (3) narrowing of the skull base, (4) "towering" petrous ridges, and (5) relative "rotation" of the cochlea and other temporal bone structures. The most significant change was the rotational effect, which was more pronounced medially, resulting in an abnormal orientation of inner ear structures relative to middle ear structures and of middle ear structures relative to the external auditory canal. There was a notable lack of evidence for otitis media or its sequelae in any of the achondroplastic subjects. Audiograms were obtained in six of the nine achondroplastic subjects (two adults and four children). There was evidence of mixed hearing loss in the four children, but only of sensorineural hearing loss in the adults. We believe that the persistent hearing loss in achondroplasia is not due to sequelae of otitis media as some authors have suggested. Intrinsic vestibulocochlear changes below the limits of resolution of high-resolution CT scanning may be responsible.
We studied 25 infants aged less than 9 months who were diagnosed as having nonpolio enteroviral meningitis (EM) confirmed by virus isolation from cerebrospinal fluid (CSF). CSF protein, glucose and cellular content in these infants was compared with that of 125 age-matched febrile infants without cerebromeningeal illness. In order to control for changes occurring in the CSF during the first 2 months of life, the studied infants and the control subjects were stratified into 2-week age-groups and were compared. All but three of the infants with EM had increased CSF leukocyte count, and 10 infants showed domination of the polymorphonuclear leukocytes in the CSF. Only two had increased CSF protein levels, and low CSF/blood glucose ratios were found in all but two cases. None of the infants with EM had increased values of CSF protein concomitant with decreased CSF/blood glucose ratio. CSF in EM is characterized by increased white blood cell count in contrast with normal or near-normal CSF protein and glucose levels. In some infants, enterovirus isolation may be the only evidence of EM.