The excretion of collagen cross-links in malnourished children and their subsequent recovery - abstract

Pyridinoline (PYD) and deoxypridinoline (DYP) molecules cross-link the collagen in bone and cartilage. They are neither re-used in the body nor found in the collagen of any other organ. We have measured the urinary excretion rate of these cross-links in 46 severely malnourished boys to assess their skeletal turnover and to relate the output to the subsequent rate of growth in height. The children were 12 +/- 6mo, -3.6 +/- 1.6 SD units height-for-age and -2.4 +/- 0.9 SD units weight for height. Their excretion when malnourished and after recovery was 11.4 +/- 5.3 (mal, X +/- DS) and 32.3 +/- 10.8 (rec) of PYD and, 2.7 +/- 1.5 (mal) and 7.5 +/- 3.0 (rec) of DYP (all nmol .h-1 .m-ý). This indicates that skeletal turnover is much less in the malnourished than the recovered child. Comparison with Italian control data indicates that there is depressed skeletal metabolism in malnutrition. There was a significant relationship between the cross-link excretion, age and weight-for-height and the rate of height gain in the subsequent month by multiple regression analysis. These three factors - age, degree of wasting amd skeletal turnover accounted for 44 percent of the variance in the subsequent height velocity of the children. It may be possible to use PYD and DYP to assess therapeutic intervention designed to alleviate stunting(AU)

Fibroxanthomatous pseudotumour of the lung

The clinical, radiological and pathological features of fibroxanthomatous pseudotumour of the lung in a 17-year-old Jamaican female Negro are described. The patient was symptom-free 4 years after treatment by conservative surgery. The condition is extremely rare. Its aetiology and pathogenesis are discussed. (Summary)

Management of chronic leg ulceration in Jamaica: a new method

A report of eight patients with chronic leg ulcers, treated by the use of a "collagen implant" is presented. These cases included 5 patients with sickle cell disease. Patients of good nutritional status and with haemoglobin levels of 10 gms or more, responded well to treatment. The value of the method is the saving of patient and professional time. The method warrants further trial (AU)

The microanatomy of the alveolar duct system

Observations made on wet and dry slices of inflated human lungs taken at necropsy have been used to give a more complete account of the alveolar duct system, the basic respiratory structure. This includes consideration of the central spiral alveolar duct fibre, which is thought to consist of elastic and collagen, the spiral arrangement of alveoli and the special nature of the terminal alveolus, the interdigitation of alveoli from adjacent alveolar ducts and the arrangement of pulmonary arterioles. This suggests that the alveolar duct system is specifically designed so that changes in volume are not accompanied by changes in alveolar surface area.(AU)

Chemical composition of organs of children who died from malnutrition

Chemical analysis was carried out on samples of brain, liver, skeletal muscle, heart and kidney obtained from children who died of malnutrition. Total body potassium was measured before autopsy by the 'whole body counting' technique. There was a marked increase in liver fat, and the brain contributed a higher percentage of the body-weight in the more severely malnourished children. All the organs had approximately the same concentrations of non-collagen nitrogen. The proportion of collagen was highest in muscle. All organs were depleted of potassium, but the muscle was most severely affected. Brain potassium as a percentage of total body potassium was higher than normal in the most severely potassium depleted children. Measurements of tissue magnesium showed that there was no difference in magnesium content of tissue when expressed in terms of non-collagen nitrogen. When compared with normal values, muscle was magnesium depleted. The potassium to magnesium ratio was lowest in muscle. (AU)

Chemical composition of the whole body and individual tissues of two Jamaican children whose death resulted primarily from malnutrition

A post-mortem chemical analysis has been made of two children who died primarily of malnutrition. The absolute amounts of fat, collagen and non-collagen protein, water, sodium, and potassium found in the whole body and particular organs have been compared with the expected amounts in a normal child of the same height. The results show that the malnourished child is overhydrated with respect to body solids, has lost proportionately more non-collagen protein than collagen protein and may be specifically potassium deficient with respect to nitrogen. (Summary)

Total body protein, collagen and non-collagen protein in infantile protein malnutrition

The absolute amounts of total protein, collagen and non-collagen protein were determined in the whole bodies of ten children, aged 6-16 months. Six children died of severe protein malnutrition and four were clinically well-nourished at the time of death. In the malnourished children there was severe depletion of total protein and non-collagen protein, while collagen protein was little affected. The results show that the amount of total protein is an unreliable guide to the extent of protein depletion and suggest that catabolism of collagen is greatly reduced in severe protein malnutrition.(AU)

Hydroxyproline and creatinine excretion in infantile protein malnutrition

Total urinary hydroxyproline and urinary creatinine were measured in ten malnourished male infants shortly after admission to hospital and at intervals until they had fully recovered. Urinary hydroxyproline excretion was initially low and later rose to levels higher than reported for normal controls. This high level of hydroxyproline excretion was maintained for severalweeks. The pattern of urinary creatinine was similiar to that of urinary hydroxypoline. It is suggested that the rate of catabolism of collagen is greatly reduced in the malnourished infant (Summary)