1214
lasting 38 weeks. Cytogenetic analysis was because the appearance of the infant suggested Turner’s syndrome. She was small for dates (birth-weight 2260g, head circumference 30.5 cm, length 43 cm). The following physical abnormalities were noted: neck webbing, low posterior hairline with excessive hair, antimongoloid slant to the eyes, wide nasal bridge, a single transverse left palmar crease, and overlapping of the fourth and fifth toes on both feet. A cardiac murmur was also audible. The physical and intellectual development of this infant will be followed with interest.
MEMBRANE FRAGMENTS WITH KOINOZYMIC PROPERTIES RELEASED FROM VILLOUS ADENOMA OF THE RECTUM
pregnancy
requested
Cytogenetics Unit, State Health Laboratories Perth, Western Australia. 158 High Street, Fremantle, Western Australia.
SIR,-We read with interest the letter from Dr Chandler and his colleagues (Nov. 8, p. 931) describing particles associated with microvillous border of pig intestinal mucosa and advancing the hypothesis that these could be fragments released from the brush border. Chandler’s pictures are similar to fig. 5a of Hollman and Staubli,’ who studied 93 cases of human rectal polyposis. We wish to report on the release of membrane fragments from the microvilli of a hypersecreting villous adenoma of the
MARIE T. MULCAHY J. B. STEVENS
ENCOURAGING BREAST-FEEDING
SIR,—Dr Coles and others report (Nov. 15, p. 978) that only 50% of mothers breast-feeding on discharge from hospital still doing so at two months. We have recently studied infant feeding patterns in a geographically identified area of London (South Camden), and over 95% of mothers with children under 5 years of age living in the area have been seen. The proportion of mothers who attempted to breast-feed and the proportion who were still breast-feeding at three weeks are shown in the accompanying table. 50% of our mothers had
were
MOTHERS WHO ATTEMPTED TO BREAST-FEED AND MOTHERS STILL BREAST-FEEDING AFTER THREE WEEKS, BY SOCIAL-CLASS DISTRIBUTION
12
3
Fig. 1—Enzymoetectrophoresis
4 in starch
5 gel.
+
=
6 anode, -
=
appti-
cation line.
Slot
isozymes observed in native secretion fluid of villous of secretion fluid, appearing with the void volume in Sepharose 4B. 3, A.P. isozymes of secretion fluid with Vo/Ve value of 0, 53 in Sepharose 4B. 4, serum-A.P. isozymes of patient with villous adenoma. 5, serum-A.P. of patient with focal cholestasis, showing liver and koinozymic type ofA.P. 6, serum-A.p. of patient with cirrhosis, showing liver and intestinal type of A.P. 1,
A.P.
adenoma. 2,
up breast-feeding by three weeks, and we wonder if the mothers whom Coles et al. report, having given up breast-feeding by two months had not already done so five weeks earlier. Our data also demonstrate very dramatic social-class differences. Precisely those babies whom one would most like to see being breast-fed are not breast-fed at the moment. We would be the first to applaud the appointment of "lactation nurses", but this is not enough. About half the mothers who fail to establish full lactation report things beginning to go wrong in hospital: despite the presence of "lactation staff", at hours when these are not present other, less experienced, staff give contradictory and confusing advice. A further group of mothers "fail" during their first two or three days at home, often before the community services are aware that the mother and baby have been discharged. We firmly believe that the best person to remedy this situation is the health visitor.’ We are now asking our health visitors to conduct the antenatal discussions about feeding, visit the mother in the obstetric unit, and have immediate contact with the mother when she is home. We stress to the mothers that breast-feeding is not necessarily fully established during their hospital stay (particularly in those babies whose mothers have obstetric medication during delivery), and reassure them that one competent friend (their health visitor) is available with help and advice throughout the whole period of lactation; we shall report the results of this approach.
A.P.
given
Thomas Coram Research Unit, 41 Brunswick Square, London WC1N 1AZ.
1. 2.
MARTIN C. O. BAX HILARY HART
Sloper, K., McKean, L., Baum, J. D. Archs Dis. Childh. 1975, 50, 165. Richards, M. P. M., Bernal, J. F. Findings of the Third International Congress on Psychosomatic Medicine in Obstetrics and Gynæcology. Basle (in the press).
Fig. 2-Koinozymic fraction collected on Millipore filter stained for A.P. pH 9.0 with &bgr;-glycerophosphate. Positive reaction evidenced by leadphosphate precipitate. at
- .Triple-layered membrane ofA.p.-positive vesicles. A.p.-non-reactive vesicle.
in a 74-year-old man. The fluid originating from this contained alkaline phosphatase (A.P.) with a particular isozyme pattern as revealed in starch gel (fig. 1) and in other media.
rectum
tumour
Of specific interest is the macromolecular component for some 65% of the total A.P. activity in this secretion. This component has the behaviour of the koinozymic fraction we described for human serum-A.P.2-4 In particular, this component appears with the void 1. Hollman, K. H., Staubli, W.J. Microsc. 1962, 1, 137. 2. de Broe, M. E., Wieme, R. J. Isozymes; p. 799. New York, 1975. 3. de Broe, M. E., Borgers, M., Wieme, R. J. Clin. chim. Acta, 1975, 4. Wieme, R. J., de Broe, M. E. Clin. Chem. 1975, 21, 1008.
59, 369.
lasting 38 weeks. Cytogenetic analysis was because the appearance of the infant suggested Turner’s syndrome. She was small for dates (birth-weight 2260g, head circumference 30.5 cm, length 43 cm). The following physical abnormalities were noted: neck webbing, low posterior hairline with excessive hair, antimongoloid slant to the eyes, wide nasal bridge, a single transverse left palmar crease, and overlapping of the fourth and fifth toes on both feet. A cardiac murmur was also audible. The physical and intellectual development of this infant will be followed with interest.
MEMBRANE FRAGMENTS WITH KOINOZYMIC PROPERTIES RELEASED FROM VILLOUS ADENOMA OF THE RECTUM
pregnancy
requested
Cytogenetics Unit, State Health Laboratories Perth, Western Australia. 158 High Street, Fremantle, Western Australia.
SIR,-We read with interest the letter from Dr Chandler and his colleagues (Nov. 8, p. 931) describing particles associated with microvillous border of pig intestinal mucosa and advancing the hypothesis that these could be fragments released from the brush border. Chandler’s pictures are similar to fig. 5a of Hollman and Staubli,’ who studied 93 cases of human rectal polyposis. We wish to report on the release of membrane fragments from the microvilli of a hypersecreting villous adenoma of the
MARIE T. MULCAHY J. B. STEVENS
ENCOURAGING BREAST-FEEDING
SIR,—Dr Coles and others report (Nov. 15, p. 978) that only 50% of mothers breast-feeding on discharge from hospital still doing so at two months. We have recently studied infant feeding patterns in a geographically identified area of London (South Camden), and over 95% of mothers with children under 5 years of age living in the area have been seen. The proportion of mothers who attempted to breast-feed and the proportion who were still breast-feeding at three weeks are shown in the accompanying table. 50% of our mothers had
were
MOTHERS WHO ATTEMPTED TO BREAST-FEED AND MOTHERS STILL BREAST-FEEDING AFTER THREE WEEKS, BY SOCIAL-CLASS DISTRIBUTION
12
3
Fig. 1—Enzymoetectrophoresis
4 in starch
5 gel.
+
=
6 anode, -
=
appti-
cation line.
Slot
isozymes observed in native secretion fluid of villous of secretion fluid, appearing with the void volume in Sepharose 4B. 3, A.P. isozymes of secretion fluid with Vo/Ve value of 0, 53 in Sepharose 4B. 4, serum-A.P. isozymes of patient with villous adenoma. 5, serum-A.P. of patient with focal cholestasis, showing liver and koinozymic type ofA.P. 6, serum-A.p. of patient with cirrhosis, showing liver and intestinal type of A.P. 1,
A.P.
adenoma. 2,
up breast-feeding by three weeks, and we wonder if the mothers whom Coles et al. report, having given up breast-feeding by two months had not already done so five weeks earlier. Our data also demonstrate very dramatic social-class differences. Precisely those babies whom one would most like to see being breast-fed are not breast-fed at the moment. We would be the first to applaud the appointment of "lactation nurses", but this is not enough. About half the mothers who fail to establish full lactation report things beginning to go wrong in hospital: despite the presence of "lactation staff", at hours when these are not present other, less experienced, staff give contradictory and confusing advice. A further group of mothers "fail" during their first two or three days at home, often before the community services are aware that the mother and baby have been discharged. We firmly believe that the best person to remedy this situation is the health visitor.’ We are now asking our health visitors to conduct the antenatal discussions about feeding, visit the mother in the obstetric unit, and have immediate contact with the mother when she is home. We stress to the mothers that breast-feeding is not necessarily fully established during their hospital stay (particularly in those babies whose mothers have obstetric medication during delivery), and reassure them that one competent friend (their health visitor) is available with help and advice throughout the whole period of lactation; we shall report the results of this approach.
A.P.
given
Thomas Coram Research Unit, 41 Brunswick Square, London WC1N 1AZ.
1. 2.
MARTIN C. O. BAX HILARY HART
Sloper, K., McKean, L., Baum, J. D. Archs Dis. Childh. 1975, 50, 165. Richards, M. P. M., Bernal, J. F. Findings of the Third International Congress on Psychosomatic Medicine in Obstetrics and Gynæcology. Basle (in the press).
Fig. 2-Koinozymic fraction collected on Millipore filter stained for A.P. pH 9.0 with &bgr;-glycerophosphate. Positive reaction evidenced by leadphosphate precipitate. at
- .Triple-layered membrane ofA.p.-positive vesicles. A.p.-non-reactive vesicle.
in a 74-year-old man. The fluid originating from this contained alkaline phosphatase (A.P.) with a particular isozyme pattern as revealed in starch gel (fig. 1) and in other media.
rectum
tumour
Of specific interest is the macromolecular component for some 65% of the total A.P. activity in this secretion. This component has the behaviour of the koinozymic fraction we described for human serum-A.P.2-4 In particular, this component appears with the void 1. Hollman, K. H., Staubli, W.J. Microsc. 1962, 1, 137. 2. de Broe, M. E., Wieme, R. J. Isozymes; p. 799. New York, 1975. 3. de Broe, M. E., Borgers, M., Wieme, R. J. Clin. chim. Acta, 1975, 4. Wieme, R. J., de Broe, M. E. Clin. Chem. 1975, 21, 1008.
59, 369.
