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FAT-SOLUBLE VITAMINS A, E AND K

HUGH R. BUTT, M.D.
[+] Author Affiliations

Rochester, Minn.

From the Division of Medicine, Mayo Clinic, Rochester.


JAMA. 1950;143(3):236-241. doi:10.1001/jama.1950.82910380003008
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VITAMIN A 

Chemistry.—  Vitamin A is a colorless, fat-soluble vitamin. Karrer and associates isolated it in 1931 and determined its structure, but effective syntheses of vitamin A were achieved by Milas1 and others only during the last five years.The vitamin is an alcohol and hence is not itself saponifiable. Evidence has been presented indicating that vitamin A occurs in more than one form. The form that predominates in the tissues of salt water fish and mammals has been designated as vitamin A1 and the form which predominates in the tissues of fresh water fishes as vitamin A2. Both forms appear to exert similar functions, although vitamin A1 is considerably more effective in mammals than vitamin A2. The international unit of vitamin A has been fixed as the activity of 0.6 micrograms of pure beta-carotene. This, dissolved in a vegetable oil at such concentration

REFERENCES

Milas, N. A.:  Synthesis of Biologically Active Vitamin A Substances , Science 103:581 ( (May 10) ) 1946;.
Hrubetz, M. C.; Deuel, H. J., Jr., and Hanley, B. J.:  Studies on Carotenoid Metabolism: V. The Effect of a High Vitamin A Intake on the Composition of Human Milk , J. Nutrition 29:245 ( (April) ) 1945;.
Clements, F. W.:  Manifestations of Nutritional Deficiency in Infants , in Harris, R. S., and Thimann, K. V.: Vitamins and Hormones: Advances in Research and Application , New York, Academic Press, Inc., 1946;, vol. 4, pp. 71-133
Guilbert, H. R.; Howell, C. E., and Hart, G. M.:  Minimum Vitamin A and Carotene Requirements of Mammalian Species , J. Nutrition 19:91 ( (Jan.) ) 1940;.
Booher, L. E.; Callison, E. C., and Hewston, E. M.:  Experimental Determination of Minimum Vitamin A Requirements of Normal Adults , J. Nutrition 17:317, 1939;.
Booher, L. E., and Callison, E. C.:  Minimum Vitamin A Requirements of Normal Adults: Utilization of Carotene as Affected by Certain Dietary Factors and Variations in Light Exposure , J. Nutrition 18:459, 1939;.
Recommended Dietary Allowances, Revised 1948, National Research Council, Food and Nutrition Board, no. 129, 1948.
Ingelfinger, F. J.; Moss, R. E., and Helm, J. D., Jr.:  The Effect of Atropine Upon the Absorption of Vitamin A , J. Clin. Investigation 22:699 ( (Sept.) ) 1943;.
Forbes, G. B.:  Chylothorax in Infancy: Observations on the Absorption of Vitamins A and D and on the Intravenous Replacement of Aspirated Chyle , J. Pediat. 25:191 ( (Sept.) ) 1944;.
Fox, H. J.:  Absorption of Unemulsified and Emulsified Vitamin A in Sprue , J. Lab. & Clin. Med. 34:1140 ( (Aug.) ) 1949;.
Darby, W. J.; Kaser, M. M., and Jones, E.:  Influence of Pteroylglutamic Acid (Member of Vitamin M Group) on Absorption and Storage in the Liver of the Rat , J. Nutrition 33:243 ( (Jan.) ) 1947;.
Weick, G., and Tsao, M.:  Comparison of Absorption in Normal Children and Children with Cystic Fibrosis of the Pancreas Using Oily and Water Soluble Preparations , Univ. Hosp. Bull., Ann Arbor 13:114 ( (Nov.) ) 1947;.
Danielson, W. H.; Palmer, H. D., and Binkley, E. L.:  Absorption of Different Forms of Vitamin A in Cystic Fibrosis of Pancreas , Rocky Mountain M. J. 44:626 ( (Aug.) ) 1947;.
Lemley, J. M.; Brown, R. A.; Bird, O. D., and Emmet, A. D.:  Absorption and Storage of Vitamin A in the Liver of the Rat , J. Nutrition 33:53 ( (Jan.) ) 1947;.
Rodahl, K.:  Toxicity of Polar Bear Liver , Nature 164:530 ( (Sept. 24) ) 1949;.
Toomey, J. A., and Morissette, R. A.:  Hypervitaminosis A , Am. J. Dis. Child. 73:473 ( (April) ) 1947;.
Josephs, H. W.:  Hypervitaminosis A and Carotenemia , Am. J. Dis. Child. 67:33 ( (Jan.) ) 1944;.
Rothman, P. A., and Leon, E. E.:  Hypervitaminosis A , Radiology 51:368 ( (Sept.) ) 1948;.
Wyatt, T. C.; Carabello, C. A., and Fletcher, M. E.: Hypervitaminosis A: Report of a Case, to be published.
Caffey, J.:  Poisoning Due to Excess Vitamin A: Its Relation to Infantile Cortical Hyperostosis , Am. J. Dis. Child. 79:404 ( (Feb.) ) 1950;.
Evans, H. M., and Burr, G. O.:  The Anti-Sterility Vitamin Fat Soluble E , Proc. Nat. Acad. Sc. 11:334, 1925;.
Mason, K. E.:  Distribution of Vitamin E in the Tissues of the Rat , J. Nutrition 23:71 ( (Jan.) ) 1942;.
Evans, H. M., and Burr, G. O.:  Development of Paralysis in the Suckling Young of Mothers Deprived of Vitamin E , J. Biol. Chem. 76:273 ( (Jan.) ) 1928;.
Hickman, K. C. D.; Harris, P. L., and Woodside, M. R.:  Interrelationship of Vitamins A and E , Nature 150:91 ( (July 18) ) 1942;.
Minot, A. S., and Frank, H. E.:  Serum Tocopherol: Its Relation to Failure of Vitamin E-Therapy for Pseudohypertrophic Muscular Dystrophy , Am. J. Dis. Child. 67:371 ( (May) ) 1944;.
Shank, R. E.; Gilder, H., and Hoagland, C. L.:  Studies of Diseases of Muscle. I. Progressive Muscular Dystrophy: Clinical Review of Forty Cases , Arch. Neurol. & Psychiat. 52:431 ( (Dec.) ) 1944;.
Pappenheimer, A. M.:  Muscular Disorders Associated with Deficiency of Vitamin E , Physiol. Rev. 23:37 ( (Jan.) ) 1943;.
Milhorat, A. F., and Bartels, W. E.:  The Defect in Utilization of Tocopherol in Progressive Muscular Dystrophy , Science 101:93 ( (Jan. 26) ) 1945;.
Dam, Henrik:  The Antihaemorrhagic Vitamin of the Chick: Occurrence and Chemical Nature , Nature 135:652 ( (April 27) ) 1935;.
Butt, H. R.; Snell, A. M., and Osterberg, A. E.:  The Use of Vitamin K and Bile in Treatment of the Hemorrhagic Diathesis in Cases of Jaundice , Proc. Staff Meet., Mayo Clin. 13:74 ( (Feb. 2) ) 1938;.
Warner, E. D.; Brinkhous, K. M., and Smith, H. P.:  Bleeding Tendency of Obstructive Jaundice: Prothrombin Deficiency and Dietary Factors , Proc. Soc. Exper. Biol. & Med. 37:628 ( (Jan.) ) 1938;.
Fieser, L. F.:  The Chemistry of Vitamin K , Ann. Int. Med. 15:648 ( (Oct.) ) 1941;.
Shemiakin, M. M.; Schukina, L. A., and Schvezov, J. B.:  Studies in the Vitamin K Group. II. The Mechanism of Biological Action of Vitamin K and of its Synthetic Analogs , J. Am. Chem. Soc. 65:2164 ( (Nov.) ) 1943;.

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Milas, N. A.:  Synthesis of Biologically Active Vitamin A Substances , Science 103:581 ( (May 10) ) 1946;.
Hrubetz, M. C.; Deuel, H. J., Jr., and Hanley, B. J.:  Studies on Carotenoid Metabolism: V. The Effect of a High Vitamin A Intake on the Composition of Human Milk , J. Nutrition 29:245 ( (April) ) 1945;.
Clements, F. W.:  Manifestations of Nutritional Deficiency in Infants , in Harris, R. S., and Thimann, K. V.: Vitamins and Hormones: Advances in Research and Application , New York, Academic Press, Inc., 1946;, vol. 4, pp. 71-133
Guilbert, H. R.; Howell, C. E., and Hart, G. M.:  Minimum Vitamin A and Carotene Requirements of Mammalian Species , J. Nutrition 19:91 ( (Jan.) ) 1940;.
Booher, L. E.; Callison, E. C., and Hewston, E. M.:  Experimental Determination of Minimum Vitamin A Requirements of Normal Adults , J. Nutrition 17:317, 1939;.
Booher, L. E., and Callison, E. C.:  Minimum Vitamin A Requirements of Normal Adults: Utilization of Carotene as Affected by Certain Dietary Factors and Variations in Light Exposure , J. Nutrition 18:459, 1939;.
Recommended Dietary Allowances, Revised 1948, National Research Council, Food and Nutrition Board, no. 129, 1948.
Ingelfinger, F. J.; Moss, R. E., and Helm, J. D., Jr.:  The Effect of Atropine Upon the Absorption of Vitamin A , J. Clin. Investigation 22:699 ( (Sept.) ) 1943;.
Forbes, G. B.:  Chylothorax in Infancy: Observations on the Absorption of Vitamins A and D and on the Intravenous Replacement of Aspirated Chyle , J. Pediat. 25:191 ( (Sept.) ) 1944;.
Fox, H. J.:  Absorption of Unemulsified and Emulsified Vitamin A in Sprue , J. Lab. & Clin. Med. 34:1140 ( (Aug.) ) 1949;.
Darby, W. J.; Kaser, M. M., and Jones, E.:  Influence of Pteroylglutamic Acid (Member of Vitamin M Group) on Absorption and Storage in the Liver of the Rat , J. Nutrition 33:243 ( (Jan.) ) 1947;.
Weick, G., and Tsao, M.:  Comparison of Absorption in Normal Children and Children with Cystic Fibrosis of the Pancreas Using Oily and Water Soluble Preparations , Univ. Hosp. Bull., Ann Arbor 13:114 ( (Nov.) ) 1947;.
Danielson, W. H.; Palmer, H. D., and Binkley, E. L.:  Absorption of Different Forms of Vitamin A in Cystic Fibrosis of Pancreas , Rocky Mountain M. J. 44:626 ( (Aug.) ) 1947;.
Lemley, J. M.; Brown, R. A.; Bird, O. D., and Emmet, A. D.:  Absorption and Storage of Vitamin A in the Liver of the Rat , J. Nutrition 33:53 ( (Jan.) ) 1947;.
Rodahl, K.:  Toxicity of Polar Bear Liver , Nature 164:530 ( (Sept. 24) ) 1949;.
Toomey, J. A., and Morissette, R. A.:  Hypervitaminosis A , Am. J. Dis. Child. 73:473 ( (April) ) 1947;.
Josephs, H. W.:  Hypervitaminosis A and Carotenemia , Am. J. Dis. Child. 67:33 ( (Jan.) ) 1944;.
Rothman, P. A., and Leon, E. E.:  Hypervitaminosis A , Radiology 51:368 ( (Sept.) ) 1948;.
Wyatt, T. C.; Carabello, C. A., and Fletcher, M. E.: Hypervitaminosis A: Report of a Case, to be published.
Caffey, J.:  Poisoning Due to Excess Vitamin A: Its Relation to Infantile Cortical Hyperostosis , Am. J. Dis. Child. 79:404 ( (Feb.) ) 1950;.
Evans, H. M., and Burr, G. O.:  The Anti-Sterility Vitamin Fat Soluble E , Proc. Nat. Acad. Sc. 11:334, 1925;.
Mason, K. E.:  Distribution of Vitamin E in the Tissues of the Rat , J. Nutrition 23:71 ( (Jan.) ) 1942;.
Evans, H. M., and Burr, G. O.:  Development of Paralysis in the Suckling Young of Mothers Deprived of Vitamin E , J. Biol. Chem. 76:273 ( (Jan.) ) 1928;.
Hickman, K. C. D.; Harris, P. L., and Woodside, M. R.:  Interrelationship of Vitamins A and E , Nature 150:91 ( (July 18) ) 1942;.
Minot, A. S., and Frank, H. E.:  Serum Tocopherol: Its Relation to Failure of Vitamin E-Therapy for Pseudohypertrophic Muscular Dystrophy , Am. J. Dis. Child. 67:371 ( (May) ) 1944;.
Shank, R. E.; Gilder, H., and Hoagland, C. L.:  Studies of Diseases of Muscle. I. Progressive Muscular Dystrophy: Clinical Review of Forty Cases , Arch. Neurol. & Psychiat. 52:431 ( (Dec.) ) 1944;.
Pappenheimer, A. M.:  Muscular Disorders Associated with Deficiency of Vitamin E , Physiol. Rev. 23:37 ( (Jan.) ) 1943;.
Milhorat, A. F., and Bartels, W. E.:  The Defect in Utilization of Tocopherol in Progressive Muscular Dystrophy , Science 101:93 ( (Jan. 26) ) 1945;.
Dam, Henrik:  The Antihaemorrhagic Vitamin of the Chick: Occurrence and Chemical Nature , Nature 135:652 ( (April 27) ) 1935;.
Butt, H. R.; Snell, A. M., and Osterberg, A. E.:  The Use of Vitamin K and Bile in Treatment of the Hemorrhagic Diathesis in Cases of Jaundice , Proc. Staff Meet., Mayo Clin. 13:74 ( (Feb. 2) ) 1938;.
Warner, E. D.; Brinkhous, K. M., and Smith, H. P.:  Bleeding Tendency of Obstructive Jaundice: Prothrombin Deficiency and Dietary Factors , Proc. Soc. Exper. Biol. & Med. 37:628 ( (Jan.) ) 1938;.
Fieser, L. F.:  The Chemistry of Vitamin K , Ann. Int. Med. 15:648 ( (Oct.) ) 1941;.
Shemiakin, M. M.; Schukina, L. A., and Schvezov, J. B.:  Studies in the Vitamin K Group. II. The Mechanism of Biological Action of Vitamin K and of its Synthetic Analogs , J. Am. Chem. Soc. 65:2164 ( (Nov.) ) 1943;.
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