bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a Daily Dose of 25 μg Vitamin K1 to Prevent Vitamin K Deficiency in Breast‐Fed Infants
Authors: Cornelissen E. A. M. , Kollée L. A. A. , van Lith T. G. P. J. , Motohara K. , Monnens L. A. H.
Published: January 2024

Vitamin K prophylaxis is recommended to prevent the hazard of hemorrhage caused by vitamin K deficiency in young infants. A single administration after birth seems inadequate to completely prevent late haemorrhagic disease in breast‐fed infants. The preventive effect of a daily oral dose of 25 μug vitamin K1, which is comparable to about half the dose ingested by formula‐fed infants, was evaluated in 58 breast‐fed infants. No clinical or biochemical signs of vitamin K deficiency occurred; PIVKA‐II was not detectable, and vitamin K1 concentrations were moderately elevated. Vitamin K1 levels were negatively correlated with the number of hours elapsed since the most recent gift. Twenty to 28 h after the administration, median (P10‐P90) levels were 1,262 (267–4,328), 1,072 (293–3,427), and 882 (329–2,070) pg/ml at 4, 8, and 12 weeks of age, respectively. Vitamin K1 levels in formula‐fed infants (n = 10) were around 7,000 pg/ml. In conclusion, daily supplementation of 25 μg vitamin K1 can be recommended for breast‐fed infants to prevent vitamin K deficiency beyond the neonatal period.
Ranitidine Treatment in Newborn Infants
Authors: Fontana Massimo , Tornaghi Raffaella , Petrillo Maddalena , Lora Elisa , Porro Gabriele Bianchi , Principi Nicola
Published: January 2024

Data about the use of ranitidine in the early postnatal period are lacking. In this study, 30 term newborn infants <2 days old with bleeding erosions in their upper gastrointestinal tracts were treated with ranitidine by continuous i.v. infusion (0.2 mg/kg/h) for 48 h and thereafter by mouth (5 mg/kg b.i.d.) for 1 month. Mean gastric pH (SD) rose from 4.27 (1.62) to 5.70 (0.95) during i.v. infusion; after oral therapy it was still 5.55 (1.25). Serum ranitidine concentrations were 642.4 (376.5) and 321.5 (368.2) ng/ml after i.v. and oral therapy, respectively, with wide interindividual variations; the correlation between serum ranitidine and gastric pH was found to be weak. No untoward effect was observed either on the cardiorespiratory rate or on creatinine and aminotransferase values. Mean serum prolactin concentration after i.v. therapy was found to be lower, although within the reference range, than in control infants; no significant correlation was observed between serum ranitidine and prolactin concentrations. From these data, a <0.2 mg/kg/h rate seems to be advisable for continuous ranitidine infusion in neonates, whereas the 5 mg/kg b.i.d. regimen could be considered adequate for oral therapy.
The Pre‐ and Postnatal Development of Na+/K+‐ATPase in Gastrointestinal Organs of the Rat
Authors: Horváth Károly , Blochin Boris , Hill Ivor , Verma Rita , Lu Rong Bao , Lebenthal Emanuel
Published: January 2024

Developmental changes in Na+/K+‐ATPase enzyme activity have been documented postnatally in a number of organs, but little is known about prenatal levels or the factors affecting them. This study determined the normal developmental patterns of Na+/K+ ‐ATPase activity in the pancreas, liver, small intestine, kidneys, and colon of pre‐ and postnatal rats. In addition the effect of betamethasone administration on enzyme activity was determined both antenatally and postnatally. The individual organs showed a variable pattern of maturational change in enzyme activity. In the pancreas, changes in Na+/K+‐ATPase activity appeared to reflect the changing ratio of ductular to acinar cells. The pattern of enzyme activity in the small intestine was similar to that of the kidney and was inversely related to that of the colon. Enzyme induction by administration of betamethasone was also variable and bore no relationship to the DNA/protein ratio. In the preterm rat, betamethasone increased the Na+/K+‐ATPase activity only in the colon. Use of steroids to increase enzyme activity in the colon at an early stage of development may have therapeutic implications for treating abnormalities of potassium and sodium homeostasis in the preterm infant.
Chromium and Parenteral Nutrition in Children
Authors: Bougle D. , Bureau F. , Deschrevel G. , Hecquard C. , Neuville D. , Drosdowsky M. , Duhamel J. F.
Published: January 2024

Chromium (Cr) dosage was assayed in i.v. nutrition, serum, and losses of five children on total parenteral nutrition for 4 weeks. The Cr supply (4.7 ± 1.2 μUg/kg/day) was above recommended levels (0.5 μUg/kg/day). Serum (18.2 ± 1.8 μUg/L) and urine (37.4 ± 10.5 μUg/L) were also higher than control values (0.7–0.9 μUg/L and 0.2–0.8 μUg/L, respectively). Serum and urine Cr concentrations displayed a positive correlation. Serum Cr and Fc showed a negative correlation. These results confirm the potential toxicity of Cr previously reported in animals. Cr levels of i.v. nutrition solutes should be checked thoroughly.
Conversion of Cholesterol to Coprostanol by the Intestinal Microflora During the First Two Years of Human Life
Authors: Midtvedt Ann‐Christine , Midtvedt Tore
Published: January 2024

The establishment of the conversion of cholesterol to coprostanol by the intestinal microflora was followed in 25 healthy Swedish children by gas‐chromatographic analysis of fecal samples taken at 0, 1, 3, 6, 9, 12, 15, 18, 21, and 24 months of age. In 15 children, the microbial conversion of cholesterol to coprostanol started during the second half of the first year of life. During the second year of life, a sequestered distribution of the conversion rate could be distinguished. At the end of the study, 13 of the children were stable high converters, 3 were stable low converters, and 6 were unstable converters while the conversion pattern of three children could not be determined. The initiation of the establishment of conversion was delayed by breast‐feeding, and only one child had coprostanol in feces while still being breast‐fed. Those children exclusively breast‐fed for more than 4 months or weaned after 6 months of age had significantly lower conversion rates at 12 months of age than did the other children (p < 0.05). Once conversion started, previous breast‐feeding tended to result in a stable, later high rate of conversion of cholesterol. Between 6 and 15 months of age, the conversion rate increased with age, but after standardization for the period of exposure to foods other than breast milk, no age factor could be identified.
The Effect of Somatostatin on Small Intestinal Transport in Intractable Diarrhoea of Infancy
Authors: Bisset W. M. , Jenkins H. , Booth I. , Smith V. , Milla P. J.
Published: January 2024

It has been reported that somatostatin may be an effective antisecretory agent in a range of conditions causing severe secretory diarrhoea. In many children, intractable diarrhoeal illnesses result in significant morbidity and mortality. In a group of seven children with secretory diarrhoea, the effect of i.v. infusion of somatostatin (3.5 μg/kg statum plus 3.5 μg/kg/h) on the net mucosal flux of salt and water was assessed using an in vivo steady‐state perfusion technique. In one of the seven children who had evidence of deranged mucosal secretion and preserved villus function, somatostatin infusion resulted in a moderate reduction in secretion. In the remaining six, it had little or no beneficial effect. Somatostatin did not alter the rate of glucose absorption.
Absorption in the Isolated Bowel Segment
Authors: Murr Michel , Kimura Ken , Ellsbury Dan , Yoshino Hiroaki , Yamazato Masahito , Soper Robert
Published: January 2024

An isolated bowel segment (IBS) is a viable amesenteric segment of intestine. This study was undertaken to investigate the effects of mesenteric vascular and neural supply on intestinal absorption. Ten rats were used for leucine absorption and another 10 for glucose absorption experiments. L‐leucine, 12 ml of 15.0 mM/L, or 3.0 mM/L of D‐glucose solution were recirculated through the IBS (n = 5) and rat jejunum that underwent sham operation (n = 5) at 2.56 ml/min for 90 min. Absorption was expressed as millimoles of leucine or glucose per gram of mucosal protein. The Student's t test was used for statistical analysis; a p ≤ 0.05 was considered significant. The net absorption of L‐leucine was 36.20 ± 3.31 mM/g of mucosal protein in the IBS and 15.52 ± 1.48 mM/g of mucosal protein in the control group (p < 0.001). The net absorption of D‐glucose was 3.82 ± 0.26 mM/g of mucosal protein in the experimental group and 4.34 ± 0.31 mM/g of mucosal protein in the control group (p = 0.02). This study concludes that absorption of leucine and glucose in the IBS is preserved after mesenteric division.
Examination of Anti‐Neutrophil Cytoplasmic Antibodies in Childhood Inflammatory Bowel Disease
Authors: Proujansky Roy , Fawcett Paul T. , Gibney Kathleen M. , Treem William R. , Hyams Jeffrey S.
Published: January 2024

The detection of anti‐neutrophil cytoplasmic antibodies (ANCA), in a perinuclear fluorescence pattern, in the serum of adults with inflammatory bowel disease has recently been described to be sensitive and specific for a diagnosis of ulcerative colitis in comparison to Crohn's disease and other colitides. We have examined the sera of 41 children and adolescents with ulcerative colitis, 27 with Crohn's disease, and a control group for the presence of ANCA. Anti‐neutrophil cytoplasmic antibodies were detected in the serum of 27 of 41 patients with ulcerative colitis (66%), five of 27 with Crohn's disease (19%), and in none of our control subjects or patients with functional abdominal pain. Overall, the presence of ANCA was 66% sensitive and 84% specific for a diagnosis of ulcerative colitis when compared to Crohn's disease. There was no relationship between a positive ANCA value and disease activity or other clinical indicators. We conclude that evaluation for the presence of ANCA may be a useful adjunct for the clinical assessment of patients with inflammatory bowel disease. The presence of ANCA in children and adolescents, however, will not definitively distinguish between patients with ulcerative colitis and Crohn's disease.
Hepatitis B Virus in the Colostra of HBeAg‐Positive Carrier Mothers
Authors: Lin Ho‐Hsiung , Hsu Hong‐Yuan , Chang Mei‐Hwei , Chen Pei‐Jer , Chen Ding‐Shinn
Published: January 2024

To investigate the amount of hepatitis B virus (HBV) in colostra of hepatitis B e antigen (HBeAg)‐positive carrier mothers and the relationship of HBV amount between colostrum and maternal blood, 50 HBeAg‐positive carrier mothers were recruited and studied for hepatitis B surface antigen (HBsAg) titer, HBeAg titer, and HBV‐DNA concentration in their sera and colostra. According to the presence or absence of seral HBV‐DNA determined by dot hybridization, these 50 HBeAg‐positive carrier mothers could be divided into two groups: group 1 (n = 28, HBV‐DNA > 0.04 ng/ml), and group 2 (n = 22, HBV‐DNA ≥ 0.04 ng/ml). The colostral HBsAg and HBeAg liters were both significantly higher in group 2 than in group 1. In addition, both colostral HBsAg and HBeAg titers had positive correlation with each corresponding maternal blood. Although the colostral HBV‐DNA was undetectable by dot hybridization, all were positive by polymerase chain reaction with Southern blot hybridization. Because HBV‐DNA can be detected in all HBeAg‐positive carrier mother's milk, it reinforces the necessity of hepatitis B vaccination for the neonates born to these carrier mothers, particularly in countries with a high carrier rate.
Outpatient Percutaneous Liver Biopsy in Children
Authors: Gonzalez‐Vallina Ruben , Alonso Estella M. , Rand Elizabeth , Black Dennis D. , Whitington Peter F.
Published: January 2024

We reviewed data from 184 percutaneous liver biopsies performed as an outpatient procedure in 104 patients (5 weeks to 22 years of age) over a 4‐year period. Hepatic allograft rejection was the indication for 130 of the biopsy procedures, while 54 were performed for a variety of indications in patients who had not undergone transplant. Abnormalities of coagulation that necessitated correction were present in 19 patients at the time of biopsy. Patients tolerated the procedure well. There were no major complications. None of the patients required blood product transfusion or hospitalization as a result of the procedure. Two patients suffered respiratory depression as a complication of sedation, which was easily reversed with administration of intravenous naloxone. Two specimens were insufficient for interpretation. We conclude that percutaneous liver biopsy in the proper outpatient setting can reduce the need for hospitalization solely for the purpose of the procedure.
Longitudinal Assessment of Growth, Mineral Metabolism, and Bone Mass in Pediatric Crohn's Disease
Authors: Issenman Robert M. , Atkinson Stephanie A. , Radoja Christine , Fraher Laurence
Published: January 2024

In children with inflammatory bowel disease, controversy continues about the use of long‐term alternate day prednisone therapy (ADP) to suppress disease activity and to encourage appetite and growth. One possible side effect of both disease process and prednisone therapy is risk of development of osteoporosis. To evaluate this risk factor, growth, biochemical indices of mineral and vitamin D status, and bone mass were measured in nine adolescents with Crohn's disease (CD) who were treated with ADP (0.3 mg/kg >3 months per year) compared with eight adolescents treated with minimal ADP exposure (<3 months per year). Single photon densitometry was used to measure bone mineral mass at the 1/3 distal radius three times over 2 years. Mean age of the 17 CD boys was 13.9 ± 2.1 years at baseline. CD patients had lower bone BMC/BW mineral content/bone width (BMC/BW) compared with age‐ and height‐matched normal boys at all times. The difference was less when compared to height‐matched normal values as CD patients were shorter than healthy reference boys. Plasma 1,25‐dihydroxyvitamin D, alkaline phosphatase, and parathyroid hormone significantly increased with treatment of disease but there were no differences between treatment groups. CD patients treated with ADP had similar heights and weights at baseline and demonstrated similar linear growth over 2 years (9.1 cm/2 years) to CD patients without ADP (10.3 cm/2 years). In both groups, BMC/BW increased significiantly from year 1 to year 2, but absolute values for bone mass did not differ between the groups. These data suggest that over a 2‐year treatment period male CD patients with chronic low‐dose ADP exposure achieve linear growth rates and maintain bone mineralization at least as well as male CD patients who do not receive ADP.
Comparative In Vitro and In Vivo Studies of Enteric‐Coated Pancrelipase Preparations for Pancreatic Insufficiency
Authors: Thomson M. , Clague A. , Cleghorn G. J. , Shepherd R. W.
Published: January 2024

We evaluated three acid‐resistant pancreatic enzyme preparations by in vitro assays, and by comparing degree of steatorrhea, creatorrhea, fecal wet weight, and stool energy losses in a randomized crossover study of patients with pancreatic insufficient cystic fibrosis. Aims of the study were to assess (a) the most practicable and reliable indicator of malabsorption; (b) the variation in enzyme batch potency; (c) the decline in enzyme batch potency with prolonged shelf life; and (d) the relative bioefficacy of the different preparations. In the in vivo study, absorption of energy, nitrogen, and fat did not differ when comparing the three preparations at roughly pharmaceutically equivalent doses, but when expressed per capsule of pancreatic supplement ingested, absorption reflected relative enzyme content, favoring the higher potency preparations. Although steatorrhea was reasonably controlled by these preparations, stool energy losses varied from 800 to 1,100 kJ per day, suggesting greater attention be paid to overall energy absorption rather than absorption of individual nutrients. In addition, fecal energy loss correlated more closely with fecal wet weight (r = 0.81; p < 0.05) than with steatorrhea (r = 0.40; ns), such that 1 g wet feces = 8.37 kJ (± 0.14). In vitro enzyme potency varied markedly between batches of the same brand, and also a decline of up to 20% in amylase, lipase, and trypsin activity was noted over an 8‐month period for each batch. Both observations have clinical implications at times of represcription. Finally, the higher potency preparations were more effective per capsule and reduced capsule dosage is therefore attainable.
Hypercalciuria in Premature Infants Receiving High Mineral‐Containing Diets
Authors: Abrams Steven A. , Yergey Alfred L. , Schanler Richard J. , Vieira Nancy E. , Welch Thomas R.
Published: January 2024

We evaluated urinary calcium excretion in 21 premature infants fed either a formula containing high concentrations of calcium (Ca) and phosphorus (P) or human milk fortified with a commercially available human milk fortifier. Dual‐tracer stable‐isotope Ca absorption studies were performed on all infants. Urinary Ca excretion was not significantly related to Ca or P intake or true Ca absorption. The recovery of the orally administered tracer in the urine was used to evaluate the source of calciuria in study subjects. In almost all subjects, tissue‐derived (Fbu), rather than diet‐derived (Vou), Ca was the principal source of urinary Ca. Hypercalciuric subjects demonstrated greater Vbu and Vou than nonhypercalciuric subjects. Our data demonstrate that moderate hypercalciuria is common in premature infants whose diets are high in mineral content and that hypercalciuria is not related to inadequate mineral intake or Ca absorption but is related, instead, to losses of both tissue and dietary Ca.
Incidence and Duration of Breast‐Feeding of Ill Newborns
Authors: Hunkeler B. , Aebi C. , Minder Ch. E. , Bossi E.
Published: January 2024

The many biological advantages of breast milk call for promoting breast‐feeding. The extent to which separation of ill newborns from their mothers negatively influences breast‐feeding is not known. By means of a written inquiry, we investigated the prevalence of exclusive, partial, and no breast‐feeding of 536 newborns hospitalized at a tertiary care neonatal center with no inborn patients. Three hundred twenty‐seven questionnaires were completed correctly. Fifty percent of the mothers eventually succeeded in exclusive breast‐feeding, 25% in partial breast‐feeding, and 25% never breast‐fed. The frequency of breast‐feeding was similar to the Swiss average for the first 4 months of life in healthy newborns and declined more rapidly thereafter. Univariate and multivariate statistical analyses have shown that the following conditions influence breast‐feeding negatively: gestational age ≤33 weeks, maternal age >25 years, and lower professional status of the father. Additionally, multivariate analysis revealed a promoting effect of previous breast‐feeding. Exclusive breast‐feeding has eventually been possible in half of the newborns who had initially been separated from their mothers due to illness. Knowledge of the conditions influencing breast‐feeding in such populations should help to promote breast‐feeding more specifically in tertiary neonatal centers.
Childhood Celiac Disease in Estonia
Authors: Uibo Oivi
Published: January 2024

The incidence of celiac disease (CD) and the role of IgA‐class antigliadin antibody (AGA) determination in revealing new CD cases were studied in Estonia. Altogether 36 cases of CD in Estonian children were diagnosed from January 1976 through June 1992 by criteria recommended by the European Society for Paediatric Gastroenterology and Nutrition. A significant increase was observed in the incidence of CD in Estonia (from 1:25,130 live births during 1976–1989 to about 1:2,700 live births during 1990–1992), due mainly to the introduction of IgA‐class AGA determinations in an active search for celiac patients since 1990. A total of 29 IgA‐class AGA‐positive cases was revealed among 1,048 children screened, and 23 of them had CD. Thus, the results show a relatively low incidence of CD in Estonia compared to the figures in neighboring countries. However, the incidence will probably increase if a larger pediatric population can be screened for CD using IgA‐class AGA enzyme‐linked immunosorbent assay.
Helicobacter pylori Infection in Children with Antral Gastrin Cell Hyperfunction
Authors: Rindi Guido , Annibale Bruno , Bonamico Margherita , Corleto Vito , Fave Gianfranco Delle , Solcia Enrico
Published: January 2024

SummaryAntral gastrin cell hyperfunction (AGCH) is a rare syndrome characterized by persistent hypergastrinemia and important peptic symptoms in the absence of a gastrin‐producing tumor. The pathogenesis of AGCH is still unknown and debated. Helicobacter pylori (Hp) infection has been reported as a possible cause of sustained hypergastrinemia. To assess the relevance of Hp infection in pediatric AGCH patients, Hp status, G cell function, acid secretion, and antral G and D cell populations were investigated in six children presenting with gastrointestinal bleeding of unknown origin, sideropenic anemia, and variable abdominal symptoms. All patients had moderate high basal gastrinemia with abnormally increased peak values after meals and elevated values of basal acid output (BAO), maximal acid output (MAO), and pentagastrin‐stimulated acid output (PAO). Circulating pepsinogen I was also significantly increased. Three children had Hp infection, as assessed by enzyme‐linked immunosorbent assay, urease test, and histology. Endoscopy showed duodenal erosions in three children, with ulcer in two Hp‐positive cases. At histology, moderate gastritis was observed only in the three Hp‐positive cases. In all patients, quantitative assessment of antral gastrin and somatostatin cells gave significantly elevated G cell counts; D cells were at the lower reference limit and the G/D cell ratio was significantly elevated. These data indicated a diagnosis of AGCH, possibly due to the elevated G/D cell ratio, and suggest HP infection as an overlapping factor complicating the clinical picture in some cases.
In Vitro Toxicity of Purified Gluten Peptides Tested by Organ Culture
Authors: Fluge OSystein , Sletten Knut , Fluge Gjermund , Aksnes Lage , Elsayed Said
Published: January 2024

SummaryVarious subfractions of Frazer fraction III were separated by high‐pressure liquid chromatography, and their toxicity in vitro (organ culture) was tested in comparison with α‐gliadin using duodenal biopsies from 25 patients with active celiac disease and subtotal villous atrophy, 2 patients with partial villous atrophy, and 10 nonceliac controls. One dominating fraction, designated Frazer III‐2‐VIH, was purified by several steps of rechromatography. It was markedly toxic to duodenal explants from patients with active celiac disease. The mean enterocyte height after culture was 15.9 μm compared with 25.6 μm in gluten‐free medium. This difference was statistically significant in all cases except one, in which the lowest concentration (110 μg) was used. The in vitro toxicity of Frazer III‐2‐VIII was comparable with the toxicity of α‐gliadin in twofold to fivefold higher concentrations. No toxicity could be detected in nonceliac explants (mean enterocyte height, 25.7 vs. 24.9 μm in gluten‐free medium). The N‐terminal amino acid sequence was (Gln)‐Ile‐Gln‐Val‐Phe‐Pro‐Ser‐Gly‐Gln‐Val‐Gln‐(Trp)‐Pro‐Gln‐Gln‐(Gln)‐Gln‐Pro‐Phe‐Pro‐. This sequence was not homologous to previously reported sequences of toxic gluten peptides. By use of the SwissProt and GenEMBL databases, it was concluded that the peptide Frazer III‐2‐VIII is part of the γ‐gliadin fraction.
Biological Risk Factors for Fatal Protein Energy Malnutrition in Hospitalized Children in Zaire
Authors: Brasseur D. , Hennart P. , Dramaix M. , Bahwere P. , Donnen P. , Tonglet R. , Devreker T. , Duchateau J.
Published: January 2024

SummaryBiological markers were used in an attempt to predict mortality in children admitted to the hospital in Kivu, Zaire, for protein energy malnutrition. Data for 39 children who died (16.4%) showed significantly lower levels of albumin (1.61 vs. 2.53 g/dl; p < 0.001), transferrin (82.1 vs. 167.7 mg/dl; p < 0.001), and transthyretin (6.49 vs. 9.87 mg/dl; p < 0.001), but not of retinol‐binding protein, than for the 199 survivors. Since albumin and transferrin were correlated, a Cox model was used to see whether albumin or transferrin has a significant predictive value independent of transthyretin. The relative risk predicted by each indicator was of the same order of magnitude, ∼4. We conclude that specific biological markers help to discriminate among hospitalized subjects at risk and to identify those in need of more intensive nutritional support to prevent early death.
Impact of Intrauterine growth Retardation on the Gastrointestinal Tract and the Pancreas in Newborn Pigs
Authors: Xu Ruo‐Jun , Mellor D. J. , Birtles M. J. , Reynolds G. W. , Simpson H. V.
Published: January 2024

SummaryEffects of intrauterine growth retardation (IUGR) on the gastrointestinal tract and the pancreas were examined using a model of piglets with naturally occurring IUGR. IUGR was associated with significant reductions in gastrointestinal and pancreatic tissue weights. The reduction in tissue weight in the gastrointestinal tract was due to lowered cell numbers and was proportionate to the body as a whole. In contrast to the gastrointestinal tract, the reduction in the pancreas was due to both lowered cell numbers and smaller cell size and was disproportionately greater than the body as a whole. IUGR was associated with precocious occurrence of maltase and sucrase activities in the small‐intestinal mucosa. The exocrine cells of the pancreas in the animals with IUGR appeared immature when compared with those in normal piglets. Further studies are required to examine the postnatal effects of IUGR on the gastrointestinal tract, the pancreas, and somatic development.
Effects of Deconjugated Bile Acids on Electrolyte and Nutrient Transport in the Rabbit Small Intestine In Vitro
Authors: Fasano Alessio , Verga Maria Carmela , Raimondi Francesco , Guandalini Stefano
Published: January 2024

To obtain new information on the poorly investigated mechanisms of the diarrheogenic effects of bile acids, we investigated the effects of the unconjugated bile acids chenodeoxycholate and ursodeoxycholate on the small intestine transport of electrolytes and nutrients in the rabbit jejunal and ileal mucosa mounted in vitro in Ussing or influx chambers. When added to the ileal mucosa at a concentration of 1 m M, both bile acids induced a secretory shift in ion transport; absorption of Na and Cl was abolished and secretion of bicarbonate was enhanced. No changes in short circuit current or electrolyte transport were observed when the bile acids were added to the jejunal mucosa. The addition of 1 m M chenodeoxycholate to the luminal side of the ileum induced a marked inhibition in the uptake of glucose, phenylala‐nine, and glutamic acid. A similar inhibition, though of a lesser magnitude, was also induced by both bile acids on jejunal nutrient transport. Further studies on the inhibitory effect of chenodeoxycholate on glucose influx showed that the inhibition was dose‐dependent; at 1 m M it was maximal and resulted in the complete abolition of the active component, with only the diffusional pathway still operative. We conclude that unconjugated bile acids act as secretagogues in the ileum and significantly blunt the active transport of nutrients in the small intestine. Both effects may well play a role in the diarrheogenic action of these bile acids.
Does Early Diet Have an Effect on Subsequent Macromolecular Absorption and Serum IgE?
Authors: Juvonen Pekka , Månsson Majvi , Jakobsson Iréne
Published: January 2024

A group of 130 healthy term infants were randomly assigned at birth to one of three feeding regimens for the first 3 days of life: human milk (HM), cow‐milk formula (CMF), or a casein hydrolysate formula (CHF). The formula‐fed infants received no human milk during the study days. After day 3, all infants were exclusively breast‐fed. Blood samples were taken at 4 days and at 2 and 4 months of age during outpatient visits. Macromolecular absorption was analyzed 60 min after a feed of human milk by measuring the serum α‐lactalbumin (S‐αLA) concentrations by a competitive radioimmunoassay. Total serum IgE (S‐lgE) was assayed by radioimmu‐noassay. The median S‐IgE value was significantly lower at 2 months of age in the CHF group than in the HM group. The values remained significantly lower, even at 4 months of age, in the CHF group than in either the HM or the CMF group. The median S‐αLA concentration at 2 months of age was significantly higher in the CHF group than in either the HM group or the CMF group. No significant differences could be found between the CMF and HM groups at any time. One infant in the HM group and one infant in the CMF group developed infantile colic. Two infants in the CHF group developed symptoms of cow‐milk allergy. All other infants were healthy at 4 months of age.
Changes in the Fatty Acid Composition of Preterm and Term Human Milk from 1 Week to 6 Months of Lactation
Authors: Luukkainen Päivi , Salo Matti K. , Nikkari Tapio
Published: January 2024

Using capillary gas chromatography, we analyzed the fatty acid composition of human milk from 23 women who had delivered prematurely and 16 women who had delivered at term. Milk samples were obtained at 1, 2, 4, 12, and 26 weeks after delivery. The relative amounts of saturated and monounsaturated fatty acids in preterm and term milk remained stable throughout the 6 months of lactation. The proportions of linoleate (18:2n‐6) and α‐linolenate (18:3n‐3) were similar in preterm and term milk and showed an increasing trend from transitional (8.7–9.9% and 0.9–1.1% of total fatty acids, respectively) to mature milk (9.9–11.8% and 1.2–1.5%, respectively). The proportions of the major long‐chain polyun‐saturated fatty acids (LCP), 20:3n‐6, 20:4n‐6, 22:5n‐3 and 22:6n‐3, were highest at 1 week and decreased thereafter in both types of milk. In term milk, the proportion of LCP continued to decrease from 1 month to 6 months, whereas in preterm milk it was fairly constant. Consequently, at 6 months of lactation, the relative content of arachidonate (20:4n‐6) was 1.5 times (p < 0.05) and that of docosa‐hexaenoate (22:6n‐3) was two times higher (p < 0.01) in preterm than in term milk. We conclude that in long‐term lactation, preterm human milk provides a significantly higher relative supply of LCP than term human milk. This higher LCP content may be of special benefit to the development of a preterm infant.
Influence of the Polyamine, Spermidine, on Intestinal Maturation and Dietary Antigen Uptake in the Neonatal Rat
Authors: Capano G. , Bloch K. J. , Schiffrin E. J. , Dascoli J. A. , Israel E. J. , Harmatz P. R.
Published: January 2024

Polyamines appear to have an important role in postnatal growth of the rat intestine. In the present study, we examined the effect of spermidine on the maturation of the intestine and on its ability to exclude macromolecules. Two litters of Sprague‐Dawley rat pups were assigned to one of four experimental groups. These groups received, on Days 7, 8, and 9, either (a) saline by gavage; (b) spermidine, 0.9 mg (6 μmol) by gavage; (c) cortisone acetate, 3.5 mg i.p.; or (d) saline i.p. On Day 10, animals were fed by gavage with a mixture of bovine serum albumin (BSA; 2 mg/g) and the γ‐globulin fraction of mouse antiovalbumin (anti‐OVA) antiserum (1 mg/g) and were bled 4 h later. Intestinal tissues were processed for histologic examination, sucrase determination, and identification of neonatal intestinal Fc receptor (FcRn) by Western blot. Serum immunoreactive BSA (iBSA) and mouse IgG1 and IgG2a anti‐OVA antibodies were estimated by enzyme‐linked immunosorbent assay. Sucrase activity was elevated in cortisone‐ and spermidine‐treated compared to control rats. iBSA and anti‐OVA were significantly reduced in cortisone‐treated compared to control rats but were not diminished significantly in the spermidine‐treated animals. A decrease in the neonatal intestinal Fc receptor was apparent in the spermidine‐fed group; cortisone produced a large reduction in FcRn. Spermidine‐fed animals showed morphologic evidence of maturation, with loss of giant vacuoles in the distal intestine; cortisone did not produce significant changes in morphology. Thus, while spermidine, like cortisone, enhanced the appearance of the disaccharidase sucrase, it did not significantly reduce the uptake of BSA or IgG, which is usually observed in mature compared to immature animals. The reason for this dichotomy is not known.
Safety and Efficacy of a Rice‐Based Oral Rehydration Salt Solution in the Treatment of Diarrhea in Infants Less Than 6 Months of Age
Authors: Maulen‐Radovan Irene , Fernandez‐Varela Hector , Acosta‐Bastidas Mario , Frenk Silvestre
Published: January 2024

The safety and efficacy of a rice‐based oral rehydration salt (ORS) solution for the treatment of acute diarrhea in infants <6 months of age was compared to those of a standard glucose‐based ORS solution. A total of 97 infants aged 1–6 months who had a history of acute diarrhea for 120 h or less and showed signs of mild to moderate dehydration and no complications was recruited. Subjects were assigned to two treatment groups and received either standard glucose‐based ORS solution or rice‐based ORS solution until cessation of diarrhea. There was no significant difference between the two treatment groups with regard to the main outcome variables, including total stool output {84 [95% confidence interval (CI), 56–126] vs. 106 (95% CI, 76–148) g/kg}, total ORS solution intake [171 (95% CI, 149–197) vs. 187 (95% CI, 161–218) ml/kg], or duration of diarrhea (35 ± 31 vs 38 ± 32 h). In addition, the fact that there was no difference between treatment groups in the presence of reducing substances in the stools suggests that rice was digested and absorbed by these infants. The results of our study support the conclusion that for infants <6 months of age, rice‐based ORS solution is safe and as efficacious as standard glucose‐based ORS solution in the treatment of acute diarrhea.
Neonatal Infection Does Not Affect the Immunoreactive Trypsinogen Screening Test for Cystic Fibrosis
Authors: Wilson D. C. , Leslie H. , Edgar J. D. M. , Halliday H. L. , Dodge J. A.
Published: January 2024

We aimed to discover whether neonatal infection affected levels of the immunoreactive trypsin (IRT) assay, which is used as a screening test for cystic fibrosis. Forty babies who had clinical features suggesting infection had blood spot specimens for IRT taken at the same time as blood for culture. Of 27 babies believed clinically to have infection, 19 had positive blood cultures and eight had negative culture. In retrospect, 13 were not thought to have infection. The mean (SD) IRT results in these three groups were 15 (8), 11 (4), and 16 (6) μg/L, respectively. The mean (SD; range) IRT result for all 40 babies was 14 (7; 10–39). Not only did no babies have elevated IRT results at routine neonatal screening, but none have presented with clinical features suggestive of cystic fibrosis since hospital discharge. Neonatal infection does not appear to cause elevated IRT levels and should therefore not cause false‐positive results in mass neonatal screening.
Developmental Regulation of the Porcine Exocrine Pancreas by Glucocorticoids
Authors: Sangild P. T. , Westrom B. R. , Fowden A. L. , Silver M.
Published: January 2024

The possible role of Cortisol in development of the exocrine pancreas was investigated. In the first study, fetal pigs were removed from the uterus by caesarean section (pentobarbitone anesthesia) and the pancreas collected from 51 69 to 109‐day‐old fetuses (term = 114 % 2 days). Of these, 15 88 to 90‐day‐old fetuses had been infused subcutaneously for 6 days with either saline, adrenocorticotropic hormone or Cortisol (osmotic mini‐pumps implanted at 82–84 days). The pancreas was also removed from eight newborn pigs. Quantitative enzyme analysis showed that amylase and trypsin activities per milligram pancreatic protein increased toward term, correlated positively with fetal plasma Cortisol (p < 0.01) and were stimulated by Cortisol infusion (p < 0.05). In the second study, pigs were delivered by caesarean section 2–3 days before term (to circumvent the neonatal Cortisol surge) and injected intramuscularly with saline (n = 11), metyrapone (an inhibitor of Cortisol synthesis, n = 12), adrenocorticotropic hormone (n — 14) or Cortisol acetate (< = 6) during the postnatal period. At 6–7 days of age, adrenocorticotropic hormone‐ and Cortisol acetate‐treated pigs had higher concentrations of amylase and trypsin in pancreas than metyrapone‐treated pigs. The values in saline‐injected pigs were intermediate. By gel electrophoresis and subsequent incubation with enzyme substrates, protease E, chymotrypsin C, and cathodic trypsin were first detected at 6–7 days of age, and the activities (semiquantitative densitometry) appeared lower in metyrapone‐treated pigs than in pigs from other treatment groups. The results indicate that glucocorticoids stimulate the perinatal development of pancreatic enzymes in the pig. In species that have a relatively mature gut at birth (e.g., pig, human), developmental regulation by glucocorticoids may be most important in the period immediately before and after birth.
Low Bone Mineral Content and High Serum Osteocalcin and 1,25‐Dihydroxyvitamin D in Summer‐ Versus Winter‐Born Newborn Infants
Authors: Namgung Ran , Tsang Reginald C. , Specker Bonny L. , Sierra Rosa I. , Ho Mona L.
Published: January 2024

Seasonal differences in bone mineral indices have not been studied in newborn infants. In adults, indicators of bone metabolism may show seasonal variations. In postneonatal infants and possibly in adults, vitamin D metabolism shows seasonal variations. We hypothesized that in winter‐born infants, the bone mineral content is low and serum osteocalcin is high, related to increased bone turnover and high serum 1,25‐dihydroxyvitamin D [l,25(OH)2D]. We studied 246 healthy, term appropriate‐for‐gestation infants in winter (January through March; 140 children) and summer (July through September; 106 children). The bone mineral content (BMC) of the one‐third distal radius was measured before 3 days of age by photon absorptiometry. Significant seasonal differences were found: summer‐born infants had significantly lower BMC, higher serum osteocalcin and l,25(OH)2D, and lower serum total calcium than winter‐born infants. Seasonal differences in BMC remained significant after adjusting for race and sex. BMC was not correlated with serum biochemical measures. Thus, summer‐born newborn infants have low BMC and high serum osteocalcin and l,25(OH)2D than winter‐born infants; these findings are the opposite of adult findings. We suggest that seasonal effects on fetal bone operate especially in early pregnancy (‐6 months before birth) resulting in a “phase effect” and opposite findings from later life.
Successful Pancolonoscopy and Ileoscopy in Children
Authors: Israel David M. , McLain Bruce I. , Hassall Eric
Published: January 2024

Summary: The purpose of this study was to collect prospective data regarding the quality, extent, and duration of pediatric pancolonoscopy performed by pediatric gastroenterology attending physicians and a fellow in training. Over 7 months, data were prospectively collected on 40 colonoscopic procedures. The cecum was reached in 37 cases (92.5%) and the terminal ileum in 35 cases (87.5%). When cases of stricture and equipment failure were excluded, these completion rates were 97 and 95%, respectively. The overall average duration for pancolonoscopy, ileoscopy, multiple biopsies, and polypectomy (where necessary) was 38 min. When attending physicians performed the procedure, the duration was 31 min; the duration was 37 min when the fellow completed the procedure and 45 min when the fellow required the attending physician to complete it. The average time taken to reach the cecum by the attending physician was 19 min (range, 8–32); by the fellow it was 25 min (range, 17–32), and by the combination it was 37 min (range, 11–59). The average time from cecum to terminal ileum was 3 min for all, with ranges of 1–12 min for the attending physician and 1–23 min for the fellow. The fellow initiated 24 procedures, of which the attending physician was required to complete 12, including all five procedures performed in the initial 2 months of the study, 7 of 13 in the next 3 months, and none of the six procedures in the last 2 months. Of the 40 examinations, the colon was normal in five (12.5%), and a specific diagnosis was made in 35. There were no complications due to the procedure itself, but two patients had mild self‐limited adverse effects from the sedation. No child had any recall of the procedure. Pancolonoscopy with ileoscopy in children is sensitive and specific for diagnosis. It is well‐tolerated by children when adequate sedation with close monitoring is used; it is safe when performed by experienced pediatric gastroenterologists or a fellow in training under close supervision. Trainees can acquire the skills necessary to perform this challenging procedure in children when they are closely supervised and guided in a dedicated pediatric gastroenterology program.
A Complex Biochemical Modulation of Intestinal Ion Transport in Rats Fed on High‐Fat Diets
Authors: Cartwright‐Shamoon J. M. , Dodge J. A. , McMaster C.
Published: January 2024

This study investigates the relationship between dietary fat and ion transport in rat intestine. Animals were fed isocaloric diets with high fat content as corn oil, evening primrose oil (Efamol), fish oil, Efamol/ fish oil, olive oil, coconut oil, and butter. A low‐fat (corn oil) diet was used in a control group. Biopsies of the small intestine from these animals were mounted in an Ussing chamber, and the intestinal mucosal to serosal ion transport was measured as short‐circuit current (SCC). The SCC was stimulated in rats fed on diets high in polyunsaturated fatty acids such as corn oil, Efamol, fish oil, and Efamol/fish oil. SCC was also stimulated in rats fed on diets high in monosaturated fatty acids such as olive oil. Animals fed on diets high in saturated fatty acids such as coconut oil and butter, on the other hand, showed an inhibition in the SCC. To determine whether the effect of membrane lipids was mediated by a differential effect on membrane receptor proteins, the response to secretogogue challenge was studied. Biochemical agents and secretogogues including acetylcholine, noradrenaline, dibutyryl‐cAMP, calcium ionophore A2318, and prostaglandin E2 were analysed and compared. These agents were able to influence the SCC, showing responses with marked differences between diet groups.
Fecal Excretion of Leukotriene C4 during Human Disease Due to Shigella dysenteriae
Authors: Cruz Jose R. , Cano Floridalma , Razin Ehud , Acheson David W. K. , Keusch Gerald T.
Published: January 2024

Fecal excretion of leukotriene C4 was determined in 26 individuals with dysentery and in 19 healthy controls. Of the patients, five were infected with Shigella dysenteriae type 1, 15 were infected with Shigella flexneri, two were infected with Shigella boydii, and four were infected with Shigella sonnei. Three of the healthy controls were infected with non‐dysenteriae Shigellae. All isolates of Shigella dysenteriae type 1 produced Shiga toxin; the other strains were not toxigenic. Patients with dysentery due to Shigella dysenteriae type 1 excreted higher concentrations of leukotriene C4 (median, 3,234 pg/0.05 g of feces) than either ill individuals infected with non‐dysenteriae Shigellae (median, 202 pg/0.05 g) or healthy carriers (median, 145 pg/0.05 g) and uninfected controls (median, 129 pg/0.05 g). We propose that Shiga toxin stimulates intestinal mast cells, which release leukotriene C4, contributing to the inflammatory response in Shigella dysenteriae type 1‐associated dysentery.
Endoscopic Ligation of Esophageal Varices in Children
Authors: Fox Victor L. , Carr‐Locke David L. , Connors Pamela J. , Leichtner Alan M.
Published: January 2024

Seven consecutive patients presenting acutely with suspected variceal hemorrhage underwent endoscopic variceal ligation (EVL) of esophageal varices. Active bleeding had ceased by the time of the initial EVL session in all patients, although active variceal hemorrhage was controlled by EVL in one patient during a sub‐sequent episode of bleeding. Treatment sessions were repeated at approximately monthly intervals until varices were reduced in size to grade 1 (<4 mm diameter) or eradicated. All patients had portal hypertension secondary to intrahepatic disease. Patient age ranged from 2.4 to 14.5 years (mean, 8.5 years). One patient underwent successful liver transplantation 1 week after the initial treatment session. The remaining six patients required a mean (±SD) of 4.0 ± 1.3 treatment sessions for elimination of varices. One episode of recurrent variceal hemorrhage and one episode of treatment‐related hemorrhage occurred in two separate patients. Transient, mild dysphagia or odynophagia occurred in all patients. No other complications were reported during a mean (±SD) follow‐up period of 13.8 ± 4.6 months (range, 8–20 months). Recurrent varices were seen in three of four (75%) patients returning for follow‐up endoscopy between 5 and 8 months from initial eradication. All underwent repeat EVL without complication. Endoscopic variceal ligation may be a suitable substitute for sclerotherapy in children with bleeding esophageal varices.
Characterization of Symptoms in Children with Recurrent Abdominal Pain
Authors: Hyams Jeffrey S. , Treem William R. , Justinich Christopher J. , Davis Patricia , Shoup Marie , Burke Georgine
Published: January 2024

We sought to prospectively characterize and compare the symptoms of children ≥ 5 years of age with recurrent abdominal pain to previously established criteria for irritable bowel syndrome (IBS) in adults. For all eligible subjects, a detailed questionnaire concerning characteristics of abdominal pain and defecatory pattern was completed at presentation. In addition, a battery of screening tests was performed and additional evaluation was done at the discretion of their physician. In all, 227 subjects fulfilled the entrance criteria, but 56 were sub‐sequently excluded because of diagnoses of inflammatory bowel disease (nine cases), lactose malabsorption (46 cases), or celiac disease (one case). Of the remaining 171 patients, 117 had IBS symptoms. In the IBS subjects, lower abdominal discomfort (p < 0.001), cramping pain (p < 0.0009), and increased flatus (p < 0.0003) were more common, whereas dyspeptic symptoms such as epigastric discomfort (p < 0.003), pain radiating to the chest (p < 0.009), and regurgitation (p < 0.02) were more common in the non‐IBS subjects. Our study not only confirms the clinical heterogeneity of children with recurrent abdominal pain but also concomitantly demonstrates that most children with this disorder have symptoms that fulfill the standardized criteria for IBS in adults. The identification of subgroups of children with recurrent abdominal pain can provide a framework for the diagnosis of functional bowel disease as well as establish the need for invasive and expensive tests.
Magnesium Status, Serum HDL Cholesterol, and Apolipoprotein A‐1 Levels
Authors: Nozue Tomio , Kobayashi Akio , Uemasu Fujio , Takagi Yasuo , Sako Akiko , Endoh Hiroomi
Published: January 2024

To determine the relationship between low magnesium status and lipids, we divided 27 patients with microscopic hematuria and normal renal function into two groups according to magnesium retention, as measured by a magnesium‐loading test, and compared their serum lipid and apolipoproteins. Patients with low magnesium status (n = 7) had significantly lower levels of cholesterol, HDL cholesterol, and apolipoprotein A‐1 than those with normal magnesium status (n = 20); however, there were no significant differences between the groups in serum concentrations of magnesium and apolipoprotein B. These data suggest that magnesium deficiencies are associated with low serum concentration of HDL cholesterol and apolipoprotein A‐1.