bluuebunny/crossref_metadata_2025 huggingface dataset:
15N‐Tracer Investigations into the Nitrogen Metabolism of Preterm Infants Fed Mother's Milk and a Formula Diet
Authors: Heine W. , Plath C. , Richter I. , Wutzke K. , Towe J.
Published: January 2024

Protein synthesis, protein breakdown, protein‐N turnover, and other parameters describing the nitrogen metabolism were measured in five male preterm infants. The weight of the subjects at birth was 2,064 ± 107 g and the measurements were performed at age 16.0 ± 4.5 days in the case of the mother's milk diet and 27.4 ± 6.8 days in the case of the formula diet containing 1.8% protein. The parameters were measured by means of the 15N‐tracer technique using [15N]glycine (95 atom %) applied in a single oral dose of 20 mg/kg as a tracer. The three‐pool model proposed by Winkler and Faust was used to calculate the whole body protein parameters. No difference in net protein gain, protein synthesis, protein breakdown, or the other protein metabolism parameters were recorded despite the different protein inputs. Renal nitrogen excretion and the rate of endogenous urea N excretion were significantly higher for the formula diet than for the mother's milk diet. The protein synthesis rate of 7.9 g μ kg‐1 day‐1 was, as has previously been observed, higher than in other age groups. The protein metabolism of the preterm infant older than 33 weeks of gestational age does not benefit from a formula diet based on cow's milk that is richer in protein than mother's milk.
Folate Supplementation During Lactation
Authors: Smith Anne M. , Picciano Mary Frances , Deering Ronald H.
Published: January 2024

The influence of maternal folate status and human milk folate content on infant folate status was studied in 11 lactating women taking folate supplements throughout pregnancy and lactation. Nursing mothers not taking folate supplements, as well as nonpregnant, non‐lactating women, were also studied. Maternal and infant serum and red blood cell (RBC) folate concentrations, as well as the “free” and total folate contents of human milk samples, were determined at 6 and 12 weeks post partum. Mothers taking folate supplements maintained blood folate concentrations higher than those of unsupplemented mothers and similar to or higher than those of normal adults. Infants of both supplemented and unsupplemented mothers maintained similar blood folate levels. Positive correlations were found between maternal RBC folate concentrations and infant RBC folate concentrations at 6 weeks (r = 0.62) and 3 months (r = 0.74), but no relationship was found between maternal folate status and human milk folate activity. Human milk folate levels increased with the progression of lactation, were higher in the evening than earlier in the day, and were higher at the end of a feeding than at the beginning. These results indicate that human milk folate levels are maintained at the expense of maternal reserves and that folate supplementation during lactation may be of value for preservation of maternal reserves.
Caroli's Disease in Childhood
Authors: Fagundes‐Neto Ulysses , Schettini Sergio Thomas , Wehba Jamal , Pinus Jose , da Silva Patricio Francy Reis
Published: January 2024

Caroli's disease is a rare congenital disorder characterized by segmentary saccular dilatation of the intrahepatic bile ducts, which manifests itself clinically by cholangitis and bile stones. We report two cases of Caroli's disease in schoolgirls with clinical signs of recurrent abdominal pain associated with intermittent crises of cho‐lestatic jaundice. Diagnosis was made by retrograde cholangiography in one patient and by intravenous cholangiography in the other.
Therapeutic Effects of Human Leukocyte Interferon on Chronic Active Hepatitis Bin Children
Authors: Hashida Tetsuo , Sawada Tadashi , Esumi Noriko , Kinugasa Akihiko , Kusunoki Tomoichi , Kishida Tsunataro
Published: January 2024

Seven children with chronic active hepatitis (CAH) and one child with persistently abnormal results of liver function tests due to hepatitis B virus (HBV) infection were treated with human leukocyte interferon (Hu‐IFN). Five of them were positive for eAg and two of the three who were measured for DNA polymerase (DNAP) activity in sera showed moderate elevations of its levels. Hu‐IFN was injected intramuscularly daily or once weekly at doses of 0.05–1 x 106 IU. The total dose per patient varied from 10.5–54 x 106 IU. After administration of Hu‐IFN, rapid loss of eAg was observed in two of the five eAg patients, and DNAP activity reverted to normal ranges in the two patients with moderate elevations of its levels. One of the patients who lost eAg has retained normal serum glutamic‐oxaloacetic transaminase and glutamic‐pyruvic transaminase levels for more than 2 years after therapy with Hu‐IFN. Serial hepatic biopsies were performed in only one patient. In the second biopsy, 3 months after therapy with Hu‐α‐IFN, infiltration of inflammatory cells in the portal region was improved compared with earlier findings. Immediate and/or prolonged adverse side effects were not observed during or after administration of Hu‐α‐IFN. For the present, we propose these six conditions for use of Hu‐α‐IFN in children with HBV infection. Children should: (a) be more than 1 year old; (b) have abnormal liver function for more than 6 months; (c) have a liver biopsy demonstrating CAH; (d) have moderate elevation of DNAP activity; (e) be eAg positive; and (f) be unresponsive to other treatments.
Bilirubin Production After Supplemental Oral Vitamin E Therapy in Preterm Infants
Authors: Smith David W. , Cohen Ronald S. , Vreman Hendrik J. , Yeh Anna , Sharron Stephanie , Stevenson David K.
Published: January 2024

The purpose of this investigation was to determine the influence of early vitamin E supplementation on the rate of heme catabolism (bilirubin production) in healthy preterm infants. Bilirubin production was estimated from the concentration of carbon monoxide in “end‐tidal” gas. Serum vitamin E, hemoglobin, and bilirubin levels were determined by standard techniques. Thirty infants received supplementation with vitamin E or placebo in a double‐blind, randomized fashion. Infants were studied on day 1 of life prior to therapy, and on days 3 and 7 postnatally. Results showed that in both placebo‐supplemented and vitamin E‐supplemented groups, vitamin E levels were significantly higher on days 3 and 7 compared with day 1. Bilirubin production was not significantly different on day 3 compared with day 1 in either group, but was significantly lower in both groups by day 7 compared with day 1. There were no significant differences in hemoglobin and serum bilirubin levels between the two groups at any point in time. In conclusion, although vitamin E supplementation significantly raises vitamin E levels, placebo‐supplemented premature infants also achieve vitamin E sufficiency and a decrease in bilirubin production by day 7 of age.
Sulfasalazine and Renal Tubular Function
Authors: Koutras Andreas , Daum Fredric , Das Kiron M. , Markowitz James , Duffy Lynn , Aiges Harvey , Atkinson Mark , Fisher Stanley E.
Published: January 2024

Sulfasalazine (SASP) is frequently used in the treatment of chronic inflammatory bowel disease (IBD), particularly colitis. Because the drug poses a theoretical risk for renal tubular damage, 26 patients, 8–18 years of age, with Crohn's ileocolitis were studied. Thirteen children were receiving SASP while 13 served as disease controls. Renal tubular function was assessed by measurement of urinary β2‐microglobulin and n‐acetylglucosa‐minidase activity. No abnormalities were found on routine measurement of renal function. Similarly, urinary β2‐microglobulin and n‐acetylglucosaminidase activities were within normal limits for patients receiving SASP, as well as for disease controls. Although there is a theoretical risk for renal tubular damage from the prolonged use of SASP, this study would suggest that IBD patients receiving the drug are at no greater risk for renal injury than their counterparts not receiving the medication.
Cell Culture of Embryonic Chick Duodenal Cells
Authors: Zinman H. M. , Joneja M. G. , Davies P. , Smith B. T.
Published: January 2024

A method for the primary cell culture of trypsin‐dissociated embryonic chick duodenum is described. Both heterotypic (epithelial cells and fibroblasts together) and homotypic (highly enriched cultures of epithelial cells or fibroblasts alone) cell cultures were established. Dispersed duodenal epithelial cells and fibroblasts grown in 10% fetal bovine serum (FBS) spontaneously aggregated and proliferated as a bilayer of cells with the epithelial cells growing on top of the fibroblasts. Changing the serum supplement to 6% chicken serum (CS) and 4% FBS when the fibroblast monolayer reached confluence resulted in epithelial cell proliferation. Homotypic cultures of epithelial cells and fibroblasts were prepared and analyzed by scanning electron microscopy and transmission electron microscopy. Fibroblasts, isolated by differential adhesion and grown in 10% FBS, did not demonstrate measurable alkaline phosphatase activity. Homotypic epithelial cell cultures, isolated by floating them off the fibroblasts with collagenase, and maintained on collagen in 6% CS/4% FBS, demonstrated higher alkaline phosphatase‐specific activity (16.1 β 2.3 U/mg protein) compared with epithelial‐fibroblast bilayer cell cultures (12.1 β 1.3 U/mg protein).
Protection of Suckling Mice from Heat‐Stable Enterotoxin of Escherichia coli by Infant Formulas
Authors: Cleary Thomas G. , Chambers James P. , Pickering Larry K.
Published: January 2024

Human milk contains factors that protect suckling infants against enteropathogen‐induced diarrhea. One nonspecific protective factor found in human milk is a small molecular weight material that protects suckling mice from death due to the heat‐stable entero‐toxin of Escherichia coli. This study demonstrated that cow's milk and most formulas derived from cow's milk also contain a factor(s) that can protect against heat‐stable enterotoxin of E. coli in suckling mice.
Generalized Juvenile Polyposis in an Infant
Authors: Luyer B. Le , Bihan M. Le , Metayer P. , Metayer J. , Mallet E. , de Menibus C. H.
Published: January 2024

A case of juvenile gastrointestinal polyposis in an infant is described and the literature is reviewed. Major clinical problems are related to the extent of the juvenile polyposis. The disease has a poor prognosis. The endoscopic techniques used when polyposis is limited allow histologic evaluation of the polyps and conservative treatment.
Influence of Preoperative Parenteral Alimentation on Postoperative Growth in Adolescent Crohn's Disease
Authors: Lake Alan M. , Kim Samuel , Mathis Richard K. , Walker W. Allan
Published: January 2024

The postoperative growth rates achieved in eight early pubertal adolescent males with Crohn's disease undergoing surgery for obstructive complications is reported as a function of the use of 1 month's preoperative central venous alimentation. All patients had ileal strictures with ileocolitis, bone ages less than 13, Tanner stages 1 or 2, and growth velocities below the 3rd percentile for age. During a 3‐year follow‐up, those receiving preoperative venous alimentation demonstrated greater oral caloric intake (significant for 1 year) and greater postoperative growth velocity (significant for 2 years) in comparison to those patients who did not receive preoperative venous alimentation. There was no significant difference between the two groups of patients in postoperative weight gain, sexual development, and 3‐year disease control.
Zinc in Human Milk
Authors: Krebs Nancy F. , Hambidge K. Michael , Jacobs Margaret A. , Mylet Sheila
Published: January 2024

To examine diurnal patterns of milk zinc concentrations, midfeed samples were obtained at approximately 6 a.m., 9 a.m., 12 noon, 3 p.m., 6 p.m., and 9 p.m. on a total of 29 days from 16 lactating women. Within‐feed patterns were examined in 32 subjects with analysis of samples of fore‐, mid‐, and hindmilk from a total of 175 feeds. There were no significant differences between means for any of the diurnal intervals or between means for fore‐, mid‐, and hindmilk samples. These results indicate that milk zinc concentrations of random samples of human milk collected at any time of the day or of the feed can be accepted as representative for that day.
Breast Milk Lactoferrin Levels in Relation to Maternal Nutritional Status
Authors: Houghton Murray R. , Gracey Michael , Burke Valerie , Bottrell Cheryl , Spargo Randolph M.
Published: January 2024

Lactoferrin was measured in breast milk from Aboriginal and non‐Aboriginal Australian women using an enzyme immunoassay. There was no diurnal variation in lactoferrin concentration or change in concentration between the beginning and end of a feed. Lactoferrin levels were significantly higher in the first 15 days postpartum than in the period after the 15th day. Regression analysis showed that in milk from Aboriginal women less than 15 days postpartum, higher concentrations of lactoferrin were associated with weight for height (WFH) greater than 90% and with increased parity. Comparable data were not available for Caucasian women. For Aboriginal and Caucasian women more than 15 days postpartum, lactoferrin concentrations were higher in women greater than 90% WFH. Other variables, such as parity, were not significant in the regression.
Effect of Nutritional Method on Adaptation of the Intestinal Remnant After Massive Bowel Resection
Authors: Al‐Jurf Adel S. , Younoszai M. Kabir , Chapman‐Furr Frances
Published: January 2024

Adaptation of the intestinal remnant with hypertrophy/hyperplasia and increased absorption occurs, ultimately, after massive bowel resection. During the early postresection period, the rate of the adaptational process may be influenced by the method of nutritional support. Nutrients given by mouth may support a strong stimulus for hypertrophy but may be incompletely absorbed from the short intestinal remnant. Intravenous nutrition, while eliminating the need for intestinal absorption, may not support the hypertrophic process of that remnant. We tested the effect of different nutritional methods on the hypertrophic and functional adaptation of the intestinal remnant after 90% resection in the rat. The methods included oral feeding with regular rat chow, oral feeding with elemental diet, intravenous nutrition, and a combination of intravenous nutrition and oral feedings. Full thickness intestinal wall wet weight and mucosal wet weight, as well as in vivo L‐valine absorption, were measured 9 days after operation. Resected subgroups were compared to sham‐operated controls receiving similar diets. Increase in the weight of the intestinal remnant and its mucosa was noted in all resected subgroups receiving oral diets. Valine absorption per unit length and/or unit weight was significantly decreased in rats receiving oral diets alone and rats receiving a combination of intravenous and oral elemental diet. Significant increase in intestinal and mucosal weight without decrease in valine absorption was demonstrated in the animals receiving a combination of intravenous nutrition and regular chow diet. The results suggest that a combination of intravenous nutrition and ad libitum oral feedings with regular diet may represent the best method of nutritional support in the early postresectional period.
Manometric Study on the Intestinal Motility in a Case of Megacystis‐Microcolon‐Intestinal Hypoperistalsis Syndrome
Authors: Tomomasa T. , Itoh Z. , Koizumi T. , Kitamura T. , Suzuki N. , Matsuyama S. , Kuroume T.
Published: January 2024

We report on the intestinal motility in a case of megacystis‐microcolon‐intestinal hypoperistalsis syndrome (MMIHS) based on a total registered time of 9.5 h by means of a manometric method we recently developed for neonates. The characteristics of this case are as follows: (a) the frequency of the contractions in the stomach and duodenum was significantly lower than that of healthy infants; and (b) bands of rhythmic contractions, resembling phase III activity of the interdigestive migrating contractions in adults, were recorded in the duodenum, but their occurrence was less frequent and the amplitude was significantly lower than that of healthy infants. The present study indicates that “hypoperistalsis” in MMIHS means not only the low frequency, but also the low amplitude, of the contractions in the alimentary tract.
Hemorrhagic Complications of Henoch‐Schönlein Syndrome
Authors: Clark Joseph H. , Fitzgerald Joseph F.
Published: January 2024

Two patients are described with atypical manifestations of Henoch‐Schönlein syndrome. One patient suffered severe intracranial hemorrhage and a subsequent massive gastric hemorrhage. The other patient developed an asymptomatic serosanguinous pleural effusion. Both had evidence of profound hypoprothrombinemia at the time of admission. Aggressive management of any coagulopathy accompanying Henoch‐Schönlein syndrome is cardinal in order to prevent life‐threatening complications such as gastrointestinal, intracranial, and pulmonary hemorrhage.
Reliability and Usefulness of Random Fecal α1‐Antitrypsin Concentration
Authors: Magazzu Giuseppe , Jacono Giuseppe , Di Pasquale Giuseppe , Sferlazzas Concetta , Tedeschi Antonino , Santoro Silvia , Nibali Sergio Conti , Musso Francesco , Balsamo Vincenzo
Published: January 2024

The reliability of random fecal arantitrypsin (FA‐l‐AT) concentration has been evaluated by comparing FA‐l‐AT values on random specimens and on concomitant 24–72 h fecal collections. In order to simplify the method, FA‐l‐AT data derived from lyophilized fecal samples were compared with those obtained from 37°C heat‐dried fecal samples. Random FA‐l‐AT concentration was assayed in 80 children with various gastrointestinal illnesses and 36 healthy age‐matched controls. There was a close relationship between FA‐l‐AT values obtained from random samples and 1‐day or 3‐day collections. There was also a significant relationship between FA‐l‐AT values derived from the two different ways of drying the stools. Mean FA‐l‐AT values were statistically different when compared to the controls in the following groups of disorders: untreated and after‐gluten‐challenge celiac disease, post‐enteritis syndrome, and cow'S milk intolerance. The possible meanings of the abnormal FA‐l‐AT concentration in the various disorders are discussed. We conclude that FA‐l‐AT is a simple and reliable test for enteric protein loss. The simplification of the method proposed by us should reduce the cost of the test and moreover make it feasible in all laboratories.
Breast‐Feeding Among Teenage Mothers
Authors: Lipsman Sandra , Dewey Kathryn G. , Lönnerdal Bo
Published: January 2024

Information on breast‐feeding was obtained from 25 mothers recruited from four high school programs for teenaged parents. Subjects were visited monthly 1–9 times (mean 3.7 visits) during the first 10 months of lactation to measure infant growth and maternal dietary intake and to collect a breast milk sample. Of 24 mothers visited more than once, 21 (88%) breast‐fed for more than 3 months, and at least nine continued beyond 6 months. Compared to the nutrient content of milk samples from adult women, milk of teenage mothers was significantly lower in lactose, magnesium, calcium, potassium, and sodium. However, the differences in magnesium, calcium, and potassium may have been due to differences in the timing of sample collection. On the basis of infant growth, milk volume was judged to be adequate for 88% of the infants. Mean maternal energy and protein intakes were 2,897 kcal and 115 g, respectively; mean intakes of calcium, potassium, vitamin A, riboflavin, niacin, and vitamin C exceeded the National Research Council'S Recommended Dietary Allowances (RDA) for lactation, while iron and thiamine intakes averaged 84% and 94% of the RDA, respectively. It is concluded that with active counseling teenage mothers are capable of successful lactation.
On the Source of Bile Salt‐Stimulated Lipase in Human Milk
Authors: Bläckberg Lars , Blind Per‐Jonas , Ljungberg Börje , Hernell Olle
Published: January 2024

Human milk contains a bile salt‐stimulated lipase (BSSL) which is considered to contribute significantly to lipid digestion in newborns. Human pancreatic juice contains an enzyme, carboxyl ester hydrolase (CEH), that is immunochemically and functionally identical to the milk enzyme. It has not been clear, however, whether the milk enzyme is synthesized within the mammary gland or whether the pancreatic enzyme is transported to the mammary gland for secretion. In this study we describe an enzyme‐linked immunosorbent assay (ELISA) for determinations of BSSL and CEH in serum. Serum samples from healthy adults of both sexes contain significant amounts of enzyme (3.2 ± 1.7 μg/L). Lactating women did not have higher serum levels, which would be expected if the milk enzyme were a product of the pancreas, and it was calculated that the concentrations found could not sufficiently account for the amounts secreted in the milk. We therefore conclude that BSSL is synthesized within the mammary gland. This conclusion is further strengthened by our findings that serum of breastfed newborns contains very little if any enzyme. Since macromolecular absorption is high early in life, and witch'S milk contains high enzyme levels, again one would expect high serum levels if BSSL were a pancreatic product.
Enteric Colonization in Sporadic Neonatal Necrotizing Enterocolitis
Authors: Blakey Joan L. , Lubitz Lionel , Campbell Neil T. , Gillam Geoffrey L. , Bishop Ruth F. , Barnes Graeme L.
Published: January 2024

Microflora of the gut was studied close to the onset of sporadic necrotizing enterocolitis (NEC) in neonates. Enteric flora in 25 babies with NEC differed from that in 23 matched controls. Bacteroides spp and lactobacilli were less common in babies with NEC compared with controls: 32 versus 61% (p = 0.03) and 12 versus 48% (p = 0.006), respectively. Clostridium perfringens was isolated from 40% of babies with NEC compared with 13% of controls (p = 0.03). It was present in 33% of babies with NEC aged less than 14 days but was not detected in control babies of the same age. The incidences of C. butyr icum and C. difficile were similar in patients and controls. Colonization with C. perfringens in the absence of a protective barrier flora may be crucial in the pathogenesis of severe sudden onset NEC. Two potentially valuable marker factors to predict onset of this form of sporadic NEC are the use of fecal smears and estimation of fecal tryptic activity.
Zinc, Copper, Manganese, and Selenium Metabolism in Patients with Human Growth Hormone Deficiency or Acromegaly
Authors: Aihara Katsuaki , Nishi Yoshikazu , Hatano Shuichi , Kihara Mikio , Ohta Masahiro , Sakoda Katsuaki , Uozumi Tohru , Usui Tomofusa
Published: January 2024

This study was designed to evaluate trace metal metabolism in patients with known abnormalities of human growth hormone (hGH). The mean concentration of zinc in plasma and urine decreased in patients with hGH deficiency after hGH injection, whereas, after adenomectomy, in patients with acromegaly, zinc increased in plasma, remained the same in erythrocytes, and decreased in urine. There was a negative correlation between plasma zinc and serum hGH levels and a positive correlation between urinary zinc excretion and serum hGH levels in acromegaly. In hGH deficiency, the copper content remained unchanged in plasma and erythrocytes and rose in urine after treatment; however, in acromegaly, the copper content increased in plasma and remained unchanged in erythrocytes and urine after surgery. The mean concentration of erythrocyte manganese did not change significantly after treatment in patients with hGH deficiency or acromegaly, but the pre hGH treatment level of erythrocyte manganese in hGH deficiency was lower than in the controls. Plasma selenium concentrations were decreased in hGH deficiency and increased in acromegaly patients after therapy. These results suggest that hGH affects the metabolism of zinc, copper, manganese, and selenium. hGH treatment level of erythrocyte manganese in hGH deficiency was lower than in the controls. Plasma selenium concentrations were decreased in hGH deficiency and increased in acromegaly patients after therapy. These results suggest that hGH affects the metabolism of zinc, copper, manganese, and selenium.
Consequences of Complete Bile
Authors: Van Thiel D. H. , Gavaler J. S. , Zajko A. B. , Cobb C. F.
Published: January 2024

Prepubertal male rats underwent bile duct ligation or a sham operation. Sham operated animals were divided into two groups: isocalorically fed (matched to the bile duct ligated animals) and adlibitum fed animals. At 60 days of age (after puberty in a male rat) all animals were killed. Bile duct ligated animals had larger livers, greater bilirubin, greater bile acid, greater aspartate transaminase, and greater alkaline phosphatase levels and lower testosterone and luteinizing hormone levels in their serum than did the controls. Moreover, the testes and seminal vesicles were smaller in the bile duct ligated animals than in the controls. These data suggest that chronic cholestasis contributes, at least in part, to the pubertal and maturational failure that occurs with the chronic cholestatic diseases of childhood.
Ethanol and Fetal Nutrition Effect of Chronic Ethanol exposure on rat Placental Growth and Membrane Associated folic Acid Receptor Binding Activity
Authors: Fisher Stanely E. , Inselman Laura S. , Duffy Lynn , Atkinson Mark , Spencer Hyacinth , Chang Benedict
Published: January 2024

Rat placental composition and specific folate receptor activity were measured at 20 days gestation in dams exposed to chronic high doses of ethanol (6%, vol/vol) throughout gestation and in isocalorically pair fed controls. Ethanol exposed fetuses were smaller (ethanol = 3.28 ± 0.08 vs. control = 4.01 ± 0.10 g, p < 0.001), but their placentae were larger (experimental = 0.534 ± 0.02 vs. control = 0.399 ± 0.01 g, p < 0.001). The increased weight appears to be secondary to hyperplasia as total DNA was increased while the wet/dry, RNA/DNA, and protein/ DNA ratios were not different. Despite larger placentae, specific folate receptor activity was significantly reduced in the ethanol exposed tissue, whether expressed relative to membrane protein, placental weight, or total placental binding. These results confirm that ethanol exposure is placen totoxic and suggest an additional mechanism by which ethanol may lead to intrauterine growth retardation; namely, decreased folate receptor activity.
Effect of Tin Protoporphyrin on the Excretion Rate of Carbon Monoxide in Newborn Rats After Hematoma Formation
Authors: Posselt Andrew M. , Cowan Barrett E. , Kwong Linda K. , Vreman Hendrik J. , Stevenson David K.
Published: January 2024

This study evaluated the efficacy of tin protoporphyrin (TP), a competitive inhibitor of heme oxygenase, in suppressing the total body excretion rate of carbon monoxide (CO), an index of total bilirubin formation, in neonatal rats with artificially created hematomas. Wistar rat litters less than 12 h old were each divided into three groups of similar weight and treated as follows: (a) saline control (S); (b) hematoma, 80 μl blood (H); (c) TP, 65 (μmol/kg, and hematoma (TP H). CO excretion of the H group increased rapidly after hematoma formation, reaching a maximum value of 79 ± 4 SE μl/kg/h 25 h later. Treatment with TP did not affect the pattern of CO excretion or its magnitude (78 ± 2 SE μl/kg/h, 25 h posthematoma). The S group showed no increase in CO excretion at this time (40 ± 2 SE μl/kg/h). At the conclusion of the experiment (45 h posthematoma), the plasma total bilirubin levels were slightly lower in the TP H rats (1.0 ± 0.1 SE mg/dl) than in H rats (1.2 ± 0.1 SE mg/dl). The S rats had a plasma total bilirubin concentration of 0.8 ± 0.1 SE mg/ dl. The hepatic and splenic heme oxygenase activities were decreased by 61% (p < 0.001) and 48% (p < 0.05), respectively, in the TP H rats as compared to the H rats. The S and H rats had similar enzyme activities. The results of this study suggest that though single dose TP decreased tissue heme oxygenase activity, it did not significantly affect total bilirubin formation.
Long
Authors: Rosenthal Philip , Pesce Michael
Published: January 2024

A case of Dlactic acidosis in a 2 1/2 year old child followed for 11 months is reported. The infant had previously undergone extensive small intestinal resection for midgut volvulus. Diagnosis was confirmed by measurement of plasma D lactate. Metabolic acidosis, increased anion gap, ataxia, and lethargy in patients with small intestinal resection warrant investigation for D lactic acidosis. The presumed etiology is absorption of Dlactic acid produced by bacterial fermentation of carbohydrate in the colon. Antibiotic treatment resulted in prompt resolution of symptoms in this case. Prospective and prolonged monitoring of acidosis in patients with small bowel resection is encouraged.
Absorption of a New Semielemental Diet in Infants with Cystic Fibrosis
Authors: Canciani M. , Mastella G.
Published: January 2024

Summary:

A new semielemental formula made up of whey protein hydrolysate, medium‐chain triglyceride as 50% of fat, and glucose polymer was studied in 21 cystic fibrosis infants to determine whether its intestinal absorption was better than that of standard milk‐based formula. Each experiment lasted 10 days, during which the patient was fed for 5 days on one formula and immediately afterwards for 5 days on the alternative formula, without any pancreatic enzyme replacement. Fat and nitrogen absorption were assessed by 3‐day balance studies, stool fat was assayed by a modified Van de Kamer method, and stool nitrogen by an automatic method. Ten infants with very severely impaired digestive function (coefficient of fat absorption on normal diet ≤75%) showed a highly significant improvement in fat and nitrogen absorption, leading to a significant gain in weight when fed on semielemental diet compared with standard diet. No significant improvement was observed in fat and nitrogen absorption or in weight gain in the 11 infants with less severe malabsorption (coefficient of fat absorption on normal diet >75%). These results were obtained over a short period and have to be confirmed over a prolonged period of study with pancreatic enzyme supplementation. However, they suggest that such a semielemental diet should be effective for short‐term treatment in selected CF infants who have difficulty in starting to thrive adequately.
Postnatal Dependence of Plasma Copper and Zinc Levels on Gestational Age and Maturity Observed in Infants Fed a High Zinc Content Formula
Authors: Di Toro R. , Moro C. , Perrone L. , Rea F. , Gialanella G. , Grossi G. F. , Moro R.
Published: January 2024

Summary:

We studied the effect of gestational age and maturity on plasma zinc and copper levels at 10 and 120 days of age. The association of plasma zinc changes and body growth was also investigated. Infants were receiving a controlled intake of zinc and copper solely through a zinc‐supplemented formula (4.7 mg/L of zinc and 0.16 mg/L of copper). Twenty‐eight low‐birthweight infants (<2,500 g) having gestational ages ranging from 33 to 40 weeks [17 with an appropriate birthweight for gestational age (AGA) and 11 small for gestational age (SGA)] were enrolled in the present study. Measurements of plasma zinc and copper concentration, weight, length, head circumference, and tricipital and subscapular skinfolds were carried out at 10 and 120 days of age. Proton‐induced x‐ray fluorescence technique (PIXE) was used to assess copper and zinc concentrations. At 10 days of age a significant correlation between copper concentration and gestational age was found. At 120 days of age the copper concentration was higher than at 10 days and independent of gestational age and maturity (mean ± SEM = 116 ± 5 μg/dl). At 10 days of age no significant correlation between zinc content and gestational age was found (86 ± 4 μg/dl). The plasma zinc percent change over the period from 10 to 120 days of age was positively correlated with gestational age in the whole sample as well as in AGA and SGA infants separately. The value of gestational age at which the zinc percent change turns from negative to positive was 35.6 ± 0.7 weeks for AGA, 37.4 ± 0.5 weeks for SGA, and 36.2 ± 0.5 weeks for the whole sample. No significant correlation between the increments of the measured body features and the plasma zinc change was found. Length and weight velocities were similar in AGA and SGA infants. These observations indicate that the possibility of increasing plasma zinc level by zinc supplementation depends on gestational age and maturity.
Comparative Growth and Biochemical Response of Very Low Birthweight Infants Fed Own Mother's Milk, a Premature Infant Formula, or One of Two Standard Formulas
Authors: Cooper Peter A. , Rothberg Alan D. , Davies Victor A. , Argent Andrew C.
Published: January 2024

Summary:

Very low birthweight (VLBW) infants weighing < 1,600 g at birth were fed their own mother's milk (OMM) or randomly assigned to receive one of three formulas: a “humanized” formula (SF), a partially modified casein‐predominant cow's milk formula (CF), or a premature formula (PF). All infants were fed at 120 kcal/kg/day where possible, PF infants had significantly greater weight increments (28.0 g/day) than those on OMM (19.4 g/day), SF (18.9 g/day), and CF (18.2 g/day). Those on PF also had greater increments of length, head circumference, and skinfold thickness than those on the other two formulas and greater length increments than those on OMM. Dynamic skinfold measurements suggested that no infants accumulated excessive amounts of interstitial fluid. Infants on the two standard formulas had significantly greater base deficits, whereas those on CF also had higher urea values. Those on OMM had lower phosphate and higher alkaline phosphatase values than the other groups. Thus VLBW infants fed a premature formula had better growth and fewer biochemical problems than those on standard formulas, whereas supplementation of OMM may be necessary to ensure optimal growth and bone mineralization.
Type of Milk Substitute Influences Growth of the Gastrointestinal Tract in Artificially Reared Rat Pups
Authors: Tonkiss J. , Smart J. L. , Auestad N. S. , Edmond J.
Published: January 2024

Summary:

Growth of the gastrointestinal (GI) tract was studied in rat pups that were reared normally (motherreared, MR) or were artificially reared (AR) by intragastric infusion of milk substitutes from postnatal day 5. Two mitk substitutes were used: one high in carbohydrate and low in protein compared with rat's milk (Messer) and the other close in composition to rat's milk (Auestad). Pups reared on these formulae are termed ARM and ARA, respectively. Pups were killed at 7, 12, and 20 days for the determination of the wet and dry weights of stomach and caecum and the lengths of the small and large intestines (SI and LI). At 7 days AR pups showed deficits in several GI measures compared with MR rats. However, by 20 days they showed enhanced growth of various parts of the GI tract. Stomach weight was greatest in ARA rats; caecum weight was greater in AR than in MR rats; SI was longer in AR than MR rats, with the effect more pronounced in ARM rats. These effects were already evident, or becoming so, by 12 days. In an additional experiment, rats were AR on rat's milk from 5 to 12 days. Their GI tracts did not differ from MR, suggesting that the AR procedure per se was not responsible for the above GI growth effects.
Nephrolithiasis in Childhood Inflammatory Bowel Disease
Authors: Clark Joseph H. , Fitzgerald Joseph F. , Bergstein Jerry M.
Published: January 2024

Summary:

Six children with inflammatory bowel disease and nephrolithiasis are reported. Their mean age at the passage of the first stone was 12.5 years and the mean duration of active inflammatory bowel disease was 34.5 months. Four had ulcerative colitis and two had Crohn's disease. In three patients the onset of stone disease was associated with a flare in the bowel disease. Stone passage in four patients was accompanied by an increase in abdominal pain; three experienced gross hematuria. Stones from four of the patients were composed primarily of calcium phosphate; stones from the remaining patients contained uric acid and/or calcium oxalate. The pathogenesis of nephrolithiasis as it relates to inflammatory bowel disease is considered and an approach to therapy offered.
Fibrosarcoma in a Girl with Celiac Disease and IgA Deficiency
Authors: Verkasalo M. , Savilahti E. , Rapola J. , Wallgren E. I.
Published: January 2024

Summary:

A case of abdominal wall fibrosarcoma in a 17‐year‐old girl with celiac disease and IgA deficiency is described. Celiac disease was putatively diagnosed with intestinal biopsy at the age of 15 years when she came for hospital investigations because of IgA deficiency and recurrent respiratory infections. The tumor occurred at the age of 17 years during the gluten challenge performed for final diagnosis of celiac disease. Surgical excision, irradiation, and chemotherapy were initially successful. After 7 months, however, the tumor recurred. Reoperation and a new course of irradiation therapy coinciding with the reinstitution of a gluten‐free diet proved to be effective in tumor eradication. Nine years after the cessation of cancer treatment she is well and has two healthy children.
Pulmonary Hydrogen and Methane Excretion Following Ingestion of an Unabsorbable Carbohydrate
Authors: Flatz G. , Czeizel A. , Métneki J. , Flatz S. D. , Kühnau W. , Jahn D.
Published: January 2024

Pulmonary excretion of hydrogen and methane after administration of an unabsorbable disaccharide (lactulose) was determined in 228 adult Hungarian twins, 60 monozygous (MZ) and 54 dizygous (DZ) pairs. More than 98% of the subjects (224 of 228) excreted large amounts of hydrogen between 90 and 180 min after lactulose administration. Methane excretion in the fasting state was observed in 124 of 228 of the probands (54.4%), and 68 of 228 (29.8%) produced additional methane in response to lactulose ingestion. In contrast to hydrogen production, both methane excretion and production were significantly more frequent in females than in males. In the total group, and more distinctly in females, the correlation between peak hydrogen and methane concentrations was negative. Twin concordance of fasting methane excretion and lactuloseinduced methane production was near 70% in both MZ and DZ pairs. Heritability estimates of methane excretion and production based on intrapair correlation and variance were smaller than unity, and intrapair correlation coefficients were larger in twin pairs living apart than in those living in the same household. Methane excretion is comparatively frequent in the Hungarian population, and a substantial proportion of fasting methane excreters (55%) produce additional methane from lactulose. The sex difference of methane excretion appears to be characteristic of European populations. The twin data disprove regular Mendelian inheritance of methane production and are suggestive of genetic effects in a multifactorial system.
Absorption and Tolerance of Lactose in Infants Recovering from Severe Diarrhea
Authors: Lifschitz Carlos H. , Bautista Arturo , Gopalakrishna G. S. , Stuff Janice , Garza Cutberto
Published: January 2024

Nineteen infants were challenged during their convalescence from severe diarrhea with a lactose‐containing meal. Twenty‐four hour intake, pre‐ and post‐challenge breath H2 levels, clinical responses, and growth were measured at approximately biweekly intervals for 3 months beginning 1 month after hospital discharge. Ten lactosetolerant infants were assigned randomly to receive one of two formulas similar in composition except for carbohydrates: lactose (Group L) (n = 6) and sucrose (Group S) (n = 4). Infants in Group L had greater intakes and growth rates during the initial 15 days of the study. No difference in weight for age z‐scores was detected between groups at the end of the observation period. Infants in Group L had higher baseline and peak breath H2 levels indicating greater colonic carbohydrate fermentation than infants in Group S; however, breath H2 levels were not predictive of tolerance to lactose‐containing meals. Carbohydrate absorption by infants in Group S appeared to exceed that of infants in Group L. Thus, colonic fermentation of malabsorbed carbohydrate may have prevented diarrhea and allowed acceptable rates of catch‐up growth.
Enzymatic Activity of “High‐Mannose” Glycosylated Forms of Intestinal Microvillar Hydrolases
Authors: Sjöström Hans , Norén Ove , Danielsen E. Michael
Published: January 2024

The “high‐mannose” glycosylated forms of aminopeptidase N (EC 3.4.11.2), maltase‐glucoamylase (EC 3.2.1.20), and sucrase‐isomaltase (EC 3.2.1.48, EC 3.2.1.10) have been purified. The high‐mannose glycosylated form of sucrase‐isomaltase was found to have a lower specific activity than the complex glycosylated form, whereas no difference was observed for the two other enzymes. The change in glycosylation from high‐mannose to complex form thus seems to be of importance for the enzymatic activity of sucrase‐isomaltase either by direct structural involvement or by a general stabilization effect on the protein conformation.
The Effects of Gaviscon and Metoclopramide in Gastroesophageal Reflux in Children
Authors: Forbes David , Hodgson Margaret , Hill Richard
Published: January 2024

Oral metoclopramide (0.5 mg/kg/24 h) and a liquid alginic acid‐antacid compound were administered to infants and children with gastroesophageal reflux (GER) in a double‐blind randomized controlled trial. The effect of medication was measured with 24‐h intraesophageal pH monitoring. Neither metoclopramide nor the alginic acid‐antacid compound decreased the frequency or duration of gastroesophageal reflux.
Course and Prognosis of Idiopathic Ulcerative Proctosigmoiditis in Young Patients
Authors: Mir‐Madjlessi Seid Hossein , Michener William M. , Farmer Richard G.
Published: January 2024

The course and prognosis of idiopathic ulcerative proctosigmoiditis were studied in 85 young patients whose symptoms had begun before the age of 21 (mean age at onset, 16 years), and the results were compared with those in adults with proctosigmoiditis. Data regarding extension of disease, available in 66 patients, allowed us to identify two groups of patients. Presenting symptoms were the same in both groups. In Group I (41 patients, 62%), the disease remained stable or did not extend beyond the descending colon. In Group II (25 patients, 38%), there was evidence of extension to the hepatic flexure or beyond. Extension was unpredictable in individual patients, but generally occurred within 5 years from the onset of symptoms (73%). The clinical course and prognosis were different in each group. In Group I, there were more females, the disease ran a milder course, and there were few complications. In Group II, there were relatively more males, the disease was more active and severe, and a high incidence of intestinal and extraintestinal complications was observed. Fifteen patients, all from Group II, required colectomy. The natural history of proctosigmoiditis in young patients is somewhat different from that in adults, being characterized by a greater tendency to proximal extension (38% vs. 10%). However, when the disease remains confined to the rectosigmoid region (or does not spread beyond the splenic flexure), the course and prognosis are no different than in adults.
Estimated and Measured Energy Content of Infant Formulas
Authors: De Curtis Mario , Senterre Jacques , Rigo Jacques
Published: January 2024

This study was undertaken to assess to what extent estimated energy content of 13 infant formulas was related to gross energy measured by bomb calorimetry. Measured gross energy exceeded significantly metaboliz‐able energy as claimed by the manufacturers by applying the classical Atwater's factors by about 12% (range, 6–17%). Measured gross energy also exceeded significantly gross energy calculated by applying either FAO/ WHO or our own values of heat combustion of nutrient by 6% (range, 3–9%) and 3.5% (range, 1–6%), respectively. It is concluded that for reasons of symmetry and simplicity, the labeling of the energy content of infant formulas should continue to be calculated by applying the classical Atwater's factors to the nutrient composition. However, when accurate energy balance studies are carried out, the energy content of the diet should be measured by bomb calorimetry rather than be estimated by applying conversion factors to claimed or determined nutrient composition.
Conversion of Thyroxine into Tri‐iodothyronine in Zinc Deficient Rat Liver
Authors: Fujimoto Shigehiro , Indo Yasuhiro , Higashi Akimasa , Matsuda Ichiro , Kashiwabara Norio , Nakashima Ichiro
Published: January 2024

Hepatic thyroxine (T4) to tri‐iodothyronine (T3) conversion was measured in six animal groups: Group A was fed a severe zinc‐deficient diet (1.98 ppm) for 5 weeks; group B was a pair‐fed control group for group A; group C was fed a less severe zinc‐deficient diet (6.10 ppm) for 5 weeks; group D was a pair‐fed control group for group C; group E was fed a zinc‐supplemented control diet (90.4 ppm) for 5 weeks; and group F was first fed the severe zinc‐deficient diet for 5 weeks and then placed on the zinc‐supplemented control diet until a body weight corresponding to the final weight of group E was obtained. Serum T3 and T4 levels and T4 to T3 conversion were significantly reduced in group A. A significant positive correlation was observed between T4 to T3 conversion and alcohol dehydrogenase (zinc‐metalloenzyme) activity in liver tissue from the six groups. Thus, it appeared that an appropriate amount of zinc might be one of the factors in thyroxine to tri‐iodothyronine conversion in liver tissue normally.
Prolonged Gastric Retention of a Swallowed Coin Following Pyloromyotomy
Authors: Fleisher Arlen G. , Holgersen Leif O. , Stanley‐Brown Edward G. , Mones Richard
Published: January 2024

Ingestion of foreign objects is a common problem in children 6 months to 3 years of age. Of swallowed objects reaching the stomach, 97% will pass through the remainder of the gastrointestinal tract (1). The following is a report of a child who had a pyloromyotomy for pyloric stenosis as an infant and had prolonged retention of a swallowed penny.
Prostaglandins in Disorders of the Intestinal Tract
Authors: Branski D. , Sharon P. , Abrahamov A.
Published: January 2024

Prostaglandins (PGs) are natural oxygenated products of polyunsaturated fatty acids. They have multiple effects on the gastrointestinal tract. Their major physiological roles in the intestine are the promotion of solute and water secretion and the control of bowel motility. Prostaglandins have a role in the pathogenesis of diarrhea in a wide spectrum of gastrointestinal disorders. The effects and the potential contribution of PGs in various gastrointestinal disorders are discussed, and therapeutic modalities in these disorders are reviewed.
Choledochal Cysts
Authors: Sherman P. , Kolster E. , Davies C. , Stringer D. , Weber J.
Published: January 2024

Over a 12‐year period, 23 children were diagnosed as having choledochal cysts, of which 22 were type I and one was type II. The triad of right upper‐quadrant abdominal pain, right upper‐quadrant abdominal mass, and cholestatic jaundice was present in only four of 23 (17%). Mean time from the onset of symptoms to establishing the correct diagnosis was 20 months, and in one child the diagnosis was established only at autopsy. Six children had histologic evidence of biliary cirrhosis, and three developed portal hypertension despite surgical intervention. Both ultrasonography of the abdomen and endoscopic retrograde cholangiopancreatography (ERCP) were useful methods in establishing the diagnosis, but both tests did result in false negatives. Choledochal cysts are treatable causes of cholestatic jaundice in infants and children, but the intermittent and variable nature of their presentation renders clinical diagnosis difficult.