bluuebunny/crossref_metadata_2025 huggingface dataset:
Lipases in Preterm Human Milk
Authors: Mehta Nitin R. , Jones Jay B. , Hamosh Margit
Published: February 2024

Term human milk contains two lipases: Bile salt stimulated lipase (BSSL—this lipase also has bile salt stimulated esterolytic activity, BSSE) and lipoprotein lipase (LPL). We have measured the activity of these lipases in preterm (25–36 weeks' gestation) and term (37–40 weeks' gestation) human milk collected from the time of parturition until 3 months of lactation. BSSL levels are similar in preterm and term milk and do not vary significantly as a function of length of lactation. In the three groups of women who delivered at 26–30, 31–36, and 37–40 weeks of gestation, BSSL levels were 22.5 ± 6.6, 21.0 ± 3.6. and 32.3 ± 7.6 U/ml in colostrum and 26.3 ± 1 1.4, 31.1 ± 3.4, and 33.3 ± 10.7 U/ml in milk collected at 3 months of lactation, respectively. These observations suggest that preterm milk has the same fat digesting potential as term milk. BSSE activity decreased as a function of length of gestation and lactation, 61.2 ± 8.78, 44.4 ± 4.6, and 44.9 ± 13.3 U/ml in colostrum and 40.8 ± 5.0, 35.6 ± 9.5, and 23.3 ± 3.4 U/ml in milk collected after 3 months of lactation in the three groups studied. In all milks examined, the esterase lost its bile salt dependency upon storage at ‐ 10°C for periods of 2 weeks, suggesting that spontaneous hydrolysis of milk fat and accumulation of free fatty acids can occur in milk stored at ‐ 10°C. LPL activity increased as a function of length of gestation and lactation. LPL activity increased from 12.2 ± 3.3 U/ml in colostrum to 101.6 ± 12.6 U/ml in milk collected at 6 weeks of lactation from the preterm mothers and from 17.0 ± 9.7 U/ml in colostrum to 270 ± 15.5 U/ml in milk collected at 3 weeks of lactation from mothers of term infants. Our data suggest: (a) Milk secreted by women who deliver premature infants (26–36 weeks' gestation) has the same fat digesting potential as milk secreted by mothers of term infants, (b) The esterolytic component of the BSSL develops earlier than the lipolytic activity, (c) “Drip ” milk has higher LPL activity than milk pumped concomitantly from the other breast, suggesting that there is no relationship between mammary cell damage and LPL release, (d) Since BSSL and BSSE activities are 200− to 3,000‐fold higher in human milk than LPL activity, and since BSSE loses its bile salt dependency during storage at −10°C, the rise in free fatty acid levels in banked milks could be related to BSSE rather than to LPL.
Use of Psyllium in the Management of Chronic Nonspecific Diarrhea of Childhood
Authors: Smalley James R. , Klish William J. , Campbell Mary Ann , Brown Marilyn R.
Published: February 2024

The etiology and treatment of chronic nonspecific diarrhea of childhood is still poorly understood. We evaluated 23 children with this disorder in whom other etiologies of chronic diarrhea had been ruled out. The children were treated first with an unrestricted diet for 1 week, and if no response was obtained they were then treated with psyllium bulk agents for 2 weeks (1 tablespoon b.i.d.). Eighty‐seven percent of the patients responded to therapy. Seven patients responded to an unrestricted diet only, and 13 responded to psyllium. Only three patients (13%) did not respond. Most children were on a restricted diet at presentation, but the amount of dietary fat intake did not correlate with the response, contrary to other reports. Treatment with normalization of the diet and psyllium bulk agents seems to be an effective mode of therapy for chronic nonspecific diarrhea of childhood.
Gastroschisis
Authors: Kekomäki Martti , Savilahti Erkki , Louhimo Ilmo
Published: February 2024

Thirty‐nine newborns were treated for gastroschisis at the Children's Hospital. Helsinki University Central Hospital from 1964 to 1980. Sixteen infants died during the first hospital admission. Of the 23 survivors, II were two years or older, and these 11 children were subjected to a follow‐up examination. The incidence of the lesion increased markedly during the period of observation. Dysmaturity (birth weight at or below the 10th percentile of normal intrauterine growth) accompanied gastroschisis in 17 cases, and a low birth weight (below 2,500 g) in 23 cases. The mortality of gastroschisis was clearly and constantly decreasing, being 54% for the first decade, 23% for the last 5 years, and 41% for the total series. The age of the mothers at parturition, 20.9 years, was significantly (p < 0.001) lower than the Finnish average. The extensive clinical and laboratory analysis of the 11 oldest children with completed reconstruction of the abdominal wall indicated good physical condition and, specifically, normal absorptive function of the intestine.
Nonspecific Suppressor Cell Activity and Lymphocyte Response to β‐Lactoglobulin in Cow's Milk Protein Hypersensitivity
Authors: Weil S. , Kuperman O. , Ilfeld D. , Finelt M. , Freier S.
Published: February 2024

β‐Lactogloblin (BLG) is clinically the most frequent allergen in cow's milk protein hypersensitivity (CMPH). We therefore assessed its in vitro blastogenic effect on lymphocytes of patients suffering from CMPH. Twenty‐two patients aged from 1 to 20 months were investigated, β‐Lactoglobulin produced a significantly (p < 0.00003) higher blastogenic response in lymphocytes of patients with CMPH (mean stimulation index 7.7 ± 0.7 SEM) than in 26 age‐matched controls (2.7 ± 0.4). This response was age related, being most marked in infants up to 5 months of age. Lymphocyte proliferation following stimulation with BLG can be a useful in vitro test in the diagnosis of CMPH. Because of this augmented lymphocyte response, we considered the possibility of a related defect in immune suppression. Nonspecific concanavalin A‐induced suppressor cell activity was assessed in the above patient and control populations. Concanavalin A‐induced suppressor cell activity was significantly (p < 0.05) reduced in patients with CMPH. This too was most marked in the first few months of life. We suggest that the development of CMPH may be due to delayed maturation of a suppressor cell population.
Maturational Effect of Triiodothyronine and Its Analog 3,5‐Dimethyl‐3'‐isopropyl‐L‐thyronine on Sucrase Activity in the Small Intestine of the Developing Rat
Authors: Vaucher Yvonne E. , Anna Judy A. , Lindberg Robert F. , Jorgensen Eugene C. , Krulich Ladislav , Koldovsk Otakar
Published: February 2024

In this study we compared the effect of 3,5‐dimethyl‐3'‐isopropyl‐L‐thyronine (DIMIT) with that of triiodothyronine (T3) on sucrase activity in the small intestine of the fetal and suckling rat. DIMIT (5 μg/100 g BW) was injected into pregnant Sprague—Dawley rats on days 17–20 of gestation and DIMIT (10 and 50 μg/100 g BW) and T3 (10 and 50 μg/100 g BW) were given subcutaneously to two groups of sucklings on days 4–7 and 11–14. Fetal animals were sacrificed on day 21 of gestation; sucklings on days 8 and 15. Sucrase activity in the proximal, middle, and distal small intestine was assayed. DIMIT and T3 suppressed serum thyroid‐stimulating hormone (TSH) in the fetus and suckling. Sucrase activity was increased in all small intestinal segments in the fetal and older suckling groups. In the younger sucklings the effect was seen only in the middle and distal segments. In both fetal and suckling groups the sucrase response was dose related. Thus, DIMIT has a thyromimetic effect on development of sucrase activity. The lack of sucrase reactivity in the proximal segment of the younger (8‐day‐old) sucklings to the administration of either DIMIT or T3 is interesting but unexplained.
Characteristics of Intact Lactose Transport in Rat Jejunum In Vitro
Authors: Oyesiku J. E. J. , Muller D. P. R. , Harries J. T.
Published: February 2024

The characteristics and kinetics of intact transmucosal transport of lactose have been studied in the rat jejunum using an everted sac preparation. Lactose transport displayed linear kinetics up to the maximum concentration (150 m M) of lactose studied. Ouabain (1 m M) when placed in the serosal solution, and phlorhizin (0.1 m M) when placed in the mucusal solution, had no significant effect on lactose transport. In contrast to glucose, transport of intact lactose did not occur against a concentration gradient. These results strongly suggest that intact transmucosal transport of lactose occurs by a process of simple passive diffusion, and that it is independent of the sodium‐coupled glucose transport system.
Calcium Metabolism in Young Rats During Early Dietary Phosphate Deprivation
Authors: Urban Ernest , Beck Nama , Reineck H. John , Lee Scott
Published: February 2024

A series of in vivo experiments were designed to study the early effects of phosphate depletion on calcium metabolism in young adult (8–10 week old) rats with intact thyroid‐parathyroid glands. Hypercalciuria occurred within 24 h of dietary phosphate deprivation. It was the consequence of mobilization of calcium stores from the exchangeable calcium pool of the diaphysis of bone. Increased net intestinal absorption of calcium also occurred early. This was at least in part due to decreased net intestinal secretion of calcium into the gut lumen. Thus the early onset of hypercalciuria and hypercalcemia associated with Pi deprivation in normal growing young rats is the combined result of increased net intestinal calcium absorption and increased calcium mobilization from bone.
Failure of p‐Aminobenzoic Acid Screening Test to Diagnose Pancreatic Insufficiency in Shwachman's Syndrome
Authors: Kai Hiroshi , Nose Osamu , Harada Tokuzo , Maki Ichiro , Tajiri Hitoshi , Yabuuchi Hyakuji
Published: February 2024

The 6‐h urine recovery of p‐aminobenzoic acid (PABA) following the administration of a standard dose of N‐benzoyl‐L‐tyrosyl‐p‐aminobenzoic acid (BTPABA) was performed in 13 control subjects and two siblings with Shwachman“s syndrome. The control subjects showed a recovery of 67 ± 12.1% (mean ± 1 SD) of the administered dose, consistent with previously reported values. Unexpectedly, the recovery of PABA in two siblings with Shwachman's syndrome was found to be 67 and 63%, respectively. The values are well within the normal range. In these siblings, fecal chymotrypsin activities were very low when measured with N‐acetyl‐L‐tyrosyl‐ethyl ester (ATEE) as substrate, but were normal when BTPABA was the substrate. The duodenal juice of the younger affected child following pancreozymin‐secretin stimulation showed very low chymotrypsin activity against ATEE, BTPABA, and N‐benzoyl‐L ‐tyrosyl‐ethyl ester. These findings suggest that there may be BTPABA‐splitting activity in the lower bowel of these siblings with Shwachman's syndrome. This activity might be that of enteric bacteria or of the intestinal mucosa.
Changes in Body Composition and Muscle Protein Degradation During Nutritional Supplementation in Nutritionally Growth‐Retarded Children with Cystic Fibrosis
Authors: Shepherd R. W. , Thomas B. J. , Bennett D. , Cooksley W. G. E. , Ward L. C.
Published: February 2024

Changes in body composition and muscle protein degradation were studied in seven nutritionally growth‐retarded children with cystic fibrosis (CF) before and after nutritional supplementation and in eight healthy children who served as controls. Supplemental feedings consisted of a peptide formula that increased dietary protein and energy intakes approximately 20‐40% over a 6‐month period, delivered either as oral supplement or overnight intragastric feeding. Body composition was assessed by anthropometric data and measurements of whole body potassium (40K) and creatinine excretion. Muscle protein degradation was measured by urinary 3‐methyl‐histidine excretion, an index of myofibrillar protein catabolism. Compared with controls, CF children had significantly reduced body mass, body fat, and muscle mass, and a significantly increased rate of myofibrillar protein degradation. With nutritional supplementation, significant catch‐up weight gain and improved linear growth were observed with evidence of accretion of lean body mass and muscle mass, and in all but one severely malnourished patient with progressive disease, there was normalization of the high rate of muscle protein degradation. Thus, this form of nutritional therapy has significant benefits in terms of body protein accretion and myofibrillar protein degradation.
Metal‐Binding Ligands in Viokase
Authors: Martin Mark T. , Jacobs Francis A. , Brushmiller George J.
Published: February 2024

The object of this study was to detect low molecular weight zinc binders in Viokase®, a porcine pancreatic preparation used in the treatment of variant acrodermatitis enteropathica (AE). Extracts were centrifuged and ultrafiltered to yield a soluble fraction containing solutes of molecular weights ≤500 daltons. These were studied by modified gel chromatography (MGC) using sealed Sephadex G‐15‐120 columns equilibrated with buffered solvent systems containing either 5 ppm copper (II) or 5 ppm zinc (II). Eluted fractions were assayed for these metals by atomic absorption and for amino acids by various techniques. MGC profiles of ultrafiltrates resulted in a peak consisting of glutamic acid and another peak consisting of several amino acids. A third peak was due to metal ions. Citrate and picolinate have been claimed to be important zinc‐binding ligands in Viokase, but neither was detectable by MGC, although small amounts of citrate or similar compounds were detected by the Furth and Herrmann reaction. Since amino acid ligands are easily detectable by MGC, and metal distribution among ligands is competitive in nature, the possibility of a role for citrate or picolinate as a zinc transporter in Viokase is seriously reduced. Relief to the variant AE patient was probably not due to citrate‐ or picolinate‐enhanced zinc uptake.
Measurement of Milk Yield in Women
Authors: Hartmann P. E. , Saint L.
Published: February 2024

The measurement of milk yield in any suckling mammal is difficult, and studies on women pose additional restrictions because of the limitations on the nature of the techniques which can be used. The most commonly used method for determining milk yield in women is test weighing. In this method either the infant or the mother is weighed before and after a breast feed, and the difference between the two weights is considered to be the amount of milk produced. The reliability of the results obtained by the test weighing procedure depends on both the interval over which milk yield is recorded and the pattern of breast‐feeding adopted by the mother. Other methods including isotope dilution, infant growth, and milk expression have been used to determine milk yield in women. Estimations of the yield of breast milk are usually made either to determine the nutrient intake of the infant or to investigate the synthetic capacity of the lactating breast. These goals require the estimation of both milk yield and milk composition. Although it is difficult to obtain a reliable measure of the average fat content of milk consumed by an infant, estimates can be obtained by the use of either a nipple‐shield sampling system or a predictive equation based on the concentration of fat in fore‐ and hindmilk.
Influence of Genetic Factors on the Serum Levels of Antigliadin Antibodies in Celiac Disease
Authors: Mearin Maria Luisa , Koninckx Carmen Ribes , Biemond Izak , Polanco Isabel , Peña A. Salvador
Published: February 2024

The relationship between titers of antigliadin antibodies (IgA class and total immunoglobulins IgA, IgG, and IgM) and HLA‐DR antigens was studied in two random samples of unrelated Spanish children with celiac disease. One of these groups had been on a gluten‐free diet for at least 6 months and the other had been given a similar regimen followed by at least 6 months on a gluten‐containing diet. Children with celiac disease who had the DR7 antigen but not DR3 showed significantly higher antigliadin antibody titers on a gluten‐containing than on a gluten‐free diet, whereas those with DR3 but not DR7 did not show this difference. With respect to DR phenotypes, the children with DR3/DR7 and DR7/DR5 phenotypes had significantly higher antibody titers while consuming gluten than when on a gluten‐free diet. However, children with celiac disease with the DR31DR3 phenotype showed similar antigliadin antibody titers on both diets. The present results suggest that genetic factors in the DR region influence the humoral immune response to gliadin in celiac disease.
Fecal and Biliary Bile Acid Patterns in Children with Bile Acid Malabsorption
Authors: Tazawa Yusaku , Yamada Masaaki , Nakagawa Michiko , Suzuki Hiroshi , Igarashi Yutaka , Konno Tasuke , Tada Keiya
Published: February 2024

Bile acid metabolism was examined in two children with bile acid malabsorption, who were being treated with intravenous hyperalimentation. Fecal bile acid excretion was 1,261 μmol/m2/day in a child with bile acid malabsorption of unknown origin, and 1,877 μmol/ m2/day in a child with secondary bile acid malabsorption after an operation for long‐segment aganglionosis. These values were approximately 10 times higher than those in diarrheal or nondiarrheal children without apparent abnormalities in bile acid metabolism. Fecal bile acids in these patients with bile acid malabsorption were almost completely conjugated, with little unconjugated bile acid present. It is possible that the disturbed bile acid deconjugation in the intestine might be caused by a rapid intestinal transit time, which was found in our patients with bile acid malabsorption. In the analysis of biliary lipid composition, children with bile acid malabsorption were shown to have a chenodeoxycholate‐dominant pattern, an increased glycine‐ to taurine‐conjugated bile acid ratio, and markedly supersaturated cholesterol. Such profiles may be related not only to bile acid malabsorption but also to cholestasis, presumably due to intravenous hyperalimentation.
Plasma Selenium Concentration in Healthy Japanese Children and Adults Determined by Flameless Atomic Absorption Spectrophotometry
Authors: Hatano Shuichi , Nishi Yoshikazu , Usui Tomofusa
Published: February 2024

This study showed a rapid and direct method for determining selenium concentration in plasma by flameless atomic absorption spectrophotometry, and differences in plasma selenium concentration in healthy children and adults. A direct method is possible, since selenium is heat stable in the presence of nickel. With this method, the recovery of selenium added to plasma was 100.3 ± 5.7%, and the relative standard deviation in repeated determinations of pooled plasma selenium was 3.0% and 6.8%. The plasma selenium concentration in adults was 99.4 ± 12.5 ng/ml, lower than reported concentrations from the United States and Canada, and higher than those from New Zealand. These variations may reflect dietary habits, bioavailability of selenium compounds in diet, racial difference, or different analytical methods. The mean concentration of plasma selenium at 1 to 6 months of age (51.0 ± 13.1 ng/ml) was significantly lower than in adults (p < 0.001); it increased gradually and steadily to the adult level with age. This age‐related difference of plasma selenium level is similar to that reported previously.
Free Amino Acid Concentrations in Plasma, Erythrocytes, Granulocytes, and Lymphocytes in Umbilical Cord Blood, Children, and Adults
Authors: Fukuda Kiyotaka , Nishi Yoshikazu , Usui Tomofusa
Published: February 2024

Concentrations of free amino acids were measured concurrently in plasma, erythrocytes, granulocytes, and lymphocytes in umbilical cord blood, neonates, children, and adults. In each age group, the patterns of free amino acids were fairly similar in plasma and erythrocytes except for aspartic acid which was more abundant in erythrocytes. Of the amino acids in granulocytes, 71–77% was taurine; in lymphocytes taurine, aspartic acid, and glutamic acid comprised 35–44%, 18–24%, and 20–28%, respectively, of the total in all age groups. Leukocytes may contribute to the interorgan transport of amino acids to about 10% of the erythrocytes' contribution. Postnatally, the levels of glutamic acid and tyrosine in plasma; threonine plus glutamine, serine plus asparagine, and tyrosine in erythrocytes; histidine in granulocytes; and glutamic acid in lymphocytes were significantly increased (p < 0.001); while the levels of phenylalanine and lysine in plasma; taurine in erythrocytes; valine and phenylalanine in granulocytes; and threonine plus glutamine, tyrosine, and phenylalanine in lymphocytes were significantly decreased (p < 0.001). After the neonatal period concentrations of taurine and aspartic acid in erythrocytes, taurine and valine in granulocytes, and tyrosine and phenylalanine in lymphocytes increased gradually with age; while concentrations aspartic acid in plasma, histidine in granulocytes, and glycine in lymphocytes decreased gradually with age. The levels of glycine and valine in plasma, alanine and valine in erythrocytes, serine plus asparagine, glycine, alanine, and tyrosine in granulocytes, and aspartic acid, serine plus asparagine, and alanine in lymphocytes remained constant in all age groups. The present data may be used as reference values for studies on nutrition, metabolic diseases, and blood cell disorders in children. Although further studies are obviously necessary, these results suggest that taurine, aspartic acid, and glutamic acid may play important roles in blood cells.
R1 Reticulin Antibodies
Authors: Lazzari Rosanna , Volta Umberto , Bianchi Francesco Bianco , Collina Angela , Pisi Emilio
Published: February 2024

R1 reticulin antibodies were found in sera from patients with childhood celiac disease (CCD). Although the overall sensitivity of R1 in the diagnosis of CCD was relatively low (16/43 = 37%), when only those cases in an active phase of the disease were considered, the sensitivity increased (16/24 = 67%), In spite of its low sensitivity, the R1 assay did show a high degree of specificity, as this antibody was not found in children with post‐enteritis syndrome or in healthy controls. R1 antibodies, when found in active CCD, always turned out to be positive when tested on human liver as substrate. While this fact did not enhance the sensitivity of the test, it strengthened its specificity, since R1 found in pathological conditions other than CCD, was nearly always negative on human tissue. Although the R1 reticulin antibody test cannot replace jejunal biopsy in the diagnosis of CCD, its assay, particularly on human liver as substrate, can be considered a useful tool in the screening of celiac patients.
Intestinal Absorption of Manganese in Experimental Malnutrition
Authors: Garcia‐Aranda Jose A. , Lifshitz Fima , Wapnir Raul A.
Published: February 2024

We investigated possible changes in mechanisms of the intestinal absorption of Mn in rats malnourished with a low protein‐low energy diet (M) for 4 weeks against controls fed a complete diet (C) during the same period. The absorption of Mn in the absence or in the presence of two small molecular weight ligands, citrate and L‐histidine, was studied by an in vivo procedure. In both M and C rats, jejunal Mn absorption decreased linearly with time and was enhanced by the presence of the low molecular weight ligands. The initial rate of absorption, for Mn alone, was higher in M than in C rats, but it was indistinguishable between both groups in the presence of either citrate or L‐histidine. Total Mn absorption, in midperfusion, was greater in M than in C animals with no ligands in the solutions (means ± SEM, M = 2,969 ± 923 vs. C = 654 ± 218 pmol/cm, p < 0.05). However, in the presence of citrate or L‐histidine, the well‐nourished rats absorbed more Mn than M rats. Also, water fluxes across the mucosa had a positive correlation with Mn transport when the ligands were present. This solvent drag of the trace element was not operant in the absence of citrate or L‐histidine. These data indicate that the jejunal mucosa of M rats absorbs Mn more effectively than C animals, independently from water fluxes and the presence of small molecular weight chelators. These substances do not alter the uptake of Mn in growth‐retarded rats, while they enhance the absorption of the trace metal in well‐fed animals.
Congenital Hepatic Fibrosis
Authors: Pereira‐Lima Jorge , da Silveira Themis Reverbel , Geyer Geraldo , Scholl Joâo Grigoletti
Published: February 2024

One family with four of seven siblings with congenital hepatic fibrosis. is reported. The proband, the only member of this family with symptoms referable to the disease, was hospitalized because of an upper gastrointestinal hemorrhage. He had a presinusoidal type of portal hypertension. The other three siblings had the latent form of congenital hepatic fibrosis. In the family studied, intravenous pyelography and kidney biopsies showed normal results. This condition is possibly an inherited recessive autosomal disease.
A Quantitative Study of Enteric Endocrine Cells in Celiac Sprue
Authors: Buchan A. M. J. , Grant S. , Brown J. C. , Freeman H. J.
Published: February 2024

A quantitative morphological investigation of eight endocrine cell types in mucosal biopsies from adults with untreated celiac sprue was undertaken. The quantitative data expressed as cells per millimeter of epithelium most accurately reflected the changes seen in celiac disease, as it takes into account changes in mucosal thickness due to die absence of villi in celiac biopsies. The results showed significant increases in the number of cholecystokinin and enterochromaffin cells, a significant decrease in somatostatin, gastric inhibitory polypeptide and secretin cells, and no change in the motilin, gastrin, and glicentin cells Significant changes in cell size (cross‐sectional area) were also demonstrated in the somatostatin and gastrin cells which were smaller in the celiac biopsies.
Outpatient Use of Oral Rehydration Solutions in Apache Population
Authors: Santosham Mathuram , Foster Stephan , Garrett Steven , Croll Larry , Evans Sarah , Spira William M. , Black Robert E.
Published: February 2024

Oral Rehydration Solutions (ORS) containing 90 and 50 mmol/L sodium have recently been recommended for use in ambulatory children in the U.S. These solutions are now marketed in powder form by some commercial companies. However, few data are available in the U.S. on the accuracy with which the solutions are mixed at home or on the bacterial contamination that may occur during mixing. We evaluated the effect of various forms of instructions on the occurrence of bacterial contamination and accuracy of mixing ORS at home by mothers of patients who were dispensed the dry ingredients of an ORS containing 90 mmol/L sodium at the U.S. Public Health Service Hospital, Whiteriver, Arizona. Patients were randomized to one of the four following groups: group I (23 patients) was given written instructions for mixing the solution along with a premarked container; group II (22 patients) was given written instructions only; group III (22 patients) was given a premarked container only; and group IV (19 patients) was given neither. All patients were given oral instructions in the preparation of ORS and were asked to refrigerate the reconstituted ORS. We collected samples of ORS at the patient's home 1 day after the clinic visit, to measure their electrolyte content and to identify any bacterial contamination. Mean Na+ concentrations were significantly lower in the ORS prepared by mothers/ guardians in groups that were not given a premarked container [82 ± 13 (II) and 79 ± 21 (IV) mmol/L vs. 88 ± 13 (I) and 92 ± 14 (III) mmol/L; p < 0.01]. The frequency of refrigeration was as follows: 89, 75, 74, and 53% for groups I–IV, respectively (p = 0.15). The frequency of refrigerated samples with bacterial counts below the threshold of detection in each group was 63% (I), 33% (II), 21% (III), and 12% (IV) (p = 0.043). We conclude that when the dry ingredients of ORS are dispensed to ambulatory patients, they should be given a premarked container as well as detailed written and oral instructions.
Gastric Motility in Premature Infants Fed Two Different Formulas
Authors: Hancock Priscilla J. , Bancalari Eduardo
Published: February 2024

The effect of two different formulas on gastric contractions was investigated in 10 preterm infants, of mean birth weight 1,149 g and mean gestational age 30.5 weeks, who were being advanced from a 20 calorie per ounce formula (Enfamil) to a 24 calorie per ounce formula (Similac Special Care 24). The neonates were fed by gravity with a feeding tube on a 2‐h schedule. The orogastric tube was connected between feedings to a pressure transducer and recorder system upon which pressure waves reflecting gastric contractions were recorded. In the 1st h after feeding there were significantly fewer gastric contractions with 24 calorie than 20 calorie formula. The mean intensity of the gastric contractions per minute of contraction time was significantly less in the 1st h after feeding with the 24 calorie compared with the 20 calorie formula. In the 2nd h after feeding these values were similar. Gastric contractions are decreased with 24 calorie formula compared with 20 calorie formula during the 1st h after feeding. This difference in contractions may influence tolerance to different formulas.
Rectal or Axillary Temperature Measurement
Authors: Cottrell Barbara Hansen , Anderson Gene Cranston
Published: February 2024

Physiologic jaundice (5–6 mg/100 ml plasma bilirubin) is common and considered normal in newborn infants during the first week postbirth, but is considered abnormal in older infants. Early meconium passage correlates with lower plasma bilirubin concentrations. Rectal stimulation during rectal temperature measurement may aid passage of meconium containing potentially toxic, absorbable bilirubin. In this study, 100 clinically normal infants were assigned randomly to groups for rectal or axillary temperature measurement. The time of first meconium passage, time of first all‐yellow stool, and total plasma bilirubin were compared between groups. Bilirubin was measured during metabolic screening at 48–80 h postbirth (mean 69 h in both groups). By this time 30 infants in the rectal group, but only 17 in the axillary group, had passed yellow stools (p = 0.011). The rectal group had lower mean (±1 SD) bilirubin (5.5 mg/100 ml ± 2.7 vs. 6.5 ± 3.0, p = 0.042), and a trend toward earlier first meconium (5.9 h ± 5.0 vs. 7.3 ± 5.9, p = 0.096). For clinically normal infants in the first 48–80 h postbirth, these data suggest that rectal stimulation accompanying rectal temperature measurement enhances intestinal bilirubin excretion because of more rapid me conium passage.
The Vitamin Status of Low Birth Weight Infants and Their Mothers
Authors: Navarro J. , Causse M. Bourgeay , Desquilbet N. , Hervé F. , Lallemand D.
Published: February 2024

The levels of vitamins A, E, B1, B2, folate, and B12 were measured in maternal blood, cord blood, and in 5‐day neonate capillary blood samples. Twenty‐six infants and their mothers served as controls and were compared with 32 low birth weight (LBW) infants. LBW infants showed significantly lower levels of vitamins A, E, B2, and folate than the controls. The folate status of mothers of LBW infants was significantly lower (7 ± 1.8 ng/ml) than that of control mothers (21 ± 0.8 ng/ml).
Aeromonas hydrophila Colitis in a Child
Authors: Marsik Frederic , Werlin Steven L.
Published: February 2024

A 5‐year‐old girl presented with chronic bloody diarrhea. Evaluation including sigmoidoscopy, rectal biopsy, and barium enema was consistent with the diagnosis of ulcerative colitis. Culture of the stool grew Aeromonas hydrophila. A. hydrophila colitis may be more common than presently realized.
Chronic Diarrhea and Failure to Thrive in an Infant with Campylobacter jejuni
Authors: Pignata Claudio , Guandalini Stefano , Guarino Alfredo , De Vizia Basilio , Capano Guglielmo , de Ritis Giorgio
Published: February 2024

We report the case of an infant with chronic diarrhea and failure to thrive. Campylobacter jejuni was isolated from stools and treatment with erythromycin resulted in eradication of infection and prompt resolution of symptoms. A 22‐month‐old girl was referred to our University Hospital because of weight loss and chronic diarrhea, which did not respond to repeated dietetic trials that excluded milk, gluten, and other foodstuffs. Microscopic examination of the jejunal biopsy specimen revealed a mild degree of partial mucosal atrophy with inflammatory infiltrates in the lamina propria without any hallmarks of celiac disease. Repeated stool cultures on Butzler medium were positive for C. jejuni. This finding was associated with a high titer of specific serum antibodies. Erythromycin therapy without any other form of therapy led to prompt improvement, and the patient reached her “own‘’ 50th centile as weight/height ratio. The aim of this report is to alert pediatric gastroenterologists of the possibility that Campylobacter may be associated with chronic diarrhea and failure to thrive.
Comparison of Radionuclear Scintigraphy and Liver Biopsy in the Evaluation of Neonatal Cholestasis
Authors: Tolia Vasundhara , Dubois Reuben S. , Kagalwalla Amir , Fleming Sandra , Dua Veena
Published: February 2024

Twenty‐eight patients with neonatal cholestasis were given appropriate tests to arrive at a definitive diagnosis. Comparison of the results showing total obstruction on scintigraphy but not on liver biopsy is presented. It is suggested that liver biopsy be performed to confirm the diagnosis prior to undertaking exploratory laparotomy when radionuclear scan suggests extrahepatic biliary atresia.
Hepatomegaly Following Short‐Term High‐Dose Steroid Therapy
Authors: Iancu Theodore C. , Shiloh Hanna , Dembo Leslie
Published: February 2024

Children treated with large doses of corticosteroids were found to develop hepatomegaly within a few days. No relationship could be established between the condition for which steroids were given and the liver enlargement. Liver biopsy was thought to be indicated, and thus was performed in three children because of diagnostic uncertainty. The light and electron microscopic examinations revealed normal liver architecture, without edema, sinusoid engorgement, or inflammatory changes. The hepatocytes were distended by increased amounts of glycogen. In a pattern reminiscent of some glycogen storage diseases, mitochondria and other cytosol components were displaced toward the cell membrane or around the nucleus, which occasionally contained glycogen. Moderate sinusoidal compression, interhepatocytic free glycogen particles, and mild increase in lipid droplets were also found. It is concluded that the hepatomegaly noted in patients given short‐term, high‐dosage steroid therapy is due to excessive glycogen accumulation within parenchymal cells. This finding is in accordance with observations in animals, as well as with biochemical studies demonstrating hepatocytic glycogen deposition after steroid therapy. Being benign and reversible, early hepatomegaly following administration of high‐dose corticosteroids should not influence the initial therapeutic plan required by the basic disease.
Gastric Acid Hypersecretion in Short Bowel Syndrome in Infants
Authors: Hyman Paul E. , Everett Susan L. , Harada Tokuzo
Published: February 2024

To determine the frequency of gastric acid hypersecretion in infants with chronic malabsorption due to short bowel syndrome, acid secretory function was determined in 23 infants with malabsorption 2‐22 months following small bowel resection and in a control group of 14 chronically ill, age‐ and weight‐matched infants who did not undergo bowel resection. The prevalence of basal acid hypersecretion (defined as acid output 2 SD above the mean for the control group) was 17% (4 of 23). Basal gastric acid hypersecretion was associated with two factors: massive small bowel resection and initiation of enteral feeding. Basal acid hypersecretion was present on the initial study in 3 of 7 infants with less than one‐third of the small bowel remaining, but in only 1 of 16 with more than one‐third intact (p < 0.05). Hypergastrinemia was present in 3 of 6 infants following massive bowel resection, but in only 1 of 15 with more than one‐third intact (p < 0.05), but hypergastrinemia was not consistently associated with hypersecretion. In each of six previously unfed infants, a trial of enteral feeding resulted in increased basal and maximal acid output. Three infants developed basal acid hypersecretion during initiation of enteral feeding. There was no evidence of pentagastrin‐stimulated maximal acid hypersecretion in any of the infants.
Vitamin B12 Absorption Capacity in Healthy Children
Authors: Hjelt Karsten , Krasilnikoff Peter A.
Published: February 2024

B12 absorption was investigated in 47 healthy children aged 7 months to 15.8 years (median 4.9 years). The patients had either recovered from giardiasis, the post‐gastroenteritis syndrome, or had celiac disease in remission (treated with a gluten‐free diet). The B12 absorption was measured by a double‐isotope technique using 57CoB12 and51CrCl3, the latter being the inabsorbable marker. The radiation dose was minimal. The results were presented as fractional absorption of B12 (FAB12). Within the different age groups, the absorption test was performed by means of the following oral amounts of B12: 0‐ < 1 year, 0.5 μg; 1‐3 years: 1.7 μg, 4‐6 years, 2.5 μg; 7‐10 years; 3.3 μg; and 11‐15 years, 4.5 μg. When using these oral amounts of B12, the medians (and ranges) of FAB12 were found to be: 1‐3 years (n = 18), 37% (16‐80%); 4‐6 years (n = 10), 27% (19‐40%); 7‐10 years (n = 9), 32% (21‐44%); and 11‐15 years (n = 8), 27% (19‐59%). The FAB12 in two children aged 7 and 11 months was 31% and 32%, respectively. These results may be interpretated as reference values for B12 absorption in children. Further absorption tests were performed in seven children representing the four age groups from 1 to 15 years. When a high oral amount of B12 was given (i.e., three times the saturation dose), the FAB12 ranged from 0 to 20% (median 9%), whereas a low amount (i.e., one‐ninth of the saturation dose) produced fractional absorptions from 65 to 82% (median 74%). These observations provide evidence that the saturation mechanism of B12 absorption in children is, in principle, similar to the one in adults. As the median FAB12 values for the above mentioned reference values for B12 absorption in children averaged about 30%, it may be concluded that the corresponding oral doses of B12 represent saturation amounts. Furthermore, our data show that children's absorption capacity makes it possible for them to absorb a considerable fraction of the amounts of B12 stated as Recommended Dietary Allowances (RDA) for children in the different age groups. To the best of our knowledge, this study is the first of its kind in children.
Folate Nutrition is Optimal in Exclusively Breast‐Fed Infants but Inadequate in Some of Their Mothers and in Formula‐Fed Infants
Authors: Salmenperä Leena , Perheentupa Jaakko , Siimes Martti A.
Published: February 2024

Plasma concentrations of folate were studied in a group of exclusively breast‐fed infants and their mothers (their numbers gradually decreased from 200 at birth to 7 at 12 months) and in infants completely weaned to a cow's milk formula (containing 35 μg of folate/L) and solid foods. The exclusively breast‐fed infants were in no danger of folate deficiency; their plasma levels were elevated after the age of 2 months and, on average, were 2.0‐3.3‐fold higher than maternal levels throughout the study. None of these infants ?? whereas up to 5% of the mothers had values ≤ 3 μg/L, despite supplementation during lactation with 0.1 mg folate/day. In the formula‐fed infants, 69‐94% of the plasma folate concentrations lay below the lowest concentration for the breast‐fed infants. Although no infant had signs of anemia or macrocytosis in red cell indices, the infants weaned earliest had the lowest hemoglobin concentrations (p = 0.09) and the highest mean corpuscular volume (MCV) values (p = 0.06) at 9 months of age. Thus, an infant fed a formula containing the recommended amount of ??
Seasonal Differences in Serum Vitamin D Binding Protein in Exclusively Breast‐Fed Infants
Authors: Specker Bonny L. , Tsang Reginald C. , Ho Mona , Buckley Donna
Published: February 2024

Vitamin D binding protein (DBP) is the major carrier for vitamin D and its metabolites in serum. DBP increases in pregnancy and decreases in cirrhosis; no seasonal variation has been reported in adults. We observed significant seasonal differences in 41 exclusively breast‐fed infants who were less than 6 months of age. Winter DBP concentrations exceeded summer DBP concentrations: 398 ± 22 versus 297 ± 20 μg/ml (mean ± SEM). The mean concentration for spring and fall was 329 ± 25 μg/ml. Maternal DBP concentrations did not differ by season. A sunshine exposure score, previously verified, was used to document time and body surface exposed to the sun. DBP was inversely related to sun exposure (r = −0.46, p = 0.005). Infant DBP was significantly and negatively correlated with 25‐hydroxyvitamin D concentrations (r = − 0.38, p = 0.02). We speculate that serum DBP fluctuations are a response to varying vitamin D needs: increased serum DBP occurs in low vitamin D status to maximize uptake of vitamin D from skin.
Abnormal Expression of Secretory Component in Term Newborns with Bowel Perforation—A Report of Two Cases
Authors: Arends J. W. , Walther F. J. , Forget P. P. , Huber J. , Bosman F. T.
Published: February 2024

Expression of secretory component (SC) in intestinal resection specimens from two term newborns with bowel perforation due to necrotizing enterocolitis (NEC) or an NEC‐like syndrome was determined and compared with the SC immunoreactivity in a panel of intestinal tissues from fetuses at different ages of gestation. Expression of SC was absent in one patient, whereas in the other patient, SC immunoreactivity was observed in the basal cell part of colonic epithelium only. SC was normally expressed in a follow‐up biopsy on one of these patients. In contrast, SC was present in the apical plasma membrane and brush border of colonic epithelium from 32 weeks of gestation onwards in fetuses without demonstrable intestinal disease. From these findings we conclude that the expression of SC was impaired in our patients, thus possibly playing a role in the development of the bowel perforation in these full‐term newborns with an NEC‐like syndrome or resulting from its pathogenesis.
Pseudomembranous Colitis in a Preterm Neonate
Authors: Singer Don B. , Cashore William J. , Widness John A. , Campognone Paul , Hillemeier Craig
Published: February 2024

This preterm female infant abruptly developed diarrhea and bowel distention at 25 days of age and died within 60 h with fulminating pseudomembranous colitis and proctitis. Toxin‐producing C. difficile was recovered from the stool. The pseudomembranous colitis developed 12 days after the last dose of ampicillin was given to the baby. Necrotizing enterocolitis, a condition pathologically distinct from pseudomembranous colitis, was also present.
Effect of Energy Repletion on Dynamic Aspects of Protein Metabolism of Malnourished Adolescent and Young Adult Patients with Cystic Fibrosis During the First 12 Days of Treatment
Authors: Pencharz P. , Hill R. , Archibald E.
Published: February 2024

Summary: The short‐term effect of nutritional rehabilitation on whole body protein metabolism of six malnourished (energy depleted) adolescent and young adult cystic fibrosis (CF) patients was examined during the first 12 days of treatment. Refeeding was accomplished using continuous nasogastric administration of an elemental diet. Intakes were 1.65 SD 0.3 g protein/kg/day and 85.3 SD 19.2 kcal/kg/day. Turnover measurements were carried out on four occasions, during the control period on a normal diet and days 4, 8, and 12 on the elemental diet. In response to refeeding, whole body amino nitrogen flux (Q) fell consistently over the study (p < 0.05). Protein synthesis (S) and breakdown (B) also fell but their values did not reach statistical significance. On the other hand, there was a prompt increase in ratios S/Q and B/Q in response to tube feeding discernible on days 4 and 8 (p < 0.05), but which returned to baseline by day 12. We conclude that malnourished CF patients who are still eating well have increased rates of protein turnover. There is a prompt response of protein metabolism to energy repletion with a progressive decline in rates during the first 12 days of treatment.
Persistent Morbidity and Mortality of Protein Calorie Malnutrition in Young Infants with CF
Authors: Abman Steven H. , Accurso Frank J. , Bowman C. Michael
Published: February 2024

Summary: Young infants with cystic fibrosis (CF) are at risk for developing symptomatic protein‐calorie malnutrition (PCM) characterized by hypoalbuminemia, edema, and anemia. We reviewed the hospital charts of all infants <12 months of age referred to our CF clinic between 1979 and 1982 and found nine patients with PCM (13%). Their courses were characterized by age <7 months (nine patients), frequent use of soy formula (eight patients), presence of gastrointestinal or respiratory symptoms before being diagnosed with CF (eight patients), severe respiratory distress often requiring mechanical ventilation (five patients), significant infections (three patients), and high mortality (five patients). We further noted that eight infants were not on pancreatic enzyme therapy at the onset of PCM. This clinical study extends the findings of earlier reports of PCM in patients with CF by showing that this syndrome persists as a major source of morbidity and mortality in young infants with CF, especially those fed soy formula and not receiving pancreatic enzyme supplements. Because PCM can develop rapidly and may be the presenting sign of CF in young infants, we speculate that early diagnosis of CF with institution of pancreatic supplements may decrease incidence and severity of PCM in young patients with CF.
Nutritional Balance Studies in Very‐Low‐Birth‐Weight Infants
Authors: Shenai Jayant P. , Dame Margaret C. , Churella Helen R. , Reynolds John W. , Babson S. Gorham
Published: February 2024

Summary: Although the optimal type and amount of protein for feeding very‐low‐birth‐weight (VLBW) infants is not well defined, a protein composition with a whey protein to casein ratio of 60/40 is generally considered desirable. This study used the metabolic balance technique to compare nitrogen retention rates in 19 VLBW (< 1,530 g) infants fed either an experimental whey protein‐predominant formula (WPF) containing ultra filtered whey protein or a conventional casein‐predominant formula (CPF) containing ∼20% more protein and more minerals. Blood chemistries and anthropometric measurements were assessed serially. Although infants fed CPF received and retained more protein than infants fed WPF, nitrogen retentions were 73.1 and 74.5% of intake, respectively, and not different between the two feeding groups. The data suggest that proteins from either WPF or CPF are adequately utilized by VLBW infants. Although WPF permitted nitrogen retention rates similar to fetal accretion rates, CPF more nearly met estimated nitrogen requirements of the low‐birth‐weight infant. Infants fed WPF showed a more favorable course with respect to their metabolic acid‐base status, characterized by normal buffer base concentrations and less predisposition to metabolic acidosis. We conclude that whey‐predominant protein is preferable to casein‐predominant protein in the diet of VLBW neonates because it may lessen the risk of metabolic acidosis and its potential adverse effects.