bluuebunny/crossref_metadata_2025 huggingface dataset:
Social class and conspicuous brand logo in gift choice
Authors: Lee Jaehoon , Haderlie Todd C. , Miyazaki Anthony D. , Lee Yuri
Published: January 2024

While conspicuous consumption may be more prevalent for consumers identified as lower (vs. higher) social class, little is known about when and why they prefer conspicuousness in their consumption activities. Drawing from the conceptual perspectives of class‐based norms and self‐protection, we demonstrate the differential effects of social class on preferences for conspicuous logos and the possible explanations underlying the effects. To this end, we employ gift‐giving contexts and identify gift recipients (self‐recipient vs. other‐recipient) as an important boundary condition. Across four studies, lower‐ (vs. higher‐) social‐class consumers exhibit stronger preferences for conspicuous logos, particularly when choosing a gift for others. This effect occurs because lower‐ (vs. higher‐) social‐class consumers have a stronger desire to fit in with others and gain social status. These findings shed light on when and why lower‐social‐class consumers prefer conspicuous logos.
Mucinous adenocarcinoma derived from villous adenoma of the kidney with muconephrosis
Authors: Kawamoto Tsubasa , Ishida Masanori , Yorozu Takashi , Arizono Elly , Wakabayashi Yukari , Nagao Toshitaka , Ohno Yoshio , Saito Kazuhiro
Published: January 2024

Key Clinical Message

Upper respiratory tract villous adenoma (VA) with muconephrosis is rare and should be included in the differential diagnosis when pelvic dilatation with a solid component is detected. VA may transform into malignant mucinous adenocarcinoma, which should be suspected if contrast enhancement on computed tomography (CT)/magnetic resonance imaging (MRI) and restricted diffusion on MRI are observed.
Large tumoral pseudoangiomatous stromal hyperplasia with ER/PR stromal negativity in a 20‐year‐old female: A rare case report
Authors: Mansour Somar , Abdul Rahman Seif‐Aldin , Kazour Ali , Salama Ibrahim , Shmayes Hussain , Rajab Samer , Issa Rana
Published: January 2024

Key Clinical Message

Pseudoangiomatous stromal hyperplasia (PASH) is a rare lesion of the breast stromal tissue with unknown mechanism. Hormonal stimulation of mammary myofibroblasts is the most important theory due to stromal positivity of progesterone receptor (PR) or/and estrogen receptor (ER). We report a case of PASH with stromal PR/ER negativity.
Combined life‐threatening internal organ bleeding and postpartum hemorrhage associated with acquired hemophilia A
Authors: Kanitthamniyom Chanakarn , Siladech Pharit , Polpichai Natchaya , McCullough Maireigh , Saowapa Sakditad
Published: January 2024

Key Clinical Message

Acquired hemophilia A (AHA) can present as life‐threatening bleeding during the postpartum period. Prompt treatment allows patients with AHA to achieve complete remission and have normal subsequent pregnancies.

Acquired hemophilia A (AHA) is a rare bleeding disorder caused by the production of autoantibodies against factor VIII (FVIII). AHA can present with severe bleeding, especially in postpartum patient. We report a 38‐year‐old woman who presented in an emergency department with severe postpartum hemorrhage 2 weeks after cesarean section. Her investigation showed an isolated prolongation of partial thromboplastin time (PTT), low factor VIII assay and a factor VIII inhibitor test, resulting in abnormal Bethesda units which consistent with AHA. This case report highlights the importance of early diagnosis and treatment of AHA. With timely and appropriate management, most patients can achieve a good outcome.
Brain herniation and subsequent complications following partial resection of high‐grade glioma: A case report
Authors: Hanif Sheheryar , Yousaf Irfan , Iqbal Maham , Kumari Usha , Surani Salim
Published: January 2024

Key Clinical Message

This case highlights the need for tailored strategies to address issues like brain herniation, subdural hygroma, and cerebrospinal fluid leak, which, if not managed promptly, can lead to long‐term neurological deficits. Additionally, the role of specialized facilities in delivering highly specialized care for managing such intricate cases cannot be understated.

Decompressive craniectomy‐induced subdural hygroma (SDH) frequently coexists with external cerebral herniation, resulting in neurological impairments. The incidence of brain herniation through a craniectomy defect postoperatively is 25%. Brain herniation (BH), SDH, and cerebrospinal fluid leak require urgent neurosurgical management as they can lead to irreversible long‐term neurological deficits. We report a case of a 42‐year‐old male who presented with headache and grand mal seizures. He was diagnosed with herniation of brain parenchyma through the surgical defect with a displacement of the bone flap by a heterogeneously enhancing lesion in the left parietal lobe along with SDH in the left frontoparietal region post partial resection of high‐grade glioma. In this report, we discuss the pathogenesis and management strategies of brain herniation, wound infection, cerebrospinal fluid (CSF) leak, ipsilateral SDH, floating bone flap, and communicating hydrocephalus in an adult patient following partial resection of high‐grade glioma. This particular case emphasizes the value of an individualized patient‐centered surgical approach to minimize the risk of postoperative complications.
Understanding the correlation between energy‐state mismatching and open‐circuit voltage loss in bulk heterojunction solar cells
Authors: Yang Hyun‐Seock , Kim Danbi , Oh Chang‐Mok , Tamilavan Vellaiappillai , Hangoma Pesi M. , Yi Hojun , Lee Bo R. , Shin Insoo , Hwang In‐Wook , Park Sung Heum
Published: January 2024

Photoinduced intermolecular charge transfer (PICT) determines the voltage loss in bulk heterojunction (BHJ) organic photovoltaics (OPVs), and this voltage loss can be minimized by inducing efficient PICT, which requires energy‐state matching between the donor and acceptor at the BHJ interfaces. Thus, both geometrically and energetically accessible delocalized state matching at the hot energy level is crucial for achieving efficient PICT. In this study, an effective method for quantifying the hot state matching of OPVs was developed. The degree of energy‐state matching between the electron donor and acceptor at BHJ interfaces was quantified using a mismatching factor (MF) calculated from the modified optical density of the BHJ. Furthermore, the correlation between the open‐circuit voltage (Voc) of the OPV device and energy‐state matching at the BHJ interface was investigated using the calculated MF. The OPVs with small absolute MF values exhibited high Voc values. This result clearly indicates that the energy‐state matching between the donor and acceptor is crucial for achieving a high Voc in OPVs. Because the MF indicates the degree of energy‐state matching, which is a critical factor for suppressing energy loss, it can be used to estimate the Voc loss in OPVs.
Orbital Analysis Captures the Existence of a Mixed‐Valent CuIII−O−CuII Active‐Site and its Role in Water‐Assisted Aliphatic Hydroxylation
Authors: Arora Sumangla , Rawal Parveen , Gupta Puneet
Published: January 2024

The Cu−O−Cu core has been proposed as a potential site for methane oxidation in particulate methane monooxygenase. In this work, we used density functional theory (DFT) to design a mixed‐valent CuIII−O−CuII species from an experimentally known peroxo‐dicopper complex supported by N‐donor ligands containing phenolic groups. We found that the transfer of two‐protons and two‐electrons from phenolic groups to peroxo‐dicopper core takes place, which results to the formation of a bis‐μ‐hydroxo‐dicopper core. The bis‐μ‐hydroxo‐dicopper core converts to a mixed‐valent CuIII−O−CuII core with the removal of a water molecule. The orbital and spin density analyses unravel the mixed‐valent nature of CuIII−O−CuII. We further investigated the reactivity of this mixed‐valent core for aliphatic C−H hydroxylation. Our study unveiled that mixed‐valent CuIII−O−CuII core follows a hydrogen atom transfer mechanism for C−H activation. An in‐situ generated water molecule plays an important role in C−H hydroxylation by acting as a proton transfer bridge between carbon and oxygen. Furthermore, to assess the relevance of a mixed‐valent CuIII−O−CuII core, we investigated aliphatic C−H activation by a symmetrical CuII−O−CuII core. DFT results show that the mixed‐valent CuIII−O−CuII core is more reactive toward the C−H bond than the symmetrical CuII−O−CuII core.
Can trait matching inform the design of pollinator‐friendly urban green spaces? A review and synthesis of the literature
Authors: Adedoja Opeyemi A. , Mallinger Rachel E.
Published: January 2024

Land use change is a major driver of pollinator decline and loss of pollination services. For plant and pollinator interactions to persist in rapidly changing urban systems, co‐occurring species must share matching traits, including phenological, morphological, and physiological traits. Thus, the knowledge of trait matching among interacting plants and pollinators can aid in the design of pollinator habitats and enhance the conservation value of urban green spaces, but this remains relatively understudied. Here, we review how trait matching facilitates the persistence of interactions and creation of new interactions in urban plant–pollinator networks. We highlight four major urban drivers facilitating the restructuring of plant–pollinator networks through species loss and gain in urban areas. We also show different pathways by which the matching of morphological, phenological, and physiological traits of interacting plants and pollinators is affected by urbanization. Furthermore, we show how the knowledge of functional traits can help to predict novel plant–pollinator interactions in urban environments, including those among exotic species. Finally, we show how the application of trait matching can aid management practices, facilitating the design and creation of sustainable green spaces that will accommodate functionally diverse pollinators and plants within the urban matrix.
Facile Synthesis of β‐Brominated Manganese Porphyrins and their Catalytic Potentials for Haloperoxidases‐Like Activity
Authors: Maurya Mannar R. , Prakash Ved , Avecilla Fernando , Sankar Muniappan
Published: January 2024

A novel and sustainable approach has been developed for the synthesis of β‐brominated Mn porphyrins, [MnIII(Br)(TPPBr4)] (2), [MnIII(Br)(TPPBr6)] (3) and [MnIV(Br)2(TPPBr8)] (4) by self catalytic haloperoxidase mimicking activity of [MnIII(Br)(TPP)] [bromo(meso‐tetraphenylporphyrinato)manganese(III)] (1) in aqueous medium under different mild and controlled reaction conditions. By precisely tweaking important parameters (e. g. H2O2, HClO4 and KBr), these polybrominated porphyrin complexes have been synthesized. This method is safer and applicable under milder reaction conditions than the conventional procedures for β‐bromination of porphyrins. These complexes were characterized by various spectroscopic techniques, including UV–Vis spectroscopy, elemental analysis, MALDI‐TOF mass spectrometry, cyclic voltammetry, DFT calculations and single crystal X‐ray diffraction analysis. Bromination of various phenol derivatives via haloperoxidase‐catalyzed reaction using these manganese complexes has been explored. Carrying out the catalytic reaction at room temperature in the presence of H2O2 as an oxidant and KBr as a brominating agent in a mild aqueous acidic condition results in good to excellent yield of the brominated product(s). Extra stability of 4 compared to other catalysts due to trans‐[Br−MnIV−Br] structure possibly prevents the interaction of Mn with oxidant which makes it less potential catalyst compared to 1, 2 and 3. Suitable catalytic reaction mechanism has been proposed for the bromination of substrates after identifying the reaction intermediates using mass spectrometry.
Unleashing the Power of Plasma and Flow: A Novel Cold Plasma‐Oscillatory System for Enhanced Continuous Biodiesel Production from Sunflower Oil
Authors: Taki Kimia , Hosseinzadeh Samani Bahram , Anasari Ardali Ali
Published: January 2024

While fossil fuel resources are limited, the increasing demand for energy in the industrial and transportation sectors has led to using renewable fuels. This study aims to improve biodiesel production from sunflower oil by combining cold plasma and oscillatory systems through a transesterification process. The four main operational variables are examined, such as molar ratio (MR) (1:6–1:12), catalyst concentration (CC) (0.5–1.25 wt%), plasma exposure time (PET) (25–75 s), and residence time (RT) (30–90 s). The smooth periodic constriction reactor's physical attributes, including the diameter of the tube (D), the diameter of the constricted region (d0), and the distance between baffles (l), as well as the properties of the cold plasma system, are determined. The data analysis presents that PET, RT, CC, and MR have the greatest effect on efficiency. This optimization indicates that by exposing the reaction mixture to plasma for 59.99 s, adding 1.09% by weight of the catalyst, and with a MR of 7.17 in 86.43 s, biodiesel with a conversion percentage of 94.75% is produced. The results show that the optimum point matches with EN 14214 standard.
LC‐ESI‐QTOF‐MS/MS characterization of phenolic compounds in Australian native passion fruits and their potential antioxidant activities
Authors: Liu Haoyao , Agar Osman Tuncay , Imran Ali , Barrow Colin J. , Dunshea Frank R. , Suleria Hafiz A. R.
Published: January 2024

Passion fruits, renowned globally for their polyphenolic content and associated health benefits, have enjoyed growing attention from consumers and producers alike. While global cultivar development progresses, Australia has pioneered several native cultivars tailored for its distinct planting conditions. Despite their cultivation, comprehensive studies on the phenolic profiles and antioxidant capacities of these Australian‐native passion fruits are notably lacking. This study aims to investigate and compare the polyphenolic content present in the by‐products, which are peel (L), and consumable portions, which are the pulp and seeds (P), of four indigenous cultivars: ‘Misty Gem’ (MG), ‘Flamengo’ (FG), ‘Sweetheart’ (SW), and ‘Panama’ (SH). Employing LC‐ESI‐QTOF‐MS/MS for profiling, a comprehensive list of polyphenols was curated. Additionally, various antioxidant assays—DPPH, FRAP, ABTS, RPA, FICA, and •OH‐RSA—were performed to evaluate their antioxidant potential. A total of 61 polyphenols were identified, categorized into phenolic acid (19), flavonoids (33), and other phenolic substances (9). In the antioxidant assays, the SHP sample exhibited the highest •OH−‐RSA activity at 98.64 ± 1.45 mg AAE/g, while the FGL sample demonstrated prominent DPPH, FRAP, and ABTS activities with values of 32.47 ± 1.92 mg TE/g, 62.50 ± 3.70 mg TE/g, and 57.84 ± 1.22 mg AAE/g, respectively. Additionally, TPC and several antioxidant assays had a significant positive correlation, including DPPH, FRAP, and ABTS. The Australian‐native passion fruits revealed distinct polyphenolic profiles and diverse antioxidant capacities, establishing a foundation for deeper health benefit analyses. This study accentuates the significance of understanding region‐specific cultivars and their potential nutraceutical applications.
Lactose Enhances Mineral Absorption in Infancy
Authors: Ziegler Ekhard E. , Fomon Samuel J.
Published: January 2024

To determine if lactose promotes the intestinal absorption of calcium and other minerals by infants, metabolic balance studies were performed with infants fed two formulas nearly identical in composition except for carbohydrate. One contained only lactose and the other contained sucrose and corn starch hydrolysate. Each of six normal infants had two balance studies performed with each formula in alternating sequence. When lactose was the carbohydrate, net absorption and net retention of calcium were significantly greater than when lactose was not present in the formula. Absorptions of magnesium and manganese were also significantly enhanced by lactose. Absorptions of copper and zinc were somewhat greater (not statistically significant) when lactose was present, whereas absorption of iron was not affected. Absorption of phosphorus was not different, but urinary excretion was less when the lactose‐containing formula was fed and, hence, net retention of phosphorus was significantly enhanced. These results confirm findings from animal studies and previous human studies and show that, in infants, lactose has a significant and sustained promoting effect on absorption of calcium and other minerals.
Gastric Emptying Times of Water in Infants and Children
Authors: Euler Arthur R. , Byrne William J.
Published: January 2024

Thirty children without and 15 with gastroesophageal reflux had 1‐h gastric emptying rates of water determined by a double dilutional method. The rates were similar in each group at all time intervals. No correlation between age, weight, or surface area and emptying rates was found.
Allergenicity of Whey Protein
Authors: Pahud Jean‐Jacques , Monti Julio César , Jost Rolf
Published: January 2024

Enzymatic in vitro hydrolysis was evaluated as a possible treatment to abolish the allergenicity of whey proteins in view of their use in infant formulas. Guinea pigs without prior immunological contact (including fetal life) with cow'S milk were fed various preparations of cow'S milk proteins. Oral exposure to milk or untreated whey protein led to anaphylactic sensitization of the animals. In contrast, trypsin‐hydrolyzed whey protein and a peptide preparation produced from the tryptic hydrolysate by ultrafiltration were devoid of sensitizing capacity by the oral route. The hydrolysate (crude or purified) was also ineffective in triggering local or systemic anaphylaxis in previously sensitized animals.
Copper Deficiency in Infants with Active Celiac Disease
Authors: Goyens Philippe , Brasseur Daniel , Cadranel Samy
Published: January 2024

Celiac disease was diagnosed in two unrelated infants aged 7 and 7.5 months with severe malnutrition. They showed typical clinical, biological, and histological signs of the disease. Moreover, accompanying copper deficiency was suggested by severe hypocupremia and persistent neutropenia; bone radiographs were also compatible with this diagnosis. Rapid and complete correction of these anomalies could only be obtained after addition of oral copper sulfate to the gluten free diet. Mechanisms possibly involved in the development of copper deficiency in young infants with celiac disease are: (a) chronic malabsorption; (b) high copper needs in rapidly growing infants; and (c) possibly increased biliary and digestive losses. It is therefore suggested that young children with severe celiac disease should be monitored for their copper status.
Dietary Regulation of Intestinal Lactase and Sucrase in Adult Rats
Authors: Goda T. , Bustamante S. , Koldovský O.
Published: January 2024

To characterize the mechanisms leading to dietary evoked increases of lactase and sucrase activities by carbohydrates, we performed a quantitative comparison of the effects of lactose and sucrose on the corresponding disaccharidases in the jejunum of 2‐month‐old rats. For. 7–10 days the rats were fed a low‐starch (5 cal%), high‐fat (73 cal%) diet, and for various periods of time (3–72 h) were given an isocaloric sucrose or lactose (20, 40, or 70 cal%) diet. Lactase and sucrase activities in jejunal homogenates were significantly increased within 3 h after the initial feeding of the sucrose (40 cal%) diet. After 3 h of feeding the sucrose diet, sucrase activity gradually increased and reached its maximum at 24 h, whereas lactase activity did not exhibit further change. Increased intake of sucrose led to an increase of lactase and sucrase activity. Within a range of doses of digestible amounts of lactose, the effect of diet containing lactose on these disaccharidase activities was similar to the effect of the diet containing sucrose. This similarity suggests the important role of the common constituent sugar, i.e., glucose. Further, analyses of response to these disaccharides along the villus‐crypt axis revealed that the increase of lactase activity occurs at a more apical and broader locus of cohort of epithelial cells along the height of the villus than that of sucrase, suggesting that different mechanisms are involved in dietary regulation of lactase and sucrase.
Bethanechol for Pediatric Gastroesophageal Reflux
Authors: Orenstein S. R. , Lofton S. W. , Orenstein D. M.
Published: January 2024

To investigate the effect of bethanechol on postprandial gastroesophageal reflux in children, and the relationship between its effect on the lower esophageal sphincter pressure and its effect on reflux, we studied 31 consecutive children with pathologic reflux, using manometry and pH probe, both before and after administration of bethanechol. The initial sphincter pressure was subnormal in only 35% of the patients. The bethanechol‐treated sphincter pressure was increased in 97% of the patients (from 13.4 ± 1.3 to 34.1 ± 2.6 mm Hg) and was normal in 97% of the patients, yet bethanechol did not improve any measure of postprandial reflux in the patient group as a whole. Furthermore, the 20 patients with normal sphincter pressures had significant worsening of their percent of postprandial time with reflux (from 21.8 ± 5.3 to 33.8 ± 6.0%, p = 0.009). Thus, this study demonstrates a failure of the acute administration of bethanechol to improve postprandial gastroesophageal reflux and raises the issue of whether the widespread use of bethanechol to treat reflux in children is appropriate.
Chronic Intestinal Pseudo‐obstruction Syndrome in Pediatrics
Authors: Vargas Jorge H. , Sachs Paula , Ament Marvin E.
Published: January 2024

A total of 87 cases of chronic intestinal pseudo‐obstruction were identified as fitting the criteria for the syndrome. Five families, three with autosomal dominant inheritance, accounted for 15 cases. The remainder were single cases in families, indicating either autosomal recessive inheritance, spontaneous mutation, or acquired disease. Of the 87 patients, 47 were male; 19 patients were symptomatic at birth and 37 (43%) within the first month of life; 64% were diagnosed by the first year of age and the remainder were diagnosed by 18 years of age. Patients currently range in age from 3 months to 24 years. Abdominal distension in 70, vomiting in 50, and constipation in 50 of the 87 cases were the three commonest presenting symptoms. Diarrhea and failure to thrive were present in 20 cases. Urinary tract infection and failure to void were present in 10 cases. Diagnosis was established by clinical presentation, radiographic studies. and at exploratory laparotomy. Esophageal motility was abnormal in 14 patients. Anal manometric studies were done in 16 and snowed normal recto‐anal inhibitory reflex in all but one. Only 34 patients had biopsy studies as part of their evaluation and, of these, only 12 were full‐thickness. Abnormal plexuses were found in eight and degeneration of smooth muscles in four. There was little or no benefit from the use of any medication to promote motility. One patient with intractable pseudo‐obstruction benefited from a subtotal enterectomy. Of those patients not lost to follow‐up, 31.4% died; 43% of these deaths occurred within the first 6 months from complications of total parenteral nutrition. One infant had a complete spontaneous remission by 1 year of age, with normalization of radiographic findings; another had partial remission by 6 months of age.
Ultrasound Guided Percutaneous Cholecystocholangiography for Early Differentiation of Cholestatic Liver Disease in Infants
Authors: Treem William R. , Grant Edward E. , Barth Klemens H. , Kramers Peter W.
Published: January 2024

Direct visualization of the extrahepatie biliary tree is difficult in infants and young children without resorting to an intraoperative cholangiogrum. Small size and lack of dilated intrahepatic ducts especially in infants with cholestatic jaundice often preclude using the techniques of percutaneous transhcpatic cholangiography or endoscopic retrograde cholangiopancreatography. We studied the feasibility of ultrasound‐guided percutaneous Cholecystocholangiography (US‐guided PCC) in differentiating extrahepatie from intrahepatic causes of cholestatic jaundice in four infants. Clinical, laboratory, radiographic, and histologic criteria had not conclusively excluded extrahepatie obstruction prior to the use of this technique. Four infants, between 4 and 10 weeks of age. were studied without complications. In one patient, biliary atresia was diagnosed at 4 weeks of age; in another, aspirated bile was cultured leading to a specific diagnosis of bacterial cholangitis; and, in two others, intrahepatic cholestasis was confirmed by the demonstrated patency of the extrahepatie biliary tree. In infants and young children in whom a gallbladder lumen can be seen, US‐guided PCC offers a potential rapid, nonoperative means of differentiating intrahepatic and extrahepatie causes of cholestatic jaundice, defining the anatomy of the extrahepatie biliary tree, and directly sampling gallbladder bile.
Food‐Induced Alterations of Intestinal Permeability in Children with Cow's Milk‐Sensitive Enteropathy and Atopic Dermatitis
Authors: Dupont C. , Barau E. , Molkhou P. , Raynaud F. , Barbet J. P. , Dehennin L.
Published: January 2024

Intestinal permeability was evaluated by measuring the excretion of two orally absorbed (0.1 g/kg of weight) nonmetabolizable markers, mannitol and lactulose. In 39 controls, the lactulose/mannitol urinary ratio (L/M ratio) was 2.45 ± 1.01% during fasting and remained stable after food ingestion. In 12 children with cow's milk‐sensitive enteropathy under an exclusion diet, the L/M ratio was comparable with that of controls during fasting and exhibited a threefold rise during a provocation intestinal permeability test (IPT) with milk. In 28 children with atopic dermatitis (AD), the fasting IPT L/M ratio was significantly higher than in controls (3.60 ± 3.31%). This rise was related to an increase of lactulose urinary clearance. A provocation IPT with food induced significant L/M ratio changes only in the group in which the food was proved to be responsible for the exacerbation of skin lesions. We concluded that in cow's milk‐sensitive enteropathy, an IPT allows a good evaluation of mucosal reactivity to milk, and in AD, permeability changes are present in at least some cases with cutaneous lesions clearly related to food ingestion.
Treatment of Wilson's Disease with Triethylene Tetramine Hydrochloride (Trientine)
Authors: Dubois Reuben S. , Rodgerson Denis O. , Hambidge K. Michael
Published: January 2024

Penicillamine is the drug of choice for the treatment of Wilson's disease, whatever the stage of the illness. Toxic manifestations may preclude the use of this life‐saving drug in some patients and discontinuation of penicillamine therapy usually leads to death. We report our experience with Trientine in seven patients, aged 13 to 33 years, with Wilson's disease who developed toxic manifestations with penicillamine that required discontinuation of therapy. These include two with nephrosis, one with neutropenia, two with thrombocytopenia, and one each with a SLE‐like and a Henoch‐Schonlein‐like syndrome. The patients were treated for periods from 6 weeks to 16 years with a dose of 0.5 to 2 g/day. Trientine proved to be an effective alternative copper chelating agent in the treatment of Wilson's disease in patients with penicillamine‐induced neutropenia, thrombocytopenia, SLE, and nephrosis. No serious untoward side effects were noted.
Small Intestinal Myoelectric Activity in Healthy Neonatal Piglets
Authors: Szabo Joanne S. , Fewell James E.
Published: January 2024

We evaluated 17 healthy neonatal piglets to determine the effects of an increased hyperosmolal formula (HOF; 874 ± 30 mOsmol/kg, n = 9) and commercial pig milk formula (CF; 482 ± 35 mOsmol/kg, n = 8) on small intestinal myoelectric activity (SIMEA). Four bipolar electrodes were surgically implanted along the small intestine to evaluate myoelectrical parameters and patterns of SIMEA during fasting and postprandial periods. Durations of myoelectric phase activity and migrating motility complex periodicity were unaffected by both formulas. Differences in SIMEA were not significant when CF and HOF were compared. Following a single meal of increased HOF, piglets demonstrated a significant postprandial increase of phase 2 myoelectric activity in the duodenum through ileum (p < 0.05) and time‐dependent decrease of phase 3 activity in the duodenum (p < 0.05) and jejunum through terminal ileum (p < 0.01). Diminished phase 3 activity in the terminal ileum persisted throughout the 4‐h postprandial period (p < 0.01) and was related to fewer phase 3 episodes in this region (p < 0.05). This pattern of myoelectric activity has been associated with decreased intestinal propulsion and clearing of in‐traluminal contents. We conclude that a single meal of HOF does not result in significant intestinal motor dysfunction in healthy neonatal piglets. It remains to be determined whether postprandial reductions of phase 3 my oelectric activity that follow a hyperosmolal meal serve as a precursor to neonatal necrotizing enterocolitis when additional risk factors exist.
Helicobacter pylori Infection and Chronic Gastritis
Authors: De Giacomo C. , Fiocca R. , Villani L. , Lisato L. , Licardi G. , Diegoli N. , Donadini A. , Maggiore G.
Published: January 2024

Twenty‐three children with Helicobacter (Campylobacter) pylori‐associated chronic gastritis are reported. Family history of peptic disease, previous digestive procedures, and nonspecific epigastric pain were the most frequently encountered clinical features. Antral nodularity at endoscopy and histologic evidence of follicular gastritis were characteristic morphological aspects. Rapid urease tests suggested the diagnosis in 90% of patients. Significant increases of serum IgG and IgA against Helicobacter pylori allowed the identification of infected children with 95% cumulative sensitivity. Treatment with amoxicillin and bismuth subcitrate eradicated the infection and improved gastritis in 13 of 19 children. These findings provide further evidence for the etiologic role of Helicobacter pylori in chronic antral gastritis in children.
Choledocholithiasis in Infants
Authors: Jonas A. , Yahav J. , Fradkin A. , Kessler A. , Rubinstein Z. , Avigad I. , Reichman B.
Published: January 2024

During the 3‐year period, January 1986 through December 1988, 7 of 24 infants evaluated for cholestatic liver disease were found to have choledocholithiasis with or without associated gallbladder disease. Five were born prematurely with associated predisposing factors, especially systemic infection and total parenteral nutrition. The clinical course varied from spontaneous recovery in two patients to ongoing liver disease requiring surgical or endoscopic intervention in five infants. Asymptomatic patients with normal liver function and persistently dilated extrahepatic biliary trees posed the most difficult therapeutic problems. Endoscopic retrograde cholangiography appeared to be an effective and rewarding therapeutic approach.
Epidemiologic, Clinical, and Laboratory Characteristics of Acute vs. Persistent Diarrhea in Periurban Lima, Peru
Authors: Lanata Claudio F. , Black Robert E. , Gilman Robert H. , Lazo Francisco , Del Aguila Roberto
Published: January 2024

Longitudinal studies of acute and persistent diarrhea in 677 children less than 3 years old were conducted for 27 months in an underprivileged, periurban community near Lima, Peru. Incidence rates and accurate durations of diarrhea were obtained by twice‐weekly community‐based surveillance and clinical and laboratory features of diarrheal episodes were documented. Study children had an overall incidence of diarrhea of 8.1 episodes per child‐year and an incidence of persistent (>14 days) diarrhea of 0.25 episodes per child‐year. Episodes of longer duration were associated with young age (0–5 months) and more severe illness (±6 diarrheal stools per day) in the first week. None of the laboratory tests performed in the first week of illness (fecal leukocytes, blood, reducing substances, pH, or fat) proved of value to identify episodes that would become persistent. Although steatorrhea was commonly present in the acute phase of the illness, it became less frequent by the third or subsequent week of illness in the persistent diarrheas. These results suggest that there are no clinical or laboratory features of acute diarrhea that are strongly predictive of the subset of diarrheas that persist. Thus, it is important that all diarrheal episodes should have appropriate fluid and dietary management and follow‐up to detect the persistent diarrheas that may need special intervention.
Accuracy and Reproducibility of 12‐h Esophageal pH Monitoring
Authors: Friesen Craig A. , Hodge Charles , Roberts Charles C.
Published: January 2024

Seventy‐five consecutive 24‐h intraesophageal pH recordings performed according to the methods of Jolley et al. were evaluated. Total scores and the mean duration of sleep reflux (ZMD) were calculated for the first and the last 12 h, respectively, and compared to each other, as well as to the full 24‐h recording. The accuracy of the first and last 12 h in predicting whether the 24‐h study was abnormal was 85% and 87%, respectively. The accuracy in predicting whether the ZMD for the 24‐h study was abnormal was 73% and 83%, respectively, with an overall 39% false‐negative rate. The 12‐h study reproducibility was 72% for the total score and 56% for the ZMD. Since the original standards were determined from 18− to 24‐h recordings, the test was restandardized based on 12‐h recordings from patients with normal 24‐h studies. Restandardization did not improve the accuracy or reproducibility. The high false‐negative rate for the ZMD and the poor reproducibility cast serious doubt on the utility of 12‐h pH recordings, especially in patients with respiratory symptoms.
Intestinal Neuronal Dysplasia
Authors: Schofield Deborah E. , Yunis Eduardo J.
Published: January 2024

Four hundred ninety‐eight acetylcholinesterase‐stained suction rectal biopsies from 456 children were examined to assess the occurrence of “isolated” or “primary” intestinal neuronal dysplasia at Children's Hospital of Pittsburgh. Cases of proven Hirschsprung's disease were excluded. In 38 biopsies from 38 patients, we found a mild to moderate increase in mucosal acetyl‐cholinesterase staining and abundant submucosal ganglion cells (large, irregular ganglia or at least five ganglia per HPF). This group was clinically heterogeneous with a frequent history of prematurity and small left colon/meconium plug syndrome, protein/formula intolerance, or obstructive anatomic gastrointestinal abnormalities. We feel that isolated “intestinal neuronal dysplasia,” as diagnosed by suction rectal biopsy and the above criteria, is a descriptive biopsy appearance. Rather than characterizing a unique disease entity, it is encountered in a variety of clinical situations. Based on our observations and review of the literature, we therefore conclude that “intestinal neuronal dysplasia” not associated with Hirschsprung's disease, neurofibromatosis, or multiple endocrine neoplasia syndrome has yet to be well defined in clinical and histopathologic terms. The histologic diagnosis, at this time, should be reserved for those rare, florid cases of parasympathetic hyperganglionosis that are documented by adequate tissue sampling.
Clostridium difficile in Inflammatory Bowel Disease Relapse
Authors: Gryboski Joyce D.
Published: January 2024

Stools of 65 patients with exacerbation of symptoms of inflammatory bowel disease were examined for the presence of enteric pathogens and Clostridium difficile. Ten (16%) had C. difficile toxin. Symptoms in all patients cleared after therapy, with improvement correlating with elimination of toxin from the stool.
Kinetics of Viral Replication in Experimental Rotavirus Infection
Authors: Sagher F. A. , Dodge J. A. , Simpson D. H. , Evans P.
Published: January 2024

Epidemiological studies suggest that dietary fat can affect the frequency and severity of diarrhoeal illnesses in childhood. To study the effects of dietary fat on the kinetics of rotavirus antigen, 3‐week‐old mice of rotavirus‐seronegative mothers were fed isocaloric diets with 40% of the total calories as fat [either butter (high saturated fat), olive oil (high monounsaturated fat), or corn oil (high polyunsaturated fat)] with one group on low fat (10% of calories) standard diet as controls. Seven‐day‐old mice from the first litter were killed and their stomach contents (milk) analyzed for total fatty acids. Seven‐day‐old mice from the second litter were inoculated with EDIM rotavirus, and some were killed at 48 h and others at 120 h postinoculation. The stool was removed from the distal colon of each mouse and examined for evidence of diarrhoea. The small intestine was removed, the contents washed, and the intestine divided into equal thirds. All stool and tissue samples were made to 10% (wt/vol), homogenised, and tested for rotavirus antigen by ELISA. We found that (a) dietary fat markedly altered the fatty acid profile of milk, (b) high saturated dietary fat (butter) delayed the onset of diarrhoea, reduced the excretion of rotavirus antigen in stool, and reduced mucosal antigen in the lower third of the small intestine at 120 h compared to 48 h postinoculation, (c) high polyunsaturated dietary fat initially increased the frequency of diarrhoea and viral antigen in the middle and lower segment at 120 h, followed by a reduction in rotavirus excretion in stool. We conclude that dietary saturated fat reduces the incidence and severity of rotavirus infection in mice. These observations may have implications for infant diarrhoeal illnesses.
A Prospective Analysis of Cholestasis in Infants Supported with Extracorporeal Membrane Oxygenation
Authors: Shneider Benjamin , Cronin Jonathan , Van Marter Linda , Mailer Eric , Truog Robert , Jacobson May , Kevy Sherwin
Published: January 2024

Summary: Cholestasis develops in many infants supported with extracorporeal membrane oxygenation. We prospectively investigated the role of hemolysis and di‐(2‐ethylhexyl) phthalate exposure in the development of this cholestasis. Both di‐(2‐ethylhexyl) phthalate levels and hemolysis, as measured by maximum free hemoglobin, were significantly (p < 0.025) associated with the degree of cholestasis. Other clinical and laboratory factors that may contribute to cholestasis were also investigated and not found to be related to the degree of cholestasis. We speculate that hemolysis during extracorporeal membrane oxygenation support produces a large bilirubin load whose excretion is inhibited by mechanisms similar to the inspissated bile syndrome and/or by di‐(2‐ethylhexyl) phthalate. This would result in a predominantly direct hyperbilirubinemia with little evidence of hepatocellular or canalicular injury.
Changes in Hepatic Vitamin K1 Levels After Prophylactic Administration to the Newborn
Authors: Guillaumont M. , Sann L. , Leclercq M. , Dostalova L. , Vignal B. , Frederich A.
Published: January 2024

We undertook a study of hepatic concentrations of vitamin K (vitamin K1 or phylloquinone, vitamin K1‐epoxide, and menaquinones) in 18 infants, ages 1‐8 days, with or without vitamin K1 supplementation. The infants who had no supplementation had a total hepatic storage ranging between 0.1 and 0.9 μg. Also, hepatic storage of phylloquinone was poor (< 1 μg) when compared with daily requirements. Moreover, we did not detect any menaquinone in the livers of these infants in our study. The prophylaxis applied to the other infants was very efficient. Hepatic vitamin K1 concentrations, obtained <24 h after administration, were very high (62.8‐93.5 μg/g). Vitamin K1‐epoxide concentrations were high, which proved the efficiency of the vitamin K cycle. In contrast, the decrease in vitamin K1 concentrations was also very rapid, since the median value after 48 h was 8.4 μg/g and only 2.9 μg/g 5 days after administration. However, hepatic total storage after 5 days in one infant with vitamin K1 supplementation was much higher (112 μg) than in infants who had not received supplementation. In conclusion, hepatic phylloquinone storage at birth was poor (<1 μg). The newborn infant might be in a situation of potential deficiency. After prophylactic oral administration of phylloquinone, uptake by the liver was quite satisfactory, but concentrations dropped quickly. However, phylloquinone hepatic storage remained elevated (112 μg) after 5 days.
Apple Juice Malabsorption
Authors: Hoekstra J. H. , van Kempen A. A. M. W. , Kneepkens C. M. F.
Published: January 2024

Carbohydrate malabsorption after apple juice ingestion may produce abdominal symptoms and diarrhea, especially in children. The carbohydrates suggested to play roles in this process are fructose, as it is present in excess of glucose, and sorbitol. Absorption of the carbohydrates in apple juice was investigated in 17 children and 12 adults by means of the hydrogen breath test. Apple juice was given at a dose of 15 ml/kg body weight, with a maximum of 375 ml. Fructose (0.6 g/kg) and sorbitol (0.06 g/kg), alone and in combination, were administered in amounts similar to their contents in apple juice (fructose as excess over glucose content). Apple juice malabsorption, as judged by a peak breath H2 excretion of ≥20 ppm, was found in 11 children (65%) and 4 adults (33%). Of those malabsorbing apple juice, 7 of 11 children malabsorbed fructose, 1 of 11 sorbitol, and 4 of 11 the combination; the four adults absorbed all test solutions completely. We could not find an additive effect of sorbitol on breath H2 excretion after fructose ingestion. Peak breath H2 concentrations after apple juice ingestion (mean ± SEM: 43 ± 7 ppm) were higher than those with fructose (23 ± 5 ppm; p < 0.05) or the fructose‐sorbitol combination (20 ± 5 ppm; p < 0.05). Fructose, and not sorbitol, is the sugar responsible for the increase in breath H2 after apple juice consumption and therefore for the diarrhea accompanying excessive apple juice consumption in toddlers.
Characterisation of the Local Inflammatory Response in Appendicitis
Authors: Tsuji M. , Puri P. , Reen D. J.
Published: January 2024

In this study we have characterised the local inflammatory response in acute suppurative appendicitis (S), focal appendicitis (F), and normal appendices (C). Enumeration of lymphocyte subpopulations, cells expressing IL‐2 receptor, natural killer (NK) cells, monocytes and plasma cell isotypes and subclasses infiltrating the lamina propria was carried out on all specimens using immunoperoxidase staining procedures. Total T cells were significantly increased in both acute suppurative appendicitis and focal appendicitis compared with controls (p < 0.001). Cells infiltrating the lamina propria expressed IL‐2 receptor in all appendiceal specimens but were significantly increased in both acute and focal appendicitis (p < 0.01). IgG and IgA plasma cell isotypes were significantly increased in all S and F appendiceal specimens (p < 0.001). Monocyte and NK cell numbers, however, were only increased in acute suppurative appendiceal specimens. The increased lymphocyte and plasma cell isotypes seen in focal appendicitis occurred throughout the entire organ even though the inflammatory focus was confined to only three to seven serial sections. These results clearly show a differential pattern of cellular infiltration in focal appendicitis from that seen in acute suppurative appendicitis. The selective lymphocyte and plasma cell nature of the cellular infiltrate in the lamina propria of focal appendicitis may reflect the presence of a specific immune response to an as yet unidentified luminal antigen as a possible cause of appendicitis.
Efficacy of Diazepam and Meperidine in Ambulatory Pediatric Patients Undergoing Endoscopy
Authors: Bahal‐O'Mara Neeta , Nahata Milap C. , Murray Robert D. , Linscheid Thomas R. , Williams Todd , Heitlinger Leo A. , K. Li B. Ulysses , McClung H. Juhling , Lininger Barbara
Published: January 2024

Medications are routinely administered to children prior to upper gastrointestinal endoscopy procedures. We evaluated the efficacy and safety of four dosage regimens: meperidine 2 mg/kg (M); low‐dose meperdine 1 mg/kg and diazepam 0.1 mg/kg (M low + D); high‐dose meperidine 2 mg/kg and diazepam 0.1 mg/kg (M high + D); and, diazepam 0.1 mg/kg (D) in a randomized, double‐blind trial in 71 pediatric patients (ages 1 to 19 years). Cooperation, emotional state, and sedation were rated. The frequency of negative behavior demonstration (i.e., crying, gagging, flailing, nervous behavior) indicating ineffective or inadequate sedation was recorded before, during, and after the procedure. Vital signs and oxygen saturation were noted. Significant differences were observed in the efficacy of the various sedation regimens. Overall, the physicians and nurses rated M most effective in children <11 years. In these children, M high + D and D were rated least effective by the nurses, whereas physicians felt that D was least effective. In the older children, M, M low + D, and M high + D were rated similarly effective by physicians and nurses, and D was rated least effective. In both age groups, the lowest incidence of negative behaviors during the endoscopy procedure occurred in patients who received M. Combinations of D and M + D resulted in an increased incidence of negative behaviors; thus, M may be the preferred sedation regimen in children undergoing endoscopy. The addition of diazepam to meperidine may be detrimental in terms of eliciting negative behaviors.
Olsalazine Versus Sulfasalazine in Mild to Moderate Childhood Ulcerative Colitis
Authors: Ferry George D. , Kirschner Barbara S. , Grand Richard J. , Issenman Robert M. , Griffiths Anne M. , Vanderhoof John A. , Fiedorek Stephen C. , Winter Harland S. , Hassall Eric G. , Watkins John B. , Gryboski Joyce , Ulshen Martin H. , Daum Frederic , Perman Jay A. , Thomas Daniel W. , Heubi James E. , Byrne William J. , Jones Bobbette
Published: January 2024

The safety and efficacy of olsalazine sodium was compared to sulfasalazine over 3 months in a multi‐center, randomized, double‐blind study of 56 children with mild to moderate ulcerative colitis. Twenty‐eight children received 30mg/kg/day of olsalazine (maximum, 2 g/day) and 28 received 60 mg/kg/day of sulfasalazine (maximum, 4 g/day). Side effects were frequent in both groups. Eleven of 28 patients (39%) on olsalazine reported headache, nausea, vomiting, rash, pruritus, increased diarrhea, and/or fever. Thirteen of 28 on sulfasalazine (46%) reported similar side effects and/or neutropenia, and four patients had the drug stopped because of an adverse reaction. After 3 months, 11 of 28 (39%) on olsalazine were asymptomatic or clinically improved, compared to 22 of 28 (79%) on sulfasalazine (p = 0.006). In addition, 10 of 28 patients on olsalazine versus one on sulfasalazine required prednisone because of lack of response or worsening of colitis (p = 0.005). The dose of olsalazine used in this clinical trial was thought to be equivalent to a standard dose of sulfasalazine, but fewer patients on olsalazine improved and a greater number had progression of symptoms when compared to sulfasalazine. Although side effects were slightly less frequent for olsalazine, the number of patients was too small to detect a clinically significant difference.