bluuebunny/crossref_metadata_2025 huggingface dataset:
Prostaglandins in the Plasma and Stool of Children with Rotavirus Gastroenteritis
Authors: Yamashiro Yuichiro , Shimizu Toshiaki , Oguchi Satoshi , Sato Mitsuyoshi
Published: January 2024

To investigate whether prostaglandins (PGs) are involved in the mechanism of rotavirus diarrhea, PGE2 and PGF2a concentrations in the plasma and stool of children (21 and 16, respectively) with rotavirus gastroenteritis were measured and compared with those of their respective controls. The effect of aspirin on the diarrhea was also studied in 14 patients with rotavirus gastroenteritis. The PGE2 and PGF2a contents of both the plasma and the stool of patients with rotavinis gastroenteritis were significantly higher than in the plasma and stool of the control group. Furthermore, aspirin given by mouth caused the diarrhea to cease earlier. These results suggest that PGE2 and PGF2a are involved as important mediators in the causative mechanism of rotavirus diarrhea.
Folic Acid Absorption Determined by a Single Stool Sample Test—A Double‐Isotope Technique. The Folic Acid Absorption Capacity in Children
Authors: Hjelt Karsten
Published: January 2024

The fractional folic acid absorption (FAFol) was determined in 66 patients with various gastrointestinal diseases by a double‐isotope technique, employing a single stool sample test (SSST) as well as a complete stool collection. The age of the patients ranged from 2.5 months to 16.8 years (mean 6.3 years). The test dose was administered orally and consisted of 50 μg of [3H]folic acid (monoglutamate) (~20 μCi), carmine powder, and 2 mg 51CrCI, (~1.25 μCi) as the unabsorbable tracer. The whole‐body radiation given to a 1‐year‐old child averaged 4.8 mrad only. The stool and napkin contents were collected and homogenized by the addition of 300 ml chromium sulfuric acid. A 300‐ml sample of the homogenized stool and napkin contents, as well as 300 ml chromium sulfuric acid (73% vol/vol) containing the standards, were counted for the content of 51Cr in a broad‐based well counter. The quantity of [3H]folic acid was determined by liquid scintillation, after duplicate distillation. Estimated by SSST, the FAFol, which employs the stool with the highest content of 51Cr corresponding to the most carmine‐colored stool, correlated closely with the FAFol based on complete stool collection (r = 0.96, n = 39, p < 0.0001). The reproducibility of FAFol determined by SSST was assessed from repeated tests in 18 patients. For a mean of 81%. the SD was 4.6%, which corresponded to a coefficient of variation of 5.7%. The excretion of 51CrCI, and 3H in the urine was examined in six patients with moderate to severe mucosal damage and was found to be low. The mean FAFol in 45 control children aged 9 months to 16.8 years (mean 6.4 years) was 83% (range 66–95%). The FAFol levels showed no correlation with age. In conclusion, the method fulfilled the following requirements: (a) a minimum of cooperation and control of possible errors, (b) small radiation dose, (c) direct measurement of the folic acid absorption, and (d) no need for flushing with folic acid. To the best of the author's knowledge, this study is the first attempt of direct measurement of folic acid absorption in control children.
Growth, Serum Biochemistries, and Amino Acids of Term Infants Fed Formulas with Amino Acid and Protein Concentrations Similar to Human Milk
Authors: Picone Thomas A. , Benson John D. , Moro Guido , Minoli Iolanda , Fulconis Fabio , Rassin David K. , Raiha Niels C. R.
Published: January 2024

We tested the hypothesis that amino acid intake from infant formulas modified to be similar to human milk would result in indices of protein metabolism more like those in human milk‐fed infants. Formula‐fed infants received for 12 weeks one of three isocaloric formulations of a whey‐adapted formula that differed in protein concentration: 11, 13, or 15 g/L. Infants consumed similar volumes of formula or human milk. Serum urea nitrogen concentrations reflected the protein content of the diets. Plasma indices of protein nutritional status were normal and did not differ among groups. Growth rates of all infants were normal and similar. Serum indicators of protein nutritional status varied with age, which made comparisons of formula‐fed infants with human milk‐fed infants difficult. Plasma concentrations of leucine and isoleucine at 4 weeks of age were higher in infants fed the formula containing 15 g protein/L when compared with those of infants fed the other two formulas or human milk. At 8 and 12 weeks of age, all formula‐fed infants had plasma amino acid profiles that did not differ significantly from each other except for isoleucine, which was lower in the 11‐g/L group. We found that providing formulas with an amino acid pattern similar to that of human milk did not produce a plasma amino acid pattern identical to that of the breast‐fed infant. This observation suggests that other factors, such as the hormonal response to feeding, differing nutritional bioavailability of amino acids from human and bovine milk proteins, and the changing quantity and type of amino acids with advancing lactation, influence plasma amino acid concentrations.
Inhibition by Cow's Milk of Histamine‐Induced Gastric Acid Secretion in the Rat
Authors: Wirbel A. , Ducroc R. , Garzon B. , Geloso J. P.
Published: January 2024

The effects of a 4‐day milk diet on basal and histamine‐induced gastric acid secretion were examined in vivo in adult rats. Rats were fed on raw cow's milk only. Their acid secretion was measured in the perfused stomach under basal conditions or after administration of varying doses of histamine. In milk‐fed rats, basal secretion rose slightly compared with control secretion (1.86 ± 0.09 vs. 1.52 ± 0.06 μEq HV+/10min; p > 0.01), but maximal secretion in response to noncumulative doses of histamine (range: 7.0–20.0 mg/kg) was inhibited by 57%. The degree of this inhibition was similar to that observed in control rats with an equimolar dose of H2‐antagonist cimetidine. These results indicate that in the adult rat, chronic administration of cow's milk strongly inhibits his‐tamine‐stimulated acid output.
Protein‐Losing Enteropathy in an Infant with a Lymphangiomyoma
Authors: Thomas A. G. , Livingstone D. , Miller V.
Published: January 2024

A 3‐month‐old girl with intractable diarrhoea had protein‐losing enteropathy secondary to a lymphangiomyoma. This is the first reported case of lymphangiomyoma in an infant. As enteral feeds were not tolerated, she was maintained on parenteral nutrition for 2 months. Pancreatic enzyme supplementation produced a rapid clinical improvement and normalisation of serum albumin level. Weaning was subsequently tolerated and the vitamin, mineral, and trace element deficiencies improved. Subsequent recurrence was associated with normal pancreatic function and has proved refractory to treatment.
Long‐Term Follow‐Up Study of Patients with Cholangitis after Successful Kasai Operation in Biliary Atresia
Authors: Ohkohchi Nobuhiro , Chiba Tsuneo , Ohi Ryoji , Mori Shozo
Published: January 2024

Since the introduction of cyclosporine A, liver transplantation has become accepted as the therapy for end‐stage liver disease. However, there are no definite criteria for liver replacement in biliary atresia. We investigated (a) the survival rate after hepatic portoenterostomy (n = 131), (b) liver function tests in fatal cases after an initially successful hepatic portoenterostomy (n = 9), and (c) liver function tests in the patients with episodes of cholangitis after a successful surgical treatment (n = 8). Patients with persisting jaundice after the surgery cannot be expected to survive long, and therefore they definitely should undergo liver transplantation. When total bilirubin concentration was above 10 mg/dl in patients with cholangitis after a successful operation, conservative therapy had almost no effect. Therefore, patients with total bilirubin levels above 10 mg/dl should be considered for liver transplantation. Of the liver function tests, only total bilirubin was reliable as a marker for hepatic failure in the end stage of biliary atresia. Prolongation of thrombo test and episodes of gastrointestinal bleeding also were used in selection of patients for liver replacement.
Acute Liver Injury after Protracted Seizures in Children
Authors: Ussery Xilla T. , Henar Eric L. , Black Dennis D. , Berger Stuart , Whitington Peter F.
Published: January 2024

Three children were observed to have extensive liver injury following protracted seizures. Two recovered with supportive care and one died from central nervous system complications. When first measured, the levels of aminotransferases were minimally elevated, but they increased to 250 to 8,000 times normal within 12 to 24 h after the seizure episode. They fell to near normal over the next 8 to 11 days in the survivors, and to one sixth of the peak level by 4 days in the patient who died. A percutaneous liver biopsy from one child demonstrated centrolobular necrosis consistent with severe ischemic injury. Common causes for liver dysfunction, including viral hepatitis, drug hepatitis, and Reye syndrome, were excluded on clinical, serologic, and histologic grounds. We reason that hepatic injury resulted from ischemia. We speculate that prior treatment with anticonvulsants, which are capable of inducing mixed‐function oxidases in the liver, aggravated the ischemia‐reperfusion injury by increasing the production of reactive oxygen intermediates and reducing cytoprotective mechanisms. Prevention of such injury should be directed toward control of seizures and early respiratory support when seizures occur, not restructuring medication regimens.
Exocrine Pancreatic Insufficiency in Syndromic Paucity of Interlobular Bile Ducts
Authors: Chong S. K. F. , Lindridge J. , Moniz C. , Mowat Alex P.
Published: January 2024

Severe failure to thrive is an important feature in children with both syndromic and nonsyndromic paucity of interlobular bile ducts (PILBD). Thirteen children age 7 months‐11 years with PILBD had pancreatic secretions in duodenal aspirate measured for 40 min after secretin‐pancreozymin stimulation, six of these children had chronic diarrhoea. Studies were also performed in seven children age 2–12 years who presented with failure to thrive or nonspecific diarrhoea that subsequently resolved. The results of the control and the PILBD children were similar except in the six with chronic diarrhoea. These children had significant reductions in total volume of duodenal aspirate (p < 0.05), bicarbonate concentration (p < 0.02) and output (p < 0.05), and in lipase concentrations (p < 0.005). Five of these children have had a reduction in stool frequency and more rapid weight gain since receiving pancreatic supplementation. In children with PILBD and diarrhoea, pancreatic insufficiency may be a contributory factor to poor weight gain. These children may benefit from pancreatic extract supplementation.
Value of a Chicken‐Based Formula for Refeeding of Children with Protracted Diarrhea and Malnutrition in a Developing Country
Authors: Godard Claude , Bustos Mario , Muñoz Mario , Nusslé Daniel
Published: January 2024

Two hospital‐made, lactose‐free, hypoosmolar formulas were compared for therapy for 61 children aged 10–28 months who had severe malnutrition and protracted diarrhea. The formulas were isocaloric and contained dextrin‐maltose, carrots, sunflower oil, minerals, and vitamins. One had chicken meat as the protein source and the other had hydrolyzed lactalbumin (LAD). Initially the formulas were given as a continuous enteral feeding by nasogastric tube and pump. Six patients died from metabolic and infectious complications; four failed to equilibrate and changed diet. The remaining 51 were divided into two groups: group A, chicken formula (n = 26), and group B, LAD formula (n = 25). The mean duration of diarrhea was similar in both groups: number of days with liquid stools = 6.0 ± 4.1 in group A, 5.5 ± 2.8 in group B; number of days with >4 stools/day = 3.5 ± 3.4 in group A, 4.1 ± 2.1 in group B. The time until beginning nutritional recovery was 13.2 ± 12.0 days in group A and 13.3 ± 7.8 days in group B. Intercurrent infections were significantly more frequent in patients receiving chicken formula (12 of 30 patients) than in those receiving LAD formula (4 of 27 patients) (p < 0.05). We conclude that chicken formula is an efficient substitute to expensive semielemental formulas for continuous enteral feeding of protracted diarrhea in severely malnourished children.
Spinal Cord Tumor‐Associated Syrinx Mimicking Abdominal Epilepsy
Authors: Drexler David L. , Grill Bruce B. , Ashwal Stephen
Published: January 2024

A 10‐year‐old child presented with recurrent abdominal pain. Abdominal epilepsy was suspected as conventional criteria for the diagnosis were met, including an apparent therapeutic response to anticonvulsant medication. Seven months later the patient developed recurrent abdominal pain, a gait disorder, and atrophy of the right thigh and calf. Magnetic resonance imaging of the spine revealed a thoracic syringomyelia. Anticonvulsant medications were discontinued and a syringoperitoneal shunt was placed with resolution of symptoms. This appears to be a previously undescribed presentation for syringomyelia and emphasizes the importance of considering alternative central nervous system disorders before the diagnosis of abdominal epilepsy is made.
Down's Syndrome and Coeliac Disease
Authors: Dias J. Amil , Walker‐Smith J.
Published: January 2024

The association of congenital abnormalities and gastrointestinal tract diseases has been described. The coincidence of Down's syndrome and coeliac disease has been occasionally reported, but a clear relation is not definitely established. Reviewing 190 patients with coeliac disease diagnosed at Queen Elizabeth Hospital, London, from 1960 to 1985 an increased incidence of Down's syndrome compared to the natural incidence of this abnormality in the general population was found. The age of the mothers was well below that where a reverse in the incidence of Down's syndrome is expected, and it appears therefore that this anomaly and coeliac disease may be linked. This possibility should be bourne in mind when evaluating children with Down's syndrome and gastrointestinal symptoms.
Hepatic Hypervitaminosis A
Authors: Sarles J. , Scheiner C. , Sarran M. , Giraud F.
Published: January 2024

Four siblings with hepatic fibrosis are described. The liver damage in these patients was secondary to chronic ingestion of massive doses of vitamin A for congenital ichthyosis. Although the extrahepatic manifestations were helpful in the diagnosis of hypervitaminosis A, the distinctive features of hepatic histopathology were confirmatory. The plasma concentrations of vitamin A and retinol‐binding protein were misleading. The recovery from the liver damage in these patients was slow despite a complete withdrawal of the vitamin A intake. These cases show the importance of hepatic vitamin A assessment in the diagnosis of hepatic fibrosis.
Hemangioendothelioma of the Hepatobiliary System
Authors: Maksimak Martin , Wilt Elaine , Colley A. Thompson , Garbes Archimedes
Published: January 2024

Two children are reported with hemangioen‐dothelioma of the hepatobiliary system. One patient, a 7‐month‐old girl, presented with classic symptomatology of hepatomegaly and congestive heart failure, but did not have any cutaneous lesions. She was treated with systemic steroids and supportive therapy and did very well. The other patient, a 22‐month‐old boy, is the first patient reported with exclusive involvement of the extrahepatic biliary tree. His symptoms included hepatomegaly and obstructive jaundice. He was evaluated with an endoscopic retrograde cholangiopancreatogram and a transhe‐patic cholangiogram. He did very well after resection of the lesion and Roux‐en‐Y drainage of the proximal biliary tree and remains asymptomatic 2 years after surgery.
Plasma Vasoactive Intestinal Polypeptide in the Newborn Infant
Authors: Grisoni Enrique R. , Kalhan Satish C.
Published: January 2024

Vasoactive intestinal polypeptide (VIP) has been suggested as a possible contributor to the development of gastrointestinal problems. VIP is produced by nerve endings in the intestinal tract and appears to have marked effects on gut motility and its blood flow. Since necrotizing enterocolitis and feeding intolerance are common problems in the newborn, we examined the plasma VIP responses to feeding in healthy preterm and term newborn infants. Plasma VIP levels were measured in 20 full‐term newborn infants (gestation of 39.4 ± 0.9 weeks, mean ± SD, and weight of 3,351 ± 477 g) and 38 preterm infants (gestation of 27–35 weeks, weight of 920–2,440 g). In term infants, cord blood samples were obtained from the umbilical artery and vein and then before and after the feed. For preterm infants, blood samples were obtained prior to the introduction of oral feeds during the first week, and then before and after feeding once a week over the next 4 weeks. Feeding ranged from diluted premature formula to special care (24 calories per ounce) for the preterm, and breast milk or regular commercial formula for the term infants. Twenty‐one healthy adults, age 25–42 years, were studied for comparison. In the term newborn infants, the plasma VIP levels in the umbilical venous blood were lower, although not statistically significant (p = 0.06), than the umbilical arterial blood (10.78 ± 5.89 vs. 13.54 ± 6.71 pmol/L), suggesting placental metabolism of VIP. After birth, there was a significant increase in plasma VIP levels (18.89 ± 10.07 pmol/L, p = 0.001). Introduction of formula or human milk did not cause any change in circulating VIP levels. The plasma VIP levels in the term newborn infants were significantly (p = 0.001) higher than those observed in normal adults (18.89 ± 10.07 vs. 6.04 ± 2.30 pmol/L). In the preterm infants, VIP levels during fasting were significantly lower (13.56 ± 8.67 pmol/L, p = 0.05) than those observed in term infants. There was a small statistically significant (p = 0.01) increase in VIP levels in the preterm infants during the second (17.41 ± 10.42 pmol/L) and third (16.63 ± 9.27 pmol/L) weeks after the introduction of feedings. The significance of the higher VIP levels in the newborn infants remains unknown. Because no infants developed gastrointestinal intolerance, no correlation between VIP levels and gastrointestinal problems could be demonstrated.
[51Cr]EDTA Intestinal Permeability in Children with Cow's Milk Intolerance
Authors: Schrander J. J. P. , Unsalan‐Hooyen R. W. M. , Forget P. P. , Jansen J.
Published: January 2024

Making use of [51Cr]EDTA as a permeability marker, we measured intestinal permeability in a group of 20 children with proven cow's milk intolerance (CMI), a group of 17 children with similar complaints where CMI was excluded (sick controls), and a group of 12 control children. [51Cr]EDTA test results (mean ± SD) were 6.85 ± 3.64%, 3.42 ± 0.94%, and 2.61 ± 0.67% in the group with CMI, the sick control, and the control group, respectively. When compared to both control groups, patients with cow's milk intolerance (CMI) showed a significantly increased small bowel permeability. We conclude that the [51Cr]EDTA test can be helpful for the diagnosis of cow's milk intolerance.
Adenomatous Polyp in a Four‐Year‐Old Child
Authors: Tolia Vasundhara , Chang Chung‐Ho
Published: January 2024

A 4‐year‐old white boy presented with rectal bleeding. An isolated polyp was removed and on histology was found to be adenomatous in nature. Family history was remarkable for polyposis with combined adenomatous and juvenile features. Variable expression of the syndrome was seen in various family members.
Phenobarbital Can Aggravate a Cholestatic Bile Acid Pattern in Infants with Obstructive Cholangiopathy
Authors: Nemeth Antal , Wikströ Sten‐Åke , Strandvik Birgitta
Published: January 2024

The effect of phenobarbital on urinary bile acid excretion in intrahepatic cholestasis was studied in four boys 4–43 months of age who received 10 mg/kg of body weight of phenobarbital for a period of 3 weeks‐3 years. One child was observed at two different periods: with and without histologically proven cirrhosis. Before the treatment period, the infants excreted 10‐fold higher amounts of bile acids in urine than healthy children. The primary bile acids predominated, and there were also increased amounts of polyhydroxylated bile acids, 3β‐hydroxy‐5‐cholenoic acid, and ketonic bile acids but small amounts of secondary bile acids. After the phenobarbital treatment, the patients further increased their urinary bile acid excretion, including all kinds of bile acids except the secondary ones. The sulfated fraction did not increase in absolute amounts, and its relative percentage decreased from a mean of 60–33%. Liver function test results generally did not improve, although serum concentration of bilirubin decreased. Most of these changes suggested a worsening of the cholestatic state after phenobarbital treatment. The results indicate that at our present state of knowledge, phenobarbital should not be given routinely to infants or children with intrahepatic cholestasis.
Prostaglandin and Fatty Acid Metabolism in Patients with Extrahepatic Biliary Atresia
Authors: Shimizu Toshiaki , Yamashiro Yuichiro , Yabuta Keijiro , Miyano Takeshi , Hayasawa Hirotoshi
Published: January 2024

The relationship between essential fatty acid (EFA) deficiency and disturbance of prostaglandin (PG) biosynthesis was studied in children after radical operation for extrahepatic biliary atresia (EBA). In addition, to investigate the method for treatment of postoperative EFA deficiency and disturbance of PG biosynthesis, the serum fatty acid and plasma PG levels were determined before and after supplementation of an EFA‐rich powder (38 g of linoeic acid per 100 g of powder) through Suruga II enterostomy. Before administration of the EFA‐rich powder, linoleic acid, arachidonic acid, PGE1, and PGF2α levels were significantly lower in both good bile excretion and poor bile excretion groups than in the control group. After administration, linoleic acid and PGE1 levels significantly increased in the good bile excretion group as compared with the preadministration values. These results suggest that the supplementation of EFA‐rich powder is an effective treatment for linoleic acid deficiency and disturbance of PGE1 biosynthesis in postoperative EBA patients.
Volume and Emptying of the Gallbladder in Patients with Cystic Fibrosis
Authors: Santamaria F. , Vajro P. , Oggero V. , Greco L. , Angelillo M. , Carrillo F. , De Ritis G.
Published: January 2024

As in cystic fibrosis (CF), gallbladder (GB) hypokinesia might play a role in the high incidence of either cholelithiasis or atrophic and hypoplastic GBs. We studied the contractility of the GB by ultrasonography (US) in 57 CF patients and in 25 age‐ and sex‐matched healthy controls. We evaluated the status of the GB, the GB volume after an overnight fasting and 30 min after the ingestion of a standardized milk meal, the GB contractility (the percentage of reduction, (%R) of the GB volume after a meal), the presence of gallstones, and finally, the span of the liver. In addition, liver function test results were evaluated in the CF group. We concluded that the mean values of GB contractility in CF patients do not differ from those of healthy controls, the most hypokinetic GBs (%R < 40%) being observed, however, only in the CF group. Gallstones occur in CF patients with a greater frequency than seen in the normal population, even in early childhood. The CF patients' GB mean volumes in fasting conditions are significantly greater than in healthy controls (13.5 ± 2 versus 8.5 ± 1.5 cc, p < 0.0001).
Disappearance of IgM Antibodies to Hepatitis A Virus After an Acute Infection in Children and Adolescents
Authors: Dollberg Shaul , Kerem Eitan , Klar Aharon , Branski David
Published: January 2024

The kinetics of IgM antibodies to hepatitis A virus (HAV) following an acute infection, were studied in 17 children. Antibodies disappeared in two patterns, one group at 113 ± 18 days after the acute infection in the children, and the second group at 283 ± 90 days. The same two patterns of kinetics were seen in adults. We conclude that IgM anti‐HAV antibodies can be found in the sera of children for over 6 months after the acute infection, as was observed in adults.
Duodenogastric Reflux in Children
Authors: Mouterde Olivier , Foucaud Pierre , Vatier Jacques , Dupont Christophe , Navarro Jean
Published: January 2024

The duodenogastric reflux (DGR) is a suspected cause in some esogastric pathologies in adults: esophagitis, peptic gastric ulcers, stress ulcers, ulcers secondary to drugs, gastric cancer, and gastritis. The toxic substances of the reflux are essentially bile acids, lysolecithin, and trypsin. A number of diagnostic methods have been proposed in the adult. This study suggests a diagnosis technique for DGR in the child. Fasting gastric juice was collected by gastric intubation during 1 h and three substances were measured: phospholipids as markers of biliary reflux, trypsin as a marker of pancreatic reflux, and sialic acid as a marker of the degradation of gastric mucus. The sialic acid enabled us to evaluate some of the toxicity of DGR on the stomach. The study of 49 child subjects permitted us to show the existence, in the normal child, of biliopancreatic markers in the stomach under fasting conditions through a physiological DGR; to define the norms in the child, varying according to three age groups: 0–2 months, 2–12 months, and 1–4 years (the maximum values for an age above 4 years seemed to correspond to those in the adult); and to suggest the existence of a pathological DGR in children with antral gastritis or ulcers.
Protein Turnover in Malnourished Patients with Cystic Fibrosis
Authors: Pelekanos James T. , Holt Terence L. , Ward Leigh C. , Cleghorn Geoffrey J. , Shepherd Ross W.
Published: January 2024

To evaluate the relative efficacy of nonelemental versus semielemental enteral supplements for nutritional rehabilitation of cystic fibrosis (CF) patients, whole‐body protein turnover using the [15N]glycine method was studied in nine malnourished CF patients during enteral feedings, in a block design study comparing a semielemental formula (Criticare), a higher protein density but nonelemental formula (Traumacal) (T), and a nonelemental formula that had been modified to become isocaloric and isonitrogenous to the semielemental formula (modified Traumacal, MT). No significant differences in rates of protein synthesis or catabolism were observed comparing the three formulas. However, the higher protein density nonelemental formula resulted in higher net protein deposition compared to the other two formulas (T + 0.42 g kg‐1 10 h‐1 versus 0.33 g kg‐1 10 h‐1 for Criticare and −0.59 g kg‐1 10 h‐1 for MT), although this was significant (p < 0.05) for the MT versus T comparison only. This study lends support to the use of less expensive nonelemental formulas for the nutritional management of malnourished patients with CF.
The Nutritional Value of Oat Flour for Very Young Children
Authors: Graham George G. , MacLean William C. , Morales Enrique
Published: January 2024

Whole groat flour was consumed by nine infants and young children as 22.5, 45, or 67% of total diet energy (one half of 6.4%, all of 6.4%, or all of 9.6% protein energy). Isonitrogenous and isoenergetic casein control diets were given. Apparent absorption of oat nitrogen (N) was consistently around 75% of intake (casein, 87%), but absorptions of oat energy, carbohydrate, and fat, as percentages of intake, decreased disproportionately as oat flour intake was doubled and then tripled. Apparent retentions were 39 ± 5% of mixed oat‐casein protein intake in the 22.5% diet, the preceding and following casein controls being 38 ± 8% (NS) and 44.4% (p<0.05) of the intakes; 32 ± 6% from oats in the 45% diet, controls 38 ± 5 and 46 ± 5% (both p<0.05), and 33 ± 11% from oats in the 67% diet, controls, 36 ± 9% (NS). Fasting plasma free total essential amino acid (TEAA) levels of children consuming 45% oats were low (562 ± 119 μmol of TEAA/L) and did not change significantly after meals. Fasting molar proportions of individual essentials (millimoles of EAA per mole of TEAA) were similar to those from milk protein diets and did not vary significantly 3 and 4 h after feeding, suggesting that no individual amino acid, but rather protein digestibility, was first limiting to N retention. Oats are a satisfactory source of energy, protein, and fat for very young children and many infants.
An Evaluation with Piglets of Bovine Milk, Hydrolyzed Bovine Milk, and Isolated Soybean Proteins Included in Infant Milk Formulas. I. Effect on Organ Development, Digestive Enzyme Activities, and Amino Acid Digestibility
Authors: Moughan Paul J. , Pedraza Maria , Smith William C. , Williams Megan , Wilson Margaret N.
Published: January 2024

A study, using the piglet as a model for the human infant, was undertaken to determine the effect of the protein source of a milk formula on organ development, the activity of digestive enzymes, and the absorption of amino acids as measured at the terminal ileum and over the entire digestive tract. Three isocaloric liquid milk formulas containing equal amounts of either intact bovine milk, hydrolyzed bovine milk, or isolated soybean protein as the sole source of this nutrient and with equal levels of fat and carbohydrate were each given to six 14‐day‐old piglets over a 19‐day period in a manner that mimicked human infant feeding practice. Following a 6‐day metabolism study, the piglets were killed, their organs removed, and samples of digesta collected. The protein source of the milk‐based formula did not affect (p > 0.05) the weight/unit body weight of the small intestine, large intestine, liver, or pancreas, but the relative weight of the kidneys was lower (p<0.05) for animals fed the intact bovine milk‐based formula and that of the stomach was higher (p<0.01) for piglets receiving the isolated soybean formula. The activities of pepsin, intestinal trypsin and chymotrypsin and pancreatic chymotrypsin were not influenced (p > 0.05) by protein source, but piglets receiving the bovine milk‐based formula had a lower level of activity (p<0.01) for pancreatic trypsin. The apparent ileal and fecal absorption of nitrogen was similar for the three milk‐based formulas, the overall mean ileal absorption of nitrogen (±SE) being 89.0% (±1.44). Excluding cystine, where ileal absorption was relatively lower (p<0.05) with the isolated soybean formula (86.7%) compared with the intact bovine milk (91.5%), protein source had little effect on the apparent absorption of essential amino acids. It was concluded that the replacement of intact cow's milk protein in human infant formulas by either hydrolyzed cow's milk or isolated soybean protein is unlikely to cause any major disturbance in the digestive process.
A New Laboratory Kit for Anti‐gliadin IgA at Diagnosis and Follow‐up of Childhood Celiac Disease
Authors: Ascher H. , Lanner Å. , Kristiansson B.
Published: January 2024

A new laboratory kit measuring anti‐gliadin IgA level by enzyme immunoassay has been evaluated to assess the test's potential for screening children with suspected celiac disease for small intestinal biopsy and predicting mucosal relapse after gluten challenge. One hundred thirty children were tested, and the results were related to the histopathologic findings of the intestinal mucosa and the final diagnosis. The sensitivity of the test was 97% and the specificity was 92% in the studied population. Forty‐five children with celiac disease on different diets were observed. All had reduced anti‐gliadin IgA levels on a gluten‐free diet, and 91% had normal levels after 1 year. Two of four patients with increased values had an insufficient diet. During gluten challenge, 38 of 45 children showed increased anti‐gliadin IgA levels. Of the remaining seven, five reacted either with immediate and strong symptoms or had spontaneously reduced gluten intake, or had an acquired IgA deficiency. In two cases, there was no explanation. In five children without relapse on gluten challenge, the anti‐gliadin IgA level remained normal. Provided that IgA deficiency is ruled out and the gluten intake is sufficient, the test is reliable for screening and has a potential to replace the third biopsy.
A Metabolic Bed for Collecting Excreta in Premature Infants
Authors: Kien C. Lawrence
Published: January 2024

A mattress and plastic bed for collection of urine and feces in premature infants housed in isolettes is described. The dimensions of the bed are 65.5 x 34.4 x 13.5 cm. A drainage hole is located 18 cm from the foot of the bed and midway (16.5 cm) from either side. The angle of the depression in the bed for the drainage hole is approximately 12.5°. The bed is covered with a plastic‐backed foam rubber mattress. The plastic surface on which the infant lies is impervious to water. The method of excreta collection using the bed does not involve the need for restraints; urine and/or feces are washed off the undiapered infant and the bed into a container beneath the drainage hole. The bed has been well tolerated in over 30 studies of 4 days duration, and laboratory experiments with urine and feces applied to the mattress for 15–60 min have indicated excellent recovery of total nitrogen.
Effect of Vitamin A Deficiency on the Adherence of Fimbriated and Nonfimbriated Salmonella typhimurium to Isolated Small Intestinal Enterocytes
Authors: Gabriel Elizabeth P. , Lindquist Bo L. , Abud Rodney L. , Merrick Joseph M. , Lebenthal Emanuel
Published: January 2024

In vitamin A‐deficient children, increased rates of bacterial infections in the intestine have been observed. The adherence of bacteria is a prerequisite for invasion. Thus, the effect of vitamin A deficiency on the adherence of fimbriated and nonfimbriated Salmonella typhimurium to isolated small intestinal enterocytes was studied. Male weanling rats matched by weight were divided into three groups: one group was fed a vitamin A‐free diet for 8–12 weeks; another was given the same diet supplemented with retinol acetate; a third group matched for age served as controls. The vitamin A‐deficient group showed a significantly lower growth rate and lower serum retinol levels than either the retinol acetate‐supplemented or control groups. In all the groups, S. typhimurium possessing mannose‐sensitive fimbriae adhered to enterocytes in significantly larger numbers than the nonfimbriated strains. The number of fimbriated S. typhimurium bound to enterocytes from the proximal small intestine was significantly higher in the vitamin A‐deficient rats than in the pair‐fed vitamin A‐supplemented group (19.3 ± 14.9 versus 7.8 ± 5.0; p < 0.05) or the control group (19.3 ± 14.9 versus 8.7 ± 3.5, p = 0.01). The specific activities of the enterocytes lactase, sucrase, and maltase and the protein content in the vitamin A‐deficient rats were similar to those in the controls. These results demonstrate that vitamin A deficiency in rats is associated with the increased ability of S. typhimurium to adhere to proximal small intestinal enterocytes. However, the possible changes in the membrane of the entero‐cyte do not include decreases in brush border disaccha‐ridases or protein content.
Cytopathic Effects of Measles Virus on the Human Intestinal Mucosa
Authors: Jirapinyo Pipop , Thakerngpol Kleophant , Chaichanwatanakul Katharee
Published: January 2024

We reported a case of measles with diarrhea in an infant. Capsule biopsy samples of intestinal mucosa taken 14 days after onset of fever was damaged and had low disaccharidase activities. Virus particles were found in the damaged villous cell. Second intestinal mucosa biopsy samples taken 28 days after onset of fever was found to be normal in structure, but lactase and sucrase activities were still low. Mucosal damage by virus particles was the cause of diarrhea in our infant.
Low Fractions of Mono‐ and Diconjugated Bilirubin in Patients with β‐Thalassemia
Authors: Ullrich D. , Sieg A. , Krüger N. , Schröter W. , Bircher J.
Published: January 2024

Unconjugated and mono‐ and diconjugated bilirubin was determined by alkaline methanolysis and thin‐layer chromatography in serum from 16 pediatric patients with homozygous β‐thalassemia (aged 1–23 years), in 14 age‐matched controls, and in 26 healthy adults. Total bilirubin amounted to 21 ± 20 μmol/L in patients with thalassemia compared with 7 ± 4 μmol/L in healthy children and 11 ± 3 μmol/L in healthy adults. The fractions of bilirubin conjugates in the various groups were 8 ± 4% (patients with thalassemia), 18 ± 5% (age‐matched controls; p < 0.001), and 16 ± 5% (healthy adults; p < 0.001). The low fraction of bilirubin conjugates in patients with thalassemia showed no correlation to any other physical or laboratory finding. It is concluded that subnormal values of bilirubin conjugates in thalassemia indicate defective bilirubin conjugation.
The Steatocrit Test as a Guide in the Prevention of Cow's‐Milk Enteropathy Following Acute Infectious Enteritis
Authors: lacono Giuseppe , Carroccio Antonio , Alongi Angelo , Montalto Giuseppe , Cavataio Francesca , Comparetto Leonardo , Balsamo Vincenzo , Notarbartolo Alberto
Published: January 2024

This study was designed to evaluate the following in infants with acute enteritis (AE): the influence of different types of milk on the evolution of the acute phase of the diarrhea and whether the degree of steator‐rhea during the acute phase might be a risk factor for developing cow's milk enteropathy (CME). We studied 90 infants with AE, divided into three groups and refed differently after the acute episode: group A was refed using a semielemental formula; group B was refed using a milk containing soy proteins and vegetable oils; and group C was refed using a common cow's‐milk formula. Patients with pathological steatocrit values on hospitalization were randomly assigned to groups A and B; patients with normal steatocrit values were placed in group C. After 4 weeks, the patients included in groups A and B were challenged with cow's milk and their reactions were recorded. During the acute phase of the disease, we noticed a longer persistence of diarrhea in group A than in groups B (p < 0.01) and C (p < 0.0025). In addition, the number of evacuations per day and steatocrit values were higher in group A than in groups B or C, but these differences were not statistically significant. After 4 weeks, the patients in groups A and B were challenged with cow's milk, and eight of 60 patients had positive reactions; intestinal biopsy confirmed the diagnosis of CME. The mean age of these eight patients was 40.3 days. We conclude that the risk of CME development after an AE episode is inversely related to patient age and that severe steatorrhea during AE is an additional risk factor.
The Relationship Between Fecal Fat and Water in Very‐Low‐Birth‐Weight Infants
Authors: De Curtis Mario , Kempson Cara , Ventura Valerie , Carter Nick , McIntosh Neil
Published: January 2024

Metabolic balances were carried out in nine preterm very‐low‐birth‐weight (VLBW) infants, five of whom were fed on expressed breast milk and four on a preterm formula. In 39 stool samples from these infants, there was a very close relationship between the fecal fat and the fecal water (r = −0.95; p < 0.001), independent of the type of feed. This relationship was present over a very wide range of fat and water contents. Validation experiments confirmed the reproducibility and reliability of this relationship. The correlation is clinically and experimentally so close that measurement of stool water by freeze‐drying a sample is an accurate indirect measure of fecal fat in VLBW infants when the daily stool weight was known.
Mesenteric Fibromatosis Presenting with Ascites in Childhood
Authors: Mecrow I. K. , Miller V. , Lendon M. , Doig C. M.
Published: January 2024

A 7‐year‐old boy presented with acute ascites due to mesenteric fibromatosis. The pathophysiological mechanisms for formation of ascitic fluid and some aspects of the aetiology of intra‐abdominal fibromatosis and its association with Gardener's syndrome are discussed.
Increased Tight Junction Width in Two Children with Ménétrier's Disease
Authors: Oderda Giuseppina , Cinti Saverio , Cangiotti Angela Maria , Forni Marco , Ansaldi Nicoletta
Published: January 2024

Protein‐losing enteropathy (PLE) and edema are usually the most prominent clinical features in children with Ménétrier's disease. However, the changes in gastrointestinal mucosa that can cause PLE have not been described yet in children. We studied by electron microscopy the mucosa of the gastric fundus, which is the site where macroscopic changes are most prominent, in two children with Ménétrier's disease. We found that tight junction width was increased to 10.5 ± 0.94 nm (mean ± 1 SD) in one child and to 9.7 ± 0.7 in the other. Tight junction width returned to normal when PLE and edema subsided. These ultrastructural changes were similar to those described in adults with the disease, although the clinical course of Ménétrier's disease is very different in adults and in children. Both patients showed evidence of cytomegalovirus (CMV) infection, as indicated by increasing IgG antibodies against the virus or recovery of the virus in the urine. Although Helicobacter pylori was found in the antral mucosa of one patient, the clinical course of the disease was not related to this microorganism. We conclude that increased tight junction width plays a role in PLE seen in Ménétrier's disease in children and that CMV, rather than Helicobacter pylori, is associated with the disease.
Effect of Vitamin E on Transport Processes in Isolated Rat Hepatocytes
Authors: Sokol Ronald J. , Devereaux Michael W. , Khandwala Rashmi A. , Narkewicz Michael R. , Sondheimer Neal J.
Published: January 2024

Vitamin E deficiency is a common consequence of chronic cholestatic liver disorders. Inasmuch as vitamin E content of cellular membranes alters membrane properties such as fluidity and molecular order, we postulated that vitamin E status could affect hepatocyte transport processes dependent on membrane integrity. Hepatocytes were isolated from rats maintained on diets containing deficient, sufficient, or excess vitamin E. Cell viability and oxygen consumption were maintained in all groups of hepatocytes. Hepatocyte uptake of taurocholic acid and ouabain and Na+, K+ ‐ATPase activity estimated by rubidium‐86 influx did not differ with vitamin E status. Vitamin‐E‐deficient hepatocytes had increased generation of lipid peroxide products. We conclude that deficient or excess vitamin E status had little effect on selected transport processes in normal hepatocytes.
The Age‐Related Incidence of Meconium Ileus Equivalent in a Cystic Fibrosis Population
Authors: rbaek Andersen Henrik , Hjelt Karsten , Waever Elisabeth , Overgaard Karsten
Published: January 2024

During the decade from 1976 to 1986, the age‐related incidence of meconium ileus equivalent (MIE) was calculated on the basis of 240 Danish cystic fibrosis (CF) patients. In the first 5 years, the patients were given enteric‐coated granules of pancreatic enzymes (Pancreatin, Rosco, Denmark), and a low fat diet was recommended. In the last 5 years, the Center recommended supplementation with acid‐resistent, enteric‐coated, encapsulated microspheres (Pancrease, Cilag, Birkerφd, Denmark), and high‐energy intake with a 40% fat content and no dietary restrictions. There was no difference in the incidence of MIE when these two 5‐year periods were compared, and the overall incidence of MIE was low (5.4 MIEs/1.000 patient years). This may, at least in part, be due to the rather high intake of exocrine pancreas enzyme supplementation (EPES) (a mean intake of 0.9 capsules/kg/day). MIE occurred almost exclusively among patients >15 years old and peaked in young adults aged 20–25 years (35.5 MIEs/1.000 patient years). The daily intake of EPES/kg of body weight declined significantly with age, and the patients who developed MIE received even less than average per day. Both of these points strengthen the view that a low enzyme dosage is likely to have an effect on the incidence of MIE.
Discriminant Carbohydrate Components of Human Milk According to Donor Secretor Types
Authors: Viverge Danide , Grimmonprez Louis , Cassanas Geneviève , Bardet Lucette , Solere Maryse
Published: January 2024

Because of the variability of human milk carbohydrate composition, we determined the discriminant carbohydrate components of the milk of 18 mothers according to their ABH and Lewis secretor types during the first week of lactation. Comparative chromatograms revealed that the presence of neuraminyloligosaccharides is linked to the ABH secretor groups, and that the absence of oligosaccharides with Lea or Leb specificity is linked to the Lewis nonsecretor types. The study of carbohydrate composition according to donor secretor types consisted of measuring 16 variables from 69 samples. Analysis of variance showed significant differences between groups: high levels of N‐acetylneuraminic acid and low levels of galactose distinguished ABH secretors from nonsecretors (p < 0.001). In the ABH secretor groups, A and H secretors had higher N‐acetylglucosamine contents than B and AB secretors (p < 0.001) and lower galactose levels (p < 0.001). The Lewis secretor groups were distinguished by significantly higher fucose levels (p < 0.001). The ABH(+)Le(a ‐ b ‐) group had higher lactose contents than the other groups (p < 0.01).
Pediatric HBsAg Chronic Liver Disease and Adult Asymptomatic Carrier Status
Authors: Zancan L. , Chiaramonte M. , Ferrarese N. , Zacchello F.
Published: January 2024

Unlike adults (>60% of cases), it is rare to find the chronic hepatitis B virus (HBV) carrier status with normal transaminases among children. The aim of this study was to investigate whether this status would depend on the duration of HBV infection, that is, whether chronic hepatitis in childhood would lead to the asymptomatic carrier status in later life. We reexamined all of our patients with chronic HBV infection of >10 years' duration and with histologically documented chronic hepatitis during childhood. This was a group of 36 adolescents and young adults. All subjects were screened for tumor using α‐fetoprotein assay and hepatic ultrasound. Eight patients with cirrhosis underwent esophageal fiberoptic endoscopy. All patients were in good general condition, with no clinical signs of liver failure. Only two patients had abnormal transaminase levels, both of whom had evidence of delta infection. All but one patient became anti‐HBe positive. Five cases had HBsAg clearance. (Seventy‐one percent of patients were HBeAg positive and 14% anti‐HBe positive at the onset of the disease.) Hepatic ultrasound revealed no tumors in any of the subjects, and fiberoptic endoscopy demonstrated no esophageal varices. This study suggests that (a) chronic hepatitis and asymptomatic carrier status may be subsequent stages of the B virus infection; and (b) chronic hepatitis in childhood is generally benign and may evolve into an asymptomatic carrier status. The main problem with the chronic carrier status is probably the increased risk of hepatocellular carcinoma.