bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Dietary Protein Quality and Feeding Level on Milk Secretion and Mammary Protein Synthesis in the Rat
Authors: Sampson David A. , Jansen G. Richard
Published: January 2024

Protein synthesis was studied in mammary tissue of rats fed diets deficient in protein quality and/or restricted in food intake throughout gestation and lactation. Diets containing 25% wheat gluten (WG), wheat gluten plus lysine and threonine (WGLT), or casein (C) were pair‐fed from conception until day 15 of lactation at 100% or 85% of WG ad libitum consumption (PF100 and PF85, respectively). A seventh group was fed C ad libitum. Rates of protein synthesis were measured in vivo at day 15 of lactation from incorporation of [3‐3H]phenylalanine. At both PF100 and PF85, fractional and absolute rates of mammary gland protein synthesis were two‐ to three‐fold higher in rats fed C than in those fed WG. Pup weights showed similar treatment effects. Both mammary protein synthesis rates and pup weights were significantly higher in rats fed C at PF85 than rats fed WG ad libitum. Food restriction from PF100 to PF85 depressed pup weights and mammary protein synthesis rates in rats fed WGLT, but had no effect in rats fed WG. These results demonstrate that when food intake is restricted, improvement of protein quality of the maternal diet increases milk output in the rat in association with increased rates of mammary protein synthesis.
Persistence of Colitis in Hirschsprung's Disease
Authors: Lifschitz Carlos H. , Bloss Robert
Published: January 2024

Enterocolitis, which is associated frequently with Hirschsprung's disease in the neonatal period, can be prolonged. Recurrence of symptoms has been reported even after surgical correction. We present a neonate with Hirschsprung's disease who developed enterocolitis, and in whom evidence of acute large bowel inflammation persisted until she was 16 months of age.
Seventeen‐Hour Continuous Esophageal pH Monitoring in the Newborn
Authors: Vandenplas Yvan , Sacre‐Smits Liliane
Published: January 2024

Esophageal pH monitoring has been performed in 60 asymptomatic neonates between 1 and 10 days old. Several parameters (periods with a pH <4, number of reflux episodes, number of reflux episodes lasting more than 5 min, average duration of the longest reflux episode, average pH) were studied in different positions (in prone and supine position, in right and left side lying position). For all parameters, except for the average pH, we obtained significantly more favorable results in prone position. In 22 vomiting neonates, significantly favorable results were obtained only by application of positional therapy: in prone position with head elevated (anti‐Trendelenburg). There was no significant difference between the symptomatic group (with radiologically proven reflux pathology) in prone and anti‐Trendelenburg position, and the control group in prone horizontal position. The 17‐h continuous pH monitoring in the newborn is a nonaggressive investigation technique in physiological circumstances, which adequately completes and/or replaces the traditional examinations on gastroesophageal reflux. This method enables an evaluation of the favorable effect of simple therapeutic means (positional changes). Medication, and thickening and staggering of feeding (a time‐consuming and tiring burden for the parents), can be avoided with this technique
Rotavirus Antibodies in the Mother and Her Breast‐Fed Infant
Authors: Hjelt Karsten , Grauballe Per C. , Nielsen Ole Haagen , Schiotz Peter O. , Krasilnikoff Peter A.
Published: January 2024

The transfer of rotavirus antibodies from 25 healthy mothers to their breast‐fed infants was investigated during the period of lactation (mean, 3.9 months; range, 1–9 months). Furthermore, the destiny of these antibodies in the infants' gastrointestinal tract and serum was examined. Rotavirus‐specific immunoglobulins were analyzed by the ELISA (enzyme‐linked immunosorbent assay) technique. All the mothers had rotavirus IgA and IgG in serum. About 80% of the mothers had low concentrations of rotavirus Sclg (i.e., antirotavirus immunoglobulin containing secretory component) in serum at the beginning of the lactation period declining to about 45% at the end of the period. From a few days after delivery to about 2 weeks later, the concentrations of rotavirus IgA and Sclg in milk declined. Thereafter, they remained unchanged. There was a positive correlation among the concentrations of rotavirus IgA in serum and rotavirus IgA as well as Sclg in milk. Rotavirus IgG in the infants' serum correlated with that of the mothers. Few samples of the infants' duodenal fluid contained rotavirus IgA or Sclg. On the other hand, about 80% of the infants' fecal samples contained rotavirus Sclg and IgA. Rotavirus IgA and Sclg disappeared from the infants' feces after cessation of lactation. Hence, it may be concluded that infants receive rotavirus IgG through the placenta, and rotavirus Sclg and IgA in constant amounts via milk throughout the period of lactation. The small intestine is flushed with rotavirus Sclg and IgA at each breast‐meal, and these antibodies survive proteolysis in the gut. A possible protectional effect of rotavirus Sclg or IgA requires frequent breast‐meals, and the effect is limited to the period of lactation.
Development of Gastric Histidine Decarboxylase in the Rat
Authors: Thiebaut R. , Garzon B. , Millet P. , Moreau E. , Ducroc R. , Geloso J. P.
Published: January 2024

Gastric mucosal histidine decarboxylase (HDase) was measured in fetal rats between days 16 and 21 of gestation, and in newborn rats up to weaning. HDase was not detected in fetal stomach. Its activity developed from day 1 after birth (29 ± 2 pmol CO2/mg protein/h) and increased up to day 18 when it reached the fed adult level (894 ± 170 pmol C O2/mg protein/h). Weaning increased HDase activity significantly (weaned versus un‐weanedrats: 1,664 ± 150 and 1,036 ± 170 pmol C O2/mg protein/h; p < 0.005). Up to day 18, HDase activity was not altered by 16 h to 24 h of fasting. From that day on, HDase became sensitive to both pentagastrin and carbachol. These results indicate that complete functional maturation of histamine‐producing cells is only reached at day 18, just before weaning. This developmental pattern may explain the differences observed between fetal and adult regulation of gastric acid secretion.
Distal Ileostomy Drip Feedings in Neonates with Short Bowel Syndrome
Authors: Puppala Bhagya L. , Mangurten Henry H. , Kraut Jerome R. , Bassuk Angel , Shrock Peter , Benawra Raghbir S. , Napier Kris
Published: January 2024

When a newborn infant presents with high intestinal atresia, the proximal segment of the bowel is usually grossly distended and atonic. The anastomosis of this segment to the smaller and unused distal segment will usually result in little or no propulsion of contents distally. Many techniques have been employed to correct this problem. A common surgical approach is immediate end‐to‐end anastomosis, followed by parenteral alimentation until return of normal function. This can take many weeks, and requires special attention to fluid loss and complications associated with parenteral alimentation. In this paper we report two infants in whom we utilized a new technique to circumvent these problems. The technique involves continuous drip ileostomy feedings through the distal ileostomy, while basic nutritional needs are being met parenterally. In addition, the secretions from the proximal stoma are collected and infused with the elemental feeding. The distal bowel, now being fully utilized, is stimulated to accommodate, and when the two ends are joined at a second operation, nearly normal anatomical bowel is present.
Chronic Granulomatous Disease Mimicking Crohn'S Disease
Authors: Isaacs D. , Wright Y M. , Shaw D. G. , Raafat F. , Walker‐Smith J. A.
Published: January 2024

A 34‐month‐old boy with intermittent diarrhoea and abdominal distension from 2 months of age, a chronic microabscess of the cheek, gastric antral narrowing, and perianal abscesses containing granulomata was found at colonoscopy to have extensive, noncaseating, submucosal ileal and colonic granulomata. He was initially thought to have Crohn'S disease, but then developed a cervical abscess, and a diagnosis of chronic granulomatous disease was established. This is an important, although rare, differential diagnosis of chronic inflammatory bowel disease in childhood
Multifocal Osteonecrosis in Adolescents with Crohn'S Disease
Authors: Shapiro Steven C. , Rothstein Fred C. , Newman Arthur J. , Fletcher Barry , Halpin Thomas C.
Published: January 2024

Three adolescents with severe Crohn'S ileocolitis developed osteonecrosis after receiving intravenous corticosteroids and parenteral nutrition, including 10% lipid infusion. Each had achieved clinical remission with therapy. However, several months following completion of therapy, each developed arthralgias and arthritis of weight‐bearing and non‐weight‐bearing joints. Roentgenographic evaluation revealed osteonecrosis involving multiple joints. Osteone crosis may result from the interference with blood flow to bone and has been produced in animals by infusion of lipid solutions and administration of corticosteroids. We report these cases of osteonecrosis as a probable complication of corticosteroid and lipid infusion in adolescents treated for severe Crohn'S disease.
Intrahepatic Biliary Tract Abnormalities in Children with Corrected Extrahepatic Biliary Atresia
Authors: Werlin Steven L. , Sty John R. , Starshak Robert J. , Glicklich Marvin , Nathan Radha
Published: January 2024

Three children with surgically corrected extrahepatic biliary atresia developed recurrent cholangitis associated with bile lakes that failed to drain via the hepa‐toportoenterostomy. Surgical or percutaneous drainage of these cysts was followed by both resolution of the infection and spontaneous internal drainage. We postulate that the ongoing inflammatory process resulted in intrahepatic biliary obstruction, which caused cholangitis and bile cysts. Successful treatment required not only antibiotics but drainage of the bile lakes. Development of bile cysts is a new cause of recurrent cholangitis seen in extrahepatic biliary atresia.
The Development of Methane Production in Childhood and Adolescence
Authors: Peled Y. , Gilat T. , Liberman E. , Bujanover Y.
Published: January 2024

Methane concentration in the expired air was analyzed in 393 infants, children, and adolescents. There was no methane production below the age of 3 years. In the age group 3 4 years, 6.4% of the children produced methane. The percentages were 14.3 18.2% in children aged 7 14. A rise in methane production to 39.4 45.9% was recorded from age 14 to 18, as compared with 49.4% in adults in Israel. The reasons for these changes in methane production with age are not known. Alterations in the colonic flora or the production of a specific substrate(s) are the main possibilities. In our opinion, the latter possibility deserves further investigation.
Safflower Oil Emulsion Administration During Parenteral Nutrition in the Preterm Infant. 1. Effect on Essential Fatty Acid Status
Authors: Cooke Richard J. , Zee Paulus , Yeh Yu‐Yan
Published: January 2024

Summary:

To determine the effect of a safflower oil emulsion on the essential fatty acid (EFA) status of preterm infants during parenteral nutrition, subjects were randomized to receive Liposyn at 0.34.g (group‐1), 0.68.g (<0.5% of lipid from linolenic acid, group 2), or Modified Liposyn at 0.68 g/kg/day (5.0% of lipid from linolenic acid, group 3). Doses of 0.34 and 0.68 g of Liposyn provided linoleic acid in amounts equivalcnt to 2 and 4% of the estimated caloric requirement (120 cal/kg/day) and 5 and 10% of the actual caloric intake. No significant differences were detected in plasma phospholipid triene/tetraene ratios and arachidonic acid levels between groups 1 and 2 or between groups 2 and 3, respectively. Plasma phospholipid triene/tetraene ratio and arachidonic acid did not change in the lipid‐supplemented group throughout the study period, but the former remained significantly lower (p < 0.001) and the latter significantly greater (p < 0.001) than in a reference group of infants who received fat free parenteral nutrition. We conclude that Liposyn administration providing linoleic acid at 2 or 4% of the estimated caloric requirement or 5 or 10% of the actual caloric intake prevented any significant changes in essential fatty acid status from occurring. Moreover, linolenic acid supplementation at 5% of the total lipid intake did not appear to affect arachidonic acid synthesis in the preterm infant.
Biochemical Abnormality in Brush Border Membrane Protein of a Patient with Congenital Microvillus Atrophy
Authors: Carruthers L. , Phillips A. D. , Dourmashkin R. , Walker‐Smith J. A.
Published: January 2024

Brush border membrane proteins from a child with congenital microvillus atrophy were analysed by sodium dodecyl sulfate‐polyacrylamide gel electrophoresis and compared with brush border membrane proteins from normal and disease controls. A predominant band of MW 200K was present in all preparations with the exception of the membrane preparation from the child with congenital microvillus atrophy. Although the band was present in the latter case, it was grossly diminished. The diminished 200K MW band may result in the abnormality of brush border structure. This could account for the involution of the microvilli, the distinguishing feature of congenital microvillus atrophy, and could be the underlying defect in this disease.
Effects of Anticonvulsive Drugs on the Activity of Gammaglutamyltransferase and Aminotransferases in Serum
Authors: Deutsch J. , Fritsch G. , Gölles J. , Semmelrock H. J.
Published: January 2024

A cross‐sectional study was performed to define patients at risk of developing liver disease due to long‐term treatment with anticonvulsive drugs. The activities of gamma‐glutamyltransferase, aspartate amino‐transferase, and alanine aminotransferase and the concentrations of primidone, phenobarbital, phenytoin, and valproic acid in serum were estimated. Epileptic children before therapy were used as controls. The results indicated enzyme induction due to phenobarbital and both enzyme induction and liver cell damage or plasma membrane leakage due to phenytoin. Gamma‐glutamyltransferase may be an early indicator of liver disease due to valproic acid.
Intestinal Abnormalities with Central Nervous System Malignancy
Authors: Kaufman Stuart S. , Goldgar Constance M. , Fitzmaurice Francis , Antonson Dean L. , Vanderhoof Jon A.
Published: January 2024

Two anorectic, emaciated infants with central nervous system (CNS) neoplasms are reported. Diagnosis in each case was delayed, because computed tomography of the head was initially falsely negative, and because primary gastroenterologic illness was suggested by the presence of mild inflammation and villous atrophy of the small intestine. This experience indicates that the diagnosis of CNS neoplasm must be aggressively pursued in cachectic infants who refuse to eat, regardless of the results of the initial radiologic studies. Mild histologic abnormalities of the small intestine that may be present in infants with brain tumors probably represent a nonspecific response to starvation and, if unassociated with malabsorption, should not be considered the cause of illness.
Evaluation of Endoscopic Sclerotherapy of Esophageal Varices in Children
Authors: Donovan T. J. , Ward M. , Shepherd R. W.
Published: January 2024

Sixteen children (3.5–14.7 years) with portal hypertension and variceal hemorrhage were treated by direct endoscopic variceal sclerotherapy. Follow‐up clinical and endoscopic evaluations have been carried out over a 1–6‐year period (mean, 2.3 years). Prior to sclerotherapy, three patients had undergone unsuccessful surgical approaches, and the mean transfusional requirement from the time of the first hemorrhage was 12.3 units of blood per child per year for those with extrahepatic portal vein obstruction (n = 10) and 3.8 units for those with primary liver disease. Following sclerotherapy, transfusional requirements were significantly reduced in both groups, to 1.8 units and 2.2 units (85% and 43% reduction, respectively). Re‐bleeding in four patients was due to the occurrence of gastric varices. One patient with extrahepatic portal hypertension has required subsequent shunt surgery for this complication, 5 years after sclerotherapy. Two patients have died, one with cystic fibrosis and hemorrhage from gastric varices and one from liver failure due to progressive biliary cirrhosis. Complications of sclerotherapy included transient retrosternal pain (eight occasions), esophageal ulceration with bleeding (n = 1) and esophageal stricture (n = 1). We conclude that sclerotherapy is an effective technique in obliterating esophageal varices and reducing the risk of hemorrhage in children with portal hypertension, with an acceptably low complication rate. We favor its use over more invasive surgical measures for control of acute and recurrent variceal hemorrhage, particularly for cases of extrahepatic portal hypertension in which a favorable natural history is likely.
Bile Acids and Bile Alcohols in Two Patients with Zellweger (Cerebro‐Hepato‐Renal) Syndrome
Authors: Délèze Guy , Björkhem Ingemar , Karlaganis Georg
Published: January 2024

The Zellweger cerebro‐hepato‐rcnal syndrome (CHRS) is a rare hereditary disease in which there is a generalized deficiency of peroxisomal function. Liver peroxisomes are important for the conversion of 3α,7α,12α‐trihydroxy‐5β‐cholestanoic acid into cholic acid, and, consequently, 3α,7α,12α‐trihydroxy‐5β‐cholestanoic acid and metabolites of this bile acid precursor accumulate in serum and bile of patients with CHRS. Little is known about the urinary excretion of bile acids in this disease. Using gas chromatography‐mass spectrometry we have analyzed serum bile acids and urinary excretion of bile acids and bile alcohols in two Swiss male CHRS patients. As expected, serum concentrations and urinary excretions of 3α.7α,12α‐trihydroxy‐5p‐cholestanoic acid and 3α,7α,12α,24‐tetrahydroxy‐5β‐cholestanoic acid were elevated, which is probably an obligatory finding in CHRS. In addition, the urinary excretion of 1,3,7,12‐tetrahydroxy‐5β‐cholanoic acid (a very polar unusual bile acid) was increased (99–1556 nmol/24 h). In contrast, the excretion of the major urinary bile alcohol, 27‐nor‐5p‐cholestane‐3α,7α,12α,24,25‐pentol was found to be normal. 3α,7α,12α‐Trihydroxy‐5β‐C29‐dicarboxylic acid, a metabolite of 3α,7α,12α‐trihydroxy‐5β‐cholestanoic acid previously believed to be obligatory in CHRS, was found only in one of our patients.
Antibodies to Gliadin by ELISA as a Screening Test for Childhood Celiac Disease
Authors: Ståhlberg M. ‐R. , Savilahti E. , Viander M.
Published: January 2024

The sera of 309 children who were subjected to jejunal biopsy were tested for antigliadin antibodies (AGA) with enzyme‐linked immunosorbent assay (ELISA) in order to evaluate the usefulness of this test as a screening test for childhood celiac disease (CD). Thirty‐one children had flat intestinal mucosa later confirmed to be due to CD. Ninety percent of these children had significantly elevated levels of IgA class AGA and 94% had significantly elevated levels of IgG class AGA as compared to standard references. Two hundred and seventy‐eight children had normal villous structure. In this group, 37 children out of 271 (seven excluded because of selective IgA deficiency) had elevated levels of IgA class AGA, and 93 children out of 278 had elevated levels of IgG class AGA. We conclude that ELISA‐AGA is suitable as a screening test for childhood CD.
Comparative Studies of Different Gliadin Preparations in Detecting Antigliadin Antibodies
Authors: Kumar V. , Jain N. , Lerner A. , Beutner E. H. , Chorzelski T. P. , Lebenthal E.
Published: January 2024

Antigliadin antibodies (AGA) have been used as indicators of celiac disease. The presence of these antibodies in other gastrointestinal and liver disorders and even in normal healthy controls casts a shadow on the diagnostic significance of AGA. We examined 91 normal controls of varying ages and 97 patients with various gastrointestinal and liver disorders. Forty‐eight of 97 nonceliac patients were positive for AGA, and diagnosis‐specific incidences ranged as high as 75% in patients with small bowel disease. In addition, the levels of AGA were dependent upon age as their presence increased from 12% in children with a mean age of 10, to 35–40% in normals within the 60–70 age group. The lack of celiac disease specificity of AGA was not due to either the source of gliadin nor to the sensitivities of the test methods. Both the enzyme‐linked immunosorbent assay (ELISA) and the immunofluorescence methods gave comparable results. ELISA was more sensitive than immunofluorescence. These results thus strongly suggest that AGA are not markers of celiac disease and increase with age in normals.
Antigliadin and Antireticulin Antibodies in Children with Dermatitis Herpetiformis
Authors: Vainio Eeva , Kosnai Istvan , Hällström Olavi , Karpati Sarolta , Mäki Markku , Reunala Timo
Published: January 2024

The serum samples of 27 children with dermatitis herpetiformis (DH) were examined for the presence of antigliadin (AGA) and antireticulin (ARA) antibodies. AGA were determined with an enzyme‐linked immuno‐sorbent assay (ELISA) and ARA with an immunofluorescence method. Increased IgA or IgG class AGA levels were found in four of ten children on a normal diet, in two of 25 on a gluten‐free diet (GFD), and in two of four children on gluten challenge. The corresponding figures for ARA were nine of ten, two of 25, and four of four, respectively. All nine patients with ARA on a normal diet had either subtotal or partial villous atrophy, whereas the patient negative for ARA had a normal jejunal mucosa. ARA were mostly of IgA class, and after gluten withdrawal, increased levels fell to normal range. Four children were challenged with gluten, and they all developed subtotal villous atrophy and demonstrated IgA class ARA. These results suggest that in childhood DH, ARA is a more sensitive indicator of gluten‐sensitive enterop‐athy than AGA, but both antibody determinations can be used in monitoring adherence to GFD treatment.
Membrane Distribution and Carotenoid Content in Human Colostrum
Authors: Patton Stuart , Huston Gail E.
Published: January 2024

Daily colostrum samples from 5 donors were fractionated into fat globules, non‐lipid phase (skim milk), and cells. These and portions of the intact samples were assayed for protein, phospholipid and cholesterol, the latter two serving as criteria of membrane. The intact samples were also analyzed for total lipid and carot‐enoids, and skim milk phases for protein patterns by gel electrophoresis. Membrane material was highest in the first two daily samples with substantial amounts in both fat globule and skim milk phases; quantities declined over the 5‐day sampling period, particularly in the skim milk. Membrane in the cell fraction was <1% of total. In first colostrum there was more than twice as much membrane material as in mature milk (>1 month of lactation), and seven times as much in the skim milk phase. The protein pattern and carotenoid content of colostrum changed markedly during the sampling period. The elevated carotenoids in colostrum are attributed to mobilization of lipids stored in the breast. Based on pigmentation and density, colostrum contains two kinds of fat globules.
Secondary Amyloidosis in Crohn's Disease of Childhood
Authors: Kirschner Barbara S. , Samowitz Wade S.
Published: January 2024

Secondary amyloidosis is a rare complication of Crohn's disease, especially in pediatric patients. This report describes an 11‐year‐old child with Crohn's disease who developed intermittent proteinuria and thyroid enlargement at 14 years of age as the initial manifestations of secondary amyloidosis. Deterioration in renal function resulted in her death at 20 years of age. Published reports that discuss the occurrence of systemic amyloidosis in Crohn's disease and the pediatric age group are reviewed.
Serum Transaminase Elevations in Infants With Rotavirus Gastroenteritis
Authors: Kovacs Andrea , Chan Linda , Hotrakitya Chiraporn , Overturf Gary , Portnoy Bernard
Published: January 2024

Over a 6‐week period, 35 (41%) of 86 infants admitted with diarrhea and dehydration were found to have human rotavirus (HRV) gastroenteritis, using the Rotazyme (RTZ) test. Serum transaminase levels were measured on 44 infants on admission and 72 infants during the first 3 days of hospitalization. On admission, RTZ‐positive (RTZ +) infants had higher mean and median alanine aminotransferase (ALT) levels [mean 87.5 U/L in RTZ+ vs. 50.0 U/L in RTZ‐negative (RTZ‐), p = 0.001; median 60 U/L in RTZ+ vs. 41 U/L in RTZ‐infants, p = 0.002], and higher mean and median aspartate aminotransferase (AST) levels (mean 64.3 U/L in RTZ+ vs. 44.0 U/L in RTZ‐ infants, p = 0.008; median 67.5 U/L vs. 42.0 U/L, respectively, p = <0.05). On admission, 72% of RTZ+ vs. 19% of RTZ‐ infants had ALT levels > 50 U/L (p = 0.0004). Maximum ALT levels from the first 3 days were also higher in the RTZ +group (67.7% of RTZ + vs. 34.1% of RTZ‐ having levels > 50 U/L, p = 0.005). Transaminase elevations did not correlate with dehydration or any electrolyte abnormalities. These findings suggest that transaminase elevations are common in infants hospitalized with HRV enteritis.
The Cut‐Off Criterion for a Positive Hydrogen Breath Test in Children
Authors: Solomons Noel W. , Barillas Carolina
Published: January 2024

Seventy‐three preschool children with adequate nutritional status underwent interval‐sampling, 3‐hour breath‐hydrogen carbohydrate absorption tests after consuming either 240 ml of intact milk (containing 12 g of lactose) or the same volume of milk with 90–95% of its lactose prehydrolyzed in vitro (containing < 1 g lactose, with the remaining sugar as glucose and galactose). Results were examined in a reappraisal of the cut‐off criterion for the rise of breath H2 concentration signifying biologically incomplete absorption. If the ≥; 10‐ppm criterion advocated by some investigators is used, 83% of our subjects would have been classified as incomplete lactose digesters and 30% would have their tests with the monosaccharide‐rich milk classified as positive. With the ≥20 ppm criterion used in our laboratory and others, the prevalence of lactose maldigestion in the sample becomes 60% and only 4% of subjects have apparent monosac‐charide absorption, 96% having a rise below the cut‐off level with prehydrolyzed milk. At least in Guatemalan preschoolers, the 20‐ppm criterion for a positive breath H2 test provides a superior specificity‐sensitivity balance and more reasonable diagnostic conclusions.
Effect of Iron‐Fortified Formula on SIgA of Gastrointestinal Tract in Early Infancy
Authors: Koutras A. K. , Vigorita V. J. , Quiroz E.
Published: January 2024

There is no information available about the effect of iron in formula on the development of gastrointestinal humoral immune response in early human infancy. We compared standard Enfamil to iron‐fortified formula during the first 8 weeks of human life on the development of local gastrointestinal humoral immune response by measuring fecal secretory immunoglobulin A (SIgA). Thirty children were studied and classified according to feeding in two groups: plain Enfamil (n = 15) and Enfamil with iron (n = 15). Fecal specimens were analyzed at birth, 2 weeks, 4 weeks, and 8 weeks of age. Fecal SIgA was assayed by RID (radial‐immune diffusion) during these four infantile periods in the two groups. Marked SIgA changes were detected in the group with iron‐fortified formula versus non‐iron‐fortified formula. These changes appeared to have statistical significance in all the three infantile periods (2 weeks, 4 weeks, and 8 weeks). There were no observed clinical side effects with the use of iron‐fortified formula as detected by appropriate questionnaire. The possible role of iron in earlier and enhanced development of immunologic competence and host defense is discussed. These data may suggest a beneficial effect of low‐dose iron in formula during early infantile human life by the protective role of the earlier and enhanced production of SIgA in the gut.
Evaluation of Biofeedback in Childhood Encopresis
Authors: Wald Arnold , Chandra R. , Gabel Stewart , Chiponis Darleen
Published: January 2024

In order to evaluate the efficacy of biofeed‐back for childhood encopresis, 50 children with enco‐presis were prospectively studied and randomized to receive biofeedback (B) or mineral oil therapy (M). Specificity of biofeedback was also evaluated by comparing outcomes of both regimens in children with normal (n = 32) and abnormal (n = 18) defecation patterns. Using a single blinded design, there were no significant differences in clinical outcomes between the 24 children receiving B and the 26 children receiving M at 3, 6, and 12
Total Parenteral Nutrition with Intralipid in Pr Infants Receiving TPN with Heparin
Authors: Berkow S. E. , Spear M. L. , Stahl G. E. , Gutman A. , Polin R. A. , Pereira G. R. , Olivecrona T. , Hamosh P. , Hamosh M.
Published: January 2024

Plasma lipolytic activity (lipoprotcin lipase and hepatic lipase). free fatty acids (FFA). triglyceridcs. cholesterol, and glucose levels were measured in 21 premature infants [gestational age 26–37 weeks (mean ± SEM 30.4 ± 0.63 weeks), aged 1–8 days (mean ± SEM 3.00 ± 0.35 days)]. All infants were maintained on total parenteral nutrition with heparin (1 U/ml) and were given Intralipid, 1. 2, and 3 g/kg/day. over 15 h on days 1, 2, and 3. respectively. Blood samples were drawn before and at the end of Intralipid administration. Baseline plasma lipolytic activity, before the start of lipid infusion, was 1.54 ± 0.24 U/ml (1 U = I μmol [3H]oleic acid released from tri[3H]olein/h). Lipolytic activity increased after lipid infusion to 4.04 ± 0.96, 4.32 ± 0.63. and 6.09 ± 1.00 U/ml on days 1, 2, and 3 of the study. Hepatic lipase amounted to 38–47% of total lipolytic activity. During the 3 days of lipid infusion, there were dose‐dependent increases in plasma FFA, triglyceride, and cholesterol. Whereas FFA and triglyceride concentrations returned to prelipid infusion levels 9 h after stopping the infusion of Intralipid, 1, 2, or 3 g/kg, there was a cumulative increase in plasma cholesterol and glucose concentrations. The close correlation between FFA concentrations and plasma lipolytic activity (r = 0.655, p < 0.001) suggests considerable in‐travascular lipolysis. The positive correlation between plasma FFA and triglycerides (r = 0.632, p < 0.001) and FFA and cholesterol (r = 0.582. p < 0.001) indicate, however, that intravascular lipolysis does not prevent the lipemia associated with Intralipid infusion to low birth weight infants. This study suggests that the infusion of a mixture of small amounts of heparin and Intralipid leads to detachment of lipoprotcin lipase and hepatic lipase from the capillary endothelium of low birth weight infants. The resulting intravascular lipolysis probably exceeds the FFA disposal capacity of premature infants. The rise in plasma FFA concentration to 2.0 μmol/ml warrants caution in the combined use of Intralipid (at rates exceeding 2 g/kg/day) and low levels of heparin for the clinical management of premature infants maintained on total parenteral nutrition.
Cornstarch Therapy in a Patient with Type III Glycogen Storage Disease
Authors: Borowitz Stephen M. , Greene Harry L.
Published: January 2024

A child with type III glycogen storage disease is described. The patient presented with growth failure and hepatic dysfunction, and no clinical or biochemical evidence of myopathy. Institution of high protein nocturnal intragastric feedings was associated with improved growth and less hepatic dysfunction. Compliance with tube feedings was sporadic necessitating another approach to the patient's management. The use of oral cornstarch supplements enabled the child to maintain normoglycemia and was associated with clinical and biochemical improvement. Our experience with this child suggests cornstarch therapy may be useful in those patients with type III glycogen storage disease who suffer primarily from hepatic dysfunction and growth failure.
Growth and Adiposity of Term Infants Fed Whey‐Predominant or Casein‐Predominant Formulas or Human Milk
Authors: Harrison Gail G. , Graver Ellen J. , Vargas Margaret , Churella Helen R. , Paule Charles L.
Published: January 2024

Growth, estimated composition of weight gained, and stool patterns of term infants who were fed either a whey‐predominant formula or a casein‐predominant formula in a random design and of breast‐fed infants were compared. All infants (N = 111) were healthy, singleton products of uncomplicated pregnancies. Birth weights and other anthropometric measures in the first few days of life were not different among the three feeding groups. Formula or breast milk was the infants' principal source of energy from birth to age 16 weeks. Average energy intakes of formula‐fed infants and change of intakes with age were similar in both groups at all ages. Feeding groups were not significantly different at any age in weight, length, weight or length gain, head circumference, skinfold measurements, upper arm fat area and muscle area, or estimated total body fat. Stools of infants on the whey‐predominant formula differed from both the breast‐fed and casein‐predominant formula groups.
Differences in Fatty Acid Composition of Human Milk in Vegetarian and Nonvegetarian Women
Authors: Specker Bonny L. , Wey Howard E. , Miller Donald
Published: January 2024

The purpose of the current study was to determine whether there were differences in the fatty acid composition of milk from vegetarian mothers compared to nonvegetarian mothers and whether fatty acid composition was related to length of time on a vegetarian diet. Median time on a vegetarian diet was 81 months (range 36–132 months). Milk fat and fatty acids produced de novo in the mammary gland did not differ between diet groups. Milk from vegetarian women (n = 12) contained higher percentages of the precursors of arachidonic acid compared to nonvegetarian women (n = 7). Although there was no difference between diet group in the amount of arachidonic acid present (percent of total), a lower percentage was observed in women the longer they were on a vegetarian diet (r = −0.724, p = 0.008), with a corresponding higher percentage of the sum of precursors of arachidonic acid (r = 0.563, p = 0.056). The percentage of docosahexenoic acid was similar in the milk of vegetarian women compared to nonvegetarian women. The length of time on a vegetarian diet had no effect on these two fatty acids. In summary, differences in fatty acid content were apparent between the two dietary groups and changes with time on a vegetarian diet suggest that not only does current maternal diet affect fatty acid milk composition, but long‐term dietary habits may as well.
Antibodies to 90 Kilodalton Glycoprotein in Childhood and Adolescent Celiac Disease
Authors: Teppo A. ‐M. , Mäki M. , Háullström O. , Maury C. P. J.
Published: January 2024

Antibodies to 90 kilodalton (kDa) glycoprotein, a mannose‐rich protein of skin and intestinal mucosa, were determined in 31 children or adolescents with untreated cehac disease, in 30 of these patients during gluten withdrawal, and in 17 patients on gluten challenge. Highly elevated antibody levels to 90 kDa glycoprotein were found in patients with untreated cehac disease. Close, positive correlation (r 0.74, p 0.0005) was found between the age of these patients and the level of 90 kDa glycoprotein antibodies. The antibodies to 90 kDa glycoprotein behaved, compared with the reticulin antibodies, in a different manner kinetically. During gluten challenge antibodies to 90 kDa glycoprotein increased on an average 2.6 months later than the antibodies to reticulin. On the other hand, in patients undergoing gluten withdrawal the antibodies to reticulin markedly decreased or disappeared during the first 3 months on the diet, whereas the level of 90 kDa glycoprotein antibodies did not decrease until the 5th to 11th months on the diet. These results suggest that the antibodies reacting with the 90 kDa glycoprotein differ from those reacting with reticulin and that in celiac patients undergoing gluten challenge the synthesis of reticulin antibodies is an earlier event than the production of 90 kDa glycoprotein antibodies. The level of 90 kDa glycoprotein antibodies may reflect the extent of tissue damage.
Factors Responsible for Persistence of Childhood Constipation
Authors: Loening‐Baucke Vera A.
Published: January 2024

In this study 56% of children with chronic constipation and encopresis were unable to defecate rectal balloons. Most of them had an abnormal contraction of the external anal sphincter during defecation trials. Eighty‐six percent were still unable to defecate balloons 1 year later after having complied with a conventional treatment program. Only 14% of patients unable to defecate balloons had recovered by 1 year, whereas 64% of patients able to had recovered (p ‐ 0.02). Only 13% of patients unable to relax the external sphincter had recovered by 1 year, whereas 70% of those able to do so had recovered (p ‐ 0.01). In addition, none of the patients with an abdominal fecal mass present during the initial examination independent of ability or inability to defecate balloons had recovered (p ‐ 0.001). This study shows that abnormal defecation dynamics and the severity of constipation are predictors for persistence of chronic constipation and encopresis.
Lowered Serum Ca, Blood Ionized Ca, and Unresponsive Serum Parathyroid Hormone with Oral Glucose Ingestion in Infants of Diabetic Mothers
Authors: Venkataraman Pankaja S. , Blick Kenneth H. , Dasharathy Gayathri , Parker Michael K.
Published: January 2024

Oral glucose ingestion may lower serum Ca in infants of diabetic mothers (IDMs). Six metabolically stable IDMs were studied following ingestion of 1.7 0.1 g/kg (mean ± SE) of glucose over 20 min and serum Ca. Mg. P. blood iCa, serum PTH, and CT were measured at 0. 1/2, 1, and 2 h. Data obtained in IDMs were compared with previously reported findings in 10 normal neonates. In IDMs as in normal neonates. serum Ca. Mg. P declined significantly after oral glucose ingestion. Blood Ca2+ was significantly lower at 1 1/2 h in IDMs versus normal neonates, and by analysis of covariance, trends in blood Ca2+ were significantly different in IDMs versus normal neonates (p < 0.05). Serum PTH concentrations were unaltered in IDMs versus a significant rise in serum PTH noted in normal neonates. The difference between the two groups was significant statistically (p < 0.05). Baseline serum CT was elevated in both groups and did not change. Thus, in IDMs responses to oral glucose ingestion differs from that seen in normal neonates as follows: blood Ca2+ is lowered in IDMs versus normal neonates, and serum parathyroid hormone (PTH) does not respond to a decline in blood Ca2+ in IDMs, whereas in normal neonates serum PTH rises and blood Ca2+ is maintained. We speculate that relative parathyroid gland unresponsiveness occurs in IDMs, which may result in lowered blood Ca2+ after oral glucose ingestion in these infants.
Effects of Berberine on Basal and Secretagogue‐Modified Ion Transport in the Rabbit Ileum in Vitro
Authors: Guandalini Stefano , Fasano Alessio , Migliavacca Maurizio , Marchesano Giuseppe , Ferola Anna , Rubino Armido
Published: January 2024

The antisecretory effect of berberine sulfate (BS) was determined in the rabbit ileal mucosa in vitro mounted in Ussing chambers. When present in the luminal side, the drug had no effect on potential difference (PD) or on the short‐circuit current (Isc) changes induced by theophylline or prostaglandin E2(PGE2). When present in the serosal medium at a concentration of 2 mM, however, berberine reduced PD and Isc and abolished residual ion flux (bicarbonate secretion) but had no significant affect on basal net Na and CI transepithelial transport. BS effect on basal PD was not affected by the absence of Ca2+ in the medium: neither was it inhibited by the α‐adrenergic blocker yohimbine. Serosally added BS effectively antagonized the secretory effect on Isc of agents that increase each of the known intracellular mediators of ion secretion: cyclic 3′, 5′‐adenosine monophosphate (cAMP), cyclic 3′, 5′‐guanosine monophosphate (cGMP), and Ca2+: it also inhibited the ion transport modifications evoked by PGE2. The drug had no effect on the concentration of cyclic nucleotides either under basal condition or in the presence of some secretagogues. Finally, BS did not impair the PD rise due to luminal addition of glucose.
Short‐Term Malnutrpition in Neonatal Rabbits. I. Brush Border Enzymes
Authors: Baker Susan S. , Suthutvoravut Umaporn , Walker W. Allan
Published: January 2024

Seventy‐two hour starvation in neonatal rabbits was studied. Fasted animals received no feeds, only water every 8 h for 72 h. Fed animals were suekled by the dam. I here was no difference in birth weight, serum albumin, blood urea nitrogen, electrolytes, or urine specific gravity between led and fasted animals. Weight at 72 hr was less in lasted (p < 0.01) than fed rabbits. Serum cortisol (p < 0.05) and corticosterone (p < 0.01) levels were higher in the fasted group. Proximal and distal small bowel homogenates had less DNA and protein (p < 0.01) in the lasted group, but the protein DNA ratio was the same in the proximal and distal small bowel homogenates from both groups. Sucrase (E.C.3.2.1.26) specific activity was significantly increased in proximal small bowel homogenates from the fasted group (p < 0.01) but was the same in distal small bowel homogenates from both groups. Sucrase total activity per proximal segment was the same in fed and fasted animals but was significantly less per segment in distal small bowel homogenates from fasted animals. Alkaline phosphatase (E.C.3.1.3) total and specific activity was decreased in proximal (p < 0.01 ) and distal (p < 0.05) small bowel homogenates from the lasted group. Lactase (E.C.3.2.1.23) total activity was decreased in proximal and distal (p < 0.01) small bowel homogenates from the lasted group but lactase specific activity was unchanged. Thus, a brief period of malnutrition in neonatal animals can result in a variety of regional functional changes in the gastrointestinal mucosa.
Renal Abnormalities in Paucity of Interlobular Bile Ducts
Authors: Tolia Vasundhara , Dubois Reuben S. , Watts Frederick B. , Perrin Eugene
Published: January 2024

Paucity of interlobular bile ducts is a common histologic characteristic in persistent conjugated hyperbilirubinemia of infancy. It occurs in two forms: the syndromatic and the nonsyndromatic types. The syndromatic form is also called arteriohepatic dysplasia. The nonsyndromatic type of paucity of interlobular bile ducts occurs less frequently and is usually associated with more severe disease and a less favorable prognosis. We present two unusual renal anomalies in association with paucity of interlobular bile duels. In the first case, juvenile nephronophthisis was diagnosed in a 4‐week‐old infant with arteriohepatic dysplasia: the patient died from severe renal disease by 2 months of age. The second case presented with severe bilateral hydronephrosis and hydroureter secondary to posterior urethral valves associated with the nonsyndromatic form of paucity of interlobular bile duels. He, however, improved after corrective surgery of the urethral valves. Other renal abnormalities previously reported in the literature in association with chronic liver disease are also reviewed.
Successful Management of an Acquired Gastric Outlet Obstruction with Endoscopy Guided Balloon Dilatation
Authors: Treem William R. , Long William R. , Friedman David , Watkins John B.
Published: January 2024

Summary

Antral‐pyloric strictures and gastric outlet obstruction are known complications of caustic ingestions. These lesions can develop even in the absence of overt signs of potentially serious upper gastrointestinal tract pathology of abdominal pain at the time of ingestion. The development of radial balloon catheters, which can be endoscopically guided into narrow strictures and inflated, offers an alternative therapy to surgical resection if obstructing lesions. We report the successful management of a pyloric stricture secondary to a caustic ingestion by sequential endoscopically guided balloon dilatations and offer guidelines for the use of this procedure.
Clinical and Laboratory Correlates of Esophagitis in Young Children
Authors: Hyams Jeffrey S. , Ricci Andrew , Leichtner Alan M.
Published: January 2024

To develop clinical and laboratory criteria to identify young children with gastroesophageal reflux (GER) who are at particular risk for esophagitis and then to monitor their clinical course we have prospectively studied 40 subjects (ages 2–22 months, mean 8 months) with persistent symptoms of GER with 18 h intraesophageal pH monitoring, endoscopy, and grasp and suction esophageal biopsies. Esophagitis was found in 16 of 20 patients under 7 months, 12 of 14 between 7 and 12 months, and five of six between 12 and 24 months. Esophagitis was equally frequent in those patients with or without poor weight gain, wheezing, or irritability. Only 15% of patients with esophagitis had occult blood in their stool. No parameter of intraesophageal pH monitoring was both sensitive and specific in identifying patients who were ultimately found to have either mild or severe esophagitis. Follow‐up data (37 patients) revealed that fundoplication was eventually required in four of eight patients with severe esophagitis, three of 22 with mild esophagitis, and none of seven without esophagitis. Currently used clinical and laboratory assessments of GER have limited value in identifying those children with either normal esophageal mucosa or at risk for varying degrees of esophagitis. Preliminary observations suggest that the presence of severe histologic esophagitis at the time of initial evaluation may have prognostic value in identifying those patients most likely to fail medical therapy and require fundoplication.
Comparison of Nitrogen Utilization of Two Elemental Diets in Patients with Crohn's Disease
Authors: Vaisman Nachum , Griffiths Anne , Pencharz Paul B.
Published: January 2024

Energy, nitrogen absorption, and nitrogen utilization of two commercial elemental diets, Vivonex and Vital, were compared in 10 teenage boys and girls with Crohn's disease. The diets were given in random order as overnight feedings and were the sole source of nutrients for two consecutive periods of 3 weeks each. Urine and stools were collected for 48 h at the end of each 3‐week period. Energy absorption was slightly better on Vivonex (p < 0.05), although 95–100% of energy was absorbed with both formulas. Nitrogen absorption was not different for the two formulas, but nitrogen utilization was significantly better on Vital (28.6 ± 12.9% versus 9.7 ± 17.7%, p < 0.01). This difference may be attributable to the different concentrations of sulfur‐containing and aromatic amino acids in the two formulas.
Spontaneous Perforation of Common Bile Duct
Authors: Shun A. , Middleton A. W. , Kamath K. R. , Brewster D.
Published: January 2024

A 2‐week‐old Micronesian infant presented with spontaneous perforation of the common bile duct. Mild jaundice, acnolic stools, and heavily bile‐stained ascites were the main clinical features. The presentation of this rare disorder is characteristic enough to permit early diagnosis. Surgery is the treatment of choice.
Comparison of Glucose/Electrolyte and Glucose/Glycine/Electrolyte Oral Rehydration Solutions in Hospitalized Children with Diarrhea in Costa Rica
Authors: Pizarro Daniel , Levine Myron M. , Posada Gloria , Sandi Leyla
Published: January 2024

The experience of Nalin et al. and Palra et al. with a “super oral rehydration solution (ORS)” containing glucose plus glycinc to enhance the intestinal absorption of sodium and water prompted us to investigate a similar ORS containing the standard World Health Organization (WHO/ORS) plus either 55 or 110 mmol/L glycine in infants and small children with noncholera diarrhea. We did not find a statistically significant difference between the glycine‐fortified ORS and the standard WHO/ORS with respect to the clinical outcome and composition of serum electrolytes.