bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolic Fate of Free and Peptide‐Linked Phenylalanine During Infusion into Portal or Femoral Vein of Rats
Authors: Niitzenadel W. , Fahr K. , Schwartze E.
Published: February 2024

[14C]Phenylalanine, either as free amino acid or as glycylphenylalanine, was continuously infused over 3 h into the portal or femoral vein of anaesthetized Wistar rats. Radioactive phenylalanine and metabolites, as well as labelled proteins, were determined in plasma during infusion and at the end of the experiments in kidney, liver, brain, heart, and femoral muscle. No differences in plasma and tissue pools were observed, if the results after portal versus femoral infusion are compared. The infusion of peptide‐linked phenylalanine results in a distribution of radioactivity similar to that occurring after infusion of the free amino acid. Peptidase activity toward glycyl‐phenylalanine was found in plasma as well as tissues. The unhydrolyzed di‐peptide could not be detected in plasma or in the tissues. These data suggest that administration of nutrients into the peripheral vein does not alter their metabolic fate.
Plasma Immunoreactive Anionic Pancreatic Trypsin in Cystic Fibrosis
Authors: Durie P. R. , Gaskin K. J. , Geokas M. C. , O'Rourke M. , Largman C.
Published: February 2024

Previous data from this laboratory have shown good correlation between plasma cationic trypsin(ogen) and levels of pancreatic function in older cystic fibrosis (CF) patients with and without malabsorption. In the present study a radioimmunoassay for human anionic trypsin(ogen) has been employed in the assessment of pancreatic function in older patients with CF. Immunoreactive anionic trypsin(ogen) levels correlated poorly with pancreatic function due to an apparent elevation of this enzyme in many older CF patients with malabsorption (CF + M). When plasma from three older CF + M patients is examined for the molecular size of the apparent immunoreactive material detected, no free anionic trypsinogen is observed. Instead, a broad peak of apparent immunoreactive material appears in the gammaglobulin region. However, only free anionic trypsinogen could be detected in plasma from two CF patients without malabsorption (CF ‐ M), who had not received pancreatic enzyme supplements. It appears possible that a human plasma immunoglobulin G (IgG) to porcine pancreatic enzyme in the CF + M patients might interfere in the assay by binding TLCK‐anionic trypsin tracer. It is unclear why such an effect does not appear to occur in the cationic trypsin(ogen) assay. The results of the current study suggest that, for assessment of pancreatic insufficiency in CF, the radioimmunoassay for cationic trypsin(ogen) is more useful than the presently available radioimmunoassay for the anionic form.
Effect of Neuraminidase Treatment of IgG and α1‐Acid Glycoprotein on Their Intestinal Transport in Suckling Rats In Vivo
Authors: Friedrich Manfred , Berger Eric G.
Published: February 2024

Binding and transport of rat immunoglobulin G (IgG), human α1‐acid glycoprotein, and their neuraminidase‐treated derivatives were studied in vivo in the intestine of suckling rats. IgG and asialo‐IgG binding was saturable, preceding active transport; the amounts of gut‐associated α1‐acid glycoprotein and asialo‐α1‐acid glycoprotein (“binding”) were not saturable; and transport was passive. Binding of asialo‐IgG to the intestine was significantly higher than that of native IgG, whereas transport rates were similar. No difference was found for both binding and transport of native and asialo‐α1‐acid glycoprotein. These results suggest an interaction between the heteroglycan moiety of IgG and its intestinal receptor and exclude a role of sialic acid in the intestinal transport of a heterologous, passively absorbed glycoprotein.
Delayed Complete Functional Lactase Sufficiency in Breast‐Fed Infants
Authors: Lifschitz Carlos H. , Smith O'Brian E. , Garza Cutberto
Published: February 2024

Colonic fermentation of unabsorbed lactose was evaluated by measuring breath hydrogen (BH2) after a regular feeding in 17 white, normal, exclusively breastfed infants 4‐5 weeks of age. Interval breath samples were collected with a specially modified face mask and analyzed by gas chromatography for H2 and CO2 concentrations. Five infants (29%) produced 20 ppm or more of H2, four of whom underwent repeated testing. Three infants stopped producing over 20 ppm of H2 as they grew older. On a repeat evaluation, one of these three infants had levels over 20 ppm when other foods were introduced into his diet. The other continued to have elevated BH2 when weaned. Stools of infants with elevated BH2 levels had no detectable glucose, and pH was over 5.5. Weight‐for‐age of infants with elevated BH2 was at or above the 75th percentile. BH2 levels, normalized for the amount of breast milk ingested, fell significantly with age. These results show that complete small bowel absorption of lactose from breast milk does not occur in all white, normal, term, appropriate‐for‐gestational‐age infants in the first months of life. The absence of glucose in the stool and the normal stool pH suggest that the unabsorbed lactose that produced H2 can be degraded in the colon.
Fecal α1‐Antitrypsin Excretion in Young People with Crohn's Disease
Authors: Thomas Daniel W. , Sinatra Frank R. , Merritt Russell J.
Published: February 2024

Fecal α1‐antitrypsin excretion, a noninvasive indicator of protein‐losing enteropathy, was correlated with clinical disease activity in pediatric patients with Crohn's disease. Disease activity was defined as the sum of 11 abnormal clinical parameters which were adapted from previously published disease activity scoring methods. Each patient was also given a subjective clinical rating when evaluated. In addition, four different devised disease activity scoring methods were correlated retrospectively with subjective clinical ratings for hospitalized patients. A total of 125 random fecal α1‐antitrypsin determinations were performed on 22 patients. Ninety‐six percent of clinically active episodes of Crohn's disease were associated with elevated fetal α1‐antitrypsin (p < 0.001). The degree of elevation was found not to correlate directly with the severity of assessed disease activity or site of intestinal involvement. A direct linear relationship was demonstrated between 23 paired random fecal α1‐antitrypsin and intestinal α1‐antitrypsin clearance assys (r = 0.93). There was a high, and remarkably similar, degree of correlation with each of the four different derived activity scoring methods and simple subjective ratings (r = 0.89‐0.93). We conclude that: (a) fecal α1‐antitrypsin excretion may be helpful in assessing the presence or absence of Crohn's disease activity by providing an objective and specific indicator of intestinal damage; and (b) it appears that a simple subjective rating score is as clinically useful as other previously devised activity indices.
Nonpancreatic Hydrolysis of N‐Benzoyl‐L‐tyrosyl‐p‐aminobenzoic Acid (PABA Peptide) in the Rat Small Intestine
Authors: Sterchi E. E. , Green J. R. , Lentze M. J.
Published: February 2024

Factors affecting the intestinal hydrolysis of orally administered N‐benzoyl‐L‐tyrosyl‐p‐aminobenzoic acid (PABA peptide) and urinary recovery of p‐amino‐benzoic acid have been studied in rats, after diversion of the pancreatic and biliary secretions. The exclusion of pancreatic secretions from the small intestine lowered, but did not completely abolish, the urinary recovery of PABA, whereas diversion of the bile had no significant effect. A particulate‐bound enzyme capable of splitting PABA peptide was found to be present throughout the rat small intestine, and its activity remained unchanged in the absence of biliopancreatic secretions. The intestinal PABA peptide hydrolase could be solubilized with papain and Triton from a partially purified brush‐border membrane fraction, and it eluted in gel filtration as a highmolecular‐weight peak, well separated from the other known peptidases of the intestinal brush‐border membrane.
Chronic Diarrhea and Neutropenia Not Associated with Pancreatic Insufficiency
Authors: Marino Lucyndia R. , Dahms Beverly B. , Halpin Thomas C.
Published: February 2024

Six children with chronic diarrhea and neutropenia, initially referred for evaluation of Shwachman‐Diamond syndrome, were found to have no evidence of pancreatic insufficiency. All presented in the spring with a prodromal respiratory illness. Hematologic evaluation was normal except for iron deficiency anemia and neutropenia. Small intestinal biopsies of all children showed inflammation, consistent with chronic enteritis. The children were followed until growth returned to previous percentiles. Diarrhea and neutropenia resolved by 6‐month follow‐up, and there was no recurrence of the neutropenia at 1 year.
Hypothesis Revisited
Authors: Anderson Charlotte M.
Published: February 2024

An earlier hypothesis based on the results of pancreatic studies in cystic fibrosis (CF) patients without steatorrhoea suggesting that the basic defect was related to an abnormality in control of electrolyte movement, particularly the bicarbonate ion, and water in exocrine secretory tissue is reviewed in light of recent advances in knowledge of secretory mechanisms. Evidence for defective bicarbonate–chloride exchange in a variety of CF exocrine tissues other than the pancreas is cited. Recent recognition of the close relationship between bicarbonate and mucus secretion and their stimulation by prostaglandin E2 is discussed. Consideration is given to the possibility of altered metabolism of PGE2 because of abnormal handling of essential fatty acids in CF, and an attempt is made to relate such a defect to the recent confirmation of oligosaccharide side chain differences such as an increased fucose–sialic acid ratio in CF gastrointestinal mucus and other glycoproteins. It is suggested that membrane permeability to chloride, bicarbonate–chloride exchange, and movement of water through extra‐and intracellular exocrine tissues depends on modifications of the carbohydrate structure of glycoproteins during secretion and that these changes are stimulated by co‐ordination of cell messengers PGE2, calcium, and cyclic AMP. Disturbed PGE2 metabolism in CF could inhibit these changes rendering resulting secretions dry, concentrated, and readily able to block ducts or tubes.
Intestinal Disaccharidase and Alkaline Phosphatase Activity in Giardiasis
Authors: Welsh Jack D. , Poley J. Rainer , Hensley Jess , Bhatia Mira
Published: February 2024

We report results on determinations of small intestinal brush‐border enzyme activities in 22 children (aged 11 months to 14 years) with giardiasis. In particular, activities of disaccharidases (lactase, sucrase, maltase) and of alkaline phosphatase were investigated. Forty‐one percent of the patients, irrespective of age, had a demonstrable depression of disaccharidase activities, usually in a combination involving two or more enzymes. A depression of intestinal alkaline phosphatase activity was present in 33% of patients, and only in those who demonstrated disaccharidase deficiencies. Mild villus atrophy was present in two mucosal specimens, whereas all others showed normal villus morphology by light microscopy. The results obtained in this study suggest that giardiasis in otherwise healthy children does not cause marked structural damage to the small bowel mucosa, as seen by the light microscope. However, some form of damage to the brush border does occur frequently, as evidenced by a depression of brush‐border enzymes. This damage most likely contributes to the diarrhea and also to the carbohydrate intolerance in these patients.
Picolinic Acid in Acrodermatitis Enteropathica
Authors: Krieger Ingeborg , Cash Ralph , Evans Gary W.
Published: February 2024

Three children with acrodermatitis enteropathica (AE) were treated with oral zinc dipicolinate (zinc‐PA). The daily dose of zinc required to prevent exacerbations, when administered as the dipicolinate complex, was one‐third the minimum amount of zinc required as the sulfate salt. The concentration of picolinic acid in the plasma of asymptomatic children with AE was significantly less than that of normal children. However, oral treatment with PA alone was ineffective. The plasma of the three AE children contained a measurable quantity of kynurenine which was undetectable in plasma from normal children. Absorption of an oral zinc load was normal. The results support the hypothesis that the genetic defect in AE is in the tryptophan pathway, although the role of PA in zinc metabolism remains to be defined.
Total Parenteral Nutrition in Bone Marrow Transplantation
Authors: Weisdorf Sally , Hofland Constance , Sharp Harvey L. , Teasley Kathleen , Schissel Kathleen , McGlave Philip B. , Ramsay Norma , Kersey John
Published: February 2024

Bone marrow transplantation (BMT) is associated with severe metabolic stress secondary to anorexia, mucositis, enteritis, and infection. We compared nutritional parameters and clinical outcomes of 22 patients who received prophylactic total parenteral nutrition (TPN) to those of 22 controls, matched for age and diagnosis, who received nutritional support ad libitum. Over the 5‐week study period, the TPN group averaged caloric intakes greater than 1.5 × basal energy expediture (BEE) per day and gained 2.5% of body weight; the control group averaged less than 0.9 × BEE and lost 3.7% of body weight. Visceral protein status as reflected by serum albumin was not different. Engraftment of donor marrow cells was 3 days earlier (p < 0.01) in the TPN group than in the controls, despite there being no significant difference in the number of marrow cells each group received. There was no difference in the two groups' clinical outcomes; mortality, duration of hospital stay, and incidences of sepsis, graft‐versus‐host disease, and return of malignancy were equivalent. Thus, patients who received prophylactic TPN engrafted sooner than patients who did not; however, overall clinical outcome was unaffected by TPN. Controlled studies of prophylactic TPN are indicated for the BMT patient population.
Mother‐Infant Prothrombin Precursor Status at Birth
Authors: Bloch Clifford A. , Rothberg Alan D. , Bradlow Basil A.
Published: February 2024

Previous work from this laboratory has suggested there is a risk of hemorrhagic disease of the new‐born (HDNB) in approximately one‐third of term neonates, presumably as a result of vitamin K deficiency. Using the same assay for PIVKA (protein induced by vitamin K absence, prothrombin precursor), we studied 46 normal mother‐infant pairs at term to investigate the relationship between neonatal and maternal PIVKA status. PIVKA was found in 13 infants (28%) and in seven mothers (15%). Maternal PIVKA status correlated with infant status (p < 0.03). These data suggest that fetal vitamin K deficiency and risk of HDNB may be a consequence of maternal deficiency of the vitamin.
Synthesis of a Metallothionein‐Like Protein by Developing Turkey Embryos Maintained in Long‐Term, Shell‐Less Culture
Authors: Richards Mark P.
Published: February 2024

Turkey embryos were maintained in long‐term, shell‐less culture to the age of 17 days. At this time, 10 cultures were given saline (controls), and 10 cultures were given 30 μg zinc in saline (+ Zn). In addition, all cultures received 5 μCi each of [35S]cystine and 65Zn dissolved in the saline and applied to the chorioallantoic membrane. After a further 20 h of incubation, no significant differences were found for embryo, liver, or yolk sac weights nor for relative liver size, hematocrit, serum protein, or serum concentrations of zinc and copper for the control and + Zn cultures. The addition of zinc to the cultures significantly (p < 0.01) elevated hepatic and yolk sac cytosol 65Zn and zinc concentrations. More than 70% of the increased 65Zn and zinc in the cytosol of liver and yolk sac could be accounted for as that bound to a lowmolecular‐weight metallothionein (MT)‐like protein. Added zinc significantly (p < 0.01) increased the incorporation of [35S]cystine and 65Zn into the MT‐like protein from liver and yolk sac indicating de novo synthesis of this protein. Liver and yolk sac MT‐like proteins eluted from DEAE Sephadex A‐25 columns as a single predominant species. The synthesis of an MT‐like protein by liver and yolk sac suggests a role in embryonic zinc homeostasis. Moreover, shell‐less culture of the avian embryo appears to be a useful method for studying zinc metabolism during periods of embryonic growth and development.
Effect of Various Metals and Calcium Metabolism Inhibitors on the Growth of Bifidobacterium bifidum Var. pennsylvanicus
Authors: Topouzian Nancy , Joseph Betty J. , Bezkorovainy Anatoly
Published: February 2024

In view of the facts that the normal intestinal flora exerts beneficial effects and that bifidobacteria are a more important component in the breast‐fed than in the bottle‐fed infant, factors affecting the growth of the latter microorganisms are of interest. A series of transition and other metals were shown to be growth inhibitors of Bifidobacterium bifidum var. pennsylvanicus. Such inhibition could be reversed fully or partially by 0.5–1.0 mM Fe2+ in the case of Zn2+, Cu2+, Au3+, Pt4+, La3+, Cr3+ Mn2+, Ni2+, and Cd2+, but not with Ag+, Hg2+, and VO2+. In addition, 2–4 mM Ca2+ substantially relieved the inhibitory effects of Zn2+, Mn2+, and La3+, and partially relieved the effects of Cd2+. Mg2+ was ineffective in relieving Zn2+ inhibition, but Ba2+ and Sr2+ could replace Ca2+ to some extent. The calcium metabolism antagonists verapamil, ruthenium red, 2‐chloroadenosine, lasalocid, Ca‐ionophore A‐23187, and calmodulin inhibitors W‐5 and W‐7 inhibited microbial growth. Inhibition could be relieved fully or partially with 0.5–1 mM Fe2+. Mg2+ relieved the inhibition by lasalocid, Ca‐ionophore A‐23187, and verapamil, whereas Ca2+ was effective only in the case of Ca‐ionophore A‐23187. We conclude that calcium and magnesium fluxes play an important role in the physiology of the bifidobacteria and that several metal growth inhibitors interfere with iron metabolism.
Effect of Taurine Supplementation on Hepatic Function During Short‐Term Parenteral Nutrition in the Premature Infant
Authors: Cooke Richard J. , Whitington Peter F. , Kelts Drew
Published: February 2024

To evaluate the potential role of taurine deficiency in the pathogenesis of parenteral nutrition‐induced cholestasis, 20 premature (<34 weeks AGA) infants were randomized to receive parenteral nutrition with and without taurine (10.8 mg/kg/day) during the first 10 days of life. Birth weight, gestational age, and protein and caloric intake were similar in both groups. Plasma taurine levels and hepatic function were assessed before the study began (3 ± 1 days of age), at 5 ± 1 days of age, and at 9 ± 1 days of age. Although plasma taurine levels were significantly greater at 5 ± 1 and 9 ± 1 days of age (p = 0.009) in the group receiving supplementation, no differential effect on hepatocellular function could be detected during this short period of time. A decrease in plasma ammonia (p = 0.001), alanine aminotransferase (ALT) (p = 0.036), γ‐glutamyltranspeptidase (GGTP) (p = 0.05), 5‐nucleotidase (5'N) (p = 0.001), and bile salt concentrations was noted in both groups, indicating the rapid maturation of hepatic function even in the presence of parenteral nutrition during the first 10 days of life.
Measuring Milk Intake in Breast‐Fed Babies
Authors: Coward W. A.
Published: February 2024

The relative merits of test weighing, water turnover methods, and a flowmeter method for the measurement of milk intake in breast‐fed babies are reviewed to allow the prospective investigator to choose the method most suited to his or her needs. Provided that measurements are made over 3–4 days to minimize the effects of day‐to‐day variation in milk intake, test weighing is a satisfactory procedure when feed frequency is low and individual feed volumes are large. However, in developing countries where frequency is high and feed volumes low, test weighing is inherently less accurate and may impose an unfamiliar and unphysiological discipline on the mother and child that severely limits its usefulness. In these circumstances methods based on the measurement of water turnover rates using 2H2O are the only procedures likely to yield useful information. A method in which single doses of 2H2O are given to the mother, and milk intake rates measured over 14 days, is described. Neither test weighing nor water turnover methods provide simultaneous milk intake and composition data. The development of flowmeter methods will make this possible, but their use is likely to be limited to metabolic wards rather than the home and widespread use in community studies is not a practical proposition.
Breath Hydrogen Test in Infants and Children with Blind Loop Syndrome
Authors: Nose Osamu , Kai Hiroshi , Harada Tokuzo , Ogawa Minoru , Maki Ichiro , Tajiri Hitoshi , Kanaya Shinobu , Kimura Saburo , Shimizu Kazuo , Yabuuchi Hyakuji
Published: February 2024

Breath hydrogen production after oral lactose loading was examined in infants and children with stagnant loop syndrome, blind loop syndrome, or both. All six infants under 3 years of age had bacteriological evidence of small intestinal colonization. The characteristics of the breath hydrogen test in this syndrome are: (a) extremely high basal excretion of breath hydrogen (after overnight fasting); (b) an earlier and greater breath hydrogen value (0.293 ± 0.201 ml/min/m2: mean ± SD) after oral lactose administration than formed in lactose malabsorption alone (0.050 ± 0.041 ml/min/m2); and (c) the observation of a sustained hydrogen rise over several hours. This investigation demonstrated that the breath hydrogen test is a promising and noninvasive tool for diagnosing blind (or stagnant) loop syndrome.
Familial Intrahepatic Cholestasis Associated with Progressive Neuromuscular Disease and Vitamin E Deficiency
Authors: Nakagawa Michiko , Tazawa Yusaku , Kobayashi Yasuko , Yamada Masaaki , Suzuki Hiroshi , Konno Tasuke , Tada Keiya
Published: February 2024

Three Japanese patients with familial progressive intrahepatic cholestasis developed complications involving neurologic abnormalities characterized by ataxia and pigmentary retinopathy. Serum vitamin E concentrations were extremely low in all patients, suggesting a long‐term vitamin E deficiency. High dose oral supplementation of a‐tocopherol produced normal serum vitamin E levels in two patients. Parenteral administration of vitamin E resulted in no clinical improvement in one patient who first received the treatment at 14 years of age. In the other two patients, the progression of neurological abnormalities was slowed by vitamin E supplementation. Cholestyramine treatment resulted in an apparent decrease in serum vitamin E levels despite oral atocopherol supplementation.
Plasma Vitamin E Levels in Children with Cholestasis
Authors: Alvarez Fernando , Cresteil Daniele , Lemonnier Frederique , Lemonnier Alain , Alagille Daniel
Published: February 2024

Plasma vitamin levels were assayed in 58 children presenting with chronic cholestasis. In the infants who developed cholestasis during the first weeks of life, vitamin E levels dropped below normal values after the age of 4 months. In the older children, vitamin E levels were not correlated with the etiology of cholestasis but with the degree of cholestasis, as expressed by serum bilirubin, serum bile acids, and fat absorption coefficient. We did not find any relationship between vitamin E levels and other biological parameters such as alkaline phosphatases, triglycerides, phospholipids, and cholesterol. These results further support the importance of vitamin E deficiency in chronic cholestasis of infants and children.
Serum Bile Acid Patterns Determined by an Enzymatic Method and High‐Performance Liquid Chromatography in Young Infants with Cholestasis
Authors: Tazawa Yusaku , Yamada Masaaki , Nakagawa Michiko , Konno Tasuke , Tada Keiya
Published: February 2024

Serum unconjugated and conjugated bile acids in young infants with intrahepatic cholestasis (idiopathic neonatal hepatitis syndrome, n = 8) or extra‐hepatic cholestasis (preoperative extrahepatic biliary atresia, n = 8) were examined by an enzymatic procedure and high‐performance liquid chromatography. In comparison with the mean level of total serum bile acid of controls having no liver or gastrointestinal diseases, those of each group markedly increased (15.6 ± 5.1 vs. 120.9 ± 64.0 and 161.8 ± 54.2 nmollml), but those of unconjugated bile acid were almost unchanged (1.4 ± 0.5 vs. 1.0 ± 0.6 and 0.6 ± 0.2 nmol/ml). The ratios of cholate to chenodeoxycholate and glycine‐ to taurine‐conjugated bile acids (G/T) were not significantly different between the groups of intrahepatic and extrahepatic cholestasis. However, in the patients with intrahepatic cholestasis, the G/T ratio varied greatly and the quantitative determination of individual conjugated bile acids in serum revealed that a half of the patients examined had very low levels of taurine‐conjugated cholate and chenodeoxycholate, suggesting a bile acid metabolism alternation specific for underlying intrahepatic cholestasis.
Exocrine Pancreatic Function in Diabetic Children
Authors: Sato M. , Yamamoto K. , Mayama H. , Yamashiro Y.
Published: February 2024

Exocrine pancreatic function was evaluated in 19 diabetic children on the basis of a pancreozyminsecretin test, a p‐aminobenzoic acid (PABA) test, and a determination of fasting plasma trypsin and elastase‐l levels. In the pancreozymin‐secretin test, the diabetics exhibited lower mean values in all the parameters measured, significant differences being seen in the volume of duodenal fluid and the output of bicarbonate and amylase. Compared to the controls, the diabetics also had lower levels in the PABA test and in the trypsin and elastase‐1 measurements. No significant correlation was seen between exocrine pancreatic dysfunction and the duration of diabetes. However, the duration of diabetes in children who showed extremely low levels (below the mean ± 2 SD for the control subjects) in the PABA test and low plasma trypsin and elastase‐1 values was more than 1 year. This study revealed that diabetic children had reduced exocrine pancreatic function, some in an early stage of the disease. Therefore, the reduction may be due to a functional disturbance rather than to an anatomical loss of exocrine pancreatic tissue.
Total Parenteral Nutrition with a New Amino Acid Solution for Infants
Authors: Kanaya Shinobu , Nose Osamu , Harada Tokuzo , Kai Hiroshi , Ogawa Minoru , Maki Ichiro , Tajiri Hitoshi , Kimura Saburo , Yabuuchi Hyakuji , Imura Kenji , Kamata Shinkichi , Itakura Takeo , Takagi Yoji , Okada Akira
Published: February 2024

The currently available, commercially prepared amino acid mixtures for intravenous usage do not result in completely normal plasma amino acid patterns. Taking into consideration the known imbalances that occur with the commercial preparations, we designed a new amino acid solution (AF). This solution was prepared to contain a low concentration of those amino acids usually found in increased concentrations in plasma during the course of total parenteral nutrition (TPN) with a commercially prepared product (CF) and a high concentration of branched‐chain amino acids and arginine. Plasma amino acid concentrations were determined for nine infants receiving CF (Group A) and eight infants receiving AF (Group B) as the protein source while on TPN for 5 days. These data were compared to 2‐h postprandial values obtained from breast‐fed, growing infants serving as controls. In comparison with controls, the plasma concentrations of threonine, glycine, methionine, phenylalanine, tryptophan, and lysine were higher in infants in group A, while those of taurine, alanine, valine, cystine, isoleucine, and proline were lower. In group B, the levels of valine and leucine were slightly higher, while those of alanine, cystine, tyrosine, histidine, and proline were lower. Mean nitrogen balances in groups A and B were + 112 and + 170 mg/kg/day, respectively. Therefore, our new amino acid solution may be better for infants receiving TPN.
Chronic Constipation in Childhood
Authors: Abrahamian Frida P. , Lloyd‐Still John D.
Published: February 2024

One hundred eighty‐six patients with chronic constipation and soiling were seen between 1975 and 1982. On follow‐up, 47% had resolution of symptoms, with another 36% having their soiling controlled with either continuous or intermittent laxatives. Thirteen clinical features were analyzed in relation to outcome. The only predictor of poor outcome was the presence of soiling (p = 0.003), while the presence of abdominal pain correlated well with cure (p = 0.007). Fifty‐five percent of patients had a positive family history for constipation. Significant psychological problems were present in 20% of patients; however, these did not appear to affect the outcome. Constipation was uncommon over the age of 12 years, and there was no evidence of the development of laxative dependence. These findings suggest that chronic idiopathic constipation of childhood may be a constitutional condition which tends to resolve with age.
The Selective Administration of Corticosteroid into the Mesenteric Arteries in Children with Ulcerative Colitis
Authors: Hirai Yoshinori , Takamatsu Hideo , Nakagawa Toshiyuki , Koide Toshio
Published: February 2024

Three children with acute, severe ulcerative colitis were successfully treated by the selective administration of prednisolone into the mesenteric arteries combined with total parenteral nutrition (TPN) and Salazopyrine therapy. The regimen was as follows: route: a selective angiographic catheter via a femoral artery; drug: prednisolone; dosage: 1–1.5 mg/kg body weight in single injection (if the disease was located in the left side colon, 0.7 mg/kg was given into the inferior mesenteric artery (IMA) and 0.3 mg/kg into the superior mesenteric artery (SMA), and if the disease occupied the entire colon, 1.0 mg/kg was into the IMA and 0.5 mg/kg into the SMA). The symptoms in two children improved dramatically following this regimen. Thereafter, they did well with Salazopyrine alone. The third child repeated the therapy three times in 2 subsequent years. Each time, the symptoms improved dramatically several days after the regimen. Here, however, since mild relapses were not infrequent in this child, the third regimen was followed by azathioprine administered in combination with systemic prednisolone for 5 weeks. Thereafter, the patient did very well with salazopyrine alone. Such selective administration of corticosteroid into the mesenteric arteries, in combination with TPN and salazopyrine, may emerge as an effective treatment for acute, severe ulcerative colitis in children.
Biochemical Quantification of Crypt Hyperplastic Villous Atrophy by Aldolase Activity Assay
Authors: Bender Steffen W. , Posselt Hans‐Georg , Stäps Marianne , Streb Hanspeter , Luang‐Aroon Boosba , Hauk Hartmut
Published: February 2024

Aldolase activity with the two substrates fructose‐1‐phosphate and fructose‐1,6‐diphosphate was measured in the homogenate of small intestinal biopsy specimens from children with different malabsorptive diseases (celiac disease, cow's milk protein intolerance, infectious diarrhea, giardiasis, and Crohn's disease) and controls. It is demonstrated that the ratio of fructose‐1,6− diphosphate/fructose‐1‐phosphate activity, which reflects the relative amounts of the crypt enzyme aldolase A (EC 4.1.2.13) and the villous enzyme aldolase B (EC 4.1.2.7), correlates very well with both the ratio of crypt to villous height (correlation factor r = 0.92) and the mitotic index (r = 0.80).
Endocrine Dysfunction in Children with Crohn's Disease
Authors: Chong S. K. F. , Grossman A. , Walker‐Smith J. A. , Rees L. H.
Published: February 2024

A series of 14 children with Crohn's disease and growth retardation was screened for endocrine dysfunction. Four children presented with growth failure. All had normal cortisol responses to insulin‐induced hypoglycaemia. Ten children had normal growth hormone responses in the same test, while four had abnormal responses. Gonadotrophin responsiveness to luteinizing hormone releasing hormone (LHRH) paralleled the clinical evidence of puberty, or its lack. Serum total thyroxine was normal in every patient, while serum total triiodothyronine was low in six; in these six patients serum triiodothyronine normalised with treatment. Serum folate was subnormal in 13 patients and the erythrocyte sedimentation rate was elevated in all at the time of diagnosis. Our results demonstrate a spectrum of endocrine changes seen in children with Crohn's disease, particularly prepubertal gonadotrophin responses to LHRH and a relative preservation of growth hormone and cortisol responsiveness to hypoglycaemia, with a defect in thyroxine to triiodothyronine conversion in severely ill children. Serum folate and sedimentation rate may be useful screening tests for Crohn's disease in a child presenting with failure of growth.
Studies with Enterotoxigenic Microorganisms
Authors: Burke Valerie , Gracey Michael
Published: February 2024

Chlorpromazine or aspirin alone, when given to rats parenterally, reduced intestinal fluid secretion induced by cell‐free preparations of enterotoxigenic organisms including Escherichia coli, Aeromonas hydrophila, Staphylococcus pyogenes, and Salmonella typhimurium. A combination of chlorpromazine‐aspirin given parenterally caused much more marked reduction of fluid secretion. Indomethacin also had significant antisecretory effects against a range of bacterial enterotoxins, while loperamide was effective against heat‐labile toxin (LT)‐positive E. coli and A. hydrophila. Nicotinamide increased net fluid absorption in the presence of E. coli LT, A. hydrophila, and S. typhimurium. Of the adsorbents tested, aluminium hydroxide showed a positive effect only with E. coli LT and A. hydrophila, while cholestyramine affected net fluid flux only with E. coli ST (heat‐stable toxin). Charcoal was effective against all microorganisms tested but only when premixed with the perfusate before the experiments. Aspirin and chlorpromazine probably act at multiple sites to decrease intestinal secretion, and the combination of low doses of these drugs with possibly different sites of action may have advantages over a single agent used in high dosage.
Postnatal Undernutrition
Authors: Majumdar A. P. N.
Published: February 2024

Rats were kept undernourished from birth to 24 days of age. At 17 days of age, the undernourished animals were divided into two groups and then injected with either saline or epidermal growth factor (EGF; 20 μg/kg) once a day for 7 days. They were killed 12–14 h after the last injection at which time the animals were 24 days old. During the experimental period the undernourished animals were prevented from weaning. A well‐nourished group (weaned) which was injected with saline from 17 to 24 days of age, was also included. Undernutrition by itself significantly decreased body weight and the weight of the oxyntic gland area, antrum, and small intestine. This was also accompanied by a parallel reduction in DNA, RNA, and protein content in the oxyntic gland and small intestine. However, administration of EGF to undernourished rats resulted in a partial reversal of the situation. In undernourished rats, EGF caused significant enhancements in body weight as well as the weight of the gastrointestinal tissues and their protein and nucleic acid content when compared with the saline‐treated undernourished controls. Furthermore, the magnitude of stimulation was found to be greater in the oxyntic gland than in the small intestine following EGF administration. The antral or serum gastrin levels were not affected by EGF. In both saline‐ and EGF‐treated undernourished rats, lactase, sucrase, and alkaline phosphatase activities (expressed as total or. specific activity) were found to be significantly higher than in the well‐nourished animals. Total maltase activity did not differ significantly between the groups, but when expressed as specific activity, the saline‐ or EGF‐treated undernourished groups revealed significantly higher values than the well‐nourished animals. It is concluded that whereas EGF promotes general body and gastrointestinal growth, it does not affect the functional maturation of the digestive tract.
Prostaglandins in Small Intestinal Mucosa of Children with Celiac Disease
Authors: Branski D. , Karmeli F. , Gross‐Kieselstein E. , Abrahamov A. , Rachmilewitz D.
Published: February 2024

Diarrhea is one of the important clinical symptoms in patients suffering from celiac disease and is attributed mainly to malabsorption. We determined pros tanoid content in small intestinal mucosa of five patients with active celiac disease and in a control group consisting of six patients. Prostaglandin E2 and thromboxane B2 content in duodenal mucosa of patients with active celiac disease was 1,581 ± 161 and 118 ± 40 pg/mg wet wt, respectively, significantly higher than their content in duodenal mucosa of the control group, 378 ± 86 and 8 ± 8, p<0.001 and p<0.02, respectively. 6‐Ketoprostaglandin Fla content in celiac patients was not significantly different from its content in the control group: 908 ± 437 and 124 ± 53 pg/mg wet wt, respectively. It is possible that, in celiac disease, increased mucosal prostanoid content may contribute, at least in part, to intestinal electrolyte and fluid secretion and consequent diarrhea.
IgA Antigliadin Antibodies in Celiac and Inflammatory Bowel Disease
Authors: Koninckx Carmen Ribes , Giliams J. P. , Polanco I. , Pena A. S.
Published: February 2024

Antibodies against gliadin of the IgA class were assessed with an enzyme‐linked immunosorbent assay technique in children with celiac disease, healthy blood donors, and adult patients with active Crohn's disease or ulcerative colitis. Significantly higher antibody values were found in celiac children during gluten chal‐lenge and during the first 3 months on a gluten‐free diet, compared with the findings in the healthy blood donors. The patients with active Crohn's disease had signifiantly higher levels of IgA antibodies to gliadin than the controls did. Although the highest values were found in patients with celiac disease on a gluten‐containing diet, the difference between the means of these two groups was not statistically significant. No correlation was found between disease activity in ulcerative colitis and antibody values. The present results support the view that high levels of IgA‐class antibodies against gliadin are indicative of small intestinal disease, especially celiac disease. The variability of the levels of antibodies found among the patients suggests that not only the amount of gluten in the diet but also other factors are important.
Lymphonodular Hyperplasia of the Colon as a Pathologic Finding in Children with Lower Gastrointestinal Bleeding
Authors: Kaplan Barbara , Benson Jane , Rothstein Fred , Dahms Beverly , Halpin Thomas
Published: February 2024

The serious implication of gastrointestinal blood loss in children is well recognized; however, the significance of lymphonodular hyperplasia of the colon (LNHC) as a pathologic finding in this group of children is unclear. We reviewed the records of 95 children, ages 2–48 months, who were referred to our clinic with a history of hematochezia. Proctosigmoidoscopy was performed on 65 of them. Twenty children (31%) examined proctosigmoidoscopically were found to have LNHC, with no other identified source of bleeding. Clinical histories, endoscopic findings, and colonic biopsy specimens from the LNHC group were examined. Clinical presentation of patients in this group was not distinctive. LNHC was most prominent in the distal colon and rectum and was endoscopically characterized by friability (13/20) and ulceration (3/20). Characteristics of biopsy specimens from children with LNHC were then compared with tissue obtained from an age‐matched control population and children with colitis. Biopsy specimens from children with LNHC contained increased numbers of lymphoid follicles and larger follicles than those from the control group. Specimens also contained mucosal inflammation and epithelial thinning and ulceration overlying enlarged follicles. We conclude that LNHC is a frequent procto‐sigmoidoscopic finding in children evaluated for lower gastrointestinal bleeding. The endoscopic and histologic appearance of these lesions would suggest that LNHC is not a normal finding and represents a potential source of rectal bleeding in children.
Total Lipid Content and Fatty Acid Composition of Preterm Human Milk
Authors: Ehrenkranz Richard A. , Ackerman Barbara A. , Nelli Catherine M.
Published: February 2024

The total lipid content and fatty acid composition of preterm human colostrum and milk were analyzed from aliquots of 24‐h collections of colostrum, transitional milk, and mature milk obtained from 21 women who had delivered premature infants with a mean birth weight of 1,049 ± 38 g (mean ± SEM) and a mean gestational age of 29 ± 0.4 weeks. The total lipid content increased significantly with time of lactation (p < 0.001), from 1.99 ± 0.25 g/dl in colostrum to 3.89 ± 0.28 g/dl in mature milk. With respect to the fatty acid pattern, the percentages of 12:0 and 14:0 increased significantly (p < 0.001), while those of 16:0 (p < 0.05) and 18:1 (p < 0.001) decreased significantly with time of lactation. The percentages of 10:0, 16:1, 18:0, 18:2, and 18:3 did not vary significantly with the duration of lactation. Similar compositional changes have been described in term human colostrum and milk as the duration of lactation progresses.
Heart Rate and Sleep Time
Authors: Pereira Gilberto R. , Johnston Francis E. , McKinney Shortie , Coleman James R. , Kurtz Janice , Horowitz Marc P. , Rounds Jean L.
Published: February 2024

In a clinical trial based on the direct relationship between heart rate activity and energy expenditure during awake and asleep states, 21 healthy 18‐month‐old infants had their heart rate monitored over a period of 24 h and correlated with their nutritional intake, growth parameters, and measurements of adiposity (fat cell size and skinfold thickness). Infants with higher 24‐h and asleep heart rates had smaller fat cells (r = −0.50) and skinfold thickness (abdominal r = −0.70, suprailiac r = −0.80, triceps r = −0.67). Infants with higher relative weight had higher heart rates during awake periods (r = 0.60). Infants sleeping for longer periods had higher weight gain velocity from birth (r = 0.51) and higher relative weight (r = 0.54). This study demonstrates the heart rate activity and duration of sleep are related to growth and adipose tissue deposition during infancy.
Traditional and Modern Health Professionals and Breast‐Feeding in the Philippines
Authors: Popkin Barry M. , Yamamoto Monica E. , Griffin Charles C.
Published: February 2024

We analyze a survey designed to assess the knowledge and attitudes of 1,298 Filipino health professionals towards breast‐feeding. Some of the issues examined are the benefits of breast‐feeding, the psychophysiology of lactation, contraindications to breast‐feeding, and the effects of drugs and contraceptives on lactation. We found a fairly low level of knowledge about breast‐feeding, particularly of health contraindications.
Successful Surgical Resection of an Hepatic Gastrinoma in a Child
Authors: Smith Arnold L. , Auldist Alex W.
Published: February 2024

An 8‐year‐old boy with persistent duodenal ulceration was found to have hypergastrinaemia due to a solitary hepatic gastrinom. Surgical resection has been followed by total clinical remission for a period exceeding 2 years.
Treatment and Prognosis of Symptomatic Gallbladder Disease in Patients with Cystic Fibrosis
Authors: Stern Robert C. , Rothstein Fred C. , Doershuk Carl F.
Published: February 2024

Twenty‐four (3.6%) of 670 patients with cystic fibrosis seen over a 25‐year period developed symptomatic gallbladder disease. Only four patients were less than 16 years old. Four patients presented with unusual problems, including one with acute cholangitis and two with atonic gallbladder, one of whom required cholecystectomy. Another patient was found to have cholangiocarcinoma of the gallbladder when an exploratory laparotomy was performed to investigate biliary obstruction. Twenty patients had cholelithiasis, 15 of whom underwent cholecystectomy. Only one patient had substantial pulmonary difficulties postoperatively. Patients who presented with classic biliary colic had no further symptoms after cholecystectomy. One patient developed intrahepatic stones 6 years later and required a choledochoduodenostomy. As the pulmonary status of most cystic fibrosis patients will eventually deteriorate, we recommend that serious consideration be given to performing a cholecystectomy as soon as practical after the diagnosis of symptomatic cholelithiasis. Our experience indicates that surgery can be performed safely unless pulmonary status is already extremely compromised and the patient is in overt respiratory failure.
Intravenous Amino Acids and Stimulation of Gastric Acid Secretion in Infants
Authors: Hyman Paul E. , Everett Susan L. , Harada Tokuzo
Published: February 2024

To determine the immediate, short‐term effect of intravenous amino acids on gastric acid secretion in infants, we measured acid secretion by continuous aspiration of gastric contents in nine enterally fed, chronically ill infants who required intravenous supplements. On day 1, basal acid output was 25 ± 15 μmol/kg/h (mean ± SD), and postpentagastrin maximal acid output was 91 ± 59 μmol/kg/h. On day 2 basal acid output was 24 ± 16 μmol/kg/h. Acid output was measured for 4 h following addition of amino acids to the intravenous solution. The rate of amino acid infusion was 0.15 g/kg/h. The infusion of intravenous amino acids resulted in an immediate and sustained twofold increase in acid secretion. Hourly totals of amino acid‐stimulated acid output were 51 ± 38, 44 ± 37, 46 ± 30, and 47 ± 31 μmol/kg/h in hours 1–4, respectively. These results were significantly different from basal acid output (p < 0.01) during the last 2 h of amino acid infusion. Serum gastrin concentration was not significantly different before and after the amino acid infusion (87 ± 63 pg/ml vs. 105 ± 56 pg/ml). We conclude that amino acids infused at a rate typical for parenteral nutrition stimulate gastric acid secretion in infants.
Gallbladder Wall Thickening in Acute Hepatitis
Authors: Levine Jeremiah , Seidman Ernest , Teele Rita Littlewood , Walker W. Allan
Published: February 2024

Massive gallbladder wall thickening in association with hepatitis was diagnosed in a 13‐year‐old hemophiliac boy. The gallbladder returned to normal with improvement of clinical symptoms, illustrating the nonsurgical nature of this problem in pediatrics.