bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Orally Administered Epidermal Growth Factor on Normal and Damaged Intestinal Mucosa in Rats
Authors: Petschow Bryon W. , Carter Dixie L. , D. Hutton Gary 
Published: January 2024

SummaryThe effect of orally administered epidermal growth factor (EGF) on the mucosal growth and hydrolase activity of normal and damaged small intestine was examined in rats. Adult rats fed EGF daily at 10 times the estimated daily intake of EGF from human milk showed increases in specific activity but not total activity of various brush‐border hydrolases with unaffected mucosal protein content and villus‐to‐crypt ratios through day 9. Ingestion of EGF for 13 days resulted in significant decreases in mucosal protein content without changes in villus height or hydrolase activity. The effect of oral EGF on recovery of damaged intestine was studied in rats fed a liquid diet supplemented with EGF at 0, 1, 10, or 20 times the estimated daily intake from human milk after treatment with methotrexate (MTX) to induce acute intestinal injury. Animals treated with MTX showed significant reductions in body weight and small intestinal villus height, mucosal protein content, and hydrolase activities through day 6 posttreatment. Daily ingestion of EGF did not affect the MTX‐induced reductions in mucosal protein content and hydrolase activity by day 3 but caused significant increases in mucosal disaccharidase and leucine aminopeptidasc activity by day 6 at the 1‐or 10‐times human milk EGF levels. Similar changes were not observed in MTX‐treated rats fed the 20‐times human milk level of EGF. These studies suggest that oral EGF is capable of modulating mucosal protein levels and stimulating entcrocyte hydrolase expression during repair of the intestinal mucosa.
Feeding Resistance and Gastroesophageal Reflux in Infancy
Authors: Dellert Susan F. , Hyams Jeffrey S. , Treem William R. , Geertsma M. Alex 
Published: January 2024

SummaryResistance to oral feedings occurring during the course of chronic gastroesophageal reflux (GER) in infants has received little attention in the literature. Accordingly, we reviewed the clinical courses of 600 infants of <24 months of age with GER seen over an 8‐year period to determine the prevalence and course of this problem. After excluding infants with severe neurologic disease, craniofacial disorders, or a history of esophageal surgery, 25 infants were found to have resistance to oral feedings that was severe enough to warrant tube feedings for nutritional support. Sixteen of these 25 infants had a history of resistance to oral feeding antedating a diagnosis of GER, whereas nine developed resistance to feeding during the course of therapy. Gestational age, age at onset of GER symptoms, severity of GER, presence/severity of esophagitis, type of medical therapy, need for fundoplication, or postfundoplication complications were similar in these two groups. When the clinical records of these 25 infants were compared to an age‐ and sex‐matched infant population with GER but without feeding resistance, no differences were noted in severity of GER or the presence/severity of esophagitis. However, failure to thrive and the need for fundoplication were significantly more common in the feeding resistance group (p < 0.001). Among those infants with neurodevelopmental evaluation, mild delay was seen more commonly in the infants with feeding resistance but fell short of statistical significance (p = 0.08). Our observations suggest that resistance to oral feedings is an uncommon but severe problem associated with GER in infancy. Future work will need to further characterize possible neurodevelopmental abnormalities or upper gastrointestinal dysmotility that might predispose patients to this type of feeding difficulty.
Dietary Intake and Nutritional Treatment in Childhood Crohn's Disease
Authors: Thomas A. G. , Taylor F. , Miller V. 
Published: January 2024

SummaryDietary intake was assessed in 24 children with active Crohn's disease. Seventeen of the children were sex and height matched with healthy siblings of other patients. The mean energy intake was 1,764 KJ/day (420 kcal/day) lower in patients during relapse than controls (p < 0.05). All 24 children entered a randomised controlled trial of high‐dose steroids compared to an elemental diet. The elemental diet was well tolerated orally in most cases; only one patient required nasogastric administration. There was a similar improvement in disease activity and duration of remission in both groups regardless of the site of disease. Subsequent growth velocity was significantly better in the group treated with the elemental diet despite a greater and more sustained increase in energy intake in the group treated with steroids. Reintroduction of specific foods in the elemental diet group initially caused symptoms in three children but were subsequently tolerated. During remission, there was no significant difference in energy intake, but vegetables were consumed significantly less frequently (p < 0.01) and confectionery significantly more frequently (p < 0.05) when patients were compared with their own siblings.
Relationship Between Plasma Triglycerides and Apolipoprotein CII in Infants During the First Year of Life
Authors: Boediman Dradjat , Murakami Ryusuke , Nakamura Hajime 
Published: January 2024

SummaryPlasma triglyceride and apolipoprotein CII (apo CII) levels were measured in normal full‐term infants and low‐birth‐weight infants at birth (from umbilical cord blood at 0 weeks), as well as at 2, 3, 4, 8, 24, and 48 weeks of age, and the relationship between plasma triglyceride and apo CII levels was studied. In both full‐term and low‐birth‐weight infants, the plasma triglyceride and apoprotein CII levels were very low at birth, but they increased rapidly thereafter in the full‐term infants and somewhat more slowly in the low‐birth‐weight infants. Both triglyceride and apoprotein CII levels became stable from 3 weeks of age in full‐term infants and from 8 weeks in low‐birth‐weight infants. When the logarithmic values of triglyceride and apoprotein CII levels were compared, they showed a close correlation, and slopes of regression lines were 0.62 in full‐term infants aged 0–2 weeks, 1.04 in full‐term infants aged 3–48 weeks, 0.56 in low‐birth‐weight infants aged 0–4 weeks, and 1.04 in low‐birth‐weight infants aged 8–48 weeks. These results suggest that there may be some differences in triglyceride transport between full‐term infants aged 0–2 weeks and 3–48 weeks as well as between low‐birth‐weight infants aged 0–4 weeks and 8–48 weeks.
Development of Lipolytic Activity in Gastric Aspirates from Premature Infants
Authors: Lee Ping‐Cheung , Borysewicz Ryszard , Struve Mark , Raab Karlo , Werlin Steven L. 
Published: January 2024

SummaryNeonates, having little or no pancreatic lipase, would have a compromised ability to digest lipids if not for lingual and gastric lipases. To document the postnatal developmental profile of preduodenal lipase activity, 350 premature infants who were at various gestational ages and who had an orogastric tube had their gastric aspirates collected. Two hundred one infants had their gastric aspirates collected within 12 h after delivery. Serial collections were performed in 25 infants at various postnatal ages. Gastric aspirates collected from premature infants had a pH activity profile similar to that of lingual and gastric lipase but different from that of pancreatic lipase, indicating that their origin was from the tongue and/or stomach. Lipolytic activity and pH of these aspirates were quite variable, but no correlation was found between pH and enzyme activity. At birth, lipase activity was lower in the younger infants (26 weeks, n = 13). It increased to a peak at 30–32 weeks of gestational age and then declined to a lower level at term (≥40 weeks, n = 40). Postnatally, a composite plot of the serially collected aspirates also showed a predominant peak at 28–33 weeks of age. Comparison among siblings in twins (n = 12 pairs) and triplets (n = 3) showed great variations in their lipolytic activities, suggesting that the hereditary factor is not a major determinant. Various combinations of antibiotic medications (ampicillin, cefotaxime, gentamicin, and vancomycin) and drugs (dexamethasone, heparin, furose‐mide, phenobarbital, albumin, and vitamin K) apparently had no effect on the level and development of gastric lipolytic activities. Continuous as opposed to intermittent parenteral alimentation with Intralipid, a soybean oil emulsion for intravenous use, appeared to promote the development of lipase activities in the gastric aspirates postnatally.
Polymorphonuclear Leukocytes and Human Colostrum
Authors: Buescher E. Stephen , Mcllheran Sarah M. 
Published: January 2024

SummaryPolymorphonuclear leukocytes (PMN) from human colostrum were compared with blood and oral exudate PMN from the same donors for their locomotive, respiratory burst, phagocytic, and shape change (polarization) capabilities. Blood PMN were functionally superior to PMN from other sites. Colostrum PMN were similar to oral exudate PMN in all areas except locomotive responses. Exposure of blood PMN to aqueous human colostrum resulted in decreased stimulated adherence to plastic, decreased bactericidal activity against Staphylococcus aureus, reversible induction of cellular shape change, and reversible decreases in cellular deformability. The colostrum effects on PMN shape change and deformability were accompanied by significant increases in cytoskeleton‐associated actin. PMN isolated from colostrum have suppressed functions, consistent with their being exudate cells. In addition, the colostrum environment effectively suppresses multiple functions in PMN from blood, these effects being mediated in part by rapid cytoskeletal assembly. PMN in colostrum do not appear to be beneficial to the breast‐fed infant due to deficiencies in function.
Nutrient Absorption and Weight Gain in Persistent Diarrhea
Authors: Bhutta Zulfiqar A. , Molla A. M. , Issani Z. , Badruddin S. , Hendricks K. , Snyder J. D. 
Published: January 2024

Summary:We prospectively studied clinical outcome and nutrition absorption in male children (6–36 months of age) with persistent diarrhea (PD) and severe protein‐energy malnutrition (mean z score for age, −4.2 × 0.8). Fifty‐one children were randomly allocated to receive a combination of khitchri, a rice‐lentil mixture, yogurt, and half‐strength buffalo milk (group A; n = 26) or full‐strength soy formula (group B; n = 25) for 14 days. The initial caloric intake (p < 0.02) and mean weight gain (p < 0.02) were greater in the group B patients. The mean stool volume and frequency were comparable between the two groups. Seven children in group A were considered clinical failures by criteria of weight loss and PD, compared to three in group B. The coefficients of absorption (COA) for protein were similar between the two groups, but group B patients had higher values of COA for energy and fat (p < 0.05) in the second week of nutritional rehabilitation. The majority (63%) of the children improved on the khitchri‐yogurt‐milk diet but the nutritional outcome was not as good as with the soy formula. These data indicate that a traditional diet can be successfully used in the dietary management of PD and severe malnutrition but that a more optimal composition, yielding a higher success rate, should be sought.
Serum Food Antibodies Analyzed by Enzyme‐Linked Immunosorbent Assay (ELISA) and Diffusion‐in‐Gel (DIG)‐ELISA Methods in Children with and without Celiac Disease
Authors: Fälth‐Magnusson Karin , Jansson Gunnar , Stenhammar Lars , Magnusson Karl‐Eric 
Published: January 2024

Summary:Serum antibodies IgA, IgG, and IgM against gliadin, ovalbumin, and β‐lactoglobulin were analyzed at the time of 228 small bowel biopsies in 116 celiac children. These were compared to the antibody levels at the time of biopsies performed in 199 children, where the biopsy discarded a clinical suspicion of celiac disease. For antibodies against gliadin, the enzyme‐linked immunosorbent assay (ELISA) and diffusion‐in‐gel (DIG)‐ELISA methods were compared. It was found that the combined information from IgA and IgG antigliadin antibodies gave the highest specificity (94%) and sensitivity (89%). The antibody responses to food antigens decreased with age in both celiac and reference children. The ELISA and DIG‐ELISA methods gave comparable results and were equally efficient.
Absorption of Macronutrients from a High‐Protein Diet in Children During Convalescence from Shigellosis
Authors: Kabir Iqbal , Malek Mohammed A. , Mahalanabis D. , Rahman M. Mujibur , Khatun M. , Wahed M. A. , Majid N. 
Published: January 2024

Summary:Absorption of macronutrients and energy intake were determined in 29 children aged 24–59 months, during convalescence from acute shigellosis. A 72 h metabolic balance study was performed to determine the absorption of carbohydrate, fat, and protein. Eighteen children received a high‐protein (5 g/kg/day) diet, and 11 children received a standard‐protein (2.5 g/kg/day) diet. The mean × SD energy intake was 612 × 38 kJ/kg/day for children receiving the high‐protein diet, compared with 633 × 50 kJ/kg/day for the standard‐protein group. The coefficient of carbohydrate absorption was 89 and 92% for the high‐protein and standard‐protein diets, respectively (p = 0.059). The coefficient of protein absorption was 80 and 71% for the high‐protein and standard‐protein groups, respectively, and was significantly higher in the high‐protein group (p < 0.01). Absorption of fat was similar in both groups. The results of the study show better absorption of protein from a high‐protein diet during convalescence, which may have a positive impact on catchup growth of children suffering from shigellosis.
Manometry, Profilometry, and Endosonography
Authors: Benninga M. A. , Wijers O. B. , van der Hoeven C. W. P. , Taminiau J. A. J. M. , Klopper P. J. , Tytgat G. N. J. , Akkermans L. M. A. 
Published: January 2024

Summary:Normal anal manometric and profilometric values and normal endosonographic features of the anal canal are required for evaluation of pathological conditions such as slow‐transit constipation, anorectal outlet obstruction, and Hirschsprung's disease, status after surgery for imperforate anus, and other anal abnormalities. Anorectal manometry, profilometry (rapid‐pull‐through, three‐dimensional, eight‐channel radial manometry), and endosonography were carried out in 13 healthy children. A significant correlation was demonstrated between conventional manometric and profilometric maximal squeeze pressure of the external anal sphincter (EAS). However, the maximal anal resting tone of the sphincter complex in profilometry was twice as high as in manometry due to reflexive contraction of a pelvic floor muscle, probably the EAS. With profilometry a positive correlation was found between age and sphincter length. Endosonographically assessed thickness of the EAS, puborectal muscle, and levator ani complex showed a significant correlation with age. However, no correlation was demonstrated between age and internal anal sphincter thickness. Thus, the development of the essential structures of the anal canal in children is age dependent. In addition, these measurements of normal physiology and anatomy of the anal canal provide the basis for detecting pathological conditions of the anorectal region in children.
New Treatment for Rectal Impaction in Children
Authors: Gilger M. A. , Wagner M. L. , Barris J. O. , McCarroll L. R. , Healy W. M. 
Published: January 2024

Summary:To determine the efficacy, comfort, and safety of the pulsed‐irrigation enhanced‐evacuation (PIEE) procedure in children, we evaluated 27 procedures performed on 24 consecutive children, 16 boys and 8 girls, 4–15 years old (mean, 8.7), with chronic constipation, encopresis, and rectal impaction. Children with known heart, lung, and/or neurologic diseases were excluded. Temperature, pulse, respiratory rate, and blood pressure were obtained prior to, during, and immediately after the procedure. Abdominal radiographs were obtained before and after the procedure, and the degree of disimpaction was estimated by a single radiologist. Patients graded the discomfort of the procedure at the time of speculum insertion and every 15 min from 1 to 5: 1, painless; 2, mild discomfort; 3, moderate discomfort; 4, severe discomfort; 5, extremely painful. Serum sodium, potassium, chloride, and bicarbonate values were obtained before, immediately after, and 90 min after the procedure and compared by paired Student t analysis. A digital rectal examination confirmed rectal impaction prior to insertion of the speculum. One course of pulsed irrigations was performed, typically lasting 25–30 min. No significant changes in vital signs were found during or after the procedure. In 18 of 23 (78%) procedures, there was at least a 50% emptying of feces from the colon immediately after the procedure. Patients continued to empty their colon up to 12 h later; thus, the procedure effectively disimpacted all patients. In terms of comfort, patients graded the PIEE a 2.6 × 0.75 (range, 1–5). Speculum insertion was the most uncomfortable factor and received a 2.7. No child had any indication of water intoxication. Serum sodium levels (mean × SD) before the procedure were 139.4 × 1.95 mM. Immediate postprocedure levels fell to 136.8 × 2.21 m M, p < 0.05; 90 min later, they returned to 137.9 × 2.67 m M, p < 0.05. The largest change in serum sodium pre‐ and postprocedure was 7 m M (from 139 to 132), found in two patients. No other electrolyte changes were noted. In conclusion, the PIEE procedure successfully disimpacted all patients, either immediately or within hours of completion. Patients accepted the procedure well, and no clinically significant electrolyte changes were noted. This new method of rectal disimpaction appears to be safe, effective, and acceptable to children.
The Clinical Significance of a Prolonged Stable pH around 4.0 in 24‐h pH Monitoring
Authors: Watanabe Yasuhiro , Catto‐Smith Anthony G. 
Published: January 2024

SummaryEsophageal acidity may remain stable for long periods at or near pH 4.0, potentially influencing the estimation of risk of esophagitis in esophageal pH monitoring assessment. Our aim was to determine the frequency and clinical significance of a prolonged stable pH around 4.0 (PSpH4) (pH 3.5–4.5) by retrospective examination of 503 pH records from children and by analysis of clinical information, pH parameters, motility studies, and esophageal biopsies. The frequency, duration, and proportion of total time with PSpH4 were quantified, and the ratio of the time for which the pH was <pH 4.0 during PSpH4 episodes to the total reflux time below pH 4.0 was calculated [stable/reflux (S/R) rate]. One hundred fifty‐eight PSpH4 episodes were identified in 80 records. The average duration was 60 min and the S/R rate was 30%. Sixty‐one percent of PSpH4 episodes started in the postprandial period (p < 0.05). Proportionally more episodes of PSpH4 occurred with an increased total percentage reflux time (p < 0.01). In recordings with PSpH4, the average number of reflux episodes remained normal, even when the percentage reflux time was ≥ 10%. No correlation was shown between PSpH4 and esophageal dysmotility, esophagitis, cardiorespiratory symptoms, or prematurity. PSpH4 did not occur in recordings obtained after fundoplication. We conclude that PSpH4 is common and may result in an overestimation of risk of esophagitis. Qualitative assessment of pH monitoring is necessary along with conventional quantitative measurements.
Prospective Evaluation of Upper Gastrointestinal Mucosal Lesions in Children with Ulcerative Colitis and Crohn's Disease
Authors: Ruuska T. , Vaajalahti P. , Arajärvi P. , Mäki M. 
Published: January 2024

SummaryEighty‐eight consecutive children with inflammatory bowel disease were studied, and upper gastrointestinal endoscopy was performed in 80 of them as one of the initial investigations before commencing medical or nutritional treatment. Forty‐one children were found to have Crohn's disease and 47, ulcerative colitis. Upper gastrointestinal endoscopy revealed pathology in 32 (80%) cases of Crohn's disease, esophagitis in 16, and esophageal ulcer in two, nonspecific gastritis in 22, duodenitis or duodenal ulcer in 18, and Helicobacter pylori infection in two cases. Granulomas were detected in 10 patients in the upper gastrointestinal tract: one esophageal, eight gastric, and three duodenal. Of the ulcerative colitis patients, seven had esophagitis, one had esophageal ulcer, 17 had nonspecific gastritis, two had gastric ulcers, two had duodenal ulcers, and five had H. pylori infection; altogether 30 (75%) yielded pathological findings. Radiological studies using barium meal revealed pathology in only eight of all inflammatory bowel disease cases. Symptoms at admission were not conclusive for definite diagnosis because 63% of patients with Crohn's disease had signs of colitis (such as diarrhea, bloody diarrhea) compared to 94% of ulcerative colitis patients. Upper gastrointestinal endoscopy may be used to achieve a specific diagnosis, thus being helpful when planning treatment. Also a considerable incidence of nonspecific gastritis, duodenitis, and esophagitis with or without concomitant H. pylori infection may be anticipated in children suffering from both ulcerative colitis and Crohn's disease.
Comparison of Weight‐Based Dosages of Enteric‐Coated Microtablet Enzyme Preparations in Patients with Cystic Fibrosis
Authors: Beker Leila T. , Fink Robert J. , Shamsa Falah H. , Chaney Hollis R. , Kluft Janet , Evans Eileen , Schidlow Daniel V. 
Published: January 2024

SummaryTwenty‐one stable hospitalized cystic fibrosis patients with malabsorption syndrome participated in an open‐label crossover clinical trial to evaluate the efficacy of two‐period dosing regimens of a pancreatic microtablet enzyme preparation in the treatment of steatorrhea. Standard dosing consisted of 500 U lipase/kg body weight/ meal, 250 U lipase/kg body weight/snack; high dosing consisted of 1,500 U lipase/kg body weight/meal, 750 U lipase/kg body weight/snack. Doses were determined by units of lipase/kg body weight to provide dosing consistency among patients of varying size. Each patient was on a regular diet of – 100 g of fat per day. Two separate, 72‐h stool collections were performed between markers. A significant difference in mean percentage fat absorbed between the standard dose and the high dose was found (86% versus 91%, p < 0.05). Subjects were then stratified into two groups, based on the grams of fecal fat eliminated (GFFE) as follows: Group 1 with =s7 GFFE/24 h on both dosages (n = 7) and Group 2 with > 7 GFFE/24 h on either dose (n = 14). A significant difference (p < 0.05) between Group 1 (96%) and Group 2 (88%) was noted in the percentage fat absorbed while on the high dose. Fat absorption improved from 81% to 88%, (p < 0.05) in Group 2. During the study period, the adverse reactions of constipation or elevated serum uric acid levels were not observed. The increased doses of pancreatic enzymes resulted in improved correction of steatorrhea.
Plasma Carnitine Levels in Cystic Fibrosis
Authors: Kovesi Thomas A. , Lehotay Denis C. , Levison Henry 
Published: January 2024

SummaryPlasma carnitine concentrations were measured in 43 children and adults with cystic fibrosis (CF), and values were compared with those from normal controls. Clinically significant abnormalities of plasma carnitine concentration were not found in CF patients. The concentration of free carnitine was slightly but significantly elevated in CF patients, and the acylcarnitine concentration and acylcarnitine/free‐carnitine ratio were slightly but significantly lower. Total carnitine concentrations were similar to those of controls. The CF patients did not have abnormal urinary acylcarnitines. Altered concentrations of free and esterified carnitine were not associated with nutritional status or with liver or pulmonary function.