bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parenteral Nutrition in Preterm Infants
Authors: Bürger U. , Wolf H. , Fritsch U. , Bauer M. 
Published: January 2024

SummaryThirty‐three premature infants receiving parenteral nutrition during the first 5 days of life were divided into three groups. Infants in group I (n = 13) received no ventilatory therapy. Those in groups II (n = 10) and III (n = 10) were intubated and artificially ventilated because of hyaline membrane disease, apnea, or other illness. All infants received glucose, amino acids, fat emulsion, and electrolytes in their total parenteral nutrition regimen. Groups I and II were administered a transfer‐adapted amino acid solution (Aminoplasmal paed 5%) for their protein supplementation, and group III, a so‐called human milk‐adapted solution (Aminovenos 6%). The three groups were compared with respect to amino acid blood level, amino acid excretion, and nitrogen balance. Taurine levels decreased significantly during parenteral nutrition in all three groups. The other amino acids, with a few exceptions, remained within acceptable range. Elevations of serine, proline, and methionine were found in group III after the third day. All three groups exhibited good nitrogen retention. Excretion of amino acids was only about 1%.
Chylous Ascites in Infants and Children
Authors: Cochran William J. , Klish William J. , Brown Marilyn R. , Lyons Jane M. , Curtis Tom 
Published: January 2024

SummarySuccessful treatment of an infant with chylous ascites secondary to “congenital leaky lymphatics” is described, followed by a literature review of cases of pediatric chylous ascites. The infant was placed on home total parenteral nutrition for 10 weeks, during which time the chylous ascites resolved and did not recur with the introduction of a normal diet. Forty cases of pediatric chylous ascites have been reported since 1960, with an age range from birth to 18 years. The presenting signs and symptoms were secondary to abdominal distension in over 80% of cases. The chylous ascites was secondary to trauma, which included child abuse (19%), obstruction (27%), or lymphatic abnormalities (54%). Most studies described were not helpful in making the diagnosis, except for lymphangiography and exploratory laparotomy. Many patients were treated with a high protein, low fat diet, with or without medium chain triglycerides, with variable success. Total parenteral nutrition (TPN) was the primary therapeutic modality in five patients, and in all but one of the cases there was complete resolution of the chylous ascites over 3 to 10 weeks with no significant side effects. Total parenteral nutrition, including home TPN, is a safe and effective therapeutic modality for some cases of chylous ascites.
Calcium Absorption during Development
Authors: Toverud Svein U. , Dostal Lori A. 
Published: January 2024

SummaryDuring the period of natural weaning in the rat (beginning during the third week) the mechanisms of calcium absorption from the duodenum change from an efficient nonsaturable process, which is insensitive to vitamin D, to a combination of a less efficient nonsaturable process and a saturable vitamin D‐dependent component. The stimulatory effect of vitamin D on active calcium transport requires the development of mucosal receptors for 1,25‐(OH)2D3 and increasing circulating levels of 1,25‐(OH)2D3. Concurrent increases in the concentration ##of the cytosolic calcium‐binding protein (CaBP) support the suggestion that the CaBP mediates, in part, the effect of 1,25‐(OH)2D3 on active calcium transport. The decline in the efficiency of nonsaturable calcium absorption during the third week coincides with, but is probably not due to, the loss of pinocytotic capacity of the small intestine. The time of appearance of the receptors for 1,25‐(OH)2D3 and the decline in nonsaturable calcium absorption are under glucocorticoid control as are several other maturational events in the intestine at this time.
Measurement of Total Body Potassium in Premature Infants by Means of a Whole‐Body Counter
Authors: Spady Donald W. , Filipow Larry J. , Overton Thomas R. , Szymanski Waldemar A. 
Published: January 2024

SummaryThis paper describes a whole‐body counter (WBC) specially designed to measure total body potassium (TBK) in infants under 4,500 g. The counter is a “shadow shield” design and consists of a single 10 cm μ 10 cm μ 45 cm NaI(Tl) crystal, positioned lengthwise and shielded from environmental background radiation by a minimum of 10 cm of lead. The standard error of counting for a 2,000‐s counting period is 19.9% for a 1,000‐g infant and 11.9% for a 2,000‐g infant. TBK of stillborn pigs, measured by the WBC, agreed to an average of 3% of TBK determined by carcass analysis in the same animals. A total of 118 measurements of TBK have been made in 50 premature infants ranging in weight between 1,100 and 3,600 g and in age between 2 and 75 days. The observed relationship of TBK with weight is described by the equation: TBK (mEq) = 0.0433Wt (g) + 1.57 r = 0.92. Potassium retention per gram weight gain is estimated to be 0.043 mEq. The obtained TBK values agree well with values published by other workers but extend the range of measurement to 1,100 g.
Effect of Iron Fortification of Infant Formula on Trace Mineral Absorption
Authors: Haschke F. , Ziegler E. E. , Edwards B. B. , Fomon S. J. 
Published: January 2024

SummaryThis study was designed to examine whether iron fortification of infant formulas has an effect on utilization of other nutrients, particularly the trace elements zinc and copper. Metabolic balance studies were performed with seven normal infants who were between 43 and 420 days of age. Two formulas of nearly identical composition except for iron concentration (10.2 and 2.5 mg/L) were fed. Each infant had four balance studies performed, two while being fed formula 10.2 and two while being fed formula 2.5, in an alternating sequence. No effect of formula iron concentration was evident on absorption and/or retention of nitrogen, fat, calcium, and magnesium. Although absorption of phosphorus was significantly (p < 0.05) less with formula 10.2 than formula 2.5, the difference was trivial. No effect on absorption of zinc was seen. However, absorption of copper was only 13.4% (SD 13.0) of intake when formula 10.2 was fed, compared with 27.5% (SD 15.3) of intake when formula 2.5 was fed. The difference was statistically significant (p < 0.01). We conclude that iron in amounts present in iron‐fortified formulas has a measurable effect on copper utilization. Because the magnitude of the effect is relatively small, we doubt that the finding is clinically relevant.
Morphometric Studies and Eosinophil Cell Counts in the Duodenal Mucosa of Children With Chronic Nonspecific Diarrhoea and Cow's Milk Allergy
Authors: Challacombe D. N. , Wheeler E. E. , Campbell P. E. 
Published: January 2024

SummaryMorphometric studies and eosinophil counts in the lamina propria of the duodenal mucosa have been performed in patients with chronic nonspecific diarrhoea and with persistent diarrhoea due to a cow's milk allergy, using a semiautomatic image analysing system. The results have shown that the mean eosinophil count was significantly higher in both of these groups of patients compared with a control group (p < 0.001), and some of the patients with chronic nonspecific diarrhoea had partial villous flattening. These findings in patients with chronic nonspecific diarrhoea could be related to the pathogenesis of this disorder.
Ultrasonic Homogenization of Expressed Human Milk to Prevent Fat Loss During Tube Feeding
Authors: Martinez F. E. , Desai I. D. , Davidson A. G. F. , Nakai S. , Radcliffe A. 
Published: January 2024

SummaryEffective use of expressed human milk in infant feeding requires proper handling, processing, storage, and administration in order to maintain its unique nutritional properties. One of the problems with expressed human milk is the separation of fat during processing, storage, and administration to the infant. Administration by continuous nasogastric infusion, either by intermittent gravity flow or by continuous mechanical pump, resulted in significant loss of fat and variation in the constitution of the milk delivered. Homogenization by ultrasonic treatment prevented changes in fat concentration during infusion and essentially eliminated loss of this nutrient during administration. The conditions necessary to achieve fat dispersion and stabilization of fat particles in human milk by ultrasonic treatment are described.
Efficacy of Oral Rehydration Solutions in a Rat Model of Secretory Diarrhea
Authors: Rolston D. D. K. , Borodo M. M. , Kelly M. J. , Dawson A. M. , Farthing M. J. G. 
Published: January 2024

SummaryControversy continues regarding the ideal composition of glucose/electrolyte solutions used for oral rehydration of infants and children with acute diarrhea. We have used cholera toxin‐treated rat small intestine as a model of secretory diarrhea to assess the efficacy of oral rehydration solutions by intestinal perfusion. All solutions tested reversed net water secretion hut a hypo‐tonic bicarbonate‐free solution was more effective than other solutions, including the World Health Organization oral rehydration solution (p < 0.003). Net sodium secretion persisted with all solutions tested but there was a significant linear relationship between sodium concentration of the solution perfused and net sodium transport (r= 0.75, p < 0.05). Cholera toxin treatment alone and in combination with perfusion of oral rehydration solutions significantly reduced plasma sodium concentration and osmolulity (p < 0.05), the effects being most marked with low sodium solutions. Although direct parallelism between observations in this animal model of secretory diarrhea and human diarrheal disease has not been established as yet, the model may be useful in assessing clinical efficacy of new oral rehydration solutions and in systematic analysis of the relative benefits of their individual components.
A Description of the Changing Body Composition of the Growing Premature Infant
Authors: Spady Donald W. , Schiff David , Szymanski Waldemar A. 
Published: January 2024

SummaryData from studies of two similar groups of premature infants were used to describe the changing body composition (BC) of a “typical” premature infant, 3 to 4 weeks old, gaining weight from 1,200 to 2,000 g and being fed its mother's expressed breast milk at a metabolizable energy intake of 93.6 kcal/kg/day. Serial measurements had been made of total body water (TBW), the extracellular fluid space (ECF), nitrogen balance, and gross energy balance in one group of premature (n = 17) infants and of total body potassium (TBK) in another group (n = 23); all infants studied weighed between 900 and 2,300 g. Equations relating TBW, ECF, and TBK to body weight were derived for estimating the content of these substances at body weights between 1,200 and 2,000 g. Protein content at 1,200 g body weight was estimated from measured TBK and N:K ratio (determined from the reference fetus) at this weight. Subsequent protein content was determined from average N accretion, determined from data of N balance, and carbohydrate and ash content were estimated from reference data. The remainder of the body weight was assumed to be fat. At l,200 g, the proposed BC of the premature infant is 72.1% water, 10.7% protein, 14.9% fat, 1.9% ash, and 0.4% carbohydrate. At 2,000 g comparable figures are 67.8% water, 11.6% protein, 18.2% fat, 1.9% ash, and 0.5% carbohydrate. The description also provides estimates of the body cell mass (BCM) and intracellular fluid (ICF), the relationship of K to the BCM and ICF, and the energy balance of the growing premature infant.
Cecal Polyp and Appendiceal Intussusception in a Child with Recurrent Abdominal Pain
Authors: Bailey David J. , Courington Kenneth R. , Andres Joel M. , Bagwell Charles E. , Hitchcock Charles L. 
Published: January 2024

SummaryA 7‐year‐old boy developed recurrent abdominal pain. He was eventually discovered to have an inverted appendix via colonoscopy. At surgery, a polyploid intracecal mass was palpated at the base of the partially invaginated appendix. Resection of the cecal mass (histologically, a juvenile polyp) and appendix was easily accomplished. The types of clinical presentation and treatment of children with appendiceal intussusception are discussed.
Syndromic Paucity of the Intrahepatic Bile Ducts
Authors: Deprettere Andre , Portmann Bernard , Mowat Alex P. 
Published: January 2024

SummaryThe clinical, biochemical, and histological features of 27 children with syndromic paucity of the interlobular bile duets are described. All presented in the first 5 months of life, 21 with jaundice, two with spontaneous bleeding due to vitamin K malabsorption in addition to jaundice, two with pruritus, and two with failure to thrive. Interlobular bile ducts were abundant in liver biopsies from five (18% of cases) in the first 6 months of life. The degree of portal fibrosis and cellular infiltrate was mild in all except three patients. Clinically significant heart lesions occurred in 52% but only 22% had peripheral pulmonary stenosis. Characteristic facial appearances were present in only 70% embryotoxon and vertebral anomalies were present in 56 and 33% respectively. Two infants died of cardiovascular complications, one of alimentary bleeding and one of progressive liver disease. Complications of vitamin K deficiency occurred in 15%, vitamin D deficiency in 30% and vitamin E deficiency in 37%. Survivors at ages of 19 months to 16.5 years had considerable morbidity with pruritus occurring in 70% jaundice in 48%. Nanthomas in 30%, 74% having hepatomegaly aznd 63% splenomegaly. All had abnormal biochemical tests of liver function. 90% had growth retardation, and 50% developmental delay. We conclude that differentiation from extrahepatic biliary atresia can be difficult if biliary flow cannot be demonstrated. Prevention of fat‐soluble vitamin deficiency is essential, further research is required to decrease the morbidity associated with this syndrome in infancy.
Variation in Zinc, Calcium, and Magnesium Concentrations of Human Milk within a 24‐Hour Period from 1 to 6 Months of Lactation
Authors: Karra Mihira V. , Kirksey Avanelle 
Published: January 2024

SummaryLongitudinal changes in nutrient levels of human milk have been observed with the progression of lactation, but less is known about changes at different feedings during a 24‐h period. In this study, calcium, magnesium, and zinc levels were examined in milk obtained from 49 women at every breast feeding during one 24‐h period each month for the first 6 months of lactation. Magnesium and zinc concentrations showed significant diurnal variation at each stage of lactation examined, whereas calcium levels were relatively constant. Maximum variations of 7.5, 17, and 48% were observed within a 24‐h period in mean levels of calcium, magnesium, and zinc, respectively. Irrespective of variability, zinc and magnesium concentrations in a single milk sample obtained between 10:00 a.m. and 2:00 p.m. were highly correlated with the mean value of samples collected at each feeding during a 24‐h period.
Acidification of Endosomes Is Not Important for the Entry of Rotavirus into the Cell
Authors: Keljo David J. , Kuhn Michael , Smith Angela 
Published: January 2024

SummaryRotavirus causes enteritis in both man and animals. The mechanism by which this protein‐enveloped virus enters the cell to initiate infection is not known. Many viruses depend on the acidification of endosomes for entry into the cell. We studied the importance of the acidification of endosomes for the initiation of two early phases of rotavirus infection, virus RNA and peptide synthesis. Monensin, nigericin, chloroquine and ammonium chloride at a variety of concentrations caused no specific inhibition of virus RNA or peptide synthesis. We conclude that the acidification of endosomes is not important for the entry of rotavirus into the cell.
Ectopic Gastric Mucosa in Rectum
Authors: Menchaca Marines Mario C. , Posselt Hans‐Georg , Waag Karl Ludwig 
Published: January 2024

SummaryA 3‐year‐old boy with rectal bleeding and colicky abdominal pain is described in whom heterotopic gastric mucosa in the rectum was found. Increased uptake of 99mTc‐pertechnetate was demonstrated in two sites: rectum and left colon. However, gastric mucosa could be identified by endoscopic and histologic examination in the rectum only. The patient was asymptomatic after the operation and during follow‐up, over 14 months.
Eosinophilic Gastroenteropathy in Childhood
Authors: Whitington Peter F. , Whitington Gene L. 
Published: January 2024

SummaryEosinophilic gastroenteropathy (EG) is an uncommon, idiopathic disease in children that is characterized by eosinophilic inflammation of the intestine. Over a 7‐year period 17 infants and children with EG were evaluated; the retrospective review of their clinical data constitutes the basis of this report. A scale developed for grading the degree of mucosal eosinophilia was used in the evaluation of the intestinal histopathology; all patients had eosinophilic infiltration that was far more severe than that seen in other intestinal disorders of childhood. Peripheral eosinophilia was observed in 12 patients. However, two more had evidence of rapid turnover of eosinophils with significantly increased numbers of precursors in bone marrow and intense intestinal infiltration. Serum IgE correlated with the severity of the disease; extreme elevations were associated with chronic severe illness similar to that commonly reported in adults. Evidence of viral infection in two patients and dietary responsiveness in two infants bring to question the specificity of diagnosis on histology alone. Treatment with oral cromolyn sodium and/or prednisone was effective, but some patients have remained dependent upon therapy.
Relationship of Endomysial Antibodies to Jejunal Mucosal Pathology
Authors: Rossi Thomas M. , Kumar Vijay , Lerner Aaron , Heitlinger Leo A. , Tucker Neil , Fisher John 
Published: January 2024

SummarySerum immunoglobulin A class antibodies reactive to the endomysial lining of the smooth muscle bundles of the gastrointestinal tract have recently been reported to be specific and sensitive indicators of celiac disease (CD). A total of 203 subjects were examined for serum endomysial antibodies (EmA) and in 103 small bowel biopsies were obtained. EmA were detected in 43 cases including 26 CD patients evaluated during the gluten challenge phase of diagnosis by European Society for Pediatric Gastroenterology and Nutrition criteria, 11 of 53 symptomatic patients, and 6 asymptomatic family members. All patients with detectable antibody at the time of biopsy exhibited grade III‐IV villous atrophy. Disaccharidase activities performed in 19 cases revealed severe deficiencies. EmA were not detected in 160 subjects including 42 infants and children with chronic nonspecific diarrhea. Eighteen of these possessed grade II‐III villous atrophy with moderate disaccharidase deficiency and 24 were found to have normal histology and enzymes. The EmA were also not detected in 3 CD patients who were well maintained on a gluten‐free diet for > 1 year and 25 asymptomatic family members exhibiting normal histology and enzymes. An additional 90 infants and children with other gastrointestinal and liver diseases were also negative for the serum EmA. Fourteen of these patients underwent biopsies and were demonstrated to have normal histology.
Hepatobiliary Scintigraphy and the String Test in the Evaluation of Neonatal Cholestasis
Authors: Rosenthal Philip , Miller John H. , Sinatra Frank R. 
Published: January 2024

SUMMARYWe evaluated [99mTc]diisopropylphenyl‐carbamoylmethylimidodiacetic acid ([99mTc]DISIDA) cholescintigraphy with measurement of duodenal fluid radioactivity collected by the string test in patients with neonatal cholestasis. Twenty‐six infants with prolonged jaundice and acholic stools were studied prospectively. Twelve patients had neonatal hepatitis, 12 biliary atresia, and one each Alagille syndrome and α1‐antitrypsin deficiency liver disease. All infants except the biliary atresia patients and four of the neonatal hepatitis patients revealed bowel activity on scan 6 h after tracer administration. At 24 h, three of these latter patients with neonatal hepatitis and two of the patients with biliary atresia revealed bowel activity. String radioactive counts for neonatal hepatitis ranged from 99,574 to 967,205 cpm (374,504 ± 232,210 cpm; mean ± SD) and for biliary atresia from 8,342 to 370,346 cpm (117,149 ± 98,698 cpm; mean ± SD). While neither test alone was capable of correctly differentiating among all patients, those patients with biliary atresia had either a negative hepatobiliary scan at 24 h or string radioactive count below 197,007 cpm. Disparity between the hepatobiliary scan and the string radioactive counts mandates further diagnostic investigation. These data suggest that simultaneous administration of the string test with hepatobiliary scintigraphy is advantageous in the evaluation of infants with chole‐static jaundice.
Changes in Human Milk at 0600, 1000, 1400, 1800, and 2200 h
Authors: Lammi‐Keefe Carol J. , Ferris Ann M. , Jensen Robert G. 
Published: January 2024

SummaryMilk from six mothers was collected every 4 h from 0600 to 2200 h. Total lipid and cholesterol, lactose, glucose, protein N, indicator acids 12:0, 14:0, and 18:2, and α‐ and γ‐tocopherols were analyzed. Total calories were calculated. Although considerable variation was seen in the lipid content, this was not significant and was apparently due to individuality. Differences in the other lipid components were not significant and were generally related to the total lipid content. Except for protein N (p < 0.05), none of the other components varied significantly. Based upon these data and the results of others, the time of sampling of human milk should be matched to the population being studied to obtain consistent results, at least with lipids.
Association of Juvenile and Adenomatous Polyposis with Pulmonary Arteriovenous Malformation and Hypertrophic Osteoarthropathy
Authors: Prieto G. , Polanco I. , Sarria J. , Larrauri J. , Lassaletta L. 
Published: January 2024

SummaryThe juvenile form is the usual type of colonic polyp seen during childhood. However, mixed forms associating juvenile and adenomatous polyps have been reported. A syndrome including the association of generalized juvenile polyposis, pulmonary arteriovenous malformation, and hypertrophic osteoarthropathy has been described in three cases; however, this is the first report of the association of mixed juvenile and adenomatous polyposis, pulmonary arteriovenous malformation, and hypertrophic osteoarthropathy.
Impact of Orthotopic Liver Transplantation on Mortality from Pediatric Liver Disease
Authors: Lloyd‐Still John D. 
Published: January 2024

SummaryIn 1983 we assessed the implications for hepatic transplantation programs by studying mortality from liver disease in a tertiary care children's hospital. The current study reviews the impact of orthotopic liver transplantation (OLT) on survival for the period 1984–1989. Findings showed that deaths from liver disease decreased from 9.2 to 3.8 per year. Twenty‐eight infants and children were referred and underwent OLT, with a 64% survival rate. Deaths from biliary atresia, which used to account for 24% of the total, have been reduced to 4.3%. Deaths from liver failure in infancy (which decreased from 49% to 39%) still present formidable challenges for transplantation. The implications of these findings are discussed.