bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemorrhagic Pleural Effusion and Mediastinal Mass
Authors: Standaert L. , Verstappen G. , Malbrain H. , Van Bosstraeten B. , Kerremans R. , Eggermont E. , Daele M. Casteels‐Van 
Published: January 2024

SummaryA girl was referred to our hospital because of a right‐sided recurrent hemorrhagic pleural effusion associated with a mediastinal mass. It was later found that the findings were due to a pancreatic pseudocyst with internal fistulization through a necrotic opening in the left hemi‐diaphragm, and with mediastinal and right‐sided pleural extension. The object of this report is to remind clinicians that a pleural effusion and a mediastinal mass may be the presentation of a pseudocyst of the pancreas, and to point out the importance of endoscopic retrograde cholangiopancreatography—even for children.
Diversity of Bile Acids in the Fetus and Newborn Infant
Authors: Lester Roger , Pyrek Jan St. , Little J. M. , Adcock Eugene W. 
Published: January 2024

SummaryThe bile acids found in the fetus and newborn are more numerous and diverse than has generally been appreciated. The four conventional bile acids, cholic, chenodeoxycholic, deoxycholic, and lithocholic acids, are found. In addition, however, stereoisomers of the conventional bile acids, bile acids with functional groups at different positions or in greater number than found in conventional bile acids, and “short‐chain” and “long‐chain” bile acids are found. The site of origin, pathways of synthesis, metabolism, and excretory routes of these unconventional bile acids are largely unknown. Their effects on the function of the liver and other tissues have not yet been established. It is uncertain which of these compounds is peculiar to the fetus and newborn, and which will be found in normal or abnormal adults. This review is an early look at a field bound to advance rapidly in the next several years.
Distribution of trans‐Octadecenoic Acid in the Major Glycerolipids of Human Milk
Authors: Hundrieser Kenneth E. , Clark Richard M. , Brown Peter B. 
Published: January 2024

SummaryThe intramolecular distributions of fatty acids in triacylglycerol, phosphatidylcholine, and phosphatidylethanolamine of human milk were determined. Milk donated from 10 mothers during their 2nd week of lactation was analyzed. Based on pancreatic lipase digestion of milk triacylglycerols, the 14:0 and 16:0 fatty acids were observed predominantly in the sn‐2 position, while 18:0, 18:1, and 18:2 were observed predominantly in the sn‐1,3 positions. The average trans‐18:1 content of the triacylglycerols was 3.4% and was greater in the sn‐1,3 positions. Phosphatidylcholine and phosphatidylethanolamine were digested by phospholipase A2. As in other tissues, saturated fatty acids were esterified at the sn‐1 position and polyunsaturated fatty acids at the sn‐2 position of the phospholipids. The proportion of trans‐18:1 averaged 2.5% in phosphatidylcholine and 3.7% in phosphatidylethanolamine. The proportion of trans‐18:1 was slightly greater in the sn‐2 position of the phospholipids. In conclusion, there appeared to be a reverse positional distribution of saturated and polyunsaturated fatty acids in triacylglycerol compared to phosphatidylcholine and phosphatidylethanolamine. When compared to other mammalian tissues, there were only small differences observed in trans‐18:1 content between positions within a glycerolipid class and between glycerolipids of human milk.
Supplementation of Milk with Iron Bound to Lactoferrin Using Weanling Mice
Authors: Fransson Gun‐Britt , Keen Carl L. , Lönnerdal Bo 
Published: January 2024

SummaryLactoferrin is an iron‐binding protein present in high concentrations in human milk. The efficacy of supplementing iron bound to lactoferrin to iron‐deficient and iron‐sufficient young mice was evaluated in comparison with supplementation of iron as iron chloride. Mice fed a nonsupplemented milk diet (1 mg Fe/L) for 4 weeks had a microcytic, hypochromic anemia and low tissue iron concentrations. Iron supplementation of the diet with lactorferrin‐iron. or iron chloride at a level of 5 mg Fe/L prevented the anemia and resulted in tissue iron levels similar to levels found for mice fed a stock commercial diet. There was no significant difference in any of the parameters analyzed between the groups of mice receiving the two iron supplements following a diet deficient in iron. Apolactoferrin when supplemented to the diet had no negative effect on the iron status of the mice. These results show that lactoferrin may be a useful vehicle for supplementation of iron.
Intrahepatic Biliary Tract Abnormalities in Children with Corrected Extrahepatic Biliary Atresia
Authors: Werlin Steven L. , Sty John R. , Starshak Robert J. , Glicklich Marvin , Nathan Radha 
Published: January 2024

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

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

Summary:To determine the effect of a safflower oil emulsion on the essential fatty acid (EFA) status of preterm infants during parenteral nutrition, subjects were randomized to receive Liposyn at 0.34.g (group‐1), 0.68.g (<0.5% of lipid from linolenic acid, group 2), or Modified Liposyn at 0.68 g/kg/day (5.0% of lipid from linolenic acid, group 3). Doses of 0.34 and 0.68 g of Liposyn provided linoleic acid in amounts equivalcnt to 2 and 4% of the estimated caloric requirement (120 cal/kg/day) and 5 and 10% of the actual caloric intake. No significant differences were detected in plasma phospholipid triene/tetraene ratios and arachidonic acid levels between groups 1 and 2 or between groups 2 and 3, respectively. Plasma phospholipid triene/tetraene ratio and arachidonic acid did not change in the lipid‐supplemented group throughout the study period, but the former remained significantly lower (p < 0.001) and the latter significantly greater (p < 0.001) than in a reference group of infants who received fat free parenteral nutrition. We conclude that Liposyn administration providing linoleic acid at 2 or 4% of the estimated caloric requirement or 5 or 10% of the actual caloric intake prevented any significant changes in essential fatty acid status from occurring. Moreover, linolenic acid supplementation at 5% of the total lipid intake did not appear to affect arachidonic acid synthesis in the preterm infant.
Effects of Anticonvulsive Drugs on the Activity of Gammaglutamyltransferase and Aminotransferases in Serum
Authors: Deutsch J. , Fritsch G. , Gölles J. , Semmelrock H. J. 
Published: January 2024

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

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

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

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

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

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

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

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

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

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

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

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

SummaryIn order to evaluate the efficacy of biofeed‐back for childhood encopresis, 50 children with enco‐presis were prospectively studied and randomized to receive biofeedback (B) or mineral oil therapy (M). Specificity of biofeedback was also evaluated by comparing outcomes of both regimens in children with normal (n = 32) and abnormal (n = 18) defecation patterns. Using a single blinded design, there were no significant differences in clinical outcomes between the 24 children receiving B and the 26 children receiving M at 3, 6, and 12