bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Pathogenesis of Biliary Atresia
Authors: Ho Chi‐Whai , Shioda Kei , Shirasaki Kazuya , Takahashi Shigeki , Tokimatsu Shiyuji , Maeda Kazuichi 
Published: January 2024

SummarySpecimens of the extrahepatic biliary trees and wedge liver biopsies were studied in 11 cases of biliary atresia. The hepatic arteries at the porta hepatis were examined with ultrasound in five of the 11 cases. The basic histopathological features were found to be epithelial damage and an inflammatory, sclerosing change of both the intrahepatic and the extrahepatic biliary trees, combined with an arteriopathy manifesting as hyperplasia and hypertrophy of the hepatic arteries in all cases. Based on the results of ultrasonography and histological examination, this arteriopathy was thought to affect the arteries from the trunk of the common hepatic artery to its peripheral branches supplying the entire biliary tree. To determine whether these morphologically abnormal hepatic arteries are related to the pathogenesis of biliary atresia in association with abnormal blood flow and pressure requires further investigation.
Assessment of Vitamin K Status of the Newborn Infant
Authors: von Kries Rüdiger , Greer Frank R. , Suttie John W. 
Published: January 2024

SummaryThis article reviews our current knowledge of the assessment of vitamin K status in the human infant, where a deficiency state has been described. Laboratory measures for the functional assessment of vitamin K‐dependent coagulation factors as well as the quantitative assay for vitamin K1 (phylloquinone) are reviewed. In addition, four different methods of measuring abnormal prothrombin, a protein induced by vitamin K absence (PIVKA‐II), and its use in clinical pediatrics are discussed. Finally, additional methods are briefly described for assessing vitamin K status, including serum osteocalcin, urinary excretion of γ‐carboxyglutamic acid, and deficiencies of the enzymes necessary for the regeneration of phylloquinone in the so‐called vitamin K cycle.
Postmenstrual Age Correlates to Indices of Protein Metabolism in Very Low Birth Weight Infants
Authors: Boehm G. , Räihä N. C. R. 
Published: January 2024

SummaryIn 14 infants who were normal in weight for gestational age and 14 infants who were small for gestational age, the plasma essential amino acid profiles and serum urea concentrations were studied between the 30th and 46th weeks of postmenstrual age. All infants were of very low birth weight (<1,500 g) and were fed with fresh human milk fortified with 6 g freeze‐dried human milk per 100 ml (mean protein intake 3.1 g/kg/day, mean energy intake 130 kcal/kg/day). With the exception of threonine, all measured plasma essential amino acid concentrations increased significantly with increasing postmenstrual age (appropriate for gestational age infants: r = 0.861, p < 0.01; small for gestational age infants: r = 0.772, p < 0.001). No differences in this increase could be found between the infants who were small or appropriate for gestational age. The serum urea concentrations also increased with increasing postmenstrual age without differences between the study groups (appropriate for gestational age infants: r = 0.658, p < 0.01; small for gestational age infants: r = 0.604, p < 0.05). The results indicate that very low birth weight infants of similar weights may have very different protein requirements, depending on their postmenstrual ages. Thus, postmenstrual age is of greater importance than birth weight when protein nutrition is planned for very low birth weight infants.
An Open Triple Crossover Study Comparing Water Absorption from Potable Water, Lucozade, and Dioralyte Using the Stable Isotope 18O
Authors: Mecrow I. K. , Miller V. 
Published: January 2024

SummaryNine volunteer children aged 6–9 years were randomised in a Latin square design to receive one of three oral solutions [Lucozade (Beechams), Dioralyte (Rorer Pharmaceuticals), and potable water] labeled with the stable isotope 18O. After administration, breath CO2 was collected using a face mask for a period of 120 min. Mass spectrometric analysis gave the enrichments of 18O in CO2 at parts per million levels. Analysis showed the accumulation of the tracer (and, by inference, absorption from the gut) to be quickest from Dioralyte and slowest from Lucozade. We hope to use this technique to investigate the absorption of water from oral rehydration solutions in infants with dehydration due to gastroenteritis.
Does the Bile Salt‐Stimulated Lipase of Human Milk Have a Role in the Use of the Milk Long‐Chain Polyunsaturated Fatty Acids?
Authors: Hernell Olle , Bläckberg Lars , Chen Qi , Sternby Berit , Nilsson Åke 
Published: January 2024

SummaryLong‐chain polyunsaturated (LCP) fatty acids derived from linoleic (18:2 n‐6) and α‐linolenic (18:3 n‐3) acids are considered essential nutrients in preterm infants. The efficiency by which such fatty acids are released as absorbable products from triacylglycerol was explored in vitro using rat chylomicron triacylglycerol as substrate. When incubated with purified human pancreatic colipase‐dependent lipase and colipase, arachidonic acid (20:4 n‐6) was released less efficiently than linoleic acid from such triacylglycerol. This difference was not seen when purified human milk bile salt‐stimulated lipase (BSSL) was incubated with the triacylglycerol substrate, and it was almost abolished when colipase‐dependent lipase (with colipase) and BSSL acted simultaneously, as they do in breast‐fed infants. There was no difference in arachidonic acid and eicosapentaenoic acid (20:5 n‐3) release rates with either colipase‐dependent lipase or BSSL, albeit the release was more rapid with the milk enzyme than with colipase‐dependent lipase. Again, the most efficient release as absorbable free fatty acids was achieved when the two lipases operated together. The relative resistance to hydrolysis of arachidonic acid and eicosapentaenoic acid by colipase‐dependent lipase was best explained by the localization of the first double bond to the ***6–5 position of the respective fatty acid. The results obtained suggest that BSSL is of importance for the efficient use of human milk LCP fatty acids.
Effects of Cerulein and Epidermal Growth Factor on Pancreatic Growth in the Reserpinized Rat Model
Authors: Bérubé France‐Line , Benrezzak Ouhida , Vanier Micheline , Morisset Jean 
Published: January 2024

SummaryThis study was undertaken to determine the effect of reserpine on rat pancreatic growth, to evaluate if reserpine‐caused alterations can be prevented by epidermal growth factor (EGF) and/or cerulein treatment, to evaluate the time course of rat pancreas recovery after reserpine, and to determine if EGF and/or cerulein treatment can accelerate such a recovery. In the first experiment, three groups of male Sprague‐Dawley rats (250–265 g) were used. Ad libitum‐fed control animals received the reserpine vehicle, and one experimental group received reserpine (1 mg kg‐1 day‐1 for 7 days) while the other, pair‐fed group received the reserpine vehicle with a reduced amount of food to result in malnourishment. Rats from each of these three groups were also assigned to one of four treatments consisting of saline, EGF (10 μUg kg‐1), cerulein (1 μUg kg‐1), or a combination (same doses) twice a day for 7 days. In the morning of the 8th day, after an overnight fat, rats were killed. In the second experiment, rats were selected and treated with reserpine or the vehicle as described in experiment 1; after the 7‐day treatment, a first cohort of animals was allowed a 30‐day recovery period. Three other groups (an ad libitum‐fed control, a pair‐fed, and a reserpine group) were allowed a 6‐day recovery period during which they were treated subcutaneously, twice a day, with either saline, EGF (10 μUg kg‐1), cerulein (1 μUg kg‐1), or a combination (same doses). On the morning of the 31st or 7th day, after an overnight fat, rats were killed. After death, all pancreata were examined for weight and protein, amylase, chymotrypsinogen, RNA, and DNA content. In the ad libitumfed control group, EGF caused pancreatic hypertrophy, whereas cerulein was associated with hypertrophy and hyperplasia. In the pair‐fed malnourished group, the EGF effect was limited to slight increases in pancreatic weight and cell mass whereas cerulein caused hypertrophy; EGF plus cerulein caused pancreatic hyperplasia. In the reserpine group, EGF had no effect, whereas cerulein caused pancreatic hypertrophy and an increase in DNA content above the reserpine control. After 30 days of recovery, pancreata of pair‐fed animals and those of rescrpine‐treated animals were comparable with those of the ad libitum‐fed control rats with the exception of amylase levels, which remained reduced in the reserpine group. After 6 days of recovery, the pancreata of the reserpine rats did not improve, but chymotrypsinogen content returned to ad libitum‐fed control values. During the 6‐day recovery period, total regeneration of the pancreatic tissue was observed in response to cerulein whereas EGF had no effect. In conclusion, modifications and alterations of the pancreatic tissue caused by reserpine and associated malnutrition can be prevented by cerulein, and cerulein remains the most potent factor to promote regeneration of the pancreatic gland after reserpine treatment and an episode of malnutrition.
Is Histological Diagnosis of Neuronal Intestinal Dysplasia Related to Clinical and Manometric Findings in Constipated Children? Results of a Pilot Study
Authors: Koletzko Sibyllc , Ballauff Antje , Hadziselimovic Faruk , Enck Paul 
Published: January 2024

SummaryNeuronal intestinal dysplasia (NH>) of the colon has been reported in adults and children with chronic constipation. However, it is unknown whether these histological abnormalities are related to the severity of symptomatology or the findings of anorectal manometry. We studied 57 children (2 weeks to 17 years old, 33 boys) who had chronic constipation and/or soiling or obstructive symptoms early in life and evaluated anamnestic data, symptoms, outcome after 6 months of conventional therapy, rectal biopsies for signs of dysganghonosis, and results of anorcctal manometry. In cooperative patients, defeciaion dynamics were recorded during manometry with simultaneous surface electromyogram of the external anal sphincter. In 30 older patients, severity of constipation was assessed by measurement of colonic transit time with radiopaque markers. Histology confirmed Hirschsprung's disease in nine (excluded from further analysis), hyperganglionosis of the plexus submucosus (classic NID) in six, heterotopic ganglion cells without hyperganglionosis (abortive NID) in 18, and no signs of dysganglionosis in 24 patients. The rectoanal inhibitory reflex was more often absent or abnormal in children with classic NID (six of six) and abortive NID (11 of 17) compared with children with normal histology (four of 22) (p < 0.001). All other manometric parameters analyzed, colonic transit times, and clinical outcomes were not related to histological diagnosis. In contrast, the severity of constipation and outcome was significantly worse in children with abnormal defecation dynamics. These results suggest that histological signs of NID in the submucous plexus are of uncertain value in assessing the clinical picture and should not influence decisions concerning further treatment, especially surgical interventions.
Current Surgical Management of Patients with Chronic Ulcerative Colitis
Authors: Martin Lester W. 
Published: January 2024

SummaryThis report consists of a review of an experience with total colectomy with mucosal proctectomy and neorectal reservoir for pediatric patients with ulcerative colitis. The entire experience includes 221 patients, with 73 patients <21 years of age. Fifty‐six consecutive surviving pediatric patients, all > 1 year after operation, have been studied with 100% follow‐up evaluation for up to 17 years after operation. Fifty (89%) are leading normal lives with an acceptable stool frequency and complete continence. A number of postoperative complications have been encountered that are of particular concern to the pediatric gastroenterologist. The most distressing finding has been the subsequent diagnosis of Crohn's disease in most of the patients whose postoperative course was unsatisfactory. This underscores the need for a more accurate means of differentiating ulcerative colitis from Crohn's colitis before advising surgery.
Interleukin‐2 Production in Pediatric Inflammatory Bowel Disease
Authors: Gurbindo C. , Sabbah S. , Menezes J. , Justinich C. , Marchand R. , Seidman E. G. 
Published: January 2024

SummaryCrohn's disease (CD) and ulcerative colitis (UC) represent clinically distinct chronic imflammatory bowel diseases (IBD) of unknown etiology. Although the mucosal immune system is implicated in their pathogenesis, immunological differences between the two disorders are not well defined. The aim of this study was to compare in vitro mucosal T‐lymphocyte function in CD and UC. Peripheral blood mononuclear cell interleukin‐2 (IL‐2) production was similar in pediatric IBD and control patients under unstimulated conditions, but was significantly increased in response to phytohemagglutinin (PHA) stimulation for the UC group. Lamina propria mononuclear cells (LPMNC) isolated from colonic resections in IBD patients had significantly lower spontaneous proliferation and IL‐2 production in vitro than did LPMNC of control patients. In contrast, significantly greater IL‐2 production was detected when the LPMNC of CD patients were cultured with PHA, in comparison with those of UC or control patients. When indomethacin, a prostaglandin synthetase inhibitor, was added to the cultures, significantly increased IL‐2 secretion was observed for CD LPMNC, but not for UC cultures, under both stimulated and unstimulated conditions. These findings demonstrate abnormal LPMNC IL‐2 production in IBD. Furthermore, our data suggest that inhibition of the prostaglandin synthetase pathway upregulates IL‐2 production by LPMNC in CD. These results support the hypothesis that immunoregulatory mechanisms controlling IL‐2 production differ between CD and UC.
The Diagnostic Value of the Gliadin Antibody Test in Celiac Disease in Children
Authors: Bodé S. , Weile B. , Krasilnikoff P. A. , Gudmand‐Høer E. 
Published: January 2024

SummarySerum gliadin antibodies (IgA/IgG) were determined in 191 consecutive children (median age, 2.75 years; range, 0.33–15.5 years) admitted for a small‐intestinal biopsy on suspicion of celiac disease. The test was a diffusion‐in‐gel enzyme‐linked immunosorbent assay (DIG‐ELISA). Of these 191, 14 (7.3%) appeared to have untreated celiac disease. Depending on the choice of cut‐off value of the test (combined determination of IgA and IgG), the sensitivity was 86–100%, the specificity was 97–99%, and the positive/negative predictive values were 70–92% and 99–100%, respectively. No variation according to age was found. Gliadin antibodies were determined in 47 children who had well‐treated celiac disease. Fourteen of these children were also investigated when challenged with gluten. Gliadin antibodies (IgA or IgG) decreased significantly in 13 of 13 cases when the patients shifted from a gluten‐containing diet to a gluten‐free one. During the gluten challenge, the IgG and IgA increased in 14 of 14 and 11 of 14 cases, respectively (two patients suffered from IgA deficiency). In eight patients who later appeared to be free of celiac disease, the gliadin antibodies were determined on gluten‐free diet and during gluten challenge; no significant differences in gliadin antibodies were found. We conclude that this test is useful in selecting patients with symptoms suggesting celiac disease for a small‐intestinal biopsy. The test seems to be of some value in monitoring the effects of a gluten‐free diet and during gluten challenge.
Do Umbilical Vein Catheterization and Sepsis Lead to Portal Vein Thrombosis? A Prospective, Clinical, and Sonographic Evaluation
Authors: Yadav S. , Dutta A. K. , Sarin S. K. 
Published: January 2024

SummaryExtrahepatic portal vein obstruction (EHPVO) affects 20–30% of all patients with portal hypertension in India. The etiopathogenesis of this disease is unknown. In retrospective studies, umbilical vein cannulation and sepsis have been alleged to cause portal thrombosis. This prospective study was undertaken to detect clinically and by serial sonography whether thrombosis and consequent obstruction of the splenoportal venous system develops after umbilical vein catheterization and sepsis. Forty‐seven children who had undergone exchange transfusion for hyperbilirubinemia, belonging to two different age groups, were studied. Twenty‐two new‐borns (Group A) were studied within 4 weeks of birth and later at 3‐month intervals until the age of 12 months and subsequently at 24 months. Another group of 25 children (Group B), 1− to 5‐year‐olds who had earlier undergone exchange transfusion and 15 healthy newborns (Group C) were also screened. In Group A, seven (29%) neonates had septicemia, and in five, the splenic vein could not be initially visualized. The splenic vein was not seen in five of the 15 newborns in Group A who had no umbilical sepsis. Twenty‐one of the 22 neonates in Group A were folio wed‐up, and the splenic vein was well visualized and found patent on subsequent ultrasound in all of them. In Group B, four (16%) children had umbilical sepsis. None of these or the other Group B children showed any thrombosis or obstruction of the splenoportal system. The portal vein and its branches and the splenic vein were visualized in all healthy (Group C) neonates. In conclusion, our results demonstrate that umbilical vein catheterization and sepsis do not lead to development of portal vein thrombosis, at least, in the hospital.
Asymptomatic Uveitis in Children with Chronic Inflammatory Bowel Diseases
Authors: Hofley P. , Roarty J. , McGinnity G. , Griffiths A. M. , Marcon M. , Kraft S. , Sherman P. 
Published: January 2024

SummaryUveitis may be an asymptomatic ocular process when it occurs in association with chronic inflammatory bowel disease (IBD). However, the frequency of uveitis in pediatric IBD is not known, as few patients have eye examinations on a routine basis. Experience with a child with Crohn's disease, who had asymptomatic uveitis identified by routine screening initiated because of associated arthritis, prompted us to undertake this evaluation. The purpose of this cross‐sectional prospective study was to ascertain the point‐prevalence of uveitis in pediatric IBD patients, including 97 with Crohn's disease and 50 with ulcerative colitis. Each child underwent an ophthalmologic assessment, including slit‐lamp examination. In Crohn's disease, inflammatory cells and/or flare were observed in the anterior chamber of six (6.2%) patients. These changes were mild in all six patients and required no treatment. In the group with ulcerative colitis, there were no cases of asymptomatic uveitis. There was a higher frequency of asymptomatic transient uveitis in patients with Crohn's colitis (four of 22, 18.2%) than in those of other anatomic subgroups (two of 75, 2.7%; p < 0.05). Frequency of uveitis was also higher in IBD patients having other extraintestinal manifestations (15.0%) than in those without (3.1%; p < 0.10). There was no relationship observed between the activity of bowel disease and presence of ocular inflammation.
Effects of Different Formula Feeds on the Developmental Pattern of Urinary Bile Acid Excretion in Infants
Authors: Wahlén Eva , Strandvik Birgitta 
Published: January 2024

Summary:The excretion of bile acids in urine was followed prospectively during the first year of life in 17 infants fed different diets from the age of 3 to 10 days. Eight infants were breast‐fed, four were fed formulas that were based on adapted cow's milk, and five were fed a formula that was based on soy protein isolate. The formulas had higher protein concentrations than human milk; had different types of proteins, and had not been supplemented with taurine. Urinary bile acids were determined by gas‐liquid chromatographic/mass spectrometric analyses of 24‐h urinary samples collected at 1–12 days (only formula‐fed infants) and at 1, 3, 6, 9, and 12 months of age. The results showed a higher urinary bile acid excretion at 3 months of age in both formula groups than in the breastfed infants. A deficiency of dietary taurine during formula‐feeding did not seem to limit the formation of taurine conjugates during the first month of life. The developmental pattern of urinary bile acid excretion during the first year differed according to the type of feeding. Isomers of cholic and chenodeoxycholic acid appeared in the urine of all breast‐fed infants at 6 to 12 months of age. These metabolites, assumed to be the first metabolites derived from the developing gut flora of the infants, appeared at an earlier age and in higher amounts in both formula groups compared to breast‐fed infants. Bile acids lacking a 7‐hydroxy group, known to be formed by the intestinal flora, appeared in infants in all feeding groups later than the isomers. The results of the study imply that the early introduction of formula may modify bile acid metabolism in infants.
Effect of Enteral Tube Feeding on Growth of Children with Symptomatic Human Immunodeficiency Virus Infection
Authors: Henderson Robin A. , Saavedra Jose M. , Perman Jay A. , Hutton Nancy , Livingston Robert A. , Yolken Robert H. 
Published: January 2024

SummaryMalnutrition and growth failure are frequent clinical consequences of human immunodeficiency virus (HIV) infection in children. Tube feeding is a means by which to increase the enteral intake of nutrients. We examined the effect of tube feeding in 18 children, median age 6 months (range, 3–159). Tube feedings were initiated due to growth failure in all, which was also associated with dysfunctional swallowing or aspiration in seven children and gastroesophageal reflux in two. Tube feedings were infused via nasogastric tube (n = 4) or gastrostomy tube (n = 14) and were continued for a median of 8.5 months (range, 2–24). Stoma complications developed in three children with gastrostomy tubes; these were the only tube‐related side effect. Tube feedings were discontinued due to noncompliance (n = 3), gastrostomy leakage (n = 2), intolerance (n = 2), and death (n = 3). Anthropometric changes were evaluated comparing mean standard deviation scores (Z) before and after tube feeding. Tube feeding resulted in significantly increased weight for age (Z, −2.13 + 0.7 vs. −1.46 + 1.4; p = 0.04), weight for height (Z, −1.07 + 1.0 vs. −0.13 + 1.0; p = 0.004), and arm fat area (Z, −1.75 + 1.3 vs. −0.62 + 1.2; p = 0.01). However, tube feeding did not result in significant changes in height for age (Z, −1.93 + 0.8 vs. −1.74 + 1.6) or arm muscle area (Z, −1.24 + 0.9 vs. −0.57 + 1.2). Tube feedings effectively increased the weight of HIV‐infected children in this study, but they were not sufficient to correct linear growth deficits.