bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enteric Protein Loss Measured by Fecal α1Antitrypsin Clearance in the Assessment of Crohn's Disease Activity
Authors: Griffiths Anne M. , Drobnies Adrienne , Soldin Steven J. , Hamilton J. Richard 
Published: January 2024

SummaryWe compared conventional measures of disease activity with 24‐h fecal α1antitrypsin clearance in 59 children and adolescents with Crohn's disease and 30 with ulcerative colitis. Among the Crohn's patients clearance was increased significantly in those with abnormal erythrocyte sedimentation rates (ESR) (>15 mm/h, p < 0.005) and diminished serum albumin (<35 g/L, p < 0.005), but not in those with an abnormal Crohn's disease activity index (CDA1 < 150). Correlation between α1‐antitrypsin clearance and ESR was poor (r = 0.17) as with CDAI (r = 0.09). We conclude that severity of enteric protein loss is not closely related to the degree of abnormality of commonly used measures of disease activity in young patients with Crohn's disease. In contrast, in patients with ulcerative colitis, α1antitrypsin clearance correlated more consistently with clinical assessment of inflammatory activity (p < 0.001).
Vitamin K Deficiency in Breast‐Fed Infants at One Month of Age
Authors: Motohara Kunihiko , Endo Fumio , Matsuda Ichiro 
Published: January 2024

SummaryPIVKA‐II (protein induced by vitamin K absence or antagonist‐II) was measured, as an indicator of vitamin K deficiency, in breast‐fed infants of ∼1 month of age. The infants consisted of three different groups: untreated (group 1); those given 5 mg vitamin K once at birth (group 2); and those given 5 mg twice, at birth and at 14 days after birth (group 3). At 1 month of age, the rate of PIVKA‐II‐positive infants and their PIVKA‐II levels were significantly reduced in group 3 as compared with the levels of the other two groups, whereas these parameters were similar between groups 1 and 2. This observation suggested that vitamin K administration once at birth may be unsafe by 1 month of age. An additional administration of vitamin K seemed to be necessary for complete prevention of vitamin K deficiency, causing severe bleeding in breast‐fed infants of ∼1 month of age.
Tocopherols in Human Milk
Authors: Lammi‐Keefe Carol J. 
Published: January 2024

SummaryA procedure for the determination of tocopherols in human milk using normal phase high‐performance liquid chromatography (HPLC) is described. The method involves extraction of the total lipid from milk and direct injection of the dissolved lipid into the HPLC without further fractionation. Operating conditions are as follows: instrument, Varian Model 5000 Liquid Chromatograph; column, Alltech‐NH2 (25 cm × 4.6 mm); solvents, n‐hexane:2‐propranol (98:2); flow rate, 2.0 ml/min; detector, 290 nm; and absorbance range, 0.01. Chromatographic separation of the tocopherol isomers, α, (β, γ, and δ, was achieved. The tocopherol isomers of milk were separated, allowing quantitation of α‐ and ‐γ‐tocopherol, the predominant milk isomers. Good recovery, reproducibility, and precision for the method were demonstrated.
Congenital Stenosis of the Esophagus Due to Tracheobronchial Remnants
Authors: Shoshany G. , Bar‐Maor J. A. 
Published: January 2024

SummaryLower esophageal strictures in infants in more than 90% of cases are related to reflux esophagitis, while the remainder are congenital or induced by injuries such as penetrating trauma or corrosion by caustic agents. Among congenital disorders cartilaginous remnants in the esophagus are very rare, but it is a possibility that should always be considered, especially if signs of esophagitis are not seen on esophagoscopy. The first aim, when evaluating the vomiting or regurgitating infant, is to establish whether this is due to an organic disorder. When stricture of the esophagus becomes evident following prolonged vomiting, clinicians tend to attribute this to reflux with peptic injury, and in most of the cases that will be correct (1). Carefully performed investigation will bring forth those rare etiologic factors that can be easily overlooked (2). The investigation has to include radiographic studies, esophagoscopy, pH monitoring, and in selected cases, manometry. Recognition of the correct etiologic factor that caused the stricture will pave the way for adequate management. We report on two patients with congenital stenosis of the lower esophagus due to cartilaginous rings, one of which was diagnosed preoperatively.
Reversible Valproate Fulminant Hepatic Failure
Authors: Colletti Richard B. , Trainer Thomas D. , Krawisz Bruce R. 
Published: January 2024

SummaryValproate fulminant hepatotoxicity, usually fatal, is believed to be idiosyncratic and metabolic without an immunologic basis. There are no previous reports of a hypersensitivity reaction among numerous cases of fatal valproate fulminant hepatitis. Little is known about the electron microscopical features of valproate hepatitis. We report a case of reversible fulminant hepatitis attributable to valproate with clinical and histological characteristics of a hypersensitivity reaction. Electron microscopical findings included microvesicular steatosis with normal‐appearing mitochondria.
Pyloric Stenosis and Eosinophilic Gastroenteritis in Infants
Authors: Snyder John D. , Rosenblum Norman , Wershil Barry , Goldman Harvey , Winter Harland S. 
Published: January 2024

SummaryEosinophilic gastroenteritis is known to cause gastric outlet obstruction in adults, but has been reported only rarely in infants presenting with pyloric stenosis, a common form of gastric outlet obstruction in children. We describe two infants who presented with classic clinical and radiographic evidence of pyloric stenosis and who were found to have histologic evidence of eosinophilic
Effect of Intralipid on the Phagocytic and Microbicidal Capacity of Human Monocytes in Culture
Authors: Padeh S. , Shor R. , Passwell J. H. 
Published: January 2024

SummaryWe studied the effect of Intralipid (ID in monocyte cultures based on the ability of the cultures to phagocytose and kill Candida albicans and produce the oxidative burst. The IL was taken up by monocytes in cultures, and these cells phagocytosed more Candida organisms than did the control cells [85 ± 2.2% in the IL treated (1%) compared to 68 ± 2.3% after 1 h in the control). The percentage of killing of Candida albicans, which had been taken up by the IL‐treated monocytes measured after 2 h in culture (48.3 ± 6.0%), was no different when compared to control (47.0 ± 5.8%). Following ingestion of IL. there was an increase in basal H2O2 production, however, the presence of the IL in the cells had no effect on the expected increase in H2O2 production following stimulation with either phorbol myris‐tate acetate (PMA) or zymosan particles. Compared to untreated cells, a significant increase in the number of monocytes with positive nitroblue tetrazolium staining was observed in monocytes that had ingested IL (when they were stimulated with either PMA or Candida microorganisms). Similar results were obtained in monocyte‐derived macrophages (i.e., monocytes in monolayer cultures for 10 days). These findings suggest that the essential monocyte functions of phagocytosis, microbicidal activity, and ability to elicit an oxidative burst are not directly altered by the conventional use of IL in clinical practice. Intralipid
Bile Salt‐Stimulated Lipase of Human Milk
Authors: Freed Lois M. , York Carla M. , Hamosh Paul , Mehta Nitin R. , Hamosh Margit 
Published: January 2024

SummaryHuman milk contains a lipase (bile salt‐stimulated lipase) that is considered to have an important role in infant fat digestion. In this study we compared the characteristics of bile salt‐stimulated lipase activity in milk samples from mothers delivering prematurely (26–30 and 31–37 weeks of gestation) and in milk from mothers delivering at term (38–42 weeks of gestation). Preterm milks were collected at day 1–5 and during week 6 of lactation. Term milks were collected during week 6 of lactation. The characteristics of the enzyme (kinetics. enzyme concentration, pH optimum, and pH stability, effects of bile salt structure and concentration, eserine inhibition) were identical regardless of length of pregnancy or duration of lactation. Bile salt‐stimulated lipase had a neutral to alkaline pH optimum (pH 7.3–8.6), was stable for 1 h at a wide pH range (pH 3.1–8.6), was active only in the presence of primary bile salts, and was inhibited by eserine. The data indicate that, following parturition at as early as 26 weeks of gestation, the mammary gland synthesizes bile salt‐stimulated lipase with identical characteristics as does the mammary gland after a full‐term pregnancy.
Vitamin E in Human Milk from Mothers of Preterm and Term Infants
Authors: Haug Martin , Laubach Christel , Burke Mechthild , Harzer Gerd 
Published: January 2024

SummaryThe content of vitamin E (α‐and β + γ‐to‐copherol) was analyzed in 63 human milk samples obtained from 13 mothers of preterm infants (“preterm” milk) and in 59 milk samples obtained from nine mothers of full‐term infants (“term” milk). The changing pattern of the α‐and (β + γ‐tocopherol content during the course of lactation was identical for both groups. Total vitamin E, α‐as well as (β + γ‐tocopherol, decreased during the first 2 weeks of lactation and remained constant thereafter. The ratio of α‐to β + γ‐tocopherol decreased from about 10:1 to 4:1. At days 3 and 36 of lactation, vitamin E contents (median values and ranges) expressed as milligrams α‐tocopherol equivalent per 100 ml were 1.45 (0.64–6.4) and 0.29 (O.I7–0.48). respectively, for preterm and 1.14 (0.63–4.21) and 0.28 (0.19–0.86). respectively, for term human milk. The vitamin E. α‐tocopherol and (β + γ‐tocopherol content of preterm human milk did not differ significantly (p ≤ 0.05) from that of term human milk at each sampling day. Based on these findings we conclude that the increased requirement of prematures for vitamin E is not reflected in the vitamin E content of milk from mothers delivering preterm infants.
The Incidence of Childhood Celiac Disease in Sweden
Authors: Stenhammar L. , Ansved P. , Jansson G. , Jansson U. 
Published: January 2024

SummaryWithin a defined population in southeast Sweden, celiac disease was diagnosed in 167 children born between 1970 and 1982. The diagnosis was based on the criteria of the European Society for Paediatric Gastroenterology and Nutrition. Another six children had an initial flat small intestinal mucosa but do not yet fulfill the criteria for the diagnosis of celiac disease. The incidence of celiac disease was 1.27/1,000 live births for the years 1970–1976 and 1.43/1,000 for 1977–1982. In contrast to our findings, a decline in the disorder during the late 1970s was reported from other countries. We discuss the observation that the incidences of celiac disease in children are moving discrepantly in different populations.
Serum Transthyretin Levels and Protein Intake as Predictors of Weight Gain Velocity in Premature Infants
Authors: Georgieff Michael K. , Sasanow Sharon R. , Pereira Gilberto R. 
Published: January 2024

SummaryNutritional intakes, transthyretin (prealbumin) levels, and anthropometric measurements were measured weekly in 26 preterm infants from week 2 of life throughout hospitalization. A sustained significant increase in protein intake occurred in 14 infants over a 2‐week period. When mean protein intake increased, mean transthyretin levels increased during the same week (p < 0.001), followed 1 week later by significant increases in mean weight, occipitofrontal head circumference (OFC), and mid‐arm circumference (MAC). In the other 12 infants, a sustained significant decrease in protein intake occurred over 2 weeks. When mean protein intake decreased (p < 0.01), transthyretin levels decreased during the same week (p < 0.05), followed I week later by significant decreases in mean weight and MAC growth. Over all hospitalization weeks (n = 95), rates of weight gain were more significantly associated with previous trends in transthyretin levels (p = 0.007) than with protein intake alone (p = 0.08). In particular, declines in rates of weight gain were predicted significantly more frequently by the prior week's transthyretin trend (70%) than by the trend in protein intake (47%). In growing premature infants, changes in transthyretin levels occur 1 week before changes in anthropometric measurements. Changes in transthyretin levels are more predictive than changes in protein intake alone for monitoring growth velocity in preterm infants.
Failure of Blind Small Bowel Biopsy in the Diagnosis of Intestinal Lymphangiectasia
Authors: Hart Michael H. , Vanderhoof Jon A. , Antonson Dean L. 
Published: January 2024

SummaryA case of primary intestinal lymphangiectasia is presented in which multiple blind peroral jejunal biopsies were unable to document any abnormality, despite strongly suggestive clinical history and radiographic findings. Endoscopically directed biopsy was necessary to document the characteristic pathologic lesion. This report documents the importance of endoscopy in the diagnosis of intestinal lymphangiectasia when clinical history is suggestive of intestinal lymphangiectasia but standard small bowel biopsy fails to show any abnormality.
Long‐Term Effects of Early Kwashiorkor Compared with Marasmus. II. Intellectual Performance
Authors: Galler Janina R. , Ramsey Frank C. , Forde Victor , Salt Patricia , Archer Esther 
Published: January 2024

SummaryIntellectual performance including IQ (Wechsler Intelligence Scale for Children‐Revised) and conservation was measured at ages 11–18 years in a follow‐up study of Barbadian girls and hoys who had histories of kwashiorkor (n ‐ 53) or marasmus (n ‐ 55) in their first year of life. They were compared with healthy neighborhood children matched by sex and age who had normal patterns of growth in early childhood (n ‐ 58). On both IQ and conservation tests, children with previous kwashiorkor or marasmus had similar scores, which were significantly lower than scores of healthy comparison children. These findings were examined in relationship to current environmental conditions, which were similar in children with histories of kwashiorkor or marasmus and somewhat less advantaged than those of the comparison children. The effect of early malnutrition and related conditions at the time of the episode still emerged as significant even when the current environmental factors were controlled for.
Plasma and Urine Zinc in Infants and Children with Extrahepatic Biliary Atresia
Authors: Hambidge K. M. , Krebs N. E. , Lilly J. R. , Zerbe G. O. 
Published: January 2024

SummaryThe objective of this study was to undertake a pilot assessment of zinc status in infants and children with extrahepatic biliary atresia. Plasma zinc concentrations and urine zinc excretion rates were measured longitudinally in 45 infants and young children with this disorder. The mean (‐ SD) plasma zinc (298 observations) was 56.8 ‐ 17.9 μg dl (controls 85.6 ‐ 10.8). Plasma zinc was not correlated with age and did not appear to he related to repeated surgical procedures or to episodes of cholangitis. Plasma zinc was only weakly correlated with serum albumin (r ‐ 0.27, p ‐ 0.001). The 24‐h urine zinc excretion rates were correlated with age but not so strongly as for normal children. Hyperzincuria was evident from the linear regression equation of 24‐h urine zinc on age. On a body weight basis, urine zinc excretion rates were 6 times normal for the first 2 years and remained high across the entire age range, to replace these losses, net zinc absorption would need to increase by 40%. The relationship of these data to the zinc nutritional status of these patients and to their underlying hepatic disease remains to be clarified by more definitive studies.
Hepatobiliary Scintigraphy with Technetium‐99m Disofenin in the Evaluation of Neonatal Cholestasis
Authors: Cox Kenneth L. , Stadalnik Robert C. , McGahan John P. , Sanders Kathleen , Cannon Robert A. , Ruebner Boris H. 
Published: January 2024

SummaryTo assess the reliability of technetium‐99m disofenin scanning in evaluating neonatal cholestasis. 33 neonates (3 months of age) with direct hyperbilirubinemia were evaluated prospectively by cholescintigraphy. Results of this test were compared to those of standard serum tests of liver function, ultrasonography, and liver biopsy. The diagnosis of biliary atresia was suggested by a serum γ‐glutamyl transpeptidase (γ‐GTP) 300 units, absence of the gallbladder on ultrasonography, and a lack of delectable radioisotope in the gastrointestinal and or extrahepatic biliary tract on cholescintigraphy. Each of these tests lacked sensitivity and or specificity when compared to liver biopsy. Of the nine neonates with biliary atresia, three had gallbladders identified In ultrasonography and two had γ‐GTP 300 units Of the 24 neonates without biliary atresia, eight had cholescintigraphy without detectable radioisotope excretion, four had ultrasonography that failed to visualize the gallbladder, and nine had γ‐GTP 300 units. Cholescintigraphy excluded the diagnosis of biliary atresia when gut and or extrahepatic biliary excretion of isotope was seen. However, cholescintigraphy required more time. 6–8 days, and was less specific than ultrasonography and liver biopsy. We recommend that cholescintigraphy should not be routinely used in evaluating neonatal cholestasis, especially if it delays surgical intervention.
Serum Pepsinogen I in Childhood Duodenal Ulcer
Authors: Tam P. K. H. 
Published: January 2024

SummaryTo delineate possible genetic factors invoked in the pathogenesis of childhood duodenal ulcer (DU), serum pepsinogen I concentrations were measured in 14 patients and their parents. Sixty‐five normal subjects were simultaneously studied to determine normal values in relation to age. Hyperpepsinogenemia occurred in six of 14 patients and 13 of 28 parents. Hyperpepsinogenemic patients invariably had hyperpepsinogenemic parents, four of six having both parents affected. Hyperpepsinogenemic parents (10 of 13) usually but not invariably gave birth to hyperpepsinogenemic patients. Most hyperpepsinogenemic parents (11 of 13) were asymptomatic. Our findings suggest a genetic basis (hyperpepsinogenemia) for the predisposition to childhood DU in nearly half the patient population, the inheritance being likely to be autosomal dominant with incomplete penetrance. In addition, the existence of normopepsinogenemic families suggests that childhood DU is a heterogeneous entity and not a single disease. A high familial incidence of DU is also present in the normopepsinogenemic subgroup (four of eight) but whether genetic factors or socioenvironmental factors are responsible here will require elucidation from studies with other markers.
Neonatal Gallbladder Enlargement and α‐Antitrypsin Deficiency
Authors: Gremse David A. , Peevy Keith J. , Simon Neal , Wiseman Hollis J. 
Published: January 2024

SummaryPatients with clinical signs of α1‐antitrypsin deficiency in the neonatal period usually present with prolonged obstructive jaundice. We report a patient with α1antitrypsin deficiency who presented with gallbladder enlargement in the neonatal period. This gallbladder enlargement may be due to cystic duct hypoplasia or atresia. which has been reported in association with α1‐antitrypsin deficiency. The diagnosis of α1‐Antitrypsin deficiency should be considered in neonates with gallbladder enlargement and prolonged obstructive jaundice.
Marked Basal Gastric Acid Hypersecretion and Peptic Ulcer Disease
Authors: Hyman Paul E. , Hassall Eric 
Published: January 2024

SummaryThree children with peptic ulcer disease had recurrent symptoms unresponsive to cimetidine or ranitidine therapy alone. Acid secretory studies showed a marked basal acid hypersecretion, which was atropinesensitive in two of three patients and was best suppressed by ranitidine in combination with an anticholinergic drug. Marked reduction in acid output following intravenous atropine suggested that the hypersecretion was under vagal, muscarinic control. However, in one patient, large doses of the selective m1‐muscarinic antagonist pirenzepine were ineffective in suppressing basal acid hypersecretion. Given the efficacy and safety of drug therapy used in these children over a 3‐year period, we conclude that medical management is an effective alternative to surgery for pediatric patients with refractory or recurrent peptic ulcer disease.
Comparison of Two Special Infant Formulas Designed for the Treatment of Protracted Diarrhea
Authors: Galeano Narmer F. , Lepage Guy , Leroy Claudie , Belli Dominique , Levy Emile , Roy Claude C. 
Published: January 2024

SummaryThe nutritional management of intractable diarrhea and short bowel syndrome remains a challenging problem. The advantage of continuous nasogastric infusion is undisputed, but what to feed remains in question, and no studies, to these authors' knowledge, have yet compared two widely used specially designed protein hydrolysate formulas. A randomized crossover trial of two periods of 7 days was carried out with Alfare and Pregestimil administered by a constant infusion pump in six malnourished infants aged 1–13 months. Two had intractable diarrhea, and four the short bowel syndrome. Identical quantities of calories were administered during the two periods. There was good tolerance for both formulas and satisfactory weight gain. Despite compositional differences related to osmolality, the source of the hydrolysates and their profile, and the qualitative pattern of the carbohydrates, no difference was observed with regard to stool weight, Na+ and K+ losses, and the enteral absorption of fat, carbohydrate‐derived energy, and total energy. The percent absorption of nitrogen was somewhat higher (p < 0.01) with Pregestimil (83.8 ± 2.7) than with Alfare (77.3 ± 3.4), but nitrogen retention was unaffected. Energy absorption was the same on both formulas, but maldigested or malabsorbed carbohydrates accounted for 63% of total energy loss during Alfare feeding and 72% during the week of Pregestimil. These data call for studies with protein hydrolysate formulas reformulated with a lower concentration of carbohydrates and a higher one of fat.
Motilin Levels in Term Neonates Who Have Passed Meconium Prior to Birth
Authors: Mahmoud Eugene L. , Benirschke Kurt , Vaucher Yvonne E. , Poitras Pierre 
Published: January 2024

SummaryMotilin levels were measured by radioimmunoassay from umbilical cord blood obtained at birth from 38 term neonates (median gestational age 40 weeks, range 39–42 weeks). Birth weights of these neonates ranged from 2,840 to 4,593 G (median 3,600 G). Forty‐two percent (16/38) of these neonates passed antenatal meconium.The median motilin level was 177 fmol/ml in those neonates who passed antenatal meconium and 111.5 fmol/ml in those neonates who did not pass meconium prior to birth (p < 0.01). Although fetal distress has been found to be associated with elevated motilin levels at birth, such an association was not found in this study. These data support an association between elevated motilin levels at birth and antenatal meconium passage.
Giant Inflammatory Polyposis Causing Partial Obstruction and Pain in “Healed” Ulcerative Colitis in an Adolescent
Authors: Adelson Joel W. , deChadarévian J. ‐P. , Azouz E. Michel , Guttman Frank M. 
Published: January 2024

SummaryA 16‐year‐old boy with chronic ulcerative colitis developed unexplained increasingly intractable abdominal pain and rectal bleeding over several months during a period when acute colitic attacks were quiescent. No abdominal mass was palpable. The cause of symptoms was subtotal colonic obstruction due to the development of massive or giant inflammatory (pseudo) polyposis, which had caused nearly complete obliteration of the lumen of the transverse colon. The radiological and histopathological findings are presented; this case confirms the conclusion drawn in a recent retrospective surgical pathology report that giant inflammatory polyposis may produce distinct symptoms, especially pain, independent of the existence of relatively quiescent underlying inflammatory bowel disease. This unusual complication of inflammatory bowel disease deserves greater clinical awareness.