bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Electron Microscopic Investigation of Time‐Related Changes in the Intestine of Neonatal Mice Infected with Murine Rotavirus
Authors: Osborne M. P. , Haddon S. J. , Spencer A. J. , Collins J. , Starkey W. G. , Wallis T. S. , Clarke G. J. , Worton K. J. , Candy D. C. A. , Stephen J. 
Published: January 2024

SummarySeven‐day‐old mice were infected orally with murine rotavirus (EDIM) and regions of the gut examined at 24 h intervals up to 7 days by electron microscopy. Structural changes were correlated with data on viral antigen production, thymidine kinase activity, and clinical signs of diarrhea. No pathological changes were detected in the colon. Infection and structural damage were confined to the small intestine, with middle regions showing the most pronounced changes. Constriction of villus bases, edema of the lamina propria, and vacuolation of enterocytes occurred at 24 h postinfection (PI), i.e., before evidence of major virus replication. Transient villus atrophy occurred at 48 h PI. Recovery of villus length was evident by 72 h PI accompanied by evidence of marked enterocyte replication at villus bases. Many enterocytes were damaged with little evidence for the presence of virus particles. By 96 h PI, villi had almost recovered from infection although some enterocytes were still damaged; no virus particles were detected in these cells. A second phase of villus damage and edema of the lamina propria occurred at 120 h PI; the pathology resembled that at 24–48 h PI. By 144 to 168 h PI, recovery of the mucosa from infection was virtually complete. We suggest that many of the pathological features following rotavirus infection result from rotavirus‐induced ischemia of villi and that diarrhea results from malabsorption of fluid by damaged villi and hypersecretion of ions released from increased numbers of dividing cells at villus‐crypt borders.
Intestinal Enzyme Profiles in Normal and Rotavirus‐Infected Mice
Authors: Collins J. , Starkey W. G. , Wallis T. S. , Clarke G. J. , Worton K. J. , Spencer A. J. , Haddon S. J. , Osborne M. P. , Candy D. C. A. , Stephen J. 
Published: January 2024

SummaryTo investigate further the pathophysiology of rotavirus‐induced diarrhea, changes in specific activities of eight relevant intestinal enzymes [alkaline phosphatase, thymidine kinase, lactase, maltase, sucrase, Na+,K+‐adenosine triphosphatase (ATPase), adenylate and guanylate cyclases] were measured following infection of suckling mice with murine rotavirus (epizootic diarrhea of infant mouse strain) and compared with age‐matched control mice. The concentration of lactose within the lumen of the gastrointestinal tract during infection was also measured. During the course of infection, activities of alkaline phosphatase and lactase decreased, whilst the activity of thymidine kinase increased. Precocious maturation profiles of sucrase and maltase enzymes were observed. No significant changes were detected in the activities of Na+,K+‐ATPase or the adenylate and guanylate cyclases. These results are discussed in relation to existing and novel hypotheses on the pathogenesis of rotavirus‐induced diarrhea.
Vitamin D Metabolism in Biliary Atresia
Authors: Kimura Saburo , Seino Yoshiki , Harada Tokuzo , Nose Osamu , Yamaoka Kanji , Shimizu Kazuo , Tanaka Hiroyuki , Yabuuchi Hyakuji , Fukui Yuichi , Kamata Shinkichi , Okada Akira 
Published: January 2024

SummaryIn children with biliary atrcsia, defective intestinal absorption of vitamin D and impaired hepatic uptake and 25‐hydroxylation of vitamin D lead to a deficiency of vitamin D and rickets. We recently observed severe rickets in a 3‐year‐old boy with corrected biliary atrcsia resulting in jaundice, despite oral treatment with 1α‐hydroxyvitamin D, (1α‐OHD,) or 1,25‐dihydroxyvitamin D, [1,25‐(OH)2D3]. He had low 25‐hydroxyvitamin D (25‐OHD) and high 1.25‐(OH)2D serum levels. Intramuscular vitamin D2 administration produced radiological and biochemical evidence of recovery. Oral 1.25‐(OH)2D3 (O.1 μg/kg) and 25‐OHD3 (10 μg/kg) tolerance tests were done to assess the ability to absorb vitamin D and the effectiveness of using these drugs orally. Eleven children with corrected biliary atresia, aged 9 months to 7 years, were studied. In oral 1.25‐(OH)2D3 tolerance tests, the increments above the baseline serum levels of 1.25‐(OH)2D were 140.7 ± 27.4 pg/ml in non‐jaundiced patients (n = 5). In jaundiced patients (n ‐ 3). 1,25‐(OH)2D3 absorption in two patients with high basal 1.25–(OH)2D values was lower than that of nonjaundiced patients: however, the absorption in the third patient with a low basal value was similar to that of nonjaundiced patients. In oral 25‐OHD3 tolerance tests, the mean increase of serum 25‐OHD was 48.9 ± 30.6 ng/ml in non‐jaundiced patients (n = 5) and 23.7 ± 9.5 ng/ml in jaundiced patients (n ‐ 4), the peak serum 25‐OHD levels being reached 6–12 h after 25‐OHD3 loading. The increase of serum 25‐OHD in jaundiced patients tended to be less than that in nonjaundiced patients at 4 hours after 25‐OHD3 administration (15.1 ± 12.6 vs 48.9 ± 30.6 ng/ml), but the difference was not significant. In addition, oral treatment with 25‐OHD, (4 μg/kg/day) for 3 months resulted in marked increases in the serum 25‐OHD level and hone density in the jaundiced patients (n = 3).
Randomized Study of Premedication for Esophagogastroduodenoscopy in Children and Adolescents
Authors: Figueroa‐Colon Reinaldo , Grunow John E. 
Published: January 2024

SummaryIn order to compare three premeditation regimens, 58 children and adolescents were randomized to three groups: Group I, meperidine intramuscular; Group II, atropine intramuscular and diazepam intravenous; and Group III, meperidine, promethazine, and chlorpromazine intramuscular. Almost all patients required supplemental intravenous diazepam or meperidine to obtain adequate sedation. An endoscopist without knowledge of the medication group scored each patient for adequacy of sedation. Sedation was more effective in Group III than in Groups I and II (p < 0.005); however. Group III patients were less arousable at completion of the procedure (p < 0.0005) and had a greater duration of sedation (220 min compared with 56 and 88 min for Groups I and II, respectively, p < 0.001). Complications were minor and not associated with any specific treatment. The evidence from this study supports the following conclusions: (a) adequate sedation for esophagogastroduodenoscopy in pediatric patients requires sedation with more than one of the drugs used in this study; and (b) the regimen meperidine, promethazine, and chlorpromazine, with diazepam supplement, was superior in providing sedation, but patients required a longer period of recovery than did patients sedated with one of the other regimens.
Loss of the Glycocalyx of Enterocytes in Small Intestine
Authors: Poley J. Rainer 
Published: January 2024

SummaryObservations are reported on biopsied small bowel mucosa by scanning and transmission electron microscopy in 10 infants and children with chronic diarrhea and intolerance to dietary protein(s). The most striking and consistent finding was widespread loss of glycocalyx from the surface of enterocytes, exposing the tips of the microvilli. Concomitantly, disaccharidase activities were markedly depressed in nine of the 10 patients, and such enzyme activities showed a tendency to return toward normal after removal of the offending dietary antigen(s) in concert with efforts to rebuild the glycocalyx. By light microscopy, no discernible structural damage was seen in eight of the 10 patients; two showed blunting of villi, but there was also loss ofglycocalyx. The pathogenesis of the loss of the glycocalyx is unknown. Its finding is rather unique, because it has not been observed in any other condition characterized by chronic diarrhea in children. It is possible that the loss of the glycocalyx is a sequel to cell damage by a hitherto not defined interaction between host and dietary protein. Immunologic processes may be involved.
Plasma Immunoreactive‐Trypsin(ogen) Levels During Development
Authors: Levine Jeremiah J. , Udall John N. , Bloch Kurt J. , Hanson Donald G. , James Brent C. , Walker W. Allan 
Published: January 2024

SummaryWe previously showed that the uptake of intact trypsin from the intestine of suckling animals was greater than that of weaned animals. To extend these studies, we measured plasma cationic immunoreactivetrypsin(ogen) in human subjects aged 3 days to 43 years. In agreement with the observation of other investigators, we found that the concentration of cationic immunoreactive‐trypsin(ogen) was significantly increased in 3‐day‐old infants compared with other age groups. None of the cationic immunoreactive‐trypsin in adult samples was bound to α1‐antitrypsin, whereas 28% of cationic immunoreactive‐trypsin in infant samples was bound to α1‐antitrypsin.
Cholesterol Ester Storage Disease
Authors: D'Agostino Daniel , Bay Luisa , Gallo Guillermo , Chamoles Nestor 
Published: January 2024

SummaryCholesterol ester storage disease (CESD) is infrequent in children. Four new cases in two nonrelated families are presented. Acid lipase deficiency in the leukocytes of the patients and reduced activity (50%) in those of parents were demonstrated. Clinical manifestations varied from neonatal cholestasis to asymptomatic hepatomegaly. Hepatic histology showed lipid vacuoles and cholesterol ester storage in hepatocytes and Kupffer cells. Increased levels of cholesterol and hepatomegaly were the first findings. There is as yet no specific treatment for CESD: however, the early detection of cases would make possible the timely control of complications.
Symptomatic Selenium Deficiency in a Child on Home Parenteral Nutrition
Authors: Kelly Deirdre A. , Coe Andrew W. , Shenkin Alan , Lake Brian D. , Walker‐Smith John A. 
Published: January 2024

SummaryA 27‐month‐old girl with microvillous atrophy who was maintained on long‐term home parenteral nutrition presented with regression of walking skills. She was found to have a tender skeletal myopathy affecting both legs only. Plasma selenium level was <0.05 μmol/L (0.4 μg/dl) (normal 0.8–1.6 μmol/L: 6.3–12.6 μg/dl). red blood cell glutathione peroxidase was undetectable, and plasma glutathione peroxidase was 6 U/L (normal 90–350 U/L). Electromyography was abnormal, muscle biopsy showed a nonspecific myopathy, and muscle selenium was 0.23 μg/g dry weight (normal 0.45–1.05 μg/g dry weight). Following replacement with intravenous sodium selenite, there was a rapid improvement with complete disappearance of muscle pain and tenderness within 1 week. Crawling and walking skills were regained within 6 weeks, in dicating that selenium deficiency was the cause of her symptoms. It is suggested that selenium be monitored and supplemented in children on long‐term total parenteral nutrition particularly if cntcral absorption is deficient.
Pathophysiology of Gastroesophageal Reflux and Distal Esophageal Motility in Children with Gastroesophageal Reflux Disease
Authors: Cucchiara S. , Staiano A. , Di Lorenzo C. , De Luca G. , della Rocca A. , Auricchio S. 
Published: January 2024

SummaryWe investigated the mechanisms of gastroesophageal reflux (GER) and esophageal motility during endogenous esophageal acid exposure in 17 patients with reflux disease alone (age range 3–20 months) (group A) and in 10 patients with reflux disease complicated by esophagitis (age range 4–19 months) (group B), by simultaneous recording distal esophageal sphincter relaxation was the predominant mechanism of reflux in both groups of subjects; however, it was more frequent in group B patients (Bpts), whereas reflux episodes due to appropriate sphincter relaxation were delected more frequently in group A patients (Apts). During endogenous acid exposure, primary peristalsis was the most frequent esophageal motor event in all patients; furthermore, its amplitude was significantly higher in Apts as compared with Bpts. Primary peristalsis was more efficacious (rise of intraluminal pH by at least 0.5 unit) in patients with reflux disease alone, whereas nonspecific motor irregularities were more common in children with reflux esophagitis. It is concluded that the major mechanism of GER in patients with reflux esophagitis is an inappropriate sphincter relaxation; reflux due to appropriate sphincter relaxation is associated with less severe reflux disease; and patients with esophagitis exhibit a deranged esophageal motility during spontaneous acid exposure.
A Carbon‐13 Breath Test to Characterize Glucose Absorption and Utilization in Children
Authors: Lifschitz Carlos H. , Boutton Thomas W. , Carrazza Francisco , Beyreiss Klaus , Schmitz Jacques , Ricour Claude , Shulman Robert , Nichols Buford L. 
Published: January 2024

SummaryAfter the administration of a 59% glucose‐water solution that contained tracer amounts of the stable non‐radioactive isotope 13C, breath samples were collected from five children with congenital glucose‐galactose malabsorption and five with severe small bowel villous atrophy and chronic diarrhea. The 13CO2, breath test curves of the children with the congenital malabsorption and chronic diarrhea were compared with each other and with those from three healthy children and four infants with severe malnutrition but no diarrhea. The breath test curves from the children with glucose‐galactose malabsorption and from those with diarrhea were significantly different from those of the other two groups, a finding consistent with impairment of glucose absorption. The [13C]glucose breath test clearly identified the children with severe glucose malabsorption. Further studies are required to determine whether less severe cases of carbohydrate malabsorption also can be identified using the parameters described in our study.
Anti‐reticulin Antibodies
Authors: Khoshoo V. , Bhan M. K. , Unsworth D. J. , Kumar R. , Walker Smith J. A. 
Published: January 2024

SummaryR‐1 anti‐reticulin antibodies (ARA) were present in sera of 10 of the 12 children who subsequently fulfilled the ESPGAN diagnostic criteria for celiac disease (CD), hut was not found in any children in the age‐matched control groups, viz., severely malnourished (n = 20). acute gastroenteritis (n = 23), normally nourished asymptomatic (n = 38), and 42 children with protracted diarrhoea and failure to thrive due to nonceliac causes. ARA was a highly specific (100%) and sensitive (83%) assay for the early diagnosis of CD. A positive ARA assay with an initial subtotal villous atrophy was seen to always suggest CD, and these together would provide a useful basis for instituting gluten‐free diets in suspected cases of CD rather than histological findings alone, which may be often present in children in the third world with protracted diarrhoea and associated severe malnutrition.
Concentrations of IgA, Secretory IgA, IgM, Secretory IgM, IgD, and IgG in the Upper Jejunum of Children Without Gastrointestinal Disorders
Authors: Hjelt Karsten , Sorensen Christian Hjort , Nielsen Ole H. , Krasilnikoff Peter A. 
Published: January 2024

SummaryJejunal fluid was collected from 40 children aged 1–12.2 years and from 10 adults (age 20–25 years) who were without gastrointestinal disorders. They were intubated pernasally with a special tube system that made it possible to avoid contamination from the upper respiratory tract secretions. Quantitation of immunoglobulin A (IgA), secretory IgA (SIgA), IgM, SIgM, IgD, IgG, and albumin was performed by double sandwich enzyme‐linked immunosorbent assay. IgA was the dominating immunoglobulin in jejunal fluid, showing the highest concentrations, followed in order by IgM, IgG, and IgD. The IgD concentrations were about 1,000 times less than in plasma of age‐matched children. The immunoglobulin concentrations did not show any age‐related differences, except for IgG and for the SIgA/IgA ratio. The former declined with children's age (p < 0.02), whereas the latter was significantly higher in adults (interquartile range: 97–100%) than in young children aged l‐<5.5 years (interquartile range: 55–94%) (p < 0.001). This indicates an age‐related decline in leaking from gut mucosa. The concentrations of SIgA and SIgM showed a positive correlation (p < 0.001). The majority of IgA and IgM were estimated to be locally produced, whereas IgD and IgG were transudated from plasma.
Protein‐Losing Enteropathy Detected by 99mTc‐Labeled Human Serum Albumin Abdominal Scintigraphy
Authors: Lan Janet A. , Chervu L. Rao , Marans Zvi , Collins Janna C. 
Published: January 2024

Summary
99mTc‐labeled human serum albumin (HSA) abdominal imaging is a new way of demonstrating gastrointestinal protein loss. We present two children with hypoalbuminemia of obscure etiology in whom albumin loss was localized in the gastrointestinal tract with 99mTc‐HSA scintigraphy and the loss correlated with abnormal fecal α1‐antitrypsin excretion. In the absence of gastrointestinal blood loss or contamination of the 99mTc‐HSA with free pertechnetate, significant activity accumulating in the gastrointestinal tract and moving with its contents is thought to represent 99mTc‐HSA leakage into bowel lumen. Abdominal imaging with 99mTc‐HSA has a low radiation burden to the patient and is readily available, relatively inexpensive, and easily performed. It can be used as a screening test for the detection of protein‐losing enteropathy. It also offers the potential of being able to localize the site of protein loss visually within the gastrointestinal tract.
A Controlled Trial on Utility of Oral Zinc Supplementation in Acute Dehydrating Diarrhea in Infants
Authors: Sachdev H. P. S. , Mittal N. K. , Mittal S. K. , Yadav H. S. 
Published: January 2024

SummaryA controlled, randomized trial was conducted in 50 infants with acute dehydrating diarrhea to evaluate the effect of oral zinc supplementation in acute diarrhea. After completion of rehydration, 25 infants in Group A received oral zinc sulfate (20 mg elemental zinc twice daily) and an equal number in Group B were given placebo (glucose). Both groups were comparable with respect to various initial characteristics including nutritional status, diarrhea! disease, serum alkaline phosphatase, and serum and rectal mucosal zinc content. During therapy all the assessed parameters of zinc status (serum alkaline phosphatase and serum and rectal zinc) recorded significant elevation and reduction in Groups A and B, respectively. At recovery the zinc status of Group A was significantly better and was nearer that of healthy controls. The diarrheal duration and frequency in the zinc‐supplemented group were lower, but the differences were not significant (0.05 < p < 0.1). However, when only subjects with relatively severe initial zinc depletion (rectal zinc lower than the 15th percentile of healthy controls: 11 in Group A and 14 in Group B) were considered, the diarrheal duration and frequency were significantly (p < 0.05 and p < 0.01. respectively) lower in the zinc‐supplemented cases. Weight gain in both groups was similar. It is concluded that oral zinc administration in acute diarrhea can replenish body zinc status and this may shorten the diarrheal duration and frequency in children with relatively severe zinc depletion.
Comparison of Efficacy of a Glucose/Glycine/Glycylglycine Electrolyte Solution Versus the Standard WHO/ORS in Diarrheic Dehydrated Children
Authors: Pizarro Daniel , Posada Gloria , Mahalanabis Dilip , Sandi Leyla 
Published: January 2024

SummaryIt was hypothesized that a mixture of glucose and amino acids enhances sodium and water absorption and therefore diminishes the volume of oral rehydration solution, stool output, and duration of diarrhea. To investigate this hypothesis, the efficacies of two oral rehydration solutions (ORS) were compared, one containing (mmol/L): Na+ 90, K+ 20, Cl+80, citrate 10, glucose 67, glycine 53, and glycylglycine 30, yielding an osmolality of 350 mosmol/kg H2O, and the other, the standard ORS recommended by the World Health Organization, containing the same electrolyte concentration and only glucose 110 mmol/L, yielding 310 mosmol/kg H2O. The study group comprised 31 infants and small children for group A (receiving solution A, the glucose/glycine/glycylglycine‐based ORS) and 31 patients for group B (receiving solution B, the standard WHO/ORS). There were no significant differences between the groups in age, fluid loss, or dehydration, or between the groups with respect to clinical outcome, mean time to achieve rehydration, mean percent body weight gain, and serum electrolyte composition. The only statistically significant difference was the mean time between admission and the last diarrheic stool. The glycylglycine/glycine/glucose electrolyte solution was found to be suitable for rehydration, but not to have an advantage over the standard WHO/ORS.
Enhancement of Neonatal Somatic and Hepatic Growth by Orally Administered Epidermal Growth Factor in Rats
Authors: Berseth Carol Lynn , W. Go Vay Liang 
Published: January 2024

SummaryPrevious studies have shown that orally administered epidermal growth factor (EGF) enhances neonatal intestinal growth and that it may be absorbed in the intestine and bound by other organs. This study investigated whether the ingestion of EGF would be associated with growth of nonintestinal organs. In short‐term studies, 87 newborn rat pups were fed artificial formula containing various concentrations of EGF for 39 h. In long‐term studies, suckling newborn pups were fed EGF or an equal volume of distilled water for 5 days. The pups fed formula containing EGF for 39 h had a significant increase in hepatic incorporation of [3H]thymidine into DNA compared with pups not fed EGF. By 5 days of age, 13 pups fed EGF had heavier livers that contained more DNA and RNA compared with 14 control pups. Moreover, EGF‐fed pups had heavier hearts and kidneys than pups fed no EGF. These data suggested that ingestion of EGF is associated with the growth of nonintestinal organs.
Intestinal Duplication in a Patient with Neurofibromatosis
Authors: Berezin Stuart , Fakhry Joseph , Newman Leonard J. , Davidian Marianna , Slim Michael S. 
Published: January 2024

SummaryA 5‐year‐old boy with neurofibromatosis is described, whose symptoms of abdominal pain and vomiting were due to an intestinal duplication. Intestinal duplication has not been previously reported as a cause of gastrointestinal symptoms in neurofibromatosis. The utilization of ultrasound and computerized tomography scan as useful modalities for the diagnosis of duplication of the bowel is described.
Wilson's Disease Associated with Pancreatitis
Authors: Weizman Zvi , Picard Elie , Barki Yehiel , Moses Shimon 
Published: January 2024

SummaryA 12‐year‐old boy presented with a 2‐month history of abdominal pain and distention. A diagnosis of Wilson's disease was established, and D‐penicillamine therapy was initiated. An associated pancreatitis was diagnosed on presentation, based on elevated serum amylase and an enlarged pancreas ultrasonically. Subsequently, an 18‐month follow‐up disclosed no abdominal pain, with repeatedly normal serum amylase level and a normal pancreas on ultrasonography. Since abdominal pain is a common symptom in Wilson's disease on presentation, this possibility should be considered in untreated patients. It is concluded that pancreatitis may be associated with Wilson's disease, possibly because of copper deposition in the pancreas, and is probably responsive to copper chelation therapy.