bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Gestational Age, Size for Dates, and Prenatal Steroids On Cord Transferrin Levels in Newborn Infants
Authors: Chockalingam Uma , Murphy Edrie , Ophoven Janice C. , Georgieff Michael K. 
Published: February 2024

SummarySerum transferrin levels assess protein status in older children and adults. To generate standards for its use in newborn infants, we measured umbilical cord serum transferrin levels in 161 appropriate (AGA), 25 large (LGA) and 16 small (SGA) for gestational age infants between 25 and 43 weeks' gestation. We also assessed the effects of intrauterine growth, exposure to prenatal steroids, and presence of pulmonary maturity on neonatal transferrin levels. Cord transferrin levels in AGA infants were significantly correlated with increasing gestational age (r = 0.60; p < 0.001). Infants born before 37 weeks' gestation had significantly lower transferrin levels, when compared with those born at term (p < 0.001). LGA infants had significantly higher levels than age‐matched AGA infants (253 ± 75 vs. 214 ± 53 mg/dl; p < 0.025). Despite significantly lower mean birth weights (p < 0.001), SGA infants also had significantly higher levels than gestational age‐matched AGA controls (227 ± 63 vs. 167 ± 40 mg/dl; p < 0.005). For infants <35 weeks' gestation, neither the 20 preterm infants with exposure to prenatal steroids (maternal betamethasone), nor the 26 infants with pulmonary maturity had significantly elevated transferrin levels, when compared with gestational age‐matched control infants. Newborn transferrin levels correlate well with gestational age and are significantly affected by size for dates, but not by a brief course of prenatal steroids or by pulmonary maturity.
Test‐Retest Reproducibility of Hydrogen Breath Test for Lactose Maldigestion in Preschool Children
Authors: Barillas‐Mury Carolina , Solomons Noel W. 
Published: February 2024

SummaryThe test‐retest reproducibility of the H2 breath test within the same individual has not been rigorously evaluated in preschool children. In the present study, 10 children‐5 of whom were diagnosed as lactose‐digesters on their first testing, and 5 of whom were diagnosed as lactose‐maldigesters at first screening—were retested under identical conditions of a second opportunity. In each case, the same diagnostic classification was provided, for a reproducibility of 100%. Regression of the area under the curve of the change in breath H2 concentration during the 3 h of the test had a Pearson's correlation coefficient of 0.59 (p = 0.05). The time course of 3‐h H2 breath tests in 43 children with lactose maldigestion revealed a peaking of the concentration of H2 most commonly 120 min following the oral dose of 240 ml whole milk. Seventy‐seven percent of the children who eventually proved to be lactose maldigesters were so diagnosed by the end of the second hour of the breath test. Thus, even the abbreviated breath sampling schedule used in children is sensitive, and few maldigesters would go undetected because of a late rise in breath H2 concentration.
Kinetics of Copper Absorption in Zinc‐Overload States and Following the Withdrawal of Zinc Supplement
Authors: Cossack Zafrallah T. , van den Hamer Cornells J. A. 
Published: February 2024

SummaryZinc (Zn), in therapeutic dosages, has been used to inhibit copper (Cu) absorption in patients with Wilson's disease. A series of experiments were conducted to substantiate the effects of high dosages of Zn on Cu absorption using the experimental animal model. In the first experiment, five groups of mice were fed five different levels of Zn: 6 ppm (basal diet), 30 ppm (control), 750 ppm, 1,000 ppm, and 2,400 ppm, for a period of 35 days. 64Cu‐loading test was conducted to measure whole body retention (WBR) of 64Cu at the 10th, 14th, 21st, and 35th day. Results showed that the inhibition of 64Cu absorption by Zn is dose‐and time‐dependent. However, maximum inhibition occurred in mice fed 1,000 ppm of Zn, and no additional effect was observed in mice fed 2,400 ppm of Zn. In the second experiment, the distribution between the gastrointestinal tract (GIT) and gut‐free carcass, of the retained dose of 64Cu, was measured in controls and in the group fed 750 ppm of Zn. While WBR of 64Cu was significantly lower (p < 0.01) in mice fed 750 ppm of Zn, the distribution of the retained dose was not affected. In the third experiment, a group of mice was fed 30 ppm of Zn for a period of 70 days (control), and a second group was fed 1,000 ppm of Zn for the first 35 days (repletion), after which they were switched to the basal diet (6 ppm) for the following 35 days (depletion). WBR of 64Cu was conducted in intervals throughout the experimental period. Endogenous fecal Zn (MFZn) was determined at the end of repletion (0 t), and at intervals during depletion. Results from this experiment indicated that the effect of Zn on 64Cu absorption continued for up to 21–35 days, following the withdrawal of Zn supplement. In addition, WBR of 64Cu correlated significantly (r = −0.92, p < 0.005) with MFZn. We conclude that (a) high doses of Zn may not cause a complete inhibition of Cu absorption, and (b) endogenous Zn secreted into the GIT (as MFZn) plays a major role in inhibiting Cu absorption and thus, the maintenance of high endogenous Zn status is essential for maximal inhibition of Cu absorption.
Congenital Agastria
Authors: Dorney Stuart F. A. , Middleton Archie W. , Kozlowski Kazimierz , Benjamin Bruce N. P. , Kan Alex E. , Kamath K. Ramanand 
Published: February 2024

SummaryCongenital agastria has never before been reported. Congenital microgastria is rare but is well documented. We have cared for a Melanesian child in whom there was no radiological, anatomical, or physiological evidence of either a rudimentary stomach or a pylorus. The esophagus joined the first part of the duodenum directly. At this esophago‐duodenal junction there was microscopic evidence of fundic‐type gastric mucosa. The intestine was normally rotated and there was a functioning spleen. The child also had a severe micrognathia and a cleft soft palate and required a tracheostomy to relieve upper airway obstruction. The combination of micrognathia and agastria presented a difficult nutritional delivery problem. A jejunal pouch was constructed and placed between the esophagus and duodenum to provide some storage capacity. The child grew and developed well for almost 3 years. He suffered three episodes of severe acute enteritis, probably related to lack of the protective acid‐pepsin barrier against ingested microorganisms. Unfortunately, the third episode of acute enteritis caused his death 3 months after returning home to his own country.
An Analysis of Cereals That React with Serum Antibodies in Patients with Coeliac Disease
Authors: Troncone Riccardo , Auricchio Salvatore , De Vincenzi Massimo , Donatiello Anna , Farris Evelina , Silano Vittorio 
Published: February 2024

SummarySera from six children with active coeliac disease, and elevated titres against gliadins and from six age‐matched controls, were examined for IgG antibodies against different cereal proteins by a solid‐phase radioim‐munoassay. Antibodies to the major wheat proteins and the prolamines of other cereals were present in low titre in all control sera. In coeliac sera, significantly higher titres were found against A‐gliadin, as well as against hexaploid and tetraploid wheat whole gliadins. Gliadin peptic‐tryptic digest retained a significant antigenic activity, completely lost by peptic‐tryptic‐pancrealic digest. High titres were also found when coeliac sera were tested against wheat glulenins, albumins, and globulins, as well as against barley, oats, and maize prolamines; rice prolamines gave lower titres. Serum from whole gliadins and A‐gliadin immunized rabbils showed a similar spectrum of reactivity against prolamines as coeliac sera. Our results indicate a dissociation belween immunogenic properlies of cereal proteins and loxicily in coeliac disease.
Breath Hydrogen Test in Children with Giardiasis
Authors: Vega‐Franco Leopoldo , Meza Carlos , Romero Jose Luis , Alanis Soledad E. , Meijerink Jeanette 
Published: February 2024

SummaryRespiratory hydrogen excretion was measured in 50 children with giardiasis in order to study lactose absorption. Samples of expired air were collected before and after the children drank 250 ml of whole cow's milk. The test was repeated after successful elimination of Giardia lamblia following treatment with tinidazol. The number of children showing a rise in breath hydrogen excretion >20 ppm decreased from 33 (72%) before treatment to 20 (44%) after treatment. This study permits the conclusion that the presence of G. lamblia in the intestine might interfere with optimum lactose absorption.
Efficacy of Mung Bean (Lentil) and Pop Rice Based Rehydration Solutions in Comparison with the Standard Glucose Electrolyte Solution
Authors: Bhan M. K. , Ghai O. P. , Khoshoo Vikram , Vasudev A. S. , Bhatnagar S. , Arora N. K. , Rashmi  , Stintzing Gudmund 
Published: February 2024

SummaryChildren with acute diarrhea and moderate dehydration between 3 months and 5 years of age were randomly assigned to receive treatment with standard WHO oral rehydration solution (ORS) (n = 33) and two other solutions in which the 20 g/L glucose was substituted by 50 g/L of pop rice (n = 31) and 60 g/L of mung bean (lentil) powder (n = 29). Satisfactory oral rehydration, as assessed clinically and by changes in PCV and total serum solids (TSS), was achieved in 90.9% with WHO ORS, 96.8% with pop rice, and 96.6% in the mung bean ORS treated group (p > 0.05). The purging rates (ml/kg/h) until recovery were 2.49 ± 1.5 (pop rice); 2.91 ± 2.0 (WHO), and 3.41 ± 1.7 in the mung bean group (p > 0.05). The percentage of patients recovering from diarrhea within the 72 h study period was 58.0 (pop rice), 48.4 (WHO), and 44.8 for mung bean group (p > 0.05). Though differences in stool volumes and duration in the three groups were not statistically different, there was a trend toward improvement in efficacy with the pop rice ORS in several parameters: greater weight gain, higher percentage decline in TSS, higher urine output despite lower ORS intake, and lower purging rates. The intake of semisolids in the 24–72 h study period was also higher in the pop rice group as compared to the other two groups (p < 0.05). The number of breast feeds and intake of artificial milk was however similar in all groups (p > 0.05).
Straight Ileoanal Anastomosis and Ileal Pouch‐Anal Anastomosis in the Surgical Management of Idiopathic Ulcerative Colitis and Familial Polyposis Coli in Children
Authors: Odigwe L. , Sherman P. M. , Filler R. , Shandling B. , Wesson D. 
Published: February 2024

SummaryWe compared the postoperative course in children and teenagers who underwent subtotal colectomy, mucosal proctectomy, and either straight ileoanal anastomosis (group 1, n = 8) or ileal pouch‐anal anastomosis (group 2, n = 10) for the surgical treatment of idiopathic ulcerative colitis (n = 15) and familial polyposis coli (n = 3). Two of eight children in group 1 developed intractable diarrhea that persisted despite revision of the anastomosis to include an ileal pouch; therefore, ileostomies were necessary in both cases. One patient in group 2 had a diverting ileostomy as a result of abscess formation at the site of the ileoanal anastomosis. Despite a longer period of postoperative follow‐up (48.9 ± 11.8 months), the remaining six patients in group 1 had a significantly greater number of bowel movements each day (7.8 ± 6.5) as compared with the nine patients in group 2 who had 4.8 ± 2.6 stools each day (p < 0.05) at a mean follow‐up of 15.7 ± 9.0 months. A proportion of children in both groups had a poor postoperative functional outcome as determined by fecal incontinence (2 of 6 in group 1, 6 of 9 in group 2), perianal dermatitis (2 of 6, 4 of 9), and therapy with the antidiarrheal agent loperamide (4 of 6, 2 of 9). Increased school attendance (5 of 6, 7 of 7) and improvement in level of participation in social activities (5 of 6, 7 of 7) as compared with the 6‐month period prior to surgery occurred, however, for most of the children with ulcerative colitis in both groups. We conclude that although significant complications can develop following the formation of an ileoanal anastomosis, with or without an ileal reservoir, many children achieve a good functional outcome.
Effect of the Lectin Concanavalin A on the Neonatal Guinea Pig Gastrointestinal Mucosa in Vivo
Authors: Weaver L. T. , Bailey D. S. 
Published: February 2024

SummaryThe effect of intrapharyngeal infusion and subsequent passage of the lectin concanavalin A through the gastrointestinal tract of neonatal guinea pigs was examined. The lectin, administered at a concentration of 1 mg/ml, caused considerable mucosal damage in the stomach. Subsequent passage of the lectin through the small intestine caused little cellular damage to the mucosa, as judged by light and electron microscopy. Parallel morphometric analyses of the jejunum showed a decrease in mean villus height and an increase in mean crypt depth of 8% after 5 h of lectin administration. A 4.7‐fold increase in jejunal crypt cell production rate was observed, accompanied by a statistically significant increase in the number of intraepithelial lymphocytes. These morphologic and kinetic changes were accompanied by a threefold increase in the urinary lactulose:mannitol excretion ratio, indicative of a loss of mucosal integrity. No systemic antibody response to concanavalin A was demonstrated within 5 h of intragastric infusion of the lectin. Concanavalin A, conjugated with 10 nm colloidal gold particles, was also directly infused into the lumen of the jejunum in vivo. Within 60 min, both villous and crypt epithelial cells contained gold particles, demonstrating the rapid accessibility of crypt cells to the lectin. Intercellular spaces appeared within the villous epithelium, although both junctional complexes and spot desmosomes were retained. The brush border was abnormal with signs of incipient vesicularization. These findings have implications for our understanding of the pathogenesis of childhood coeliac disease and for the vulnerability of the neonatal gut to food proteins.
Use of a Long‐Acting Somatostatin Analogue (SMS 201–995) in Controlling a Significant Ileal Output in a 5‐Year‐Old Child
Authors: Ohlbaum Ph. , Galperine R. I. , Demarquez J. L. , Vergnes P. , Martin Cl. 
Published: February 2024

SummaryWe report the efficacy of a long‐acting somatostatin analogue, associated with conventional therapy, in controlling profuse ileostomy losses in a child with short bowel syndrome following a volvulus. The first therapeutic effects of the treatment [50 to 100 μg/day of SMS 201–995 (Sandoz Ltd.) subcutaneously] appeared 48 h after institution. Ileal output was reduced on an average from 1,800 to 600 ml. The transit time to the ileostomy was prolonged from 20 to 360 min. The loss of chloride and sodium was reduced. Clinical tolerance was good. This treatment allowed rapid weaning of parenteral nutrition and implementation of a constant rate enteral infusion with rapid nutritional restitution. Hospitalization was shortened and this treatment raises future opportunities in the short bowel syndrome.
The Occurrence and Significance of the Bilirubin Species, Including Delta Bilirubin, in Jaundiced Infants
Authors: Ostrea Enrique M. , Ongtengco Edgar A. , Tolia Vasundhara A. , Apostol Emmanuel 
Published: February 2024

Summary:An improved technique for bilirubin analysis, using high‐performance liquid chromatography, has enabled us to study the occurrence and significance of four species of bilirubin (unconjugated, monoconjugated, diconjugated, and delta bilirubin) in 40 infants with jaundice of various etiologies. We found that: (a) infants with indirect hyperbilirubinemia showed >90% of their total serum bilirubin as unconjugated bilirubin. The small remaining fraction consisted of conjugated bilirubin; predominantly delta bilirubin (5%); (b) infants with elevated direct serum bilirubin (≥2 mg/dl) showed almost twice more monoconjugated than diconjugated bilirubin fractions; (c) the standard diazo test for bilirubin analysisunderestimates the direct bilirubin by as much as 34%; and (d) delta bilirubin, a tightly protein bound bilirubin, was observed in significant amounts in infants with elevateddirect bilirubin. Its concentration, which ranged from 10–73% of the total bilirubin, was related to the duration rather than to the cause of the jaundice. It was also observed at birth in an infant with giant‐cell hepatitis. It is concluded that the identification of more specific bilirubin species in jaundiced infants, especially in those with elevated direct serum bilirubin, will further help in the understanding and management of their disease.
Role of Type 1 Somatic Pili (Fimbriae) in Mucosal Attachment of the Enteroadherent Escherichia coli, Strain RDEC‐1, in Rabbits
Authors: Sherman P. , Soni R. , Boedeker E. 
Published: February 2024

Summary:We have previously shown that attachment of the rabbit enteroadherent Escherichia coli, strain RDEC‐1, to ileal brush borders in vitro is mediated by both man‐nose‐resistant, AF/R1 pili and mannose‐sensitive, type 1 pili. Because the role of type 1, somatic pili as adhesins that mediate bacterial enteroadherence in vivo remains controversial, we examined adherence of RDEC‐1 expressing either type 1 pili or AF/R1 pili to rabbit ileum in ligated loops and after oral infection of rabbits. A rabbit fecal commensal E. coli, 640, which also expressed type 1 pili was used as a control. After oral infection of rabbits we evaluated: (a) diarrhea, (b) fecal shedding of organisms, (c) luminal colonization of jejunum and ileum, and (d) mucosal adherence of bacteria to jejunum, ileum, and colon. RDEC‐1 expressing either type 1 or AF/R1 pili adhered to enterocytes both in ileal ligated loops and in the distal ileum, cecum, and proximal colon of infected rabbits. In contrast, enteroadherence of 640 was not observed. Diarrhea developed in rabbits challenged with either type 1 or AF/R1 piliated RDEC‐1, but not in rabbits fed 640. Seven days after infection of rabbits with RDEC‐1 bearing type 1 pili, luminal colonization of jejunum (4.22 ± 0.55 CFU/g, X ± SE) and ileum (6.34 ± 0.55) was the same as after infection with AF/R1 piliated RDEC‐1 (jejunum 4.47 ± 0.20, ileum 5.81 ± 0.70) and significantly greater than luminal colonization by type 1 piliated 640 (jejunum > 2.22 ± 0.14, ileum > 2.06 ± 0.15). Indirect immunofluorescence using polyvalent antiserum produced against type 1 pili (purified from RDEC‐1) was positive for RDEC‐1 adherent to ileal enterocytes both in ligated loops and after oral infection of rabbits. These findings support the hypothesis that type 1 pili could mediate adherence of enteroadherent E. coli to intestinal mucosal surfaces during infection in vivo.
Barrett's Esophagus in an Infant
Authors: Nibali S. Conti , Barresi G. , Tuccari G. , Rivosecchi M. , Magazzù G. 
Published: February 2024

Summary:Data on the frequency of regression of Barrett's esophagus after medical therapy or antireflux surgery in adult patients are conflicting; these data, with regard to Pediatric age, where Barrett's esophagus is considered rare, are scarce and disappointing after antireflux surgery. We report a 4‐month‐old infant affected by severe reflux esophagitis who developed a junctional‐type Barrett's epithelium. Histochemical procedures to detect mucin pattern were also carried out. The regression of Barrett's esophagus was observed 4 months after antire‐flux surgery whereas medical therapy had been unsuccessful. We suggest that esophageal biopsy should also be performed in the presence of severe esophagitis. Longer follow‐up observations of other patients may clarify the role of antireflux surgery when Barrett's esophagus complicates gastroesophageal reflux (GER).
Infantile Colitis
Authors: Chong S. K. F. , Wright V. M. , Nishigame T. , Raafat F. , Isaacs D. , Morson B. C. , Walker‐Smith J. A. 
Published: February 2024

Summary:A brother and sister of first cousin Pakistani parents presented with recurrent mouth ulcers and chronic diarrhoea in the neonatal period. Diarrhoea persisted in spite of treatment with oral prednisolone and sulphasalazine. Both children required subtotal colectomy with ileostomy. Histopathology of the resected colons was virtually identical and showed multiple deep “flask”‐shaped ulcers, often penetrating to the serosa, in the presence of chronic inflammation, but without any of the characteristic histological features of Crohn's disease. The appearance closely resembled the colitis of Behcet's syndrome. Both children (aged 6 and 3.5 years, respectively) have continued to have recurrent perianal disease with intermittent bloody diarrhoea since the operation. Apart from the initial symptoms of oral aphthous ulcerations in both children, no other major criteria have developed so far. Intestinal Behcet's syndrome should be considered in the differential diagnosis of chronic inflammatory bowel disease in childhood.
Changes in Phospholipid and Cholesterol Concentrations of the Rat Microvillus Membrane During Maturation
Authors: Engelhardt Elizabeth L. , Neu Josef , Sankar Mira B. , Gimotty Phyllis A. , Meyer Jay W. 
Published: February 2024

Summary:We studied the cholesterol and phospholipid content and the cholesterol‐to‐phospholipid molar ratio of the small intestinal microvillus membrane in fetal, weanling, and adult rats. We also investigated the effect of glucocorticoid administration on these lipids and the ontogeny of 1,2‐diglycerol‐CDP choline phosphocholine transferase (PCT). Cholesterol and phospholipid concentrations decreased with maturation, phospholipids declining more than cholesterol. Thus, the cholesterol‐to‐phospholipid molar ratio rose with maturation. A similar decline was seen with PCT activity. Glucocorticoid treatment had no effect on cholesterol, phospholipids, or PCT. However, the maturational increase in the cholesterol‐to‐phospholipid molar ratio was blunted by glucocorticoid administration in the weanling and adult rats.
Serotonergic Mediation of Vomiting
Authors: Gale Jem D. 
Published: February 2024

Summary:In the latter part of the 20th century, significant advances have been made in the understanding of the emetic reflex. As a result, there have been major improvements in the treatment of vomiting, particularly that associated with chemo‐ and radiotherapeutic treatments for neoplastic disease. The 5‐HT3 receptor antagonists (ondansetron and granisetron) have been demonstrated to be of benefit in treating the profound emesis observed during cancer treatment. This observation, together with results from pharmacologic and physiologic investigations in both animals and humans, have identified 5‐hydroxytryptamine (5‐HT or serotonin) to be of fundamental importance in the pathogenesis of emesis. 5‐HT appears to be released by radiation and chemotherapeutic agents from enterochromaffin cells within the wall of the intestine, and possibly from neurons within the brainstem. Stimulation of 5‐HT3 receptors, located centrally in the dorsal medulla of the brainstem and peripherally on vagal afferent terminals in the gastrointestinal tract, appears to play a pivotal role in eliciting emesis. The interaction of 5‐HT with non‐5‐HT3 receptors, particularly 5‐HT1A and 5‐HT4 receptors, may be important in the emetic reflex. The development of agents that interact with these receptors may offer alternative approaches to the treatment of nausea and vomiting.
Management of Cyclic Vomiting Syndrome
Authors: Fleisher David R. 
Published: February 2024

Summary:The general goals of treatment of cyclic vomiting syndrome (CVS) are: interruption of established episodes, amelioration of symptoms in patients whose episodes cannot be interrupted, aborting episodes during prodromal symptoms, prophylaxis to abolish or lessen the frequency of episodes, and recovery. Complications of cyclic vomiting episodes include esophagitis, hematemesis, depletion of intracellular electrolytes, hypertension, and secretion of inappropriate antidiuretic hormone.