bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemorrhagic Colitis and Pseudomelanosis Coli in Ipecac Ingestion by Proxy
Authors: Johnson Joseph E. , Carpenter Becky L. M. , Benton Jane , Cross Robert , Eaton Lisle A. , Rhoads J. Marc 
Published: January 2024

SummaryThis report describes a toddler with chronic diarrhea, vomiting, and hypotonia due to surreptitious administration of syrup of ipecac by his mother (Munchausen's syndrome by proxy). Several features of this case distinguish it from previous reports of chronic ipecac ingestion in childhood: the development of grossly bloody stools; radiologic, endoscopic, and biopsy evidence of a chronic moderate colitis resembling ulcerative colitis; and the histologic finding of pseudomelanosis coli, providing an important clue to toxic ingestion. The significance and possible mechanism for genesis of pseudomelanosis coli is discussed. This case emphasizes the variability in presentation and difficulty in diagnosing long‐term ipecac ingestion by proxy. Ipecac toxicity should be considered in children with unexplained colitis and vomiting.
Effect of Dietary Fiber and Starch on Fecal Composition in Preschool Children Consuming Maize, Amaranth, or Cassava Flours
Authors: Hamaker Bruce R. , Rivera Kervan , Morales Enrique , Graham George G. 
Published: January 2024

SummaryMetabolic balance studies were carried out in young children fed diets based on maize, amaranth, or cassava flours and in corresponding casein controls. Dietary fiber intakes were 22.2, 20.5, and 9.0 g/day for the maize, amaranth, and cassava groups, respectively. Fecal energy losses at least doubled in all test diets when compared with the corresponding controls and could generally be accounted for by recovered fiber in the feces. Fecal starch was also a significant contributor to fecal energy in the cassava group. All cassava fiber was recovered in the feces, whereas only 48.4 and 16.3% were recovered from ingested maize and amaranth. 2,6‐Diaminopimelic acid (DAPA), an indicator of bacterial mass, was highest in the cassava group. Expired breath hydrogen was highest for those consuming maize or cassava. Resistant starch may have been responsible for the high DAPA and breath hydrogen values in the cassava group.
Fatal Liver Failure in Two Children with Niemann‐Pick Disease Type B
Authors: Labrune P. , Bedossa P. , Huguet P. , Roset F. , Vanier M. T. , Odievre M. 
Published: January 2024

SummaryWe report on two young patients with Niemann‐Pick disease type B presenting with severe hepatic disease. Both children developed cirrhosis and died of intrahepatic block and mechanical hemolysis. Autopsy findings revealed complete obstruction of the sinusoids by lipid‐laden Kupffer's cells. These two cases illustrate a new hepatic lesion of Niemann‐Pick disease.
Erosion Through the Posterior Gastric Wall by a Pancreatic Pseudocyst Secondary to Gastric Duplication
Authors: Chawla Anupama , Gadaleta Dominick , Kenigsberg Kenneth , Kahn Ellen , Markowitz James 
Published: January 2024

SummaryGastric duplications are the rarest form of enteric duplication. They account for about 20% of all gastrointestinal duplications. Delayed and missed diagnosis leads to prolonged morbidity and mortality. We report a case of a child with a gastric duplication cyst in the body of the pancreas, associated with a pancreatic pseudocyst that ultimately eroded into the posterior wall of the stomach.
Metabolites of Lactose Synthesis in Milk from Women During Established Lactation
Authors: Arthur Peter G. , Kent Jacqueline C. , Hartmann Peter E. 
Published: January 2024

Summary: Metabolites in the lactose synthesis pathway were measured in human milk during established lactation. The mean concentrations (range) were: lactose, 198 m M (175–233); glucose, 1.5 m M (0.1–2.4); glucose 6‐phosphate, 11 μ M (4–23); glucose 1‐phosphate, 2.7 μ M (1.6–6.8); UDP‐glucose, 2.7 μ M (0.6–6.0); UDP‐galactose, 0.7 μ M (<0.1–2.5); inorganic phosphate, 2.2 m M (0.8–2.9). During storage of milk within the breast for 2 h, glucose 6‐phosphate concentration increased by 1.4 ± 0.5 μ M, while UDP‐glucose decreased by 1.0 ± 0.4 μ M. None of the other metabolites showed significantchanges in concentration during this period. Only glucose showed a circadian rhythm in concentration, with the highest concentrations between 1400 and 1800 h. The volumes of milk produced by the mothers ranged from 178 to 1,739 ml/24 h. Despite this variation, there were no significant relationships between the 24‐h average concentrations of glucose, glucose 6‐phosphate, glucose 1‐phosphate, UDP‐glucose, UDP‐galactose, or inorganic phosphate and the amount of lactose produced over 24 h.
Crying Does Not Exacerbate Gastroesophageal Reflux in Infants
Authors: Orenstein Susan R. 
Published: January 2024

SummaryThe behavior and intraluminal esophageal pH of 48 infants (5–26 weeks old) were continuously recorded during the 120‐min period following their ingestion of a standard volume of apple juice (pH ∼ 4). To evaluate the effect of three basic behavior states on the frequency of infant gastroesophageal reflux, the data from all 19 of these infants who spent time in all three behavior states during the 120‐min study were analyzed for this study. Results were expressed as the frequency of gastroesophageal reflux episodes per hour of time spent crying, per hour of time awake without crying, and per hour of time asleep. Reflux frequency while crying was compared to reflux frequency while awake without crying; reflux frequency awake (both crying and not crying combined) was compared to reflux frequency asleep. The results indicate that, as has been shown previously, sleeping decreases reflux frequency [nine (1–48) episodes per hour awake vs. two (0–134) episodes per hour asleep, expressed as median (range), p = 0.025], but that, contrary to expectation, crying appears to decrease rather than increase both reflux frequency [11 (0–84) episodes per hour crying vs. 17 (0–213) episodes per hour awake without crying, p = 0.035] and total duration [21% (0–79) of crying time with pH < 4 vs. 41% (0–93) of noncrying awake time with pH < 4, p = 0.025], Crying does not exacerbate reflux in infants with gastroesophageal reflux disease.
Short‐Term Polycose Substitution for Lactose Reduces Calcium Absorption in Healthy Term Babies
Authors: Moya M. , Cortes E. , Ballester M. I. , Vento M. , Juste M. 
Published: January 2024

SummaryA vitamin D‐independent paracellular and not saturable mechanism important for intestinal calcium absorption turned out to be less effective in lactose‐free diets. Twelve normal term babies with identical repletion levels of 25‐hydroxyvitamin D (25D) were fed sequentially with starting formulas that differed only in their carbohydrate sources: lactose (control) and polycose. A 3‐day test was performed after a 1‐week adjustment to the new diet. Fecal excretion of calcium was significantly higher in the lactose‐free formula period compared to the control one: 56.6 (13.9) versus 39.6 (12.8) mg/kg/day (p < 0.02); subsequently, the net retention was considerably higher and statistically significant (p < 0.01) for the control period versus the lactose‐free formula period: 99.4 (15.3) versus 78.1 (14.3). Plasma 25D values were 21.8 (9.1) and 23.7 (7.1) ng/ml at the beginning of the lactose and polycose periods, respectively, and 1,25‐dihydroxy‐vitamin‐D values were 64 (62) and 75 (45) pg/ml, not significant. Results suggest that formulas containing polycose as the sole carbohydrate source may reduce the intestinal absorption of calcium in term newborns, but determining long‐term biological significance requires further observation.
OKT3 Treatment of Steroid‐Resistant Rejection in Pediatric Liver Transplant Recipients
Authors: McDiarmid Sue V. , Busuttil Ronald W. , Terasaki Paul , Vargas Jorge H. , Ament Marvin E. 
Published: January 2024

SummaryOf a total of 187 consecutive liver grafts in 149 pediatric recipients, 59 episodes of steroid‐resistant, biopsy‐proven rejection (32% of grafts) were treated with OKT3 monoclonal antibody. After 59 OKT3‐treated episodes, liver function at the end of treatment was normal in 40%, improved in 35%, and unchanged in 24%. Of 21 partial responses, 12 episodes eventually resolved to yield an overall complete response rate of 59%. CD3‐positive T‐cells >5% occurred during 61% of OKT3‐treated rejection episodes and was associated with impaired efficacy of OKT3 (30% complete response rate). Six grafts were re‐treated with OKT3 for rejection and in all CD3‐positive T‐cells could not be maintained <5%. Of the six grafts requiring repeat OKT3, five failed‐re‐treatment and required retransplantation. OKT3 antibodies of low titer were found prior to a second use of OKT3 in 65% of episodes. Patients treated with OKT3 after failing more than two preceding steroid courses had a significantly increased chance of graft loss (57%; p = 0.01). We conclude that this group of pediatric patients appeared less responsive to OKT3 compared to other series combining pediatric and adult recipients, possibly due to a more vigorous immune response in the child.
Effect of Oral Insulin on Lactase Activity, mRNA, and Posttranscriptional Processing in the Newborn Pig
Authors: Shulman Robert J. , Tivey David R. , Sunitha Iruvanti , Dudley Mary A. , Henning Susan J. 
Published: January 2024

SummaryInsulin, found in human and pig colostrum and mature milk, appears to influence small intestinal growth and development. Ileal lactase activity is increased when porcine insulin is added to feedings administered to newborn piglets. We studied 2‐day‐old miniature piglets to determine whether the increase in lactase activity is accompanied by changes in enterocyte expression of lactase activity, steady‐state levels of lactase mRNA, and/or posttranscriptional changes in lactase processing. We randomized the piglets to receive bottle feedings of a swine‐weaning milk formula with (group F + I) or without (group F) the addition of 85 mU/ml of regular porcine insulin. The piglets were fed for 6 days (to 8 days of age), after which they were killed and the small intestine removed for analysis. Despite large differences between groups in enterocyte expression of lactase activity in the ileum, no differences were noted in the level of ileal lactase mRNA. The relative proportions of the 207, 210, and 230 kDa precursors of the 160 kDa mature lactase protein were similar between groups. These data indicate that the insulin‐induced increased expression of ileal lactase activity is not regulated at the level of its mRNA or at the level of processing of the polypeptide.
Levels and Molecular Forms of Immunoreactive Trypsin and Chymotrypsin in Amniotic Fluids from Normal and Cystic Fibrosis Fetus
Authors: Carrère J. , Muller F. , Boué A. , Guy‐Crotte O. , Figarella C. 
Published: January 2024

SummaryWe previously suggested that an activation defect of pancreatic proteolytic zymogens in newborns suffering from cystic fibrosis (CF) might contribute (by an adaptative‐like process) to the significant increase of the serum trypsin level observed in the disease at birth. To give support to this hypothesis we studied two pancreatic enzymes: trypsin 1 (IRT) and chymotrypsin A (IRChT) by noncompetitive enzyme immunoassays in amniotic fluids taken at 17–18 weeks of pregnancy. In normal fluids (102), the levels of the two enzymes were widely dispersed between 5 and 100 μ,g/L. A similar pattern was observed for the fluids with a 1 in 4 risk of CF with a normal outcome (24). In contrast, the levels of pancreatic enzymes in the fluids with affected fetus (40) were always below 45 μg/L for IRT and 55 μg/L for IRChT and most of them were under 20 μg/L for both enzymes. The molecular forms of IRT and IRChT in amniotic fluids were studied by gel filtration. In amniotic fluids with affected fetus, a major form of IRT was eluted in a position consistent with the elution of proteins around 25 kDa and two peaks of IRChT were eluted at 75 kDa and 25 kDa. These patterns are similar to those observed in normal serum when zymogens are present and are quite different from the patterns obtained by gel filtration of amniotic fluids with normal outcome. In normal fluids, the major form of IRT was eluted with a protein of higher molecular weight (–76,000) consistent with a complex of trypsin with α1‐proteinase inhibitor and an additional peak of IRChT (–14 kDa) was present, possibly corresponding to a degraded form of chymotrypsin. These data shows the absence of active pancreatic proteases in the intestinal fluid of CF affected fetus in opposite to their presence in normal fetus. This absence could lead to an increased synthesis of proteolytic enzymes at birth.
Solubility and Digestibility of Milk Proteins in Infant Formulas Exposed to Different Heat Treatments
Authors: Rudloff Silvia , Lönnerdal Bo 
Published: January 2024

SummaryThere are presently several fundamentally different technologies to produce infant formulas (IF), such as sterilization, spray‐drying, and treatment at ultrahigh temperature (UHT). The effects of heat treatment on milk proteins in IF were analyzed by column chromatography, gel electrophoresis, and Kjeldahl analysis, revealing strong protein‐protein and protein‐lipid interactions in processed milk. These interactions were more pronounced in conventionally (in‐can) sterilized than in spray‐dried (powdered) and UHT products confirming their temperature dependency. Analysis of raw materials, intermediate and end products of IF processing revealed that after homogenization the first indications of protein denaturation occurred, but that in‐can sterilization as the final heat treatment caused irreversible denaturation of proteins and strong protein‐lipid interactions. Lowering of the pH to 4–5, which is physiological for the stomach of young infants, enhanced the interactions. Support for an impairment of protein digestibility was given by in vitro analysis of protein digestibility, demonstrating significantly lower digestibility of in‐can sterilized IF compared to their spray‐dried and UHT counterparts. To investigate the effect of heat treatment on chemical reactions, i.e., occurrence of Maillard products, we showed by a fluorimetric assay that the amount of “available” lysine is lower in sterilized than in powdered IF. Our findings suggest that a more differentiated view regarding the protein quality of IF is needed.
Congenital Sodium Diarrhea with a Partial Defect in Jejunal Brush Border Membrane Sodium Transport, Normal Rectal Transport, and Resolving Diarrhea
Authors: Fell J. M. , Miller M. P. , Finkel Y. , Booth I. W. 
Published: January 2024

SummaryDefective jejunal sodium/proton exchange causes severe, congenital secretory diarrhea. We report a boy who presented typically in utero, but in whom diarrhea resolved during the first year of life. Pregnancy was complicated by polyhydramnios, and an ultrasound at 31 weeks showed a distended fetal small intestine. The abdomen was grossly distended at birth, and profuse secretory diarrhea began immediately. He subsequently thrived on breast milk and electrolyte supplements. Studies of jejunal brush border sodium/proton exchange at 6 months showed a partial defect. Nonequilibrium rectal dialysis showed rectal sodium and potassium transport to be intact. Diarrhea lessened after 9 months, and the patient subsequently required occasional laxatives. These observations suggest that there is a spectrum of congenital abnormality in this exchanger, and that in children with incomplete defects normal colonic sodium salvage can subsequently mask net small intestinal secretion.
Eicosanoids in Hypoxic Insult to Neonatal Rabbit Bowel
Authors: Dollberg Shaul , Udassin Raphael , Ginat‐Israeli Talia , Weidenfeld Josef , Branski David 
Published: January 2024

SummaryEicosanoids, derivatives of arachidonic acid, play a role in several inflammatory diseases of the bowel. To determine whether prostaglandin E2 (PGE2), leukotriene B4 (LTB4), and leukotriene C4D4E4 (LTC4D4E4), have a role in hypoxic insult to the intestine, we examined the levels of these mediators in a hypoxic neonatal rabbit model. One group of animals underwent hypoxic insult postnatally, the second group did not undergo hypoxia and served as a control. The levels of PGE2, LTB4, and LTC4D4E4 were determined by radioimmunoassay. PGE2 in the hypoxic group was 1,779± 142 pg/mg protein (mean± SD) as opposed to 2,380± 197 pg/mg protein in the control group (p < 0.02). LTB4 level was 5,446± 3,492 pg/mg protein in the hypoxic rabbits and 3,362± 2,570 pg/mg protein in the control group (p < 0.03). There was no statistically significant difference in the level of LTC4D4E4 between the two groups. Our study shows that hypoxia shifts the arachidonic acid metabolism toward enhanced lipoxygenase activity with a resultant increase in LTB4 levels and a concomitant decrease in cyclooxygenase activity with reduced PGE2 levels in the bowel. The shift in the balance between these eicosanoids may play a role in the pathogenesis of ischemic‐hypoxic bowel diseases by enhancing the inflammatory response in the intestine, and simultaneously, diminishing cytoprotection.
Inhibition of Adhesion of S‐Fimbriated Escherichia coli to Epithelial Cells by Meconium and Feces of Breast‐Fed and Formula‐Fed Newborns
Authors: Schroten H. , Lethen A. , Hanisch F. G. , Plogmann R. , Hacker J. , Nobis‐Bosch R. , Wahn V. 
Published: January 2024

SummaryWe investigated the ability of meconium, feces from human milk‐fed (HMF) newborns, and feces from formula‐fed (FF) newborns to inhibit adhesion of S‐fimbriated E. coli to human buccal epithelial cells. S‐fimbriae are a common property of E. coli strains causing sepsis and meningitis in neonates. Meconium had the highest content of neuraminic acid and the strongest inhibitory effect on bacterial adhesion. HMF also exerted high inhibitory activity while FF was markedly less active: To achieve inhibitory effects comparable to HMF a sixfold amount of FF was required. Glycoproteins from excretions were separated by gel chromatography. Fractions obtained were analyzed for adhesion‐inhibiting activity. In all excretions analyzed, the mucin‐containing fraction could be identified as the major inhibitory component. Inhibition was probably mediated by specific interaction of this fraction with S‐fimbriae, as shown by binding of isolated fimbriae on Western blots after electrophoretic separation of glycoproteins. In conclusion, our data support the view that the mucin‐containing fraction from meconium and human milk exerts antibacterial functions by preventing adhesin‐mediated binding of pathogenic bacteria to mucosal epithelia.
ELISA Method for Quantitative Measurement of IgA and IgG Specific Anti‐gliadin Antibodies
Authors: Perticarari S. , Not T. , Cauci S. , Luchesi A. , Presani G. 
Published: January 2024

SummaryIn this study we describe the application of an enzyme‐linked immunosorbent assay (ELISA) for the measurement of anti‐α‐gliadin antibodies (AGA) in absolute units (μmlg protein/ml). Enriched samples of IgA and IgG AGA were obtained by means of protein A chromatography after immunoaffinity purification of pooled sera from untreated celiac patients. No cross‐reactivity with other food antigens (β‐lactalbumin, soya proteins, ovalbumin) was detected. The quantitative evaluation of protein content in IgA and IgG AGA samples obtained by immunoaffinity chromatography, was performed by means of ELISA sandwich method using a reference curve obtained with pure standard human immunoglobulins. Scalar concentrations of purified IgA and IgG were then used to obtain a reference standard curve by means of an ELISA method. Such standard curve was utilized for titrating AGA in 214 sample sera. The minimal detectable concentration of IgA and IgG AGA was 0.02 μmlg/ml. The reproducibility of within‐ and between‐assay resulted very good for IgA‐AGA and acceptable for IgG‐AGA. The method here described seems to be satisfactory not only for quantitative diagnostic purposes in routine screenings but also in epidemiological studies. Moreover, it can constitute a suitable way to solve practical problems of quality control of AGA ELISA assay.
Rectal Histopathology in Endemic Shigella and Salmonella Diarrhea
Authors: Sachdev H. P. S. , Chadha V. , Malhotra V. , Verghese A. , Puri R. K. 
Published: January 2024

SummaryRectal histopathology was evaluated in 34 cases (2 months‐12 yrs old) of endemic “invasive diarrhea” [>20 WBCs per high‐power field on stool microscopy with (RBC positive) or without (RBC negative) associated RBCs] where S. dysenteriae (n = 9), S. flexneri (n = 11), and nontyphoidal Salmonella were isolated as the sole identifiable enteropathogens. Persistent diarrhea (>14 days duration) was more common with Salmonella infection whereas RBC‐positive “invasive diarrhea” was more frequent with Shigella, particularly S. dysenteriae (all cases) infection. The histopathological profile was comparable to the earlier descriptions of infective colitis to a large extent and the nature of the infecting organism could not be determined on the basis of rectal histology alone. The other noteworthy features were as follows: (i) mild crypt distortion (26%) and branching (21%) in both Shigella and Salmonella infection; in Salmonella infection, dilation of the glands was significantly greater with persistent diarrhea; (ii) presence of chronic inflammatory cells either alone or in combination with neutrophils in 62%; a predominant neutrophilic response was significantly higher with S. dysenteriae infection and an acute presentation; (iii) pseudomembrane formation (six subjects; 18%) especially in S. dysenteriae (four cases); and (iv) a significant association of neutrophilic response, edema, and neutrophils within the vessels in the lamina propria and mucin depletion in the glands with RBC‐positive “invasive diarrhea.”
Urinary Growth Hormone in Growth‐Impaired Children with Chronic Inflammatory Bowel Disease
Authors: Braegger C. P. , Torresani T. , Murch S. H. , Savage M. O. , Walker‐Smith J. A. , MacDonald T. T. 
Published: January 2024

SummaryGrowth impairment of undefined aetiology occurs in ˜30% of children with chronic inflammatory bowel disease. We measured urinary growth hormone concentrations in 36 children with chronic inflammatory bowel disease and 51 normal controls. The median urinary concentration of growth hormone in the stunted children with chronic inflammatory bowel disease was 15.8 ng/g creatinine (range 4.3‐32.6), compared with 11.7 ng/g creatinine (range 4.1‐35.9) in those with normal growth. The difference was statistically not significant (p = 0.15). Moreover, there was no significant difference between the patients and the control group. One stunted patient had a urinary growth hormone (UGH) concentration below the normal range, whereas four patients with normal height were also below the normal range. Four of these five patients (80%) were on corticosteroid treatment at the time of urinary collection, whereas only 26% of the patients with normal UGH were also on corticosteroid treatment. We conclude that growth retardation in children with chronic inflammatory bowel disease is probably not related to growth hormone deficiency but must involve other mechanisms.