bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simultaneous pH Recordings from Multiple Esophageal Sites in Children with and without Distal Gastroesophageal Reflux
Authors: Sondheimer Judith M. , Haase Gerald M. 
Published: January 2024

SummaryWe made continuous, simultaneous recordings of esophageal pH from three sites in the esophageal body, for 18–24 h, in 11 children with normal prolonged distal esophageal pH studies (Group I) and in 14 children with abnormal distal esophageal pH recordings (Group II). A flexible catheter housing four antimony microelectrodes was used, and data were stored in a portable recorder. A computer allowed for evaluation of the percent of time esophageal pH was <4.0, number of reflux episodes per hour, acid clearance time, and the duration of longest reflux episode. Recordings made while subjects were upright or recumbent could be distinguished and analyzed separately. In the recumbent position, comparison of pH recordings from distal, middle, and proximal esophageal pH electrodes in Group I showed significant decreases in the percent of time spent with pH <4.0, reflux episodes per hour, acid clearance time, and duration of longest reflux episode in the proximal esophageal sites, with a near negligible total acid exposure in the most proximal electrode. In Group II subjects, however, comparison of recumbent recordings from distal, middle, and proximal esophagus indicates that the proximal esophagus is highly exposed to acid reflux and that the decrease in acid exposure from distal to proximal esophagus in reflux patients is not proportionally as great as that of Group I. The data suggest that in the recumbent position, the ability of the subjects with abnormal reflux scores to protect the upper esophagus is less than that of subjects with normal amounts of distal esophageal acid exposure.
The Endorectal Pull‐Through Procedure in Children and Young Adults
Authors: Perrault Jean , Telander Robert L. , Zinsmeister Alan R. , Kaufman Bruce 
Published: January 2024

SummaryAt our institution, proctocolectomy with rectal mucosectomy and ileoanal anastomosis with endorectal pull‐through is now the procedure of choice for young patients with chronic ulcerative colitis and familial polyposis. We have followed up 66 patients (37 male and 29 female, with a median age of 16 years) for at least 6 months after closure of the temporary ileostomy. The patients were seen regularly in follow‐up or were sent a comprehensive questionnaire to assess their condition. Twenty‐two patients had the construction of a J‐pouch. and 44 had a straight ileo‐anal pull‐through. Stool frequency, day (median 4 to 7 stools) and night (median 1 to 3 stools), was similar in the two groups. Voluntary continence was excellent in both groups during waking hours. Occasional night‐time incontinence in small volumes, mild perianal itching, and minimal bleeding from irritation were similar in both groups. Most of the patients could distinguish gas from stool. When medication was used, bulk agents were usually chosen, with a nonspecific anti‐diarrheal agent taken occasionally. A few patients with the straight ileo‐anal pull‐through expressed some dissatisfaction early during the follow‐up period: however, all but two patients expressed satisfaction later. Of the 66 patients, 41 had at least one complication during the postoperative period; however, in 26 the complications were minor. The more severe complications included small bowel obstruction (11 patients requiring surgical decompression), infection (one patient requiring surgery), and transient neuropathy (three patients).
Food Proteins and Maturation of Small Intestinal Microvillus Membranes (MVM). I. Binding Characteristics of Cow's Milk Proteins and Concanavalin A to MVM from Newborn and Adult Rats
Authors: Stern Martin , Gellermann Barbara 
Published: January 2024

SummaryTo study maturational changes of food protein and lectin binding to rat small intestinal microvillus membranes (MVM), MVM were prepared from newborn and adult animals by a modified CaCl2 precipitation technique. Radiolabeled cow's milk proteins [α‐lactalbumin, α‐casein, β‐lactoglobulin, bovine serum albumin (BSA)] and the lectin concanavalin A (Con A) were used for incubations. Binding assays were done using miniature ultracentrifugation for separation of unbound material. Binding of Con A to MVM from newborn and adult rats was strong, specific, and saturable. Binding of Con A was inhibited by cold Con A and by the sugar ligand polymer mannan. Adult MVM bound more Con A than newborn preparations. Unlike Con A, binding of cow's milk proteins by MVM was weak, nonspecific, and noninhibitable. Newborn MVM bound more cow's milk proteins than adult controls. This was true for all the proteins tested (p < 0.001). Binding rose with decreased molecular weight of cow's milk proteins, but molecular weight was not the only determining factor for binding. Trypsin treatment of MVM caused a marked increase of BSA binding in adult but not in newborn preparations. This finding indicated the importance of protein components of MVM for cow's milk protein binding. Maturational changes in protein‐lipid interactions and membrane fluidity possibly influence nonspecific cow's milk protein binding to MVM. Differences in binding between newborns and adults were not directly related to maturational shifts in membrane glycosylation that are indicated by differential Con A binding. Increased cow's milk protein binding in newborn individuals might increase the potential risk to develop an adverse reaction to food proteins.
Case Report
Authors: Adam G. , Brereton R. J. , Agrawal Meena , Lake B. D. 
Published: January 2024

SummaryA boy, and 10 months later his sister, presented in the neonatal period with meconium ileus. Both became jaundiced and were found to have biliary atresia and Niemann‐Pick disease, type C. The causes of the meconium ileus were not established. Both died before the age of 6 weeks.
Anaphylactic Shock Due to Cow's Milk Protein Hypersensitivity in a Breast‐Fed Infant
Authors: Lifschitz Carlos H. , Hawkins Hal K. , Guerra Celine , Byrd Nancy 
Published: January 2024

SummaryA newborn infant developed anaphylactic shock three times, once after ingesting his mother's milk and once after ingesting a formula containing casein hydrolysate. Symptoms resolved after cow's milk was withdrawn from the mother's diet and lactation was resumed. The case demonstrates that anaphylactic shock may occur in breast‐fed infants and emphasizes the need to consider allergic phenomena even in these infants.
Gastric Emptying in Infants
Authors: Hyman Paul E. , Abrams Candy E. , Dubois Andre 
Published: January 2024

SummaryIn a double‐blind, placebo‐controlled, randomized study we measured the effect of 1 mg/kg intravenous metoclopramide on the gastric emptying of a 15 ml/kg 5% glucose meal, using a phenol red dye dilution technique. In a group of nine infants referred for multiple daily episodes of regurgitation, metoclopramide doubled the rate of gastric emptying (p < 0.02). In six infants with prolonged gastroparesis following abdominal surgery, metoclopramide more than doubled the rate of gastric emptying (p < 0.05). In contrast, in seven infants with gastroparesis related to prematurity, metoclopramide did not significantly change gastric emptying. No extrapyramidal side effects of metoclopramide occurred during the study.
Effect of Feeding Volume on Early Postcibal Gastroesophageal Reflux in Infants
Authors: Sutphen James L. , Dillard Vivian L. 
Published: January 2024

SummaryUsing esophageal pH monitoring, we have investigated the effect of feeding volume on early (1 h) postcibal gastroesophageal reflux (GER) in a population of 50 infants referred for evaluation. Two feedings with the volume of both feedings specified (9 and 18 ml/kg) were given to one group of infants. A second group was given one feeding ad libitum and another specified at 9 ml/kg. Volume of intake was a very significant determinant of both the total duration and the maximum single continuous episode of GER during early postcibal esophageal pH monitoring in both groups by paired analyses. This effect was observed in infants with significant GER (n = 44) and in a subgroup of infants who were normal (n = 6).
Absorption of Medium Chain Triglycerides in the Stomach of the Human Infant
Authors: Faber J. , Goldstein R. , Blondheim O. , Stankiewicz H. , Darwashi A. , Bar‐Maor J. A. , Gorenstein A. , Eidelman A. I. , Freier S. 
Published: January 2024

SummaryFollowing previous observations that medium chain triglycerides (MCT) are absorbed from the stomach of suckling rats, this study was devoted to studying absorption of MCTs in human infants. Four groups of patients were studied: (a) infants suffering from pyloric stenosis, (b) premature infants, (c) children suffering from cystic fibrosis, (d) infants with miscellaneous conditions. Infant formulae with known amounts of MCT were introduced by gastric tube and samples were removed at 0, 20, 40, and 60 min. In patients with pyloric stenosis there was an 18.1% decrease in MCT during the first 20 min. No significant changes in MCT took place during the subsequent 40 min. A similar response was observed in the group of premature infants. Older infants with miscellaneous diagnoses and children with cystic fibrosis showed an even rate of disappearance of MCT during the 60‐min test period, and ∼30% of the original MCTs present disappeared during this period. We conclude that MCTs are absorbed in the stomach of infants and children. Absorption appears to improve with age. Because MCT are an important constituent of formulae for premature infants and children with defects of small intestinal digestion and absorption of fat, these observations have practical implications.
Comparison of a Lactose‐Free Cereal‐Based Formula and Cow's Milk in Infants and Children with Acute Gastroenteritis
Authors: Bhan M. K. , Arora N. K. , Khoshoo V. , Raj P. , Bhatnager S. , Sazawal S. , Sharma K. 
Published: January 2024

SummarySixty children < 2 years of age suffering from mild acute gastroenteritis with < 5% dehydration were randomly assigned to two different isocaloric feeding regimens, viz., a locally prepared milk‐free formulation (group A) of rice, lentil, sugar, and coconut oil and a spray dried commercial cow's milk formula (group B). There were two treatment failures in group A and one in group B. The postintervention duration of diarrhea (days) in group A (11.0 ± 10.0) was higher than in group B (7.6 ± 10.8), but these differences were not significant (p > 0.05). The energy intake (kcal/kg/24 h) on postintervention day 4 was 78.7 ± 31.7 in group A and 101.3 ± 41.1 in group B (p > 0.05). The corresponding values for day 7 were 74.2 ± 29.1 and 110.0 ± 41.1, respectively (p < 0.05). The mean weight gain (g/kg/24 h) between admission and the day of recovery in group A (2.0 ± 4.2) was significantly lower (p < 0.05) than in group B (5.8 ± 7.8). Similar trends in weight gain were observed at days 4 and 7. These findings suggest that a cow's milk‐based formula is well tolerated by majority of the infants with mild acute gastroenteritis after initial rehydration with ORS. The infants who were fed the milk‐free cereal‐based diet showed significantly less energy intake and gained weight less rapidly than those who were fed the cow's milk‐based formula.
Characterization of Binding of Simian Rotavirus SA‐11 to Cultured Epithelial Cells
Authors: Keljo David J. , Smith Angela K. 
Published: January 2024

SummaryRotavirus causes enteritis in both man and animals. The identity of the rotavirus receptor is not known. The nature of the binding interaction and the relationship between virus binding and internalization have not previously been reported. We studied the binding of [5,6‐3H]uridine‐labeled rotavirus SA11 to confluent monolayers of MA104 cells. We found approximately 13,000 receptor units per cell. The binding was sodium‐dependent, pH‐insensitive between 5.5 and 8, independent of added calcium, and dependent on sialic acid residues in the membrane. It could be inhibited by mucin. These features may provide clues to the identity of the receptor. Virus was not internalized to significant extent at 4°C. After warming to 37°C, virus was internalized over about 60 min. All binding sites appeared to be equally internalizable. The techniques developed to distinguish between binding and internalization may help to elucidate the mechanism of internalization.
An Unusual Presentation of Pancreatic Carcinoma in Childhood
Authors: Weisselberg B. , Yahav J. , Ben‐Ami T. , Engelberg S. , Morag B. , Sack J. 
Published: January 2024

SummaryCarcinoma of the pancreas is rare in the pediatric population, with only 58 cases described in subjects under 16 years of age (1–3). The clinical presentation generally consists of abdominal pain and mass. We present a case of carcinoma of the pancreas in an 11‐year‐old girl, with abdominal pain and unusual behavior.
Familial Extrahepatic Biliary Atresia
Authors: Lachaux A. , Descos B. , Plauchu H. , Wright C. , Louis D. , Raveau J. , Hermier M. 
Published: January 2024

SummaryOnly a small number of cases with familial extrahepatic biliary atresia, suggesting a recessive autosomal inheritance, have been reported. However, the cases reported in twins are consistent with an acquired disease. Here the case of two brothers with familial atresia of the extrahepatic biliary system is studied. Diagnosis was confirmed by laparotomy and histologic study of biliary fibrous remnants. In the present cases parental consanguinity might suggest a recessive autosomal inheritance. However, clustering of cases in a family might also suggest a common exposure to responsible factors not so far identified.
Familial Achalasia with Absent Tear Production
Authors: Nussinson E. , Hager H. , Samara M. , Bar‐Nathan N. , Siplovich L. 
Published: January 2024

SummaryThree of five siblings were evaluated because of dysphagia and failure to thrive. Radiologic and manometric studies were consistent with achalasia of the cardia. All of these siblings had deficient tear production. This report documents the unusual association of familial achalasia and deficient tear production, which is probably an autosomal recessive inherited syndrome.
Gastroduodenal Endoscopic‐Histologic Correlation in Pediatric Patients
Authors: Black Dennis D. , Haggitt Rodger C. , Whitington Peter F. 
Published: January 2024

SummaryThe histopathologic abnormalities in endoscopic biopsies from the stomach and duodenal bulb were correlated with the visual findings of upper gastrointestinal endoscopy in 94 children (mean age, 8.4 years; 51 boys and 43 girls) with a variety of complaints. Histology was graded by observers blinded to the endoscopic findings, and both endoscopy and histology were graded using scales reflecting increasing severity with increasing grade. In all three locations studied (gastric body, antrum, and duodenal bulb), endoscopic grade was significantly higher than the histologic grade. Correlation was especially poor with mild endoscopic findings such as erythema and granularity/nodularity, which had little predictive value for histologic inflammation. Few patients had severe disease with eight of 94 having ulcer by endoscopy and seven of 94 having greater than grade 2 histologic disease in any location. We conclude that endoscopy without biopsy should not be used to diagnose gastroduodenal inflammation in pediatric patients.
Heterogeneity of Pepsinogens in the Urine of Children
Authors: Nevoral J. , Tomáŝová H. , Ŝrajer J. 
Published: January 2024

SummaryThe existence of a significant linear relationship between the concentration of chlorides and the activity of pepsinogen (PG) in the urine was ascertained in the case of full‐term infants 3 days to 6 weeks of age. At the age of 4–6 weeks, a significant relationship was found between the urinary pepsinogen activity and the urinary creatinine concentration, and between the urinary pepsinogen activity in the urine and the urine osmolality. Immediately after birth, the Pg7 fraction of PG II in the urine was found in all cases and, at the age of 4–6 weeks, in 11% of cases. In regard to the time factor, the conspicuous drop in the occurrence of the Pg7 fraction corresponds to the new qualitative relationship between the pepsinogen activity in the urine and the creatinine concentration in the urine and between the former and the urine osmolality. In premature infants, the Pg7 fraction disappears more slowly. The spectrum of pepsinogens in the urine was examined in children suffering from various diseases. In a girl with lymphoma, we found the Pg7 fraction, but this finding was temporary only.
Reaction of Rectal Mucosa of Celiac Patients to Direct Contact with Gluten
Authors: de Sousa J. Salazar , Ramalho P. Magalhães , Scares Jorge , Rodrigues Carlos , Costa M. Virgínia , da Silva Aires 
Published: January 2024

SummaryIt is assumed that the eolonic mucosa of celiac patients is not sensitive to gluten. This assumption has been supported by the absence of clinical manifestations of colonic involvement in patients with active celiac disease which, by itself, does not confirm insensitivity to gluten. Eight children, aged from 11 to 25 months, with an initial diagnosis of celiac disease were studied: in five children a definite diagnosis has already been confirmed. Rectal gluten challenge was done by means of retention enemas. A volume of 100 ml of a 10% gluten suspension in water was introduced into the rectum three times per day for 8 days: each enema was retained at least 1 h. Rectosigmoidoscopies and rectal biopsies were done before and at the end of the challenge period. The endoscopic appearance of rectal mucosa was normal in all the children either before or after gluten challenge. The means of total mucosal thickness, intraepithelial lymphocyte counts, mitotic crypt cell activity, and cellular infiltration of lamina propria increased after challenge; the mean of goblet cell/epithelial cell ratio in the surface epithelium decreased. The differences between each pair of means (before and after challenge), however, were not significant except for total mucosal thickness (p < 0.05). the meaning of which is unclear. This study did not definitely demonstrate that the rectal mucosa of celiacs is insensitive to gluten. For practical clinical purposes, however, it behaves as such. This makes the rectal mucosa a useless tool for the final diagnosis of celiac disease.
Crohn's Disease of the Esophagus
Authors: Treem William R. , Ragsdale Bruce D. 
Published: January 2024

SummaryEsophageul involvement wilh C'rohn's disease has been rarely reported and pathologic documentation of granulomutous disease is often missing. A 12‐year‐old hoy who presented initially with dysphagia, odynophagia, and weight loss was found to have granulomatous esophagitis, gastritis, and subsequent colitis by endoscopic examination. Esophageal manometry showed a hypertensive lower esophageal sphincter with normal peristalsis and sphincter relaxation. The esophageal symptoms responded to oral steroids and sulfasalazine without any specific treatment for acid peptic disease. This case is the youngest reported patient with Crohn's disease of the esophagus. A review of the medical literature illustrates salient clinical, radiographic, endoscopic, and pathologic features of esophageal involvement in Crohn's disease. This case and the summarized cases emphasize the potential significance of esophageal symptoms in patients with Crohn's disease.
Evaluation of a New Catheter for Total Parenteral Nutrition
Authors: Superina Riccardo A. , Wesson David E. , Bahoric Andre , Filler Robert M. 
Published: January 2024

SummaryCentral venous catheters play an important role in the management of children with a variety of disorders. Desirable characteristics of such catheters include case and reliability of placement, secure fixation, low rates of complication, and ease of removal. We describe our experience with a new form of catheter that displays all of these characteristics. One hundred twenty‐nine catheters were inserted in III paients over a 2‐year period for a total of 5.729 treatment days. This catheter is made of silicone rubber and is positioned by using P‐wave changes seen during intraoperative electrocardiography. x‐Ray confirmation is not routinely necessary. The catheter is fixed in position by use of a grommet, which is sutured in the neck at the site of the venotomy. This form of fixation allows the catheter to be casily in position for the duratio of use. Our experience with this catheter has been associated with a low incidence of septic (1.1–4.2 septic episodes per 1.000 patient days) and mechanical (2.3 episodes per 1,000 patient days) complications in a setting that includes both in‐hospital and home total parenteral nutrition patients. It is felt that this new form of eatheter and catheter fixation offers several advantages over other types of central venous catheters currently in use.
Tracheal Obstruction Secondary to Esophageal Achalasia
Authors: Akhter Javeed , Newcomb Richard W. 
Published: January 2024

SummaryA 12‐year‐old girl presented with cough, emesis, and weight loss of 18‐month duration. She was diagnosed as having achalasia of the esophagogastric junction. Flow‐volume loops done because of the cough revealed a configuration consistent with variable intrathoracic tracheal obstruction. A barium swallow revealed the cause of obstruction to be massive dilatation of the esophagus. Balloon dilatation of the esophageal sphincter resolved all symptoms and normalized the flowvolume loops. This case illustrates that some pulmonary symptoms in achalasia can be due to direct tracheal obstruction in addition to the usual aspiration of esophageal contents.
Development of Glutaminase Along the Villus–Crypt Axis in the Jejunum of Rat
Authors: Nagy Laura E. , Pittler Arlyn , Kretchmer Norman 
Published: January 2024

SummaryThe activity of glutaminase (E.C. 3.5,1.2), the entry enzyme for oxidation of glutamine, was measured in enterocytes isolated along the villus‐crypt axis from rat jejunum. Specific activity of glutaminase was 5.05 ± 0.24 μmol glutamate/mg protein/h in villus cells (fully differentiated cells) and 4.16 ± 0.30 in the deep crypt (undifferentiated cells). Activity of glutaminase was significantly (p < 0.05) increased in cells isolated from the villus–crypt junction (differentiating cells) compared to the activity of the enzyme in both the villus and crypt at 6.21 ± 0.45. A similar pattern of activity of glutaminase was observed when the cells of the villus–crypt gradient were separated by sequential horizontal sectioning with a cryostat. Oxidation of L‐[U‐14C]glutamine to 14CO2 was also significantly (p < 0.01) higher in cells isolated from the villus–crypt junction compared to both villus or deep crypt cells. The quantity of glutaminase protein was determined by a dot immunobinding assay using an antibody to purified glutaminase. Immunoreactive glutaminase protein relative to total cellular protein was 6.06 ± 0.40 cpm/μg homogenate protein in the villus cells, 3.01 ± 0.24 (p < 0.05) at the villus–crypt junction, and 4.49 ± 0.57 (p < 0.05) in the deep crypt. Thus, the highest activity of glutaminase present in the villus–crypt junction is the result of an increase in activity of the enzyme rather than an increase in the enzyme protein.