bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum Lipoprotein Profile in Children With Celiac Disease
Authors: Rosenthal E. , Hoffman R. , Aviram M. , Benderly A. , Erde P. , Brook J. G. 
Published: January 2024

SummaryJejunal mucosa is responsible for the absorption of triglycerides and the production of lipoproteins [chylomicrons, very‐low‐density lipoprotein (VLDL), high‐density lipoprotein (HDL)] and apolipoproteins (B‐48, A‐I, A‐II, A‐IV, C‐II). Mucosal damage is known to cause fat malabsorption and probably also affects the serum lipid profile. To determine lipoprotein production in states of enterocyte dysfunction, we compared the serum lipid profiles in a group of 12 children with untreated celiac disease (flat jejunal mucosa) with the profiles in a control group of 10 children suffering from other intestinal diseases. Statistically significant differences were found in the following parameters (celiac versus control): plasma levels of triglycerides (70 versus 119 mg/dl), cholesterol content in LDL (107 versus 67.7 mg/dl), protein content in VLDL (6 versus 10 mg/dl), and level of apoprotein A‐I (112 versus 140 mg/dl). No significant differences were found between the two groups in the serum levels of total cholesterol, the cholesterol content in VLDL and HDL, the protein content in LDL and HDL, and the level of apoprotein B. Following institution of a gluten‐free diet, the lipoprotein profile reverted to normal. These data suggest that the changes in the serum lipoprotein profile in celiac disease are secondary to alterations in enterocyte function and not only a reflection of fat malabsorption.
Whey Protein Hydrolysate Formula for Infants with Gastrointestinal Intolerance to Cow Milk and Soy Protein in Infant Formulas
Authors: Merritt Russell J. , Carter Margaret , Haight Michael , Eisenberg Larry D. 
Published: January 2024

SummaryTwenty‐one infants less than 6 months of age with gastrointestinal symptoms of cow milk and/or soy protein‐based infant formula intolerance (diarrhea in 14, hematochezia in 16, emesis in 8, failure to thrive in 4, and colic in 10) were treated clinically with a whey protein hydrolysate formula. Six patients improved when placed directly on the formula, and 15 remained asymptomatic or improved when given the whey hydrolysate formula following initial treatment with a casein hydrolysate or elemental formula. Eighteen had supporting evidence of an allergic basis for their symptoms, including a family history of allergies in 6, a clinical challenge with the offending formula in 1, laboratory tests consistent with atopy in 11, and/or rectal biopsy with histologic allergic features in 7. The whey hydrolysate formula may be an acceptable alternative to soy or casein hydrolysate formulas in most infants with gastrointestinal symptoms of cow milk and/or formula intolerance.
Syringomyelia Presenting as Cricopharyngeal Pseudostricture
Authors: Malik Munir I. , Schwarz Kathleen B. , Kotagal Suresh 
Published: January 2024

SummaryA 14‐year‐old boy was referred for evaluation of a cervical esophageal “stricture” diagnosed by upper gastrointestinal radiograph, which had been performed for evaluation of dysphagia and dysphonia of several months' duration. Neurological examination revealed several cranial nerve abnormalities and hyperreflexia, raising the suspicion of a cervicomedullary junction lesion. However, computed tomography of the head, neck, and spine was completely normal. Findings on the swallowing videofluoroscopy were interpreted as consistent with a stricture (a “tight constriction distal to the pyriform sinus”). However, no evidence for this was found by either esophagoscopy or esophageal manometry, which revealed a low‐pressure cervical esophageal sphincter. Neurologic evaluation was pursued with magnetic resonance imaging, which revealed a large syrinx extending from C2 to T2 segments. We report this case to point out the importance of considering neurologic disease in the differential diagnosis of “stricture” of the cervical esophagus.
Eosinophilic Proctitis with Giant Cells
Authors: Raafat F. , Castro R. , Booth I. W. 
Published: January 2024

SummaryTwo infants, subsequently shown to have cow's milk protein intolerance, presented with rectal bleeding in the first week of life. Rectal biopsies showed eosinophilic infiltration of the mucosa with several multinucleated giant cells. IgG, IgM, and IgA containing plasma cells were present but IgE could not be detected in rectal biopsies. While cow's milk protein intolerance is a well‐recognized cause of proctocolitis in infancy, eosinophilic granulomatous‐like lesions with giant cells may be a prominent feature and do not exclude the diagnosis.
Variations in Oligosaccharides and Lactose in Human Milk During the First Week of Lactation
Authors: Viverge D. , Grimmonprez L. , Cassanas G. , Bardet L. , Solere M. 
Published: January 2024

SummaryVariations in oligosaccharides and lactose in human milk were studied in 15 mothers during the first week of lactation. The neuraminyloligosaccharides and heavy neutral oligosaccharides increased slightly from days 2 to 5 postpartum and appeared to decrease until day 7. The lacto‐N‐difucohexaoses, lacto‐N‐fucopentaoses, and lacto‐N‐tetraose increased until day 5 and then decreased. Lactodifucotetraose and the fucosidolactoses decreased substantially until day 5 (p < 0.05) and appeared to stabilize in the following days. Lactose increased until day 5 (p < 0.05) and continued to increase thereafter. Lactose was negatively correlated with total oligosaccharides (p < 0.10). The fluctuations observed in total oligosaccharides from days 2 to 5 postpartum and their subsequent stabilization and regular decrease during lactation confirm the hypothesis of Kulski and Hartmann that mammary secretion occurs in three periods: colostrum for the first 36 h postpartum, transitional milk from days 2 to 5 postpartum, and mature milk after day 5. The oligosaccharide variations we found corresponded to those of other milk constituents observed by other authors. The significance of the oligosaccharide variations is discussed.
Low Blood and Plasma Carnitine Levels in Children Receiving Long‐Term Parenteral Nutrition
Authors: Dahlström K. A. , Ament M. E. , Moukarzel A. , Vinton N. E. , Cederblad G. 
Published: January 2024

SummaryTotal and free carnitine and acylcarnitine concentrations were analyzed in whole blood and plasma in 12 children with a mean age of 68.4 ± 42.9 months who had received carnitine‐free total parenteral nutrition (TPN) for an average of 4 years. The purpose of the study was to see if the children had become carnitine deficient and, if so, whether this correlated with poor lipid clearance. Compared to controls, the TPN‐dependent children had significantly decreased concentrations of total and free carnitine in blood (26.6 ± 9.4 (SD) μmol/L vs. 43.3 ± 9.1 μmol/L, p < 0.001, and 17.1 ± 7.7 μmol/L vs. 35.2 ± 8.1 μmol/L, p < 0.001, respectively). Similar results were found in plasma (total carnitine of 19.0 ± 8.0 μmol/L vs. 41.9 ± 5.2 μmol/L, p < 0.001, and free carnitine of 15.7 ± 7.3 μmol/L vs. 36.1 ± 5.2 μmol/L, p < 0.001, respectively). The acylcarnitine concentration in plasma was decreased in the TPN children (3.3 ± 1.5 μmol/L vs. 5.8 ± 3.0 μmol/L, p < 0.01) compared to controls. Despite the low carnitine concentrations, serum triglyceride levels and serum free fatty acid levels were within the normal range. There was no correlation between carnitine concentrations in plasma and serum triglyceride and free fatty acid levels. Our data show that children receiving carnitine‐free TPN for many years developed markedly decreased concentrations of carnitine in blood and plasma. However, no adverse effects of the low carnitine levels were found on triglyceride and free fatty acid metabolism under stable conditions.
Food Proteins and Maturation of Small Intestinal Microvillus Membranes (MVM). III. Food Protein Binding and MVM Proteins in Rats from Newborn to Young Adult Age
Authors: Stern Martin , Gellermann Barbara , Wieser Herbert 
Published: January 2024

SummaryTo investigate postnatal maturational profiles of functional and biochemical properties of rat small intestinal microvillus membranes (MVM), we did a longitudinal study in rats from birth to the age of 12 weeks. In parallel, we studied binding of cow's milk proteins and of the wheat gliadin peptide B 3142, as well as MVM proteins (SDS‐PAGE). Changes in MVM fluidity and lipid composition exhibited early (0–4 weeks) and intermediate and late (6–12 weeks) patterns, as has been published earlier. Postnatal changes of food protein and peptide binding occurred early during the observation period, not related to weaning. There was not much further change in binding after 6–8 weeks. Developmental profiles of MVM protein and some lipid changes resembled, but did not equal, changes in food protein binding. We conclude that changes in MVM biochemical composition affect MVM binding characteristics. In particular, high molecular weight MVM proteins (susceptible to trypsin treatment) appear to play a role in postnatal maturational differences in MVM food protein binding.
Esophageal Chest Pain in Children with Asthma
Authors: Berezin S. , Medow M. S. , Glassman M. S. , Newman L. J. 
Published: January 2024

SummarySixteen patients with asthma and chest pain of >2 months duration underwent gastroenterological evaluation utilizing fiber‐optic esophagogastroduodenoscopy (EGD), esophageal manometry, and Bernstein testing. Eleven of 16 patients (75%) had endoscopic and histologic evidence of esophagitis. One patient with esophagitis exhibited high‐amplitude peristaltic contractions during motility testing. Four of these 11 patients (36%) had a positive Bernstein test. Extended intraesophageal pH monitoring of seven patients with esophagitis revealed significant gastroesophageal reflux (GER) in all of these patients. Chest pain was associated with an episode of GER in three patients (43%). Nine of 11 patients (82%) with esophagitis responded to medical therapy, resulting in resolution of esophageal inflammation and chest pain. One patient required Nissen fundoplication surgery after failure of medical therapy, and one patient who refused surgery progressively developed more severe esophagitis during 9 months of medical therapy. Children with asthma may have chest pain due to gastroesophageal reflux‐associated esophagitis that usually responds to medical therapy.
Histologic Findings Are Not Correlated with Disaccharidase Activities in Infants with Protracted Diarrhea
Authors: Shulman Robert J. , Langston Claire , Lifschitz Carlos H. 
Published: January 2024

SummaryHistologic assessment as well as information about the disaccharidase activity of the small intestinal mucosa can be useful in the management of patients with small intestinal mucosal damage. In an effort to determine whether the degree of small intestinal mucosal damage would be reflected in a corresponding reduction in disaccharidase activity, we compared small intestinal mucosal histology with the results of disaccharidase activity measured in per oral suction small intestinal biopsies obtained from 21 infants with protracted diarrhea. The degree of small intestinal mucosal damage was graded using a subjective score (i.e., 0 to 4+ damage) by a pathologist (P) and by a computer‐assisted digitizing system (to assess villus surface area, VSA, and villus/crypt ratio, V/C) in a blinded fashion. The mean (±SD) age of the infants was 2.5 ± 1.5 months, and the duration of diarrhea was 25.2 ± 11.5 days. There was good correlation between the results obtained from the digitizing system and from the pathologist: VSA versus P, r = 0.695; V/C versus P, r = 0.791; p = 0.0004. All infants demonstrated some degree of small intestinal mucosal damage. The mean (±SD) values for P, VSA, and V/C were 2.2 ± 1.3, 2.9 ± 0.9, and 0.9 ± 0.5, respectively. The mean values for lactase, sucrase, and maltase were 17.1 ± 17.0, 71.1 ± 54.0, and 224.3 ± 233 μmol/min/g protein, respectively. No correlation was observed between the histologic scoring results and lactase, sucrase, or maltase measurements. Expressing the disaccharidase activities per unit wet weight of tissue did not improve the correlations. Log transformation of the data also failed to improve the correlations. We conclude that extrapolation of disaccharidase activity from the results of histologic measurements in infants with protracted diarrhea is not reliable.
The Effect of Three Intravenous Fat Emulsions Containing Different Concentrations of Linoleic and α‐Linolenic Acids on the Plasma Total Fatty Acid Profile of Neonates
Authors: McClead Richard E. , Lentz Mary E. , Coniglio John G. , Meng H. C. , Gozs Susan 
Published: January 2024

SummaryWe determined the fatty acid profile of total plasma lipids in infants who received one of three intravenous fat emulsions that differed primarily in their linoleic and α‐linolenic acid content: (I) a safflower oil emulsion, (II) a 50:50 mixture of safflower and soybean oils, or (III) a soybean oil emulsion. After 2 weeks of fat therapy, oleic acid, expressed as a percentage of total plasma lipid fatty acids, decreased in all groups, but less so in group III (p < 0.01). The linoleic acid percentage increased in all groups, but group I had the greatest increase (p < 0.05). Group II patients had higher percentages of the linoleic acid metabolites, dihomo–γ‐linolenic acid (II > I, p < 0.05; II > III, p < 0.01) and arachidonic acid (II > III, p < 0.05). Group II patients also had higher levels of α‐linolenic acid (II > I, p < 0.05) and its metabolite, eicosapentaenoic acid (II > I, p < 0.05). Another α‐linolenic acid metabolite, docosahexaenoic acid, however, increased in group III, remained stable in group II, and decreased in group I (III and II > I, p < 0.05). We conclude that the content of linoleic acid and α‐linolenic acid in intravenous fat emulsions results in statistically significant changes in the fatty acid profile of total plasma lipids in infants receiving total parenteral nutrition.
A Study of the Microcirculation in Whole Villi of Neonatal Mice Using a Peroxidase Histochemical Staining Method
Authors: Osborne Michael P. , Haddon Susan J. , Worton Kim J. , Spencer Anthony J. , Starkey William G. , Thornber Dawn , Stephen John 
Published: January 2024

SummaryThe anatomy of the microcirculation of intestinal villi from the upper, middle, and lower small intestine of neonatal mice from 8 to 14 days old was studied using a histochemical peroxidase technique that specifically stained erythrocytes. Over 8–14 days, there was little chronological variation between the same regions of gut; the exception was the lower intestine, which, in younger mice, was noticeably less well perfused with erythrocytes. Vascular beds in the middle and lower intestine comprised a hairpin loop with cross‐connections. In the upper intestine, the capillary beds were generally more complex, particularly in apical regions of the villi. Most villi were well perfused with erythrocytes, but a minority (<10%) contained considerably fewer red cells, some to the point of being totally ischemic. Other villi (<5%) were hyperemic, and the vascular beds packed and engorged with red cells. Usually, the packing density (hematocrit) of red cells within blood vessels increased progressively from villus base to apex. Red‐cell deformation was more prevalent at villus apices, with marked crenation in some villi, yet in the basal regions of these same villi, the red cells were of normal discoid shape. The peroxidase staining technique produces a reliable histological picture of red cells circulating through villi. It also reveals differential perfusion of erythrocytes between and within villi, and that blood vessels pass through hypertonic zones in the apical regions of villi.
Bile Composition of Adult Baboons Is Influenced by Breast Versus Formula Feeding
Authors: Mott Glen E. , Jackson Evelyn M. , McMahan C. Alex 
Published: January 2024

SummaryWe tested the hypothesis that infant cholesterol intake and breast‐ versus formula‐feeding influence the bile cholesterol saturation index and bile acid conjugate composition in adult baboons at 7–8 years of age. We also measured the influence of the postweaning intake of dietary cholesterol and fat (saturated and unsaturated) on the effects of the infant diets. The 80 baboons were derived from six sires and 80 dams and randomly assigned at birth to breast‐feeding or to one of three formulas containing about 2, 30, or 60 mg cholesterol/dl. After weaning at 16 weeks of age the animals were assigned to one of four adult diets, which contained 0.01 or 1.0 mg/kcal of cholesterol containing 40% of calories from saturated or unsaturated fat. The bile cholesterol saturation index was significantly higher at 7–8 years of age in baboons breastfed as infants compared with those fed formula (87.0% versus 72.8%, p < 0.004). The cholesterol saturation index was not significantly different among the three formula groups. Among baboons who were breast‐fed and subsequently fed saturated fat as adults, the glycine/ taurine (G/T) ratios of the bile acid conjugates were about three times those of baboons fed unsaturated fat (1.53 versus 0.47); whereas among formula‐fed animals the type of fat did not influence the G/T ratio (interaction, p = 0.022). Adult baboons fed the three formulas in infancy had an inverse relationship of the G/T ratio to the level of formula cholesterol (p < 0.05), We conclude that breastfeeding and formula feeding in infancy differentially affect biliary lipid composition and its response to dietary cholesterol and fat in adulthood. These deferred effects of infant diet on bile lipid composition may influence gallstone formation and intestinal cholesterol and bile acid metabolism.
Biliary Infusion Therapy in the Inspissated Bile Syndrome of Cystic Fibrosis
Authors: Evans Jonathan S. , George Donald E. , Mollit Daniel 
Published: January 2024

SummaryA 3.5‐month‐old white boy was born with meconium ileus, peritonitis, and jejunal atresia from cystic fibrosis. He subsequently developed unrelenting and severe extrahepatic biliary obstruction as demonstrated by liver biopsy showing periportal inflammation, cholestasis, and fibrosis. Surgical exploration confirmed the diagnosis of extrahepatic biliary obstruction by severely inspissated bile. A cholecystostomy tube was left in place. The cholestasis remained unresponsive to conservative medical therapy. The obstruction was relieved by hydrostatic infusion of 2% N‐acetylcysteine into the biliary tree over a 6‐day period. The child also received concurrently four i.v. injections of synthetic cholecystokinin. This therapeutic modality was thought to be both safe and effective.
Hemobilia in a Child with Liver Abscess
Authors: Khalil A. , Chadha V. , Mandapati R. , Mathur N. B. , Mittal S. K. , Gulati P. , Chowdhury V. , Tyagi S. , Khalilullah M. 
Published: January 2024

SummaryHemobilia in children is rare and has so far been described only as a complication of blunt abdominal trauma. A case of hemobilia secondary to liver abscess treated successfully by selective arterial embolization is described. Hemobilia should be considered in any case of gastrointestinal hemorrhage before any operative intervention is undertaken.
Chronic Diarrhea and Malnutrition—Histology of the Small Intestinal Lesion
Authors: Sullivan Peter B. , Marsh Michael N. , Mirakian Rita , Hill Susan M. , Milla Peter J. , Neale Graham 
Published: January 2024

SummaryThe purpose of this study was to quantitate the jejunal lesion in Gambian children with chronic diarrhea‐malnutrition syndrome. There were 40 subjects (20 male, 20 female) with a mean age of 19.7 months. All were severely malnourished, with marasmus in 30, marasmic kwashiorkor in 9, and kwashiorkor in 1. Of subjects tested, 70% were anergic to intradermal challenge with either purified protein derivative or candidin. Jejunal biopsies, performed on every subject after admission to hospital, were studied by computerised image analysis and immunocytochemistry. A spectrum of mucosal changes that varied from “normal” to “flat” was seen. Mucosae with “normal” architecture revealed infiltration of villous epithelium by small lymphocytes, while crypt hypertrophy was invariably present. At the other extreme, the surface epithelium of flat mucosae was less severely infiltrated, although heavy lymphoid infiltrates persisted within crypt epithelium. Immunohistochemical studies revealed that most intraepithelial lymphocytes were of the CD8 + phenotype. Mucosal morphology did not relate to clinical, biochemical, or anthropometric data for each child. These findings are consistent with an intestinal reaction to some environmental antigen (dietary, microbial, or both) of the cell‐mediated type. This interpretation is strengthened by the expression of major histocompatability class 2D locus alloantigens on crypt epithelial cells in the absence of gut‐reactive autoantibodies.
Unidirectional Water Absorption as a Measure of Intestinal Surface Area in Rats
Authors: Fiedorek Stephen C. , Klish William J. , Graham David Y. 
Published: January 2024

SummaryMethods to measure expeditiously the anatomic and functional mucosal surface area of the small intestine are needed. We postulated that passive, unidirectional water flux would assess the anatomic mucosal surface area and that the increase in unidirectional flux that occurs in the presence of glucose would correlate with functional surface area. These hypotheses were tested in control and methotrexate‐treated rats. A single‐pass perfusion technique was used in vivo. Methotrexate treatment reduced anatomic and functional surface area (p < 0.05) as measured by computerized planimetry, wet mucosal weight, sucrase activity, and sucrase activity normalized to mucosal DNA content. A formula to predict anatomic surface area was derived from control animal data. The best model used passive, unidirectional water flux as the independent variable, but this model overestimated mucosal surface area in the methotrexate‐treated animals (p < 0.01). Mean unidirectional water flux increased by 45% (p < 0.01) in controls during glucose perfusion, but did not increase in methotrexate‐treated animals (p > 0.37). Thus, unidirectional water flux cannot be used as a universally applicable method to assess the anatomic mucosal surface area, but glucose‐enhanced unidirectional water flux should be evaluated further as an indirect measure of functional surface area.