摘要:

The duodenogastric reflux (DGR) is a suspected cause in some esogastric pathologies in adults: esophagitis, peptic gastric ulcers, stress ulcers, ulcers secondary to drugs, gastric cancer, and gastritis. The toxic substances of the reflux are essentially bile acids, lysolecithin, and trypsin. A number of diagnostic methods have been proposed in the adult. This study suggests a diagnosis technique for DGR in the child. Fasting gastric juice was collected by gastric intubation during 1 h and three substances were measured: phospholipids as markers of biliary reflux, trypsin as a marker of pancreatic reflux, and sialic acid as a marker of the degradation of gastric mucus. The sialic acid enabled us to evaluate some of the toxicity of DGR on the stomach. The study of 49 child subjects permitted us to show the existence, in the normal child, of biliopancreatic markers in the stomach under fasting conditions through a physiological DGR; to define the norms in the child, varying according to three age groups: 0–2 months, 2–12 months, and 1–4 years (the maximum values for an age above 4 years seemed to correspond to those in the adult); and to suggest the existence of a pathological DGR in children with antral gastritis or ulcers.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Little has been published about outpatient sedation for pediatric patients. We designed a study to evaluate the efficacy and adverse effects of diazepam and meperidine in combination for sedation in ambulatory pediatric patients undergoing endoscopy, colonoscopy, or liver biopsy. Thirty patients (7 months-20 years) were observed. Each patient received a single combined dose of intravenous diazepam and meperidine. The standard dose was 0.1 mg/kg for diazepam and 2.0 mg/kg for meperidine. In patients weighing >100 lb, set doses of meperidine (100 mg) and diazepam (5 mg) were used. The time to achieve sedation and the vital signs were measured; cooperation, emotional state, and drowsiness were rated before, during, and after procedures. The amnesic effect was noted, as were any adverse effects. Diazepam and meperidine were effective in 26 of 30 patients, with sedation generally produced within 2–3 min. Cooperation and emotional state improved significantly following drug administration (p < 0.05). When a prospective 24-h telephone follow-up study was instituted in 40 consecutive patients receiving diazepam and meperidine no significant adverse effects were noted. Only 20% of patients old enough to be questioned remembered the procedure. Diazepam and meperidine in combination appear to be effective and safe in pediatric patients undergoing gastrointestinal procedures. Prolonged monitoring of patients does not appear necessary in this patient population.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

To evaluate the relative efficacy of nonelemental versus semielemental enteral supplements for nutritional rehabilitation of cystic fibrosis (CF) patients, whole-body protein turnover using the [15N]glycine method was studied in nine malnourished CF patients during enteral feedings, in a block design study comparing a semielemental formula (Criticare), a higher protein density but nonelemental formula (Traumacal) (T), and a nonelemental formula that had been modified to become isocaloric and isonitrogenous to the semielemental formula (modified Traumacal, MT). No significant differences in rates of protein synthesis or catabolism were observed comparing the three formulas. However, the higher protein density nonelemental formula resulted in higher net protein deposition compared to the other two formulas (T + 0.42 g kg-110 h-1versus 0.33 g kg-110 h-1for Criticare and −0.59 g kg-110 h-1for MT), although this was significant (p < 0.05) for the MT versus T comparison only. This study lends support to the use of less expensive nonelemental formulas for the nutritional management of malnourished patients with CF.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Whole groat flour was consumed by nine infants and young children as 22.5, 45, or 67% of total diet energy (one half of 6.4%, all of 6.4%, or all of 9.6% protein energy). Isonitrogenous and isoenergetic casein control diets were given. Apparent absorption of oat nitrogen (N) was consistently around 75% of intake (casein, 87%), but absorptions of oat energy, carbohydrate, and fat, as percentages of intake, decreased disproportionately as oat flour intake was doubled and then tripled. Apparent retentions were 39 ± 5% of mixed oat-casein protein intake in the 22.5% diet, the preceding and following casein controls being 38 ± 8% (NS) and 44.4% (p<0.05) of the intakes; 32 ± 6% from oats in the 45% diet, controls 38 ± 5 and 46 ± 5% (both p<0.05), and 33 ± 11% from oats in the 67% diet, controls, 36 ± 9% (NS). Fasting plasma free total essential amino acid (TEAA) levels of children consuming 45% oats were low (562 ± 119 μmol of TEAA/L) and did not change significantly after meals. Fasting molar proportions of individual essentials (millimoles of EAA per mole of TEAA) were similar to those from milk protein diets and did not vary significantly 3 and 4 h after feeding, suggesting that no individual amino acid, but rather protein digestibility, was first limiting to N retention. Oats are a satisfactory source of energy, protein, and fat for very young children and many infants.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The effect of ascorbic acid (AA) [284 μmol (50 mg) twice daily] on the net intestinal absorption and maximum apparent retention of Fe, Cu, and Zn was investigated by metabolic balance studies in a randomised crossover study of six low-birth-weight (LBW) neonates fed a cows'-milk-based formula containing (μmol/L) Fe, 126; Cu, 11; Zn, 87; and AA, 400. Absorption ± SD (Fe, −5.0 ± 7.5; Cu, 0 ± 0.4; Zn, −0.8 ± 3.4) (μmol kg-1day-1) was not altered by AA (Fe, −4.1 ± 4.6; Cu, 0.3 ± 0.6; Zn, −1.1 ± 2.7) neither was retention (without AA: Fe, −6.0 ± 8.4; Cu, −0.1 ± 0.3; Zn, −2.4 ± 4.2; with AA: Fe, −4.9 ± 4.7; Cu, 0.1 ± 0.6; and Zn, −2.7 ± 3.1). Supplements of AA administered as in the circumstances of routine care of LBW neonates do not enhance the absorption and retention of Fe, nor do they impair these aspects of the metabolism of Cu and Zn.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A modified urease broth test was used in 109 gastric biopsy specimens of children that yielded a 96% sensitivity and a 100% specificity rate forCampylobacter pyloriinfection. The longest reaction time was ±4 min. The correlation between the degree ofC. pyloriinfection and the reaction time was found to be highly significant (γ = 0.78, p<0.001). Patients were examined as outpatients, and immediate medications were prescribed for eradication of the bacteria on the basis of the urease broth test results. This is the first report on the use of this modified rapid urease test for the diagnosis ofC. pyloriinfection in children.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

An in vitro system is described and validated for studying transport of solutes and water in both uninfected and rotavirus-infected neonatal mouse intestine. Control intestine exhibited stable water absorption for periods of up to 40 min. Water absorption was temperature-dependent, Na-dependent, and enhanced by glucose-containing perfusion solutions. Theophylline induced net secretion of water by control intestinal tissue. Water transport by rotavirus-infected lower small intestine was significantly depressed as compared to control levels, and rotavirus-infected middle small intestine exhibited net secretion of water. Upper small intestine and colon from infected animals did not differ significantly from control tissues in their ability to transport water. Water secretion by infected middle small intestine was reversed to absorption by glucose-containing solutions.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We evaluated plasma amino acid (AA) concentrations associated with a histologically defined lesion caused by bile duct ligation (BDL) in developing rats. Nineteen rats that underwent BDL at 14 days of age had marked bile duct proliferation with bridging fibrosis, multifocal lobular necrosis, and minimal polymorphonuclear periportal infiltrate in their livers at sacrifice (11–31 days after ligation). These were compared to two age-matched control groups: 21 nonoperated rats and 22 shamoperated rats; and eight rats with cirrhosis caused by carbon tetrachloride. Signs of liver damage including jaundice, growth failure, bleeding, and ascites were accompanied by elevated bilirubin, ammonia, aspartate aminotransferase (AST), and alkaline phosphatase levels in BDL rats compared to controls. They had higher concentrations of total AAs, phenylalanine, tyrosine, and cyst(e)ine when compared to controls and to CCl4-treated rats. Micronodular cirrhosis was present in CCl4-treated rats with elevated AST and alkaline phosphatase levels. Glutamine and glutamate levels were higher in them than in BDL rats or controls, and branched chain AA levels were lower. These two chronic lesions, one obstructive and one hepatotoxic, both result in fibrotic change, but their metabolic abnormalities as reflected in plasma AA levels are distinct. We found that BDL is an appropriate model with which to study metabolic changes and growth failure due to chronic biliary stasis during its progression to frank cirrhosis.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We have previously demonstrated that a spiral myotomy and delayed definitive procedure is a viable alternative for esophageal reconstruction in long-gap esophageal atresia. In this study we sought to determine whether this procedure leads to esophageal motility disturbances and to compare the manometric findings with controls as well as with those seen in children with esophageal atresia and primary anastomosis. Six beagles had esophageal transection and a spiral myotomy, one had esophageal transection without a myotomy, and two served as normal controls. Following esophageal reconstruction, esophageal manometry was studied in all dogs using a standard pull-through technique. We found that the three control dogs all had similar manometric findings with normal peristalsis. In contrast, the dogs with a spiral myotomy all had propagation of waves in the myotomized segment but termination of waves at the anastomotic site. There was delayed velocity through the myotomized segment and retrograde peristalsis distally. Finally, upper esophageal sphincter pressure was elevated, while lower esophageal sphincter pressure was similar to that in the normal dogs. These findings are similar to those described in children with primary anastomosis and suggest that (a) spinal myotomy is a good alternative to other esophageal replacement options in patients with long-gap esophageal atresia and that (b) the motility dysfunction observed in children with esophageal atresia following primary anastomosis may be secondary to the disruption of the vagus nerve and that may be part of the congenital abnormality or secondary to surgical trauma.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A study, using the piglet as a model for the human infant, was undertaken to determine the effect of the protein source of a milk formula on organ development, the activity of digestive enzymes, and the absorption of amino acids as measured at the terminal ileum and over the entire digestive tract. Three isocaloric liquid milk formulas containing equal amounts of either intact bovine milk, hydrolyzed bovine milk, or isolated soybean protein as the sole source of this nutrient and with equal levels of fat and carbohydrate were each given to six 14-day-old piglets over a 19-day period in a manner that mimicked human infant feeding practice. Following a 6-day metabolism study, the piglets were killed, their organs removed, and samples of digesta collected. The protein source of the milk-based formula did not affect (p > 0.05) the weight/unit body weight of the small intestine, large intestine, liver, or pancreas, but the relative weight of the kidneys was lower (p<0.05) for animals fed the intact bovine milk-based formula and that of the stomach was higher (p<0.01) for piglets receiving the isolated soybean formula. The activities of pepsin, intestinal trypsin and chymotrypsin and pancreatic chymotrypsin were not influenced (p > 0.05) by protein source, but piglets receiving the bovine milk-based formula had a lower level of activity (p<0.01) for pancreatic trypsin. The apparent ileal and fecal absorption of nitrogen was similar for the three milk-based formulas, the overall mean ileal absorption of nitrogen (±SE) being 89.0% (±1.44). Excluding cystine, where ileal absorption was relatively lower (p<0.05) with the isolated soybean formula (86.7%) compared with the intact bovine milk (91.5%), protein source had little effect on the apparent absorption of essential amino acids. It was concluded that the replacement of intact cow's milk protein in human infant formulas by either hydrolyzed cow's milk or isolated soybean protein is unlikely to cause any major disturbance in the digestive process.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID