摘要:

A retrospective clinical study was done of 38 infants with temporary monosaccharide intolerance who were admitted to hospital between November 1976 and August 1978. There were two clinical groups. Group 1 consisted of 31 infants who developed monosaccharide intolerance as a sequela to acute gastroenteritis (i.e., 4% of infants admitted with acute gastroenteritis). Rotavirus was the cause of gastroenteritis in 64% of cases of monosaccharide intolerance. Monosaccharide intolerance was easily managed by dietary manipulations and lasted a mean of 2.5 days. Group 2 consisted of seven infants who developed monosaccharide intolerance during the course of protracted diarrhoea. The monosaccharide in-tolerance lasted up to 70 days, with a mean of 21 days, and required a period of total bowel rest followed often by complicated dietary manipulation.

ISSN:0277-2116    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Ultrastructural studies of the small and large intestine from children revealed five cases showing abnormal small electron-dense bodies within enterocytes and goblet cells. The characteristic features of the bodies were: (a) they occurred within microvilli and within the apical part of the cell cytoplasm; (b) they showed an association with the most apically located desmosomes of the epithelial cells; (c) in the microvilli they were present within protrusions of the membrane, suggesting that they may bud out of the cell; and (d) they were not membrane-bound within the cell but were found outside the cell as luminal, membrane-bound particles. These bodies occurred in two children with Crohn's disease and in three children having other gastrointestinal disorders. Similar electron-dense bodies which did not have all of the characteristics listed above were found in a sixth child who had Crohn's disease. These electron-dense bodies do not resemble any known inclusion of intestinal epithelium, nor do they resemble any previously described microorganism, although their apparent release from the cell by a process of budding is suggestive of a microbial identity. The occurrence of these bodies in childhood Crohn's disease suggests that they may be disease-related, but their precise nature and relevance to this or other gastrointestinal disorders remain unknown.

ISSN:0277-2116    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

We evaluated fecal clearance of α1-antitrypsin (α1-AT) as a method of detecting and quantitating intestinal protein loss in patients with inflammatory bowel disease. We investigated α1-AT clearance (Cα1-AT) in 14 patients (seven with Crohn's disease, seven with ulcerative colitis) and in 10 children with gastrointestinal disorders and normal serum albumin values who served as controls. The inflammatory bowel disease patients were analyzed for nutritional status, intestinal absorption, disease activity and distribution, and presence or absence of rectal bleeding. α1-AT was measured in stool (72-h collections) and serum by radial immunodiffusion, and the clearance was calculated. The mean Cα1-ATin patients with inflammatory bowel disease was significantly (p < 0.05) higher than that of the controls. Cα1-ATin the former patients was inversely related to the serum albumin level (p < 0.001), but not to disease activity, medications, absorption, nutritional status, or moderate rectal bleeding. In the patients with Crohn's disease there was a trend to increased Cα1-ATfrom only ileal to diffuse small intestinal disease involvement. We conclude that in patients with inflammatory bowel disease, fecal clearance of α1-AT is a useful method for quantitating intestinal protein loss, and that moderate rectal bleeding does not affect the Cα1-ATdetermination.

ISSN:0277-2116    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Three children with acrodermatitis enteropathica (AE) were treated with oral zinc dipicolinate (zinc-PA). The daily dose of zinc required to prevent exacerbations, when administered as the dipicolinate complex, was one-third the minimum amount of zinc required as the sulfate salt. The concentration of picolinic acid in the plasma of asymptomatic children with AE was significantly less than that of normal children. However, oral treatment with PA alone was ineffective. The plasma of the three AE children contained a measurable quantity of kynurenine which was undetectable in plasma from normal children. Absorption of an oral zinc load was normal. The results support the hypothesis that the genetic defect in AE is in the tryptophan pathway, although the role of PA in zinc metabolism remains to be defined.

ISSN:0277-2116    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Hepatitis B virus (HBV) infection is endemic among institutionalized retarded patients, who usually have mild, anicteric hepatitis following nonparenteral exposure. We evaluated the risk of HBV infection (as evidenced by serologic studies) among their contacts, including noninstitutional caretakers, during brief home exposure. Caretakers shaved, bathed, and changed diapers for five patients during home visits or foster home placements. Seven of the 14 caretakers, who were exposed for 3–12 months, developed antibodies (anti-HBeand/or anti-HBs). A mother and her daughter's caretaker were found to have asymptomatic acute HBV infection, and the mother developed antibodies to HBsHBc, and HBc. In a second household, another caretaker became anti-HBspositive. Only one of nine play contacts and none of seven casual contacts had markers of past or present HBV infection. The study was a unique opportunity to retrospectively and prospectively monitor HBV transmission. Our results show that noninstitutional caretakers deserve the protection of HBV vaccine to diminish the potential for chronic infection and transmission of HBV infection.

ISSN:0277-2116    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The effect of exogenous corticosteroid therapy on growth was studied in 12 patients with HBSAgnegative chronic aggressive hepatitis. All patients were less than 13 years of age at diagnosis and were free of cirrhosis. The patients' growth records were retrospectively reviewed for incremental growth changes while they were receiving daily prednisone and alternate-day prednisone, as well as for 1 year after the cessation of therapy. These values were compared with age-matched growth velocities in normal children. Daily steroid therapy was associated with a reduction in growth velocity (p < 0.01). There was an acceleration in growth velocity during the period of alternate-day therapy, compared with predicted values (p < 0.03), which persisted during the 1st year after therapy was discontinued (p < 0.02). Nine of 12 patients crossed growth percentiles during steroid therapy. We have confirmed that daily steroid administration is associated with a reduction in linear growth, while alternate-day therapy has an apparent positive effect on growth, presumably through control of the underlying disease. The mechanism of this supranormal growth rate is unclear.

ISSN:0277-2116    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The relationship between the pulmonary excretion rate of carbon monoxide (VECO) and the concentration of CO, in a sample of breath, drawn through a nasopharyngeal catheter at end-expiration, was assessed in 25 studies of nine preterm and 14 term infants. The VECOand this approximate end-tidal sample of CO (ETCO) correlated significantly over a wide range of CO elimination rates: VECO= 10.45 ETCO+ 2.25 (n = 25, r = 0.95). The ETCOcorrectly predicted elevations in VECO> 2 SD of the mean VECOfor normal infants (13.9 ± 3.5 μl/kg/h), with 90% sensitivity and 73% specificity (p < 0.01). Three subjects with Rh isoimmune hemolytic disease were easily identified by the ETCOas well as the VECO. The ETco is a simple, noninvasive measurement for rapidly identifying infants with significant hemolytic disease.

ISSN:0277-2116    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The effects of intragastric glucose infusions on [15N]glycine kinetics and whole body protein turnover were investigated in four children with type I and two children with type III glycogen storage disease. Either fasting or the administration of insufficient glucose was associated with a diminution in the glycine pool size relative to values observed when patients received adequate glucose. The cause of the smaller pool size was an increased fractional glycine turnover. Simultaneous determination of whole body protein turnover, using a stochastic model based on [15N]urea excretion, showed higher rates of protein synthesis, nitrogen flux, net tissue protein retention, and reutilization of amino acid nitrogen derived from protein catabolism, in patients receiving sufficient exogenous glucose. Depletion of amino acid pools, presumably because of intensive utilization of these gluconeogenic precursors when inadequate glucose is administered, was associated with a lower rate of whole body protein synthesis.

ISSN:0277-2116    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The effect of feeding on calf blood flow (CBF) was investigated in 27 preterm and 10 term small-for-gestational-age (SGA) neonates using the venous occlusion plethysmographic method pre- and postprandially. Blood pressure and heart rate were simultaneously monitored. Feeding consisted of commercially prepared formula with average amounts of 20 ml/kg for preterm and 30 ml/kg for term SGA infants. As a group, the preterm neonates showed no significant CBF changes 1/2 h postprandially from the control value of 8.4 ± 2.6 ml/min/100 ml (mean ± SD). Although the difference was not statistically significant, 10 of the 27 preterm infants showed a mean CBF decrease of 9% and 17 showed no change to a slight in-crease immediately postprandially. These changes were followed by a 35% mean increment in CBF of all preterm infants at 2–21/2 h postprandially. CBF decreased in term SGA infants by 40% at 1/2 h postprandially from a control flow of 8.6 ± 2.9 ml/min/100 ml (p< 0.01). CBF returned to the control level 1–1 1/2 h postprandially and superseded the control value by 16% at 2–2 1/2 h. Peripheral vascular resistance varied inversely with CBF. Blood pressure and heart rate showed no significant changes. These observations indicated that unlike term infants, most preterm infants manifest no significant immediate peripheral vascular response to feeding before the onset of a hyperdynamic circulatory state. This difference was related to gestational age rather than to birth weight as term SGA infants responded like term appropriate-forgestational-age infants. The possible mechanisms involved in these CBF changes with feeding are discussed.

ISSN:0277-2116    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Bone marrow transplantation (BMT) is associated with severe metabolic stress secondary to anorexia, mucositis, enteritis, and infection. We compared nutritional parameters and clinical outcomes of 22 patients who received prophylactic total parenteral nutrition (TPN) to those of 22 controls, matched for age and diagnosis, who received nutritional supportad libitum.Over the 5-week study period, the TPN group averaged caloric intakes greater than 1.5 × basal energy expediture (BEE) per day and gained 2.5% of body weight; the control group averaged less than 0.9 × BEE and lost 3.7% of body weight. Visceral protein status as reflected by serum albumin was not different. Engraftment of donor marrow cells was 3 days earlier (p < 0.01) in the TPN group than in the controls, despite there being no significant difference in the number of marrow cells each group received. There was no difference in the two groups' clinical outcomes; mortality, duration of hospital stay, and incidences of sepsis, graft-versus-host disease, and return of malignancy were equivalent. Thus, patients who received prophylactic TPN engrafted sooner than patients who did not; however, overall clinical outcome was unaffected by TPN. Controlled studies of prophylactic TPN are indicated for the BMT patient population.

ISSN:0277-2116    

出版商:OVID    

年代:1984

数据来源: OVID