ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Sick neonates often have a disturbed gastrointestinal motility. As somatostatin inhibits various gastrointestinal functions, we investigated whether or not somatostatin levels are high in sick infants. Somatostatin and gastrin levels were measured in plasma samples collected from sick and healthy neonates. Somatostatin levels were found to be significantly elevated in sick infants when compared to healthy ones, both term (91 versus 5 pM) and preterm (35 versus 5 pM). We suggest that the gastrointestinal symptoms seen in infants during illness may be related to an enhanced secretion of gastric somatostatin.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Serum pepsinogen I (PG I) levels were determined by radioimmunoassay in 23 children with peptic ulcer disease (PUD) before and after treatment with ranitidine and in 44 children who were being investigated for recurrent abdominal pain. Upper gastrointestinal endoscopy was performed in all. No lesions were detected in controls, while 18 patients showed a duodenal ulcer, 4 had an antral ulcer, and 1 had both. An 8-week course of ranitidine healed PUD in 93.5% of them, while long-term (1–5 years) endoscopic follow-up showed a 41.9% ulcer relapse rate after stopping treatment. Gastric acid secretion after pentagastrin stimulation [maximal acid output (MAO)] was tested in all controls and in 22 PUD patients: While controls had normal MAO values for their age. 65% of patients had a secretion above the normal range. No significant correlation was detected between serum PG I and MAO either in controls or in patients. Mean serum PG I concentrations were not significantly higher in the whole patient group than in controls, but PUD patients who relapsed after discontinuing ranitidine treatment had shown on admission significantly higher PG I levels when compared both with those who did not relapse and with controls. All patients who relapsed, but only 42.8% of those who did not, had a serum PG I concentration above the normal upper limit for a pediatric population (56.7 ng/ml). None of the PUD patients who had serum PG I levels under this limit relapsed. Our results suggest that pretreatment serum PG I levels in children with PUD may predict fairly accurately which will not relapse after attaining ulcer healing by a short-term ranitidine course.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Little is known about the development of gut endocrine responses to food intake in infants after the first postnatal month. To examine this question and to ascertain whether the mode of feeding from birth affects postprandial endocrine changes, blood glucose levels and the plasma concentrations of 11 regulatory peptides were measured at 9 months of age before and after a breast feeding in 13 exclusively breast-fed infants and before and after a formula feeding in 7 infants infants weaned during the first 3 months of life. In the prefeeding concentrations of these substances, no significant differences were found between the two groups, with the possible exception of the plasma concentration of pancreatic polypeptide (p = 0.06). Postprandially, the respnses were significantly smaller in the breast-fed infants, whose plasma concentrations of insulin, gastric inhibitory polypeptide, pancreatic polypeptide, and cholecystokinin were lower than in the formula-fed infants. In addition, the overall level of the insulin–glucagon ratio was lower (p = 0.03) in the breast-fed infants. A difference in the opposite direction was observed for plasma gastrin levels. No significant differences appeared between the groups for blood glucose, or plasma glucagon, vasoactive intestinal polypeptide, motilin, enteroglucagon, secretin, or neurotensin concentrations after feeding. It is concluded that at 9 months of age, the gut regulatory responses to milk feeding are of lower magnitude than during the neonatal period, but even at this age the response patterns still depend on the mode of feeding.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Central 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.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Thirty-one children with variceal bleeding due to portal hypertension (extrahepatic obstruction 19, non-cirrhotic portal fibrosis five, and cirrhosis of liver seven patients) were treated with endoscopic sclerotherapy with absolute alcohol. Acute variceal bleeding was successfully controlled in 10 patients by emergency sclerotherapy. A 3 weekly schedule of sclerotherapy could achieve obliteration of varices in all the patients. The mean (SD) number of sclerotherapy courses and the time required for variceal cradication was 4.5 × 1.7 and 14.4 × 3.9 weeks, respectively. During a mean follow-up of 23.3 × 11.4 months, variceal recurrence was seen in three (9.7%) patients, two with cirrhosis and one with noncirrhotic portal fibrosis. Recurrence was not seen in any patient with extrahepatic obstruction. Five (16.1%) patients had a rebleed that could be controlled with emergency selerotherapy. Esophageal stricture developed in four (12.9%) patients and could be dilated easily in all of them. The other complications of sclerotherapy included retrosternal pain, dysphagia, and fever; these were mild and short lasting. Survival in patients with extrahepatic obstruction and noncirrhotic portal fibrosis was 100%. The only death was in a cirrhotic, who died due to terminal hepatic failure. In conclusion, endoscopic sclerotherapy can be recommended as a safe and effective treatment in children for the control of acute variceal bleeding and for variceal obliteration.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A series of 31 infants, 28 with cow's milk protein sensitive enteropathy (CMPSE) and 3 controls, was studied for severity and extent of mucosal damage of the upper small bowel in relation to the development of clinical symptoms. Following challenge with the offending cow's milk, 18 infants (Group I) developed severe mucosal changes at both the proximal and distal small bowel mucosa and all of these infants presented with clinical symptoms. The other 10 infants (Group 2) who did not develop clinical symptoms following the challenge had less severe damage to the distal small bowel mucosa as compared to the proximal region. The histological score of both the proximal and distal postchallenge biopsies were significantly lower in Group 2 as compared to Group I infants. The mucosal disaccharidase and alkaline phosphatase levels were depleted in both the proximal and distal biopsies following challenge but the depletion was greater in the proximal than the distal biopsies. It is suggested that the extent and severity of mucosal damage to the proximal duodenum and jejunum have a critical bearing on the development of clinical symptoms.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

An amphiphilic detergent-solubilized human adult intestinal microvillous aminopeptidase N (EC 3.4.11.2) was purified by immunoadsorbent technique using meconial aminopeptidase N antibodies. Its molecular and kinetic properties were investigated to confirm the differences previously observed from the meconial enzyme.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

In an attempt to explore the possible variation over time of acute appendicitis (AA) 406 medical files comprising all children aged 0–14 years operated on during an 11-year period (1973–1983) at the Soroka Medical Center were reviewed. Only patients that were histopathologically confirmed were included in the study. Soroka Medical Center is the only general hosptal providing services to the entire population of the region. Hence, a reasonable coverage of all AA patients is expected. As a result, comparison of incidence rates among different subgroups is plausible. The annual rate of AA was 3.75 operations/10.000 children. The rates were somewhat higher for boys (5.20 versus 2.31, p. < 0.05). They were also higher for Jewish versus Bedouin children (4.44 versus 1.14, p. < 0.05). The highest rate of AA was among children in the 10-to 14-year-old age group (7.79). A gradual increase in the rates of AA during the study period was noticed, over and above the increase in the region's populat in. However, the ratio of change over time was higher for the Bedouins. Although this cannot be proven, the caques of AA have been hypothesized to be multifactorial. Diet is considered to have an important role in the etiology of AA. Some seasonal trends could be observed. paralleling changes in humidity. viral and bacterial infeetions, suggesting the involvement of these factors in the etiology of AA.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID