ISSN:0277-2116    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Background:The dual capacity of stomach tissue to secrete acid and to respond to secretagogues is indicative of the terminal stages of gastric functional maturation. In this study 6-to 10-week-old human fetal stomachs xenografted into nude mice were used to study parietal cells' functional maturation.Methods:Thirty-four transplants were microsurgically grafted either inside a pouch created on the nude peritoneum (n= 15) or on the host stomach and esophagus (n= 19). The mucosa of transplanted tissues was analyzed by immunohistochemical techniques to detect gastric cells. Gastric cell secretions were collected before and after pentagastrin or omeprazole treatment.Results:Parietal, G, and D cells were detected immunohistochemically only after 1 month of grafting. All xenografts actively secreted acid after 1 or 2 months' transplantation at each graft site. Acid secretion was significantly stimulated by intraperitoneally injected pentagastrin (mean pH ± SD, 3.2 ± 0.7 vs. 2.0 ± 0.5;n= 10,P= 0.005) and was dramatically inhibited by intragastrically administered omeprazole (2.3 ± 0.6 vs. 6.5 ± 0.7;n= 15,P= 0.0007) after 5 hours.Conclusion:Stomach xenografts were able to develop normally. Parietal cells were physiologically mature with functional proton pumps and active gastrin receptors, as demonstrated after omeprazole and pentagastrin treatment, respectively. Because stomach xenografts matured very rapidly, it is possible that a stomach xenograft model can be used for further studies on the functional maturation of human gastric epithelial cells, as well as the factors that influence this maturation in humans.

ISSN:0277-2116    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Background:To investigate the prevalence of overweight and obesity in an adolescent group representative of a rural Mediterranean area and to determine possible associations with energy and nutrient intakes and levels of physical exercise.Methods:A representative sample of adolescents was drawn from the secondary school of Torre Pacheco (Murcia), a rural Mediterranean area located in the southeast of Spain. The population selected (331 adolescents aged 14–18 years), was divided into two groups: normal-weight subjects with a body mass index less than 23 kg/m2and overweight or obese subjects with a body mass index of 23 kg/m2or more. Weight, height, abdominal and hip perimeters, triceps skinfold, and upper arm circumference were measure. A prospective 7-consecutive-days food record and physical activity questionnaire were completed.Results:Overweight boys and girls had an apparently lower energy intake (P= 0.001 andP= 0.042, respectively), and carbohydrate intake (P= 0.000,P= 0.032) than their normal-weight counterparts, but they tended to underreport more often. Overweight boys derived a greater percentage of their energy from fat (P= 0.049) and less from carbohydrate (P= 0.016) than their normal-weight counterparts. Among girls, the percentage of energy derived from fat increased with body mass index (r= 0.210,P= 0.008), whereas fiber intake decreased (r= −0.145;P= 0.041). Overweight and obesity were negatively related to physical activity level only among boys (P= 0.033).Conclusion:There is a high prevalence of overweight and obesity in the adolescent population studied (48.2% in boys and 30.7% in girls). The study shows an association between overweight and obesity and nutrient intake and activity level.

ISSN:0277-2116    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Background:A prospective study of inflammatory bowel disease (IBD) in Sweden was performed to investigate whether the incidence and morbidity have changed from 1984 through 1995.Methods:Children 15 years of age or less with IBD were included—i.e., those with a definite diagnosis of ulcerative colitis (UC) and Crohn's disease (CD) and those classified as having indeterminate colitis (IC) and probable Crohn's disease (PCD). The study covered 56.5% of the pediatric population of Sweden.Results:The diagnosis of IBD was made in 639 children, which corresponds to a mean annual incidence of 5.8 per 100,000. The incidence increased from 4.6 per 100,000 per year from 1984 through 1986 to 7.0 from 1993 through 1995. It reflected an increase in UC from 1.4 to 3.2 per 100,000 per year, which is a significant yearly percentage of increase (8%; confidence interval, 2–14%;P< 0.05). In contrast, no change occurred in the incidence of CD (1.2–1.3 per 100,000). The incidence of IC and PCD also remained fairly stable. The percentages of children who underwent surgery decreased from 17.3% in the first 6 years to 4.6% in the last 6 years (P< 0.001). Surgery was performed in 27.7% of CD and 5.3% of UC cases. The median age at diagnosis was 12.2 years for UC, 13.0 years for CD, 11.2 for IC, and 11.2 for PCD. At diagnosis, 48 children (7.5%) were 5 years of age or less, whereas most of the patients were 11 years of age or more (398 children, 62.3%).Conclusions:In Sweden, the incidence of UC has increased, whereas that of CD remains the same. A significant number of children were classified with IC and PCD. In most children, IBD was diagnosed when they were 11 years old or more, but some cases were detected even in those below 6 years of age. A decrease in the frequency of surgery occurred during the study.

ISSN:0277-2116    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Background:Gastric autoantibodies are common inHelicobacter pylori–infected adults, and the presence of these antibodies is associated with atrophic gastritis. The role ofH. pyloriin the autoimmune type of atrophic gastritis is unresolved, and it is not known at what stage the autoantibodies appear in serum duringH. pyloriinfection. Therefore, we screened children with and withoutH. pyloriinfection for gastric parietal cell antibodies.Methods:Seventy-one children withH. pyloriinfection verified by examination of gastric biopsy specimens (mean age, 9.4 years), 8 children with positive serology but negative histology forH. pylori(mean age, 11.6 years), and 130 children with negative serology forH. pylori(mean age, 7.7 years) were screened for the presence of gastric parietal cell antibodies in serum by indirect immunofluorescence. In addition, 61 children with celiac disease (mean age, 7.1 years) were screened for gastric parietal cell antibodies andH. pyloriantibodies.Results:None of the children withH. pyloriinfection had gastric parietal cell antibodies in serum. Only three positive parietal cell antibody reactions were found: a 14-year-old boy with positive serology forH. pyloribut no other signs of infection (titer 5000), a 14-year-old girl with tuberculosis (titer 1250, seronegative forH. pylori) and a 10-year-old girl with insulin-dependent diabetes mellitus (titer 6250, seronegative forH. pylori).Conclusions:Although gastric autoantibodies are often found in adults with chronicH. pylorigastritis, it seems thatH. pylori–infected children are not positive for gastric parietal cell antibodies. It remains to be studied in whichH. pyloriinfections and at what stages gastric autoantibodies appear.

ISSN:0277-2116    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Background:Liver transplantation is established treatment for children with end-stage liver disease and has a 5-year survival rate of 80% to 85%, even in infants under 12 months. Long-term outcome in nutritional rehabilitation and normal development is unknown. This study aimed to prospectively evaluate growth and psychoneurologic performance of children who undergo liver transplantation in infancy.Methods:Twenty-five infants (18 girls, 7 boys) who underwent liver transplantation at less than 12 months of age (median age, 9 months) were evaluated for 4 years. Growth measurements were expressed as standard deviation scores (SDSs; mean ± SEM), and psychoneurologic performance was assessed with the unrevised Griffiths Mental Ability Scales (normal range, 80–120).Results:Four children died during the study (4-year survival, 84%). The children were malnourished before transplantation (SDSs: weight, −1.9 ± 0.2; midarm muscle area, −0.93 ± 0.3; midarm fat area, −1.52 ± 0.3; and height, −0.95 ± 0.3). Nutritional rehabilitation for all parameters occurred within 12 to 24 months after transplantation, which was most significant for weight (−1.1 ± 0.2,P= 0.001), midarm muscle area (0.74 ± 0.3,P= 0.001), and midarm fat area (−0.44 ± 0.3,P= 0.01). There was some improvement in height (−0.72 ± 0.3,P= 0.14), which was not significant, although infants who were severely stunted before transplantation (mean height standard deviation score [SDS] −2.46) showed significant catch-up at 1 year after transplantation (mean height SDS −1.2,P= 0.003). Psychoneurologic scores were within normal limits before transplantation and were maintained for the 4-year follow-up period, although individual scores varied during this period. Improved nutritional status was associated with increased muscle bulk and subsequent improvement in motor scores from 90.6 at initial assessment to 97.3 at 4 years (P= 0.28). There was a temporary reduction in social skills and eye–hand coordination in the first year, which may have been an effect of the hospital environment or cyclosporine immunosuppression. Language abilities also regressed during the first year, possibly related to the effect of nasogastric tube feeding in delaying normal speech development.Conclusions:Liver transplantation in infancy has not only a successful outcome but is also associated with long-term catch-up growth and nutrition and maintenance of normal development.

ISSN:0277-2116    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Background:Triple therapy with a proton-pump inhibitor and two antibiotics is widely used in the treatment ofHelicobacter pyloriinfection in adults. Experience with such therapy in the pediatric population is limited. This was a prospective, nonrandomized, open-label trial to evaluate safety and efficacy of a combination of lansoprazole, clarithromycin, and amoxicillin in symptomatic children withH. pyloriinfection.Methods:Children withH. pylorigastritis diagnosed by endoscopy performed for persistent nausea, vomiting, recurrent abdominal pain, and diarrhea with consistent histology were treated with the regimen of 0.45 mg/kg per day lansoprazole divided into two doses (maximum dose, 15 mg twice daily), amoxicillin 40 mg/kg per day in two doses (maximum dose, 1.0 g twice daily), and 250 mg clarithromycin twice daily (<10 years old) or 500 mg twice daily (>10 years old) for 2 weeks. Pre-and posttreatment endoscopic biopsy specimens were graded for the severity of gastritis andH. pyloridensity by a blinded pathologist. A questionnaire for assessing the severity of symptoms at the time of initial and second endoscopy were completed by patient and/or parent.Results:Thirty-two children (age range, 1–25 years; mean age, 11 years; 19 females, 13 males) were treated with this regimen during an 18-month period.H. pyloriorganisms with varying grades of gastritis were present in tissue specimens of all patients. Only 28 children had follow-up endoscopy, which showed eradication ofH. pyloriin 15 (54%) children. Histologic symptoms of gastritis improved after therapy in the whole group. Overall, symptoms of vomiting, abdominal pain, diarrhea, anorexia, and halitosis significantly improved (P< 0.05). Minor adverse effects of therapy occurred in 25% of patients.Conclusions:Symptoms, histologic, and endoscopic findings improved after triple therapy in children withH. pylorigastritis; however, eradication of bacteria was achieved in only 56% of children.

ISSN:0277-2116    

出版商:OVID    

年代:2000

数据来源: OVID