ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryThis study prospectively evaluated 35 consecutive infants who presented with fresh blood mixed with stools. The mean age at onset of bleeding was approximately 4 weeks. All infants were otherwise asymptomatic and exhibited normal growth and physical examinations. None had evidence of a bleeding diathesis, viral or bacterial enteritis, or necrotizing enterocolitis. Con sent for limited colonoscopy and biopsy was obtained for 34 infants. Twenty-five had macroscopic colitis and 10 infants had marked nodular lymphoid hyperplasia. Thirty-one infants had histopathological evidence of colitis characterized by a marked eosinophilic infiltrate. Compared with 19 controls (age, 4.1 ± 3.6 months) the mean number of eosinophils per high-power field was greater in the patients with colitis. Patients with colitis also had an elevated mean absolute peripheral eosinophil count and a low mean serum albumin compared to control values.The 31 infants with colitis were receiving solely breast milk (10), cow's milk formula (9), soya formula (9), breast milk with cow's milk formula (2), or nutramigen (1) at the time of presentation. Nineteen infants had rapid resolution of frank bleeding and gradual correction of serum albumin with dietary change. While limited colonoscopy and biopsy were useful in establishing a definitive diagnosis, a low serum albumin and high peripheral eosinophil count suggested the diagnosis. Colitis characterized his-tologically by >20 eosinophils per high-power field is a common cause of rectal bleeding in otherwise healthy young infants. Resolution of bleeding and increase in serum albumin after dietary change suggest that this is an allergic colitis: however, the pathogenesis of this disorder needs further clarification.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryCeliac disease is characterized by hypersensitivity to the alcohol-soluble wheat proteins called gliadins. Total avoidance of gliadin is the lifelong treatment for such patients. However, wheat gliadins are often present as impurities in industrial starch commonly used in the preparation of different pharmaceutical products. Therefore, some drugs might contain gliadin, which can be dangerous for sensitive patients if taken in large amounts or used permanently. The purpose of this study was to develop a sensitive, reliable assay that is specific for the detection of gliadins in pharmaceutical products. Gliadins were extracted here using sodium dodecyl sulfate rather than 70% ethyl alcohol, which has been the traditional solvent. This gliadin extract was utilized in a dot-blot assay that incorporated an antigliadin antibody developed in rabbit and labeled with peroxidase. 4-Chloro-1-naphthol was used as a peroxidase-specific substrate. Isolated wheat gliadin was used as the positive control. Dilution experiments showed that the lower level of sensitivity for the assay was in the range of 0.0045 mg/ml of gliadin, which is a concentration level lower than that suggested for a gluten-free diet. The assay developed here revealed that 71.2% of 59 prescription and nonprescription drugs tested contained gliadin in the amount detected by our dot-blot assay. The prescription drugs tested were among the top 50 most frequently dispensed in U.S. community pharmacies. The nonprescription drugs were among those that constitute the largest sales in the United States. The results showed that the simple dot-blot assay developed here can be used for pharmaceutical testing performed either by hospital laboratories or by patients themselves.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryPolyamines appear to have an important role in postnatal growth of the rat intestine. In the present study, we examined the effect of spermidine on the maturation of the intestine and on its ability to exclude macromolecules. Two litters of Sprague-Dawley rat pups were assigned to one of four experimental groups. These groups received, on Days 7, 8, and 9, either (a) saline by gavage; (b) spermidine, 0.9 mg (6 μmol) by gavage; (c) cortisone acetate, 3.5 mg i.p.; or (d) saline i.p. On Day 10, animals were fed by gavage with a mixture of bovine serum albumin (BSA; 2 mg/g) and the γ-globulin fraction of mouse antiovalbumin (anti-OVA) antiserum (1 mg/g) and were bled 4 h later. Intestinal tissues were processed for histologic examination, sucrase determination, and identification of neonatal intestinal Fc receptor (FcRn) by Western blot. Serum immunoreactive BSA (iBSA) and mouse IgG1and IgG2aanti-OVA antibodies were estimated by enzyme-linked immunosorbent assay. Sucrase activity was elevated in cortisone- and spermidine-treated compared to control rats. iBSA and anti-OVA were significantly reduced in cortisone-treated compared to control rats but were not diminished significantly in the spermidine-treated animals. A decrease in the neonatal intestinal Fc receptor was apparent in the spermidine-fed group; cortisone produced a large reduction in FcRn. Spermidine-fed animals showed morphologic evidence of maturation, with loss of giant vacuoles in the distal intestine; cortisone did not produce significant changes in morphology. Thus, while spermidine, like cortisone, enhanced the appearance of the disaccharidase sucrase, it did not significantly reduce the uptake of BSA or IgG, which is usually observed in mature compared to immature animals. The reason for this dichotomy is not known.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummarySomatic gene therapy has been proposed as a method of treating various metabolic diseases and conditions associated with a deficiency in secretory proteins. The intestine, because of its accessibility, large size, rapid rate of cell turnover, and known location of stem cells, is an attractive site for retro viral gene therapy. Stem cells in the intestine are known to reside in the crypts of Lieberkühn. In this study the IEC-6 cell line, derived from rat intestinal crypt cells, was used as anin vitromodel to study the feasibility and dynamics of retroviral gene transfer in intestinal cells. Using a replication-deficient retrovirus, we delivered a reporter gene, bacterial β-galactosidase (β-gal) into NIH-3T3 fibroblasts and IEC-6 cells. Successful transduction was measured by X-gal histochemistry. Viral titers on IEC-6 cells were lower than on NIH-3T3 cells but were within the same order of magnitude. Gene transfer increased linearly with retroviral concentration up to a 1:5 dilution of retroviral supernatant. With undiluted viral medium, gene transfer was inhibited and this effect was more pronounced with the IEC-6 cells. The negative effect of the undiluted retroviral supernatant was minimized by decreasing the harvest time from the packaging cell line. An optimal plating density 12 h prior to infection was found to be approximately 105cells/6-cm dish in both cell lines. The infection rate was proportionally enhanced by the use of multiple infections. In conclusion, under ideal conditions, the IEC-6 cells were infected at similar levels of efficiency as NIH-3T3 cells. The conditions established should be helpful in devising strategies for gene transfer into intestinal epithelium using retroviral vectors.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryEsophageal acidity may remain stable for long periods at or near pH 4.0, potentially influencing the estimation of risk of esophagitis in esophageal pH monitoring assessment. Our aim was to determine the frequency and clinical significance of a prolonged stable pH around 4.0 (PSpH4) (pH 3.5–4.5) by retrospective examination of 503 pH records from children and by analysis of clinical information, pH parameters, motility studies, and esophageal biopsies. The frequency, duration, and proportion of total time with PSpH4 were quantified, and the ratio of the time for which the pH was <pH 4.0 during PSpH4 episodes to the total reflux time below pH 4.0 was calculated [stable/reflux (S/R) rate]. One hundred fifty-eight PSpH4 episodes were identified in 80 records. The average duration was 60 min and the S/R rate was 30%. Sixty-one percent of PSpH4 episodes started in the postprandial period (p< 0.05). Proportionally more episodes of PSpH4 occurred with an increased total percentage reflux time (p< 0.01). In recordings with PSpH4, the average number of reflux episodes remained normal, even when the percentage reflux time was ≥ 10%. No correlation was shown between PSpH4 and esophageal dysmotility, esophagitis, cardiorespiratory symptoms, or prematurity. PSpH4 did not occur in recordings obtained after fundoplication. We conclude that PSpH4 is common and may result in an overestimation of risk of esophagitis. Qualitative assessment of pH monitoring is necessary along with conventional quantitative measurements.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryUltrasound is a new test proven to be sensitive in the demonstration of gastroesophageal reflux (GER). Following reflux seen with ultrasound various symptoms can be observed in physiological circumstances, and thereby a causal relationship between reflux and these symptoms can be observed in physiological circumstances, and thereby a causal relationship between reflux and these symptoms can be proven. We performed a study in 220 children suspected of GER to determine the incidence of sonographically demonstrated “symptomatic reflux” in different clinical groups: children with (1) vomiting only, (2) respiratory symptoms, (3) attack-like symptoms, and (4) pain and irritability. Overall, GER was demonstrated in 78% of all 209 children in whom technically satisfactory studies could be performed. This reflux was associated with symptoms in 32% of the cases. Symptomatic reflux was most frequent in group 3, which included children investigated for near-miss sudden infant death syndrome. The symptoms that were noted most frequently were vomiting, motor unrest, coughing, and wheezing. Apnea, bradycardia and attacks of unusual posturing could incidentally be related to reflux. Ultrasound is a cheap, simple, noninvasive, and physiological test to show clinically significant reflux.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryIn view of the potential roles of intestinal immunodeficiency and hypersensitivity in the infection/diarrhea/malnutrition cycle, we need a safe and ethical method to study intestinal immunity of children in the developing world. Work in adults has shown that the fluid obtained by whole-gut lavage (WGLF), essentially a gut perfusate, can be used to assess intestinal immunity, inflammation, and gut losses of protein and blood. Gut lavage was successfully performed in 24 of 25 “normal” children aged 6–9 years, from Freetown, Sierra Leone, with parental informed consent. WGLF was treated with protease inhibitors, stored at −20°C, and transferred to Edinburgh for laboratory studies. These showed that no child had occult blood loss but four had evidence of protein-losing enteropathy. Compared with values for Scottish adults, WGLF from the Sierra Leonean children had significantly higher concentrations of IgA and IgM and of IgA and IgM antibodies to dietary antigens and toSalmonella typhilipopolysaccharide. In three children, very low levels of IgA and IgA antibody were present: Two of these were the only cases with detectable sIL2R in lavage fluid, indirect evidence of intestinal T cell activation; tumor necrosis factor was not detectable. Substantial information on childrens' intestinal immunity can be obtained by the method described.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID