ISSN:0277-2116    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The records of 583 children who were treated for intussusception at the Children's Hospital of Buffalo in the period 1930–1985 were reviewed. Following a change in management in 1970 from operative treatment to hydrostatic reduction of the intussusception by barium enema, two main groups are defined. In earlier years 95% of patients underwent operative reduction whereas in the latter period 92% had barium reduction attempted. The remaining 8% in this group had clinical contraindications for hydrostatic enema attempt. Ten percent had pathological lead points. Recurrent intussusception occurred in 50 cases (8.5%), 66% following barium enema reduction and 33% after surgery. The mortality in the earlier group was 3.9% and 1.3% in the latter group. No deaths occurred in patients treated successfully with barium enema reduction, and there were no deaths in the children with simple uncomplicated intussusception requiring surgery.

ISSN:0277-2116    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

This study was undertaken in the young and growing rabbit to establish the effect of feeding a highcholesterol (2%) diet on the intestinal in vitro uptake of glucose, galactose, leucine, and cholic acid. Three groups of animals were fed standard Purina chow for 14, 28, and 42 days. A fourth group was fed chow for 14 days followed by high-cholesterol diet for 10 days followed by chow for 4 days. A fifth group was fed chow for 14 days followed by the high-cholesterol diet for 10 days followed by chow for 18 days. Short-term feeding with a high-cholesterol diet reversed the normal developmental decline in the jejunal uptake of some nutrients (e.g., glucose), enhanced the age-related uptake of other nutrients (e.g., galactose and leucine), but had no effect on others (e.g., jejunal uptake of cholic acid). Two weeks after stopping the high-cholesterol diet, there was enhanced jejunal uptake of all nutrients. Colonic uptake of glucose, galactose, and leucine was unresponsive to the effects of early development or of a high-cholesterol diet, whereas the colonic uptake of cholic acid did increase. This altered uptake is not explained by nonspecific mechanisms such as changes in body weight gain, intestinal mass, or effective resistance of the intestinal unstirred water layer. In summary, early feeding of rabbits for a short interval with a high-cholesterol diet is associated with transport changes that may persist, progress, or appear for the first time when the animals are switched from the high-cholesterol diet back to chow. Thus, early feeding with a high-cholesterol diet alters the normal development of intestinal transport function.

ISSN:0277-2116    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Duodenal bile acids, identified by gas-liquid chromatography (GLC) and gas chromatography-mass spectrometry (GC-MS), were correlated with quantitative aerobic and anaerobic duodenal culture in 26 children with enteropathies. Four patients whose duodenal fluid contained either ⩾106gram-negative aerobes or ⩾106aerobic lactobacilli per milliliter had a significantly greater molar percentage of keto-bile acids (32.3 ± 8.4%) than did 19 controls (0.72 ± 1.50%) chosen because duodenal fluid contained ⩽104bacteria per milliliter or three other patients with ⩽106anaerobes (6.1 ± 4.6%). As expected, free bile acids were seen in greater quantities (10.75 ± 3.25%) among the patients with anaerobic overgrowth or aerobicLactobacillusovergrowth than among the controls (1.6 ± 1.0%) or the other three aerobic overgrowth patients (2.2 ± 1.4%). Incubation of glycocholate or glycochenodeoxycholate for 60 h withEubacterium tortuosumfrom one patient orEscherichia colifrom another produced the types of bile acids found in the duodenum of those patients. Successful antibacterial therapy improved gastrointestinal function and normalized duodenal bile acids not only among patients with anaerobic overgrowth but also among those with pure aerobic overgrowth. These data suggest that pure aerobic bacterial overgrowth syndrome occurs in children, and that altered duodenal bile acid composition may play a pathophysiologic role in this disorder.

ISSN:0277-2116    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Passive permeability of small intestine to lactulose and mannitol was studied in children suspected of having intestinal disease, using a hypertonic differential sugar absorption test. Children with coeliac disease and cows' milk intolerance were shown to have an elevated urinary lactulose/mannitol recovery ratio when compared with controls, children with normal jejunal biopsy, or children in whom alternative explanations for failure to thrive had been demonstrated. The abnormality in permeability ratio principally reflects a reduced urinary recovery of mannitol following oral administration. This study demonstrates that a hypertonic sugar absorption test is well tolerated even by young children, is practicable in routine clinical pediatric practice, and is capable of demonstrating abnormal intestinal function in children with small intestinal disease.

ISSN:0277-2116    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

To evaluate the incidence of either evident anemia or a subclinical status of iron deficiency in celiac disease (CD), we studied 80 celiac children aged 6 months to 18 years. They were subdivided into various groups according to morphology of gut mucosa and diet. Only eight of 47 celiac children had an evident anemia at the time of the first peroral bowel biopsy. In addition, 51% of the patients with atrophic mucosa and 56% of the children on a gluten-containing diet had serum iron levels <50 μg/dl; 35% of patients of both groups had serum ferritin levels <12 μg/L. On the contrary, only a small number of children with normal mucosa on a gluten-free diet showed a laboratory, subclinical picture of iron deficiency. The results of our study can therefore be summarized in three major items: (a) Low levels of both serum iron and ferritin can frequently be found during active CD. (b) Regular determination of serum iron levels appears to be useful in controlling the state of iron stores in such patients, as well as in deciding whether and when to recommend temporary iron supplementation, (c) Serum ferritin tests did not offer more information than the easier and cheaper serum iron determinations.

ISSN:0277-2116    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Within a defined population in southeast Sweden, celiac disease was diagnosed in 167 children born between 1970 and 1982. The diagnosis was based on the criteria of the European Society for Paediatric Gastroenterology and Nutrition. Another six children had an initial flat small intestinal mucosa but do not yet fulfill the criteria for the diagnosis of celiac disease. The incidence of celiac disease was 1.27/1,000 live births for the years 1970–1976 and 1.43/1,000 for 1977–1982. In contrast to our findings, a decline in the disorder during the late 1970s was reported from other countries. We discuss the observation that the incidences of celiac disease in children are moving discrepantly in different populations.

ISSN:0277-2116    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

An 8-week-old infant presented with vomiting and failure to thrive due to small bowel obstruction caused by a diffusely enlarged pancreas. Surgical bypass of the obstruction was followed by secretory diarrhea, hypokalemia, and dehydration. Plasma vasoactive intestinal peptide (VIP) (823 pg/ml), pancreatic polypeptide (4,500 pg/ml), and neurotensin (680 pg/ml) concentrations were markedly elevated. No neoplastic process was identified. Therapy with the long-acting somatostatin analogue SMS 201–995 was followed by decline in VIP concentrations (900 to 200–300 pg/ml), decrease in stool frequency, and normalization of serum electrolytes. During 12 months of somatostatin analogue therapy, length and weight progressed along the 3rd percentile on the Tanner growth chart.

ISSN:0277-2116    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

In 89 healthy full-term newborn infants, we studied the different contribution of gastrin 17 (G17) and gastrin 34 (G34) to neonatal hypergastrinemia and the G17 and G34 response to a meal in the first days of life. Serum concentrations of G17 and G34 were measured by radioimmunoassay specific for the NH2-terminus of G17 and G34 in 23 newborn infants in the cord blood and in 66 newborn infants before or 20 min after bottle-feeding. Basal serum G17 and G34 values were also obtained in 38 healthy fasting adults. Mean (±SEM) G17 levels in the cord blood were not different from those of the adult controls (29.28 ± 4.16 versus 31.00 ± 2.62 pg/ml) and increased significantly either at 12 h (48.06 ± 7.32 pg/ml, p < 0.025) or on the 4th day of life (80.56 ± 9.99 pg/ml, p < 0.01). Serum G34 levels in the cord blood were significantly higher than in adult controls (163.22 ± 11.19 versus 126.68 ± 5.57 pg/ml, p < 0.005) and increased at 12 h of life (225.22 ± 25.95 pg/ml, p < 0.02), but no increase was found on the 4th day of life (204.87 ± 18.08 pg/ml). Neither postprandial G17 nor G34 increases were found on the 1st or on the 4th day of postnatal life. The study supports the following conclusions: (a) neonatal hypergastrinemia is mainly due to G34 fraction; (b) the increased levels of gastrin on the 4th day of life are due to G17 fraction; (c) bottle-feeding does not stimulate either G17 or G34 release in the first 4 days of life.

ISSN:0277-2116    

出版商:OVID    

年代:1987

数据来源: OVID