ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Pediatric patients with ulcerative colitis and Crohn's disease often suffer from malnutrition and growth failure. This is particularly true in pubertal children. Chronic insufficient nutrient intake is most often the cause of growth failure. Both parenteral nutrition and defined enteral formulas are available to rehabilitate patients with malnutrition and growth failure. Assessment of nutritional status and growth and the use of parenteral nutrition and defined enteral formulas to reverse malnutrition, growth failure, and inflammation in pediatric patients with inflammatory bowel disease are discussed.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Two epileptic patients treated with anticonvulsants of valproic acid, phenobarbital, nitrazepam, and diphenylhydantoin developed anorexia, convulsions, and unconsciousness. The liver biopsy samples showed degenerated hepatocytes containing enlarged mitochondria with a distorted matrix. The matrix granules in the mitochondria were enlarged in size as compared with those of chronic hepatitis (P0= 0.0009). X-ray microanalysis has revealed the presence of calcium in large mitochondrial matrix granules. Both patients were thought to have valproic acid intoxication because they recovered quickly after the withdrawal of valproic acid.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Age-dependent changes of serum α-fetoprotein (AFP) levels were analyzed in 284 normal infants, including 113 full-term neonates and 171 infants between 1–12 months old. Serial statistical analyses attempted to clarify some confusing and conflicting observations presently existing in the literature. The results showed the following: (a) variations of AFP values were homogeneous throughout infancy, after the logarithmic transformation that is essential in dealing with AFP data. (b) To obtain an approximately 95% prediction band of normal AFP levels in infancy, the regression analysis should be based on the power regression rather than the exponential progression model: logY= 7.397 - 2.622 · log (X+ 10), whereX= age in days andY= AFP level in nanograms per milliliter. (c) A sex-related difference existed with higher mean values for male babies between 2–4 days of age, a fact that may be missed with casual analysis. In addition, the mean AFP level was found to be relatively constant at some time during the 1st week of life, in contrast to its subsequent extremely rapid decline. These characteristic changes deserve further investigation.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Alagille's syndrome is a common form of familial intraphepatic cholestasis. In addition to the hepatobiliary system, many other organ systems are affected. Most of the affected patients survive through adulthood. Hepatic involvement is the cause of death in about one-third of patients. Hepatocellular carcinoma complicating the course of this disease is very rare and has been reported previously in only three cases. We report a family in which three of four siblings with this syndrome developed hepatocellular carcinoma and died as a result of it. None of these children had a liver disease, other than Alagille's syndrome, that could account for the development of such a tumor. This experience suggests that Alagille's syndrome, or at least chronic cholestasis, may be a predisposing factor for the development of hepatocellular carcinoma. Annual determination of α-fetoprotein and abdominal computed tomography (CT) scan may detect the development of a hepatocellular carcinoma in such cases while they are still resectable.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

We studied the effects of positional treatment and cisapride (a new prokinetic agent) on the incidence and duration of gastroesophageal reflux in 22 infants (4–26 weeks old) in asleep, awake, fasted, and postcibal periods. In addition to gastroesophageal reflux (assessed by 24-h continuous esophageal pH monitoring), all infants presented with a disrupted irregular sleep pattern (“respiratory dysfunction”) (assessed by a simultaneously performed cardiopneumogram). Reflux was particularly prominent during the sleep and fasted periods. Investigations (cardiopneumogram and esophageal pH monitoring) in the study population were repeated under treatment conditions (cisapride) after 13–16 days. All pH monitoring data with regard to the total investigation time decreased significantly (p < 0.001). The treatment-related differences were largest in the asleep and fasted periods, but treatment data were not completely within normal ranges (established in age-matched asymptomatic infants), as they were for the awake periods. Associated symptoms of gastroesophageal reflux (belching, cough, nocturnal wheezing, irritability, and restlessness at night) were evaluated before and during treatment by history. A combination of positional treatment and cisapride seemed effective (objectivated by pH monitoring data and clinical improvement); cisapride did not cause adverse reactions. The disrupted sleep pattern improved significantly or disappeared (p < 0.001) in all infants. These data suggest that in a number of young infants, gastroesophageal reflux may be associated with a disturbed, irregular sleep of poor quality, which is characterized by a typical breathing pattern (multiple, irregularly repeated, short apneas).

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Gastric emptying was measured using a modification of the double-sampling dye dilution technique in 16 children with gastroesophageal reflux and partial thoracic stomach (hiatal hernia), 13 with reflux per se, and 12 controls with nonspecific vomiting. No differences could be demonstrated between the rate of emptying in these groups. Our study failed to provide a rational explanation for the copious projectile vomiting that is a frequent manifestation of these disorders.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

We report our 20 years' experience on the management of 78 children with primary chronic peptic ulcer, giving special emphasis to the recent 32 patients (29 duodenal ulcer, 3 gastric ulcer) who received H2-antagonist therapy guided by endoscopic surveillance. The most striking observation was the marked decrease in the incidence of “failed medical treatment necessitating surgery” from 34.8% (16/46) in the pre-H2-antagonist era to 3.1% (1/32) in the H2-antagonist era. H2antagonist was uniformly well tolerated and without side-effects. In 29 patients with duodenal ulcer, a 6-week therapeutic course resulted in complete ulcer healing in 22 (75.9%). Further therapeutic courses resulted in complete ulcer healing in four additional patients (13.8%). There was only partial ulcer healing in two patients (6.9%) and nonhealing in one patient (3.49%). There were 11 episodes of recurrence in nine patients (symptomatic 5, asymptomatic 6). Recurrence was more frequent when nocturnal-dose maintanence was not given (8/11 recurrences). All recurrences responded satisfactorily to further H2-antagonist therapy. Patients with gastric ulcer responded even more favorably, all three healing completely with a single therapeutic course and not requiring maintenance therapy. We conclude that H2-antagonist is safe and highly effective for healing peptic ulcer in children. For duodenal ulcer, maintenance therapy ensures a satisfactory remission rate.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The determination of serum levels of D-xylose and the urinary excretion of an orally administered mixture of low-molecular-weight polyethylene glycol were compared to assess their sensitivity to predict smallbowel mucosal damage. Eighteen infants with severe diarrhea and villus atrophy were observed. Results of the D-xylose and polyethylene glycol tests were compared with the villus-to-crypt ratios that were determined from biopsy specimens. The D-xylose test predicted accurately 12 (67%) of the 18 small-bowel biopsy results, while the polyethylene glycol test predicted 14 (78%). However, the McNemar test indicated that the two tests did not differ significantly in their ability to predict an abnormal small-bowel biopsy. We conclude that neither the D-xylose nor the polyethylene glycol test is a reliable indicator of small intestinal mucosal damage in infants with chronic diarrhea.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID