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1.
Topaloglu B Bicakci U Tander B Ariturk E Kilicoglu-Aydin B Aydin O Rizalar R Ayyildiz SH Bernay F 《Pediatric surgery international》2008,24(5):555-560
The aim of the study reported here was to evaluate the biochemical and histopathologic effects of omeprazole and vitamin E
in rats with corrosive esophageal burns. A total of 144 Wistar Albino rats were divided into 12 experimental groups (12 rats
per group) and used in an animal study. Group I rats were given a laparotomy and received no treatment (control group), while
groups II, III and IV received a laparotomy and were treated with omeprazole, vitamin E or omeprazole/vitamin E, respectively.
Groups V-XII rats received a laparotomy and were given a caustic acid burn through acid instillation (1 ml caustic 10% sulphuric
acid; groups V–VIII) or alkali instillation (corrosive 10% sodium hydroxide solution; groups IX–XII) into the isolated esophageal
segment via a 22-Fr cannula for 2 min. Each group of rats subjected to caustic burn received either no treatment (groups V
and IX) or were treated with omeprazole, vitamin E or omeprazole/vitamin E, respectively (remaining six groups). Omeprazole
(20 mg/kg) or vitamin E (10 mg/kg) was administered to the rats intraperitoneally or intramuscularly, respectively. Seventy-two
rats (50% of each group, n = 6) were killed immediately after the experimental treatment (acute phase). The remaining rats were kept under standard
conditions for 21 days (late phase) before being killed. The distal esophageal segments were harvested from all animal and
used in histopathologic and biochemical analyses. Compared to the controls (no caustic burn), rats receiving only the acid
or alkali installation (and no subsequent treatment) had the highest mean malondialdehyde (16.9 and 15.8 μmol MDA/g protein,
respectively) and hydroxyproline (5.9 and 5.7; mg HP/g wet tissue) levels of all groups. In comparison, rats treated with
acid + omeprazole and/or vitamin E had relatively lower MDA (12.9 and 11.6 μmol/g protein, respectively) and HP levels (4.3
and 4.08 mg/g wet tissue, respectively). Similarly, rats treated with alkali + omeprazole and/or vitamin E had low levels
of MDA (13.9 and 11.7 μmol/g protein, respectively) and HP (4.3 and 4.4 mg/g wet tissue, respectively). The glutathione (GSH)
levels of acid-only- or alkali-only-treated rats were lower than those found in omeprazole- and/or vitamin E-treated rats.
Based on these results, we conclude that vitamin E and omeprazole affect the biochemical and histopathologic parameters in
rats receiving corrosive esophageal burn from acid and alkali. The effect of both substances was slightly greater in the acid-treated
groups. 相似文献
2.
J. A. Belmonte L. Ibáñez M. R. Ras C. Aulesa J. Vinzo J. Iglesias J. Carol 《European journal of pediatrics》1999,158(7):556-559
The administration of iron supplementation in children with burns has been a subject of controversy. Recent studies argue
against its use in the acute phase of stress. To assess whether iron metabolism parameters show significant differences in
the acute phase and the recovery phase of burn, 21 patients (age range: 17 months to 13 years) with burns of more than 10%
of body surface who had not received blood transfusions or iron supplementation were studied. Sideraemia, ferritin, transferrin,
transferrin saturation index (TSI) and C-reactive protein (CRP) were assessed both in the acute and the recovery phase after
burn. Sideraemia, transferrin, and TSI were significantly lower in the acute than in the recovery phase (17.3 ± 3 vs 53.8 ± 6.6 μg/dL,
190.5 ± 15 vs 287.9 ± 14.3 mg/dL and 7.7 ± 1.3 vs 15.4 ± 1.6%, P < 0.0001, P < 0.001 and P = 0.0006, respectively) while plasma ferritin and CRP were significantly higher (84.7 ± 8.8 vs 43.1 ± 8.5 ng/mL and 9.5 ± 1.5
vs 0.7 ± 0.2 mg/dL, P = 0.016 and P < 0.0001, respectively). When the above parameters were analysed based on age (≤ 2 years, >2 years), the observed differences
persisted.
Conclusion Hyposideraemia is a frequent finding in the acute phase of paediatric burns and is accompanied by increased ferritin levels
and decreased transferrin concentrations. The low iron values tend to recover without the use of iron supplementation suggesting
an endogenous block of iron release in the acute phase and indicates that iron therapy should be not recommended in the initial
period of stress of the burned patient.
Received: 12 March 1998 / Accepted in revised form: 2 September 1998 相似文献
3.
Ming-Guo Xu Li-Na Men Chun-Yu Zhao Xia Zhao Yuan-Xiang Wang Xiang-Chun Meng Ding-Rong Shen Bao-Ying Meng Qing Zhang Tao Wang 《European journal of pediatrics》2010,169(3):289-296
Kawasaki disease (KD) is associated with coronary artery injury. Studies have shown that the endothelial progenitor cell (EPC)
participates in the process of arterial repair. Data have been reported that the number of EPC increased significantly in
the subacute phase of KD. However, until now, there are no data about the functions of EPC in KD patients. The present study
was designed to further investigate the number and functions of EPC in KD. Ten KD patients in the acute phase and ten healthy
volunteers were recruited and attributed to the KD group and control group, respectively. The circulating CD34/kinase insert
domain-containing receptor double positive cells were evaluated in the two groups using flow cytometry. In vitro assays were
used to measure the functions of EPC, including proliferation, adhesion, and migration activities. The plasma levels of nitric
oxide (NO), tumor necrosis factor-α (TNF-α), and high sensitivity C-reactive protein (hs-CRP) were also assessed in both groups.
The number of EPC in the KD group was significantly higher than that of the control group (0.021 ± 0.007% vs. 0.014 ± 0.003%,
P < 0.05). The migratory response of EPC was significantly decreased in the KD group, compared with that of the control group
(5.50 ± 1.78 vs. 3.40 ± 1.35 cells/high power field, P < 0.01). Similarly, the proliferative and adhesive activities of EPC in the KD group were also decreased (0.47 ± 0.08 vs.
0.66 ± 0.07, P < 0.01; 6.5 ± 2.12 vs. 11.2 ± 2.04 cells/high power field, P < 0.01). The plasma NO, TNF-α, and hs-CRP levels in the KD group were higher than those of the control group (54.10 ± 11.78
vs. 38.80 ± 11.10 μmol/l, P < 0.01; 48.20 ± 7.42 vs. 37.00 ± 11.12 pg/ml, P < 0.05; 87.10 ± 30.18 vs. 5.30 ± 3.37 mg/l, P < 0.01). The number of circulating EPC positively correlated with the level of NO (r = 0.92, P < 0.001), and the functions of EPC negatively correlated with the levels of TNF-α and hs-CRP, respectively. In Kawasaki disease,
the number of EPC was enhanced and the functions of EPC were attenuated. The two-way regulation of circulating EPC in KD patients
may be associated with the disorders of cytokines or messengers in KD patients. 相似文献
4.
Circulating soluble adhesion molecule levels in children with acute lymphoblastic leukaemia 总被引:3,自引:0,他引:3
M. Hatzistilianou F. Athanassiadou C. Agguridaki D. Catriu 《European journal of pediatrics》1997,156(7):537-540
The aim of this study was to evaluate levels of serum soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular
cell adhesion molecule-1 (sVCAM-1) and soluble E-selectin (sE-selectin) as parameters of disease activity and to monitor the
response to treatment in children with acute lymphoblastic leukaemia (ALL). The above soluble adhesion molecules were determined
in the serum of 35 children with ALL and 30 healthy children (control group) of the same age range. The samples were obtained
before treatment, 6 months after the beginning of the treatment (remission of the disease), 6 months after the end of the
treatment and during relapse of the disease. The mean levels of sICAM-1, sVCAM-1 and sE-selectin at the onset of the disease
were 646.6 ± 80.9 ng/ml, 1786 ± 151.8 ng/ml and 140.5 ± 17.3 ng/ml, respectively. These values were significantly higher (P < 0.001) than those of the control group, which were, 245.8 ± 25.7 ng/ml, 798.6 ± 78.9 ng/ml and 44.7 ± 18.2 ng/ml respectively.
During remission, the mean levels did not differ significantly from those of the control group. After the end of the treatment
the mean levels again did not show any significant differences compared to the control group. During relapse the soluble adhesion
molecule mean levels (923.9 ± 110.1 ng/ml, 2945.7 ± 349.9 ng/ml and 258.2 ± 5.1 ng/ml) were significantly higher (P < 0.001) than those of the control group and also than those obtained during remission and after the end of the treatment
(P < 0.001). Pearson's correlation coefficient r was computed in order to detect possible linear correlations between: (1) sICAM-1 and sVCAM-1 (r = 0.632); (2) sICAM-1 and sE-selectin (r = 0.788) and (3) sVCAM-1 and sE-selectin (r = 0.752). All three cases correspond to P < 0.001, thus indicating strong linear correlations.
Conclusion The levels of soluble circulating adhesion molecule levels can be utilized for monitoring disease activity of ALL and its
response to treatment, as well as for early detection of relapse. Strong linear correlations between the three soluble adhesion
molecules tested suggest that each of them may be sufficient as an indicator.
Received: 5 August 1996 / Accepted: 13 February 1997 相似文献
5.
A comparison of intratracheal and intravenous administration of gentamicin during liquid ventilation
M. A. Zelinka M. R. Wolfson I. Calligaro S. D. Rubenstein J. S. Greenspan T. H. Shaffer 《European journal of pediatrics》1997,156(5):401-404
Pulmonary absorption of aminoglycosides is poor with intravenous administration, but may be enhanced by direct intratracheal
administration of these drugs using perfluorochemical liquid ventilation (LV). To test this hypothesis, gentamicin sulfate
was administered to two groups of newborn lambs during LV. Serum and lung tissue levels of gentamicin were compared after
either pulmonary intratracheal (IT) or intravenous (IV) routes of administration. Serial serum levels of gentamicin were obtained
every 15 min for the 1st h, every 30 min for the 2nd h, and then hourly until sacrifice (maximum 6 h). At sacrifice, representative
samples of each lung lobe were homogenized and analyzed for tissue gentamicin content. At 1 h, serum gentamicin levels were
similar in both groups: IT administration levels were 3.7 ± 0.55 SE μg/ml and IV levels were 3.5 ± 0.85 SE μg/ml. The peak
serum gentamicin level of 4.8 ± 0.8 SE μg/ml for the pulmonary administration group occurred 1.5 h after administration. Lung
tissue levels of gentamicin for IT administration (4.04 ± 0.62 SE μg/g) were significantly greater than for IV administration
(1.75 ± 0.33 SE μg/g; P < 0.05). There were no significant differences in interlobar gentamicin distribution for either mode of administration.
Conclusion Perfluorochemical can be used as a vehicle for intratracheal delivery of antimicrobials. This route provides equivalent serum
levels at 1 h, higher lung tissue levels, and uniform interlobar distribution relative to intravenous administration of gentamicin.
We speculate that pulmonary administered gentamicin during LV may provide an effective alternative treatment modality in the
management of severe neonatal pneumonia.
Received: 12 April 1996 and in revised form: 24 July 1996 / Accepted 28 July 1996 相似文献
6.
The gap between the pouches has a direct bearing on the tension at the anastomosis that ultimately determines the anastomotic
leak in esophageal atresia with or without tracheoesophageal fistula (EA-TEF). Long-gap EA has been reported to be associated
with aortic-arch anomalies and 13 pairs of ribs. Our observation that EA-TEF with an azygos-vein anomaly (AVA) invariably
had a long gap led us to retrospectively analyze our data. The mean gaps (±SD) in the groups with 13 pairs of ribs (n=6), right-sided aortic arch (n=16), and AVA (n=9) were 1.25 ± 0.27, 2.18 ± 0.98, and 3.16 ± 0.16 cm, respectively. There was no statistically significant difference in
the gap in patients who had 13 pairs of ribs compared with controls who had 12 pairs of ribs. The gap was highest in the AVA
group and was statistically significant (P < 0.001) compared with patients with a normal azygos vein. In addition, the AVA group had a significant increase in mortality
(P < 0.05) compared to the groups with a normal azygos vein; although there was no statistically significant difference in other
factors: birth weight, time between delivery and surgery, cardiac anomalies, anorectal malformations, renal malformations,
and chest infection in the AVA group and controls. An extra pair of ribs is not associated with a long gap, and an AVA per
se is an independent predictor of a long gap and mortality in EA-TEF.
Accepted: 11 May 2000 相似文献
7.
H. Kobayashi T. Miyano K. Horikoshi K. Orihata S. Watanabe S. Futagawa 《Pediatric surgery international》1998,13(7):491-493
Biliary atresia (BA) is the end-result of a destructive inflammatory process that affects intra- and extrahepatic bile ducts,
leading to fibrosis and obliteration of the biliary tracts with the development of biliary cirrhosis and portal hypertension
(PH). Endothelins (ET) are 21-amino-acid peptides of endothelial origin with potent vasoconstrictor activity that bind to
various cells of the liver. Nothing is presently known about plasma ET levels in BA. The aim of this study was to determine
the clinical significance of plasma ET levels in patients with BA after hepatic portoenterostomy (Kasai's procedure) and to
correlate these with liver function tests (LFT) and PH. We measured plasma concentrations of ET in 19 patients with BA (5
boys and 14 girls; mean age 11.6 ± 5.5 years) after portoenterostomy and 10 age-matched controls. Patients were grouped according
to outcome based on LFT: group A consisted of 9 patients with an ‘‘unfavorable outcome” and Group B 10 patients with a “favorable
outcome”. The plasma ET levels were measured using a highly sensitive and specific enzyme immunometeric assay (EIA). No patient
had ascites or hepatorenal syndrome. Plasma ET levels were significantly higher in patients with BA than in controls (3.42 ± 0.42 vs
1.75 ± 0.39 pg/ml, respectively; P < 0.01) and in patients in group A than in group B. (3.75 ± 0.25 vs 3.06 ± 0.23 pg/ml, respectively; P < 0.01). In group A, plasma ET levels were higher in patients with PH (n = 4) than in those without PH (n = 5) (3.99 ± 0.06 vs 3.64 ± 0.22 pg/ml, respectively; P < 0.05). We conclude that plasma ET levels are high in patients with BA, especially those with severe biliary cirrhosis,
and that ET may partially contribute to development of PH in BA. The results of the present study also suggest that plasma
ET concentrations may be a useful marker in the follow-up of patients with BA.
Accepted: 12 September 1997 相似文献
8.
The aim of this study was to assess the effects of parenteral alanyl-glutamine dipeptide (Ala-Gln) on TPN-associated liver
injury. Forty-three New Zealand rabbits (6–8 days old) were divided into three groups: 12 in the control group (maternal fed);
18 in the TPN group (TPN for 10 days); 13 in the Gln-PN group (TPN+Ala-Gln 400 mg kg−1 day−1 for 10 days). At the end of the experiment, liver function and histology were evaluated; MDA content of liver tissues and
hepatocyte apoptosis by TUNEL assay were also determined. The serum concentration of direct bilirubin and bile acid in the
Gln-PN group was significantly lower than TPN group (P < 0.05), but showed no difference compared with the control group. AST level of the Gln-PN group was lower than the other
two groups. The light microscopy (LM) features in the TPN group included cholestasis or diffuse steatosis, while in the Gln-PN
group, inflammatory infiltration and mild hydropic degenerative changes were mainly found without obvious cholestasis or proliferation
of bile ducts. The electron microscopy appearances corresponded with LM findings. The liver MDA content in the Gln-PN group
was clearly lower than the TPN group (P < 0.05), and was lower without statistical significance compared with control group. TUNEL assays showed the ratio of apoptotic
hepatocytes in the TPN group was the highest among all the groups (44.59 ± 6.68 vs. 0.92 ± 0.85 in the control group, P < 0.01; 44.59 ± 6.68 vs. 4.14 ± 2.76 in the Gln-PN group, P < 0.01). There were significantly fewer apoptotic hepatocytes in the Gln-PN group. From this study, we found that glutamine
dipeptide supplementation could attenuate TPN-associated liver injury in infant rabbits, and could also decrease liver MDA
production and hepatocyte apoptosis during total parenteral nutrition.
This study was supported in part by the National Key Program Grant (No.2004BA709B09). 相似文献
9.
M. F. Krause H. -G. Lienhart J. Haberstroh T. Hoehn J. Schulte-Mönting J. U. Leititis 《European journal of pediatrics》1998,157(5):410-415
Marked hypoxia secondary to intrapulmonary right-to-left shunting is a characteristic of respiratory failure in human neonates
and can sometimes be complicated by additional extrapulmonary right-to-left shunting. To investigate the effect of inhaled
nitric oxide (iNO) on intrapulmonary shunting, two typical pulmonary diseases of the newborn (respiratory distress syndrome
and meconium aspiration) were reproduced in 32 mechanically ventilated rabbits weighing approximately 2 kg each. After tracheotomy,
catheters were inserted into a jugular vein, a carotid artery and the right ventricle (to measure systolic right ventricular
pressure [SRVP] and mixed venous oxygen content for calculation of shunt by Fick equation). Repeated airway lavages (LAV)
with normal saline or repeated instillations of a suspension of human meconium (MEC) were continued until both the a/A-ratio
was ≤0.14 and a peak inspiratory pressure ≥22 mbar was needed to keep the tidal volume constant at 10 ml/kg of body weight.
Measurements of shunt, SRVP, systolic systemic pressure, physiological dead space, tidal volume and a ventilation index were
performed before and after completion of lung damage and at 20 and 60 min after administering iNO at 80 ppm. Four groups of
rabbits were studied (n = 8 in each group): LAV control and intervention, Mec control and intervention. 60 min after starting iNO, there was a decrease
in shunt (LAV: 67.6% ± [SD] 11.3% vs 56.2 ± 16.4, P = 0.05; MEC: 52.6 ± 6.3 vs 44.3 ± 8.3, P < 0.05), in SRVP (LAV: 29.7 mmHg ± 10.1 mmHg vs 20.0 ± 8.2, P < 0.01; MEC: 25.1 ± 4.4 vs 22.3 ± 5.0, P = 0.46) and in dead space (% of tidal volume, LAV: 32.7% ± 10.5% vs 25.9 ± 10.1, P < 0.01; MEC: 26.1 ± 16.6 vs 18.9 ± 10.1, P = 0.05). These results demonstrate that iNO decreases intrapulmonary shunt (as well as SRVP and dead space). We suggest that
iNO may be beneficial in human newborns with severe respiratory failure even if no extrapulmonary shunting via ductus or foramen
ovale is apparent.
Received: 18 March 1997 and revised form 6 September 1997 / Accepted: 7 September 1997 相似文献
10.
L. Sirota R. Straussberg N. Gurary D. Aloni H. Bessler 《European journal of pediatrics》1999,158(11):910-913
The capacity of peripheral blood mononuclear cells (PBMC) to produce interleukin (IL) IL-1β, IL-2, IL-3, IL-6, IL-10 and
tumor necrosis factor-α (TNFα) was examined in term newborns with hyperbilirubinemia after 24 hours' exposure to phototherapy
(wave length 425–475 nm). The results were compared with those from untreated neonates. Fifty newborns spontaneously delivered
at term were included in the study. Blood samples were collected from 20 newborns before and 24 h after phototherapy. The
control group consisted of 30 neonates examined on two consecutive days. PBMC isolated from blood samples were incubated in
vitro for cytokine production. The concentration of cytokines in the supernatants was tested using ELISA kits (for IL-1β,
IL-6, IL-10 and TNFα), or by bioassays (for IL-2 and IL-3). Phototherapy caused a 70% increase in IL-2 secretion (123 ± 27
vs 208 ± 30 units/ml, P < 0.01) and 56% in IL-10 production (1.07 ± 0.19 vs 1.67 ± 0.33 ng/ml, P < 0.03), whereas the spontaneous secretion of IL-1β was reduced by 43% (13.7 ± 2.3 vs 7.3 ± 1.7 ng/ml, P < 0.02). In the control group the secretion of these cytokines was similar on the two consecutive days and did not differ
significantly from secretion in the other group before phototherapy. On the other hand, lipopolysaccharide induced TNFα production
was higher on the second day in the two groups of newborns irrespective of phototherapy (388 ± 58 vs 683 ± 88 pg/ml, P < 0.001, in the control group and 384 ± 75 vs 588 ± 91, P < 0.05, before and after phototherapy). The synthesis of IL-3 and IL-6 did not change significantly between the two days
of the study. The results demonstrate that in addition to the well-known positive effect of phototherapy on the neonate serum
bilirubin level, this treatment affects the function of the immune system in newborns via alterations in cytokine production.
Received: 4 September 1997 / Accepted: 14 February 1998 相似文献
11.
Contribution of the blood glucose level in perinatal asphyxia 总被引:3,自引:0,他引:3
This is a comparative study between 60 asphyxiated newborns (cases) and 60 normal neonates (controls) in respect of their
plasma glucose and uric acid levels and also their clinical and neurological status. The mean plasma glucose level was significantly
lower (35.1 ± 11.4 mg/dl vs. 56.9 ± 5.5 mg/dl; P < 0.001) and the mean serum uric acid level was higher (8.0 ± 1.2 mg/dl vs. 4.5 ± 0.83 mg/dl; P < 0.001) in the asphyxiated group when compared to the controls. Within the perinatal asphyxia group, the plasma glucose
level and Apgar scores showed a significant positive linear correlation (r = 0.740, P < 0.001), whereas a significant negative linear correlation was observed between the glucose level and different stages of
hypoxic ischemic encephalopathy (HIE) (r = −0.875, P < 0.001). Although a strong positive linear correlation was found between uric acid and HIE stages (r = 0.734, P ≤ 0.001), the linear correlation between uric acid and Apgar scores (r = −0.885, P < 0.001) and uric acid and the plasma glucose level (r = −0.725, P < 0.001) were found to be significantly negative among the cases. Conclusion: The severity of encephalopathy and cellular
damage varies with the severity of hypoglycemia. 相似文献
12.
Currently, no serum marker has proved helpful in diagnosing intestinal ischemia and reperfusion (I/R) injury. An experimental
study was conducted to determine the value of serum D-lactate in detecting intestinal I/R injury. Thirty New Zealand White
rabbits were divided into three groups of 10 animals each: sham-operation controls (S); I/R; and I/R plus mannitol treatment
(M). Serum samples were obtained before operation (T0), at the end of the ischemic period (T1), after the first 30 min of reperfusion (T2), and at the end of the reperfusion period (T3). In Group S, mean D-lactate levels for T0, T1, and T2 were 0 μg/dl, while T3 was 5.8 ± 4.7 μg/dl. Before the operation (T0), serum mean D-lactate levels were 0 μg/dl in all groups (S, I/R, M). Levels increased after 1 h of ischemia (T1) in groups I/R (83.5 ± 25.6 μg/dl) and M (89.8 ± 19.9 μg/dl), but not in group S (0 μg/dl). The mean T2 level in group I/R (231.6 ± 78.6 μg/dl) was statistically higher than in group M (140.1 ± 53.5 μg/dl) (P = 0.007). At the end of the reperfusion period, the mean T3 level in group I/R (698.4 ± 360.4 μg/dl) was significantly higher than in group M (158.7 ± 61.4 μg/dl) (P = 0.000). In group I/R, mean D-lactate levels changed significantly at each time point (T1 vs T2, P = 0.001; T2 vs T3, P = 0.004). However, in group M the increase from T1 to T2 was significant (P = 0.012), but that from T2 to T3 was not (P = 0.293). As a result, the mean T3 level was significantly higher than the T2 level in group I/R (P = 0.004), but not in group M. This study confirmed a significance rise in D-lactate levels in animals with I/R injury compared
to sham-operated and I/R injury plus M treatment. We suggest that serum D-lactate levels could be a useful marker of intestinal
I/R injury before laparatomy.
Accepted: 26 May 1998 相似文献
13.
Background We have shown that tension applied to the esophageal pouches in long-gap esophageal atresia allows primary repair without
necessity for intestinal or gastric transposition.
Objective To determine whether the mural structure of the upper esophageal pouch is altered by tension.
Materials and methods We examined the esophagus with high-resolution endoscopic ultrasonography. The upper pouch was examined before traction and
the upper and lower esophagus were examined after primary repair. Of 11 patients examined, 7 were male. At initial surgery
the age, weight and length of the patients (mean ± SD) were 118 ± 88 days, 4.7 ± 1.2 kg and 54 ± 4 cm, respectively. The gap
length was 4.7 ± 1.1 cm.
Results The pretraction measurement of the muscularis propria of the upper pouch was similar to the postanastomotic measurement of
the upper esophagus, and there was no statistically significant difference from the lower esophageal segments after anastomosis:
0.83 ± 0.19, 0.80 ± 0.15 and 0.81 ± 0.22 mm, respectively (P = 0.90). The thickness of combined mucosa and submucosa was also very similar in all three measurements, respectively: 0.93
(0.21) mm vs. 1.06 (0.08) mm vs. 1.0 (0.11) mm (P = 0.14).
Conclusion The layers of the upper esophageal pouch are preserved in infants with esophageal atresia in whom esophageal length is increased
with tension. 相似文献
14.
Influence of apolipoprotein E genotypes on serum lipid parameters in a biracial sample of children 总被引:1,自引:0,他引:1
The goals of this study were to compare the allelic distribution of the apolipoprotein E(apoE) gene in Hungarian and Hungarian
Gypsy children and to examine the impact of apoE polymorphism on quantitative levels of lipids in the two racial groups. Our
data yielded calculated allele frequencies of 6.4% and 8.9% for apoE2; 83.8% and 73.8% for apoE3; and 9.8% and 17.3% for apoE4
in Hungarian and in Gypsy children, respectively. The frequency of the apoE4 allele was significantly higher (P < 0.05) in Gypsy children than in Hungarians. The effect of apoE genotypes on serum lipid parameters differed considerably
in the two racial groups. In the Gypsy group the lowest total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C)
and triglyceride levels were in the E3/E3 group and these values differed significantly (P < 0.0001 for TC and LDL-C and P < 0.01 for triglyceride) from the values in the E2/E3 and E3/E4 groups. There were no significant differences in TC, LDL-C
and triglyceride levels between E2/E3 and E3/E4 groups. The high-density lipoprotein-cholesterol (HDL-C) levels did not differ
significantly among the genotype groups. In Hungarian children, the apoE2/3 group displayed lower, the E3/4 group higher,
values of TC and LDL-C than in the E3/3 group, but the differences were not significant (P > 0.05). HDL-C and triglyceride values did not differ among the genotype groups.
Conclusion Our results demonstrate that the apolipoprotein E allele frequencies differ between Hungarian and Gypsy children and suggest
that these alleles influence the serum lipid levels, but other genetic and environmental factors can considerably change this
effect.
Received: 5 May 1999 / Accepted: 1 October 1999 相似文献
15.
Low serum inhibin B levels as a marker of testicular damage after treatment for a childhood malignancy 总被引:4,自引:0,他引:4
Cicognani A Cacciari E Pasini A Burnelli R De Iasio R Pirazzoli P Paolucci G 《European journal of pediatrics》2000,159(1-2):103-107
The aim of this study was to evaluate the role of inhibin B and the determination of its concentration to diagnose testicular
damage after treatment for a childhood malignancy. Thirty-seven males treated for Hodgkin disease (n=11) or non-Hodgkin lymphoma (n=26) were examined at a mean age of 16.9 ± 2.9 years. Mean age at the stop of therapy was 11.3 ± 3.0 years and in most cases
the chemotherapy regimen included gonadal damaging alkylating agents. Thirty-three normal males (mean age 17.9 ± 4.1 years)
were examined as controls. Serum samples were collected for determination of inhibin B, follicle-stimulating hormone (FSH),
luteinizing hormone (LH), and testosterone. Median inhibin values were significantly lower in patients than in controls (96.0
vs 225.0 pg/ml, P < 0.0001) and a strong negative correlation was found between inhibin B and FSH (r=−0.86, P < 0.0001), a weak correlation with LH (r = −0.32, P < 0.05) and no correlation with testosterone. In post-pubertal patients (i.e., over 16 years) a positive correlation was
found between testicular size and inhibin level (r=0.53, P < 0.05), but not between testicular size and testosterone level. Pathological low levels (values that differed by more than
2 SD from the mean value of control subjects) were found in 20 patients for inhibin B and 8 for testosterone (P < 0.01) and pathological high values in 19 patients for FSH and 3 for LH.
Conclusion This study confirms the role that inhibin B plays in the regulation of FSH secretion and provides further evidence of the
utility of its evaluation as a direct indicator of male gonadal dysfunction.
Received: 21 April 1999 / Accepted: 27 September 1999 相似文献
16.
ZÜBEYDE GÜNDÜZ SMET YAVUZ MEHMET KOPARAL SEFER KUMANDA RECEP SARAYMEN 《Pediatrics international》1996,38(3):237-241
The mechanisms underlying febrile convulsions (FC), which have multiple etiological factors, are not yet clear. The aim of the present study was to determine whether there were any changes in serum and cerebrospinal fluid (CSF) zinc (Zn) levels in children with febrile convulsion during seizures. A total of 102 children were included in the study, with four groups formed as follows: group A, 40 children with FC (aged 9 months to 5 years); group B, 20 children having fever without convulsion (aged 6 months to 5 years); group C, 20 children with afebrile convulsion (aged 6 months to 6 years) and group D, 22 healthy children (aged 5 months to 6 years). Serum and CSF zinc levels for groups A, B and C and serum Zn levels only for group D were measured. The serum Zn levels of 17 children in group A were again measured during healthy periods. Serum Zn levels of groups A, B, C and D had a mean of 0.70 ± 0.10 mg/dL, 1.07 ± 0.08 mg/dL, 1.26 ± 0.32 mg/dL and 1.17 ± 0.21 mg/dL, respectively, and the values of group A were lower than those of the other three groups (P < 0.001). In group B, serum Zn levels were also lower than those of groups C and D (P < 0.05). The CSF Zn levels of groups A, B and C were found to have a mean of 0.07 ± 0.02 mg/L, 0.12 ± 0.02 mg/L and 0.14 ± 0.04 mg/L, respectively. In group A, the CSF Zn levels were lower than those of groups B and C (P < 0.001), and in group B they were lower than those of group C (P < 0.05). For the 17 patients in group A, serum Zn levels during healthy periods (0.87 ±0.10 mg/dL) were found to be higher than the values shortly after seizures, but lower than those of groups B, C and D (P < 0.001). We could not observe any relationship between zinc levels of the serum and CSF and the degree and duration of the fever. These findings suggest that serum and CSF Zn levels decreased during infectious diseases, and that this decrease was more significant in patients with FC. 相似文献
17.
Disease-related response to inhaled nitric oxide in newborns with severe hypoxaemic respiratory failure 总被引:2,自引:0,他引:2
J.-C. Mercier T. Lacaze L. Storme J.-C. Rozé A. Tuan Dinh-Xuan M. Dehan 《European journal of pediatrics》1998,157(9):747-752
Inhaled nitric oxide (iNO) has been shown to improve oxygenation in severe persistent pulmonary hypertension of the newborn
(PPHN). However, PPHN is often associated with various lung diseases. Thus, response to iNO may depend upon the aetiology
of neonatal acute respiratory failure. A total of 150 (29 preterm and 121 term) newborns with PPHN were prospectively enrolled
on the basis of oxygenation index (OI) higher than 30 and 40, respectively. NO dosage was stepwise increased (10–80 ppm) during
conventional mechanical or high-frequency oscillatory ventilation while monitoring the oxygenation. Effective dosages ranged
from 5 to 20 ppm in the responders, whereas iNO levels were unsuccessfully increased up to 80 ppm in the nonresponders. Within
30 min of iNO therapy, OI was significantly reduced in either preterm neonates (51 ± 21 vs 23 ± 17, P < .0001) or term infants with idiopathic or acute respiratory distress syndrome (45 ± 20 vs 20 ± 17, P < .0001), `idiopathic' PPHN (39 ± 14 vs 14 ± 9, P < .0001), and sepsis (55 ± 25 vs 26 ± 20, P < .0001) provided there was no associated refractory shock. Improvement in oxygenation was less significant and sustained
(OI = 41 ± 16 vs 28 ± 18, P < .001) in term neonates with meconium aspiration syndrome and much less (OI = 58 ± 25 vs 46 ± 32, P < .01) in those with congenital diaphragmatic hernia. Only 21 of the 129 term newborns (16%) required extracorporeal membrane
oxygenation (57% survival). Survival was significantly associated with the magnitude in the reduction in OI at 30 min of iNO
therapy, a gestational age ≥34 weeks, and associated diagnosis other than congenital diaphragmatic hernia. Conclusion, iNO
improves the oxygenation in most newborns with severe hypoxaemic respiratory failure including preterm neonates. However,
response to iNO is disease-specific. Furthermore, iNO when combined with adequate alveolar recruitment and limited barotrauma
using exogenous surfactant and HFOV may obviate the need for extracorporeal membrane oxygenation in many term infants.
Received: 24 April 1997 / Accepted in revised form 3 January 1998 相似文献
18.
Akira Miyano Toru Miyamichi Masahiro Nakayama Hiroyuki Kitajima Akira Shimizu 《Pediatric and developmental pathology》1998,1(6):513-521
The serum concentration of inflammation-associated proteins and several complement components in the cord blood of 215 newborns
with and without chorioamnionitis (CAM), who were delivered between 17 and 42 weeks of gestation, were measured. We investigated
the relationship of levels of serum proteins to acute, subacute, and chronic CAM, and to subacute necrotizing funisitis (SNF).
Complement components C3d, C3, and C4 levels increased in subacute CAM (P = 0.0002, P = 0.0007, P = 0.0029, respectively), whereas factor B increased in each type of CAM (P = 0.0001, P = 0.0009, P = 0.0004, respectively). Among the immunoglobulins, IgG levels were unrelated to the presence or type of CAM, IgM levels
increased in subacute CAM (P < 0.0001), and IgA levels increased in chronic CAM (P < 0.0001). Among the acute phase reactants (APR), haptoglobin and C-reactive protein (CRP) levels increased in acute (P < 0.0001, P = 0.0022, respectively) and chronic CAM (P = 0.0035, P = 0.0345, respectively), whereas orosomucoid levels increased in chronic CAM (P = 0.0003). IL-6 levels increased in acute (P = 0.0011) and subacute (P = 0.0475) CAM. C3d (P = 0.0063), C3 (P = 0.0289), C4 (P = 0.0491), and IgM (P < 0.0001) levels were increased in SNF. These findings suggest that the histologic distinction of acute, subacute, and chronic
CAM is a useful indicator of the inflammatory mediator status of the infants. The infants with SNF may have ended their initial
active inflammatory states, but they still have subacute immune activation.
Received March 11, 1997; accepted March 4, 1998. 相似文献
19.
B. H. P. Nagel M. Palmbach D. Petersen M. B. Ranke 《European journal of pediatrics》1997,156(10):758-763
In order to validate an association between pituitary size and severity of growth hormone deficiency (GHD) we evaluated the
magnetic resonance images (MRI) of 107 children with different causes of short stature. Ninety-one MRIs were evaluable (64
male, 27 female; age: 9.1 ± 3.9 years). The levels of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor
binding protein-3 (IGFBP-3), and tests of GH stimulation and spontaneous secretion, led to the following sub-groups: severe
isolated GHD (SIGHD) (GH < 7 ng/ml) (n = 21); partial, isolated GHD (GH 7–10 ng/ml) (n = 22); multiple pituitary hormone deficiency (MPHD) (n = 13); neurosecretory dysfunction (n = 10); non-classifiable diagnosis (NC) (n = 13); idiopathic short stature (n = 9); and intra-uterine growth retardation (n = 3). Pituitary height (PHT) was measured and hypoplasia was assumed when PHT was <−2 SDS. An ectopic posterior pituitary
with missing stalk and a hypoplastic anterior pituitary was present in 12 (57%) SIGHD cases, 12 (92%) MPHD cases and 1 patient
from the NC group. An isolated hypoplastic anterior pituitary was observed in 15%−33% of the other groups. PHT (mm; mean,
SD) in MPHD (1.7 ± 0.5) was lower than in SIGHD (2.7 ± 1.0, P < 0.05), with PHT of both groups being lower than in all the other groups (3.8 ± 0.9, P < 0.0001). PHT SDS correlates with IGF-I SDS (r = 0.48, P < 0.0001), IGFBP-3 SDS (r = 0.46, P < 0.0001) and the highest peaks in tests of GH stimulation and GH spontaneous secretion (r = 0.36, P < 0.0001). In contrast to all the other groups, no correlation with age was observed in MPHD and SIGHD. Breech delivery was
recorded in up to 26% of patients in all seven groups. Surprisingly, only 1 out of 23 patients with an ectopic posterior pituitary
was born by breech delivery, suggesting that ectopia of the posterior lobe is not necessarily related to breech delivery.
Conclusion PHT is significantly correlated with GH secretion in several types of short stature. Patients with␣ectopic posterior pituitary,
missing stalk and hypoplastic␣anterior pituitary either suffer from SIGHD or MPHD, and this anatomical defect is not necessarily
related to breech delivery.
Received: 1 December 1996 and in revised form: 8 February 1997 / Accepted: 18 February 1997 相似文献
20.
K. Schmitt G. Häusler P. Blümel E. Plöchl T. Waldhör H. Frisch 《European journal of pediatrics》1997,156(2):99-103
Administration of human growth hormone (GH) has yielded conflicting results concerning its role on thyroid function in patients
with Ullrich-Turner syndrome. Therefore, we investigated the course of thyroid hormone parameters and thyroxin binding globulin
in relation to GH therapy, IGF-I and additional oxandrolone-(Ox) or testosterone (T) treatment in 20 patients with Ullrich-Turner
syndrome. During the 1st year the patients received only GH. There was no change in T4, fT4, and TSH levels, T3 increased
significantly (P < 0.01) after 6 and 12 months, resulting in a higher T3/T4 ratio. TBG (P < 0.05) and IGF-I (P < 0.01) increased after 6 months and remained elevated at 12 months. A significant positive correlation was found between
the change of T4 and TBG after 6 months (r = 0.47, P < 0.05) and after 12 months (r = 0.69, P < 0.005). Thirteen patients were further investigated after addition of an anabolic compound; 7 received Ox (0.0625 mg/kg/day
po) and 6 low dose T (5 mg i.m. every 14 days). Chronological age was comparable in these groups (10.7 ± 2.7 vs 10.7 ± 3.6
years). After 6 months of combination therapy with Ox, T4, T3 and TSH decreased. As T4 and T3 showed a parallel decrease the
T3/T4 ratio remained elevated. TBG declined after 6 and 12 months (P < 0.05), while IGF-I showed a further increment (P < 0.05). There was no correlation between the changes in T4 and IGF-I, TSH and TBG, respectively. In the T-treated group
only IGF-I increased (P < 0.05) to the same extent as in the Ox-treated patients, whereas the thyroid parameters did not change.
Conclusion The observed changes in thyroid hormone and TBG levels in the Ox group were not mediated by GH or IGF-I. The Ox-induced TBG
decrease might be linked to altered pancreatic functions regulating carbo-hydrate metabolism.
Received: 22 April 1996 / Accepted: 1 August 1996 相似文献