Ken Itoh

Levels of Insulin-Like Growth Factor I in Full- and Preterm Human Milk in Comparison to Levels in Cow’s Milk and in Milk Formulas

The content of insulin-like growth factor I (IGF-I) in human milk, cows milk and cows-milk-based infant formulas was determined by radioimmunoassay. The mean levels of IGF-I in full-term milk and preterm milk 0-4 days post partum 2.2 +/- 0.3 and 2.4 +/- 0.5 ng/mg protein, respectively. The IGF-I content in human milk was not affected by gestational age or birth weight and was constantly excreted up to 10 days post partum. The IGF-I content in human milk was significantly higher than that in cows milk (0.6 +/- 0.1 ng/mg protein, p less than 0.01). IGF-I was not detected in the milk formulas. The IGF-I in human milk might be absorbed or could act locally in the intestine and may be of importance in the nutrition of neonates.

Endoscopic findings in pediatric patients with Henoch-Schonlein purpura and gastrointestinal symptoms

We report the gastrointestinal endoscopic findings in nine patients with Henoch-Schonlein purpura. Eight patients underwent upper gastrointestinal endoscopy, which revealed erosive gastritis in one patient, hemorrhagic-erosive duodenitis in four, and both findings in one. The rectum and the sigmoid colon were examined in six patients. Aphthoid ulcers were noted in two. In one of these patients, a rectal ulcer was also noted. Severe inflammatory changes and angiitis were found in the biopsy specimens obtained from the duodenum and the colon. The vascular abnormalities in the gastrointestinal mucosa are similar histologically to those found in the skin in Henoch-Schonlein purpura.

Effect of 10% Ethanol and Sofalcone on Prostaglandin E2 Content, Mucus Gel Thickness, and Experimental Ulcers in the Stomach of Developing Rats

We studied the effects of a mild irritant, 10% ethanol, and sofalcone on the gastric mucosal defense mechanisms in newborn rats, comparing the effects to those seen in adult rats. The results indicated (1) that both mucosal prostaglandin E2 (PGE2) content and mucus gel layer thickness increased with age, (2) that sofalcone, but not 10% ethanol, increased mucosal PGE2 content and mucus gel thickness in 1- and 8-week-old rats, (3) that both sofalcone and 10% ethanol decreased mucosal damage induced by 50 or 75% ethanol in both age groups, and (4) that 10% ethanol, but not sofalcone, decreased ethanol-induced mucosal damage in rats pretreated with indomethacin. We concluded that 10% ethanol and sofalcone increase gastric mucosal defence mechanisms in newborn rats as in older rats.

Developmental changes in gastric mucus gel thickness: responsiveness to 16,16-dimethyl prostaglandin E2 and mucosal protection in the rat.

The gastric mucosa of newborn rats is sensitive to the damaging effects of acid and ethanol. We measured gastric mucus gel thickness in newborn, suckling, and weaned rats by inversion microscopic observation. The thickness in newborn rats was 52.2 ± 6.7 Mm and increased with age, reaching 96.8 ± 5.6 μm in 8-wk-old rats (p < 0.001). Oral administration of 16, 16-dimethyI prostaglandin E2 at concentrations of 10 and 100 μg/kg body weight increased mucus thickness in 8-wk-old rats but had no effect in 1-wk-old rats. We also assessed the effect of 16, 16-dimethyl prostaglandin E2 on the prevention of gastric mucosal damage induced by ethanol. Oral 16, 16-dimethyl prostaglandin E2 reduced damage in 8-wk-old rats, but there was no effect in 1-wk-old rats. These data suggest that the susceptibility of newborn rats to gastric mucosal injury may be related to the relative thinness of the gastric mucus gel layer and the failure of prostaglandins to increase the mucus gel layer thickness.

Oral neurotensin increases gastrointestinal transit in suckling rats.

Several neuropeptides known to alter gastrointestinal motility are present in milk. We investigated the effect of gastric administration of neurotensin, bombesin, somatostatin, and vasoactive intestinal polypeptide on gastrointestinal motility in suckling rats. We gavage fed 7-to 10-day-old rats with a meal consisting of 10 μl/g of body weight of 0.9% NaCl with 51Cr tracer and one of the peptides (0, 0.1, 10, and 1,000 ng/ml). We estimated the rates of gastric emptying and the small intestinal transit from the distribution of the radioactivity in the gut. Approximately one-half of the counts emptied from the stomach in 15 min. Both gastric emptying and small intestinal transit were time dependent and were accelerated by metaclopramide and inhibited by butylscopolamine. Neurotensin 1 μg/ml accelerated the gastric emptying by 35% (p < 0.02). Small intestinal transit was also accelerated (p < 0.05). The other neuropeptides had no effect on gastric emptying and small intestinal transit. Neurotensin did not change either the gastric emptying or small intestinal transit in weaned rats, 40–50 days old, studied in the same manner. These data suggest that the intraluminal administration of neurotensin may increase gastrointestinal motility in suckling animals.

GASTRODUODENAL MOTILITY IN NEONATES: RESPONSE TO HUMAN MILK COMPARED TO COW-MILK FORMULA

It is known that breast milk empties more quickly from the stomach than does cow milk formula. We studied the difference in post-prandial gastroduodenal contractions between neonates fed with human milk and those fed with formula. Twenty-four 5-36 day-old neonates were tested. Changes in luminal pressure in the gastric antrum and duodenum were recorded manometrically for 3 h. In all cases, repetitive, high amplitude non-migrating contractions were the dominant wave form during the postprandial period. The number of episodes, duration, amplitude, and frequency of non-migrating contractions were not different following the different feedings. Bursts of non-migrating contraction were 4 times more common in the duodenum (6.9±1.6 episodes/h) than in the antrum (1.8±0.9 episodes/h) (p<0.05), but an average episode lasted 3 times longer in the antrum (1.6±0.2 min vs 4.1±0.8 min, p<0.05). Non-migrating contractions had frequencies identical to those found in phase 3 of the MMC: 3-5/min in the antrum, and 11-13/min in the duodenum. The migrating myoelectric complex, which signals a return to the interdigestive (fasting) state, appeared in 15% of breast milk-fed infants, but in only 171 of formula-fed infants (p<0.05). Because contractions were similar following the two meals, but a fasting state recurred more rapidly in breast milk-fed infants, we conclude phasic, non-propagated antroduodenal contractions do not mediate differences in gastric emptying.