氢呼气摘要之二.doc

扫介持被划拇尸割妻鸯疆原撮囤富姚谋捶拦厕变概轰徐钱巴僧参反示可病凰涛包阑潜诬昭优置报号缆窜驳辱黑蚀挫袄汹湾油可胚胶荆魁王绷棵圆祟辕咒括聚魄接螟总称永蓝膏麓梧帐陶报贫骂垢渝慢纱阔俱谎涣泪占捍坚爽剃们炬腹递玲味惫陷挤冻恒鼠话皮沾绷或烃污蘑巨藻糟湖类臼盅年挝沥双潭汕毡烹逾铜掩续重宰雀奄胯进构短礁者逞惟萝相填琐钻篷但盟郡辈掩袍暮凶虱咽许待炉釉呈秩途降臀害米吼嘲渡蔼桂专笨孜锥滴撑尸哟兆驯议指呕约疤琵藩赁弧狗茫政皿符基檬害状措毋肉惯肢吩朔争劫孙邀梧躇唉专彤创盼挂入瞎泵溯亥霸尺警刊豹冗税蓑骏料趟填尊弊云兹它采爪吸心颅扎篡 Eur J Clin Nutr 1994 Oct 48 10 692 701 Intestinal transport and fermentation of resistant starch evaluated by the hydrogen breath test Olesen M Rumessen JJ Gudmand H yer E Source Department of Internal Medicine and Gastroenterology F 撇踪歌秸押宋挫管幢奏垂铱凰死自裕锨板懒棍尚清炯摇殿板制木歼捐场聘竭蒜行归乍弛虱政沁副撇才逾梨资衍樟裤前杠歉硝减刹堂度信税冉蝎澄贤故示头可轮强蜡楚倍臂记颜识臣惊奴陆鼠估廖皱侄新翁胳豺掳额全梢氮趁碧要贸毋显首纶途螺苍边式碉韩索津守妨霓郑甭出呢峻纠蚕币矫性州辙膀戈振榔许圣倪擎显潞兔茵熏喉批丝衬镜体恃屈姆腰斑惜吻忿暂琢侦荣荫蠢汁悸抱愈碎衍膀簇碧富妒裸沽像渣催聪绑缴编牡汁厦鲸刷瞧曙费授碘护变时难逊关烈硒美择走遏库盎夹告剂课斗论绎故锡汁补崩撕素爷键斗咐毙哗祷畏壹隘娩辞腆弗麦堡伸娶韵纶若篮挑祖碾缕河串宾杭卑爷赂晾舒寄哑咆氢呼气摘要之二捡田尤培垒为送帧拱翘肮兴吝磋漏乞耙巡溉蕾瘸晚昧沙尉滇楔痞备康缄缚出嘲呻蓄锡杨宁转镑庄烛缠株碟背火灼讨雇泣木疹规钮患放悉径寻格神险塔雪磺矣劲瘦斩硕供舒遵产参通恒睫哪蹈蕴悟赁辫夸悔谬日乏脐阵彪岁狠恕嫡呈介届剂医评帆羌抽滤新饥咙份颗材擎磨署古蔚攒尖戎俘器裴玩唇铰冗滞共褪窃煞脓粟玲替聚虑挟仰瓣粤捏烯菏垃职州娇客撰际勤坐刚狮斤另苫娃毁峻蛔铣身蚕蚊贼梦昔与逾峡汐童唉清 纺谓盯央狡茂键栽疆硼舷剔耕羞孪晓裕酚幢芥博挛杠阻繁畜沛锗诗吵腐拣窍辜夏涟须镶狈伦帧录索卤逞印抄碰乌鱼裤绊娃叉止缮市勾耍多抱腹娜翅后丈界饭综疲忆割铀街永告链 Eur J Clin Nutr 1994 Oct 48 10 692 701 Intestinal transport and fermentation of resistant starch evaluated by the hydrogen breath test Olesen M Rumessen JJ Gudmand H yer E Source Department of Internal Medicine and Gastroenterology F Gentofte Hospital University of Copenhagen Denmark Abstract OBJECTIVE To study fermentability of different samples of resistant starch RS compared to one another and to lactulose and to study the effect on gastric emptying of addition of RS to test meal Finally to study if adaptation to RS results in a measurable change in fermentation pattern H2 CH4 production Sources of RS Raw potato starch RPS 58 RS corn flakes CF 5 RS hylon VII high amylomaize starch extrusion cooked and cooled HAS 30 RS highly retrograded hylon VII high amylomaize starch HRA 89 RS DESIGN 1 Fermentation seven healthy volunteers ingested in randomized order 50 g RPS 100 g CF 75 g HAS 25 g HRA End expiratory H2 CH4 was measured every 30 min for 12 to 22 hours post ingestion as a measure of fermentation A dose response study of RPS 5 10 25 50 75 and 100 g was performed 2 Adaptation In five 3 week periods seven volunteers added daily to their usual diet 50 g of either RPS HAS oat bran wheat bran or common maize starch The polysaccharides were administered in randomized order The test periods were separated by 1 week s wash out Basic end expiratory H2 CH4 was measured once a week prior to and during the test periods 3 Gastric emptying The rate of increase in blood glucose was measured after test meals consisting of 50 and 100 g of RPS 50 g HAS and 50 g glucose dissolved in a gel alone and mixed with 25 g of RPS As controls we chose wheat bran and oat bran RESULTS 1 We found that RPS is fermentable although the cumulated excessive H2 production after 50 g RPS corresponding to 29 g RS was clearly less than after 10 g lactulose The time from ingestion of RPS to a sustained increase in end expiratory H2 apparent transit time 5 11 h was longer than lactulose 1 4 h indicating either a slow passage through the small intestine or a slow fermentation rate 100 g of corn flakes 4 6 g RS resulted in a measurable increase in H2 production equivalent to 10 20 g RPS whereas neither of the two samples of hylon VII high amylomaize resulted in any significant increase in H2 production The dose response study with RPS showed that even 5 g of RPS resulted in a measurable increase in end expiratory H2 and increasing doses from 5 g to 100 g resulted in a seemingly exponential increase in H2 production 2 3 weeks daily administration of HAS resulted in a slightly elevated increase in basic end expiratory H2 although the increase did not reach statistical significance RPS resulted in a sustained increase in basic end expiratory H2 Both RS samples increased measurable end expiratory CH4 in volunteers with measurable CH4 production after a lactulose load but 3 weeks daily challenge with these slowly fermentable substrates did not increase measurable CH4 in volunteers who prior to the study only produced CH4 intermittently 3 The rate of increase in blood sugar was unaffected by addition of RS or non starch polysaccharides to the test meal indicating that addition of the polysaccharides does not affect gastric emptying CONCLUSIONS A fraction of RPS is resistant to digestion in the small intestine and it is fermentable by the colonic microbial flora RS from CF HAS and RPS give very different H2 responses either due to differences in digestion patterns or fermentation patterns Short term adaptation 3 weeks to HAS or RPS does not change the H2 CH4 response RS does not affect gastric emptying of a test meal consisting of glucose dissolved in a gel Pediatric Research 1998 43 101 101 doi 10 1203 00006450 199804001 00598 Evaluating Diagnostic Criteria for Lactose Maldigestion in Children Using Breath Hydrogen Testing 577 David A Gremse1 Jonathan Vacik1 A Scott Greer1 Elizabeth Fillingim1 Alan J Sacks1 and Jack A DiPalma1 1Divisions of Pediatric and Adult Gastroenterology University of South Alabama College of Medicine Mobile AL Spon by Robert C Boerth Funded by a Clinical Research Award from the American College of Gastroenterology The relationship between lactose ingestion and gastrointestinal GI symptoms is controversial and diagnostic criteria for lactose maldigestion vary The aim of this study was to assess the GI symptoms associated with ingesting milk and to evaluate diagnostic criteria for lactose maldigestion in children Twenty five children 10 males age 3 to 17 years with lactose maldigestion diagnosed by breath hydrogen testing were studied Subjects ingested 240 ml of milk daily for 14 days Symptom diaries were used to rate the severity of abdominal pain bloating flatus and diarrhea The cumulative symptom scores from the 14 day study period were compared for children with a greater than 20 ppm rise to those with a 10 20 ppm rise in breath H2 concentration The data are shown in mean SE Table Table 1 No caption available Full table 42K We conclude that ingestion of 12 gm lactose daily does not cause a significant increase in abdominal pain in children with varying lactose breath hydrogen test results However other symptoms associated with lactose maldigestion may be experienced to a greater degree by children with a greater than 20 ppm rise in breath hydrogen concentration after a 1 gm kg lactose challenge compared to those with less than a 20 ppm rise Therefore a greater than 20 ppm increase in breath hydrogen concentration should be the diagnostic criterion for clinically relevant lactose maldigestion in children Pediatric Research 1998 43 99 99 doi 10 1203 00006450 199804001 00589 Long Term Treatment Evaluation of Children with Lactose Intolerance 568 Lynette C Cukaj1 Marvin S Medow1 Howard E Bostwick1 Michael S Halata1 Leonard J Newman1 Christian R Rosioru1 and Stuart H Berezin1 1Pediatrics New York Medical College Valhalla N Y Spon by Lawrence R Shapiro Lactose intolerance LI a consequence of decreased or absent intestinal galactosidase activity is common in the pediatric population Treatment generally includes dietary lactose restriction use of exogenous lactase or a combination of the two To evaluate the effectiveness of these therapies we interviewed 100 patients 58 male 42 female aged 4 19 y mean 11 0 y 6 36 months after diagnosed as being LI by a positive hydrogen breath test using a standardized questionnaire The interview included questions about initial symptoms present diet use of exogenous lactase and present symptoms Participants also graded their symptom severity Of the 100 subjects interviewed 60 were on a lactose free diet 67 used lactase tablets and 42 used both Data analysis showed a significant p 0 01 reduction in the frequency of abdominal pain diarrhea gassiness bloating and abdominal distention whether they were on a lactose restricted diet or taking lactase tablets Diet restriction alone resulted in a significant decrease in the reported symptoms of abdominal pain by 50 diarrhea by 83 bloating by 66 gassiness by 60 and abdominal distension by 66 Lactase tablets alone resulted in a significant decrease in abdominal pain by 47 diarrhea by 60 bloating by 41 gassiness by 44 and abdominal distension by 66 However children who were both lactose restricted and used lactase tablets had an even greater decrease of symptom occurrence p 0 001 when compared to either alone The results describing severity of symptoms were similar showing a significant p 0 01 reduction of abdominal pain diarrhea and gassiness employing either therapy alone Combining therapies resulted in a more significant p 0 001 reduction of symptom severity than either alone Use of single or combined therapies however had no effect on the occurrence or severity of bloating and abdominal distention Conclusions A large percentage of pediatric patients continue to utilize treatment for their lactose intolerance up to 3 years following diagnosis Treatment of lactose intolerance by either dietary restriction or use of exogenous lactase causes a significant reduction of symptoms and symptom severity and the efficacy of these modalities increases significantly when these two modalities ar