Mark Glassman

New York Medical College | NYMC · Department of Pediatrics

• Background.— Pseudoverrucous papules and nodules were originally described as a reaction to irritation in association with urostomies. These changes have not been described as occurring on the perianal skin or around colostomies.

To evaluate the response to rectal distension in children with chronic constipation and children with chronic constipation and encopresis. We studied 27 children, aged 3 to 16 years, with chronic constipation; 12 had encopresis. Anorectal motility was measured with a solid state catheter. When the catheter was located in the internal sphincter, the...

To determine the importance of acid reflux-induced dysmotility in the genesis of noncardiac chest pain in children. We performed esophageal manometries during intraesophageal perfusion with 0.9% NaCl or 0.1 N HCl in 19 children (age, 14.5 +/- 0.5 yr) with gastroesophageal reflux, biopsy-proven esophagitis, and complaints of at least one episode of...

Esophageal motility was studied in 31 patients with mild to moderate esophagitis and in 48 patients without esophagitis to determine the effect of esophageal inflammation on lower esophageal sphincter pressure, and the amplitude, duration, and velocity of esophageal contractions. There were no significant differences in any of these parameters asso...

To determine whether obesity should be added to the current American Academy of Pediatrics (AAP) criteria for cholesterol screening in childhood, the charts of 99 children referred for evaluation of either hypercholesterolemia (n = 53) or obesity (n = 45) were reviewed. Compared with obese children, nonobese hypercholesterolemic subjects were young...

The relationship between gastric Helicobacter pylori colonization and esophagitis was determined in 457 children undergoing endoscopic evaluation of abdominal pain and/or vomiting. In all patients, biopsies of the esophagus were examined histologically, and two antral biopsies were analyzed for the presence of H. pylori, using standard microbiologi...

Four children with portal hypertension and ascites developed hematemesis, abdominal pain, and fever as the acute manifestations of bacterial peritonitis. Initial management in the emergency department was directed toward controlling the upper gastrointestinal hemorrhage, and antibiotic therapy was delayed in four of six episodes until ascitic fluid...

We describe two children who underwent magnetic resonance imaging (MRI) as part of the evaluation of isolated splenomegaly after Doppler ultrasound was unable to identify the portal vein. The diagnosis of cavernous transformation of the portal vein and the normalcy of the biliary tract and hepatic architecture were confirmed by MRI. Because of the...

The charts of 54 children diagnosed with antralH. pylori were reviewed, to establish the incidence of gastroduodenal inflammation and compare therapeutic efficacies of antisecretory vs. antibacterial therapy. Histology demonstrated normal mucosa in three cases (6%) and gastric/duodenal inflammation ( Whitehead grade 3) in 51 biopsies (94%). 23/43 c...

To evaluate the relationship between colonic methane production and carbohydrate malabsorption, we measured end-expiratory methane levels in 70 normal and 40 lactose-intolerant children. Time-dependent excretion of hydrogen and methane was determined every 30 min for 120 min following a fasting oral lactose challenge (2 g/kg). Mean breath hydrogen...

The charts of 54 children diagnosed with antral H. pylori were reviewed, to establish the incidence of gastroduodenal inflammation and compare therapeutic efficacies of antisecretory vs. antibacterial therapy. Histology demonstrated normal mucosa in three cases (6%) and gastric/duodenal inflammation (> or = Whitehead grade 3) in 51 biopsies (94%)....

We report the results of a survey of the membership of the North American Society for Pediatric Gastroenterology and Nutrition designed to determine pediatric gastroenterologists' attitudes toward the use of immunosuppressive therapy for inflammatory bowel disease (IBD), and to assess how these medications are actually being used in the treatment o...

The charts of 83 children with chest pain who underwent esophageal manometry followed by esophagogastroscopy were reviewed. Forty-seven (57%) had normal esophageal histology and normal motility (group I). Esophagitis and normal motility were demonstrated in 15 children (group II), normal esophageal histology and esophageal dysmotility in 13 (group...

Gastroesophageal reflux and malnutrition are major determinants of perioperative morbidity and mortality in neurologically impaired children. The incidence of these risk factors can be reduced through careful preoperative evaluation and nutritional rehabilitation combined with the use of perioperative techniques intended to control the acid aspirat...

A 4-week-old infant presenting with neonatal cholestasis was found to have congenital toxoplasmosis and biliary atresia. This is the first patient in which their coincidence is reported. Because biliary atresia can coexist with either congenital infection or inborn errors of metabolism, evaluation for an obstructive etiology of jaundice in infants...

A 12-year-old girl is described who developed rectal bleeding 5 months after being diagnosed as having a Coombs-positive hemolytic anemia. Colonoscopy showed that the rectal bleeding was due to ulcerative proctitis. This is the first case report of Coombs-positive hemolytic anemia preceding the onset of ulcerative proctitis in a child.

Two adolescent patients with inflammatory esophagogastric polyps (IEPs) are presented. In each case, the patients complained of chest pain and dysphagia. In one patient, there was no histological evidence of esophagitis in association with the IEPs. Their clinical course suggests that the presentation of IEPs in adolescents is indistinguishable fro...

Chest pain in adolescents and children is usually not of cardiac origin. Of cardiac conditions commonly linked to chest pain in childhood, mitral valve prolapse (MVP) is the most prevalent, but this association has recently been questioned. In light of recent reports of gastroesophageal sources of chest pain in adults with MVP, we performed a compr...

As outlined, scanty data exist with regard to immunologic therapy in children with IBD despite the fact that the pediatric population affords a unique opportunity for clinical evaluation. Children are less affected by modifying conditions such as smoking, alcohol ingestion, and the long-term use of medications, and because of their specific needs f...

Sixteen patients with asthma and chest pain of greater than 2 months duration underwent gastroenterological evaluation utilizing fiber-optic esophagogastroduodenoscopy (EGD), esophageal manometry, and Bernstein testing. Eleven of 16 patients (75%) had endoscopic and histologic evidence of esophagitis. One patient with esophagitis exhibited high-amp...

Sixteen patients with asthma and chest pain of >2 months duration underwent gastroenterological evaluation utilizing fiber‐optic esophagogastroduodenoscopy (EGD), esophageal manometry, and Bernstein testing. Eleven of 16 patients (75%) had endoscopic and histologic evidence of esophagitis. One patient with esophagitis exhibited high‐amplitude peris...

Lactose-intolerant children manifest diminished or nonexistent intestinal lactase activity, resulting in flatulence, abdominal pain, and diarrhea. To assess the hydrolytic capability of lactase-containing tablets taken immediately before oral lactose challenge, we studied 18 children previously identified as being lactose intolerant and having no u...

Thirty-six children identified as having primary type IIa hypercholesterolemia were treated with a diet restricting the intake of saturated fat to 10% of total energy and supplemented with soluble fiber for 8.1 +/- 2.4 (mean +/- SEM) months. In 14 of 36 patients first treated with the American Heart Association "Step-One" diet for 8.0 +/- 1.1 month...

To determine an effective nutritional regimen for management of growth failure in infants with congenital heart disease and congestive heart failure, the authors studied 19 infants with cardiac anomalies who were not candidates for early corrective surgery. Patients were randomly assigned to one of three feeding groups: group 1 (n = 7) received con...

To evaluate the accuracy of IgG and IgA serological tests in establishing a diagnosis of Helicobacter (Campylobacter) pylori gastric infection, 60 children presenting with chronic abdominal pain were prospectively studied. Endoscopic antral biopsies were obtained and analyzed for the presence of H. pylori using three standard methods: culture and i...

• Thirty-six children identified as having primary type IIa hypercholesterolemia were treated with a diet restricting the intake of saturated fat to 10% of total energy and supplemented with soluble fiber for 8.1 ± 2.4 (mean ± SEM) months. In 14 of 36 patients first treated with the American Heart Association "Step-One" diet for 8.0 ±1.1 months, to...

Seventy-eight patients with inflammatory bowel disease (35 with Crohn's disease and 43 with ulcerative colitis) and a control population of 36 children without organic disease were surveyed to determine the frequency of symptoms compatible with cow's milk-protein sensitivity during infancy. The incidence of a history compatible with cow's milk sens...

The intraesophageal acid perfusion (Bernstein) test was evaluated as a provocative test for nonspecific chest pain in children with esophagitis. Sixty patients with atypical chest pain were studied. None of the patients had heartburn or other characteristic symptoms of esophagitis. Forty-five patients had esophagitis; in 18 (40%) of these patients,...

Over a one-year period, 95 children and adolescents presenting with epigastric pain and/or vomiting, and without associated risk factors for development of peptide disease, underwent endoscopic antral biopsies for pathologic diagnosis and to detect presence of Campylobacter ss. pylori (C. pylori). Additional biopsies of the esophagus, stomach, and...

To evaluate relationships between gastroesophageal reflux (GER) and the development and onset of apparent life-threatening event(s) (ALTE), 16 infants presenting with ALTE and 6 control subjects manifesting clinical GER alone were studied using prolonged, esophageal pH monitoring in conjunction with simultaneous pulse oximetry and transthoracic imp...

Intestinal pseudoobstruction is characterized by signs and symptoms of recurrent intestinal obstruction in the absence of an identifiable mechanical lesion. Underlying illnesses that have been associated with intestinal pseudoobstruction include scleroderma, amyloidosis, various endocrinopathies (eg, hypothyroidism), narcotic or laxative abuse, and...

During a period of 30 months, cow's milk- or soy protein-induced colitis was diagnosed in 22 infants. All patients presented with hematochezia. Only three patients had substantial diarrhea. Colonoscopic evaluations demonstrated a characteristic mucosal appearance, manifested by aphthoid ulcerations with intervening, normal-appearing mucosa. Histolo...

The incidence and temporal patterns of gastroesophageal reflux (GER) in infants presenting with an apparent life-threatening event (ALTE) was compared with GER characteristics of infants evaluated for persistent emesis, utilizing continuous 24 h intraesophageal pH monitoring. These data indicate that the incidence of significant GER was similar in...

Twenty seven children who had been diagnosed as having idiopathic chest pain were investigated to find out if the pain was of gastrointestinal origin. The symptoms had lasted from two weeks to eight months. In 21 of the 27 children (78%) the chest pain had a gastrointestinal cause: 16 had oesophagitis, four had gastritis, and one had diffuse oesoph...

The diagnostic efficacy of abdominal ultrasound obtained within 72 hours of admission in children with undiagnosed, acute-onset abdominal pain was studied. In our 54 patients, sonogram supported the clinical diagnosis in 22 patients (40.7%), established a previously unsuspected diagnosis in nine (16.6%), and was normal in 23/54 (42.6%). Twenty-one...

An 18-year-old male with hemophilia presented with symptoms and signs of upper intestinal obstruction. Evaluation was consistent with an intramural duodenal hematoma and obstructive pancreatitis. As it is not possible to distinguish between these two disorders on a clinical basis, it is important to realize that pancreatitis may occur in such patie...

Hepatic hemangioma (hemangioendothelioma) is a rare but most common benign vascular tumor of the pediatric age group. Prompt diagnosis and treatment prevent complications. Familiarity with various CT patterns should facilitate correct diagnosis of hemangioendothelioma of the liver in infants and children and avert angiography.

We retrospectively evaluated the utility of hepatobiliary scintigraphy and various clinical factors in differentiating intrahepatic cholestasis from biliary atresia in 28 consecutive infants with neonatal cholestasis. One millicurie of technetium-labeled diisopropyliminodiacetic acid (DISIDA) was administered intravenously, and images were obtained...

A 13-year-old girl presented with a history of fever, arthritis, conjunctivitis, abdominal pain, and diarrhea. Colonoscopy and barium enema were consistent with Crohn's disease. A renal biopsy, performed because of persistent proteinuria and hematuria in the absence of obstruction to the urinary tract, revealed diffuse proliferative necrotizing glo...

A 13-year-old girl presented with a history of fever, arthritis, conjunctivitis, abdominal pain, and diarrhea. Colonoscopy and barium enema were consistent with Crohn's disease. A renal biopsy, performed because of persistent proteinuria and hematuria in the absence of obstruction to the urinary tract, revealed diffuse proliferative necrotizing glo...

The pathogenesis and optimal treatment of choledochal cyst have long remained questions of considerable speculation and dispute. Because the pregnancy of a 37-year-old woman was felt to be at risk, five antenatal ultrasound examinations were made. The fourth examination at 31.5 weeks of gestation demonstrated a choledochal cyst. Following birth, th...

Examination of 136 children who were referred to the Pediatric Gastroenterology Clinic at Yale‐New Haven Hospital for chronic or severe diarrhea between 1977 and 1981 revealed that 31 patients (22.8%) had serum immunoglobulin levels below the 5th percentile for age. Twenty‐four of these 31 patients (77.4%) had normal or near normal serum immunoglob...

Examination of 136 children who were referred to the Pediatric Gastroenterology Clinic at Yale-New Haven Hospital for chronic or severe diarrhea between 1977 and 1981 revealed that 31 patients (22.8%) had serum immunoglobulin levels below the 5th percentile for age. Twenty-four of these 31 patients (77.4%) had normal or near normal serum immunoglob...

A 26-month-old boy with Stage III abdominal ganglioneuroblastoma had tachycardia and hypertension. The hypertension increased following the institution of chemotherapy and necessitated the use of both alpha and beta adrenergic blocking agents to control the effects of the marked catecholamine production. After excision of the residual tumor, the bl...

The total food consumption of experimentally naive rats following 24, 48, 72, and 96 hr fasts was observed during the period of the recovery of body weight. The total amount of food consumed in excess of prefast food consumption was found in all groups to be equivalent to 24 hr intake and was, therefore, independent of degree of fast and body weigh...