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Martin Howard Ulshen

Professor Emeritus of Pediatrics
Pediatrics, Gastroenterology, Hepatology and Nutrition
375 Hanes House, Box 102375, Durham, NC 27710
377 Hanes House, 330 Trent Drive, Durham, NC 27710

Selected Publications


Parental knowledge of fecal incontinence in children.

Journal Article J Pediatr Gastroenterol Nutr · September 2012 OBJECTIVES: Fecal incontinence (FI) is a common and stressful symptom of constipation in children. Recurrent FI causes psychological and physiological changes, complicating treatment as symptom duration progresses; however, parental misconceptions about th ... Full text Link to item Cite

Outcomes of catheter-associated infections in pediatric patients with short bowel syndrome.

Journal Article J Pediatr Gastroenterol Nutr · April 2010 Children with short bowel syndrome requiring long-term total parenteral nutrition are at high risk for catheter-associated infections. The optimal management of catheter infections in this patient population is unknown. We conducted a retrospective observa ... Full text Link to item Cite

Audio-recorded guided imagery treatment reduces functional abdominal pain in children: a pilot study.

Journal Article Pediatrics · November 2009 OBJECTIVE: This study was designed to develop and to test a home-based, guided imagery treatment protocol, using audio and video recordings, that is easy for health care professionals and patients to use, is inexpensive, and is applicable to a wide range o ... Full text Link to item Cite

Parents' worries about recurrent abdominal pain in children.

Journal Article Gastroenterol Nurs · 2006 Recurrent abdominal pain is a common childhood disorder characterized by multiple episodes of stomachaches severe enough to interrupt daily activities. Recurrent abdominal pain is a difficult diagnosis for parents, children, and clinicians since there is n ... Full text Link to item Cite

Prevalence of factor V G1691A (Leiden), prothrombin G20210A, and methylene tetrahydrofolate reductase C677T thrombophilic mutations in children with inflammatory bowel disease.

Journal Article J Pediatr Gastroenterol Nutr · November 2002 BACKGROUND: Patients with inflammatory bowel disease (IBD) have an increased incidence of thromboembolic events. This risk may be caused by an increased frequency of thrombophilic mutations such as factor V Leiden G1691A (FVL), prothrombin G20210A (PT), or ... Full text Link to item Cite

Abdominal migraine: prophylactic treatment and follow-up.

Journal Article J Pediatr Gastroenterol Nutr · January 1999 BACKGROUND: Abdominal migraine is a syndrome characterized by recurrent stereotypic episodes of paroxysmal abdominal pain and nausea and/or vomiting with wellness between episodes. It is often associated with a positive family history of migraine and no ot ... Full text Link to item Cite

Lymphoid hyperplasia causing recurrent rectal prolapse.

Journal Article J Pediatr · September 1997 An 8-year-old girl had a 5-month history of recurrent rectal prolapse. On colonoscopy, two submucosal masses were noted in the distal rectum and diagnosed by biopsy as benign lymphoid hyperplasia. These were excised by limited dissection superficial to the ... Full text Link to item Cite

Fasting prevents experimental murine colitis produced by dextran sulfate sodium and decreases interleukin-1 beta and insulin-like growth factor I messenger ribonucleic acid.

Journal Article Endocrinology · February 1997 Cytokines and insulin-like growth factors (IGFs) are involved in the induction and/or perpetuation of inflammatory bowel disease. The effect of fasting on inflammatory bowel disease was studied in a mouse experimental model of acute colitis caused by addin ... Full text Link to item Cite

Enhanced growth of small bowel in transgenic mice expressing human insulin-like growth factor I.

Journal Article Gastroenterology · February 1997 BACKGROUND & AIMS: Growth hormone and insulin-like growth factor I (IGF-I) stimulate small bowel growth. The aim of this study was to analyze whether IGF-I mediates enterotrophic actions of growth hormone. METHODS: IGF-I transgenic mice that overexpress an ... Full text Link to item Cite

Luminal epidermal growth factor preserves mucosal mass of small bowel in fasting rats.

Journal Article Clin Sci (Lond) · May 1996 1. Fasting causes atrophy of small bowel mucosa which rapidly resolves with luminal feeding. This effect of enteral nutrient may be mediated by stimulation of growth factor secretion. We therefore evaluated whether luminal administration of epidermal growt ... Full text Link to item Cite

Increased ileal proglucagon expression after jejunectomy is not suppressed by inhibition of bowel growth.

Journal Article Dig Dis Sci · April 1996 After jejunectomy, a rapid and sustained increase in the abundance of proglucagon mRNA occurs in residual ileum and is accompanied by increases in plasma intestinal proglucagon-derived peptides. This response may be a component of adaptive growth, or progl ... Full text Link to item Cite

Effects of fasting, refeeding, and intraluminal triglyceride on proglucagon expression in jejunum and ileum.

Journal Article Diabetes · April 1996 Intestinal proglucagon is thought to be synthesized primarily by the distal gut, although the role of proglucagon-derived glucagon-like peptide I (GLP-I) as a major physiological incretin would seem to be associated with production in proximal small bowel. ... Full text Link to item Cite

Oral transforming growth factor-alpha enhances jejunal mucosal recovery and electrical resistance in piglet rotavirus enteritis.

Journal Article Pediatr Res · August 1995 A randomized, investigator-masked trial determined the effects of oral recombinant human transforming growth factor-alpha (TGF alpha) on jejunal mucosal recovery in 75 piglets with rotavirus diarrhea. Rotavirus inoculation of artificially reared piglets in ... Full text Link to item Cite

Regulation and localization of the insulin-like growth factor system in small bowel during altered nutrient status.

Journal Article Am J Physiol · April 1995 Insulin-like growth factor-I (IGF-I) may regulate small bowel growth. Analyses here in ad libitum-fed, fasted, and refed rats demonstrate that during fasting and refeeding changes in jejunal mass correlate with changes in serum IGF-I and jejunal IGF-I mRNA ... Full text Link to item Cite

Comparison of rectal mucosal proliferation measured by proliferating cell nuclear antigen (PCNA) immunohistochemistry and whole crypt dissection.

Journal Article Cancer Epidemiol Biomarkers Prev · 1995 Rectal mucosal proliferation has been promoted as an intermediate marker for risk of colorectal neoplasia. Proliferating cell nuclear antigen (PCNA) immunohistochemistry has become a standard method to measure cell proliferation. Whole-crypt dissection may ... Link to item Cite

Effect of institutional prestige on reviewers' recommendations and editorial decisions.

Journal Article JAMA · July 13, 1994 OBJECTIVE: To determine whether manuscripts from institutions with greater prestige are more likely to be recommended for publication by reviewers and to be accepted for publication. DESIGN: Retrospective study of reviewers' recommendations and editorial d ... Link to item Cite

Reproducibility and variability of the rectal mucosal proliferation index using proliferating cell nuclear antigen immunohistochemistry.

Journal Article Cancer Epidemiol Biomarkers Prev · 1994 Rectal mucosal proliferation has been shown to be increased in patients with neoplastic lesions of the large bowel and may serve as a marker of risk for colorectal malignancy. We conducted analyses to determine reliability and components of variability tha ... Link to item Cite

Olsalazine versus sulfasalazine in mild to moderate childhood ulcerative colitis: results of the Pediatric Gastroenterology Collaborative Research Group Clinical Trial.

Journal Article J Pediatr Gastroenterol Nutr · July 1993 The safety and efficacy of olsalazine sodium was compared to sulfasalazine over 3 months in a multicenter, randomized, double-blind study of 56 children with mild to moderate ulcerative colitis. Twenty-eight children received 30 mg/kg/day of olsalazine (ma ... Full text Link to item Cite

Enhanced growth of small bowel in transgenic mice overexpressing bovine growth hormone.

Journal Article Gastroenterology · April 1993 BACKGROUND: Transgenic mice with a bovine growth hormone gene linked to a mouse metallothionein I promoter (growth hormone transgenics) are a model of chronic growth hormone excess. METHODS: Growth of small bowel mucosa in ad libitum-fed growth hormone tra ... Full text Link to item Cite

Immunosuppressive therapy in pediatric inflammatory bowel disease: results of a survey of the North American Society for Pediatric Gastroenterology and Nutrition. Subcommittee on Immunosuppressive Use of the Pediatric IBD Collaborative Research Forum.

Journal Article Am J Gastroenterol · January 1993 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 ... Link to item Cite

Rectal mucosal ornithine decarboxylase activity is not a useful marker of risk for colorectal neoplasia.

Journal Article Dig Dis Sci · November 1992 Rectal mucosal ornithine decarboxylase activity has been reported to distinguish patients with adenomas from normal controls. In order to further explore this association, we assayed biopsy samples from 119 unselected individuals undergoing routine colonos ... Full text Link to item Cite

Nutrient-independent increases in proglucagon and ornithine decarboxylase messenger RNAs after jejunoileal resection.

Journal Article Gastroenterology · August 1992 To assess potential mediators of adaptive bowel growth, ileal proglucagon messenger RNA (mRNA) ornithine decarboxylase (ODC) mRNA, plasma enteroglucagons, and plasma glucagonlike peptide I (GLP-I) were analyzed in rats soon after jejunoileal resection or c ... Full text Link to item Cite

Effects of nursing on growth and development of small bowel mucosa in newborn piglets.

Journal Article Pediatr Res · October 1991 Trophic factors in natural milk are potential mediators of the rapid growth of intestine in neonates. To determine whether nursing stimulates growth and development of small bowel mucosa, litters of piglets were divided into suckled and artificially reared ... Full text Link to item Cite

Immunology of inflammatory bowel disease: summary of the proceedings of the Subcommittee on Immunosuppressive Use in IBD.

Journal Article J Pediatr Gastroenterol Nutr · May 1991 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, ... Link to item Cite

Problems identified by secondary review of accepted manuscripts.

Journal Article JAMA · March 9, 1990 To test the hypothesis that no important deficits would be identified on further review of accepted manuscripts, and that such manuscripts would be recommended for publication on rereview, we sent manuscripts that had been accepted for publication, after r ... Link to item Cite

Effect of acceptance or rejection on the author's evaluation of peer review of medical manuscripts.

Journal Article JAMA · March 9, 1990 To determine whether authors of rejected manuscripts would evaluate the editorial review process less favorably than would authors of manuscripts accepted for publication, a questionnaire was sent to solicit evaluations of the quality of the reviews that h ... Link to item Cite

Molecular biology of gastrointestinal peptides and growth factors: relevance to intestinal adaptation.

Journal Article Digestion · 1990 New approaches towards understanding regulation of growth and adaptation of the small intestine are made possible by the isolation and characterization of genes and complementary DNAs (cDNAs) encoding gastrointestinal peptides, growth factors and their rec ... Full text Link to item Cite

Nutritional management of chronic diarrhea and/or malabsorption.

Journal Article J Pediatr Gastroenterol Nutr · November 1989 Full text Link to item Cite

α1-Antitrypsin deficiency: Two wrongs can make a right

Journal Article Gastroenterology · 1989 Cite

Unraveling sucrase-isomaltase "deficiency" states

Journal Article Gastroenterology · 1989 Cite

Bacterial gastroenteritis.

Journal Article Pediatr Clin North Am · February 1988 Acute diarrhea is a major cause of childhood morbidity. Important advances in the understanding of bacterial gastroenteritis have been made in the past two decades. This article reviews the epidemiology, pathogenesis, and methods of diagnosis of bacterial ... Full text Link to item Cite

Gastroesophageal reflux in infancy

Journal Article Gastroenterology · January 1, 1988 Full text Cite

Natural history of Cryptosporidia

Journal Article Gastroenterology · January 1, 1987 Full text Cite

Liver transplantation in the infant

Journal Article Gastroenterology · January 1, 1987 Full text Cite

To dry or not to dry, that is the question

Journal Article Gastroenterology · January 1, 1987 Full text Cite

Effects of intraluminal epidermal growth factor on mucosal proliferation in the small intestine of adult rats.

Journal Article Gastroenterology · November 1986 To determine whether intraluminal administration of epidermal growth factor (EGF) has a trophic effect on small bowel mucosa, catheters were surgically placed in the ileum of adult rats and infused with EGF. Comparing animals receiving EGF (5 micrograms/48 ... Full text Link to item Cite

Intestinal brush border peptidases: activities in normal and abnormal peroral intestinal biopsy specimens.

Journal Article J Lab Clin Med · March 1986 Discriminating substrates were used to develop assays that accurately measure the activity of each of four brush border peptidases in peroral jejunal biopsy specimens. Seventy-five biopsy specimens, 43 normal and 32 abnormal, were assayed for aminopeptidas ... Link to item Cite

Salicylates and Reye's syndrome

Journal Article Gastroenterology · January 1, 1986 Full text Cite

To treat or not to treat

Journal Article Gastroenterology · January 1, 1986 Full text Cite

A promising rotavirus vaccine

Journal Article Gastroenterology · January 1, 1986 Full text Cite

Esophagitis: a frequent consequence of gastroesophageal reflux in infancy.

Journal Article J Pediatr · December 1985 A control group of infants was evaluated to determine criteria for the diagnosis of histologic esophagitis. Based on our observations, histologic esophagitis was defined as four or more intraepithelial neutrophils or one eosinophil per high power field or ... Full text Link to item Cite

Effect of proximal transposition of the ileum on mucosal growth and enzyme activity in orally nourished rats.

Journal Article Am J Clin Nutr · November 1985 To determine whether exposure to proximal intestinal contents per se is an adequate stimulus for ileal adaptation of the magnitude seen after jejunectomy, rats were prepared by transposing 30 cm of distal ileum to the duodenojejunal junction or by sham ope ... Full text Link to item Cite

Guilt not by association

Journal Article Gastroenterology · January 1, 1985 Full text Cite

Drink your milk!

Journal Article Gastroenterology · January 1, 1985 Full text Cite

Screening for celiac disease: Are we there yet?

Journal Article Gastroenterology · January 1, 1985 Full text Cite

Is polyamine biosynthesis necessary for intestinal adaptation?

Journal Article Gastroenterology · January 1, 1985 Full text Cite

Vitamin E in cholestasis

Journal Article Gastroenterology · January 1, 1985 Full text Cite

Upper gastrointestinal endoscopy in infants: diagnostic usefulness and safety.

Journal Article Pediatrics · November 1984 Although fiberoptic, upper gastrointestinal (UGI) endoscopy has become an accepted diagnostic technique in the older child and adult, concerns about safety have limited the use of this procedure in infants. A 1-year experience with 49 upper gastrointestina ... Link to item Cite

Mallory-Weiss syndrome in a 10-month-old infant requiring surgery.

Journal Article J Pediatr Surg · October 1984 Mallory-Weiss syndrome is infrequent in children. Intractable hemorrhage requiring surgery has been reported in only one 6-year-old child in the English literature. We present a case of intractable hemorrhage from a Mallory-Weiss lesion in a 10-month-old i ... Full text Link to item Cite

Clinical manifestations of congenital syphilitic hepatitis: implications for pathogenesis.

Journal Article J Pediatr Gastroenterol Nutr · September 1984 To study the clinical course and biochemical features of congenital syphilitic hepatitis, the records of all 22 pediatric patients admitted to North Carolina Memorial Hospital between 1969 and 1979 with a positive maternal, cord blood, or serum VDRL were r ... Full text Link to item Cite

Familial visceral myopathy.

Journal Article J Urol · May 1984 We report on a 13-year-old white body with familial visceral myopathy. The abnormalities of the gastrointestinal and urinary tracts are described and the literature regarding urologic implications of this disorder is reviewed. ... Full text Link to item Cite

Effect of removal of pancreaticobiliary secretions on adaptation to short bowel in orally nourished rats.

Journal Article Am J Clin Nutr · May 1984 To evaluate the need for intraluminal pancreaticobiliary secretions for mucosal adaptation in animals with short bowel, groups of paired rats were prepared with: 1) normal bowel length, 2) 60% proximal small bowel bypass, and 3) similar bypass of distal bo ... Full text Link to item Cite

To shunt or not to shunt?

Journal Article Gastroenterology · January 1, 1984 Full text Cite

Would you believe the tongue?

Journal Article Gastroenterology · January 1, 1984 Full text Cite

Pseudomembranous colitis presenting as mild, chronic diarrhea in childhood.

Journal Article J Pediatr Gastroenterol Nutr · 1983 Two children presented with mild, chronic diarrheal illnesses. Investigation revealed typical pseudomembranous colitis in both cases, which responded to therapy. While variation in the severity of pseudomembranous colitis is recognized, the subtle, chronic ... Full text Link to item Cite

Phenolphthalein laxatives and factitious diarrhea.

Journal Article Clin Pediatr (Phila) · September 1982 Full text Link to item Cite

Intramural esophageal hamartoma: a report of two cases and review of the literature.

Journal Article Gastrointest Radiol · November 15, 1980 Intramural esophageal hamartoma is an unusual cause of distal esophageal obstruction in childhood. Two cases are reported with a review of the literature. ... Full text Link to item Cite

Site of substrate stimulation of jejunal sucrase in the rat.

Journal Article J Clin Invest · October 1979 To identify the site of stimulation of sucrase by a sucrose diet, changes in sucrase-specific activity of jejunal mucosa were studied after introduction of sucrose diet to carbohydrate-deprived rats. Results were correlated with simultaneous changes in vil ... Full text Link to item Cite

Hepatoxicity with encephalopathy associated with aspirin therapy in rheumatoid arthritis.

Journal Article J Pediatr · December 1978 Encephalopathy secondary to aspirin-induced hepatoxicity developed in three patients with JRA. In each patient clinical and biochemical resolution occurred after discontinuing the drug, but toxicity appeared on rechallenge. Liver biopsies in two patients s ... Full text Link to item Cite

Effects of cholestyramine on small intestinal mucosa

Journal Article Pediatric Research · January 1, 1978 Cite

Clinical and physiological abnormalities in hepatic function.

Journal Article Pediatr Clin North Am · November 1975 Full text Link to item Cite