{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T18:14:19Z","timestamp":1760897659179},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[1988,10,1]],"date-time":"1988-10-01T00:00:00Z","timestamp":591667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1988,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Neonatal and infantile hypoglycemia due to insulin excess has been associated with a spectrum of anatomic changes, i.e., nesidioblastosis, endocrine cell dysplasia, islet cell hyperplasia, and adenomatosis. The mechanism of hyperinsulinemia in these patients has been attributed to: (a) an increase in islet cell mass, (b) abnormal islet cell architecture with alternation in paracrine function, (c) imbalance of alpha, beta, and delta cell secretion, and (d) a regulatory defect of insulin secretion. Morphometric, immunocytochemical, and electron microscopy studies have not substantiated an increase in endocrine cell mass in many patients. Nesidioblastosis is believed to be a normal phase of fetal development of the pancreas rather than a pathologic entity. A regulatory defect in insulin storage and release is the best explanation of hyperinsulinism in these patients<\/jats:bold>.<\/jats:p><jats:p><jats:bold>We report experience with 165\u00a0neonates and infants including 6 of our own collected during the last decade. Subtotal pancreatectomy (79\u201390%) was carried out as the initial operative procedure in 76% of patients. Twenty\u2010eight percent required a second operation of near\u2010total to total pancreatectomy. Eleven percent required a third procedure. A near\u2010total pancreatectomy (95\u201398%) was performed as the initial operation in 24% of the patients. Five percent of these patients required a second operation<\/jats:bold>.<\/jats:p><jats:p><jats:bold>There is a clear advantage of performing an extensive pancreatectomy (95\u201398%) at the initial operative procedure. In the 40 patients so treated, the incidence of mental retardation was 12.5% and seizures, 2.5%. Ten percent required diazoxide for further management, and 7.5% required insulin on a long\u2010term basis. Mortality was 2.5%. In our report, covering experience from 1934 to 1971, the mortality was 8.3% and mental retardation, 52%<\/jats:bold>.<\/jats:p>","DOI":"10.1007\/bf01655860","type":"journal-article","created":{"date-parts":[[2005,5,8]],"date-time":"2005-05-08T03:22:01Z","timestamp":1115522521000},"page":"598-607","source":"Crossref","is-referenced-by-count":26,"title":["Changing concepts of islet cell dysplasia in neonatal and infantile hyperinsulinism"],"prefix":"10.1002","volume":"12","author":[{"suffix":"Jr.","given":"C. G.","family":"Thomas","sequence":"first","affiliation":[{"name":"Departments of Surgery, Pediatrics, and Pathology University of North Carolina School of Medicine Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. E.","family":"Cuenca","sequence":"additional","affiliation":[{"name":"Departments of Surgery, Pediatrics, and Pathology University of North Carolina School of Medicine Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. G.","family":"Azizkhan","sequence":"additional","affiliation":[{"name":"Departments of Surgery, Pediatrics, and Pathology University of North Carolina School of Medicine Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. E.","family":"Underwood","sequence":"additional","affiliation":[{"name":"Departments of Surgery, Pediatrics, and Pathology University of North Carolina School of Medicine Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. N.","family":"Carney","sequence":"additional","affiliation":[{"name":"Departments of Surgery, Pediatrics, and Pathology University of North Carolina School of Medicine Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1988,10]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197705000-00002"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(83)80277-2"},{"key":"e_1_2_1_4_1","first-page":"30","article-title":"The juvenile human endocrine pancreas: Normal versus idiopathic hyperinsulinemic hypoglycemia","volume":"1","author":"Witte D.P.","year":"1984","journal-title":"Semin. Diag. Pathol."},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.26.7.632"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197706092962305"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00445763"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(78)80121-3"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(79)80080-3"},{"key":"e_1_2_1_10_1","first-page":"49","article-title":"Elevated serum proinsulin in beta cell nesidioblastosis","volume":"14","author":"Kuhl C.","year":"1979","journal-title":"Scand. J. Gastroenterol."},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(80)80773-6"},{"key":"e_1_2_1_12_1","first-page":"356","article-title":"Pancreatic pathology in hyper\u2010insulinemic hypoglycemia of infancy","volume":"42","author":"Jaffe R.","year":"1980","journal-title":"Lab. Invest."},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1980.01380070068015"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(80)80075-X"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198002000-00009"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(80)80395-2"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.30.2.122"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.56.7.496"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198108000-00004"},{"key":"e_1_2_1_20_1","first-page":"39","article-title":"Immunohistochemical, morphometric and clinical studies of the pancreatic islets in infants with persistent neonatal hypoglycemia of familial type with hyper\u2010insulinism and nesidioblastosis","volume":"40","author":"Falkmer S.","year":"1981","journal-title":"Acta Biol. Med. Geriatr."},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1982.01380330019006"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.70.3.440"},{"key":"e_1_2_1_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(82)90140-4"},{"key":"e_1_2_1_24_1","first-page":"71","article-title":"Neonatal nesidioblastosis\u2014Diagosis and preoperative mananagement","volume":"16","author":"Pollak A.","year":"1983","journal-title":"Prog. Pediatr. Surg."},{"key":"e_1_2_1_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1994.tb17748.x"},{"key":"e_1_2_1_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800710125"},{"key":"e_1_2_1_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1984.01390170020005"},{"key":"e_1_2_1_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198409000-00013"},{"key":"e_1_2_1_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00283651"},{"key":"e_1_2_1_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.60.5.500-b"},{"key":"e_1_2_1_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00171778"},{"key":"e_1_2_1_32_1","volume-title":"The Pancreas in Pediatric Surgery","author":"Welch K.J.","year":"1986"},{"key":"e_1_2_1_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(86)90035-7"},{"key":"e_1_2_1_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0065-3101(22)00724-1"},{"key":"e_1_2_1_35_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198701223160416"},{"key":"e_1_2_1_36_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198701223160417"},{"key":"e_1_2_1_37_1","doi-asserted-by":"publisher","DOI":"10.3109\/15513818309048282"},{"key":"e_1_2_1_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0344-0338(86)80007-3"},{"key":"e_1_2_1_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02890134"},{"key":"e_1_2_1_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1981.01380170055010"},{"key":"e_1_2_1_41_1","first-page":"129","article-title":"Nesidiodysplasia and nesidioblastosis of infancy: Ultrastructural and immunohistochemical analysis of islet cell alterations with and without associated hyperinsulinaemic hypoglycaemia","volume":"70","author":"Gould V.E.","year":"1981","journal-title":"Scand. J. Gastroenterol."},{"key":"e_1_2_1_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(86)80154-X"},{"key":"e_1_2_1_43_1","first-page":"642","article-title":"Nesidioblastosis and congenital neuroblastoma: A histologic and immunocytochemical study of a new complex neurocristopathy","volume":"103","author":"Grotting J.C.","year":"1979","journal-title":"Arch. Pathol. Lab. Med."}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/BF01655860.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/BF01655860\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/BF01655860","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/BF01655860.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T15:14:06Z","timestamp":1703690046000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/BF01655860"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1988,10]]},"references-count":42,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1988,10]]}},"alternative-id":["10.1007\/BF01655860"],"URL":"https:\/\/doi.org\/10.1007\/bf01655860","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[1988,10]]}}}