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Biomedical subjects

B May

Publications and source records attributed to B May.

204 records · Page 12Linked to original sources

Interleukin-4 inhibits the increased production of vascular endothelial growth factor by peripheral blood mononuclear cells in patients with inflammatory bowel disease.

BACKGROUND/AIMS: Vascular endothelial growth factor (VEGF), a potent angiogenic, permeability-enhancing cytokine plays an important role in tissue repair and chronic inflammatory disorders. Peripheral blood mononuclear cells (PBMCs) and the inflamed mucosa have been demonstrated to be main sources of the recently described circulating VEGF in patients with inflammatory bowel disease (IBD). There is no current information about the influence of immunoregulatory cytokines on VEGF in IBD. The present study examines the effect of interleukin-4 on the increased VEGF production of PBMCs in patients with IBD. METHODOLOGY: Unstimulated PBMCs from 17 patients with Crohn's disease, 16 patients with ulcerative colitis and 8 healthy controls were cultured with or without IL-4. VEGF production was measured in the supernatant using an enzyme-linked immunosorbent assay. RESULTS: IL-4 led to a significant reduction of the VEGF production by PBMCs of both active Crohn's disease patients (471.7 +/- 377.5 pg/mL vs. 208.2 +/- 123.2 pg/mL, P = 0.018, n = 7) and active ulcerative colitis patients (177.1 +/- 79.4 pg/mL vs. 87.4 +/- 77.2 pg/mL, P = 0.008, n = 9). IL-4 inhibited significantly the VEGF production by PBMCs of patients with inactive Crohn's disease (179.2 +/- 133.9 pg/mL vs. 87.7 +/- 56.6 pg/mL, P = 0.005, n = 10). There was no significant difference of VEGF release by PBMCs cultured with IL-4 in patients with active Crohn's disease or active ulcerative colitis compared with PBMCs cultured without IL-4 in patients with inactive disease and healthy controls (112.6 +/- 41.9 pg/mL, n = 8). CONCLUSIONS: IL-4 has been shown to reduce the increased VEGF production of PBMCs in patients with IBD to normal levels. The known defective immunosuppressive effect of IL-4 in IBD may contribute to the pathogenic cascade leading to inflammation by VEGF mediated mechanisms.

Adult↗

Long-term response of primary biliary cirrhosis (stage I) to therapy with ursodeoxycholic acid.

We report about a 56-year-old asymptomatic female patient, who was examined in April 1991 for an increase of biochemical parameters of the liver. Based on the biochemical and serological results (abnormal cholestatic liver function tests, positive antimitochondrial antibodies) as well as liver biopsy primary biliary cirrhosis stage I was diagnosed. Therapy with ursodeoxycholic acid (12mg/kg body-weight/die) was started. Follow-up examinations indicated that cholestatic parameters had normalized and antimitochondrial antibodies became negative. In a further biopsy of the liver nearly regular liver parenchyma was demonstrated. Thus, therapy with ursodeoxycholic acid was stopped. However, in November 1992 cholestatic parameters increased again and, antimitochondrial antibodies recurred (subtype anti-M9: positive) without any clinical symptoms. Ursodeoxycholic acid therapy was reintroduced again. Within 3 months cholestatic parameters returned to normal and antimitochondrial antibodies were eliminated again. Since then ursodeoxycholic acid has been given continuously and a long-term remission as defined by clinical, serological and histological criteria could be maintained until today. This case report indicates a serological remission and a marked histological improvement in a female patient with an early stage of primary biliary cirrhosis (stage I) during therapy under ursodeoxycholic acid. It has to be discussed whether certain early stages of primary biliary cirrhosis with benign antimitochondrial antibody-profile (anti-M9: positive) respond well to long-term treatment with ursodeoxycholic acid.

Bile Ducts, Intrahepatic↗

Pneumatosis cystoides intestinalis: case reports and review of the literature.

Pneumatosis cystoides intestinalis is an uncommon condition in which submucosal or subserosal gas cysts are found in the wall of the small or large bowel. Many different causes of pneumatosis cystoides intestinalis have been proposed, including mechanical and bacterial causes. Approximately 85% of cases are thought to be secondary to coexisting disorders of the gastrointestinal tract or the respiratory system. Since 1986 we have observed 4 cases of pneumatosis cystoides intestinalis. A review of the literature is presented with emphasis on the etiology, diagnosis, differential diagnosis, and therapy of pneumatosis cystoides intestinalis. Symptoms of pneumatosis cystoides intestinalis include diarrhea, constipation, rectal bleeding, passage of mucus per rectum, vague abdominal discomfort, abdominal pain, urgency, malabsorption, weight loss, and excessive flatus. Depending on the location of the gas filled cysts the range of symptoms in each patient may vary enormously.

Aged↗

[Endoscopic palliative therapy of malignant esophageal and cardia stenoses. Results--complications--follow-up].

60% of oesophageal and cardiac carcinomas are curatively inoperable at the time of diagnosis. Non-surgical, especially endoscopic palliative procedures gained enormously in topicality. Since 1984 we treated 96 patients with malignant stenoses of the upper gastrointestinal tract by different endoscopic therapies: bougienage, laser coagulation, ballon dilatation, implantation of bridging tubes. Complication rate and lethality of all procedures were low. By none of the endoscopic measures was a prolongation of survival time achieved. Bougienage in combination with laser coagulation as well as tube implantation improved the patients' life quality.

Adult↗