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Biomedical subjects

K Geboes

Publications and source records attributed to K Geboes.

At least 199 records · Page 11Linked to original sources
PubMed1989

Experimental studies of injection therapy for severe nonvariceal bleeding in dogs.

Efficacy and tissue effects of injection therapy for nonvariceal upper gastrointestinal bleeding were studied in 16 mongrel dogs. The results were compared with those obtained by neodymium-yttrium-aluminum-garnet laser, bipolar electrocoagulation, and heater probe. Epinephrine (1:10,000), absolute ethanol, and 1% polidocanol were used as injection solutions. In acute, severely bleeding experimental ulcers as well as in transected submucosal arteries, injection methods were not as effective as thermal methods in achieving complete hemostasis, although injection therapy, especially with large volumes of epinephrine (1:10,000), very quickly decreased the rate of bleeding. Chronic experiments showed that epinephrine (1:10,000) caused almost no tissue injury, but also did not induce vessel thrombosis. In contrast, absolute ethanol and 1% polidocanol caused tissue necrosis, ulceration, and vessel thrombosis, the former by acute dehydration and fixation of the tissue, the latter by acute edema and subsequent inflammation and sclerosis. These data suggest that although epinephrine injection may slow or temporarily stop bleeding, this modality is not as efficacious as injection with 1% polidocanol or absolute ethanol in inducing definitive vessel thrombosis. In the present experimental conditions sclerotherapy was not as effective as thermal methods in achieving hemostasis. These data also show that injection therapy with 1% polidocanol and absolute ethanol is by no means safer than thermal methods.

Animals↗
PubMed1989

Immune cells in a case of postherpetic marginal trophic ulcer.

The corneal surface was examined by means of replica histology, and the excised limbic conjunctiva was examined by routine histological and immunohistochemical methods with monoclonal antibodies directed against major histocompatibility class II antigens, lymphocyte subsets, Langerhans cells (HLA-DR, OKT4-Leu3a, OKT8, BA1, B1, and OKT6) and immunoglobulins A, G, M, and D. The findings were compared with those found in normal conjunctiva. No inflammatory cells were present in the replica of the corneal surface. An inflammatory infiltrate composed of B lymphocytes and null cells, in addition to T lymphocytes, Langerhans cells, and polymorphs, was present in the epithelium as well as in the stroma of the limbic conjunctiva. The composition of the infiltrate points towards the involvement of cell mediated immunity as well as humoral immunity. No immunoglobulins were bound to the conjunctival epithelium.

Aged↗
PubMed1989

Immunopathology of trachomatous conjunctivitis.

Upper palpebral conjunctival biopsy specimens obtained from eight patients with active trachoma were examined by routine histological and immunohistochemical methods. The epithelium expressed class I major histocompatibility complex (MHC) products throughout and class II MHC products in the superficial layers. The epithelial inflammatory infiltrate consisted of polymorphonuclear leucocytes, macrophages, T lymphocytes, and dendritic cells. In the underlying stroma the inflammatory infiltrate was organised as B lymphoid follicles, and there was also a diffuse infiltrate consisting of plasma cells and scattered B lymphoid cells, dendritic cells, T cells, macrophages, and polymorphonuclear leucocytes. Each type of cell has its special location in the tissue. Plasma cells were located on a subepithelial band and as a dense infiltrate round the acini of accessory lacrimal glands. IgA+ plasma cells outnumbered IgG+ cells, whereas IgM+ and IgE+ cells were few. Our data provide good evidence for the presence of both humoral and cell mediated immune responses and a possible role for autoimmune mechanisms in the conjunctival tissues of trachoma patients.

Child↗
PubMed1989

Endoscopy in inflammatory bowel disease.

Ileocolonoscopy is a very useful diagnostic examination for the assessment of inflammatory bowel disease. Specific indications justify the procedure only when they are likely to influence therapeutic management. Colonoscopy of the entire colon and the terminal ileum can be necessary to establish a differential diagnosis, to determine the extent of inflammatory activity, preoperatively to guide the surgeon, and to examine the bowel proximal to stomas. Early endoscopic examination of the ileocolonic anastomosis after resection of the terminal ileum and part of the colon enables evaluation of the severity of recurrence, predicting clinical outcome. Routine postoperative colonoscopy is, however, not warranted, as we do not have a medical treatment influencing evolution of the disease. Total colonoscopy is also indicated for prevention of cancer in long-standing ulcerative colitis. The best screening strategy has still to be identified.

Colitis, Ulcerative↗
PubMed1989

Diagnosis of ulcerative colitis in endoscopic biopsies.

Accurate diagnosis of "colitis", and hence the appropriate therapy, can be a big problem. Routine microscopy of endoscopic biopsies remains very important. Yet a biopsy diagnosis may also be difficult, and its accuracy depends upon the criteria used. The major parameters for the diagnosis of ulcerative colitis are reviewed.

Biopsy↗
PubMed1988

Phenotypic characterization of inflammatory cells in phlyctenular eye disease.

Phlyctenular conjunctival biopsy specimens obtained from seven patients presenting with ulcerated limbal phlyctens were examined with routine histology and immunohistochemistry using a panel of monoclonal and polyclonal antibodies and immunoperoxidase techniques. Large numbers of mononuclear phagocytes, dendritic Langerhans cells and polymorphonuclear leukocytes and moderate numbers of T-lymphocytes were observed in the epithelium. This infiltrate was most intense at the basal epithelial layers which expressed HLA-DR antigens. The underlying stromal inflammatory infiltrate was organized as perivascular cuffs and a scattered subepithelial infiltrate, and consisted of many mononuclear cells and poly-morphonuclear leukocytes. Among the mononuclear cells, monocyte derived cells dominated and included monocytes macrophages and dendritic cells. T-lymphocytes were present in moderate numbers, whereas B-lymphocytes and plasma cells, mostly of IgA class, were infrequent. These findings provided in situ immunohistochemical evidence that phlyctenular eye disease is the result of delayed type hypersensitivity immune response in which monocytes and monocyte derived cells play a central role.

Antibodies, Monoclonal↗
PubMed1988

Intestinal nodular lymphoid hyperplasia in patients with common variable immunodeficiency: local accumulation of B and CD8(+) lymphocytes.

Common variable immunodeficiency (CVI) with hypogammaglobulinemia is often complicated by nodular lymphoid hyperplasia of the intestine. In this study the lymphoid constituents of intestinal nodular hyperplasia of five CVI patients were characterized with monoclonal antibodies. Few CD4(+) but abundant CD8(+) T lymphocytes were found around the follicles. The follicles were populated mainly by B cells expressing surface IgM. A few cells in the lamina propria expressed Leu7. No intracytoplasmic immunoglobulin-containing plasma cells were seen. Peyer's patches in gut biopsies from controls were also composed of follicles with B lymphocytes. A ring of T lymphocytes surrounded the follicles. CD4(+) helper cells largely outnumbered CD8(+) cells in this ring. Moreover, plasma cells were present in the lamina propria and the mixed cell zone covering the follicles. In peripheral blood of the patients, B cells were present in normal proportions but they could not be induced to produce IgG in vitro by T cell-dependent (pokeweed mitogen) or T cell-independent (Staphylococcus aureus Cowan I) mitogens. In two of the patients, IgM production could be induced in vitro. Peripheral blood T cells were predominantly CD8(+) in three of the five patients, and in these same patients an increase in suppressor-cell activity of peripheral blood T cells on immunoglobulin production was observed. The data demonstrate a block in B-cell differentiation in the gut and in peripheral blood. Whether the local increase in CD8(+) cells in the nodular lymphoid hyperplasia is a primary event or is secondary to chronic immune stimulation and whether it contributes to local inhibition of B-cell differentiation remain to be investigated.

Adult↗
PubMed1988

Changes in small intestinal epithelial expression of MHC class II antigen after terminal ileal resection for Crohn's disease.

Aphthous lesions in the neoterminal ileum from patients operated for Crohn's disease are an early sign of recurrence that can be identified during ileocolonoscopy. The origin of these lesions was studied in nine patients treated by terminal ileal resection and right hemicolectomy for complicated Crohn's disease. During surgery the neoterminal ileum was turned inside out, the mucosa was carefully inspected and two large mucosal biopsies were obtained. The same procedure was carried out in seven patients operated for other diseases. Four to six months after surgery endoscopy of the neoterminal ileum was carried out and multiple biopsies were obtained from the neoterminal ileum. Another follow-up colonoscopy with biopsies was carried out one year after the operation. The operative specimens and the per- and postoperative biopsies were submitted to routine microscopy and immuno- and enzyme-histochemistry. None of the Crohn's patients had macroscopic lesions in the neoterminal ileum at operation and only one had microscopic signs of inflammation and a positive section margin. Four-six months after operation all Crohn's patients had active aphthous lesions in a 5-20 cm segment of the neoterminal ileum at endoscopy. Biopsies taken at this time showed microscopic features which were not observed in biopsies from control subjects: an increase of HLA-DR+, ATPase+ dendritic cells in the ileal mucosa and a defective expression of MHC class II antigens by the small intestinal epithelial cells. MHC class II expression by the small intestinal epithelial cells returned towards normal after one year.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphatases↗
PubMed1988

Mucin histochemistry of heterotopic gastric mucosa of the upper esophagus in adults: possible pathogenic implications.

The mucin profile of 24 endoscopic biopsies of heterotopic gastric mucosa (HGM) of the upper esophagus in adults and a control group of ten cases of Meckel's diverticula containing heterotopic gastric mucosa were studied with two combined histochemical methods: alcian blue pH 2.5/PAS and high iron diamine/alcian blue pH 2.5. The clinical and light microscopic features of the 24 HGM cases were also reviewed. In addition to overall secretion of neutral mucins by the 24 HGM cases, mucin histochemistry showed prominent secretion of acidic mucins in 19 of 24 HGM cases (79%), with sulphomucins in 11 of 24 HGM cases (45.8%). This mucin profile of HGM was unlike that of either normal gastric mucosa or heterotopic gastric mucosa in Meckel's diverticula. Moreover, a comparison between the mucin profile and clinical features of HGM and Barrett's esophagus showed certain similarities. The data suggest a physiopathologic link between HGM and Barrett's esophagus.

Adolescent↗
PubMed1988

Symptomatic gastrointestinal metastases from malignant melanoma. A clinical study.

Gastrointestinal metastases from malignant melanomas are not uncommon but rarely cause symptoms. We report six patients hospitalized because of gastrointestinal (GI) symptoms due to metastases from a primary extraintestinal melanoma. The clinical symptoms are nonspecific and include abdominal pain, weight loss, and occasionally GI bleeding. The diagnosis may, therefore, be unduly delayed, even though the prognosis of GI metastases from malignant melanomas is poor and the results of adjuvant chemotherapy, as well as of surgery, are not encouraging. Screening of patients with malignant melanoma for GI metastases is not yet routinely indicated, but should be considered in prospective studies evaluating adjuvant therapy.

Aged↗
PubMed1988

Estrogen-progesterone treatment of Osler-Weber-Rendu disease.

A 56-year-old woman with Osler-Weber-Rendu disease had longstanding iron deficiency anemia from recurrent melena. Since neither laser photocoagulation nor surgery were successful in stopping the increasing transfusion need, combined estrogen-progesterone therapy was started. Except for slight bleeding from a temporary ileostomy, the bleeding and need for transfusion terminated promptly. This experience confirms that estrogen-progesterone therapy may promote cessation of bleeding gastrointestinal telangiectasias and indicates the need for controlled investigations.

Estradiol Congeners↗
PubMed1988

Whipple's disease in a patient with longstanding seronegative polyarthritis.

We describe a middle-aged woman with Whipple's disease. She suffered from a seronegative rheumatoid-like polyarthritis for more than 20 years before the diagnosis of Whipple's disease was made. This case shows that arthritis may be a feature of occult Whipple's disease. Without gastrointestinal symptoms, diagnosis is very difficult. Diagnosis is important because treatment can rapidly improve this life-threatening disease.

Arthritis↗
PubMed1987

Immunocytological study of phlyctenular eye disease.

Scrapings from phlyctens and conjunctiva of 12 patients with phlyctenular keratoconjunctivitis were studied using OKT4-Leu3a, OKT8, B1, BA1, S-100 and HLA-DR monoclonal antibodies. T-lymphocytes were present in both conjunctival and phlyctenular scrapings. OKT4-Leu3a positive cells outnumbered the OKT8 positive cells in both conjunctival and phlyctenular scrapings. B1 and BA1 positive cells were absent from the conjunctival scrapings, but were present in the phlyctenular scrapings. S-100 positive cells were present in both conjunctival and phlyctenular scrapings. However, they were very few in the conjunctival scrapings. Most of the cells in both conjunctival and phlyctenular scrapings were HLA-DR positive. These findings support the hypothesis that cell mediated immunity is responsible for the pathogenesis of phlyctenular eye disease.

Adolescent↗
PubMed1987

Jejunal mucosa lymphoid cell subsets and the expression of major histocompatibility complex antigens in children.

Using monoclonal antibodies with the immunoperoxidase technique the distribution pattern of class I and class II antigens of the major histocompatibility complex (MHC), and of the lymphocyte subsets have been studied in intestinal biopsies from children without mucosal lesions, from children with coeliac disease (CD) and from infants with cow's milk protein intolerance (CMPI). The staining of the intestinal mucosa for class I antigens is unaltered irrespective of the histological picture or the clinical diagnosis. Class II antigens are only partially or not expressed at all by epithelial cells in untreated coeliac disease and in some cases of cow's milk protein intolerance. The number and the composition of the lamina propria lymphocytes in both CD and CMPI are different from the normal situation. An increase of all lamina propria lymphocyte subsets is observed in untreated CD. A decrease of OKT4+ lymphocytes is observed in the lamina propria of CMPI patients. These changes may be involved in the pathogenesis of these diseases.

Animals↗