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Biomedical subjects

O Fausa

Publications and source records attributed to O Fausa.

At least 91 records · Page 5Linked to original sources
PubMed1987

An autoantibody profile in primary sclerosing cholangitis.

A high frequency of a variety of autoantibodies has been found in sera from patients with primary sclerosing cholangitis (PSC). The prevalence of all types of autoantibodies in PSC was significantly higher than that in healthy controls and patients with isolated inflammatory bowel disease. The titres of the antibodies were rather elevated, particularly in females, and most of them were IgM. The most frequent type of antinuclear antibody was the 'homogenous' type, which is a marker of many autoimmune diseases. The overall prevalence of the antibody was 35%, whereas in female patients it reached 67%. No correlation was found between autoantibody positivity and any clinical parameter. The present findings support the hypothesis that immunological factors may be relevant in PSC.

Antibodies, Antinuclear↗
PubMed1987

Circulating secretory immunoglobulins of the A and M isotypes in chronic liver disease.

Serum levels of secretory IgA (SIgA) and secretory IgM (SIgM) were quantified by an enzyme-linked immunosorbent assay in 97 patients with various chronic liver diseases and 17 patients with uncomplicated ulcerative colitis. The values obtained were compared with 89 matched controls and related to other serum variables. All types of liver disease had elevated median levels of serum SIg. Patients with primary biliary cirrhosis (PBC) had the highest SIg levels, particularly SIgM, but increased total serum IgM was slightly more specific for PBC. Thus, the SIg levels did not add more discriminative information than several other variables. Elevated levels of circulating SIgA correlated mainly with variables that indicate reduced liver function. The difference observed between patients with PBC and primary sclerosing cholangitis (PSC) in the alkaline phosphatase (ALP)-to-SIg ratio is discussed.

Alkaline Phosphatase↗
PubMed1987

Heterogeneous epithelial expression of class II (HLA-DR) determinants and secretory component related to dysplasia in ulcerative colitis.

The intensity and degree of heterogeneous epithelial marker expression were evaluated immunohistochemically in 29 mucosal biopsy specimens from 7 ulcerative colitis (UC) patients with dysplasia. Biopsy specimens from UC patients with mild (n = 7) or severe (n = 6) inflammation and from histologically normal samples (n = 7) served as controls. HLA-DR showed heterogeneous epithelial expression in all lesions with high grade dysplasia and in 6 of 8 with low grade dysplasia. SC was heterogeneous stained in 17 of 21 lesions with high grade dysplasia and in all but two lesions with low grade dysplasia. In histologically normal mucosa, SC was homogeneously expressed and epithelial DR was virtually absent. In mildly inflamed UC lesions, SC exhibited patchy distribution in only one sample and DR in two, whereas both SC and DR showed a slight degree of heterogeneous expression in all lesions with severe inflammation. Moreover, the overall intensity of SC staining tended to decrease with increasing degree of inflammation, whereas the opposite was seen for DR. Decreased SC and increased DR expression thus seemed to be related to intensified inflammatory activity, whereas heterogeneous expression of these markers was significantly more related to dysplasia.

Adolescent↗
PubMed1987

Sorbitol as a sweetener in the diet of insulin-dependent diabetes.

UNLABELLED: We compared sorbitol given alone and as part of a mixed meal to nine insulin-dependent diabetics (IDD's) during continuous subcutaneous insulin infusion (CSII). Blood glucose, sorbitol and breath hydrogen + methane were measured following six test meals: Pure glucose, sorbitol and lactulose, a mixed meal alone, and sweetened with sorbitol and sucrose. Blood glucose increase was very small after lactulose and sorbitol, significantly larger after glucose. A considerable increase in breath hydrogen + methane appeared after sorbitol and lactulose, but not after glucose. No differences in blood glucose responses were found after the mixed meal alone or sweetened with sorbitol and sucrose. A sustained low level increase in breath hydrogen + methane occurred after all solid meals. Sorbitol was not detected in serum after any meal. CONCLUSION: Sorbitol ingested by IDD's during CSII in watery solution is not absorbed in the small intestine and causes osmotic diarrhoea. Ingested in a composite meal it does not affect blood glucose and does not cause osmotic diarrhoea.

Adolescent↗
PubMed1987

Expression of major histocompatibility complex class II subregion products by jejunal epithelium in patients with coeliac disease.

The MHC class II subregion products (HLA-DR), HLA-DP, and HLA-DQ) were located by immunofluorescence in serial sections of ethanol-fixed, paraffin-embedded jejunal mucosa from control subjects and patients with coeliac disease (CD). DR staining was seen in a granular luminal distribution and basolaterally on surface epithelial cells in both untreated and treated CD patients and in controls. In untreated CD the crypt epithelium was positive for DR almost to the bottom of the glands. This contrasted with virtually absent glandular DR staining in controls and weak staining including only the upper part of the crypts in 5 out of 11 treated patients. HLA-DP was present apically in the surface epithelium in all untreated patients, in 5 out of 11 treated patients, and in 4 out of 11 controls. HLA-DQ appeared only in three untreated patients and was restricted to patches of surface epithelium. The number of intraepithelial T lymphocytes per millimetre of surface epithelium was significantly higher in untreated than in treated CD patients or controls; it was also significantly higher in specimens with epithelial DP expression than in those without. This suggested that intraepithelial lymphocytes modulate epithelial class II expression.

Adult↗
PubMed1987

Local immunoglobulin production is different in gastritis associated with dermatitis herpetiformis and simple gastritis.

The degree of inflammation and atrophy in gastric body mucosal specimens (n = 38) from 28 patients with dermatitis herpetiformis (DH) was graded histologically. Immunoglobulin (Ig) producing cells were enumerated by paired immunofluorescence staining in a 500 microns wide section area from the muscularis mucosae to the lumen (mucosal 'tissue unit'). The number of immunocytes of the three main classes (IgA, IgM, and IgG) was significantly raised with increasing degree of gastritis. All three classes were increased in specimens showing atrophy compared with those without atrophy. IgA cells predominated as in simple gastritis, but a striking difference was a marked increase of IgM cells in specimens with the most pronounced DH-associated gastritis. Relative class distribution of immunocytes within different mucosal zones showed that the percentage of IgA cells was significantly higher in the luminal than in the basal zone, whereas the contrary was true for IgG cells. IgM cells did not show any zonal preference. No relation was seen between small bowel and gastric lesions. The disproportionate increase of gastric IgM producing cells in DH might nevertheless reflect seeding of precursor cells of the secretory immune system generated in the proximal small intestine where the local IgM response is relatively pronounced.

Adolescent↗
PubMed1987

Primary sclerosing cholangitis: a long-term follow-up study.

During the 10-year period from 1 January 1975 to 31 December 1984, primary sclerosing cholangitis (PSC) was diagnosed in 45 patients. Twelve of the patients have died (26.7%), 10 of them of causes related to PSC. Inflammatory bowel disease was found in all patients; ulcerative colitis was found in 37, Crohn's disease in 6, and unclassified colitis in 2 patients. Of the patients alive, 27 were submitted to a follow-up study in 1985. At the follow-up examination no general progression of the liver disease, as measured on the basis of clinical examination and levels of transaminases, alkaline phosphatases, and bilirubin, was found. Cholangiographic evaluation in 24 patients showed that the stage of ductal changes progressed from mild to moderate in 3 patients; in the other patients the stage was not altered. Morphologic examination of liver biopsy specimens in patients with a benign clinical course usually showed portal inflammation, fibrosis, and minor signs of piecemeal necrosis, whereas widespread piecemeal necrosis was found in patients who deteriorated and died. The 50% survival since diagnosis of liver disease was calculated to be 17 years in patients with PSC and 50 years in a comparable group among the general population. The estimated survival curve in PSC was displaced to the left, indicating a reduced life expectancy of about 30 years.

Adolescent↗
PubMed1986

Antibodies to wheat germ agglutinin in coeliac disease.

Serum IgG and IgA antibodies to wheat germ agglutinin (WGA) were measured by an enzyme-linked immunosorbent assay (ELISA) with N-acetyl-D-glucosamine in all incubation steps to inhibit sugar-specific binding. Patients with coeliac disease (CD) had significantly higher antibody levels to WGA than patients with other intestinal disorders or healthy controls. Similar results were obtained for antibodies to the gluten fraction glyc-gli. The WGA antibodies did apparently not cross-react with gluten antigens, but commercial gluten powder contained traces of WGA or a similar lectin. Our findings support the proposal that WGA may be involved in the pathogenesis of CD.

Adult↗
PubMed1985

Collagenous colitis.

A clinical and morphological description of "collagenous colitis" with reference to own cases is given. The disease presents with watery diarrhoea and abdominal pain in middle aged subjects, mostly women. Clinical and laboratory findings are normal. In colo-rectal biopsies there is a severe thickening of the so called "collagen table" in the superficial inter-cryptal lamina propria. Ultrastructural examination shows bandlike subepithelial collagenous fibrils of types I and III. The etiology of this lesion in the large bowel is hitherto unknown. The clinical course seems to be rather benign, requiring only symptomatic treatment.

Colitis↗
PubMed1985

A novel pathway for biosynthesis of cholestanol with 7 alpha-hydroxylated C27-steroids as intermediates, and its importance for the accumulation of cholestanol in cerebrotendinous xanthomatosis.

A mixture of 7 alpha-3H- and 4-14C-labeled cholesterol was administered intravenously to rats. Cholestanol with 20-30% lower ratio between 3H and 14C than in cholesterol could be isolated from different organs. In a healthy human control, cholestanol isolated from feces had a 3H/14C ratio which was 28% lower than in administered cholesterol. Cholesterol and coprostanol reisolated in these experiments had the same ratio between 3H and 14C as in the precursor. A previously unknown pathway for formation of cholestanol, involving 7 alpha-hydroxylated intermediates, may explain these results. Under normal conditions, this pathway is responsible for at most 30% of the cholestanol synthesized from cholesterol. Intravenous administration of the 7 alpha-3H- and 4-14C-labeled cholesterol to a patient with cerebrotendinous xanthomatosis (CTX) resulted in formation of cholestanol which had 70-75% lower 3H/14C ratio. It is concluded that the novel pathway involving 7 alpha-hydroxylated intermediates is accelerated in patients with CTX. This acceleration may contribute essentially to the accumulation of cholestanol, which is a predominant feature of this disease. 7 alpha-Hydroxycholesterol and 7 alpha-hydroxy-4-cholesten-3-one might be intermediates in the novel pathway to cholestanol. After intravenous administration of 7 beta-3H-labeled 7 alpha-hydroxycholesterol in a patient with CTX, significant amounts of 3H were incorporated into plasma and fecal cholestanol. Only small amounts of 7 alpha-hydroxycholesterol and 7 alpha-hydroxy-4-cholesten-3-one are excreted into the intestine, and we therefore conclude that the 7 alpha-dehydroxylation step mainly occurs in the liver. In CTX, the synthesis of cholestanol may be accelerated because the concentrations of 7 alpha-hydroxylated bile acid intermediates in the liver are increased. A possible mechanism for the conversion of a minor fraction of 7 alpha-hydroxycholesterol into cholestanol is suggested.

Adult↗
PubMed1985

Crohn's disease. Treatment and outcome.

Two hundred and fourteen patients with Crohn's disease (CD) were observed for a mean of 9 years. Colonic CD was diagnosed in 25%, small-bowel CD in 17.5%, and ileocolic CD in 57% of the patients. The cumulative operation rates at 10 years were 47%, 58%, and 71%, respectively. Patients with isolated colonic CD were operated on later in the course of their illness than others (p less than 0.05 at 10 years). More than 50% of the patients remained in the 'well being' group regardless of the duration and localization of the disease. The quality of life was better in the non-operated than in the operated group of patients (p less than 0.02). Large-bowel carcinomas occurred in three patients. Of six deaths related to CD, two were caused by cancer and three by renal failure due to amyloidosis. The total number of deaths was 3.6 times that expected.

Amyloidosis↗
PubMed1985

Crohn's disease. Diagnostic procedures and problems.

Two hundred and fourteen patients with Crohn's disease (CD) were investigated by radiological methods, endoscopy, and histological examinations of multiple biopsy and surgical specimens. Radiological lesions suggestive of CD were found in all patients with small-bowel disease but in less than half of those with large-bowel CD. Endoscopic findings were conclusive in 36% of patients with small-bowel disease, in 91% of those with small- and large-bowel disease, and in 86% of those with CD of the large bowel. Histological examinations of biopsy specimens were conclusive in less than one third of the patients. Histological examination of operative specimens, however, was conclusive in 90-100% of all patients. In 43 patients initially diagnosed as having ulcerative colitis, abdominal pain was less frequent, but diarrhea and visible blood were more frequent as initial symptoms. Of these patients, 21 had combined small- and large-bowel disease at the end of the observation time. In intestinal CD, multiple biopsy specimens may disclose Crohn-specific lesions even in endoscopically normal mucosa at a distance from visible lesions.

Colitis, Ulcerative↗
PubMed1985

Crohn's disease. Clinical manifestations.

Two hundred and fourteen patients with Crohn's disease (CD) consecutively admitted during a 5-year period were observed for a mean of 9 years (range, 0-35 years). Sixty-five per cent had their initial symptoms between 10 and 30 years of age and 9.2% after the age of 50 years. The CD diagnosis was delayed for more than 10 years in 8% (mean, 4.5; range, 0-31 years). Large-bowel involvement was seen in 82.5% and was the only localization of the disease in a fourth of the patients. Recurrent abdominal pain occurred in two-thirds of patients with ileal or ileocolic disease. Acute abdominal pain was the cause of laparotomy in 14% of the patients with ileocolic CD. Diarrhea and rectal bleeding occurred significantly more often in colonic CD, whereas fistula complicated ileocolic disease more often than isolated involvement of small or large bowel. Associated extraintestinal diseases were seen in 117 patients (55%), most frequently related to colonic involvement (joint disease, 21%; eye, 12%, skin, 8%). Of 26 patients (12%) with liver pathology, 10 patients had amyloid deposits. Amyloidosis was diagnosed in altogether 12 patients (6%).

Adolescent↗
PubMed1985

Studies of the mechanism of the increased biosynthesis of cholestanol in cerebrotendinous xanthomatosis. The activity of delta 5-3 beta-hydroxysteroid dehydrogenase.

It was recently proposed that the increased biosynthesis of cholestanol in cerebrotendinous xanthomatosis (CTX) is due to increased activity of the delta 5-3 beta-hydroxysteroid dehydrogenase involved in bile acid biosynthesis, causing increased conversion of cholesterol into cholestanol through 4-cholesten-3-one. Our attempts to confirm this hypothesis have failed. Liver biopsy specimens from two patients with CTX did not have any increased capacity to catalyze conversion of 7 alpha-hydroxycholesterol into 7 alpha-hydroxy-4-cholesten-3-one. Further, we did not find any changes in the activity of liver microsomal delta 5-3 beta-hydroxysteroid dehydrogenase after feeding rabbits with cholestanol or cholesterol. The findings are discussed in relation to our hypothesis that the accelerated biosynthesis of cholestanol in CTX is due to an increased conversion of early bile acid intermediates into cholestanol.

3-Hydroxysteroid Dehydrogenases↗
PubMed1985

Short-chain fatty acids in the small-bowel bacterial overgrowth syndrome.

The short-chain fatty acids (SCFAs) have been measured by gas chromatography in fasting jejunal secretions, saliva, and feces from 8 patients with the small-bowel bacterial overgrowth syndrome (BO) and 9 control patients; in jejunal secretions and saliva from 6 healthy subjects; and in feces from 20 healthy subjects. The concentrations of SCFAs (median (range), mumol/l) in jejunal secretions of BO patients were as follows: total, 990 (210-12,370); acetic acid, 650 (170-6770); propionic acid, 110 (16-3070); isobutyric acid, 26 (1-310); n-butyric acid, 90 (12-1340); isovaleric acid, 35 (2-680); n-valeric acid, 7 (3-200). In BO patients the total concentration of SCFAs in jejunal secretions was approximately four times higher than in control patients (p less than 0.01) and in healthy subjects (p less than 0.025). The relative distribution of the acids resembled the distribution found in feces more than that of saliva or the normal jejunal secretions. These findings indicate that patients with BO have a colon-like flora in the small intestine and that the main part of the SCFAs in the jejunal secretions of these patients is produced by the altered microbial flora in the jejunum. Combined with other tests, analyses of intestinal SCFAs may prove to be valuable in the diagnosis of small-bowel bacterial overgrowth.

Adult↗
PubMed1985

Diagnostic value of gastrointestinal endoscopy in patients with uncharacteristic abdominal disorders.

Endoscopic examinations were performed in 50 patients admitted for uncharacteristic abdominal disorders. Despite previous hospitalizations for the same complaints, no certain diagnosis had been established. Endoscopic retrograde cholangiopancreatography and colonoscopy were performed systematically, whereas gastroscopy was performed only on special indications. Of the 18 patients in whom a primary organic disease was diagnosed, duodenoscopy was of importance in 1 (duodenal cancer), colonoscopy in 3, and gastroscopy in 8 patients. In addition, colonoscopy verified the psychosomatic diagnosis in a patient with melanosis. In the rest of the material cannulation of the pancreatic duct (n = 36) or bile duct (n = 33), colonoscopy (n = 42), or gastroscopy (n = 21) did not show signs relevant to the patients' symptoms. Several of these signs, such as polyps or gallstones, together with the importance of negative examinations in the diagnosis of many patients, add to the value of endoscopic procedures in patients with uncharacteristic abdominal disturbances.

Adolescent↗
PubMed1985

Collagenous colitis. A clinical, histological, and ultrastructural study.

Eleven patients with so-called collagenous colitis are described and the literature reviewed. The disease presents with persisting watery diarrhoea in middle-aged subjects, predominantly women. The fairly uniform clinical features of abdominal discomfort are suggestive of the irritable bowel syndrome. The morphological changes in colorectal biopsy specimens are diagnostic, showing an excessive intercryptal subepithelial collagen deposition throughout the large bowel. Associated hyperplasia, degeneration, and desquamation are seen in the intercryptal epithelial cells and a mild inflammatory response in the lamina propria. A comparable collagenization has not been demonstrated in other disorders, but otherwise the changes demonstrated histologically and ultrastructurally are of a quantitative nature. Collagenous colitis is unrelated to other diseases and the cause unknown. It has either a benign, continuous course or exacerbations and remissions. Loperamide relieved diarrhoea in five of six patients. The collagen deposition seems to be slowly progressive, but clinical and histopathological resolution may occasionally be seen.

Adult↗