Search PubMed⌕ Search

Biomedical subjects

P Sherman

Publications and source records attributed to P Sherman.

At least 91 records · Page 5Linked to original sources
PubMed1988

Treatment of Campylobacter pylori-associated antral gastritis in children with bismuth subsalicylate and ampicillin.

We evaluated the efficacy of medical therapy, consisting of liquid bismuth subsalicylate prescribed either in combination with oral ampicillin (n = 15) or alone (n = 1), in the clearing of bacterial colonization on the antrum in 16 children with Campylobacter pylori-associated antral gastritis. We also examined the effects of medical treatment on altering the severity of associated antral inflammation. Eight patients had upper gastrointestinal tract hemorrhage, two had acute gastric outlet obstruction, and 10 had symptoms of episodic epigastric abdominal pain. Duodenal ulcers were demonstrated in 10 of the 16 patients; in the other six, C. pylori-associated antral gastritis was documented without evidence of acute peptic ulceration. Seven days after a 6-week course of medical therapy, repeat upper endoscopy plus mucosal biopsy specimens showed that C. pylori colonization of the antrum had cleared in 12 of the 16 (75%) patients. Inflammation in the antrum improved in all patients in whom colonization by C. pylori was eradicated. In contrast, in the four with persistent colonization of the antrum, the severity of antral gastritis had not improved (p less than 0.01). Clinical symptoms improved in 9 of 12 patients in whom C. pylori colonization was no longer present, whereas subjective symptoms were unaffected in those with continued bacterial colonization of the antrum (p less than 0.05). We conclude that oral bismuth subsalicylate, in conjunction with ampicillin, can eradicate C. pylori colonization of the antrum, and that clearing of C. pylori is correlated with an improvement in the associated antral gastritis and clinical symptoms. These findings provide additional support for the hypothesis that these gastric organisms could play an etiologic role in primary antral gastritis and peptic ulcer disease.

Adolescent↗
PubMed1988

Attaching and effacing adherence of Vero cytotoxin-producing Escherichia coli to rabbit intestinal epithelium in vivo.

Vero cytotoxin-producing Escherichia coli (VTEC) strains have been associated with sporadic cases and outbreaks of hemorrhagic colitis and with the hemolytic uremic syndrome in humans. Since adherence of enteric pathogens to epithelial surfaces is often a prerequisite for the subsequent delivery of bacterial enterotoxins and mucosal invasion, we evaluated intestinal adherence by 18 VTEC strains, which were of human origin and belonged to 10 distinct serotypes, 7 days after enteral challenge of rabbits. A total of 23 postweaning rabbits (body weight, 1 kg) were each fed 2 X 10(8) VTEC, and 5 rabbits were challenged with an equal number of fecal commensal E. coli strains as controls. Each rabbit was monitored daily for the development of diarrhea. At 7 days after infection the proximal jejunum, distal ileum, cecum, and proximal colon were removed from each rabbit and examined for the presence of adherent organisms under light microscopy, after Giemsa staining of Formalin-fixed secretions, and by transmission electron microscopy. Nonbloody diarrhea developed in 16 of 23 VTEC-infected rabbits in contrast to 0 of 5 infected with commensal E. coli strains (P less than 0.02). Organisms were adherent to surface epithelial cells in the ceca (20 of 23 rabbits), proximal colons (9 of 23), and distal ilea (6 of 23) of VTEC-infected rabbits. Intimate attaching and effacing binding of bacteria to intestinal epithelial cells, in regions where the normal microvillous membrane architecture had been disrupted, was observed under electron microscopy for VTEC of multiple serotypes. In contrast, no organisms were adherent to the jejuni. Adherence of organisms was not seen in any portion of the intestines of rabbits that were challenged with commensals. These findings indicate that multiple serotypes of VTEC demonstrate intimate attaching and effacing binding to rabbit enterocytes and colonocytes in vivo. In addition to bacterial binding in the ceca and colons, VTEC adhere to enterocytes in the distal small intestines of per orally infected postweaning rabbits.

Animals↗
PubMed1988

Characterization of flagella purified from enterohemorrhagic, vero-cytotoxin-producing Escherichia coli serotype O157:H7.

Escherichia coli of the serotype O157:H7 has recently been isolated in human fecal specimens in association with sporadic cases and outbreaks of hemorrhagic colitis and with the hemolytic uremic syndrome. The aim of this study was to characterize the flagellin protein subunit constituents of flagellar filaments from E. coli O157:H7 strain CL-56. Flagellin isolated from a reference Salmonella enteritidis strain was used for comparison. Flagella were dissociated by incubation of bacteria under acidic conditions, centrifugation, and differential ammonium sulfate precipitation. Reconstituted flagellar filaments were demonstrated by three complementary methods: transmission electron microscopy, antigenic reactivity with H7 antiserum by a dot blot immunoassay, and immunogold localization of antiserum raised to the purified antigen to intact flagella on whole E. coli O157:H7. On sodium dodecyl sulfate-polyacrylamide gels flagellin proteins from E. coli O157:H7 demonstrated an apparent Mr of 66,000. The isoelectric point of E. coli O157:H7 flagellin was 5.42. By immunoblotting, H7 flagellin proteins were shown to be immunogenic. They induced a systemic immune response both in rabbits challenged with whole bacteria and in a human previously infected with E. coli O157:H7.

Actin Cytoskeleton↗
PubMed1987

Association of Campylobacter pylori on the gastric mucosa with antral gastritis in children.

We investigated the presence of Campylobacter pylori colonization of the gastric mucosa and of histologic evidence of gastritis in a prospective study of 71 consecutive children undergoing upper gastrointestinal tract endoscopy and gastric biopsies because of gastrointestinal symptoms. Two tissue samples from the gastric antrum were obtained from 67 of the 71 children (mean age [+/- SD], 11.4 +/- 3.8 years). One sample was evaluated for evidence of gastritis and stained with silver to detect organisms morphologically resembling campylobacter. The second sample was cultured for C. pylori, and a portion was used to perform a urease-screening test for the presence of C. pylori. Antral gastritis was diagnosed histologically in 18 of 67 patients. C. pylori was identified by both culture and silver staining on the antral mucosa in 7 of 10 patients with unexplained gastritis (primary gastritis) but in none of 8 patients with gastritis associated with an identifiable underlying cause (secondary gastritis). C. pylori was not identified in any of the 49 cases with normal histologic features. The urease-screening test was positive in only three of six patients with a positive culture for C. pylori. Duodenal ulcers were diagnosed by endoscopy in five patients. Each of the five had C. pylori on the antral mucosa, but organisms were not identified on the duodenal mucosa. We conclude that the presence of C. pylori on the antral mucosa is specifically associated with primary antral gastritis and may also be associated with primary duodenal ulceration.

Adolescent↗
PubMed1987

Surface properties of the Vero cytotoxin-producing Escherichia coli O157:H7.

Strains of Escherichia coli serotype O157:H7 are Vero cytotoxin-producing enteric pathogens which have been associated with sporadic cases and outbreaks of hemorrhagic colitis and with the hemolytic uremic syndrome in humans. In addition to toxin production, adherence of many pathogenic bacteria to intestinal mucosal surfaces is a critical primary step in the pathogenesis of diarrheal diseases. Although E. coli serotype O157:H7 organisms adhere to intestinal epithelia of orally infected animals in a pattern morphologically identical to that previously described in adherent, effacing E. coli infections, the mechanisms of bacterial adherence are not known. To determine the cell surface adhesins which mediate attachment of E. coli O157:H7 to epithelial surfaces, we evaluated the surface properties of these organisms. Five strains isolated from children with the hemolytic uremic syndrome were grown both in broth cultures and on agar media. Adherence and invasion of E. coli O157:H7 in Intestine 407 and HEp-2 epithelial cell lines was quantitated using an enteroinvasive E. coli strain (serotype O164:NM) as a control. Cell surface properties of E. coli O157:H7 were evaluated by agglutination of a series of erythrocytes, transmission electron microscopy, DEAE-ion-exchange chromatography, and hydrophobic interaction chromatography. E. coli O157:H7 strains adhered to but did not invade either Intestine 407 or HEp-2 cells. Homologous O157:H7 rabbit antiserum blocked attachment of bacteria to tissue culture cells, in contrast to heterologous antiserum and preimmune rabbit serum, which did not inhibit attachment of E. coli O157:H7. None of the five O15:H7 isolates mediated mannose-resistant hemagglutination under any of the in vitro culture conditions. One isolate mediated mannose-sensitive hemagglutination after serial passage in broth cultures. Pili and fibrillae were not visualized by electron microscopy on nonhemagglutinating organisms, but pili were demonstrated on the one isolate which mediated mannose-sensitive hemagglutination. All O157:H7 strains demonstrated high anionic surface charge (DEAE) but low surface hydrophobicity properties (hydrophobic interaction chromatography). The findings suggest that surface structures other than pili can mediate attachment of serotype O157:H7 bacteria to epithelial cells in vitro.

Bacterial Adhesion↗
PubMed1987

Bacteria and the mucus blanket in experimental small bowel bacterial overgrowth.

Self-filling blind loops were created experimentally in jejunal segments of specific pathogen-free male Wistar rats, and the loop contents and mucosa were examined over an 8-week period for evaluation of the interaction between mucus and luminal bacteria. Corresponding jejunal segments from rats that did not undergo surgery were used as controls. Proliferation of anaerobic bacteria developed in the test animals by the first week after surgery. Despite anaerobic bacterial proliferation, no adherence by bacteria to the intestinal microvillus surface was observed by scanning or transmission electron microscopy. Rather, bacteria were present within the mucus layer overlying the intestinal mucosal surface. Immunoassay of goblet cell mucin demonstrated an increase in the proportion of mucin present in the intestinal lumen and a decrease in mucin levels in the jejunal mucosa. These results suggest that the interaction of bacteria with mucus is an important mechanism of protection of the mucosal surface in experimental small bowel bacterial overgrowth.

Animals↗
PubMed1987

Radiolabeled meta-iodobenzylguanidine and the adrenergic neurons of salivary glands.

The handling of radiolabeled meta-iodobenzylguanidine (MIBG) by salivary glands was evaluated. In the submaxillary glands of rats, the uptake of 125I-MIBG was decreased after 1) nerve injury induced by 6-hydroxydopamine, 2) inhibition of the uptake-1 pathway by desmethylimipramine, and 3) surgical denervation. However, the reduction in 125I-MIGB uptake was less than that of 3H-norepinephrine (3H-NE) and of the endogenous content of NE in the glands. Yet, the sympathomimetic phenylpropanolamine displaced about the same fraction of 125I-MIBG as 3H-NE. These results suggest that 40% or more of 125I-MIBG resides in extraneuronal sites but that at least 30% and possibly more lies in the adrenergic nerve terminals. Fasting and feeding rats produced changes in the rates of disappearance of 125I-MIBG and 3H-NE from the submaxillary gland that were different, and the rates of loss of 125I-MIBG cannot be used as an index of adrenergic nerve activity. In man, the concentrations of 123I-MIBG in the salivary glands, particularly the parotid gland, are readily visible and measureable. Imipramine reduced the uptake of 123I-MIBG into parotid glands little or not at all; some of the 123I-MIBG may enter neurons via an imipramine-insensitive pathway, but a substantial fraction probably arrives in intraneuronal locations. Thus, phenylpropanolamine displaced over 50% of the parotid pool of 123I-MIBG. However, in only the most severe case of generalized autonomic neuropathy was the uptake of 123I-MIBG reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Iodobenzylguanidine↗
PubMed1987

Campylobacter pyloridis-associated primary gastritis in children.

Campylobacter pyloridis are spiral-shaped Gram-negative bacteria that have recently been associated with gastritis and peptic ulcer diseases in adults. The organisms have been identified in biopsy specimens of the gastric antrum by staining sections with silver stain. To determine the frequency of colonization of the antral mucosa with C pyloridis in association with gastritis in childhood, we retrospectively reviewed 53 cases in patients (mean age 11.9 years) in whom upper endoscopy with antral biopsy was performed for the evaluation of symptoms referable to the upper gastrointestinal tract. A silver impregnation method was used to detect the presence of C pyloridis. Nineteen of 53 antral biopsy specimens showed evidence of mucosal inflammation. Ten of these 19 patients had no apparent predisposing etiology for gastritis, and six of these ten had C pyloridis identified on antral biopsies. Nine of the 19 patients had secondary causes of gastric inflammation (two gastroduodenal Crohn disease, two eosinophilic gastroenteritis, four drug related, and one dys-gamma-globulinemia and lymphonodular hyperplasia). In contrast, none of these nine patients had C pyloridis demonstrated on antral biopsies. Silver stain for C pyloridis was negative in all 34 of the 53 children who had normal antral histologic findings. C pyloridis was not demonstrated by silver stain on any of the duodenal sections, although eight of the 19 children with gastritis and nine of the 34 children with normal antral histologic findings had histologic evidence of duodenal inflammation. We conclude that C pyloridis is associated with primary antral gastritis but not with secondary gastritis in the pediatric population.

Adolescent↗
PubMed1987

Metaiodobenzylguanidine as an index of the adrenergic nervous system integrity and function.

The radiopharmaceutical, metaiodobenzylguanidine (MIBG) acts as an analog of norepinephrine (NE). Experiments in rats were carried out to determine how closely the movements of [125I]MIBG in the heart mimicked those of [3H]NE, and if the changes [125I] MIBG concentrations would reflect injury to, and function of, adrenergic neurons in the heart. Injury to adrenergic neurons by 6-hydroxydopamine substantially reduced the uptake of [125I] MIBG into the left ventricle, but the effect was less than that on uptake of [3H]NE uptake and concentration of endogenous NE. Similarly, when desmethylimipramine was given to inhibit the uptake-1 pathway of neurons, the reduction in uptake of [125I]MIBG was statistically significant but less than that of [3H]NE; part of this difference may be attributable to partial uptake of [125I]MIBG into neurons by a diffusion pathway. Substantial fractions of [125I]MIBG and [3H]NE were displaced from the heart by the sympathomimetic drug, phenylpropanolamine. When adrenergic neurons of the heart were stimulated by feeding of rats, the disappearance rates of [3H]NE and [125I]MIBG from the heart were significantly increased. Although not a perfect analog of [3H]NE, [125I]MIBG appears to enter and leave the heart in patterns similar to those of [3H]NE. Thus, movements of [125I]MIBG give indices of adrenergic neuron injury and function in the heart.

3-Iodobenzylguanidine↗
PubMed1987

Metaiodobenzylguanidine to map scintigraphically the adrenergic nervous system in man.

Metaiodobenzylguanidine (MIBG) localizes in adrenergic neurons; MIBG labeled with 123I then serves as an analog of norepinephrine, and concentrations of [123I]MIBG reflect sites of adrenergic neurons in organs. Movements of [123I]MIBG into and out of organs were measured by quantitative scintigraphy in man. We perturbed adrenergic neuron function in several ways, and [123I]MIBG concentrations in the heart were subsequently altered in patterns consistent with the concept that [123I]MIBG resides mostly in adrenergic neurons. Uptake of [123I]MIBG into the heart was inhibited by the tricyclic drug, imipramine, and this agent also accelerated the rate of loss of [123I]MIBG. Phenylpropanolamine, a sympathomimetic drug that acts by displacing norepinephrine from neurons, increased the rates of loss of [123I]MIBG from the heart. Exercise was followed by a movement of [123I]MIBG into blood and urine. Generalized autonomic neuropathies were associated with marked diminutions of [123I]MIBG uptake into the heart. We conclude that quantitative scintigraphy in patients will enable determinations of regional disturbances in integrity (by measuring uptake of [123I]MIBG) and function (by measuring rates of loss of [123I]MIBG) of the adrenergic nervous system in the heart.

3-Iodobenzylguanidine↗
PubMed1986

Production of secretory immunoglobulin A in rat self-filling blind loops. Local secretory immunoglobulin A immune response to luminal bacterial flora.

The immunoglobulin A (IgA) response to small intestinal bacteria was studied in rats with self-filling blind loops (SFBLs), surgically constructed in continuity with the intestine or at the end of a Roux-en-Y loop (RY-SFBL) so as to avoid filling with chyme. Total bile salt in the RY-SFBL lumen was much lower (4.35 +/- 0.8 mumol) than in the SFBL lumen (116 +/- 15 mumol), but other parameters, such as the number of anaerobic bacteria and disaccharidase activities were similar. Within 1 wk of establishing the blind loops, they had accumulated at least 14 times as much IgA as found in the normal jejunum. Luminal IgA per milligram mucosal protein was almost as high in the RY-SFBL as in the SFBL, indicating that a significant proportion of the IgA must be nonbiliary and probably mucosal in origin. Oral treatment with lincomycin significantly reduced luminal IgA accumulation in the RY-SFBL. Column chromatography and enzyme-linked immunosorbent assay (ELISA), which employed antirat secretory component antibody, established that the majority of the luminal IgA was nonmonomeric and complexed with secretory component. Centrifugation of luminal contents to separate soluble and particulate bound IgA showed that the RY-SFBL contained a higher proportion of precipitable IgA than either the SFBL or lincomycin-treated RY-SFBL. Immunoglobulin A eluted from the precipitates by KSCN was bound to a greater extent by bacterial sonicates than IgA in the supernatant. For either precipitate or supernatant IgA, the greatest binding was observed when the IgA was obtained from the RY-SFBL. These observations indicate that rat intestinal mucosa rapidly responds to bacterial overgrowth by secreting secretory immunoglobulin A (sIgA) with specificity for luminal bacterial antigens. As the sIgA present within the SFBL is to a certain extent derived from bile, the lower proportion of SFBL sIgA bound by bacterial antigens than of RY-SFBL sIgA suggests that biliary sIgA is less specific for local antigens than the sIgA that is secreted by the local mucosa.

Animals↗
PubMed1986

Eosinophilic gastroenteritis presenting in an adolescent with isolated colonic involvement.

Eosinophilic gastroenteritis most commonly involves the stomach and proximal small intestine with eosinophilic inflammation of either the mucosa, submucosa or serosa. The patient reported here had isolated eosinophilic colitis. The initial presentation with iron deficiency anaemia owing to occult gastrointestinal blood loss emphasises the need to evaluate the entire gastrointestinal tract in patients with eosinophilic gastroenteritis.

Adolescent↗
PubMed1986

Value of the peroral pneumocolon in children.

This is the first study in children of the use of the peroral pneumocolon, which entails insufflation of air per rectum to examine the terminal ileum and cecum in conjunction with a conventional barium follow-through examination. Of 1188 conventional barium follow-through examinations performed during 2 1/2 years, results were ambiguous in 13 patients, who then underwent a peroral pneumocolon study. This study showed terminal ileitis in six patients, confirming the diagnosis of Crohn disease in five and Behçet syndrome in the other. In four patients peroral pneumocolon findings were normal. More extensive cecal or proximal ileal disease was shown in three patients by peroral pneumocolon, and fistulae suspected on conventional study were confidently excluded in two others. In all 13 the examination was well tolerated, and avoided further, more invasive procedures. The peroral pneumocolon is a useful procedure in children for these indications.

Adolescent↗
PubMed1985

Mucin depletion in the intestine of malnourished rats.

The effects of malnutrition on mucosal goblet cell mucin levels were studied in rats deprived of 50% of their daily intake, as judged by pair-fed, age-matched control animals, for 5 wk. Average daily weight gain was 0.7 g/day compared with 5.8 g in age-matched (AM) rats; final weight was 246 +/- 9 g compared with 406 +/- 4 g. Immunoassayable mucin, sucrase, protein, and DNA were assayed in mucosal scrapings from the proximal, middle, and distal segments of the small intestine in malnourished rats, AM rats, and a third group of low-weight, less mature (LM) rats. Total protein, total DNA, and protein-to-DNA ratios in malnourished rats were unchanged compared with AM control rats and often higher than levels in LM control rats. In malnourished animals, mucin concentration per milligram protein was significantly decreased below AM control animals in the upper two segments and below LM control animals in all segments. Mucin concentration per milligram DNA was significantly lower in malnourished rats than in all segments of both control groups. In contrast, sucrase activity per milligram protein or DNA was either unchanged or increased in the malnourished rats, indicating that the reduction in mucin concentration was selective and did not reflect all surface glycoproteins. Isolated mucins from malnourished and AM control rats were chemically similar, and the affinity and number of antigenic determinants were the same. Malnutrition therefore leads to an absolute decrease in intestinal mucin rather than reduced molecular antigenicity. Impaired capacity to maintain mucosal mucin content may be a factor in reducing intestinal resistance to enteric infection in malnutrition.

Animals↗