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Models for investigating the aetiology of cerebral arterial spasm: comparative responses of the human basilar artery with rat colon, anococcygeus, stomach fundus, and aorta and guinea-pig ileum and colon.

1 The pharmacological similarity between human basilar artery and a number of isolated tissues (rat colon, anococcygeus, stomach fundus and aorta and guinea-pig ileum and colon) has been assessed during investigations of the aetiology of cerebral arterial spasm. 2 The responses of each of the six tissues to human normal and abnormal cerebrospinal fluid (CSF) and to human serum were compared with those of the human isolated basilar artery. 3 These studies revealed the presence of a vasodilator factor in CSF from subarachnoid haemorrhage patients and several tissues may be of use for further work in identifying the vasoactive substances in CSF. 4 No tissue displayed exactly the same spectrum of biological reactivity as the human basilar artery. The rat stomach fundus showed the closest similarity and was further studied for similarities in drug-induced responses. 5 The rat stomach fundus, like the human basilar artery, was contracted by 5-hydroxytryptamine, prostaglandin F2alpha and histamine and relaxed by dopamine. However, noradrenaline relaxed the fundus but contracted the basilar artery.

Animals

Scanning electron microscopy of interaction of peripheral blood lymphocytes from colonic cancer patients with human colonic cancer-derived cells; P-4788.

Peripheral blood lymphocytes and the various lymphocyte fractions from patients with cancer of the colon were cultivated with target cells (P-4788) derived from the colon cancer. Changes in the surface ultrastructure during tumor cell destruction were studied by scanning electron microscopy (SEM). P-4788 cells adhering to the coverslip showed various surface activity. The surfaces of some cells were relatively flat; others were smooth or had fine granules. Still other cells were villous, round or had marked blebs. When host lymphocytes were added to the target cells, adhesion of the two cell groups began by many fine projections. After incubation for 6 h, some lymphocytes had adhered to the target cells. Many lymphocytes had adhered to the target tumor cells by 24--48 h incubation. Ultimately the tumor cells became swollen and disrupted. Most lymphocytes adherent to the target cells had few microvilli. Lymphocytes after elimination of phagocytes by carbonyl iron treatment also adhered readily. Some target cells showed adhesion with lymphocytes passed through nylon-wool columns, although the number of lymphocytes adhering was fewer than in the case of lymphocytes not passed through nylon-wool columns. T cells were collected from lymphocytes that form rosettes with SRBC by isolation with NH4Cl. They had markedly elongated microvilli which in places were sparsely scattered and tended to be localized on the side, a finding which suggests loss of cell activity by the time of SEM. Only a few T cells adhered to target cells and they seemed to be T cells without activity. It was thought that there are cytotoxic cells among T cells and that the co-existence of T cells, non-T cells and monocytes caused target cell destruction.

Adenocarcinoma

Acidification of rat colon with lactulose. Its effects on the healing of colonic anastomoses.

Preoperative preparation of rats with lactulose, 2.5 ml/kg of a 52.5% w/w solution, for two days resulted in increased bursting pressure and bursting wall tension of low colonic anastomoses three days postoperatively when compared with unprepared controls (85.8, viz, 36.1 mm Hg and 0.55, viz, 0.19 dynes/cm X 10(-5). After seven days, there was no appreciable difference in the rats with colonic acidification and in the controls.

Animals

Crohn's disease of the colon. III. Toxic dilatation of the colon in Crohn's colitis.

In a group of 160 patients with Crohn's disease involving the colon, there were seven patients with toxic dilatation, four with granulomatous colitis and three with ileocolitis, all successfully treated without mortality. This complications is more common than previously recognized in Crohn's colitis. In Crohn's disease, toxic dilatation is less likely to proceed to perforation of the bowel, because of the nature of the pathology and is more likely to respond to conservative measures: intubation, with decompression, corticotropin, steroids and high-dose antibiotic administration. Although patients do recover from this life-threatening complication with conservative management, the majority of patients, if not all, will ultimately come to surgical excision of the colon. If surgery is mandatory, it should be carried out early, rather than late, in the patient who is failing to respond to medical therapy, certainly before the development of perforation, massive hemorrhage, or gram negative sepsis with shock. The surgical therapy will depend upon the state of the bowel at laparotomy. Thus, an intact bowel in a young patient, would favor subtotal colectomy or proctocolectomy; a sealed perforation, a diverting ileostomy with skin level colostomy decompression as suggested by Turnbull and a free perforation, the minimum adequate procedure which will tide the patient over the early postoperative period. Diverting ileostomy alone has been effective in two of our patients but should be avoided in ulcerative colitis. The critically ill patient with the ominous finding of "disintegrating colitis" and multiple leaks, will require nothing less than total radical excision of the diseased bowel in the hope of immediate salvage.

Adrenocorticotropic Hormone

Giant pseudopolyposis causing colonic obstruction. Report of a case seemingly associated with Crohn's disease of the colon.

Gian pseudopolyposis is uncommon and only one obstructive case has previously been reported. In that case the underlying disease was ulcerative colitis while the present case seemed associated with Crohn's disease. Clinically this condition imitates a malignant tumour, and because of the rarity we failed to reach the right preoperative diagnosis in spite of correct colonoscopy and biopsy findings.

Colonic Diseases

[Intestinal amebiasis in children. I. Etiological study of colonic lesions of the rectosigmoid colon].

A total of 253 children from two months to 12 years old, who had diarrheic or dysenteric syndromes, were studied from the rectosigmoidoscopic and parasitologic points of view. In addition, 112 and 20 of these patients were also studied bacteriologically and virologically, respectively. Only in 28 patients torphozoites of Entamoeba histolytica were found by means of direct microscopic examination, staining techniques and amoebal cultures. Enteropathogenic bacteria were isolated in 41 of the 112 cases examined. No viral particles were detected in the 20 cases studied. From the discussion of these results, the conclusion is reached that the rectosigmoidal mucusal alterations which have been currently considered as suggesting amoebal lessions are not characteristic of invasive intestinal amebiasis in children.

Child