Medication-induced digestive system injury in the elderly.
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Three bioreactors, connected in series, were used to process CELSS potato residues for recovery of resources. The first stage was an anaerobic digestor (8 L working volume; cow rumen contents inoculum; fed-batch; 8 day retention time; feed rate 25 gdw day-1) that converted 33% of feed (dry weight loss) to CO2 and "volatile fatty acids" (vfa, 83:8:8 mmolar ratio acetic:propionic:butyric). High nitrate-N in the potato residue feed was absent in the anaerobic effluent, with a high portion converted to NH4(+)-N and the remainder unaccounted and probably lost to denitrification and NH4+ volatilization. Liquid anaerobic effluent was fed to an aerobic, yeast biomass production vessel (2 L volume; Candida ingens inoculum; batch [pellicle] growth; 2 day retention time) where the VFAs and some NH4(+)-N were converted into yeast biomass. Yeast yields accounted for up to 8% of potato residue fed into the anaerobic bioreactor. The third bioreactor (0.5 L liquid working volume; commercial nitrifier inoculum; packed-bed biofilm; continuous yeast effluent feed; recirculating; constant volume; 23 day hydraulic retention time) was used to convert successfully the remaining NH4(+)-N into nitrate-N (preferred form of N for CELSS crop production) and to remove the remaining degradable soluble organic carbon. Effluents from the last two stages were used for partial replenishment of minerals for hydroponic potato production.
BACKGROUND: The aim of this work was to determine in Brittany the incidence and main clinical pattern of inflammatory bowel disease (IBD) occurring during childhood. These data are compared to the previous epidemiologic data available from the Northern France registry or around the world. METHODS: Private and public Brittany gastroenterologists (2,836,418 inhabitants including 618,049 children under 17 years of age) referred all patients consulting for inflammatory bowel disease from January 1994 to December 1997. An interviewer-practitioner completed at the gastroenterologist's office a standard questionnaire for each patient. Each case was independently reviewed by four experts in a blind manner and made a final diagnosis of Crohn's disease (CD), ulcerative colitis (UC), or ulcerative proctitis and acute colitis (onset of symptoms < 6 weeks) or unclassified chronic colitis. RESULTS: Among 1,309 cases recorded, 88 were under 17 years of age (6.7%): 43 (49%) had CD (including three possible cases), 14 (16%) had UC (including three proctitis), 24 (27%) acute colitis and 7 (8%) unclassified chronic colitis. The crude mean annual incidence (per 100,000 children) based on definite and probable cases only was 2.5 for IBD, 1.6 for CD and 0.57 for UC, without variation between 1994 and 1997. The male/female ratio was 2.3 for CD and 1.3 for UC. The mean time between onset of disease and diagnosis was equal to 7.2 and 8.6 months for CD and UC respectively (median: 3 and 5 months). A familial history of IBD was present in 5 cases (8%). In CD, the small and large bowel were involved in 58% of patients, whereas an isolated involvement of small or large bowel occurred in 15% and 23% of cases. Among the 14 UC, there were three proctitis and four pancolitis. Among 43 CD, a granuloma was present in 48% of cases. CONCLUSIONS: In Brittany the incidence of CD and UC in childhood was similar to the published data from Northern France. Clinical presentation and symptoms were not different. However, the rate of acute colitis was higher and the accurate incidence of IBD could be underestimated, requiring a follow-up to classify these cases.
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The alimentary tract of adult Sanguinicola inermis Plehn, 1905 (Digenea: Sanguinicolidae) was studied by transmission electron microscopy. A highly developed muscular region, likely to be a modified sucker, is present anteriorly to the oesophagus. The tegumental oesophagus, on the basis of the characteristics of the surface cytoplasm, is differentiated into anterior, median and posterior regions with the apical cytoplasm of the median oesophagus drawn into extracellular vesicles from which arise surface knobs. The oesophagus leads to a cellular intestine composed of a single layer of epithelial cells. The apical surface of the intestine is drawn into short luminal projections and the intestinal cells contain numerous organelles and secretory granules. No host cells or cell debris were evident within the alimentary tract, although the intestinal lumen was filled with electron-dense material.
Nonulcer dyspepsia (NUD) is a common syndrome, but the optimal treatments have yet to be established. This study was performed to determine the most effective treatment for NUD. Subjects were recruited through the Department of General Internal Medicine at the Kyushu University Hospital because of their somatic symptoms. When no organic lesions were found, the patients were directed to consult our department (Psychosomatic Medicine); 194 consecutive NUD patients were studied. All subjects were assessed psychiatrically with the Structured Clinical Interview for DSM-III-R(SCID). Patients with serious NUD were hospitalized, and randomly divided into control (N = 42) and experimental groups (N = 86). The controls were treated with physical treatment alone. The experimental group received psychiatric treatment in addition, based on the results of SCID. The experimental group showed a significant improvement compared with the controls (P < 0.0001). The treatment for NUD taking into consideration both the physical and psychiatric conditions is highly effective.
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61 squamous cell cancers (27 laryngeal, 12 hypopharyngeal, 14 tonsillary, 8 tongue) with different keratinization and grading and seven lymph node metastases of HPV 16/18 positive carcinomas were analysed for the presence of HPV-DNA by in situ hybridisation. 65.5% of them were found to be positive. Twelve laryngeal carcinomas (44%), five tonsillary tumours (35.7%), eight tumours of the hypopharynx (66.6%) and three tongue carcinomas (37.5%) were shown to contain HPV 16/18 DNA. The detection rates of HPV 6/11 were lower. 44 of the analysed tumours (72.1%) had a grading G2. 29 of these tumours (65.9%) were HPV positive. Only eight of the patients were no heavy smokers or alcoholic drinkers. One of the lymph node metastases was positive for HPV 16/18. The results indicate that HPV may be involved in the pathogenesis of squamous cell carcinomas of head and neck tumours.
BACKGROUND: The mutated form of the nuclear tumor suppressor protein p53 plays an important role as oncogene in the malignant transformation of cells. A new serologic parameter are antibodies against the p53 protein, that are found in many carcinoma entities and localizations and may have a prognostic relevance. Antibodies against p53 in the serum of patients with squamous cell carcinoma of the head and neck (SCCHN) have not yet been described. METHODS: A set of 117 sera from patients with SCCHN were screened for serum antibodies against p53 with ELISA (Dianova, Hamburg). The serum of 41 healthy blood donors served as controls. Tumor tissue of 45 patients was examined with ELISA for p53 protein accumulation. RESULTS: In 23 patients (19.7%) with SCCHN p53 antibodies were demonstrated. The control sera were all negative for p53 antibodies. No correlation was found between the presence of p53 antibodies and tumorstage, tumor grading, age or sex of the patient or tumorlocalization. Thirteen of the 15 tumor samples from p53 antibody positive patients showed detectable levels of p53 protein. CONCLUSIONS: The frequency of p53 antibodies in patients with SCCHN is comparable with the occurrence of these antibodies in other malignancies. An accumulation of p53 in the tumor tissue seems to be necessary to initiate the antibody production. p53 antibodies seem to be an indicator for malignancy in SCCHN and may be of potential diagnostic and prognostic value.
A study of 347 patients with gastrointestinal diseases revealed elevation of CA125 in sera of 63% of patients with pancreatic carcinoma, 46% of patients with carcinoma of the biliary tract, 40% of patients with liver carcinoma and 11-37% of patients with other carcinomas. All of the patients with acute pancreatitis, chronic pancreatitis, cholelithiasis, and peptic ulcer had normal CA125 values, but 35% of patients with liver cirrhosis and 10% of patients with chronic active hepatitis had elevated values. Patients with disseminated carcinomas had significantly higher levels than patients with localized carcinomas. CA125 did not significantly correlate with CA19-9 or carcinoembryonic antigen in patients with pancreatic carcinoma. Ninety-seven percent of patients with pancreatic carcinoma were defined as being positive when both serum CA125 and CA19-9 were evaluated. These results indicate that CA125 is useful for differentiating pancreatic carcinoma from chronic pancreatitis, especially when supplemented with CA19-9.
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Familial Mediterranean fever (FMF) is a hereditary episodic febrile syndrome that is expressed by acute spells of fever, painful manifestations in the abdomen, chest and joints, and slow development of nephropathic amyloidosis. Despite the recent cloning of the FMF gene (MEFV) and the identification of about 40 disease-related mutations, the diagnosis is still clinically dependent, and the pathogenesis and most of the clinical heterogeneity remain to be explained. Because episodic abdominal pain affects 95% of FMF patients, most of them are seen by gastroenterologists and undergo complete or partial abdominal imaging before the diagnosis is made. Focusing on recent advances in FMF, this article reviews both common and infrequent manifestations that a gastroenterologist may encounter during workups of FMF patients. These include episodic abdominal pain, paralytic or mechanical ileus, constipation, diarrhea, ascites, malabsorption, bowel infarction, and bleeding, arising directly from FMF or secondary to FMF common associations such as amyloidosis, vasculitides, inflammatory bowel disease, irritable bowel syndrome, or colchicine side effects. This article will help the gastroenterologist to cope with most clinical situations related to the abdominal and alimentary tract in patients with FMF.
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