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PubMed2004

Intestinal pseudoobstruction in Kawasaki disease.

Intestinal pseudoobstruction is an uncommon but important manifestation of Kawasaki disease. Its occurrence at the onset or during the course of the disease may confuse the clinical picture and cause delay in diagnosis and treatment. This delay may be responsible for the high rate of coronary artery abnormalities that have been reported in patients with this complication. We suggest that Kawasaki disease be considered in the differential diagnosis of any child presenting with intestinal pseudoobstruction and fever without definable cause.

Child, Preschool↗
PubMed2004

Interleukin (IL) 5 levels and eosinophilia in patients with intestinal parasitic diseases.

AIM: Intestinal parasitic diseases are commonly accompanied with diarrhoeal symptoms and allergic reactions. Eosinophilia occurs as a result of IL-5 synthesized from Th2 cells during allergic reactions. IL-5 acts as a factor activating eosinophils. The aim of this study was to compare the IL-5 cytokine measurements in serum samples and cell cultures. And also to compare eosinophilia observed in helminth infections and protozoon infections accompanied with allergy. METHODS: Twenty-three patients who presented with diarrhoeal symptoms and allergic complaints were tested positive for intestinal parasites, as well as 21 controls with allergic complaints who did not have any intestinal parasites were included in this study. IL-5 production in in vitro cell cultures prepared by using phytohemaglutinin (PHA) to stimulate peripheral blood mononuclear cells (PBMC) obtained from the blood samples taken from these patients were compared with the IL-5 level in serum. Furthermore, the IL-5 production in protozoon and helminth infections was also compared. Absolute eosinophil values in 1 mm(3) of blood were calculated by means of peripheral smear in both groups within the scope of the study. RESULTS: Parasites such as helminth detected in 15 (65.2%) and protozoon in 8 (34.8%) of the patients were included in this study. As regards the values of the sera in both patients with parasite infection and controls, the IL-5 production was found to be higher in the cell culture supernatant (P<0.001 and P<0.05). When the IL-5 level of the patients with helminth parasites was compared with that of those with protozoon, it was determined that the IL-5 level in serum was more significant in the patients with protozoon than in those with helminth (P<0.05). In the study group, the patients were found to have parasites, the percentage of eosinophil was 7.0% compared to 6.5% in the control group. Thus, there was no significant difference between the eosinophil values (P>0.05). CONCLUSION: It was found that IL-5 cytokine levels in serum samples from the patients with helminth and protozoon displayed more measurable values as compared to the IL-5 levels after stimulation with mitogen. It is concluded that IL-5 acts as a triggering factor in the toxiallergic complaints commonly seen in helminth and protozoon infections.

Adult↗
PubMed1995

Oral beclomethasone dipropionate for treatment of human intestinal graft-versus-host disease.

Intestinal graft-versus-host disease (GVHD) causes anorexia, vomiting, abdominal pain, and diarrhea. We investigated oral beclomethasone dipropionate (BDP), a potent, topically active corticosteroid, as therapy for this disease. Forty-two allogeneic marrow-graft recipients with biopsy-proven intestinal graft-versus-host disease of mild-to-moderate severity received BDP (8 mg daily) for up to 28 days. Weekly symptom scores, oral intake, and surveillance throat and stool cultures were compared with baseline values. Adrenal testing was performed serially in patients not receiving concurrent prednisone. Improvement was seen in appetite (P < 0.001), oral intake (P < 0.001), nausea (P = 0.013), and diarrhea (P = 0.02) over the course of therapy, and an overall beneficial response was observed in 72% of 40 evaluable patients. Surveillance cultures of throat and stool showed no increase in bacterial or fungal colonization over time. The adrenal axis became suppressed in 11 of 20 evaluable patients (55%) but suppression was not a prerequisite for clinical response, as 6 of 9 patients who retained normal adrenal function improved clinically. We conclude that oral BDP is a safe and effective treatment for mild-to-moderate intestinal graft-versus-host disease. Systemic absorption probably occurs, but adrenal suppression is not a prerequisite for clinical efficacy, suggesting that the biological effect is primarily topical. BDP should be further investigated as a topical therapy for intestinal GVHD.

Administration, Oral↗
PubMed1995

Clinical course after transanal advancement flap repair of perianal fistula in patients with Crohn's disease.

A total of 36 rectal advancement flap repairs were performed in 32 patients with perianal Crohn's disease. There were 12 anovaginal and 20 trans-sphincteric fistulas. Patients were followed prospectively for a mean of 19.5 months to evaluate postoperative recurrence rate. The prognostic influence of fistula type, rectal disease, intestinal disease and faecal diversion on recurrence was assessed. Four of 36 repairs showed primary failure, the operated fistula recurred in 11 patients after a median of 7 months, and a new fistula developed in six patients. The fistula recurrence rate was higher in patients with anovaginal fistula or Crohn's colitis but did not correlate with disease activity. Transitory mild incontinence of stool was observed in one patient only. Although rectal advancement flap repair does not cure perianal fistulas in most patients with Crohn's disease, those without Crohn's colitis may have long-term benefit. Short-term improvement of symptoms justifies this simple procedure even in patients with anovaginal fistula.

Adult↗
PubMedDate not supplied

[Intestinal 2-channel polymer catheters].

Gastrointestinal and colic catheters provide more effective aspiration from different intestinal sections, cause less postsurgical complications, and reduce recovery period after intestinal diseases followed by purulent and inflammatory processes. The catheters are useful in the management of gastrointestinal diseases, intestinal obstruction, rectum carcinoma. The use of catheters for evacuation and lavage enables fast regeneration of intestinal peristalsis and rapid patient recovery thus preventing possible bedsores.

Catheterization↗
PubMed1989

Theoretical diagnosis of ulcerative diseases of the small intestine.

The macroscopic appearance of the shape of ulcerations and distribution pattern of the lesions was analyzed in 45 operated or dissected cases presenting inflammatory small intestinal diseases, in order to establish a basis for X-ray diagnosis. Characteristic macroscopic findings could be found for each inflammatory disease. The differential diagnosis of inflammatory small intestinal disease requires X-ray demonstration of the shape of ulcerations and their distribution pattern. The double contrast method is the best suited because it offers excellent visualization of the ulcerative lesions in almost every region of the small intestine on the survey films. The X-ray findings in 30 cases examined with the double contrast method in the two weeks preceding surgery were analyzed. The aspect displayed was correlated with the shape, size and position of the ulcerations. Differential diagnosis should essentially rely on the characteristic shape of the ulcerations and subsequently on the distribution pattern of the lesions on double contrast films. The theoretical differential diagnosis of inflammatory diseases of the small intestine should be done by confrontation of these findings.

Crohn Disease↗
PubMed2004

Intestinal mycoplasma in Crohn's disease.

Intestinal diversion with reconnection in active Crohn's disease (CD) indicates that luminal contents or bacteria contribute to the formation of CD lesions. Fluorescent staining for mycoplasma in freshly resected Crohn's tissue and electron microscopy reveal intracellular organisms akin to mycoplasma. Historically, tissue culture of CD has shown mycoplasma described as contaminants. Mycoplasma are surface epithelial parasites requiring exogenous cholesterol for membrane stability and cell entry. PCR of intestinal tissue has shown Mycoplasma pneumoniae to be detectable more significantly in CD. Oral M. iowae in experimental poultry localizes to the distal small bowel and colon. Hypothetically, lipopeptides of mycoplasmal membranes are proposed to cause chronicity and stronger immune responses than by other bacteria. 'Intestinal' mycoplasmas, from a number of observations, deserve consideration as organisms mediating inflammation of acute and chronic CD.

Animals↗
PubMed1978

Intestinal mucins in health and disease.

Intestinal mucins are complex glycoproteins which are secreted from goblet cells, and form a gel-like covering over the mucosal surface. They are assumed to provide lubrication and protection of the underlying epithelium against potentially injurious chemicals, enzymes, bacteria and dietary constituents. Recent advances in our understanding of mucin structure, secretion and functional properties are reviewed in this paper. Implications for diseases such as cystic fibrosis, peptic ulcer, malignancy and inflammatory bowel disease are briefly discussed.

Carcinoma↗
PubMed2003

Expression and regulation of tissue inhibitor of metalloproteinase-1 and matrix metalloproteinases by intestinal myofibroblasts in inflammatory bowel disease.

Intestinal fibrosis and strictures frequently occur in Crohn's disease but not ulcerative colitis. We have recently shown that, compared to myofibroblasts obtained from normal and ulcerative colitis tissue, myofibroblasts isolated from fibrotic Crohn's disease mucosal samples express significantly lower amounts of transforming growth factor (TGF)-beta 3, but the expression of TGF-beta 2 was significantly greater. We now report that in myofibroblast cultures established from fibrotic Crohn's disease mucosal samples there is significantly higher constitutive expression of tissue inhibitor of metalloproteinase (TIMP)-1 compared to similar cells isolated from normal or ulcerative colitis tissue. Myofibroblasts derived from normal mucosa and from mucosa affected by ulcerative colitis or Crohn's disease also expressed matrix metalloproteinase (MMP)-1, MMP-2, and MMP-3 but did not express MMP-9. Recombinant (r) TGF-beta 1 and rTGF-beta 2, but not rTGF-beta 3, induced expression of TIMP-1 in normal intestinal myofibroblasts. These studies illustrate a potential mechanism by which differential expression of isoforms of TGF-beta may lead to excessive deposition of extracellular matrix and stricture formation via TIMP-1-mediated inhibition of MMP activity.

Cells, Cultured↗
PubMed1988

Elevated serum IgA associated with immunoproliferative enteropathy of Basenji dogs: lack of evidence for alpha heavy-chain disease or enhanced intestinal IgA secretion.

Immunoglobulin isotypes in serum and intestinal secretions of Basenji dogs with chronic diarrhea, asymptomatic Basenji dogs, and healthy control dogs were quantitated and their molecular sizes characterized to detect alpha-chain, gamma-chain, or mu-chain fragments. Quantitation of immunoglobulin isotypes in serum showed that affected Basenjis have significantly elevated serum IgA values as compared to asymptomatic Basenjis and normal control dogs. However, IgA concentrations in intestinal wash fluids were not significantly different for the three groups. Immunoelectrophoresis (IEP) and polyacrylamide gel electrophoresis (PAGE) demonstrated that virtually all IgA was in the dimeric form. Using IEP and immunoselection, we were unable to detect evidence for the presence of alpha-chain or other heavy-(H)-chain fragments. Hyperimmune serum obtained from rabbits immunized with serum or a globulin fraction of affected Basenjis also failed to detect H-chain fragments. The results of this study indicate that immunoproliferative enteropathy of Basenjis resembles closely the nonsecretory form of human immunoproliferative small intestinal disease (IPSID).

Animals↗
PubMed1978

Malabsorption of fat and vitamin B12 before and after intestinal resection for Crohn's disease.

Intestinal absorption of fat and vitamin B12 was studied prospectively in 136 patients with Crohn's disease localized to the ileum and/or the colon. Fecal fat was measured in 3-day periods on a high fat diet, and vitamin B12 absorption was assessed by the Schilling test. When related to the extent of the ileal disease there was a poor correlation to both fecal fat excretion and the result from the Schilling tests, but an exponential and highly significant correlation was found between the results of both tests and the length of the resected ileal segment. Accepting a change in either direction not exceeding 10% of the preoperative test value as unchanged, three-fifths of the patients deteriorated and one-fifth improved in fat-absorption, whereas half the patients deteriorated and one-third improved in vitamin-B12 absorption after surgery. When related to the length of the ileum resected, the test results were about the same in patients subjected to a restorative procedure sparing the major part of the colon and in ileostomy patients. Absorption of fat and vitamin B12 did not change with time elapsing from operation, indicating that there were no compensatory mechanisms as regards absorption of these substances.

Adult↗