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[Intraoperative staining of tissues].

Possibilities of vital dyeing to determine blood supplied from non blood supplied tissues are subject of many years' investigations. They may play an important role in traumatology, reconstructive and septic surgery. In acute traumatic changes one of the methods known is the so called immediate surgical treatment with delayed operation. In chronic and septic pathological changes there exists a great difficulty distinguishing necrotic parts of bone or soft tissues, which are the cause of long lasting inflammation and external fistulas. This process can last for months or even years if not treated by a proper and precise surgical procedure. Very helpful may be vital dying of tissues which was introduced by K. Klemm in 1970 for the surgical treatment of septic bone necrosis using the Disulphine Blue, produced by Imperial Chemical Industries Limited, Pharmaceuticals, Division, Macclesfield Cheshire, G. B. The tissue dyes are used widely for subcutaneous injections in lymphography, i.e. in about 30,000 patients in USA yearly. Disulphine Blue is a water soluble and partly spirit soluble powder giving a blue solution, which can be sterilized in autoclave. After an intravenous application of 0.25-0.5 ml/kg body of 6.2% solution a green colour of skin and conjunctivas appears in 5 minutes. The dye can appear in bile, bronchial tree, feces and in intestine secretions. It is evacuated with urine. Green colour of the skin disappear after 36 hours in children and after 48 hours in adults. This dye has been used as a direct visual test to investigate normal blood-supplied and necrotic soft and bone tissues. This phenomenon can have a special significance for defining the vitality in inflammation of bone tissue, in burns and in necrosis of soft tissues a.a. of the Achilles tendon. A demonstrative case report. Patient K. J., 32 years old, a worker and sportsman was hospitalized in our clinic because of chronic inflammation and purulent fistulas 10 weeks after two operations in one of hospitals because of traumatic right Achilles tendon rupture. During the first operation the tendon was sutured and the leg immobilized for a period of 6 weeks. After that time the plaster dressing was removed and during the rehabilitation was stated a secondary Achilles tendon rupture. The tendon was resutured. The course after the operation was complicated with haematoma and purulent fistulas. Antibiotics were used but without effect. In our Clinic 10 weeks after the primary injury and unsuccessful local treatment we performed a subsequent operation after slow intravenous injection of 10 ml Disulphine Blue.(ABSTRACT TRUNCATED AT 400 WORDS)

Achilles Tendon↗

Lethality of disrupted intestinal lamina propia cells for Trichinella spiralis in vitro.

The possible direct role of inflammatory cells in resistance to Trichinella spiralis was studied by observing the effects of lamina propria cells from the small intestine (LP cells) of immunized rats on various stages of the parasite. Effects produced by physically disrupted cells were compared to those produced by intact cells on worms exposed to phytohemagglutinin or immune serum. LP cells were isolated from the rat intestine by collagenase digestion of everted gut segments that were previously denuded of epithelium by treatment with hyaluronidase. Disrupted cells, but not intact ones, selectively killed T. spiralis juvenile and adult worms in vitro, whereas larvae were unaffected by similar treatment. Attempts to identify the lethal component of disrupted cells led to an evaluation of the enzyme, peroxidase. Mucosal peroxidase is localized in LP cells and its activity increases several-fold during intestinal trichinosis. It is presumed to be myeloperoxidase, a particulate-bound enzyme of myeloid-derived leukocytes that functions as part of a potent antimicrobial system in combination with H2O2 and a halide. Results indicated that the vermicidal component of LP cells was associated with the pellet fraction of disrupted centrifuged LP cells, but was not linked to a peroxidase-H2O2-halide system.

Animals↗

Fluoride balance and tissue concentrations: effect of dose frequency.

The possible effects of dose frequency on the bioavailability, balance and tissue levels of fluoride were determined using young adult rats. It was hypothesized that, because of the rapidly exchangeable pool of fluoride in calcified tissues, smaller and more frequent doses of fluoride would increase the retention of fluoride in the body. All groups were fed a low-fluoride, semi-purified diet throughout the six-week study. Group B received water with 25 ppm fluoride ad libitum. Groups C, D, and E received fluoride in amounts similar to that of group B but by ig intubation one or three times each day or by ip injection once each day. Group A received fluoride only in the food. Two 24-h fluoride intake and excretion determinations were made during each week. Plasma, enamel and femur epiphysis fluoride levels were determined at the end of the study. Compared with group B, the average fluoride absorption and balance values were 13% and 10% higher, respectively, in groups C, D and E. Plasma and calcified tissue fluoride levels were also slightly higher in the latter groups but, in general, the differences were not statistically significant. In the ip-injected group, the fecal excretion of fluoride was 96% greater than the amount ingested with the diet which indicated net intestinal secretion. It was concluded that, for a given level of intake, dose frequency has only minor effects on the absorption, balance and tissue levels of fluoride in the rat. The influence of the rapidly exchangeable calcified tissue fluoride pool on the general metabolism of the ion appears to be limited when intake occurs at least once each day.

Absorption↗

Intestinal responses to enterotoxigenic Escherichia coli heat-stable toxin b in non-porcine species.

The Escherichia coli heat-stable enterotoxin (STb) is the most prevalent toxin associated with diarrheagenic E coli isolates of porcine origin. Unequivocal biological activity of this toxin has been observed only in swine intestine. In this study, when endogenous protease activity was blocked with soybean trypsin inhibitor, intestinal secretion was stimulated by STb in jejunal loops of rats, mice, calves, and rabbits. Compared with pigs, rats, mice, and calves, rabbits were relatively insensitive to STb. These data demonstrate that the activity of STb is not a species-specific toxic activity; there is species variation in sensitivity to STb, and some common laboratory animals may have potential to be used to measure biological activity of STb.

Animals↗

[Localization of Entamoeba histolytica antigens using IgA].

The presence of IgA anti-Entamoeba histolytica antibodies has been demonstrates in intestinal secretions and serum of human amebiasis. We investigated which are the cellular components of trophozoites that react with IgA anti-ameba antibodies from immune serum, colostrum and human milk. The cellular localization of such antigens was accomplished by an indirect immunoperoxidase technique using anti-human IgA (alpha chain specific) labeled with peroxidase, both for light and transmission electron microscopy. Intracellular antigens were localized after permeating the parasites with cold acetone (-10 degrees C) for 3 min. and cryosections of 1 micron thick. The antigens that react with IgA antibodies from immune serum, colostrum and human milk were located in the plasma membrane and the internal portion of some cytoplasmic vesicles. So far, it is unknown what is the biological function of IgA in human amebiasis but in other systems it protects against certain parasites.

Animals↗

[The digestive function of the supraepithelial mucosal layer of the small intestine].

The results of biochemical estimation of the activity of intestinal proper and pancreatic enzymes in enteral contents, mucous layer and homogenate of small intestine's membrane suggest an important role of supraepithelial mucous layer in actualization of final stages of the food hydrolysis. The term "parietal digestion" is suggested for designation of a sum of hydrolytic processes in the layer of mucus.

Animals↗

Strongyloides infections in transplant recipients.

Solid organ transplant recipients can experience serious disease and death from infection due to the parasitic roundworm Strongyloides stercoralis. This parasite lives in soil contaminated with human feces. Domestic dogs and cats may be another reservoir. Larvae can penetrate the skin, are carried hematogenously to the lungs, migrate up the bronchial tree, and then can be passed to the upper small intestine. Autoinfection occurs in the setting of immunosuppression when invasive larvae penetrate the gut wall and cause disseminated infection. Polymicrobial sepsis is sometimes seen due to enteric organisms adhering to the parasite. Transplant recipients are at highest risk during the first 3 months posttransplant. Many organ systems may be affected. Pulmonary symptoms include cough, wheezing, sputum production, dyspnea, hemoptysis, tachypneas, and pleuritic pain. Hyperinfection, an augmentation of the normal skin-lung-intestine life cycle, occurs in roughly two-thirds of infected transplant recipients, with dissemination in the remainder. Diagnosis is made primarily by examination of the stool or intestinal secretions for ova and parasites. Occasionally, parasites are noted in the sputum. New serologic tests show promise. The parasite may remain in the host for over 25 years before immunosuppression causes either dissemination or hyperinfection. Thiabendazole given for 3 to 7 days is the treatment of choice for organ transplant recipients. Repeat courses may be needed to eradicate infection.

Adult↗

Analysis of the kinetics, isotype and specificity of serum and coproantibody in lambs infected with Cryptosporidium parvum.

Enteric cryptosporidiosis was studied in colostrum-deprived lambs each infected at five days old with 10(6) oocysts. The prepatent period was three to five days and faecal oocyst concentration fell below detectable levels by day 16 after infection. Specific IgA, the only isotype detected by immunofluorescent assay in faecal extracts from infected lambs, was first evident on day 10 and titres continued to rise until day 16 of infection in association with declining oocyst output. Specific IgM and IgG antibodies were first detected in serum seven days after infection. No specific antibody was detected in uninfected control lambs. Immunoblotting methods showed that serum antibody and faecal IgA had similar profiles of antigen recognition. Antigens with approximate molecular weights of 180,000, 23,000 and 15,000 were consistent features on immunoblots performed with convalescent sera and faecal extracts. The results suggest that specific IgA in intestinal secretions has an important role in immunity to cryptosporidiosis.

Animals↗

[Physiopathology of diarrhea].

Diarrhoea is defined as the daily excretion of faecal water in increased amounts. Several mechanisms may result in diarrhoea. They are: (1) increase in fluid and ions load which may exceed the maximum capacity of intestinal reabsorption; this is the "volumogenic" diarrhoea observed in Zollinger-Ellison syndrome; (2) accelerated gastrointestinal transit, notably through the colon, as in the so-called "diarrhée motrice" due to increased colonic motility; (3) osmotic diarrhoea due to ingestion of nonabsorbable solutes, as in malabsorption syndromes; (4) secretory diarrhoea with disorder of NaCl transport in the intestine as its main abnormality; this diarrhoea may be of bacterial, endocrine or other origin; (5) diarrhoea consecutive to morphological abnormalities of the small bowel and/or colon; it is often due to several of the above mechanisms, to which must be added exudation of blood, mucosities and proteins in the intestine.

Colon↗

[Intestinal enzyme activity in patients with strongyloidiasis].

Enterokinase and alkaline phosphatase activities in the duodenal juice and fecal extract of 37 strongyloidosis patients living in moderate climate and 17 inhabitants of the tropics have been studied. In 60.7% inhabitants of the regions with moderate climate and 80% from the tropics decreased enterokinase activity in duodenal juice has been observed, while the decrease in alkaline phosphatase activity in fecal extract has been noted in 87.8% and 71.4% cases, respectively. After convalescence from 1 to 6 months, no normalization of intestinal enzymatic activity has been observed.

Adolescent↗

Changes in plasma kallikrein and PGF2 alfa concentrations during circulatory shock. Studies with superior mesenteric artery occlusion in anesthetized dogs.

Among the mediators for development of endotoxic shock, plasma kallikrein and prostanoids have been suggested to play an important role. The role of kallikrein and PGF2 alfa in circulatory shock of intestinal origin was investigated in anesthetized dogs by measuring inactive and active kallikreins and PGF2 alpha in superior mesenteric vein, right ventricle and aorta during shock induced by occlusion of the superior mesenteric artery. After removal of the clamp in dogs subjected to occlusion for 1 hour, the mean arterial blood pressure fell rapidly within 5 min and gradually increased over the next 60 min, with return to the control values. The plasma concentrations of PGF2 alfa in superior mesenteric vein, right ventricle and aorta increased three- to fivefold within 5 min of reperfusion. Thereafter the PGF2 alfa levels fell, so that at 60 min after declamping they did not significantly differ from the control values. No significant changes were observed in the levels of inactive and active kallikreins. The results suggest that PGF2 alfa released by intestinal tissues may contribute to the development of shock caused by intestinal ischemia.

Animals↗

[Absorption in the human small intestine relative to the intraluminal milieu].

The bulk of water and electrolyte absorption takes place in the human jejunum from isotonic solutions, and is determined largely by special transport mechanisms for different monosaccharides, amino acids and dipeptides. This is of considerable significance for regaining the large volumes of fluid delivered to the small intestine during the digestion of food. Small changes in intraluminal pH do not significantly influence the absorptive function of the jejunum and are rapidly compensated by the buffering capacity of the gut. The maintenance of an isotonic as well as neutral intraluminal milieu seems to be essential to the physiological processes of intestinal absorption.

Diarrhea↗

[Immunologic study of the non-pathogenic bacterial flora of the small intestine in children with persistent diarrhea].

Twenty five children with diarrhea were studied. Ten children without diarrhea or that had the last episodic one year before biopsy, represented the control group. Jejunal juice and biopsy specimens obtained from each patient were cultured, and bacteria obtained from these were tested against a further piece of mucosa and sample of pure juice from the same patient, to determine the presence within them of antibody against the small bowel bacteria. Duodenal mucosae antibody against non-pathogenic bacteria was demonstrated in 95% of children with diarrhea and only 25% of control group. The immunoglobulin classes involved, IgA and IgM, suggest a strong local immune system stimulation, although a systemic immune response can not be excluded since IgG was frequently found in the mucosa.

Child↗