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PubMed1991

Induction of suppressor cells by Mycobacterium paratuberculosis antigen in inflammatory bowel disease.

We studied the M. paratuberculosis-induced proliferation and suppressor cell generation by peripheral blood lymphocytes from patients with inflammatory bowel disease. Peripheral blood lymphocytes were separated from 33 patients with Crohn's disease, 18 with ulcerative colitis, nine with other intestinal diseases, and five with autoimmune disorders. Proliferation of peripheral blood lymphocytes from normal individuals in response to 10 micrograms/ml of M. paratuberculosis antigen was reduced by depletion of CD4+ T cells. The ability of M. paratuberculosis antigen to suppress concanavalin A-induced proliferation (expressed as a percentage suppression) was reduced by depletion of CD8+ T cells. This suppression was the same whether peripheral blood lymphocytes were from normal individuals, patients with intestinal diseases other than inflammatory bowel disease, or patients with autoimmune disorders (47 +/- 14%, 44 +/- 24%, and 30 +/- 26%, respectively). In contrast, the suppression induced by M. paratuberculosis for patients with Crohn's disease and ulcerative colitis (66 +/- 22% and 67 +/- 22%) was much greater than that for normal individuals (P less than 0.001). In particular, lymphocytes from patients with active Crohn's disease demonstrated little proliferation in response to this antigen but marked suppressor activity (79 +/- 13%). How the immunomodulatory effects of this antigen relate to the pathogenesis of the inflammatory bowel diseases remains to be determined.

Adolescent↗
PubMedDate not supplied

[Von Recklinghausen's disease and intestinal neurofibromatosis: a case report].

We report the case of a patient with von Recklinghausen's disease, who was admitted with a diagnosis of acute abdomen due to small bowel neurofibromatosis. The patient was submitted to an abdominal CT scan that showed a homogeneous round lesion, with a regular margin, probably belonging to the small bowel and with the appearance of a benign lesion that probably caused an intestinal intussusception. The patient was submitted to a surgical procedure that mainly consisted in multiple small bowel resections. The histopathological examination confirmed the benign nature of the lesions. About one third of patients affected by von Recklinghausen's disease present involvement of the bowel, but only 5% of them are symptomatic. The intestinal tumours are usually neurofibromas and are mainly localized in the jejunum. However, there have also been reports of stromal, nervous and endocrine tumours and even other tumours not belonging to these categories, including adenocarcinoma. The overall incidence of intestinal malignancy in patients with von Reckilnghausen's disease is about 10%. The surgical operation, as well as the histopathological and immunochemical examination of the intestinal lesions are of crucial importance for the treatment of the complications of intestinal neurofibromatosis and for the treatment and diagnosis of malignancy.

Abdomen, Acute↗
PubMed2001

Fecal calprotectin as an index of intestinal inflammation.

The assessment of inflammatory activity in intestinal disease in man can be done using a variety of different techniques, from measurement of conventional noninvasive acute-phase inflammatory markers in plasma (C-reactive protein and the erythrocyte sedimentation rate) to the direct assessment of disease activity by intestinal biopsy. However, most of these techniques have significant limitations when it comes to assessing functional components of the disease that relate to activity and prognosis. Here we briefly review the value of a novel emerging intestinal function test, fecal calprotectin. Single stool assay of neutrophil-specific proteins (calprotectin, lactoferrin) give the same quantitative data on intestinal inflammation as the 4-day fecal excretion of indium-111-labeled white cells. Elevated levels of fecal calprotectin have been demonstrated in patients with NSAID-induced enteropathy and have been used in the diagnosis of colorectal cancer. Fecal calprotectin is increased in over 95% of patients with inflammatory bowel disease (IBD) and correlates with clinical disease activity. It reliably differentiates between patients with IBD and irritable bowel syndrome (IBS). More importantly, at a given fecal calprotectin concentration in patients with quiescent IBD, the test has a specificity and sensitivity in excess of 85% in predicting clinical relapse of disease. This suggests that relapse of IBD is closely related to the degree of intestinal inflammation and suggests that targeted treatment at an asymptomatic stage of the disease may be indicated. (c) 2001 Prous Science. All rights reserved.

Journal Article↗
PubMed2004

[Malabsorption syndrome. Rare differential diagnosis in a young patient].

In a young female patient originally coming from Albany, immunoproliferative small intestinal disease (IPSID) could be diagnosed as a cause for severe maladsorption. Considering clinical and histological criteria an early disease stage of IPSID could be diagnosed. Under the continuous treatment of doxycycline for more than 3 1/2 years, all disease manifestations like watery diarrhea, vomiting, pain in the upper abdomen and loss of weight disappeared. After discontinuation of the antibiotic therapy the patient reached a sustained response.

Abdominal Pain↗
PubMed1993

The morphologic features of diversion colitis: studies of a pediatric population with no other disease of the intestinal mucosa.

Studies of diversion colitis have not shown a consistent pattern of histopathologic features, and many descriptions are difficult to interpret because of the presence of underlying intestinal mucosal disease. To define the histologic changes in patients free of other mucosal inflammatory disease, we studied the resected segments of bypassed colorectum from 37 patients with Hirschsprung's disease treated by a two-stage procedure, using rectal biopsy specimens taken for initial diagnosis and trimmings from proximal to the stoma as controls. Biopsy specimens from a further 14 patients of similar age but without colorectal mucosal disease were used as additional controls. The histology of the bypassed segment was abnormal in all patients. Twenty-six had diversion colitis characterized by diffuse follicular lymphoid hyperplasia; lamina propria expansion by plasma cells, lymphocytes, and some neutrophils; cryptitis; reactive epithelium; and mucin depletion. Crypt abscesses, aphthous ulcers, mild architectural distortion, and Paneth cell metaplasia were noted in more severe cases. The remaining 11 patients had mild follicular lymphoid hyperplasia and an increase in lymphoplasmacytic infiltrates, with absence of neutrophils, epithelial injury, and other changes seen in diversion colitis, a pattern we term "diversion reaction." Diversion colitis is common in children with a bypassed colorectum. It can be distinguished histologically from other mucosal diseases in most cases. We hypothesize that diversion reaction may be an inevitable consequence of colonocyte nutrient deficiency and that diversion colitis may be superimposed by a second insult, such as a low-grade pathogen.

Anastomosis, Surgical↗
PubMed2003

Campylobacter coli - an important foodborne pathogen.

OBJECTIVES: Campylobacters are the most common bacterial cause of infectious intestinal disease (IID) in temperate countries. C. jejuni is the predominant cause of campylobacter IID, but the impact of other, less prevalent species has largely been ignored. Here, we present estimates of the burden of indigenously acquired foodborne disease (IFD) due to Campylobacter coli, the second most common cause of human campylobacteriosis. METHODS: Data from surveillance sources and specific epidemiologic studies were used to calculate the number of illnesses, presentations to general practice (GP), hospital admissions, hospital occupancy and deaths due to indigenous foodborne C. coli IID in England and Wales for the year 2000. RESULTS: We estimate that in the year 2000, C. coli accounted for over 25,000 cases of IFD. This organism was responsible for more than 12,000 presentations to GP, 1000 hospital admissions, nearly 4000 bed days of hospital occupancy and 11 deaths. The cost to patients and the National Health Service was estimated at nearly pound 4 million. CONCLUSIONS: Although C. coli comprises a minority of human campylobacter disease, its health burden is considerable and greater than previously thought. Targeted research on this organism is required for its successful control.

Campylobacter Infections↗
PubMedDate not supplied

Complications of celiotomy incisions in horses.

Complications of celiotomy incisions were evaluated retrospectively in 274 horses that survived at least 1 month after surgery, or died or were euthanatized within 1 month of surgery, as a direct result of these complications. Horses were divided into four groups; group A, a ventral median celiotomy for intestinal disease; group B, ventral median celiotomy for nonintestinal disease; group C, repair of an umbilical hernia; and group D, celiotomy in a region other than the midline. Specific incisional complications were peri-incisional edema, drainage, incisional abscess, suture sinus, and dehiscence. Incision-related complications occurred in 30% of the horses (group A, 40%; group B 18%; group C, 7%; and group D, 88%). Complications occurred more frequently in group D than group A (P = .009), which were higher than in groups B and C (P < .00001). Incisional hernia occurred in 28 of 256 (11%) horses that survived at least 4 months and were available for follow-up. Hernia formation was more common P < .00001) in horses that had other incisional complications (23 horses) than those without (5 horses). Serous or purulent incisional drainage, were more likely to be associated with hernia formation than was serosanguineous drainage or other incisional complications.

Abdomen↗
PubMed2000

Lessons from genetically engineered animal models. XII. IL-10-deficient (IL-10(-/-) mice and intestinal inflammation.

Interleukin (IL)-10(-/-) mice spontaneously develop intestinal inflammation characterized by discontinuous transmural lesions affecting the small and large intestine and by dysregulated production of proinflammatory cytokines. The uncontrolled generation of IFN-gamma-producing CD4(+) T cells (Th1 type) has been shown to play a causal role in the development of enterocolitis affecting these mutants. This article discusses studies of IL-10(-/-) mice that have investigated the role of enteric organisms in triggering intestinal disease, the mediators responsible for initiating and maintaining intestinal disease, the role IL-10 plays in the generation and/or function of regulatory cells, and the results of IL-10 therapy in experimental animal models of inflammatory bowel disease (IBD) and human patients with IBD.

Animals↗
PubMed1982

[Serological types of Yersinia enterocolitica isolated from humans and from environment].

A total of 1061 Y. enterocolitica strains isolated from patients with different clinical manifestations of yersiniosis (acute intestinal disease, hepatitis, generalized infection, meningitis, rheumatoid arthritis, chronic intestinal disease), from foodstuffs, from animals and from open water reservoirs have been studied. This study has revealed that the strains of serovars 09 and 03 are mainly isolated from humans (66% and 30.5% of cases, respectively). The strains of serovar 05B occur in 3%, and serovar 08 in 0.5% of cases. The clinical manifestations of infection have not been found to depend on the serovar of the strain causing this infection. All Yersinia serovars produced infections in children and adults with equal frequency. Y. enterocolitica strains belonging mainly to serovars 09, 03 and, less commonly, 05B and 08 circulate in different areas of our country. The same serovars of Yersinia have been isolated from foodstuffs (milk, meat, vegetables) and washings obtained from various objects of the environment, which indicates their role as the factors of infection transfer.

Animals↗
PubMed1994

[Pneumatosis cystoides intestinalis: associated diseases, morphology and presumed pathogenesis].

Based on six cases, the clinical presentation, morphology and presumable pathogenesis of pneumatosis cystoides intestinalis (PCI) are discussed. As a rule PCI is not a disease in its own right, but a complication of very different, in part extraintestinal diseases. These can be subsumed in three groups. Group 1 includes patients with PCI as a complication of lung disease and initially normal intestinal status. The patients in group 2 develop pneumatosis on the grounds of intestinal disease secondary to primary extraintestinal or generalized disease. In group 3 pneumatosis develops as a complication of primary gastrointestinal disease.

Aged↗
PubMed1997

Survey of diplomates of the American College of Veterinary Surgeons regarding postoperative intra-abdominal adhesion formation in horses undergoing abdominal surgery.

OBJECTIVE: To obtain information from specialists in equine surgery as to prevalence of, predisposing factors for, and methods to prevent postoperative adhesion formation in horses undergoing abdominal surgery. DESIGN: Survey. PROCEDURE: Surveys were mailed to 196 diplomates of the American College of Veterinary Surgeons involved in equine practice. RESULTS: 60 (31%) surveys were returned. Most respondents (55/60) routinely informed clients of the risk of postoperative adhesion formation in horses with small intestinal lesions. When asked after which procedures they routinely used measures to prevent adhesions, 56 of 60 (93%) indicated that they did after small intestinal resection and anastomosis and 56 of 60 (93%) indicated that they did after any abdominal surgery in foals. The 4 methods most frequently listed when respondents were asked which methods were effective at preventing adhesion formation were meticulous surgical technique, administration of antibiotics and nonsteroidal anti-inflammatory drugs, intraoperative peritoneal lavage, and methods that prevent abdominal contamination. Most respondents (50/60) thought that at least some horses with colic secondary to adhesion formation could be managed medically. Fifty-four (90%) respondents indicated that they were successful less than half of the time when treating horses with adhesions severe enough to require additional surgery. CONCLUSION: In general, respondents thought that less than 15% of horses undergoing abdominal surgery would develop adhesions, but that horses with small intestinal disease and foals were most prone to develop adhesions. Meticulous surgical technique was thought to be the most important factor in preventing adhesions, and many prevention regimens reported to be effective in the literature were not commonly used in practice.

Abdomen↗
PubMed2005

Evaluation of risk factors for development of catheter-associated jugular thrombophlebitis in horses: 50 cases (1993-1998).

OBJECTIVE: To evaluate risk factors associated with development of catheter-associated jugular thrombophlebitis in hospitalized horses. DESIGN: Retrospective case-control study. ANIMALS: 50 horses with thrombophlebitis and 100 control horses. PROCEDURE: Medical records from 1993 through 1998 were searched for horses with thrombophlebitis. Horses that were hospitalized for at least 5 days, had an i.v. catheter placed in a jugular vein (other than for solely anesthetic purposes), and had no evidence of thrombophlebitis during admission or hospitalization were chosen as controls. Signalment, history, clinicopathologic findings, primary illness, and treatment were obtained from the medical records. Data were analyzed by use of logistic regression to perform univariate and multivariate analyses. RESULTS: For a horse with endotoxemia, the odds of developing thrombophlebitis were 18 times those for a similar horse without endotoxemia. For a horse with salmonellosis, the odds of developing thrombophlebitis were 68 times those for a similar horse without salmonellosis. For a horse with hypoproteinemia, the odds of developing thrombophlebitis were almost 5 times those for a similar horse without hypoproteinemia. For a horse in the medicine section, the odds of developing thrombophlebitis were 16 times those for a similar horse in the surgery section. For a horse with large intestinal dise, the odds of developing thrombophlebitis were 4 times those for a similar horse without large intestinal disease. For a horse receiving antidiarrheal or antiulcerative medications, the odds of developing thrombophlebitis were 31 times those for a similar horse not receiving these medications. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that patient factors, including large intestinal disease, hypoproteinemia, salmonellosis, and endotoxemia, were associated with development of catheter-associated thrombophlebitis in horses.

Animals↗
PubMed2006

The distribution of the intestinal parasitic diseases in the Southeast Anatolian (GAP=SEAP) region of Turkey.

OBJECTIVES: The physical alterations put in place by the Southeastern Anatolia Project will undoubtedly provide a remarkable economical growth and a social development in the area. In addition, the influence that formation of dam ponds, enlargement of irrigation areas, change of product and the way of cultivation, urbanization and industrialization will have an impact on the environment. To minimize the adverse effects of this process on human beings, a Community Health Project was completed by the teams participated by Ege, Dicle, Gaziantep and Harran Universities under the Directorate of Turkish Parasitology Association and by Southeastern Anatolia Project Regional Development Administration between 2001 and 2003. RESULTS: To identify individuals with parasite, feces samples were taken from a total of 4,470 individuals. Parasites were found in feces of 41.8% of men, 44.3% of women and 32.2% of children, 0-59 months old, who were included in the research and gave feces samples for parasites tests. These prevalence values indicate how widespread parasitic diseases are in the region. The high prevalence of parasitic diseases in this area is one of the causes of malnutrition in 40% of children. Parasites were detected in 44.2% of feces samples taken from rural areas and in 39.5% taken from urban areas. When the distribution of parasites detected in feces samples was studied, the most common parasites were Giardia intestinalis (18.1%), Entamoeba coli (11.8%), Ascaris lumbricoides (4.8%), Trichuris trichiura (4.5%) and Hymenolepis nana (3.9%). Distribution of parasites according to cities varied widely. The most frequently seen parasites were T. trichiura in Gaziantep; G. intestinalis in Batman, Mardin, Diyarbakir, Sirnak and Sanliurfa; and E. coli in Siirt, Kilis and Adiyaman. CONCLUSIONS: This study is the first investigation of intestinal parasite prevalence in a large region, specifically, in this GAP region and in Turkey, in general. There is no direct relationship between irrigating the cultivation areas and diffusion of parasitic diseases because the existence of intestinal parasites mentioned above is not related to the range of irrigation of cultivation areas, but is related to factors already discussed.

Adult↗
PubMed2003

Homocysteine, cysteine, and glutathione in human colonic mucosa: elevated levels of homocysteine in patients with inflammatory bowel disease.

The present study was performed to evaluate the levels of the amino thiols cysteine, homocysteine, and glutathione in the colonic mucosa of patients with various intestinal diseases, especially chronic inflammatory bowel disease. Colonic biopsies of macroscopically normal mucosa out of a proximal and distal segment were collected from 187 patients with various intestinal diseases. Protein was assayed in duplicate by the method of Lowry et al (1951), using bovine serum albumin as standard. Total glutathione, cysteine, and homocysteine were quantified by high performance liquid chromatography (HPLC) with fluorescent detection. Only in patients with inflammatory bowel disease were the homocysteine levels in the large bowel mucosa significantly elevated compared with the concentrations in patients with normal mucosa. No significant differences were seen for glutathione and cysteine concentrations in colonic mucosa among the different groups of diseases. No correlation was found between the age of the patients and levels of the amino thiols investigated. GSH content and concentrations of cysteine and homocysteine were similar in male and female subjects. In our study markedly elevated concentrations of homocysteine in the colonic mucosa were observed in patients suffering from ulcerative colitis and Crohn's disease. This finding has been reported already in the literature for plasma homocysteine levels. Increased homocysteine levels in the colonic mucosa and plasma of patients with inflammatory bowel disease may play a role in the pathogenesis of Crohn's disease and ulcerative colitis.

Adolescent↗
PubMed1980

IgE levels in intestinal juice.

This investigation was performed to determine the possible significance of the IgE levels in intestinal secretions for the recognition of type I food allergy (immediate hypersensitivity). Four groups of individuals were studied and compared with each other: (1) healthy controls and patients with gastrointestinal disorders not affecting the small intestine; (2) patients with small intestinal disease; (3) patients with various manifestations of allergy but without food intolerance; and (4) patients with atopic sensitivity to foods. Despite the presence of proteolysis in the intestinal fluid, a statistically highly significant increase of the intestinal IgE level was observed in patients of group 4 with type I food allergy and in patients of group 3 as compared with normals. This was associated with an increase in the serum IgE level. An increased synthesis of the IgE in the lamina propria of the small intestine is most probable, but not yet adequately established.

Ancylostomiasis↗
PubMed1986

Serodiagnosis of intestinal tuberculosis by the soluble antigen fluorescent antibody test (SAFA test).

The diagnosis of intestinal tuberculosis can only be established by the tissue obtained during surgery or endoscopy. We investigated the role of the soluble antigen fluorescent antibody (SAFA) test with the possibility that it may prove to be a valuable technique for the serodiagnosis of intestinal tuberculosis. The sera of 38 patients and 60 control subjects were studied. Mycobacterial saline extract was used as an antigen in the test. Thirty-two (84%) of 38 patients with intestinal tuberculosis yielded positive values (fluorescence coefficient greater than 3). Among the control subjects a false positive result was observed in only one patient who had eosinophilic enteritis. Patients with intestinal tuberculosis had a significantly higher level of antibodies than patients with non-tuberculous intestinal disease and healthy subjects. These results suggest that this technique may be used for the diagnosis of intestinal tuberculosis and in differentiating it from other non-tuberculous intestinal diseases.

Adolescent↗