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Immunoglobulin secretion by isolated intestinal lymphocytes: spontaneous production and T-cell regulation in normal small intestine and in patients with coeliac disease.

The in vitro secretion of immunoglobulins by small intestinal lymphocytes isolated from 47 patients with normal histology and 23 patients with treated and untreated coeliac disease was examined using an enzyme linked immunosorbent assay. In control patients, duodenal lymphocytes spontaneously secreted higher levels of IgM than jejunal lymphocytes (p less than 0.05). Significantly higher levels of both IgA (p less than 0.05) and IgM (p less than 0.001) were secreted by jejunal lymphocytes of 10 patients with untreated coeliac disease than cells isolated from normal jejunal tissue. IgM and IgA secretion by duodenal lymphocytes isolated from control patients was increased in a dose dependent manner by coculture with autologous peripheral blood T lymphocytes. This effect was not observed with jejunal lymphocytes of control or treated coeliac patients. Peripheral T-cells of untreated coeliac patients, however, showed significant helper effects (p less than 0.05) for IgM and IgA secretion by autologous jejunal lymphocytes. The results suggest that jejunal lymphocytes of patients with untreated coeliac disease show major differences in their capacity to synthesise and secrete immunoglobulins in vitro and the enhanced secretion might result from changes in T-cell immunoregulatory function.

Adolescent↗

Apoptosis of antigen-specific T cells induced by oral administration of antigen: comparison of intestinal and non-intestinal immune organs.

Oral administration of a protein without adjuvant brings about oral tolerance (systemic hyporesponsiveness) to that protein by mechanisms such as antigen-induced apoptosis. We monitored the number and apoptosis induction of CD4+ T cells in antigen-specific T cell receptor transgenic mice fed the antigen ovalbumin to identify where events leading to oral tolerance occurred. The antigen was distributed throughout the body, causing apoptosis and a decrease in cell number of CD4+ T cells in most of the lymphoid system: the spleen, peripheral lymph nodes, and the thymus which was not previously reported to be affected. Although apoptosis was induced in the Peyer's patches, the cell number did not change. Unexpectedly, T cells in the mesenteric lymph nodes did not undergo apoptosis; instead, they were more numerous as compared to that in the case of control animals not administered the antigen. The results suggested that the orally administered antigen activated the intestinal immune system, while it induced immune tolerance in other sites.

Administration, Oral↗

Intestinal neurofibromatosis in von Recklinghausen's disease: presenting as chronic anemia due to recurrent intestinal hemorrhage.

Neurofibromatosis (von Recklinghausen's disease) is a neuroectodermal disorder characterized by pigmentary changes of the skin (café-au-lait spots), cutaneous and visceral tumors (neurofibromas) and systemic abnormalities. The involvement of gastrointestinal tract in neurofibromatosis is not common. The most common symptoms, refer able to lesions in the gut, are hematemesis, melena and abdominal pain. We experienced a case of intestinal neurofibroma in von Recklinghausen's disease. The patient was a 39 year-old female who had suffered from chronic iron deficiency anemia and recurrent gastrointestinal hemorrhage due to two neurofibromas of jejunum for 3 years, which was diagnosed by superior mesenteric and ileal arteriogram and 99mTc pertechnetate-labelled RBC scan, and treated by segmental resection of jejunum with end to end anastomosis.

Adult↗

[Lipoma of the small intestine: a rare cause of intestinal invagination].

Lipomas are an uncommon cause of small-bowel obstruction. The symptoms are intermittent and nonspecific. The Authors report a case in which intussusception was diagnosed with echography and the obstruction was treated with resection. They conclude that lipomas must always be considered in the differential diagnosis of intrabdominal neoplasms and in intestinal obstructions.

Adult↗

[Intestinal lymphoma presented as multiple intestinal polyposis].

Primary gastrointestinal lymphoma is a rare condition. It constitutes approximately 5% of all lymphoid malignancies. Primary lymphomas of the intestinal tract rarely present as multiple polyposis. We describe such a patient who was treated with chemotherapy. The treatment of choice is surgery when possible. Chemotherapy is used in addition when high grade non-Hodgkin lymphoma is revealed. Chemotherapy should be used for patients who are unable to undergo curative resections. Prognosis is poor for patients with a non-resectable disease.

Aged↗

[Occult stromal tumour of the small intestine: a cause of chronic intestinal blood loss in a 70 year-old woman].

The case of a 70 year-old woman with a chronic gastrointestinal blood loss due to a stromal tumor located in the middle third of the small intestine is reported. The peculiarities of the case are the characteristic immunohistochemistry of the neoplasm and, particularly, the mimetic clinical presentation, a kind of ''phantom tumor'' confirmed only with celiotomy and surgical excision.

English Abstract↗

Non 01 Vibrio cholerae in intestinal and extra intestinal infections in Vellore, S. India.

Non 01 V.cholerae is known to cause gastroenteritis and extra intestinal manifestations, including septicemia. We report here our isolation of non 01 V.cholerae from various clinical specimens. Although most of the isolates are from faeces samples from patients with diarrhoea, we have three isolates from blood culture in patients with underlying liver disease. The highest incidence occurred in 1982-1983 and 1987 and 1988.

Bacteremia↗

Interaction of porcine vasoactive intestinal peptide with dispersed pancreatic acinar cells from the guinea pig. Structural requirements for effects of vasoactive intestinal peptide and secretin on cellular adenosine 3':5'-monophosphate.

Secretin and vasoactive intestinal peptide (VIP), but not glucagon, stimulate accumulation of cyclic AMP in dispersed guinea pig pancreatic acinar cells. Secretin stimulated cellular accumulation of cyclic AMP by interacting with a single class of high affinity receptors. On the other hand, the dose-response curve for VIP-stimulated cellular cyclic AMP was biphasic and reflected interaction of this peptide with two classes of receptors. Results obtained with synthetic fragments of VIP and secretin indicate that the receptor having a high affinity for VIP has a low affinity for secretin, interacts with, but does not distinguish among, secretin, secretin 5-27 and [6-tyrosine] secretin or among secretin 14-27, VIP 14-28, VIP 15-28, and increases cellular cyclic AMP when occupied by VIP, but not when occupied by secretin, [6-tyrosine] secretin, or secretin 1-14. The receptor having a low affinity for VIP has a high affinity for secretin, interacts with and distinguishes among secretin, secretin 5-27, and [6-tyrosine] secretin, interacts with secretin 14-27 but not with VIP 14-28 or VIP 15-28, and increases cellular cyclic AMP when occupied by VIP, secretin, [6-tyrosine] secretin, or secretin 1-14.

Animals↗

Dilation of the stump of the esophagus and intestine with Doyen's intestinal clamp followed by application of lidocaine facilitates the stapling anastomoses.

To avoid bowel tears on the esophagojejunal or colorectal mechanical anastomoses during insertion of the EEA stapler, we applied a local anesthetic to the stump of the bowel, then gently dilated the bowel with Doyen's intestinal clamp. This approach makes way for use of a larger cartridge and a more satisfactory anastomoses.

Anastomosis, Surgical↗

Sleeve anastomosis of the intestine. Physical and biochemical studies of a new intestinal anastomosis in rats.

A new, sleeve-shaped interpositional anastomosis of the small intestine was tested in rats. It was compared with a conventional two-layer anastomosis as regards healing, bursting strength, collagen content and complications. Each type of anastomosis was constructed in a separate group of 38 rats. The complications rate did not differ between the two groups. At 2 and 4 days postoperatively the bursting pressure was significantly higher in the sleeve anastomosis than in the conventional anastomosis. Hydroxyproline content did not differ between the two types of anastomosis. The study demonstrated superior breaking strength of sleeve anastomosis in the early postoperative period compared with conventional two-layer anastomosis. This finding merits further investigation.

Anastomosis, Surgical↗

[Intestinal dysbacteriosis in patients with functional and inflammatory diseases of the large intestine].

Data are given on the study of changes in microflora of the intestinal contents in patients with functional diseases: irritable colon syndrome (ICS), chronic catarrhal colitis (CCC) and non-specific ulcerous colitis (NUC). In ICS dysbacteriosis was absent in 40 per cent of the patients, 1st group dysbacteriosis was found in 44.3 per cent of cases; more serious dysbacteriosis (of the 2nd and 3rd groups) was found in CCC and NUC (34.3 and 52.3 per cent of cases, respectively). ICS, CCC and NUC patients had almost the same incidence of decreased Bifidobacterium level.

Adult↗

[Nitrogen metabolism in the large intestine of ruminants. 3. Microbial utilization of intracecally administered 14C- and 15N-marked urea in the large intestine of sheep in simultaneous intracecal administration of partially hydrolyzed straw meal].

Two experiments were performed on sheep, receiving on maintenance level a pelleted straw ration high in crude fibre (straw, 70.5%; dried sugar beet pulp, 12%; cereals, 10%; urea, 2%; ammonium hydrogen carbonate, 3%; minerals 2,5%). The animals were fitted with ileo-caecal re-entrant cannulas. The effects of the introduction of HC1-partly hydrolysed straw meal into the digesta of the large intestine on the digestion processes in that segment were studied. Under these conditions the metabolism of 14C and 15N labelled urea, which was given into the caecum, was estimated. In experiment 1 (E 1; 2 animals) unlabelled, precollected digesta were hourly reintroduced together with 14C and 15N labelled urea via the caecal cannula. In experiment 2 (E 2; 3 animals) the digesta were supplemented with partly hydrolysed straw meal (10% of the mean daily DM-intake with the ration). The supplement of partly hydrolysed straw meal caused an increase of the 15N excretion with faeces from 13.4% (E 1) to 19.8% (E 2) of the dose. The 15N was mainly incorporated in the bacterial fraction (98% E 1; 96% E 2). As a reason for the increased 15N incorporation into the bacterial fraction of 106.4 mg15N' in E 2 vs. 67.3 mg15N' in the experiment without straw meal supplement the higher supply of energy as fermentable carbohydrates was assumed.

Animals↗

Quantitative measurement of intestinal marker enzymes in intestinal metaplasia from human stomach with cancer.

Intestinal metaplasia in human stomach was distinguished macroscopically into sucrase-positive and trehalase-positive areas, and sucrase-positive and trehalase-negative areas, by location of these disaccharidase activities with TES-Tape. After location of these two areas with TES-Tape, tissues were taken from them for colorimetric measurement of sucrase, trehalase, leucine aminopeptidase (LAP), and alkaline phosphatase (ALP). Results showed that in the mucosa from sucrase-positive and trehalase-negative areas, trehalase activity was not detectable and the activities of sucrase, LAP, and ALP were lower than in sucrase-positive and trehalase-positive areas.

Alkaline Phosphatase↗

[Inventory relating to roentgen diagnostics of the gastro-intestinal tract (especially of the small intestine, colon, and biliary tract) (author's transl)].

The article describes the authors' experience in their Department in Nijmegen (Holland) with the various types of x-ray equipment: in gastroenterology--especially in the examination of the small intestine, colon, and the bile ducts--and also within the framework of a general roentgenology diagnostics section. Problems of cost are also considered, relating on the one hand to the equipment required in an examination room, and on the other hand to gastroenterological examination. In conclusion, the authors suggest the most suitable type of apparatus to be acquired for a particular purpose.

Digestive System↗

[Malignant lymphomas of the intestinal tract. Histological and immunohistological findings in 22 intestinal lymphomas].

The histology and immunohistology of 22 malignant lymphomas of the intestinal tract have been studied using the so-called "Kiel classification". We have found 12 lymphomas with low grade malignancy (lymphocytic, lympho-plasmocytoid, centrocytic, centroblastic-centrocytic) and 10 with high grade (centroblastic, lymphoblastic, immunoblastic). In all cases of lympho-plasmocytoid and immunoblastic lymphoma a monoclonal pattern of intracellular immunoglobulin was identified by the immunoperoxidae method. This technique offers considerable help in distinguishing between (monoclonal) malignant lymphomas and (polyclonal) lympho- or immunoproliferative processes.

Gastrointestinal Neoplasms↗

Small intestinal bacterial overgrowth in dogs with chronic intestinal disease.

Small intestinal bacterial overgrowth (SIBO) was diagnosed by quantitative bacterial culture of duodenal juice samples obtained endoscopically in 41 of 80 dogs that were admitted with chronic diarrhea, vomiting, or weight loss. Thirteen dogs had aerobic bacterial overgrowth, most frequently comprising Escherichia coli, staphylococci, and enterococci, and 28 dogs had mixed anaerobic overgrowth, most frequently including Clostridium and Bacteroides spp. Affected dogs comprised 23 breeds, including 10 German Shepherd Dogs and median age at diagnosis was 2 years (range, 6 months to 11 years). High serum folate and low serum cobalamin concentrations had fair specificity (79 and 87%, respectively), but low sensitivity (51 and 24%, respectively) in detecting SIBO. Histologic examination of duodenal biopsy specimens did not reveal abnormalities (26/41 dogs), or revealed mild to moderate lymphocytic (12/41) or eosinophilic (2/41) infiltrates, or lymphosarcoma (1/41). Oral antibiotic treatment was effective in 77% (23/30 dogs), but prolonged treatment (> 4 weeks) was required to control signs and prevent recurrence in 50% (15/30). Corticosteroids were used alone in a dog with eosinophilic enteritis and in combination with antibiotics in 4 dogs with marked gastrointestinal lymphocytic/plasmacytic infiltrates. This study suggested that SIBO may be observed in dogs of many breeds, without an obvious primary cause, and that, although results of indirect tests may be suggestive of SIBO, bacterial culture of duodenal juice samples remains necessary for definitive diagnosis.

Animals↗