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[Characterization of the microflora of the small intestine (author's transl)].

Normal and abnormal microflora of the upper small intestine was studied in 356 patients. Low counts are characteristic of normal microbial colonization (eubiosis), changes in quality and/or quantity are pathological (dysbiosis). The latter status is described as overgrowth syndrome. We found some types of dysbiosis. Prevalent was type Dys1 with the highest counts and the greatest variety of bacteria and yeasts. In contrast to this, type Dys2 showed higher germ counts of only one genus like coliforms (Dys2 Coli), streptococci (Dys2 Str.), lactobacilli (Dys2 L.) or yeasts (Dys2 Y.). In dysbiosis, we frequently saw bifidobacterium and bacteroides. Simultaneous sampling from stomach, duodenum, and jejunum indicated different modes of colonization of these parts (oral or fecal type).

Adult↗

Measurement of intestinal antibody by radioimmunoassay.

The study of antibody responses in the intestine has been greatly hampered by lack of reproducible sensitive assays. An assay for measuring antibody against bacteria capable of regularly detecting gut antibody in gastroenteritis is described. It is based on absorption of antibody onto bacteria and measurement of the amount of antibody bound using radiolabelled anti-immunoglobulin antibody. Anti-light chain antibody is used to detect all classes of antibody as well as partially degraded antibody which retains the capacity to bind; anti-alpha and anti-gamma antibody is used to measure IgA and IgG antibody. The sensitivity of the assay depends on the use of anti-immunoglobulin antibody purified by affinity chromatography and allows measurement of nanogram amounts of antibody. Its specificity and kinetics are described and the particular advantages it provides in the measurement of antibacterial antibody in the intestine are discussed.

Antibodies, Bacterial↗

[Diagnostic strategy in diarrhea].

Planning the strategy in diagnosis of diarrhea some questions need to be answered: 1. Do the complaints in question fulfill the defined criteria of diarrhea? 2. Is it an acute diarrhea of infectious origin requiring fast microbiologic diagnosis? 3. Is it a chronic diarrhea? A) Do anamnestic findings and present status induce a certain suspected diagnosis, as in hyperthyreoidism, drugs, intestinal resections? B) Is a complete stepwise diagnostic planning needed as in Crohn's disease, insufficiency of the pancreas, non tropical sprue? Diagnostic measures have to be taken into consideration according to the answers given.

Body Water↗

Immunoglobulin E (IgE) and IgE-containing cells in human gastrointestinal fluids and tissues.

Human gastric, small intestinal, colonic and rectal mucosae were examined for IgE-containing cells by single- and double-antibody immunofluorescence techniques, and IgE in intesinal fluids was measured by a double-antibody radioimmunoassay. IgE-containing cells were identified in all tissue specimens and comprised about 2% of all immunoglobulin-containing cells. Although less numerous than cells containing IgA, IgM or IgG, they were remarkably numerous in relation to the concentration of IgE in serum (about 0-001% of total immunoglobulin). IgE immunocytes were significantly more numerous in stomach and proximal small bowel than in colon and rectum, and were very numerous at bases of gastric and duodenal peptic ulcers. Measurable IgE was found in seventy-eight of eighty-five (92%) intestinal fluids. Sucrose gradient ultracentrifugation analysis of four of the fluids revealed that the immunologically reactive IgE was largely in fractions corresponding to molecules of lower molecular weight than that of albumin, which suggests that IgE in gut contents is degraded by proteolytic enzymes. The presence of IgE-forming cells in gastrointestinal tissues, and IgE or a fragment of IgE in intestinal fluids, suggests that IgE antibodies are available for participation in local reaginic-type reactions in the gut.

Adult↗

[A trial of the clinical use of intestinal dialysis in chronic kidney failure].

The authors analyze pilot experience with clinical introduction of intestinal dialysis in 7 uremic patients. Repeated sessions of the dialysis relieved some symptoms of uremic intoxication. The method may be of value in contraindications to chronic hemodialysis for chronic renal failure. The technique is easily performed and well tolerated by the patients. The investigations should be continued.

Adult↗

Antisecretory activity in a lectin fraction of plasma from patients with acute diarrhea.

The present study describes the first attempt to detect antisecretory activity in a lectin fraction of plasma from patients with acute diarrhea. The plasma antisecretory protein (ASP) was purified by affinity chromatography in agarose, and its antisecretory activity tested in rats subjected to intestinal challenge with cholera toxin. During the first 24 h of the diarrheal episode, antisecretory activity in patients (median 0, range 0-25%) was lower than that seen in the asymptomatic group (median 10, range 0-30%); 3 days later, when diarrhea ceased in most of the patients, the ASP activity increased significantly (median 30, range 0-75%). However, 5 days later the activity decreased again (median 0, range 0-55%). No differences in ASP levels were found between cases associated with an enteropathogen and those where no pathogen was identified. These findings reveal an inverse relationship between the increase in ASP and the patient's intestinal secretion; suggesting that ASP plays a role in the compensatory mechanisms that occur in diarrhea in humans.

Acute Disease↗

[An aspiration biopsy probe].

The authors have developed and clinically used an aspiration bioptic probe with original constructions of capsules which may sample a biopsy specimen and intestinal juice during one probing. This allows an investigator to obtain important data on small intestinal morphology and performance, to gain an insight into the nature of intestinal disease. The probe reduces the time of a patient's examination and helps treatment to be performed correctly.

Biopsy, Needle↗

Calcium absorption in Crohn's disease.

Calcium absorption and endogenous loss of calcium were measured in a group of patients with Crohn's disease, using a simultaneous metabolic balance and calcium isotope regimen. Calcium malabsorption resulting in negative calcium balance was found in only 4 of 31 patients with Crohn's disease. No elevation of endogenous fecal calcium or total secreted intestinal calcium was observed in 10 patients studied, regardless of the level of net or true calcium absorption. Correlation between calcium balance and serum protein loss was observed, but no association was noted with intestinal fat excretion, d-xylose absorption, bacterial colonization of the jejunum, or glucocorticosteroid therapy. The results indicate that in this group of patients with Crohn's disease involving different areas of the intestine, calcium malabsorption occurred infrequently and that the levels of calcium excretion correlated best with enteric protein loss.

Adolescent↗

Yeasts isolated from the intestine of rainbow trout adhere to and grow in intestinal mucus.

The yeast strains Saccharomyces cerevisiae CBS 7764 and Debaryomyces hansenii Hf1 (CBS 8339), isolated from the intestine of rainbow trout, were studied with respect to adhesion to and growth in fish intestinal mucus. The level of adhesion was dependent on the physiologic state of the yeast culture. Growing cells of both strains adhered more strongly than nongrowing cells. This correlates with a previously shown shift in cell surface hydrophobicity of these yeasts. In addition, forces other than hydrophobic interactions may participate, as all strains tested adhered more strongly to the membrane lipid phosphatidylserine than to phosphatidylcholine and phosphatidylethanolamine. Debaryomyces hansenii Hf1 also adhered to the most hydrophobic of the neutral lipids present in mucus, while no adhesion was observed to the other neutral lipids or to the hydrophilic silica gel, again suggesting hydrophobic interactions. Finally, the fish-isolated yeasts grew rapidly in isolated fish intestinal mucus as the sole source of energy and nutrients.

Animals↗