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Biomedical subjects

A T Axon

Publications and source records attributed to A T Axon.

At least 181 records · Page 10Linked to original sources
PubMed1988

Hydrophobic adhesin of E coli in ulcerative colitis.

Pathogenic E coli have adhesive properties which are mirrored by an increase in their surface hydrophobicity. E coli isolated from patients with ulcerative colitis possess a mannose resistant adhesin similar to that found in pathogenic E coli. In this study 42 E coli isolates from patients with colitis have been compared with 15 from controls to assess hydrophobicity and cellular adherence. The salting out method and the buccal epithelial cell technique were used respectively. E coli isolated from colitics are significantly more hydrophobic than control E coli (p less than 0.001). The salting out score correlates negatively with the buccal epithelial cell adhesion index. When E coli are grown at 18 degrees C both properties are temporarily reduced suggesting that they are related to each other. The salting out method clearly differentiates between E coli isolated from colitics and controls, and offers a simple method of detecting adhesive E coli in inflammatory bowel disease.

Adhesins, Escherichia coli↗
PubMed1988

In vitro mucus glycoprotein production by colonic tissue from patients with ulcerative colitis.

Colonic mucus production was measured in vitro by means of incorporation of tritiated glucosamine using biopsy material from patients with ulcerative colitis and compared with data from patients with Crohn's disease, colonic carcinoma, colonic polyps and patients with apparently normal colonic mucosae. Mucus production was significantly decreased (p less than 0.03) in all patients with ulcerative colitis, and in particular in patients with inactive disease when compared with normal subjects. In patients with active disease mucus production was not significantly different from normal subjects. The radiolabelled material was characterised by gel filtration and ion exchange liquid chromatography as mainly high molecular weight glycoproteins. These results indicate that the quantitative character of colonic mucus is abnormal in inactive ulcerative colitis.

Colitis, Ulcerative↗
PubMed1988

Oral bowel lavage preparation for colonoscopy.

Colonoscopy is a commonly performed diagnostic and therapeutic procedure in most general hospitals, which requires effective bowel preparation to be worthwhile. We report the effect of replacing a diet, laxative and bowel washout preparation with oral bowel lavage using a balanced electrolyte formulation, in our unit. The preparation was acceptable to patients, medical and nursing staff, generally preferred to previous preparations by those who had experienced them, allowed a more complete colonoscopy with an excellent quality of view, and was less expensive in nursing time. We regard oral bowel lavage as currently the method of choice for bowel preparation prior to colonoscopy in the majority of patients.

Administration, Oral↗
PubMed1987

Gastric emptying and clinical outcome after Roux-en-Y diversion.

The results of 48 Roux-en-Y (RY) diversion procedures are reported: 41 were performed as secondary procedures and 7 as part of a primary operation for peptic ulcer. There was no operative mortality, but four patients developed temporary fistulae in the postoperative period and three patients required reoperation. Good clinical results were found when RY diversion was performed as a primary procedure or when the indication for operation was peptic ulceration. The overall results, however, were poor: 24 patients (50 per cent) felt that they had not benefited and 32 patients (67 per cent) remained in Visick grades III or IV. The main cause of failure was gastric stasis, especially of solid food. Gastric emptying studies were carried out after RY diversion in 22 patients, most of whom had symptoms of stasis. Emptying of liquids was found to be normal in most patients, but emptying of solids was delayed, the median t 1/2 for solids being 160 (75-370) min compared with 67 (50-85) min in DU patients. Bilious vomiting improved significantly after RY diversion, but 18 patients (38 per cent) complained of vomiting food and 32 patients (67 per cent) experienced postprandial distress or pain. Loss of the antral mill, vagotomy of the gastric remnant and, perhaps, resistance to gastric emptying by the Roux loop itself may together explain the delay in gastric emptying of solids after RY diversion.

Adult↗
PubMed1987

Preservation of the entire anal canal in conservative proctocolectomy for ulcerative colitis: a pilot study comparing end-to-end ileo-anal anastomosis without mucosal resection with mucosal proctectomy and endo-anal anastomosis.

Mucosal proctectomy with endo-anal pull-through anastomosis (MP + PTA) for ulcerative colitis reduces resting anal pressure and low RAP has been found to correlate with minor leakage of faeces or mucus. Our hypothesis was that conservative proctocolectomy with an end-to-end ileo-anal anastomosis (EEA) would result in higher anal pressure and less leakage. Twelve patients were studied after EEA and 24 after MP + PTA: each was in good health several months after operation. After EEA, maximal RAP decreased from a median 90 cmH2O (60-116 cmH2O) to 70 cmH2O (25-104 cmH2O, P less than 0.01), whereas after MP + PTA maximal RAP decreased from 85 cmH2O (70-125 cmH2O) to 40 cmH2O (22-80 cmH2O, P less than 0.003). RAP after EEA was significantly greater than RAP after MP + PTA (P less than 0.001). The pressure profile of the anal sphincter in the EEA group did not differ significantly from that of the pre-operative group at any point from 6 to 1 cm from the anal verge, and the sphincteric high pressure zone averaged 4 cm in length both before and after operation. After MP + PTA, resting anal pressure at stations 1 to 4 cm from the anal verge was significantly less than pre-operative pressure (P less than 0.001) and the sphincteric high pressure zone was only 3 cm in length compared with 4 cm before operation. Anal squeeze pressures were similar in the two groups of patients. After EEA 11 of 12 patients achieved perfect continence, day and night, whereas after MP + PTA 58 per cent of patients experienced minor faecal leakage (P less than 0.01). These findings suggest that the entire anal canal should be kept intact in the course of conservative proctocolectomy for ulcerative colitis.

Adolescent↗
PubMed1987

Effect of histamine H2-receptor antagonist therapy on the mutagenic activity of gastric juice.

There is concern at present that treatment with histamine H2-receptor antagonists might promote the development of gastric cancer by producing conditions which favour intragastric formation of N-nitroso compounds. If H2-receptor antagonist therapy causes increased intragastric levels of N-nitroso compounds, an issue not yet resolved by analytical studies, corresponding changes in the mutagenic activity of gastric juice might be anticipated. In this study mutagenic activity and pH were measured in fasting gastric aspirate from 18 peptic ulcer patients before and during the final week of therapy with ranitidine (n = 10) or cimetidine (n = 8). Mutagenic activity was assessed using Salmonella typhimurium TA98 and TA100 in a modified pre-incubation "fluctuation" test. No significant change in mutagenic activity was detected after therapy. Of 15 patients found to have significant mutagenic activity in their fasting gastric juice before treatment, 14 remained mutagenic following treatment. Mutation frequencies (sum of positive wells in duplicate 96-well microtitre plates, mean +/- SD) for TA98 and TA100 were respectively, 20 +/- 34 and 100 +/- 64 before compared with 10 +/- 6 and 102 +/- 65 after therapy (p greater than 0.05). Changes in mutagenic activity were similar in both treatment groups and unrelated to duration of therapy, changes in gastric pH or ulcer healing. In vitro, neither cimetidine in aqueous solution, nor gastric juice preincubated with cimetidine showed significant mutagenic activity. These results provide no evidence that increased intragastric levels of genotoxic chemicals, such as N-nitroso compounds, occur during H2-receptor antagonist therapy.

Adult↗
PubMed1987

Permeability of the rat small intestine to carbohydrate probe molecules.

1. Absorption of carbohydrate probe molecules from ligated loops of rat small intestine was studied. Absorption was determined by measuring recovery of molecules in the urine, corrected for incomplete recovery after intravenous injection, and was examined for correlation with several parameters of molecular dimension. 2. Absorption depended on molecular volume rather than relative molecular mass, molecular radius or molecular area. 3. Molecules with a molecular volume below 225 X 10(-3) nm3 were absorbed to a greater extent than larger molecules, and absorption was affected critically by molecular volume, small changes in volume producing considerable variation in absorption. 4. Absorption of larger molecules was not affected by changes in volume within the range 362 X 10(-3)-1128 X 10(-3) nm3. 5. These findings support the concept that there are at least two aqueous diffusion pathways across the intestinal mucosa. small molecules diffusing through a small channel of finite dimension, compatible with a transcellular aqueous pore, whilst large molecules diffuse through a less frequent pathway of considerably larger dimensions.

Animals↗
PubMed1987

Adverse reactions to sulphasalazine and 5-amino salicylic acid in the same patient.

We report a patient who developed sulphasalazine-related hepatitis with a subsequent adverse reaction to rectal 5-amino salicylic acid, in the form of pain and fever without associated liver dysfunction, suggesting reactions to both components of sulphasalazine. Included is a review of the literature. Caution should be observed when prescribing 5-amino salicylic acid to sulphasalazine-intolerant patients.

Adult↗
PubMed1987

Lectin and mucin histochemistry as an aid to cancer surveillance in ulcerative colitis.

In a preliminary study, we assessed 10 lectins for the identification of dysplasia in colectomy specimens from patients with ulcerative colitis. Peanut agglutinin (PNA) binding was found in all cases of dysplasia. In the main study the relationship between PNA staining, high iron-diamine/alcian blue (HID-AB) histochemistry, and dysplasia was investigated in 115 pre-operative colonoscopic biopsies and the subsequent resection specimens from patients with ulcerative colitis complicated by carcinoma (n = 6) and patients undergoing proctocolectomy for failure of medical management (n = 8). Peanut lectin was of no value in the assessment of pre-malignant changes or cancer risk. However, the HID-AB stain appears to clarify the interpretation of less severe pre-malignant changes and may be usefully applied to the interpretation of colonoscopic biopsies for cancer surveillance in ulcerative colitis.

Alcian Blue↗
PubMed1987

Screening by colonoscopy for colonic epithelial dysplasia in inflammatory bowel disease.

We report the results of a prospective study of screening for colorectal epithelial dysplasia by regular colonoscopy in patients with longstanding, extensive colitis (DET group: 112 patients, 366 colonoscopies) together with the findings in all other patients with colitis who have undergone colonoscopy in our unit (non-DET group: 77 patients, 196 colonoscopies). Thirty six DET patients had dysplasia on at least one examination: two patients with high grade dysplasia (HGD) were colonoscoped on suspicion of carcinoma, one asymptomatic patient had HGD at first colonoscopy and one patient had HGD on his sixth colonoscopy, all having carcinomas resected at surgery; the remainder had low grade dysplasia (LGD). Of the DET patients, 100 constituted an ongoing surveillance group (354 colonoscopies) in which LGD was common, being seen on at least one occasion in 33% of patients (16.4% of examinations), but HGD was noted only once with a Dukes A cancer found at surgery. Six non-DET patients had dysplasia diagnosed, this being LGD in all. Even in a carefully selected group of colitics the incidence of HGD is low, but its detection may enable the removal of a colorectal carcinoma at an early and curable stage.

Adolescent↗
PubMed1987

HeLa cell and buccal epithelial cell adhesion assays for detecting intestinal Escherichia coli with adhesive properties in ulcerative colitis.

The two methods used to detect intestinal Escherichia coli in patients with ulcerative colitis, HeLa cell and buccal epithelial cell (BEC) adhesion assays, were compared. Both methods showed a significant difference between the adhesive property of colitic and control E coli: p less than 0.0002 and p less than 0.01 for the buccal epithelial cell and HeLa cell methods, respectively. HeLa cells did not detect all BEC positive isolates which were quantitatively more adhesive than any control isolate. All BEC negative isolates were HeLa cell negative. The BEC technique seems to be more sensitive for detecting adhesive E coli in ulcerative colitis because the true incidence of adhesive E coli in ulcerative colitis was higher than that determined by the HeLa cell method.

Bacterial Adhesion↗
PubMed1987

Abnormal intestinal permeability and jejunal morphometry.

The cellobiose and mannitol differential sugar test is a non-invasive investigation of small bowel permeability, in which urinary recoveries of cellobiose and mannitol after a hyperosmolar oral load are expressed as a ratio to give a permeability index. Changes in the cellobiose:mannitol ratio often occur in coeliac disease, but some patients with abnormal permeability have normal jejunums by routine microscopy. Using computed morphometry the perimeter:lamina propria area index of jejunal biopsy samples was measured and compared with the cellobiose:mannitol ratio in three groups of patients: (i) those with coeliac disease with villous atrophy; (ii) those with normal jejunums and sugar test results: and (iii) those with normal jejunums but abnormal sugar test results. In addition to the expected difference in perimeter:lamina propria area index between patients with coeliac disease and those with normal findings (p less than 0.001), the index was also abnormal in patients with normal jejunums but abnormal sugar test results: (p less than 0.001 compared with group 1) and (0.01 greater than p greater than 0.001 compared with group 2). There was a significant overall correlation between the perimeter:lamina propria area index and cellobiose:mannitol ratio (p = 0.001). This study shows that computed jejunal morphometry can identify patients with subtle morphological changes that are related to abnormal intestinal permeability.

Celiac Disease↗
PubMed1987

Ulcerative colitis and Escherichia coli with adhesive properties.

A quantitative assessment of the mannose resistant, adhesive property of Escherichia coli from patients with ulcerative colitis and from controls was made using a buccal epithelial cell adhesion assay, which also permitted assessment of adhesion to cells from other host sources. E coli from patients with ulcerative colitis adhered to buccal epithelial cells to a greater extent than those obtained from controls (p less than 0.0001), but did not show an increased affinity for the buccal epithelial cell of their host, compared with those obtained from other sources. The mannose resistant adhesive property of E coli raises the possibility that it has a role in the pathogenesis of ulcerative colitis.

Bacterial Adhesion↗
PubMed1987

Somatostatin analogue SMS 201-995 long term therapy for vipoma.

The definitive treatment of a pancreatic tumour secreting vasoactive intestinal polypeptide is surgical removal of the tumour, but when curative resection is not possible symptomatic treatment of the endocrine hyperfunction is important. Streptozotocin, although effective for palliation, can involve unpleasant side effects. We report the long term use of subcutaneous somatostatin analogue SMS 201-995 in an elderly man presenting with severe watery diarrhoea and anaemia due to a pancreatic vipoma. Good symptomatic improvement has been achieved with no side effects over a period of 24 months. We suggest there is a use for subcutaneous SMS 201-995 in elderly patients with inoperable pancreatic gut hormone producing tumours with metastases and in those where surgery would carry a high operative risk.

Adenoma, Islet Cell↗
PubMed1987

Clostridium difficile, sulphasalazine, and ulcerative colitis.

Clostridium difficile has been implicated in the relapse of ulcerative colitis. Controversy exists over this role and its relationship to sulphasalazine exposure. Sixty two of 77 patients with a documented relapse of ulcerative colitis were investigated for the presence of Clostridium difficile, or its toxin, prior to hospitalization. There was a low incidence of detection which was related to antibiotic exposure (2/62). Sampling during the treatment period showed that the occurrence of Clostridium difficile in the stool was related to antibiotic treatment (2/66). Fifty six percent of patients were taking sulphasalazine, none of whom became culture or toxin positive. This study demonstrates that Clostridium difficile is not related to relapse of ulcerative colitis and is not secondarily acquired during relapse unless the patient is exposed to antibiotics. Sulphasalazine does not predispose to acquisition of Clostridium difficile. There is no role for routine screening or treatment of Clostridium difficile in ulcerative colitis.

Adult↗
PubMed1987

Abnormal intestinal permeability. An aetiological factor in chronic psychiatric disorders?

Abnormal intestinal absorption has been suggested as an aetiological factor in schizophrenia. A procedure for investigating intestinal permeability was carried out in a group of chronic psychiatric in-patients. A proportion of the subjects studied showed abnormal intestinal permeability which could not be attributed to established bowel disease. Patients who were receiving neuroleptic but not anticholinergic drugs were those most often showing abnormal intestinal permeability. This work is at an early stage of development but preliminary findings suggest that further investigations should be carried out to establish the circumstances in which changes in intestinal permeability may be associated with mental illness.

Celiac Disease↗