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Biomedical subjects

F D Lee

Publications and source records attributed to F D Lee.

11 recordsLinked to original sources
PubMed1979

Effect of an elemental diet (Vivonex) on the absorption abnormalities and histological appearances of the jejunum in untreated adult coeliac disease.

The effect of an elemental diet (Vivonex) together with a gluten-free diet on the absorption of water, sodium and chloride in the jejunum was studied in 4 patients with untreated adult coeliac disease before and after a 1-month course of therapy. The morphology of the jejunum was also studied by jejunal biopsy taken at the same time as the intestinal perfusion. The results were compared with those obtained in 4 patients with adult coeliac disease treated with a gluten-free diet alone. No marked improvement was noted in the transportation of water, sodium and chloride after either treatment with Vivonex and a gluten-free diet or after a gluten-free diet alone, and no marked histological changes were found. Clinical improvement occurred in both groups of patients, in that the diarrhoea improved in all patients and they generally felt better. There appears to be no additional advantage of using an elemental diet with a gluten-free diet in the initial management of adult coeliac disease.

Adult↗
PubMed1979

The endoscopic and histological features of peptic duodenitis.

This study attempts to compare the endoscopic features of duodenitis with the histological characteristics. During a 12 month period, 98 patients undergoing fibreoptic oesophago-gastro-duodenoscopy had the endoscopic appearances of the duodenum classified on a three point scale of increasing severity of duodenitis. Multiple duodenal biopsies were then taken and the histological features of the severity of duodenitis graded from 0 to 4 plus by an independent observer. The histological criteria included an assessment of neutrophil infiltration, villous bluting, gastric metaplasia and chronic inflammation. Routine endoscopic assessment alone was unsatisfactory for diagnosing and grading the severity of duodenitis and multiple target biopsies are required for histological examinations.

Duodenitis↗
PubMed1978

Small-intestinal changes induced by an elemental diet (Vivonex) in normal rats.

1. Rats were fed with the elemental diet Vivonex for 1 or 3 months and their jejunal histology was compared with that of an equal number of rats fed on a normal diet. 2. After 1 month of Vivonex feeding a significant reduction in the ratio of crypt height: villus height (CH:VH) was found in the Vivonex-fed rats (n = 4) compared with the control rats (n = 4) (P less than 0.05). 3. After 3 months the CH:VH ratio was also reduced in the Vivonex-fed rats (n = 18) compared with control rats (n = 18) (P less than 0.002). Villus height was significantly increased (P less than 0.002) and crypt height decreased (P less than 0.05). 4. Jejunal protein content, alkaline phosphatase and disaccharidase activity were also determined in 12 control and 12 Vivonex-fed rats from the 3 months study. 5. Alkaline phosphatase activity was increased from a control value of 201 +/- 8 to 243 +/- 15 munits/cm in the Vivonex-fed rats (n = 12) (P less than 0.05) but no significant changes in lactase, sucrase or maltase activites were found. The observed decrease in the CH:VH ratio suggested an improved survival of the mature enterocyte population during elemental diet feeding.

Alkaline Phosphatase↗
PubMed1978

Duodenitis.

Many questions regarding duodenitis remain unanswered. However, the evidence suggests that duodenitis is a clinical entity which can give rise to dyspepsia and, on rare occasions, gastrointestinal haemorrhage. Conventional and double contrast radiology has only a small part to play in the diagnosis of duodenitis but is important in helping to exclude other lesions such as duodenal ulcer. Provided care is taken during the fibre-optic visualization of the duodenal bulb, the endoscopic appearances of moderately severe duodenitis correlate well with the histological changes seen. A diagnosis of apparent duodenitis should be confirmed by the histological criteria described. Treatment at present is similar to that of peptic ulcer, with the withdrawal of any predisposing and precipitating factors such as aspirin, alcohol and smoking. Antacids may relieve the symptoms. It is not yet known what effect these measures may have on the duodenitis as opposed to the symptoms of dyspepsia. The H2-receptor antagonist, cimetidine, should be effective in treating duodenitis but double blind clinical and endoscopic studies are required to confirm this. The place of surgery is as yet undefined. With the data at present available, it appears that duodenitis is part of the pathophysiological spectrum of the duodenal ulcer diathesis rather than a separate disease. It may represent both the production and healing phases of duodenal ulceration. In some patients the duodenal mucosa may proceed from normal to duodenitis and then to normal again without the development of frank duodenal ulceration (Figure 4). Prospective studies are required which should include a long-term clinical follow-up of a large number of patients with duodenitis accurately and specifically diagnosed by endoscopy and histopathology.

Adolescent↗
PubMed1977

Is duodenitis a dyspeptic myth?

In 502 fibreoptic oesophagogastroduodenoscopies performed over 30 months, 14 cases (2.8%) of symptomatic duodenitis without an associated duodenal ulcer were diagnosed. Follow up (1 to 3-5 years) including repeat endoscopy and double-contrast barium meal showed that duodenal ulcers later developed in 6 patients. All have undergone surgery. A further 2 patients continued to complain of dyspepsis, and repeat endoscopy showed duodenitis, confirmed by conventional light microscopy (haematoxylin and eosin). The remaining patients are symptom-free. Repeat endoscopy and histological examination were either normal or showed mild inflammation of the duodenal mucosa. These findings suggest that duodenitis can cause symptoms and may be part of the pathophysiological spectrum of duodenal ulceration rather than a separate disease. It may represent both the production and healing phases of duodenal ulceration.

Adolescent↗
PubMed1975

Immunological abnormalities in splenic atrophy.

Multiple immunological abnormalities have been demonstrated in fourteen patients with evidence in the blood-film of hyposplenism due to splenic atrophy. Reduction in spleen size was confirmed radiologically, and impairment of phagocytosis by the spleen was demonstrated by studying the survival and fate of chemically damaged autologous red blood-cells. Eight of the patients had intestinal malabsorption, and there was a high frequency of autoimmune disease in the remainder. Although patients with splenic atrophy showed little evidence of impairment of normal immune responses, there was a high frequency of autoantibody formation. There is thus an association between widespread immunological disturbances, notably autoimmunity, and splenic atrophy.

Adult↗