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PubMed2003

Hypothalamic digoxin, hemispheric chemical dominance, and inflammatory bowel disease.

The isoprenoid pathway produces three key metabolites--endogenous digoxin, dolichol, and ubiquinone. It was considered pertinent to assess the pathway in inflammatory bowel disease (ulcerative colitis and regional ileitis). Since endogenous digoxin can regulate neurotransmitter transport, the pathway and the related cascade were also assessed in individuals with differing hemispheric dominance to find out the role of hemispheric dominance in its pathogenesis. All the patients with inflammatory bowel disease were right-handed/left hemispheric dominant by the dichotic listening test. The following parameters were measured in patients with inflammatory bowel disease and in individuals with differing hemispheric dominance: (1) plasma HMG CoA reductase, digoxin, dolichol, ubiquinone, and magnesium levels; (2) tryptophan/tyrosine catabolic patterns; (3) free-radical metabolism; (4) glycoconjugate metabolism; and (5) membrane composition and RBC membrane Na+-K+ ATPase activity. Statistical analysis was done by ANOVA. In patients with inflammatory bowel disease there was elevated digoxin synthesis, increased dolichol and glycoconjugate levels, and low ubiquinone and elevated free radical levels. There was also an increase in tryptophan catabolites and a reduction in tyrosine catabolites. There was an increase in cholesterol:phospholipid ratio and a reduction in glycoconjugate level of RBC membrane in these groups of patients. Inflammatory bowel disease is associated with an upregulated isoprenoid pathway and elevated digoxin secretion from the hypothalamus. This can contribute to immune activation, defective glycoprotein bowel antigen presentation, and autoimmunity and a schizophreniform psychosis important in its pathogenesis. The biochemical patterns obtained in inflammatory bowel disease is similar to those obtained in left-handed/right hemispheric dominant individuals by the dichotic listening test. But all the patients with peptic ulcer disease were right-handed/left hemispheric dominant by the dichotic listening test. Hemispheric chemical dominance has no correlation with handedness or the dichotic listening test. Inflammatory bowel disease occurs in right hemispheric chemically dominant individuals and is a reflection of altered brain function.

Adult↗
PubMed1978

Implications from an unusual case of multiple psychosomatic illness.

A 40-year-old patient who developed over her lifetime an unusually large number of psychosomatic illnesses is presented. She manifested in succession, bronchial asthma, peptic ulcer, regional ileitis and anorexia nervosa. In addition to the factor of multiplicity of illnesses, this series of illnesses is of special interest because the association of a classical psychosomatic illness with anorexia nervosa has not been reported previously. In order to take advantage of the unusual series of illnesses in one patient, I utilized a novel investigative approach. Basing myself upon the supposition that the fundamental make-up of the personality remains fairly constant over time, I criss-crossed bits of established knowledge from one illness to another. In this way, I was able to derive various implications with respect to the psychodynamic, the cognitive-perceptual and the hypothalamic levels of functioning in all the illnesses.

Adult↗
PubMed1974

Isolation of a novel glycoprotein from the urine of a patient with chronic myelocytic leukemia.

Patient B. J. with chronic myelocytic leukemia excreted 0.5-1.1 g protein per day in the urine. Gel filtration on Sephadex G-75 showed about one-third of this protein to be in molecular weight range 20,000-40,000 (fraction BJC). BJC, prepared from 9 liters of urine by gel filtration, was chromatographed on carboxymethylcellulose. Two proteins were eluted from the resin in pure form (as shown by zone and immunoelectrophoresis) in yields representing 8 and 3 mg/liter of urine: BJC1 and BJC2. Their amino acid compositions were identical. BJC1 contained 61% carbohydrate (33% hexose, 11% sialic acid, 13% glucosamine, 5% galactosamine). BJC2 contained one-fourth to one-half as much of each carbohydrate. Molecular weight of BJC1 was estimated at 29,000 by gel filtration. Neither glycoprotein reacted with rabbit antiserum to normal human serum.Antiserum to BJC1 was made in the rabbit. Immunoelectrophoresis with this antiserum showed a faint precipitin line, corresponding in mobility to BJC1, in normal human plasma, and a stronger line in most leukemic plasmas. By immunodiffusion, BJC1 was not detectable in normal human urine, but a positive reaction occurred in the following conditions: leukemia, 64-72%; other types of disseminated neoplastic disease, 36-78%; regional ileitis, 45%; ulcerative colitis, 38%; tuberculosis, 33%; during the 1st wk after major surgery, 33%.BJC2 was found in the urine by immunoelectrophoresis in 10% of patients with neoplastic disease and was not observed in urine of other patients or in human plasma. Amino acid composition, carbohydrate content, and antigenic specificity indicate BJC1 is a previously unrecognized member of the system of normal human plasma glycoproteins. Like certain other glycoproteins, its plasma concentration frequently increases in patients with neoplastic disease, chronic inflammatory disease, or tuberculosis and after surgery. Because molecular weight is 29,000, increased plasma concentration readily causes its appearance in the urine.

Aged↗
PubMed1992

[Psychosomatic disorder, psychosis and object relations].

This paper presents a case who successively suffered from regional ileitis followed by a reactive psychosis. The author looks at the object relations of a patient afflicted by a narcissistic defect. The fundamental narcissistic disorder models the object relations of the somatic patient and of the psychotic patient. Less differentiation is found in the object representation of the psychotic patient. A comparison is suggested for the two modes of relating to objects.

Adult↗
PubMed1979

Plasma and urine cyclic guanosine 3':5'-monophosphate in disseminated cancer.

Plasma and 24-h urinary adenosine 3':5'-monophosphate (cyclic AMP) and guanosine 3':5'-monophosphate (cyclic GMP) were measured by radioimmunoassay in 12 normal subjects, 33 patients with six types of non-neoplastic disease (cholelithiasis, peptic ulcer, coronary heart disease, hypertension, regional ileitis, and cirrhosis), and 34 patients with five types of disseminated neoplastic disease (acute myelocytic leukemia; Hodgkin's disease; and metastatic cancer of the lung, colon, and breast). In patients with non-neoplastic disease, cyclic nucleotide values in plasma and urine did not differ significantly (P greater than 0.05) from those in normal subjects. In patients with disseminated cancer, cyclic AMP values in plasma and urine likewise did not differ significantly from those in normal subjects. Plasma cyclic GMP, in contrast, was significantly elevated in all five types of cancer patients, and urinary cyclic GMP was significantly elevated (five times the normal mean) in patients with acute myelogenous leukemia and Hodgkin's disease.

Adult↗
PubMed1978

Contamination of germfree animals with intestinal Crohn tissue. A preliminary report.

The preliminary results of one of a series of prospective studies in the investigation of a possible transmissible agent in Crohn's disease are presented. Filtered human Crohn tissue homogenates was inoculated into eight germfree Sprague-Dawley rats, to test the reproducibility of recent reports suggesting a transmissible agent in regional ileitis. No histological changes were evident after 150 days, and no changes were observed in animals inoculated with non-Crohn tissue homogenates.

Animals↗
PubMed1978

[Reflections on ten years' experience in the treatment of hemorrhagic colorectitis and Crohn's disease (author's transl)].

The authors offer a critical review of eight cases of hemorrhagic colorectitis and Crohn's disease (regional ileitis) managed with medical treatments, and eleven like cases treated surgically, during the last ten years. After a discussion of the resources and limitations of medical therapy, the authors describe the various surgical strategies adopted in their cases; they define the possibility of obtaining final cures in Crohn's disease with extended ileocolectomy; and concerning ulcerative forms, they point out the greater efficacy of surgical procedures involving sacrifice of the rectum compared to those in which the terminal segment of the gut is used immediately or later for restoring continuity of the intestinal canal.

Adrenal Cortex Hormones↗
PubMed1977

The surface antigens of Campylobacter sputorum subspecies mucosalis.

Campylobacter sputorum subsp mucosalis is the vibrio associated with a group of porcine enteropathies in which it is believed the primary lesion is that of adenomatosis. The surface antigens of mucosalis were investigated and individual factor sera were produced; these were used to examine a range of field strains from adenomatosis, necrotic enteritis, regional ileitis and proliferative haemorrhagic enteropathy. Neither these not sequential isolants from the same farm showed any distinctive antigenic pattern and it is suggested that changes in the surface antigens take place during the intracellular existence of the organism.

Animals↗
PubMed1980

Elevated plasma and urinary guanosine 3':5'-monophosphate and increased production rate in patients with neoplastic diseases.

The plasma and 24-hr urinary levels of cyclic adenosine 3':5'-monophosphate and of cyclic guanosine 3':5'-monophosphate (cGMP) were determined for 19 healthy normal patients, 54 patients with six types of nonneoplastic diseases (cholelithiasis, peptic ulcer, coronary heart disease, hypertension, regional ileitis, and cirrhosis), and 54 patients with five types of neoplastic disease (cancers of the lung, colon, and breast, acute myelocyte leukemia, and Hodgkin's disease). The cyclic adenosine 3':5'-monophosphate levels of urine and plasma in normal subjects, in noncancer subjects, and in cancer subjects did not differ significantly. The cGMP levels in the noncancer group were similarly unchanged from those in the normal group. However, mean cGMP levels in the urine and plasma of patients with neoplastic diseases were, respectively, 2- and 3-fold greater than the normal values (p less than 0.005 for urine and p less than 0.05 for plasma). Pharmacokinetic studies with [3H]cGMP in nine healthy controls and 15 patients with neoplasia showed that the mean production rate of this nucleotide in patients with metastatic cancer was elevated when compared to normal patients, but many values fell within the normal range. In acute leukemia, the production rate was seven times normal, with four of five patients having values clearly outside the normal range. The plasma clearance rate in patients with neoplasia was not decreased when compared to that in normal patients. It is proposed that an increased production rate, rather than any change in plasma clearance, accounts for the increased levels of cGMP in the plasma and urine of some patients with neoplastic disease.

Cyclic AMP↗
PubMed1982

Disorders of the gastrointestinal tract in children: consultation-liaison experience.

Disorders of the gastrointestinal tract are common in children. Fortunately, many are short-lived, related to infection, food intolerance, or specific etiology. Those that persist or recur require greater attention on the part of the physician and can require psychiatric consultation. The frequency of consultation will depend in large part on the psychosocial sophistication and philosophy of care of the referring physician. When consulted, the child psychiatrist can complement the medical care by examination in greater detail of the psychosocial environment of the child, the family, and by psychiatric evaluation of the child. Formulation of these factors may then point the way to more helpful management of the child and treatment. The most serious problems, such as regional ileitis and ulcerative colitis, require not only collaboration of pediatricians and child psychiatrist, but surgeons as well if patients are to receive optimum care.

Anxiety, Separation↗
PubMed1978

Crohn's disease in Barrett's esophagus.

A patient with regional ileitis (Crohn's disease) developed a benign esophageal stricture. He had no history of heartburn or other symptoms of reflux esophagitis. The diagnosis of Crohn's disease was suspected but could not be proved preoperatively. The surgically resected esophagus showed the gross and microscopic features of Crohn's disease. Barrett's esophageal mucosa was also found in the resected esophagus. Postoperatively, the patient developed a fistula at the esophagogastrostomy site. Crohn's esophagitis has been reported in 15 patients but none had Barrett's esophagus. We believe our patient reported here is the first case with Crohn's disease and Barrett's esophagus.

Crohn Disease↗
PubMedDate not supplied

Joint inflammations as complications in intestinal inflammations.

Ulcerative colitis and regional ileitis may be accompanied by articular involvement as extraintestinal complications, and were observed in 11 and 4 patients respectively. The temporal connection between the intestinal diseases and the appearance of subsidence of these complications in the majority of the cases suggest an etiologic relationship, regardless of the fact that the etiology of the intestinal diseases has not yet been elucidated. The clinical picture and course as well as the laboratory findings indicate that the joint involvement in question differs from rheumatoid arthritis.

Adolescent↗
PubMed1975

[Clinical aspects of Crohn's disease. Report of experience at the Munich surgical university hospital 1954-1974].

Crohn's regional ileitis, which is differentiated into acute, chronic uncomplicated and chronic complicated forms, is seen to have a high complication rate in the long run. It is the fistulae to sections of the intestine which are not primarily diseased, the fistulae to the bladder, vagina and retroperitoneal space, fistulae opening on the abdominal wall and perianal fistulae which make the primary condition a serious disease. In the chronic stage, an adequate resection of the intestine in good time can lead to healing. Detour anastomoses which leave behind the affected section of the intestine gives poor results.

Acute Disease↗
PubMedDate not supplied

[Ulcerative rectocolitis. Somatic aspects (author's transl)].

Regional enteritis (Crohn's disease) and ulcerative rectocolitis, both "non specific inflammatory diseases of the bowel", might be diseases with a common etiology but with clinical features corresponding to a different tissular response to a noxious factor. Both diseases are however characterized by distinct clinical, radiological, histological peculiarities; evolution also is different, as appears from the rarity of malignant degeneration in Crohn's disease and its frequence in ulcerative colitis; a psychological support seems to be classical in ulcerative colitis but is on the contrary unusual in regional ileitis. Besides the interference of psychological factors in the outbreak of an ulcerative colitis, besides the infectious and genetic theories, the immunological theory appears as one of the most interesting and promising. In a significant percentage of cases of ulcerative colitis, anticolon antibodies are evidenced, which exhibit a crossed reaction with bacterial antigens, especially with those of Escherichia coli 014. Besides this humoral immunity a cellular immunity exists also: lymphocytes of patients with ulcerative colitis behave as a toxic agent towards colic tissue cultures; this cytotoxicity parallels the course of the disease and provides an explanation for the sometimes dramatic therapeutic effects observed after administration of immunosuppressive drugs and antilymphocytic serum. Moreover, colic antigen can block this cytotoxicity; the immunologically active portion of this antigen may be isolated and its administration in patients with ulcerative colitis may perhaps induce a specific immunosuppression and influence the evolution of the disease.

Adrenal Cortex Hormones↗
PubMed1977

Conflict and somatization: psychoanalytic treatment of the psychophysiologic response in the digestive tract.

Somatization of intrapsychic conflicts, as manifested in the mouth, the stomach, the small intestine, the large bowel, and the anus, is described in this long-term study of the psychoanalytic treatment of three patients with peptic ulcer, regional ileitis, and ulcerative colitis respectively. The theoretical and practical aspects of treatment are considered, and the efficacy of and indications for psychoanalysis as the treatment of choice are discussed.

Adult↗