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- Magnusson, J, et al.
(author)
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A kinetic study in adults with food hypersensitivity assessed as eosinophil activation in fecal samples
- 2003
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In: Clinical and Experimental Allergy. - : Wiley. - 0954-7894 .- 1365-2222. ; 33:8, s. 1052-1059.
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Journal article (peer-reviewed)abstract
- BACKGROUND: Immune-mediated food hypersensitivity affecting the gut is difficult to evaluate, and objective tools to diagnose local gastrointestinal (GI) inflammatory reactions are lacking. OBJECTIVES: To determine whether allergic manifestations in adults with a history of food-related GI symptoms could be assessed in feces during symptomatic and non-symptomatic periods, using the surrogate markers, eosinophil cationic protein (ECP), eosinophil protein X (EPX) and myeloperoxidase (MPO). METHODS: Thirteen subjects with food hypersensitivity-related GI symptoms, confirmed by a positive double-blind placebo-controlled food challenge (DBPCFC), were subjected to an open kinetic food challenge design for 6 weeks. Symptoms were recorded and scored during the 3-week study period and stool samples were obtained every day. The surrogate markers ECP, EPX and MPO were measured in the supernatants from feces samples. RESULTS: A significant increase in abdominal pain, distension and flatulence was observed during challenge, with a gradual decrease during elimination diet. Both between days and subjects, EPX levels were more frequently increased compared to ECP and MPO. Individuals with a history of a short duration of symptoms had significantly higher mean levels of EPX and MPO than those with a longer duration of symptoms. CONCLUSIONS: An overall increase in levels of eosinophil markers, in particular EPX, was observed in feces from patients with food-related GI symptoms. However, rather than being a tool to differentiate symptomatic from non-symptomatic periods, EPX might be used for detecting an ongoing clinical or subclinical chronic inflammation, that may have an impact on the patient's clinical course of GI symptoms.
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- Carlsson, Eva, 1959
(author)
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Body composition and quality of life in patients with IBD, ileostomy and short bowel syndrome
- 2003
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Doctoral thesis (other academic/artistic)abstract
- Patients with IBD are at risk for intestinal disability (e.g. having a stoma, malnutrition). The general aim of the thesis was to investigate physiological, psychological and social consequences of having IBD and an ileostomy or short bowel syndrome (SBS).Patients and Methods: Six SBS patients were interviewed to investigate practical aspects on daily life. In 21 ileostomates, and 19 patients with SBS, bioelectric impedance spectroscopy (BIS) was compared with other methods for determination of water compartments and fat free mass (FFM). Differences were analysed using the Bland-Altman method. Concerns, health related quality of life (HRQOL), quality of life (QOL) and coping were assessed in 21 patients with an ileostomy and 28 patients with SBS. HRQOL were compared with a matched group from the general population. Results: The differences between methods (BIS, Dual-energy absorptiometry (DXA), Dilution and derived estimates) to assess total body water (TBW) and FFM were pronounced. The mean difference of extracellular water (ECW) between dilution and BIS was less in female ileostomates than male, (p<0.01). Hydration of FFM assessed by BIS gave a mean of 0.77 for ileostomates and 0.75 for SBS patients. Most SBS patients were maintained in a stable clinical condition within normal limits of body weight and BMI.The most serious limitation of every day life for SBS patients was the planning involved to get most out of life. Dominating concerns for the ileostomates were intimacy, access to quality medical care and energy level and for the SBS patients being a burden, further surgery and energy level. Vitality was significantly reduced in ileostomates. In SBS patients all dimensions in HRQOL were significantly reduced except physical function. More than 1/3 of SBS patients rated health worse or much worse than one year ago. Most definitions on " good quality of life " were found in the social dimension. Most " obstacles to good quality of life" were found in the psychological dimension for the ileostomates and in the physical dimension for the SBS patients. Perceived QOL was rated 70/100 for ileostomates and 64/100 for the SBS patients. Confrontation was the dominating coping style.Conclusion: The differences between methods to assess body water compartments and FFM were pronounced. Methods could not be used interchangeably. BIS should be further evaluated with repeated, longitudinal measurements. The high concern for being a burden needs further investigation and how it can be reduced. Concern for intimacy as the concern for loss of sexual drive and sexual performance needs to be further explored. Fatigue needs to be defined. It is also necessary to study how concern changes over time. Integrating items of concern into counselling may result in greater coping ability and improved QOL.Key words; inflammatory bowel disease, Crohn´s disease, ulcerative colitis, short bowel syndrome, quality of life, health related quality of life, coping, concern, body composition, bioelectric impedance spectroscopy, Dual-energy absorptiometry, total body water
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- Darwiche, Ghassan, et al.
(author)
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The addition of locust bean gum but not water delayed the gastric emptying rate of a nutrient semisolid meal in healthy subjects
- 2003
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In: BMC Gastroenterology. - 1471-230X. ; 3: 12
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Journal article (peer-reviewed)abstract
- Background: Most of the previous studies regarding the effects of gel-forming fibres have considered the gastric emptying of liquid or solid meals after the addition of pectin or guar gum. The influence of locust bean gum, on gastric emptying of nutrient semisolid meals in humans has been less well studied, despite its common occurrence in foods. Using a standardised ultrasound method, this study was aimed at investigating if the gastric emptying in healthy subjects could be influenced by adding locust been gum, a widely used thickening agent, or water directly into a nutrient semisolid test meal. Methods: The viscosity of a basic test meal (300 g rice pudding, 330 kcal) was increased by adding Nestargel (6 g, 2.4 kcal), containing viscous dietary fibres (96.5%) provided as seed flour of locust bean gum, and decreased by adding 100 ml of water. Gastric emptying of these three test meals were evaluated in fifteen healthy non-smoking volunteers, using ultrasound measurements of the gastric antral area to estimate the gastric emptying rate (GER). Results: The median value of GER with the basic test meal (rice pudding) was estimated at 63 %, (range 47 to 84 %), (the first quartile = 61 %, the third quartile = 69 %). Increasing the viscosity of the rice pudding by adding Nestargel, resulted in significantly lower gastric emptying rates (p < 0.01), median GER 54 %, (range 7 to 71 %), (the first quartile = 48 %, the third quartile = 60 %). When the viscosity of the rice pudding was decreased (basic test meal added with water), the difference in median GER 65 %, (range 38 to 79 %), (the first quartile = 56 %, the third quartile = 71 %) was not significantly different (p = 0.28) compared to the GER of the basic test meal. Conclusions: We conclude that the addition of locust bean gum to a nutrient semisolid meal has a major impact on gastric emptying by delaying the emptying rate, but that the addition of water to this test meal has no influence on gastric emptying in healthy subjects.
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- Evilevitch, Lena, et al.
(author)
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CCK regulates pancreatic enzyme secretion via short duodenal-pancreatic reflexes in pigs
- 2003
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In: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 38:2, s. 201-206
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Journal article (peer-reviewed)abstract
- Background: Different routes of administration of CCK-33 and blockage of CCK-A and muscarinic (m(3)) receptors are used in this study to evaluate the mechanisms by which cholecystokinin can stimulate the exocrine pancreas. Methods: The experiment was performed on eight anaesthetized pigs during control conditions and after administration of the CCK-A and m(3) receptor antagonists, Tarazepide and 4-DAMP, respectively. Catheters were surgically implanted in the pancreatic duct for juice collection and in the gastric and right gastro-epipoic arteries and in the jugular vein, so that infusions of CCK-33 could be made exclusively to the duodenum/stomach, duodenum/pancreas or general circulation, respectively. Results: Infusion of a low dose of CCK-33 (13 pmol kg(-1)) to the general circulation did not affect pancreatic protein or trypsin output. When the same dose was given directly to the duodenum/stomach or the duodenum/pancreas, pancreatic output increased during both control conditions and after Tarazepide and/or 4-DAMP treatment, though the increase in trypsin Output was lower after Tarazepide and/or 4-DAMP blockade. A high dose of CCK-33 (130 pmol kg(-1)) given peripherally stimulated the pancreatic secretion, but this response was totally abolished in Tarazepide and 4-Damp treated animals. Conclusions: Pancreatic enzyme secretion due to CCK-33 stimulation depends on the presence of short duodenal-pancreatic peptidergic reflexes evoked mainly via low sensitive, probably CCK-B, receptors located in the duodenum/stomach. Pancreatic secretion evoked by peripheral CCK-33 in pharmacological doses was independent Of m(3) receptors blockade but depended on CCK-A receptors located elsewhere than in the duodenum/pancreas.
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- Gunnarsdottir, Anna, et al.
(author)
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Skurðaðgerðir við launeista á Barnaspítala Hringsins 1970-1993
- 2003
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In: Laeknabladid. - 0023-7213. ; 89:2, s. 119-123
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Journal article (peer-reviewed)abstract
- Objective: Cryptorchidism is a common congenital genito-urological anomali in males with increased risk of infertility and testicular cancer. In this retrospective study the results of operations for undescended testis at Landspitalinn University Hospital were reviewed with special emphasis on patients diagnosed with testicular cancer later in life. Material and methods: The study includes 593 males with undescended testis who were operated on between 1970 and 1993. Information was gathered from hospital records, including birth-weight, age at diagnosis and operation, localization of the testes and complications to surgery. Information on patients diagnosed with testicular cancer was aquired from the Icelandic Cancer Registry. Results: The average birth-weight was 3461 g, including 58 boys (10%) with low birth-weight (
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9. |
- Hakansson, HO, et al.
(author)
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Synthesis and localization of pancreatic secretory proteins in pancreatic acinar-like metaplasia in the distal part of the oesophagus
- 2003
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In: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 38:1, s. 41560-41560
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Journal article (peer-reviewed)abstract
- Background: Pancreatic acinar-like metaplasia has previously been described in the gastric mucosa and in the distal part of the oesophagus. The resemblance to pancreatic acinar cells prompted us to study the possible occurrence of secretory pancreatic proteins in these cells. Methods: Seven specimens obtained from the distal oesophagus at gastroscopy where routine microscopy showed pancreatic acinar-like metaplasia were selected for this study. Sections were subjected to immunohistochemical detection of trypsinogen, pancreatic elastase, procarboxypeptidase B and pancreatic secretory trypsin inhibitor using specific antisera. An alkaline-phosphatase-conjugated oligodeoxynucleotide probe, complementary to the transcript for trypsinogen 2 (anionic) was used for in situ hybridization. Results: Cells with pancreatic acinar-like metaplasia were immunoreactive to all pancreatic secretory proteins studied. In situ hybridization showed the presence of trypsinogen 2 mRNA in pancreatic acinar-like metaplasia. The pancreatic proteins were not seen in other cells in the distal oesophagus. Conclusion: Pancreatic acinar-like metaplasia is common in the distal oesophagus and pancreatic secretory proteins, including trypsininogen 2, are produced in the oesophageal metaplastic acinar cells. The biological significance of this finding has yet not been thoroughly studied.
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