Teodoro Herskovic

The effect of total colectomy on morphology and absorptive capacity of ileum in the rat

Abstract The mechanism of adaptation of intestinal absorption after colectomy has not been established. This adaptation was studied by measuring morphologic changes and absorptive capacity of the ileum before and 2 months after total colectomy and ileoproctostomy in rats. The water-absorptive capacity of ileum was determined in situ by infusing a 10-cm. segment at 0.2 ml./minute with an isotonic solution with a nonabsorbable marker. Net water absorption in the ileum increased from 0.17 ± 0.012 ml./cm./hour in preoperative and control animals to 0.28 ± 0.034 ml./cm./hour 2 months after colectomy (P These findings indicate that both ileal absorptive surface and absorptive capacity increase after total colectomy in the rat and suggest that the enhancement of water-absorptive capacity in the intestinal remnant is the mechanism of functional adaptation after colectomy.

Intestinal Antibodies to Wheat Fractions in Celiac Disease

Abstract Precipitins to the peptic-tryptic digest of gluten, fraction III, were found in the intestinal secretions (stool or small bowel fluid) of 12 patients with celiac disease but not in control...

Milk-precipitating substance in the stool in gastrointestinal milk sensitivity.

Abstract An association between the presence in the stool of precipitating substances to cows milk and the occurrence of milk-induced gastrointestinal bleeding, protein loss and diarrhea was demonstrated in four children. This precipitating substance was not found in the stools of patients with a variety of diarrheal and other disorders. It is suggested that an antigen-antibody reaction is involved in the precipitation of milk protein by the fecal substance and that this substance is a coproantibody. No precipitins to milk proteins were detected in their serums, but titers to alpha lactalbumin were high in three of the four children. Immunologic mechanisms may be involved in gastrointestinal milk sensitivity, although the role of antibodies in the pathogenesis of the disorder might only be a secondary one.

Eleven adolescent girls with severe anorexia. Intestinal disease or anorexia nervosa

From the Departments of Pediatrics and Internal Medicine, Yale University School of Medicine and the Yale-New Haven Hospital, New Haven, Conn. * Reprints: Department of Pediatrics, 333 Cedar Street, New Haven, Connecticut 06510. Supported in part by grants from the Public Health Service (1-R01-02700) and the Mead Johnson Company. The patients described were studied in the Yale Children’s General Clinical Research Center with USPHS grant (FR-00125-03). Dr. Katz is a USPHS fellow in Gastroenterology, USPHS AM-5156-09. A and ~-ague gasiroiniestiiial i~’fll~..~:‘~i.-~ vag stromtestma complaints may be manifestations of granulomatous bowel disease as well as of pure psychiatric disorders. Indeed, the intense psychologic problems of the pubertai or adolescent child may at times impede the detection of

Small intestine glutaminase deficiency in celiac disease

SummaryHuman small intestine contains glutaminase I, an enzyme responsible for the deamination of glutamine. Glutaminase activity was assayed in the jejunal mucosa of patients with celiac disease and of control subjects. Enzymatic activity was markedly diminished in the jejunal biopsy specimens from these patients at the time the diagnosis of celiac disease was made, compared with glutaminase I levels from control subjects. With successful treatment on a gluten-free diet, small-intestinal glutaminase I values returned toward normal as the biopsy specimens improved histologically. Patients with celiac disease who continued to have some symptoms had biopsy evidence of moderately severe mucosal damage, and they maintained low enzyme levels. The patients with abnormal biopsies due to other small-bowel diseases also had diminished glutaminase I activity. This study suggests that patients with untreated celiac disease have a secondary deficency of this enzyme.

Mechanisms of Steatorrhea in the Zollinger-Ellison Syndrome

Excerpt Diarrhea is a prominent clinical feature of the Zollinger-Ellison syndrome (1). In approximately one half of the well-studied cases of non-beta islet cell adenomas diarrhea is associated wi...

Immune mechanisms in chronic pancreatic disease. II. Serum precipitins to pancreatic homogenates in patients with pancreatic disease: preliminary clinical observations.

SummaryPrecipitins to pancreatic homogenates, presumably representing isoantibodies, have been found in 28 of 33 patients with various pancreatic exocrine diseases. In 4 of 5 patients without demonstrable precipitins, pancreatic damage had either occurred more than 3 years previously or had just begun at the time of the study. Similar precipitins were found in 7 of 35 diabetics but in only 1 of 52 controls with various nonpancreatic diseases.It is unlikely that these precipitins have any pathogenetic significance. Their determination, however, might prove useful in the diagnosis of pancreatic inflammation and malignant neoplasia.

Angioosteohypertrophysyndrome with protein-losing enteropathy

Summary A child with the characteristic features ofthe angioosteohypertrophy syndrome and evidence of protein-losing enteropathy is presented. Studies indicate that intestinal lymphangiectasia was responsible for the gastrointestinal losses of protein and fat. A diet low in long-chain triglycerides and supplemented by medium-chain triglycerides effectively reversed the enteric losses.

A continuously monitored recirculating perfusion system for measuring intestinal absorption.

A system was developed for the continuous and simultaneous measurement of water and nutrient (or electrolyte) absorption from the intestine. A recirculating loop (with a reservoir) was kept moving by means of two peristaltic pumps. Water was quantitated by means of a chromogenic nonabsorbed marker and a spectrophotometer. The nutrient (or electrolyte) was present in radiolabeled form and was quantitated by means of a gamma-ray detector. Use of the system was illustrated by the study of22NaCl and75Se-l-selenomethionine. By utilization of a suitable detector, beta-emitting radionuclides may also be used in the perfusing fluid.