The Use of N-acetylcysteine Supplementation to Decrease Irritability in Four Youths With Autism Spectrum Disorders.

Children and adolescents with autism spectrum disorder (ASD) often experience high levels of irritability, which adversely affects their functioning and behaviors. N-acetylcysteine (NAC), an antioxidant precursor to glutathione, has recently been studied for a variety of neuropsychiatric disorders. There is growing evidence to support its use to decrease irritability and self-injurious behaviors in youth with ASD.

Irritable bowel syndrome: diagnostic approaches in clinical practice.

Background: Irritable bowel syndrome (IBS), a functional gastrointestinal disorder long considered a diagnosis of exclusion, has chronic symptoms that vary over time and overlap with those of non-IBS disorders. Traditional symptom-based criteria effectively identify IBS patients but are not easily applied in clinical practice, leaving >40% of patients to experience symptoms up to 5 years before diagnosis.

Objective: To review the diagnostic evaluation of patients with suspected IBS, strengths and weaknesses of current methodologies, and newer diagnostic tools that can augment current symptom-based criteria.

Venous complications of sclerotherapy for esophageal varices.

Although endoscopic sclerotherapy is effective in controlling bleeding from esophageal varices, the effects of sclerosing agents on the extrahepatic portal and splenic veins have not previously been investigated. This study of 21 men with portal hypertension and variceal bleeding compares the morphology of the portal and splenic veins in 11 who had received endoscopic sclerotherapy versus 10 patients who did not. The mean number of injections per patient was 11 +/- 5, the mean volume of 1.

Secretagogue-induced enzyme release from the exocrine pancreas of rats following adaptation to a high protein diet.

The mechanisms of pancreatic adaptation to dietary changes and whether these changes are reflected in the serum are not fully understood. The present study investigates secretagogue-induced release of digestive enzymes from dispersed pancreatic acini as well as the concentrations of these enzymes in serum and pancreas after adaptation to a high protein diet. Adult rats were fed an 8.

Alcohol and the gastrointestinal tract.

The effects of acute and chronic ethanol ingestion on esophageal motility and the potential complications of these alterations are reviewed. Injury to the gastric mucosa and the small intestine and alterations in intestinal absorption can also result from alcohol abuse.

The role of the Ito cell in perivenular and intralobular fibrosis in alcoholic hepatitis.

The role of the Ito cells in perivenular and intralobular scarring in alcoholic liver disease was examined morphologically. There was a substantial decrease in the number of Ito cells in the midzone of the hepatic lobule in both fatty liver and alcoholic hepatitis as judged by light microscopy. By electron microscopy, however, an increase in "activated" Ito cells or a few fibroblasts were found in small foci of fibrosis in association with inflammation and hepatocellular degenerative changes in most cases of alcoholic hepatitis.

Influence of age on the clinical presentation of acute biliary tract disease.

The influence of age on the presenting manifestation of acute biliary tract disease was evaluated by retrospective review of all cases in which this diagnosis was confirmed at operation over a 30-month period. Results indicated that acute biliary tract diseases in elderly patients presents in a manner not statistically significantly different from younger patients (p greater than 0.05 for all parameters studied).

Endoscopic retrograde cholangiopancreatography.

The ERCP report in the patient's chart was compared with findings on common duct exploration or cystic duct cholangiography in 72 patients and found to have a sensitivity of 90.4 percent, a specificity of 98 percent, and an accuracy of 95.8 percent.

Antibiotic-associated colitis with normal-appearing rectum.

A patient was recently seen with pseudomembranous colitis. He had severe disease of the proximal colon, with normal-appearing rectum and distal sigmoid, three weeks after administration of prophylactic antibiotics for surgery. The patient improved after discontinuing the antibiotics.

Metastatic lung carcinoma involving the gastrointestinal tract.

A review of 147 autopsies performed over a 4.5-year period on patients with a diagnosis of primary carcinoma of the lung revealed that 18 (12%) had metastatic lesions in the gastrointestinal tract. Fourteen had a single focus of gastrointestinal involvement, while four had multiple lesions in the gastrointestinal tract.

Duodenal villous adenoma.

Villous adenomas of the upper gastrointestinal tract, although rare, are difficult to diagnose and treat because of their location, invasiveness, and association with adenocarcinoma. Two patients with duodenal villous adenoma and upper abdominal pain as the presenting symptoms are described. Endoscopy is important for early diagnosis.

Mallory bodies. Horseradish peroxidase: specific cytochemical and biochemical marker for alcoholic hyalin.

Horseradish peroxidase (HRP), a glycoprotein enzyme, bound specifically to Mallory bodies (MBs) in cryostat sections of autopsy liver and liver biopsies. In contrast, HRP did not bind to cryostat sections of normal liver. The specificity of HRP binding was also observed using light and electron microscopy in autopsy liver-derived subcell fractions prepared by the MB isolation procedure.

Lymphocyte sequestration by the liver in alcoholic hepatitis.

The possibility that lymphocytes are sequestered by the liver in patients with alcoholic hepatitis was investigated. Sixteen patients who had liver biopsy specimens taken were studied as follows: The T- and B-lymphocyte populations of the peripheral blood and liver biopsy digest were quantitated. The liver biopsy specimens were studied by light and electron microscopy for lymphocyte-hepatocyte interaction.

Watery diarrhea syndrome with elevated levels of vasoactive intestinal polypeptide associated with pancreatitis and pancreatic pseudocyst.

A 32-year old patient presented with recurrent pancreatitis, severe watery diarrhea and elevated serum levels of vasoactive intestinal polypeptide. His diarrhea appeared to respond to intramuscular propantheline. Initially he improved but had another attack of pancreatitis while hospitalized.

Colonic varices. A complication of pancreatitis with splenic vein thrombosis.

A patient with recurrent gastrointestinal bleeding was found to have varices at the splenic flexure at colonoscopy. Angiography revealed complete occlusion of the splenic vein. Although the patient did not have cirrhosis, he did have a history of pancreatitis which presumably was responsible for the splenic vein thrombosis.