Toxic hepatitis after consumption of traditional kava preparation.

Liver toxicity from the use of kava dietary supplements has been reported, but little is known about the side effects of traditional kava preparations. We present a case study of a tourist who developed serious toxic liver disease after consumption of kava beverages in traditional Samoan kava ceremonies.

[Diverticular disease of the colon].

Diverticular disease of the colon is a common civilisatory phenomenon. Its clinical relevance is defined by the typical manifestations diverticulitis (incl. its complications abscess formation and fistulation), diverticular bleeding, and chronic pain.

Self-expanding metal stents for malignant esophagogastric obstruction: experience with a new design covered nitinol stent.

Background And Aims: Dysphagia is the most common disabling symptom in patients with inoperable esophagogastric carcinoma. Self-expanding metal stents are highly effective in the palliation of these patients.

Methods: In 35 patients with inoperable carcinoma of the esophagus or the stomach, with recurrent tumor or complications after transhiatal esophagectomy or gastrectomy or with esophageal stenosis caused by pulmonary cancer, a self-expanding nitinol stent was placed to reduce dysphagia.

[Sonographic detection of kidney infarctions using ultrasound contrast media].

Unlabelled: Contrast-enhanced CT is currently the gold standard for the diagnosis of kidney infarction. Particularly in patients with renal insufficiency, however, the use of iodine contrast media is limited. Sonographic examination using ultrasound contrast media may be an alternative for these patients.

[Acute liver failure and hemolysis in a 16-year-old woman. First manifestation of Wilson's disease].

History And Clinical Findings: A 16-year-old previously healthy female patient was admitted with progressive weakness and jaundice. There was no history of journeys to far-away countries. The patient was on oral contraceptives but no other medication, there were no signs of drug abuse.

[Pancreatic tail tumor as an unusual first manifestation of Wegener's disease].

A fifty-year-old, previously healthy woman presented with abdominal pain and weight loss. Diagnostic work-up revealed a mass in the tail of the pancreas with the appearance of a pancreatic carcinoma. Partial pancreatectomy was performed.

Better acceptance of Fecal Occult Blood Test (FOBT) for colorectal cancer screening during hospitalization.

Introduction: Colorectal cancer (CRC) is a leading cause of illness and death in the Western world. Screening with fecal occult blood test (FOBT) significantly reduces the death rate and the incidence from CRC but these tests are not widely accepted. We investigated the possible contribution of hospitalization to a better acceptance of CRC screening.

Interrelation between ABH blood group 0, Lewis(B) blood group antigen, Helicobacter pylori infection, and occurrence of peptic ulcer.

Background: Helicobacter pylori is a human pathogen that causes chronic gastritis and peptic ulcers. Epidemiological studies demonstrated that individuals who are blood group 0 positive or represent non-secretors of their blood group antigens are more likely to develop peptic ulcers. The Lewis(b) blood group antigen has been reported to mediate the attachment of H.

[Fatty liver in adult celiac disease].

History And Admission Findings: A 31-year-old woman was admitted because of heptomegaly and abnormal liver functions. For years she had suffered from diarrhoea but its cause had never been elucidated. She was underweight and had mild ankle edema.

Effects of sodium selenite on deoxycholic acid-induced hyperproliferation of human colonic mucosa in short-term culture.

It has been shown that in vitro incubation of human colonic biopsies with the secondary bile acid deoxycholic acid (DCA) leads to the hyperproliferation of colonic crypt cells with an expansion of the proliferative zone, which is regarded as a biomarker of increased cancer risk. Sodium selenite (SSE), on the other hand, has been implicated as a protective agent in experimental studies, but toxic effects were reported as well, depending on the dose of SSE. To elucidate the effects of SSE on human colonic mucosa, biopsies from endoscopically normal sigmoid colon tissue of 30 subjects were incubated with 5 microM DCA or a combination of 5 microM DCA and SSE in concentrations of 5, 10, 20, 50, 80, and 100 microM, respectively.

Effects of resistant starch on the colon in healthy volunteers: possible implications for cancer prevention.

Recent evidence suggests that resistant starch (RS) is the single most important substrate for bacterial carbohydrate fermentation in the human colon. During two 4-wk periods. 12 healthy volunteers consumed a controlled basal diet enriched with either amylomaize starch (55.

In vitro fermentation of high-amylose cornstarch by a mixed population of colonic bacteria.

Background: Malabsorbed starch is probably the most important substrate for bacterial fermentation in the human large intestine. Fermentability of starch may depend on the composition of the colonic flora and its adaptation to the substrate supply.

Methods: Ten healthy volunteers were fed a controlled diet containing either 7.

Histological changes in the colonic mucosa following irrigation with short-chain fatty acids.

Objectives: Short-chain fatty acids (SCFAs) derived from bacterial fermentation of complex carbohydrates are preferred luminal nutrients of the colonic mucosa. Starvation of colonocytes through lack or impaired metabolism of luminal SCFAs may be a cofactor in the pathogenesis of ulcerative colitis.

Design: A detailed histological evaluation of colonic biopsy specimens was performed in patients with active distal ulcerative colitis who were treated with rectal enemas containing a mixture of SCFAs, n-butyrate alone or saline placebo.

Bile acid metabolism by colonic bacteria in continuous culture: effects of starch and pH.

Secondary bile acids (BA) have been shown to be involved as a promoting agent in the adenoma-carcinoma sequence of colorectal cancer. In previous studies, fermentation of starch has been shown to inhibit the degradation of primary to secondary BA by the colonic microflora. This study was designed to investigate BA metabolism in continuous cultures of mixed fecal bacteria to get further insights into the mechanisms of this inhibition.

Effects of short-chain fatty acids on the inflamed colonic mucosa.

Selected inflammatory conditions of the distal alimentary tract may respond to topical SCFA treatment. The rationale for using SCFA enemas is based on Roediger's (1980) observation that butyrate is the preferred fuel of colonocytes and that SCFA deficiency could lead, in the short term, to mucosal hypoplasia and, in the long term, to colitis. The absence of luminal nutrients is especially evident in the excluded rectum after complete diversion of the faecal stream.

Metabolic consequences of total colectomy.

Colectomy is performed for inflammatory bowel disease, familial polyposis syndrome and colorectal carcinoma. Surgical procedures are ileostomy with or without pouch, ileorectal anastomosis or ileal pouch-anal anastomosis. One of the major functions of the intact large intestine is to absorb water and electrolytes.

Antagonistic effects of sulfide and butyrate on proliferation of colonic mucosa: a potential role for these agents in the pathogenesis of ulcerative colitis.

It has been shown that feces of patients with ulcerative colitis uniformly contain sulfate reducing bacteria. Sulfide produced by these bacteria interferes with butyrate-dependent energy metabolism of cultured colonocytes and may be involved in the pathogenesis of ulcerative colitis. Mucosal biopsies from the sigmoid rectum of 10 patients (no caner, polyps, inflammatory bowel disease) were incubated with either NaCl, sodium hydrogen sulfide (1 mmol/L), a combination of both sodium hydrogen sulfide and butyrate (10 mmol/L), or butyrate.

Effect of L-glutamine and n-butyrate on the restitution of rat colonic mucosa after acid induced injury.

Background: L-glutamine and n-butyrate are important nutrients for colonocytes affecting both their structure and function. The effect of these epithelial substrates on resealing of rat distal colon after acid induced injury was studied.

Methods: Isolated colonic mucosa of 32 rats was mounted in Ussing chambers and exposed to Krebs-Ringer solution for four hours.

[Pneumatosis cystoides intestinalis].

History And Clinical Findings: A 56-year-old man was admitted to hospital for investigation of meteorism and severe flatulence for 10 months and irregular stools. He had no previous illness. On examination his abdomen was quite distended, with very active but low-pitched peristalsis.

[Hydrogen metabolism in the large intestine--physiology and clinical implications].

During the anaerobic metabolism of the colonic bacterial flora short chain fatty acids and the gases hydrogen (H2) and carbon dioxyde (CO2) are produced. In about 50% of a European and North-American population and in 90% of rural black Africans, methane is generated from H2 and CO2. In methane-negative individuals, sulfate reducing bacteria utilize H2 to reduce sulfate to sulfide.

Influence of starch fermentation on bile acid metabolism by colonic bacteria.

Secondary bile acids (BA) may be involved in the pathogenesis of colorectal cancer. In vivo, starch malabsorption has been shown to reduce fecal excretion of secondary BA. The present in vitro study was performed to investigate the effect of starch fermentation on BA metabolism by colonic bacteria.

Effect of free glutamine and alanyl-glutamine dipeptide on mucosal proliferation of the human ileum and colon.

Background/aims: Glutamine (Gln) is considered a trophic factor for small intestinal epithelia, which is important during severe illness. Its use in parenteral nutrition is precluded by its instability, a problem that may be overcome by use of the stable dipeptide L-alanyl-L-glutamine (Ala-Gln). The hypothesis was tested that Gln or Ala-Gln may stimulate cell proliferation not only in the ileum but also in the proximal and distal colon and, thus, may contribute to the gut barrier function.

Impaired hydrogen metabolism in pneumatosis cystoides intestinalis.

Background: Pneumatosis cystoides intestinalis (PCI) is characterized by high levels of breath hydrogen. Clinical features of PCI may be due to abnormal H2 metabolism.

Methods: Breath levels of H2 and CH4 were measured in 3 patients and total gas in 2 patients with PCI on a polysaccharide-free (basal) diet and after administration of 15 g of lactulose.