The colon single-stripe sign and its relationship to ischemic colitis.

Objectives: Endoscopic findings may assist in the clinical diagnosis of ischemic colitis but have not been systematically characterized. We noted that a single linear colonic ulcer could on occasion be found endoscopically after hypotension and proceeded to investigate its relationship to ischemic colitis.

Methods: Twenty-six patients (19 female and seven male, mean age 71 yr) with endoscopic evidence of a single linear ulcer running along the longitudinal axis of the colon (colon single-stripe sign (CSSS) were retrospectively studied.

Intestinal fatty acid binding protein may favor differential apical fatty acid binding in the intestine.

The intestinal mucosa metabolizes fatty acids differently when presented to the lumenal or basolateral membrane. Expression of both liver and intestinal fatty acid binding proteins (L- and I-FABPs) uniquely in the enterocyte offers a possible explanation of this phenomenon. An organ explant system was used to analyze the relative binding of fatty acids to each protein.

Abundance of surfactant-like particles reflects mucosal integrity in patients with peptic ulcer disease.

Background: Surfactant-like particles, normal products of the human enterocyte, are released into the lumen and secreted into blood.

Aims: To assess their role as markers for mucosal functional integrity, this study examined their content in biopsy specimens and serum of patients with duodenal ulcer disease, compared with non-diseased control subjects.

Patients: Endoscopic biopsy specimens were taken 1-2 cm from areas of active inflammation or ulcer (peptic ulcer patients) or just beyond the duodenal bulb (normals) in 35 consecutive subjects.

The secretion of intestinal alkaline phosphatase (IAP) from the enterocyte.

Rat intestinal alkaline phosphatase exists in two separate forms, differing markedly in the carboxyterminal coding region, as well as in the 3' untranslated regions. It is secreted bound to a phospholipid-rich particle (surfactant-like particle) which appears to have unique properties, but whose role is still uncertain. Evidence is presented to suggest that intestinal alkaline phosphatase secretion is mediated by this particle.

A possible role for rat intestinal surfactant-like particles in transepithelial triacylglycerol transport.

To further examine whether surfactant-like particles (DeSchryver-Kecskemeti, K., R. Eliakim, S.

Characterization of proteins in rat and human intestinal surfactant-like particles.

Phospholipid-rich particles isolated from the apical surface of rat enterocytes have surfactant-like properties and are enriched for intestinal alkaline phosphatase. Purified intact rat particles were used to produce antibodies in rabbits. Antiserum against the rat particle identified major proteins of 48, 68, 98, and 118 kDa on Western blots of isolated rat surfactant-like particle and did not detect any protein in rat intestinal basolateral membranes, rat brush border membranes, or human particles, but did detect a single 180-kDa protein in a preparation of rat milk fat globules, and two proteins (66 and 103 kDa) in rat pulmonary surfactant.

Pericrypt eosinophilic enterocolitis and chronic diarrhea.

An unusual pattern of eosinophilic infiltration around intestinal crypts was detected in mucosal biopsy specimens of 10 patients with chronic diarrhea, half of whom had evidence of systemic connective tissue disease. The median duration of symptoms was 11 months, and no other explanation for diarrhea could be determined in any case. The cellular infiltrate on biopsy specimens was present deep in the mucosa of small and large intestinal specimens, separating crypt bases from the muscularis mucosae and penetrating the latter.

Mast cell granules within endothelial cells: a possible signal in the inflammatory process?

Mast cell-endothelial cell interactions have long been suspected to be important in inflammation. The detail of the pathways of communication have yet to be elucidated. In this report we describe, for the first time, mast cell granules within endothelial cells of colonic capillaries in a patient with florid colitis, as well as rats with experimentally induced mast cell degranulation.

Dietary supplementation with fish oil in ulcerative colitis.

Objective: To determine the efficacy of fish oil supplementation in patients with active ulcerative colitis.

Design: Multicenter, randomized, double-blind, placebo-controlled, crossover trail with 4-month treatment periods (fish oil and placebo) separated by a 1-month washout.

Setting: Four gastroenterology divisions.

Stromal amyloid in pheochromocytomas.

Amyloid has been documented in the stroma of a number of neuroendocrine tumors. It is usually associated with elaboration of a polypeptide hormone product. Twenty-three adrenal pheochromocytomas occurring in 18 patients were graded for the extent of amyloid deposits on the hematoxylin-eosin-stained slides, confirmed to be amyloid by Congo red stain and polarization microscopy.

The minor components of the rat asialoglycoprotein receptor are apically located in neonatal enterocytes.

Because specific uptake of the asialoglycoprotein haptocorrin has been reported in suckling distal intestine, evidence of the asialoglycoprotein receptor in rat ileum was sought. On Western blot, two different polyclonal antisera against purified rat holoreceptor recognized only proteins of the size of the minor receptor components (51 and 55 kilodaltons) in both suckling and adult rat intestine. Messenger RNA encoding the minor component (RHL-2/3) was detected in total RNA extracted from rat ileum.

A novel intracellular pathway for rat intestinal digestive enzymes (alkaline phosphatase and sucrase) via a lamellar particle.

To identify the mechanism of intestinal alkaline phosphatase (IAP) release into serum that is known to be associated with fat feeding, both luminal and serum IAP as well as sucrase-isomaltase levels were monitored by rocket electroimmunoassays and by immunogold labeling electron microscopy. Luminal and serum IAP, and to a much lesser extent sucrase-isomaltase, peaked at 7 hours after fat feeding. Analysis of the luminal IAP by isoelectric focusing showed that the enzyme had a slightly different pI than brush border IAP, but was still partially membrane bound, whereas serum IAP was no longer membrane bound.

Environmental pathology. Mast cell and eosinophil infiltration in intestinal mucosa of Lewis rats treated with L-tryptophan implicated in human eosinophilia myalgia syndrome.

A recently developed animal model for the L-tryptophan-associated eosinophilia myalgia syndrome was used to examine the small intestine and colon, because there is clinical involvement at these sites in patients. Increased perivascular inflammatory infiltrates rich in degranulating mast cells, eosinophils, and monocytes were seen in the lamina propria of experimental animals when compared with controls. L-Tryptophan-associated disease also shares many clinical features with idiopathic scleroderma/eosinophilic fasciitis, in which there is gastrointestinal involvement as well.

Small intestinal lesion resembling graft-vs-host disease. A case report in immunodeficiency and review of the literature.

We report graft-vs-host disease-like histology in a small intestinal biopsy specimen that was obtained from a patient with common variable immunodeficiency and related T-cell defect. We include findings from immunohistochemical studies and follow-up information. Review of the literature yielded only a small number of histologically documented cases of this lesion without previous bone marrow transplantation.

Thickening of muscularis mucosae in Crohn's disease.

Crohn's disease (CD) of the bowel showed a statistically significant thickening of the muscularis mucosae when compared with disease controls. In areas of gross stricture in CD, the muscularis mucosae comprised almost 10% of total wall thickness. Similar findings were also present in a previously characterized experimental model of CD (trinitrobenzene sulfonic acid-induced colitis in rats), particularly in what appeared to be grossly strictured areas.

Glomus tumor of the coccyx. A curable cause of coccygodynia.

A 30-year-old woman presented with recurrent severe coccygodynia. She underwent exploration for a possible pilonidal sinus and was found to have a precoccygeal glomus tumor that also involved bony trabeculae of the coccyx. To our knowledge, a glomus tumor involving the coccygeal bone has not been previously documented.

Effect of mucosal thickening near gastric carcinoma on the endoscopic diagnosis of malignancy.

Gastric mucosal thickening of variable degree occurs in the vicinity of gastric carcinomas and is possibly related to simultaneous tumor expression of epidermal growth factor and its receptor. Seventeen cases in which both endoscopic biopsy and subsequent resection for gastric carcinoma had been performed were studied to see if putative tumor-related mucosal thickening had an effect on endoscopic biopsy sensitivity. Biopsy fragment positivity rate was greater in cases with exophytic, protruding tumor masses (46.

Isolation and characterization of a small intestinal surfactant-like particle containing alkaline phosphatase and other digestive enzymes.

Digestive brush-border enzymes in particulate form have been reported in the intestinal lumen in vivo and in medium from organ explants in vitro. It has been suggested that these particles derive from membrane shedding of the apical brush border. This study describes the isolation and characterization of particles derived from the 105,000 x g supernatant fraction of intestinal luminal washings and from light scrapings of the mucosa itself after fat feeding of rats.

Immunohistochemical survey of cobalamin-binding proteins.

Dietary cobalamin is bound to intrinsic factor (IF) and nonintrinsic factor (R protein) in the gastrointestinal tract. Distribution of IF has previously been described only in the stomach (parietal, chief cells), duodenum (mucous cells), and pancreatic juice. Cells containing R protein have been reported to be more widespread, including mucin-secreting cells of the intestinal tract.

Intestinal surfactant-like material. A novel secretory product of the rat enterocyte.

Surface-active phospholipid-containing particles are traditionally considered to be the product of type II pneumocytes. We now demonstrate membrane-bound lamellar cytoplasmic organelles in adult and suckling rat enterocytes that are densely reactive with phospholipid-staining reagents. These structures were seen in the basolateral space, within the intercellular junctions, and unraveling on the lumenal surface, and were more abundant after fat feeding.

Mucosal thickening adjacent to gastric malignancy: association with epidermal growth factor.

A high false negative rate from endoscopic forceps biopsy is well-known in gastric carcinoma. The initial aim of the present study was to determine whether possible thickening of adjacent nontumorous mucosa by nonspecific or specific trophic factors could contribute to this observation; 167 gastrectomy specimens (77 carcinomas, 14 lymphomas, 76 gastric ulcers) were examined and mucosal thickness measured. Mean thickness of uninvolved mucosa near carcinoma (1.

Intestinal alkaline phosphatase is secreted bidirectionally from villous enterocytes.

A fraction of intestinal alkaline phosphatase (IAP) is secreted into blood. To study this process, enzyme secretion was examined in a fetal (IRD-98) and a differentiated (Caco-2) intestinal cell line. Tissue-unspecific alkaline phosphatase (AP) activity in the IRD-98 cells increased 20-fold after addition of 1.