Small bowel morphology in British Indian and Afro Caribbean subjects: evidence of tropical enteropathy

Distal duodenal biopsy specimens taken from 30 white, 35 Indian, and 20 Afro-Caribbean residents of West Birmingham during routine endoscopy for dyspepsia, were assessed by disecting microscopy and morphometry. Finger-shaped villi were significantly less frequent in the Indian and Afro-Caribbean subjects than in the white subjects when assessed by disecting microscopy (p<0.005), and both immigrant groups had decreased mucosal thickness (p<0.01), villous height (p<0.001), villous:crypt ratios (p<0.01) and enterocyte height (p<0.05) compared with the white group. In the Indian subjects villous height and villous:crypt ratios correlated significantly with the time since the last visit to the Indian subcontinent (p<0.005). Serum alkaline phosphatase values were significantly higher in the Indian subjects compared with the white (p<0.02), and serum globulins were increased in both the Afro-Caribbean and Indian subjects (p<0.01). There were no correlations between morphometric indices and body habitus or biochemical or haematological indices and the long term effect of the morphological changes is not clear. (AU)

Colonoscopy and studies of cellular immune function in children with geophagia and mucoid dysentery - abstract

Many West Indian children eat earth, of whom a number have frequent unformed stools with mucus; of these children, some are heavily infected by the whipworm, Trichuris trichiura. We have begun a study of the mucosal pathology in these children, and of their cellular immune function, both systemic and local. We performed 8 complete (i.e. to the caecum) colonoscopies on 5 children aged 3.1 to 4.8 years, of whom two had trichuriasis. Bowel preparation with senna, bisacodyl and magnesium sulphate and sedation with chlorpromazine, diazepam and pethidine were satisfactory in all cases. Chronic inflammation with crypt hyperplasia and lymphoid hyperplasia were seen in the initial mucosal biopsies of 4 patients. Lymphocytes were separated both from colonic biopsies and from blood samples and maintained in culture for 48 hours. To some of the cultures were added lectin mitogens. The lymphokines, Interleukin-2 (IL-2) and Inteferon-gamma (IFN-t), which are released by activated T-cells, were bioassayed in London from the culture supernatants. All supernatants from the mitogen-stimulated blood lymphocytes contained IL-2 and IFN-t, diminishing as expected in serial dilution. In general, the concentrations of IL-2 released by activated colonic T-cells were similar, and similar to those in children with inflammatory bowel disease previously investigated. However, one child showed no evidence of mitogen-activated of either caecum or transverse colon T-cells. The two children with Trichuris showed less IL-2 in the 1:2 dilution from their caecal T-cells than from their transverse colon T-cells. This study shows the feasibility of paediatric colonoscopy and functional studies on blood and colonic lymphocytes in Jamaica. The findings on these patients with chronic dysentery suggest that some have a reduction in T-cell function specific to the colonic mucosa (AU)

Morphological and histological study of the gastro-intestinal tract of the ferret

The morphology and histology of the post-pharyngeal part of the gastro-intestinal tract of the ferret were studied. The oesophagus was a distensible muscular tube. Its mucosa was lined by keratinizing stratified squamous epithelium. The muscle coat was striated throughout except near the cardia. A cardiac sphincter was present. The stomach was morphologically and histologically very similar to that of man. The duodenum appeared C-shaped and had a mesoduodenum. The bile and pancreatic ducts formed a common duct in the wall of the duodenum. The sphincter of Oddi was present. Brunner's glands were present in the pyloric part of the stomach, and up to the common opening of the bile and pancreatic ducts in the duodenum. The intestine could be differentiated macroscopically and microscopially into the small and large intestines. The small intestine distal to the duodenum formed coiled tubes suspended by a mesentery. It was not possible morphologically to differentiate jejunum and ileum. Histologically, however, the distal portion was identifiable as ileum by increasing numbers of goblet cells, and Peyer's patches in the submucosa. Villi were present in the mucosa throughout but there was no spiral or circular fold. The larg intestine was a straight dilated tube lying in the left flank and extending from the splenic flexure to the anus in the median plane. It was suspended by a short mesocolon except for the rectal portion in the pelvis. The ileo-colic junction was differentiated morphologically and histologically. There was no caecum, appendix, taeniae coli or appendices epiploicae. The large intestine was not differentiated topographically into ascending, transverse and descending colon (AU)

Cell turnover in the normal human small intestinal mucosa

Small intestinal cell turnover was studied in 12 normal Jamaican subjects using the DNA-loss technique. The mean DNA-loss rate was 15.4 ng atoms DNA-P per minnute, representing a loss of half a million cells per minute from a 5 cm segment of duodenal mucosa or 10-60 million cells per minute from the entire small intestine. This value agrees very well with that described in the literature and suggests that at least as regards its epithelial cell dynamics, the small intestinal mucosa of the Jamaican Negro is similar to that of Europeans (AU)

Abnormalities of absorption and jejunal mucosal histology in diarrhoeal diseases in Puerto Rican children

The D-xylose, Vitamin A and serum carotane determination were carried out and evaluated as tests of intestinal absorption in a group of children ranging in age from 9 months to 8 years. Jejunal biopsies correlated with the presence or absence of steatorrhea but there was no correlation between stool fat and other tests of absorption (AU)