Frequencies of Immune Cells in the Human Small Bowel During Normal Gestation and in Necrotizing Enterocolitis.

BACKGROUND: Only few studies have quantitated the frequencies of immune cells in the small bowel mucosa and submucosa during gestation. The aims of this study were to describe the frequencies of T and B cells, eosinophils and mast cells in the normal small bowel mucosa and submucosa (NSB) in relation to gestational age (GA) and in the uninvolved small bowel (USB) of premature newborns with necrotizing enterocolitis (NEC). METHODS: We obtained 36 NSB specimens (GA 12-41 weeks) and 8 NEC-USB specimens (GA 24-32 weeks) from autopsies and surgeries and performed immunostaining for CD3, CD79a, BMK-13 and tryptase as well as the histochemical stains giemsa and toluidine blue. Qualitative histological evaluation and two different quantitative cell-samplings were performed using digital imaging analysis with both TissuemorphDP® and newCAST® software. Linear regression analysis was performed with cell frequency as the dependent variable and GA and USB as the independent variables. RESULTS: In the NSB specimens, we found significant linear correlations between cell frequencies and GA for all examined cell types, though B cell frequencies reached a plateau midway through gestation. In the USB cases, submucosal mast cell frequencies were higher than in the NSB specimens, while T cell frequencies were lower. In USB of NEC patients, we found a significant increase of mast cells and a significant decrease of T cells compared to NSB. CONCLUSION: Throughout gestation, we found an increase of all examined immune cell types in the normal small bowel, while the number of B cells came to a standstill at midway. Future studies should examine subtypes of T cells and also include histiocytes. A larger amount of small bowel specimens, covering the full gestational age, would be of great value.

Familial accumulation of death associated with general anaesthesia.

This is a case report of a 66-year-old male patient with spinocerebellar ataxia type 1 and a family history of anaesthesia-related death was anaesthetised with total intravenous anaesthesia and neuromuscular blockade for laparoscopic cholecystectomy. Anaesthesia and surgery were uneventful. In the post-anesthesia care unit, the patient developed acute respiratory distress and was admitted to the intensive care unit (ICU) for mechanical ventilation. He recovered respiratorically and was released from the ICU after four days. Risks associated with anaesthesia in patients with neurodegenerative disorders should be considered before performing surgery.

[Iatrogenic clinically cardiac arrest after administration of nitroglycerin].

This case report highlights the importance of preload in cardiac tamponade, as cardiac arrest with pulseless electrical activity was unintentionally induced after sublingual administration of nitroglycerin in an 83-year-old woman with unrecognised haemopericardium. Cardiac tamponade is a life-threatening condition, as accumulation of fluids in the pericardial sac diminishes preload which can ultimately lead to cardiac arrest. Primary elements in the development of critical haemodynamic tamponade are rate of fluid-accumulation and compensatory mechanisms, mainly tachycardia and vasoconstriction.

[Red yeast rice as the presumed cause of acute kidney and liver failure].

Alternative medicine and food supplements are getting increasingly popular. The regulation of these remedies is lenient compared to the regulation of traditional medicine. Hence knowledge about adverse effects from alternative medicine and food supplements is scarce. This is a case report of a 65-year-old healthy male who had a daily intake of 315 mg of red yeast rice and was admitted to hospital with acute renal deficiency, hepatitis and rhabdomyolysis. This case report underlines the potential problems with these remedies, namely a lack of knowledge of adverse effects and a lack of control with the production.