Gastritis, peptic ulcer disease, inflammatory bowel disease, and stomach and colon cancers- are they all caused by viral infections?

It is hypothesized that chronic gastritis and ulcerative colitis both are induced by viral infection, and that such chronic infection of the mucosa may lead to ulceration and occasionally cancer. Duodenal ulcer disease and Crohn's disease may on the other hand, be due to activation of latent viral infection of the corresponding neural ganglions, with subsequent migration of virus along the nerves to the gut wall. The gastric acid hypersecretion often occurring in patients with duodenal ulcer disease might be a consequence of viral interference with the efferent nerve function of vagal ganglions. Correspondingly, non-ulcer dyspepsia as well as irritable colon may reflect viral infection of afferent nerve function leading to pain and discomfort.

Cytopathic effects in cultures inoculated with material from Crohn's disease

Rectal biopsy homogenates, faecal samples, and leucocyte rich plasma obtained from 39 patients were inoculated into tissue cultures. A non-transmissible cytopathic effect was observed in cultures inoculated with material from patients with Crohn's disease. In a blind study this cytopathic effect was observed in three specimens from three patients with Crohn's disease, in six specimens from four patients with ulcerative colitis, and six specimens from five patients with upper gastrointestinal disease. The cytopathic effect is unlikely to be associated with the bowel diseases tested. These results are also consistent with the failure of others to isolate a virus by the techniques used. With the limited range of techniques used no evidence was obtained to implicate conventional viruses in the pathogenesis of Crohn's disease.

Recontamination after gastrointestinal decontamination with non-absorbable antibiotics

In an attempt to restore the colonization resistance we administered anaerobic microflora to prevent an abnormal colonization of the intestine after antibiotic treatment had been discontinued. After the antibiotics had been discontinued and before the donor flora had been administered and had colonized the intestine, microorganisms present were "unopposed" and expanded to a high density. A mouse model was used to investigate which antibiotics negatively influenced the donor flora and reduced the colonization resistance when administered intraperitoneally. Erythromycin, clindamycin and carbenicillin suppressed the donor flora permanently, as could be seen by the reduced colonization resistance. Benzylpenicillin, ampicillin, doxycycline and the combination gentamicin-cephalothin affected the colonization resistance as long as these agents were present. Gentamicin alone and cephalothin and oxytetracycline had no effect on the colonization resistance.

Yersinia enterocolitica: its isolation by cold enrichment from patients and healthy subjects

Routine culture and cold enrichment were compared in a prospective study on the isolation of Yersinia enterocolitica from patients with intestinal disease. Healthy controls were examined with the cold enrichment method only. Y enterocolitica was isolated from 5.9% of 1635 patient stools, 3.4% of 206 appendices, and 4.0% of 555 control stools. Serotypes 0:3 and 0:9 were eight times more prevalent in patients than in controls. Other serotypes were twice as prevalent in controls than in patients. Cold enrichment did not significantly increase the recovery of serotypes 0:3 and 0:9 in acute enteritis, but it was responsible for all isolates of the other serotypes. Evidence is presented that the other serotypes are not pathogenic. In patient stools, Y enterocolitica was demonstrated less frequently than Salmonella (9.1%), and more often than Campylobacter jejuni (1.8%) and Shigella (0.1%).

A prospective study of rotavirus infection in infants and young children

Diarrhea in neonates, followed as a cohort, and their families was studied prospectively. The families were followed for an average of 16.3 months. Stool and serum specimens were obtained at least every three months. Stool specimens were examined for viruses by electron microscopy and cultured for enteropathogens, and serum specimens were tested for antibodies to rotavirus and Norwalk virus. During the study, 237 episodes of gastroenteritis were observed in 104 infants and their 62 siblings. Rotavirus, detected 82 times in 72 children, was by far the most common enteropathogen. It was associated with gastrointestinal symptoms in 72% (with diarrhea in 65%). Rotavirus diarrhea occurred mostly in winter months and was significantly more frequently associated with respiratory symptoms than were diarrheas with other etiologies. Rotavirus infection was uncommon in the first six months of life, but by two years of age, 62% of the infants had had at least one infection. Neither breast feeding nor the presence of antibody to rotavirus in cord blood appeared to be protective.

Serum agglutinins to Eubacterium and Peptostreptococcus species in Crohn's and other diseases

Sera from patients suffering from Crohn's and other diseases and from healthy subjects were tested for agglutinins to anaerobic, gram-positive coccoid rods belonging to species of Eubacterium and Peptostreptococcus. Four strains labelled Eubacterium contortum (two strains), Eubacterium rectale and Peptostreptococcus productus were agglutinated by a higher percentage of sera from patients with Crohn's disease than from healthy subjects and from patients with liver and intestinal diseases (including ulcerative colitis), ankylosing spondylitis, granulomatous diseases, diseases of immunity and malignancies. The agglutinins were of the IgG and IgM classes and strain-specific; the titres were low. The results obtained with sera from patients with Crohn's disease and healthy people were subjected to discriminant analysis to estimate the probability, based on the combined results with the four strains, that a patient suffers from Crohn's disease. When sera giving an a posteriori probability greater than or equal to 0.95 (a priori probability = 0.5) were considered positive, the test with four strains had a sensitivity of 54% and a specificity of nearly 100%. The results with sera submitted for diagnosis showed that positive reactions in patients with a diagnosis apparently incompatible with Crohn's disease were within acceptable limits.

Laboratory diagnosis of Johne's disease: a potential source of error

Gastrointestinal tract tissues from cattle with suspected clinical Johne's disease (JD), in which acid-fast bacilli were not identified in mucosal smears, were examined histopathologically. Twenty-two per cent were positive and 4 per cent were suggestive of JD. Failure to identify mycobacteria in mucosal smears appeared to result from the presence of mild, often focal mucosal lesions which contained relatively few bacilli. Ten of the 22 histopathologically positive cases had complement fixation titres for JD but several false-positive titres also occurred.

[Halophilic Black Sea vibrios and their role in human pathology]

During the period of 4 years 558 halophil vibrio strains (258 V. parahaemolyticus strains and 300 V. angiolyticus strains) were isolated from the water and from the representatives of the hydrobios of the Black Sea. The vibrios were isolated the whole year round, but during the winter and spring months their lowest concentration in water was observed, while in September-October it reached its maximum. During these 4 years 102 cases of gastroenteric diseases were registered, and in some of the patients halophil vibrios were isolated. In most cases the diseases developed after the consumption of sea fish and other sea products, as well as salted vegetables. The diseases had mainly a sporadic character. 90% of the strains isolated from humans belonged to serotypes O4 : K12 and O4 : K8; besides, the presence of serotypes O3 : K33, O3 : K57, O5 : K47, O6 : K46 and O10 : K52 was revealed.

Chlamydiae and inflammatory bowel disease

No association was found between inflammatory bowel disease and infection with C. trachomatis or C. psittaci when patients were tested for the presence of these organisms using immunohistological, cell culture isolation, and serological techniques.

[Clinical significance of virus diseases]

After introductory explanations the following topics are treated: acute respiratory diseases, virus infections of the central nervous system and virus infections of the intestine. In the last paragraph the present state of virus-diagnostic possibilities is described. From this is derived that the routine use of modern virus diagnostics brings great advantages for the clinician. The intensive construction of virological laboratories for the treatment of patients is emphasized.

Cell-mediated immunity to intestinal infection

Specified pathogen-free B6D2F1 mice were orally infected with various doses of Listeria monocytogenes. Oral inocula containing more than 2.5 X 10(8) live organisms consistently initiated infection in the Peyer's patches (PP) of the small intestine. At lower doses the infection was sporadic, with many mice showing no apparent infection in the PP. The PP appeared to be the only site of tissue invasion and L. monocytogenes survival in the intestinal tissues, as no organisms were recovered from mucosa dissected free of all visible PP. Within the PP, the bacteria multiplied and the infection then disseminated to the mesenteric lymph node (MLN), liver, and spleen. However, bacteria were almost completely eliminated from all tissues, both systemic and gut-associated by 6 days postinfection. Mice given a primary L. monocytogenes infection by the oral route were highly resistant to subsequent intravenous or oral challenge. Likewise, sublethal intravenous infection rendered mice highly resistant to subsequent oral infection. In addition, lymphocytes from the PP, MLN, and spleens of mice recovering from a primary oral infection were able to adoptively transfer immunity to normal recipients. Finally, after oral infection, mice did not display peripheral delayed hypersensitivity to L. monocytogenes antigens until the organisms had penetrated to the spleen.

Symposium: disease prevention in calves. Factors affecting susceptibility of calves to disease

Enteric and respiratory disorders are the main hazards to successful calf rearing. The many interrelated factors in the etiology of these disorders are reviewed, and an attempt has been to classify the factors into those of a microbiological, immunological, nutritional, genetic, physical, or psychological nature. No one would dispute that enteric and respiratory disorders are the two main hazards to calf health, but many would argue about the relative importance of specific pathogens and other predisposing factors in the etiology of these disorders.

The rôle of Chlamydia trachomatis in genital-tract and associated diseases

Images

Yersinia enterocolitica in adults with gastrointestinal disturbances: need for cold enrichment

In a survey of hospitalized adults, cold enrichment of feces resulted in an incidence rate of Yersinia enterocolitica equal to that of Salmonella spp. Y. enterocolitica was not recovered by routine procedures.

Nonvalue of cold enrichment of stools for isolation of Yersinia enterocolitica serotypes 3 and 9 from patients

During an 8-year period 14,092 fecal specimens and 1,428 excised appendixes were examined for the presence of Yersinia enterocolitica, with different combinations of direct plating media and enrichment techniques. The combination of direct plating on SS agar and 2 days of enrichment in a modified Rappaport broth at room temperature resulted in the isolation of 100% of serotype 3 and 9 strains. Such strains were recovered from 3.7% of our fecal specimens. Cold enrichment in phosphate buffer further increased the isolation rate, but the additional isolates all belonged to biotype 1. Evidence is presented that biotype 1 strains, at least in Belgium, are not pathogenic for humans. There was a significant affinity of serotype 9 strains for patients suffering from an "appendicular syndrome."