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World Journal of Gastroenterology 2013年第21期19卷 3281-3290页

作者： Manar E Selim Laila Y Al-Ayadhi Zoology Department Faculty of ScienceKing Saud UniversityAutism Research and Treatment CentreRiyadh 11459 Saudi Arabia Zoology Department Faculty of ScienceAin Shams UniversityCairo 11511Egypt Physiology Department Faculty of MedicineKing Saud UniversityAutism Research and Treatment CentreRiyadh 11459Saudi Arabia

AIM: To examine the possible ameliorative effect of breastfeeding and the uptake of human colostrum against coeliac disease in autistic rats. METHODS: Female rats were fed a standard diet and received a single intraperitoneal injection of 600 mg/kg sodium valproate on day 12.5 after conception. In study 1, neonatal rats were randomly subjected to blood tests to investigate autism. In study 2, the 1st group was fed by the mother after an injection of interferon-γ (IFN-γ) and administration of gliadin. The pups in the 2nd group were prevented from accessing maternal milk, injected IFN-γ, administered gliadin, and hand-fed human colostrum. The normal littermates fed by the table mothers were injected with physiological saline and served as normal controls in this ***: The protein concentration was higher in group 2 than in group 1 in the duodenum (161.6 ± 9 and 135.4 ± 7 mg/g of tissue, respectively, P coeliac disease. CONCLUSION: The effects of early-life nutrition and human colostrum on the functional maturation of the duodenal villi in autistic rats with coeliac disease that might limit or prevent the coeliac risk with autism.

关键词： Autism Breastfeeding coeliac disease Human colostrum

Pancreaticoduodenal artery aneurysm associated with coeliac artery occlusion from an aortic intramural hematoma

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World Journal of Gastroenterology 2016年第16期22卷 4259-4263页

作者： Akihiko Sakatani Yoshinori Doi Toshiaki Kitayama Takaaki Matsuda Yasutaka Sasai Naohiro Nishida Megumi Sakamoto Naoto Uenoyama Kazuo Kinoshita Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Department of Gastroenterology Otemae Hospital Department of Radiology Otemae Hospital

Pancreaticoduodenal artery aneurysms are a rare type of visceral artery aneurysm, whose rupture is associated with high mortality. These aneurysms are of particular interest because local haemodynamic change caused by coeliac artery obstruction plays an important role in their development. However, the pathophysiological mechanism of coeliac artery obstruction is not completely understood. Pressure from the median arcuate ligament is most frequently reported cause. Although it is well-known that stenosis or occlusion of the visceral vessels may be caused by aortic syndrome, reports of pancreaticoduodenal artery aneurysm associated with coeliac artery occlusion due to aortic syndrome are extremely rare. Our case indicates a new aetiology for a pancreaticoduodenal artery aneurysm and demonstrates the rapid deterioration of the patient affected.

关键词： Pancreaticoduodenal artery coeliac artery Visceral artery aneurysm Aortic dissection

coeliac disease in children in Christchurch,New Zealand:Presentation and patterns from 2000-2010

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World Journal of Clinical Pediatrics 2015年第4期4卷 148-154页

作者： Adeline Kho Martin Whitehead Andrew S Day Department of Paediatrics University of Otago Department of Pathology University of Otago

AIM: To evaluate the presentation patterns of a cohort of children diagnosed with coeliac disease(CD) at Christchurch Hospital, New ***: Children aged 16 years or less diagnosed with CD at Christchurch Hospital, Christchurch, New Zealand, over the 11 year period between 2000 and 2010 were identified retrospectively. Diagnosis of CD was based upon standard histological criteria of endoscopically-obtained duodenal biopsies. Overlapping search methods were used to identify all relevant diagnoses within the time period. Endoscopy reports and histology findings were reviewed to confirm diagnosis. The numbers of diagnoses per year were calculated and changes in annual rates over the study period were delineated. Available records were reviewed to ascertain presenting symptoms, baseline anthropometry and the indication for referral for each child. In addition, the results of relevant investigations prior to diagnosis were accessed and reviewed. These key investigations included the results of coeliac serology testing(including tissue transglutaminase and endomysial antibodies) as well as the results of tests measuring levels of micronutrients, such as iron. In addition, the histological findings of concurrent biopsies in the oesophagus and stomach were reviewed. RESULTS: Over the 11 year study period, 263 children were diagnosed with CD at this New Zealand paediatric facility. Children were diagnosed from late infancy to 16.9 years: the largest subgroup of children(n = 111) were diagnosed between 5 and 12 years of age. The numbers of children diagnosed each year increased from 13 per year to 31 per year over the 11 years(P = 0.0095).Preschool children(aged less than 5 years) were more likely to have low weight, and to have diarrhoea and abdominal pain prior to diagnosis. Older children(over 5 years of age) most commonly presented with abdominal pain. Fifty-six(21.6%) of the 263 children were diagnosed following screening in high risk groups, with 38 of these ch

关键词： coeliac disease Children Screening Small bowel biopsy Antibodies

From 2-dimensional to 3-dimensional: Overcoming dilemmas in intestinal mucosal interpretation

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World Journal of Gastroenterology 2019年第20期25卷 2402-2415页

作者： Richard PG Charlesworth Michael N Marsh School of Science and Technology University of New EnglandArmidaleNSW 2351Australia Wolfson College University of OxfordOxford OX2 6UDUnited Kingdom

The purpose of this review is to provide a definitive account of small intestinal mucosal structure and interpretation. The coeliac lesion has been well known, but not well described to date and this review aims to identify the interpretative difficulties which have arisen over time with the histological assessment of coeliac disease. In early coeliac interpretation, there were significant inaccuracies, particularly surrounding intraepithelial lymphocyte counts and the degree of villous flattening which occurred in the tissue. Many of these interpretive pitfalls are still encountered today, increasing the potential for diagnostic errors. These difficulties are mostly due to the fact that stained 2-dimensional sections can never truly represent the 3-dimensional framework of the intestinal tissue under investigation. Therefore, this review offers a critical account occasioned by these 2-dimensional interpretative errors and which, in our opinion, should in general be jettisoned. As a result, we leave a framework regarding the true 3-dimensional knowledge of mucosal structure accrued over the 70-year period of study, and one which is available for future reference.

关键词： coeliac disease Histology Diagnosis 2-dimensional 3-dimensional

Targeted genotyping for the prediction of celiac disease autoimmunity development in patients with type 1 diabetes and their family members

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World Journal of Diabetes 2019年第3期10卷 189-199页

作者： Maureen M Leonard Stephanie Camhi Victoria Kenyon Rebecca A Betensky Craig Sturgeon Shu Yan Alessio Fasano Mucosal Immunology and Biology Research Center Mass General Hospital for Children Boston MA 02115 United States Center for Celiac Research and Treatment Mass General Hospital for Children Boston MA 02115 United States Department of Pediatric Gastroenterology and Nutrition Mass General Hospital for Children Boston MA 02114 United States Department of Biostatistics Harvard T.H. Chan School of Public Health Boston MA 02115 United States

BACKGROUND Patients with type 1 diabetes (T1D) and their first-degree relatives (FDRs) have an increased risk of developing celiac disease (CD) compared to the general population. This is largely explained by the shared association with major histocompatibility class II human leukocyte antigen (HLA) DQ2 and/or DQ8 between the two disease states. AIM To describe the frequency of CD autoimmunity (CDA) and the distribution of HLA and haptoglobin genotypes in patients with T1D and their FDRs. Additionally, we aimed at identifying predictors associated with an increased risk of developing CDA in patients with T1D and their family members. METHODS We obtained clinical information and blood samples from 1027 participants (302 with T1D and 725 FDRs) over a five-year period. Samples were tested for autoantibodies associated with CD, HLA-DQ alleles, and haptoglobin *** fit univariate and multiple logistic regression models for CDA separately for subjects with T1D and for FDRs of subjects with T1D. RESULTS Implementation of a screening program increased the frequency of CDA by 2- fold in participants with T1D and 2.8-fold in their FDRs. Multivariate analysis found that, in participants with T1D, having both DR7-DQ2 and DR4-DQ8 was associated with an increased frequency of CDA. In FDRs of T1D patients, reported CD in the family was associated with an increased frequency of CDA during screening. Haptoglobin 2 genotype was not associated with developing CDA in the multivariate analysis. CONCLUSION Patients with T1D and their FDRs have a high frequency of CDA. Carrying both DR7-DQ2 and DR4-DQ8 was associated with development of CDA in patients with T1D.

关键词： Screening Gluten Diabetic coeliac Haptoglobin Human leukocyte antigen

Rheological, Organoleptical and Quality Characteristics of Gluten-Free Rice Cakes Formulated with Sorghum and Germinated Chickpea Flours

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Food and Nutrition Sciences 2017年第5期8卷 535-550页

作者： Mohamed G. E. Gadallah Department of Food Science Faculty of Agriculture Ain Shams University Cairo Egypt

Gluten-free bakery products are produced for people suffering from celiac disease due to sensitivity to gluten. So, the aim of this work was to study the effect of partial substitution of rice flour at 20%, 30% and 40% with sorghum and germinated chickpea flours on rheological, physical, sensory properties and staling rate of prepared gluten-free cake. Obtained results showed that germinated chickpea flour had the highest contents of crude protein (23.62%), lipids (4.89%) and crude fibers (5.76%) as compared to other grain flours. Gradual increase in gelatinization temperature and decrease in maximum viscosity and setback were fond of cake batters with increasing the substituting levels of rice flour from 20% to 40% with sorghum or germinated chickpea flours in comparison to rice flour batter. No significant difference was observed in specific volume between rice cake and cake containing 20% of germinated chickpea and sorghum flours which given 2.71, 2.62 and 2.56 cm3/g, respectively. Data also revealed that gluten-free cake lightness (L*) and total intensity significantly increased with 40% of sorghum flour followed by 30 and 20% of sorghum flour. Substitution of 40% rice flour with germinated chickpea flour resulted in significant high in redness (a*), yellowness (b*) and chroma of gluten-free cake being 11.95, 33.72 and 35.77, respectively followed by substituted levels 30% and 20% which attributed to their natural yellow pigments compared with other investigated samples. Overall acceptability of gluten-free cakes was improved after adding 20, 30% of sorghum flour and 20% of germinated chickpea flour which being 90.7, 88.6 and 87.5, respectively compared to rice flour cake (88.4). Rice flour cake was more freshness than wheat flour cake and other treatments during storage duration. After 6 days, rice cake had significant high freshness (306.2%) followed by gluten-free cake samples with 20% of sorghum or germinated chickpea flours which given 294.5% and 289.4%, re

关键词： coeliac Disease Gluten-Free Cake Sorghum Flour Germination Chickpea Flour

Utilization of Different Hydrocolloid Combinations in Gluten-Free Bread Making

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Food and Nutrition Sciences 2013年第5期4卷 496-502页

作者： Sofyan Maghaydah Selma Abdul-Hussain Radwan Ajo Yousef Tawalbeh Ola Alsaydali Applide Science Department Al-Huson University Collage Al-Balqa Applied University Al-Huson Jordan. Departement of Nutrition and Food Technology Faculty of Agriculture Jordan University of Science and Technology Irbid Jordan Deptartment of Food Science and Biotechnology College of Agriculture University of Baghdad Baghdad Iraq

coeliac disease (CD) is a common lifelong disorder with small bowel malabsorption and gluten intolerance. The only effective treatment for CD is a strict lifelong renunciation of gluten-containing foods. Currently, the cereal products designed to meet the requirements of CD patients, especially gluten-free bread, are scarce, of low quality and poor flavor. Therefore, preparation of high quality and affordable bread for coeliac patients was the main objective of this study. Three kinds of gluten-free bread were prepared, in which wheat flour was substituted with rice and corn flour at a ratio of 5:1, respectively. Gluten was substituted using different hydrocolloids: 1% xanthan and 1% carrageenan (Mix A), GFB A;1% xanthan and 1% pectin (Mix B), GFB B;and 1% carrageenan and 1% pectin (Mix C), GFB C. These three types of bread were compared to control bread produced from wheat flour (WB). Sponge and dough method with some modifications was used to produce the bread samples with a developed formula (0.8% yeast, 4.0% sugar, 2% salt, 7.0% shortening, 2.0% non-fat dry milk, and 1% sodium stearoyl lactylate (SSL)). Determination of the chemical composition, rheological properties and physical characteristics, as well as sensory evaluation of the bread samples, was undertaken. Results showed that the moisture content of WB bread (control) was significantly lower than that of all types of gluten-free bread, and there was no significant difference in ash, protein, and lipid contents among the gluten-free bread samples. GFB A, GFB B and GFB C displayed no significant differences in their specific volumes. The sensory evaluation showed that GFB C received the lowest sensory evaluation score. Therefore, GFB A and GFB B were the best gluten-free samples.

关键词： coeliac Disease (CD) Gluten-Free Bread (GFB) Xanthan Carrageenan Pectin

Is there a role for arterial reconstruction in surgery for pancreatic cancer?

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World Journal of Gastrointestinal Surgery 2013年第3期5卷 27-29页

作者： Reena Ravikumar David Holroyd Giuseppe Fusai Department of Hepatopancreato-biliary and Liver Transplant Surgery Royal Free London Hospital NHS Foundation Trust

Surgery remains the only potentially curative treatment for patients with pancreatic cancer. Locally advanced pancreatic cancer with vascular involvement remains a surgical challenge because high perioperative risk and the uncertainty of a survival benefit. Whilst portal vein resection has started to gather momentum because the perioperative morbidity and long term survival is comparable to standard pancreatectomy, there isn't yet a consensus on arterial resections. There have been various reports and case series of arterial resections in pancreatic cancer, with mixed survival results. Mollberg et al have appraised the heterogeneous published literature available on arterial resection in pancreatic cancer in an attempt to compare this to standard pancreatectomy. In this article, we discuss the results of this systematic review and meta-analysis, and the limitations associated with analysing results from heterogenous data. We have outlined the important features in surgery for pancreatic cancer and specifically to arterial resections, and compared arterial resections to the published literature on venous resections.

关键词： Arterial resection Pancreatic cancer Vascular resection Hepatic artery coeliac axis Pancreatectomy

Dyspepsia and celiac disease: Prevalence, diagnostic tools and therapy

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World Journal of Methodology 2014年第3期4卷 189-196页

作者： Laura Petrarca Raffaella Nenna Gerarda Mastrogiorgio Matteo Florio Manuela Brighi Stefano Pontone Department of Pediatrics "Sapienza" University of Rome Department of Surgical Sciences "Sapienza" University of Rome

The prevalence of dyspepsia is up to 40% in population-based study. Functional dyspepsia is an exclusion diagnosis and it is classified as a chronic abdominal pain-related functional disorder, characterized by the presence of persistent or recurrent pain or discomfort centered in the upper abdomen, neither relief by defecation, nor association with the onset of a change in stool frequency or form. Celiac disease(CD) is a common autoimmune enteropathy, with a prevalence around 1% in the general population. Its diagnosis includes a serological screening and an upper gastrointestinal endoscopy with multiple biopsies. Gluten-free diet is the only effective treatment. CD diagnosis is often delayed in asymptomatic patients or in individuals with less clinical gastrointestinal symptoms. Several studies performed coeliac disease screening in patients with symptoms suggestive of dyspepsia, showing a biopsy-proved prevalence that ranged from 0.5% to 2%. The typical endoscopic markers of villous atrophy are not sufficiently sensitive, so some endoscopic techniques, such as "water immersion" and confocal endomicroscopy were proposed to improve the diagnosticsensitivity and target biopsies. A recent meta-analysis estimated that the prevalence of CD was higher in patients with dyspepsia, but not in a statistically significant way. However this assumption should be confirmed further larger studies.

关键词： Dyspepsia coeliac disease Upper endoscopy Villus atrophy Screening