- Email: [email protected]
BACTERIA ON DUODENAL LYMPH FOLLICLE FROM CHILD WITH DIARRHŒA
454 trin consistently. A dose-response study should be done with i.v. somatostatin infusions in order to find out the dose at which the gastrin concentration is reduced. of Medicine and Clinical Chemistry,
Departments
Endocrinological
Section
750-14
Uppsala, Sweden
scanning electron microscope is an ideal instrument for studying such surface phenomena, because of its large sample capacity and its wide range of magnifications, and it should provide valuable information in further studies of G.A.L.T. in human disease.
GEORG HERBAI GUDMAR LUNDQUIST
University Hospital,
The
BACTERIA ON DUODENAL LYMPH FOLLICLE FROM CHILD WITH DIARRHŒA
SIR There is renewed interest in the structure and function of "gut-associated lymphoid tissue" (G.A.L.T.),’ but little is known about abnormalities of G.A.L.T. in disease. It is not uncommon, in our experience, for a lymphoid follicle to be obtained on proximal small-intestinal biopsy in childhood, We have started an electronmicroscopic study of small-intestinal mucosal lymph follicles and their overlying epithelium, and have found bacteria in a mucosal lymph follicle from the
We thank the University of London Board of Studies in Zoology for the use of their scanning electron microscope at Bedford College and Mrs Lyne Rolphe for technical assistance.
Elizabeth Hospital for Children, London E2 8PS
Queen
A. D. PHILLIPS S. J. RICE N. E. FRANCE J. A. WALKER-SMITH
IMMUNOLOGICAL DETECTION OF PHENYLALANINE HYDROXYLASE IN PHENYLKETONURIA
SIR,—We reported earlier’ that phenylalanine hydroxylase, detectable with a cross-reacting antiserum to monkey phenylalanine hydroxylase, was found in normal human fibroblasts and in liver tissue from phenylketonuria patients. However, we have now discovered, that the antiserum also contained antibodies to catalase. When these were removed by absorption, antibodies to human phenylalanine hydroxylase remained but the absorbed antiserum no longer reacted with normal fibroblasts, although reactivity with liver tissue from phenylketonuria patients remained. University Children’s Hospital,
K. BARTHOLOMÉ
69 Heidelberg,
E. ERTEL
Germany
2. Waksman, B. H. J. Immun. 1973, 25, 761. 3. Bockman, D, E., Cooper, M. D. Am. J. Anat. 1973, 136, 4. Craig, S. W., Cebra, J. J. J. exp. Med. 1971, 134, 188. 1.
455.
Bartholomé, K., Ertel, E. Lancet, 1976, ii, 862.
Medicine and the Law
Common Law Bacteria
adhering (x9400).
to
epithelium overlying lymph-
follicle
-
1. Parrott, D. M. V. Clins Gastroent.
in the ninth month of pregnancy early in 1972 in the front passenger seat of a motor car which was involved in a collision with another vehicle. Consequently the woman suffered injuries including a fractured pelvis and the unborn child also suffered injury; he was born the day after the collision, some three weeks short of full term, with skull fractures and brain damage which led to continuing brain dysfunction. The child, as infant plaintiff, suing through his mother, in 1973 began an action at common law claiming damages for personal injuries sustained while in utero as a result of the negligent driving of the vehicle in which she had not been a passenger. The driver of that vehicle, as defendant, denied negligence and denied owing any duty to the infant, and pleaded also that any damage proved was too remote in law to be recoverable, but later he admitted negligence and that the injuries were caused by the collision. In 1977 the court made an order that the issue of liability be tried first. Shortly before the hearing in February, 1978, the defendant’s solicitors wrote admitting liability and accepted that the plaintiff had a good cause of action at common law; they stated that the defendant would consent to judgement being entered for the plaintiff with costs to date, and the defendant was not present or represented at the hearing. Counsel for the plaintiff said that, until the recent admission, it appeared that the courts in England would at last have the opportunity of considering A
was
fourth part of the duodenum in a child of 22 months who had had diarrhoea for 7 months. The follicle was fixed in glutaraldehyde, post-fixed in osmium tetroxide, dehydrated in an alcohol, critically point dried in liquid carbon dioxide, and coated with gold-palladium in a sputter coater. Under a Cambridge S4-10 scanning electronmicroscope we found many rod-like bacteria on the surface epithelium overlying the lymph follicle (see figure). Some bacteria were also seen on the villi adjacent to the lymph follicle but rarely elsewhere. Remarkably, there seemed to be a preferential localisation of bacteria to the follicular region. This is interesting because there is good evidence that antigen enters through the epithelium overlying lymphoid follicles2,3 and that immunoblast cells are primed at these sites before migration to the lamina propria of the gut mucosa where they secrete immunoglobulin.4 Thus adherence of bacteria to the overlying epithelium of the lymph follicle may have significance in the pathogenesis of this child’s continuing diarrhoea.
1976, 5, 211.
Duty to Unborn Child
WOMAN
sitting
Departments
Endocrinological
Section
750-14
Uppsala, Sweden
scanning electron microscope is an ideal instrument for studying such surface phenomena, because of its large sample capacity and its wide range of magnifications, and it should provide valuable information in further studies of G.A.L.T. in human disease.
GEORG HERBAI GUDMAR LUNDQUIST
University Hospital,
The
BACTERIA ON DUODENAL LYMPH FOLLICLE FROM CHILD WITH DIARRHŒA
SIR There is renewed interest in the structure and function of "gut-associated lymphoid tissue" (G.A.L.T.),’ but little is known about abnormalities of G.A.L.T. in disease. It is not uncommon, in our experience, for a lymphoid follicle to be obtained on proximal small-intestinal biopsy in childhood, We have started an electronmicroscopic study of small-intestinal mucosal lymph follicles and their overlying epithelium, and have found bacteria in a mucosal lymph follicle from the
We thank the University of London Board of Studies in Zoology for the use of their scanning electron microscope at Bedford College and Mrs Lyne Rolphe for technical assistance.
Elizabeth Hospital for Children, London E2 8PS
Queen
A. D. PHILLIPS S. J. RICE N. E. FRANCE J. A. WALKER-SMITH
IMMUNOLOGICAL DETECTION OF PHENYLALANINE HYDROXYLASE IN PHENYLKETONURIA
SIR,—We reported earlier’ that phenylalanine hydroxylase, detectable with a cross-reacting antiserum to monkey phenylalanine hydroxylase, was found in normal human fibroblasts and in liver tissue from phenylketonuria patients. However, we have now discovered, that the antiserum also contained antibodies to catalase. When these were removed by absorption, antibodies to human phenylalanine hydroxylase remained but the absorbed antiserum no longer reacted with normal fibroblasts, although reactivity with liver tissue from phenylketonuria patients remained. University Children’s Hospital,
K. BARTHOLOMÉ
69 Heidelberg,
E. ERTEL
Germany
2. Waksman, B. H. J. Immun. 1973, 25, 761. 3. Bockman, D, E., Cooper, M. D. Am. J. Anat. 1973, 136, 4. Craig, S. W., Cebra, J. J. J. exp. Med. 1971, 134, 188. 1.
455.
Bartholomé, K., Ertel, E. Lancet, 1976, ii, 862.
Medicine and the Law
Common Law Bacteria
adhering (x9400).
to
epithelium overlying lymph-
follicle
-
1. Parrott, D. M. V. Clins Gastroent.
in the ninth month of pregnancy early in 1972 in the front passenger seat of a motor car which was involved in a collision with another vehicle. Consequently the woman suffered injuries including a fractured pelvis and the unborn child also suffered injury; he was born the day after the collision, some three weeks short of full term, with skull fractures and brain damage which led to continuing brain dysfunction. The child, as infant plaintiff, suing through his mother, in 1973 began an action at common law claiming damages for personal injuries sustained while in utero as a result of the negligent driving of the vehicle in which she had not been a passenger. The driver of that vehicle, as defendant, denied negligence and denied owing any duty to the infant, and pleaded also that any damage proved was too remote in law to be recoverable, but later he admitted negligence and that the injuries were caused by the collision. In 1977 the court made an order that the issue of liability be tried first. Shortly before the hearing in February, 1978, the defendant’s solicitors wrote admitting liability and accepted that the plaintiff had a good cause of action at common law; they stated that the defendant would consent to judgement being entered for the plaintiff with costs to date, and the defendant was not present or represented at the hearing. Counsel for the plaintiff said that, until the recent admission, it appeared that the courts in England would at last have the opportunity of considering A
was
fourth part of the duodenum in a child of 22 months who had had diarrhoea for 7 months. The follicle was fixed in glutaraldehyde, post-fixed in osmium tetroxide, dehydrated in an alcohol, critically point dried in liquid carbon dioxide, and coated with gold-palladium in a sputter coater. Under a Cambridge S4-10 scanning electronmicroscope we found many rod-like bacteria on the surface epithelium overlying the lymph follicle (see figure). Some bacteria were also seen on the villi adjacent to the lymph follicle but rarely elsewhere. Remarkably, there seemed to be a preferential localisation of bacteria to the follicular region. This is interesting because there is good evidence that antigen enters through the epithelium overlying lymphoid follicles2,3 and that immunoblast cells are primed at these sites before migration to the lamina propria of the gut mucosa where they secrete immunoglobulin.4 Thus adherence of bacteria to the overlying epithelium of the lymph follicle may have significance in the pathogenesis of this child’s continuing diarrhoea.
1976, 5, 211.
Duty to Unborn Child
WOMAN
sitting