Lower extremity manifestations of nutritional deficiencies in gastrointestinal disease.

Voluminous information can be written on the nutritional deficiencies that are secondary to gastrointestinal disease. This highly complicated system, with its immunologic pathogenesis, can affect every system of the body. This article describes how these manifestations of gastrointestinal disease affect the lower extremities.

Effect of nutrient deprivation on lipid, carbohydrate, DNA, RNA, and protein levels in Vibrio cholerae.

The response of Vibrio cholerae to low nutrient levels was determined by measuring the concentrations of lipids, carbohydrates, DNA, RNA, and proteins over a 30-day starvation period. Ultrastructural integrity was observed by transmission electron microscopy. Total lipids and carbohydrates declined rapidly within the first 7 days, while DNA and protein exhibited a more constant decline over the 30 days of starvation. In contrast, RNA showed little decrease upon starvation. Although neutral lipids were lost, the percentage of neutral lipids did not decline as rapidly as the phospholipids. Detectable levels of poly-beta-hydroxybutyrate disappeared completely by 7 days. Carbohydrate profiles revealed the relative loss of the five-carbon sugar ribose and N-acetylglucosamine and a relative increase in the total six-carbon sugars, especially glucose. Morphologically, ribosomes appeared to exhibit no structural change, while inclusion bodies and mesosomelike structures disappeared completely, and cell wall and membrane integrity was lost. The data suggest that V. cholerae differs somewhat from other marine vibrios in its response to low nutrients but shares some characteristics in common with them. The data also suggest that certain lipids and carbohydrates may provide the endogenous energy sources needed for dormancy preparation and cell maintenance under nutrient starvation.

Isolation and characterization of a new Cytophaga species implicated in a work-related lung disease.

A yellow-pigmented, gram-negative, gliding bacterium isolated from an industrial water spray air humidification system was implicated as a causative agent in several occurrences of lung disease with hypersensitivity pneumonitis-like symptoms. The bacterium, designated WF-164, lacked microcysts or fruiting bodies and had a DNA base composition of 34.8 mol% of guanine plus cytosine. Gliding, flexing, nonflagellated cells measuring 0.3 by 3.5 to 8.9 micron were observed by using light and electron microscopy. Tests to determine utilization of selected carbohydrates revealed an amylolitic, chitinoclastic, noncellulytic bacterium. A number of additional biochemical and physiological tests were performed. DNA homology studies detected a 77.8% similarity to Cytophaga aquatilis (ATCC 29551). Comparisons of cellular fatty acid and carbohydrate contents of isolate WF-164 with a Flexibacter sp., several Cytophaga spp., and Flavobacterium reference strains revealed similar patterns to that of C. aquatilis. On the basis of these characteristics, isolate WF-164 was identified as a new Cytophaga sp.

Bacterial endotoxin isolated from a water spray air humidification system as a putative agent of occupation-related lung disease.

Outbreaks of hypersensitivity pneumonitis or humidifier fever were attributed to the inhalation of organic material aerosolized by a chilled-water spray humidification system. The purpose of this study was to isolate and characterize the serologically detectable antigen(s) present in extracts obtained from the humidification system. By using bicarbonate or phenol-water extractions or both, the antigen was isolated and characterized, using colorimetry, gas-liquid chromatography, reverse-phase high-performance liquid chromatography, and X-ray fluorescence. Carbohydrates, hexosamines, phosphorus, and even-numbered saturated and unsaturated fatty acids were constituents of the serologically detectable antigen. When tested in in vivo and in vitro assays, the antigen had demonstrable endotoxin activity. All subjects with biopsy-proven lung disease and a majority of subjects suspected of having lung disease had antibodies directed toward the purified endotoxin. The data strongly suggest that an aerosolized bacterial endotoxin is a putative agent inducing lung disease.

A Cytophaga species endotoxin as a putative agent of occupation-related lung disease.

A previous study suggested that a biologically active bacterial endotoxin was a putative agent of lung disease in a textile-producing facility. The endotoxin was isolated from the biomass growing in a chilled-water spray air humidification system. The bacterial flora of the air humidification system were isolated and taxonomically identified to the genus level. By using indirect immunofluorescence assays, a serologically reactive Cytophaga species was identified. A serologically reactive, biologically active (Limulus assay) endotoxin was purified from phenol extracts of the Cytophaga species. The endotoxin contained sugars, hexosamines, and lipids identical to those found in the humidifier biomass endotoxin. All subjects with biopsy-proven and suspected lung disease had antibodies directed toward the purified Cytophaga endotoxin. The data suggest that the Cytophaga endotoxin is the putative agent of lung disease in the textile facility.