Altered patterns of secretion of monomeric IgA and IgA subclass 1 by intestinal mononuclear cells in inflammatory bowel disease.

Intestinal mononuclear cells (MNC) from patients with inflammatory bowel disease (IBD) demonstrated altered patterns of spontaneous secretion of immunoglobulin A (IgA). Control intestinal MNC had markedly high spontaneous secretion of IgA compared to IBD intestinal MNC. Control intestinal MNC secreted predominantly dimeric IgA (only 31% monomeric IgA), whereas IBD intestinal MNC secreted increased amounts (43%-53%) of monomeric IgA. Control intestinal MNC secreted 61% IgA subclass 1 (IgA1), whereas IBD intestinal MNC secreted 71%-74% IgA1. Intestinal MNC from involved portions of resected specimens secreted more of both monomeric IgA and IgA1 than MNC from uninvolved areas of the same bowel. Therefore, intestinal MNC from involved IBD intestinal specimens secrete less total IgA but high percentages of monomeric IgA and IgA1 compared to control intestinal MNC. This could be caused by increased homing of monomeric IgA- and IgA1-producing cells into involved intestine, or the in situ proliferation of monomeric IgA and IgA1 precursor cells resulting from immunoregulatory alterations. These observations may represent the normal mucosal IgA immune response to infectious agents or inducing factors of either a primary or a secondary nature.

VoiceBak--speech for the speechless.

The use of plastics in this device has and is playing an important role. The early developmental models of Dr. Taub incorporated a lot of cutting and cementing of plastic tubes and parts in experimenting with the valve design. This provided a much needed flexibility to evolve a workable design. The units being manufactured today by LaBarge, Inc. are a product of the workability of the plastics being used. The durability, or toughness, and ease of cleaning are two important features. The molded silicone rubber parts for the fistula flanged tubes and tension collar replaced the hand-dipped latex rubber tubes. The trach interconnect assembly has replaced the metal trach tube, which was a possible source of irritation to some laryngectomees. The use of silicone rubber parts has been a major milestone in the development of the VoiceBak. For the laryngectomee who wants to talk and is psychologically motivated, the VoiceBak can mean the difference between existing and living. For this laryngectomee, the VoiceBak is truly speech for the speechless.