Main description:

This book represents the culmination of the major aspect of Dr. Margot Shiner's professional career. It was she who devised the technique of jejunal biopsy which opened up whole new fields of small intestinal research, including microbiology, immunology, histochemistry and histopathology, thus greatly expanding our knowledge of fundamental aspects of absorptive patho physiology. Later the application of electron microscopy demonstrated the individual cell with its mechanisms both for absorption and for the production of so many chemicals such as mucus, enzymes and hormones. Like the vision from the peak in Darian, it opened up new worlds. The contribution to our understanding of cell structure and function has been greater than the direct elucidation of specific diseases but nevertheless, there are pointers to different mechanisms which could have wide applications. It is a book which serves a double function: On the one hand it is highly technical and a publication for the super expert, recording new landmarks of knowledge and interpretation. On the other hand, it is a book which can indeed fire the imagination of the rising generation of gastroenterologists, paediatricians, pathologists and medical scientists. Having seen the emergence of the art and science of present-day gastro enterology within my professional lifetime and having been able to provide the facilities for her work in the very early days, it is with particular pleasure and pride that I write this foreword.

Contents:

Clinical material.- Technique of peroral jejunal biopsy.- Technique for electron microscopy.- Comparison of histology, thick and thin ultramicrotome sections and immunofluorescence.- Challenge studies.- References.- 1. Cells of the Normal Mucosa.- The enterocyte.- Crypt cells.- Precursor cells of the enterocytes.- Goblet cells.- Paneth cells.- APUD cells.- Theliolymphocytes.- The lamina propria.- Cells infiltrating the lamina propria.- Schwann cells and unmyelinated nerve fibres.- Endothelial cells.- Fibrocytes and their fibrillar processes.- References.- Select bibliography.- 2. Coeliac Disease.- Untreated.- Comparison of adult and childhood coeliac disease.- Gluten challenge in treated children with normal mucosa.- Gluten challenge in children with partial repair of the mucosa.- The correlation of structure and function in coeliac disease.- Untreated coeliac disease.- Gluten challenge after treatment with a gluten-free diet.- References.- Select bibliography.- 3. Cow's Milk Protein Intolerance (CMPI).- Untreated.- Cow's milk challenge.- Histology and immunology.- Ultrastructural observations.- Clinical, morphological and immunological correlation.- References.- 4. Protein-Energy Malnutrition (P-EM).- Histology.- Ultrastructure.- Correlation of clinical and morphological data.- References.- 5. Miscellaneous.- Malignancies.- Fine structure of involved mucosa with IPSID.- Fine structure of the mucosa in alpha-chain disease.- Fine structure of uninvolved mucosa in lymphoma.- Ultrastructural recognition of abnormal inflammatory cells.- Giardia lamblia.- Cysts.- Whipple's disease.- Acrodermatitis enteropathica.- Multiple sclerosis.- Crohn's disease.- References.