By O. J. J. Cluysenaer M.D., J. H. M. Van Tongeren M.D. (auth.)
For not less than 3 centuries, Holland has been on the centre of study on intestinal malabsorption. within the seventeenth and 18th centuries, early descriptions of coeliac illness and tropical sprue have been released via physicians expert in Holland, and it was once in 1950 that Dicke released his painstaking and very important observations that coeliac disorder in little ones was once attributable to the inges tion of wheat flour. next cautious paintings with van de Kamer and Weijers confirmed that the damaging agent used to be gluten. due to the fact that those discoveries have been made, study in intestinal malabsorption, relatively within the grownup, has endured in different centres in Holland. At Nijmegen, for instance, dr. Cluysenaer, dr. van Tongeren and their as sociates were considering long term stories of sufferers with intestinal illness for the earlier fifteen years. during this publication they describe their event of the research and therapy of 50 sufferers with the grownup type of coeliac ailment. Their monograph provides an account of the heritage, definition and occurrence of the sickness, after which is going directly to adopt a severe evaluate of the pathogenesis of the coeliac lesion. prior to embarking at the varied styles of malabsorption visible in grownup coeliac ailment, the authors describe the traditional small gut, its morphology and function.
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The hepatocytes mostly secrete bilirubin and bile acids, along with cholesterol and phospholipids; the bile duct cells secrete in particular sodium and bicarbonate. Water and solutes go passively along with the active secretion of the above mentioned organic and inorganic ions. Secretion by the bile duct cells is believed to be controlled by some intestinal hormones such as secretin and cholecystokinin (9). The bile is collected and concentrated in the gall-bladder which, if necessary, can release a large amount of bile all at once.
The direction in which the lymph flows is otherwise determined by the presence of valves in the medium-sized an~ large lymphatic vessels (286). 1 Introduction The degradation of food in the intestine is ensured by enzymatic and chemical processes. The enzymes and other substances required for this purpose are supplied by the digestive juices secreted in the gastrointestinal tract. These include saliva, gastric juice and pancreatic juice. For the emulsification of lipids and micelle formation, bile is secreted.
There are no indications SYMPATHETIC CONTROL a b c parosymp. fiber Fig. 4. Diagram of the extrinsic sympathetic control on the intestinal wall musculature and the local intrinsic reflex arc (Reproduced from Lundgren, in Pathophysiology: 618, Lippincott, 1972; with permission of the author and publishers). plexus lOcal exclto ory reflex blood-borne extrinsic excitatory cotecholamines nervous actiVIty so far that the parasympathetic exerts any influence on the blood supply (532). Secretion in the stomach is extrinsically stimulated by the parasympathetic, partly by direct stimulation of the cells of the gastric wall, but also via its influence on the gastrin production.