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Biomedical subjects

F G Moody

Publications and source records attributed to F G Moody.

At least 37 records · Page 2Linked to original sources

Intestinal migrating myoelectric complexes in rats with acute pancreatitis and bile duct ligation.

Intestinal migrating myoelectric complexes (MMC) were studied in rats subjected to common bile duct ligation. Four pairs of bipolar electrodes were implanted on the jejunum and the ileum of 21 rats. Animals were allowed to recover 7 days before electrical recordings were made. Bile duct ligation at the entrance to the duodenum (low) or above the pancreas (high) or sham operation was performed. MMCs were recorded before and 48 and 72 hr after the operation in each animal. MMC intervals were unchanged following high ligation or sham operation. However, 48 hr after low bile duct ligation, the MMC interval (20.6 +/- 2.5 min) was significantly prolonged compared with that before ligation (14.0 +/- 1.2 min). Further prolonged intervals (28.4 +/- 4.2 min) were observed 72 hr after the ligation. There were no significant differences among the slow wave frequencies in any group of animals, being in the range of 34.1 +/- 1.1 to 36.3 +/- 1.0 cycles/min. Thus, the MMC pattern in this rat model may be affected by the development of acute pancreatitis. The mechanism(s) responsible for altering the MMC pattern are not known; however, hepatic biliary secretion alone does not appear to play a primary role.

Acute Disease↗

Alterations in rat intestinal transit by morphine promote bacterial translocation.

Translocation of enteric microorganisms from the intestinal tract to extraintestinal sites has been proposed as an early step in the development of gram-negative sepsis. This study examined the role of altered bowel transit in influencing intestinal bacteriostasis and bacterial translocation using morphine as a pharmacologic inhibitor of such transit. In the first experiment, either normal saline (N = 8) or morphine sulfate (20 mg/kg; N = 8) was injected subcutaneously. Two hours later, morphine (7.5 mg/kg) was infused subcutaneously for an additional 22 hr; control animals received saline alone. After completion of this regimen, a volume of 0.2 ml of 2.5 mM FITC dextrans (10,000 daltons) were injected intraduodenally in each group. The bowel was removed 25 min later, divided into 5-cm segments, and the content of dextrans measured. Small bowel propulsion was expressed as the geometric center of the distribution of dextrans throughout the intestine (in percentage length of small bowel). Gut propulsion was significantly reduced after morphine treatment as compared to controls (32.8 +/- 8.2% vs. 55.8 +/- 4.0%; P < 0.01). In 16 additional rats, saline or morphine was again administered as described. After 24 hr, samples were obtained from the mesenteric lymph node (MLN) complex, blood, spleen, liver, duodenum, jejunum, ileum, and cecum for standard bacteriology. The bacterial counts increased significantly in each intestinal segment following morphine treatment. Microorganisms translocated to the MLN complex in 5, and to distant sites in four of eight morphine-treated animals, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Lithotripsy in the treatment of biliary stones.

Noninvasive or minimally invasive techniques for the treatment of biliary stones have been significantly advanced in the past two decades. The least invasive, extracorporeal shock-wave lithotripsy, continues to be used successfully, not only at its earliest reported site of use in Munich, Germany, but also in numerous other centers in the world. Lithotriptors that utilize a spark gap electrode or other sources of energy to generate sound waves and imaging by radiographic and ultrasonographic targeting of stones have proved to be effective in fragmenting biliary stones (90% to 95%) that are too large or otherwise inaccessible to removal by endoscopic papillotomy. Stone clearance (53% to 90%) may require successive treatments and the removal of debris by transendoscopic or surgical means. The mortality is low (0.5%), and the post-treatment course is relatively uncomplicated in an elderly, high-risk group of patients.

Aged↗

Effect of total parenteral nutrition plus morphine on bacterial translocation in rats.

OBJECTIVE: This study tested the hypothesis that gut stasis induced by parenteral morphine sulfate (MS) leads to enhanced bacterial translocation in rats on total parenteral nutrition (TPN). SUMMARY BACKGROUND DATA: TPN and MS are common adjuncts in the care of critically ill patients. TPN is known to provoke a variable degree of translocation. MS induces gut stasis with an accompanying bacterial overgrowth. The effect of these two treatments in combination on translocation is not known. METHODS: Rats were provided with central and subcutaneous lines for the continuous infusion of nutrients and drugs, respectively. Intestinal transit was assessed by the caudal movement of a fluorescent marker intubated into the proximal duodenum. Quantitative bacteriology was carried out from various segments of the gut and from ileocecal mesenteric lymph nodes (MLN), spleen, liver, and systemic blood obtained by cardia puncture on sacrifice at 96 hours. RESULTS: Transit was unchanged by TPN alone but prolonged when given in combination with MS. Bacterial overgrowth was also enhanced by MS and increased the bacterial translocation to MLN from 50% of animals with TPN, to 100% in those receiving both TPN and MS; the colony-forming units per MLN increased from 33 +/- 14 with TPN alone to 2079 +/- 811 (STD) with TPN plus MS. Furthermore, no bacteria were found at systemic sites with TPN alone, but in 93.3% of animals receiving TPN and MS. In a subgroup of rates provided with glutamine in TPN, the TPN plus MS effects on translocation were not reversed. CONCLUSIONS: These observations demonstrate the important role that morphine plays in promoting translocation, presumably by disrupting fasting motility and enhancing bacterial overgrowth.

Animals↗

Reversibility of pancreatitis after temporary pancreaticobiliary duct obstruction in rats.

Pancreaticobiliary duct (PBD) obstruction in rats is associated with hyperamylasemia, hyperlipasemia, pancreatic edema, inflammation, and subcellular enzyme redistribution in < 24 h. The purpose of our study was to investigate whether these changes are reversible. A catheter was placed in the distal PBD and tunneled subcutaneously to the nape of the neck where flow could be controlled. The distal end was secured into the duodenum. Animals were divided into five groups: Group I, free flow for 48 h; Group II, catheter obstruction for 24 h; Group III, obstruction for 48 h; Group IV, obstruction for 24 h followed by free flow for 24 h; Group V, obstruction for 24 h followed by free flow for 48 h. After killing, amylase and lipase were measured, pancreatic water content was determined, and morphologic damage was graded blindly for edema, inflammation, acinar dilatation, and cell injury. Both groups with temporary obstruction showed less morphologic damage than groups studied directly after obstruction. Pancreatic water content was lower after reversal than after a 48-h obstruction. Serum amylase and lipase peaked after 24-h obstruction and then dropped with either treatment. We conclude that continuous obstruction causes progressive pancreatic damage, whereas releasing the obstruction results in reversal of early structural and functional changes.

Acute Disease↗

Anatomy of the bilioduodenal junction of the opossum.

Prevention of reflux is a major function of the terminal biliary duct system at its junction with the duodenum. We examined this area via scanning electron microscopy and light microscopy to explore anatomic features that might play such a role in the Virginia opossum, a species with a highly developed sphincter of Oddi (SO). The terminal apparatus, most of which consists of a dilated extramural ampulla, has a lumen with abundant folds. Mucus is produced by the lining epithelium and by a plethora of glands. Three muscle layers constitute the SO: an inner longitudinal, an outer circular, and a less consistent outermost longitudinal. The terminal apparatus forms an acute angle and narrows as it enters the duodenum; at this point, the SO becomes continuous with the muscularis externa of the intestine. Four anatomical features with potential antireflux properties may be identified: mucus production, luminal folds, and the narrow opening and oblique course of the intramural duct.

Animals↗

Influence of shock on development of infection during acute pancreatitis in the rat.

This study tested the hypothesis that hypovolemic shock elicits or promotes the development of infection during acute pancreatitis. Pancreatitis was induced in rats by ligation of the common biliopancreatic duct; nonlaparotomized animals served as controls. After 24 hr, the animals were subjected to either sham-shock (instrumented only) or to shock by withdrawal of blood through a femoral artery line by maintaining the mean arterial blood pressure at 30 mm Hg for 1 or 2 hr. After completion of the shock period, the shed blood was returned to the animal. All animals were sacrificed 24 hr later and specimens obtained from portal and systemic blood, liver, spleen, pancreas, and mesenteric lymph nodes for bacteriologic culture using standard techniques. The pancreas was also analyzed by morphometric techniques. The histologic changes of pancreatitis induced by biliopancreatic obstruction were characterized by marked edema with accompanying mild inflammation, hemorrhage, and necrosis. Concomitant with these morphologic findings was an associated translocation of enteric organisms to the mesenteric lymph nodes without spread to distant organs. Shock by itself induced only a mild edema in the pancreas and did not cause bacterial translocation. Furthermore, shock failed to aggravate the morphologic alterations of acute pancreatitis and did not promote bacterial spread to mesenteric nodes over that observed with pancreatitis alone. Thus, we conclude that periods of severe shock lasting up to 2 hr do not play a major role in the pathogenesis of infection in our model of pancreatitis.

Acute Disease↗

Bacterial flora of the gastrointestinal tract of opossums.

The bacterial flora of the stomach, small intestine, cecum and bile from 20 healthy opossums (Didelphis virginiana) captured from the wild was studied. Results showed that their gastrointestinal flora was similar to that found in other small mammals but, in addition, opossums are heavily colonized by Salmonella spp., which might adversely affect their adequacy as laboratory animals for some experimental protocols.

Animals↗

Effect of bile diversion and sphincterotomy on gallbladder muscle contractility and gallstone formation.

Feeding prairie dogs a diet rich in cholesterol induces gallstone formation that is preceded by a sustained decrease in gallbladder smooth muscle contractility. Sphincterotomy is known to prevent gallstone formation in cholesterol-fed prairie dogs. Experiments were designed to determine whether the effect of sphincterotomy is a consequence of hepatic bile diversion, and whether bile diversion prevents the altered contractility. Following sham operation, surgical biliary enteric bypass, or sphincterotomy, prairie dogs were fed a high-cholesterol or a regular diet. Gallbladder muscle contractility and the presence of crystals and stones were determined. In sham-operated animals, the cholesterol diet induced a decrease in gallbladder muscle contractility and caused the formation of cholesterol gallstones. In animals with bile diversion and sphincterotomy, the effects of cholesterol feeding were reduced or prevented. Thus, these procedures may prevent stone formation by preventing a reduction in gallbladder contractility. Contractility was depressed in animals with bile diversion fed a regular diet, compared with animals with a sham operation fed a regular diet. The mechanism for this depression may differ from that induced by the cholesterol diet. Diversion, and perhaps sphincterotomy, impairs gallbladder filling. Thus, gallbladder muscle is not stretched and does not contract against a load. This could result in a "disuse atrophy." If the results from our study apply to humans, sphincterotomy may reduce stone formation by preventing the effects of lithogenic bile on gallbladder muscle contractility and by enhancing the ability of the muscle to empty the lithogenic bile.

Animals↗

Transduodenal sphincteroplasty with transampullary septectomy for stenosing papillitis.

The papilla of Vater and its sphincter of Oddi, lying at the confluence of the bile and pancreatic ducts in man, have long been suspected as a source of upper abdominal pain. Enlarging the opening of the transpapillary segment of the bile and major pancreatic ducts by using a transduodenal sphincteroplasty with transampullary septectomy resulted in death in a patient with a peripapillary diverticulum and pancreas divisum. Eight-six patients followed for 1 to 10 years experienced a 75% success rate. Thirty-six patients had a marked stenosis of their duct of Wirsung, suggesting that their pain was primarily from the pancreas. The remainder had either a generalized narrowing (40 patients) or a normal (7 patients) papilla. Pain was not satisfactorily resolved in patients with an associated pancreas divisum, chronic pancreatitis, and recurrent episodes of acute pancreatitis with alcoholism.

Abdominal Pain↗

Stress erosive gastritis.

Bleeding from stress erosive gastritis continues to be a potential problem in critically ill and injured patients, but fortunately its incidence has decreased dramatically over the last decade. The explanation for this circumstance is probably multifactorial, but clearly relates to our increased knowledge of its pathophysiology. This understanding has led to the routine use of measures to reduce intragastric acidity (luminal acid being a prerequisite for stress ulcer to occur), coupled with improved techniques for the treatment of shock and the accompanying gastric mucosal hypoperfusion (another prerequisite for the formation of stress ulcers). A number of measures have been used to lower intragastric acidity with H2 receptor blockers emerging as the agents of choice to accomplish this goal. In the unlikely event that bleeding occurs despite these prophylactic measures, aggressive medical management will result in cessation of hemorrhage in over 80% of patients. In those few individuals requiring surgery to control bleeding, no operation has emerged as the recognized procedure of choice. Thus, we believe that a conservative operative approach is indicated in this setting and recommend vagotomy and pyloroplasty with oversewing of the bleeding erosions as appropriate therapy for most patients requiring surgical intervention.

Gastritis↗

The role of the gut in the development of sepsis in acute pancreatitis.

The pathogenesis of sepsis in acute pancreatitis is unknown. Since the intestinal tract has recently been identified as a possible source for sepsis in other conditions, we explored whether the gut may serve as a reservoir for bacteria causing systemic and pancreatic infection in acute pancreatitis. Bacterial translocation, alterations of intestinal microflora, and intestinal motility, as reflected by gut propulsion, were studied in a rat pancreatitis model. Acute pancreatitis was induced by biliopancreatic obstruction (AP); sham manipulated animals served as controls (sham). Bacteriologic cultures were obtained from various segments of the intestinal tract and from blood, liver, spleen, pancreas, and mesenteric lymph nodes 48 and 96 hr after induction of AP or sham. Bacteria were recovered from mesenteric lymph nodes of all 12 animals with AP, but only from 3/14 sham animals (P less than 0.05). Spread to distant organ sites occurred in 4 of 12 animals with AP compared to none of the sham animals (P less than 0.05). A disruption of the intestinal microflora was found in the cecum, where the gram-negative bacterial count (log/g) was significantly higher during AP when compared with sham controls: 10.62 +/- 1.04 vs 8.05 +/- 1.45 at 48 hr and 7.92 +/- 0.62 vs 6.79 +/- 0.87 at 96 hr, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

Use of a modified Ussing chamber to monitor intestinal epithelial and smooth muscle functions.

A technique that allows the simultaneous monitoring of epithelial and smooth muscle function was developed and used to study rat small intestine in vitro. A Ussing chamber was modified so that a strain gauge force transducer could be sewn to the serosal surface of an intestinal segment clamped in the chamber. The apparatus was used to monitor short-circuit current, potential difference, and resistance across the segment, and contractions of the longitudinal layer of the muscularis externa. Both spontaneous activity and responses to the application of carbachol were recorded. Carbachol applied to the serosal side induced dose-dependent increases in both short-circuit current and contractile force. The median effective doses of the two responses differed, with contractions being more sensitive to the drug. Carbachol applied to the mucosal side induced no changes in either epithelial or contractile activities. The ability of the serosal strain gauge transducer to monitor contractions faithfully was tested in an organ bath in which the gut segment was attached to an external force-displacement transducer. There was a close correlation between the dose-dependent increase in force in response to carbachol measured by the serosal transducer and that measured by the force-displacement transducer (r = 0.988). Thus our technique can be used to study simultaneously epithelial and smooth muscle functions of the intestine.

Animals↗

Salmonella infection of the biliary and intestinal tract of wild opossums.

Bacteriologic cultures were taken from the mesenteric lymph nodes, biliary tract, blood, liver, spleen and pancreas of opossums (Didelphis virginiana) obtained directly from the wild for use as research animals. The overall incidence of salmonellosis outside the intestinal tract was 61% among 18 opossums. Salmonella was recovered from the gallbladder of six (33%) animals, indicating chronic biliary tract infection. Among these six animals, translocation of Salmonella to regional lymph nodes was observed in five animals, bacteremia in three animals, and spread to liver or spleen in five animals, respectively. The biliary tract was sterile in 12 opossums (67%). In these 12 animals, bacteria were isolated from the celiac and superior mesenteric lymph nodes of five animals, the blood of two animals, and the liver and spleen of one animal, respectively. Bacteriologic cultures were obtained from the intestinal tract and from extraintestinal sites in nine opossums. Salmonella were found in the small bowel of two animals, both of which had biliary salmonellosis. In addition, Salmonella was isolated from extraintestinal organs of three animals with negative cultures from the gut. All isolates identified were: S. enterica subsp houtenae. These data establish the biliary tract of wild opossums as a reservoir for Salmonella enterica subsp houtenae which may be particularly important when opossums are used in research laboratories.

Animals↗

Choledochoduodenal flow: effect of the sphincter of Oddi in opossums and cats.

The aim of this study was to test in vivo (a) whether the sphincter of Oddi acts as a resistor or also as a pump, (b) the effect of an IV infusion of cholecystokinin (CCK) on choledochoduodenal flow, and (c) the ability of the choledochoduodenal junction to prevent duodenobiliary reflux in two animal species, opossums (n = 11) and cats (n = 8). Opossums were implanted with bipolar electrodes on the sphincter of Oddi and the adjacent duodenum. Cats were not. Experiments were performed in vivo using a propulsion evaluation system to test whether the Sphincter of Oddi was able to pump fluid from the bile duct to the duodenum against pressure gradients. In 5 opossums and 4 cats, choledochoduodenal flow was evaluated during the IV infusion of CCK (20 ng.kg-1.min-1). The opossum sphincter of Oddi moved fluid against duodenal pressure gradients of 6-45 cm H2O. The spike-burst frequency (6.4 +/- 1.7 min-1) was maximal at peak bile duct pressures and decreased as bile duct pressure decreased (4.9 +/- 1.6 min-1; P less than 0.001). Pressure pulses in the bile duct were observed at a frequency that correlated with sphincter of Oddi spike-burst frequency (r = 0.84; P less than 0.001). In cats, choledochoduodenal flow occurred only along a hydrostatic gradient; the sphincter of Oddi never acted as a pump but only as a resistor. Infusion of CCk significantly increased the frequency of sphincter of Oddi contractions in opossums, but the transfer of fluid from bile duct to duodenum was significantly reduced. In cats, the rate of fluid flow from the bile duct to the duodenum during CCK infusion did not differ from control values. Reflux of duodenal fluid into the biliary tree was never observed, even at duodenal pressures as high as 100 cm H2O. In conclusion, in vivo, the sphincter of Oddi is able to pump fluid from the bile duct to the duodenum against a pressure gradient in opossums, but, in cats, choledochoduodenal flow requires a bilioduodenal pressure gradient. The increase in sphincter of Oddi contraction frequency induced by CCK in opossums resulted in a decrease in active transsphincteric flow. Duodenobiliary reflux could not be elicited in opossums and cats under the conditions of these experiments.

Animals↗

Actin and myosin isoforms in gallbladder smooth muscle following cholesterol feeding in prairie dogs.

Gallbladder smooth muscle contractility decreases after high-cholesterol feeding in prairie dogs. This decrease is not associated with alterations in the total amounts of the contractile proteins actin and myosin. The present study was designed to determine if cholesterol feeding results in alterations in the isoforms of actin and/or myosin heavy chain in gallbladder smooth muscle. Control prairie dogs were fed a trace-cholesterol diet and test animals were fed a high (1.2%)-cholesterol diet for 8 days. Although the proportion of beta-actin was unchanged, the proportion of alpha-actin in the gallbladder was less in the animals fed the high-cholesterol diet (32.6% +/- 1.5% in the control animals and 24.6% +/- 0.4% in the diet animals). On the other hand, the proportion of gamma-actin was significantly greater in the cholesterol-fed animals. There were no significant differences in the proportions of the myosin heavy-chain isoforms between the two groups. Also, there was no change in the volume fraction of smooth muscle in the gallbladders from the two groups. Thus, cholesterol feeding induces a shift in actin isoforms at the same time that there is a decrease in contractility. Whether the altered pattern of actin isoforms is related to the functional changes remains to be determined.

Actins↗