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At least 217 records · Page 12Linked to original sources

The usefulness of dynamically balanced FFE WATS-MR imaging with kinematic display for studying pediatric gastrointestinal disease.

Abnormalities in gastrointestinal movement underlie various symptoms in the pediatric population. Although fluoroscopic, manometry, and ultrasonography remain important tools for studying gastrointestinal movement, none can depict the whole gastro-intestine full-size without radiation. The purpose of this study was to evaluate whether kinematic water selective excitation MR imaging (WATS-MR cine) could reveal gastrointestinal movement in childhood. Thirty-six patients (age: 3 to 17 years; 15 male and 22 female) underwent dynamically balanced first field echo (FFE) imaging with a thick slice of water selective excitation without breath hold. The WATS-MR cine was taken at three different times (preprandial, immediately postprandial, and 30-min postprandial) for sequential 5 min. Images were displayed in a cine mode at 10 times the normal speed, and the motion of water in each organ was evaluated. Movement of the stomach, small intestine, and colon could be observed together in a field. This study made it possible to evaluate both preprandial and postprandial gastrointestinal water movement. WATS-MR cine is useful for visualizing gastrointestinal water movement in accessible children older than 6 years without sedation. A cine mode at 10 times the normal speed provided characteristic images reflecting gastrointestinal water movement abnormalities in pediatric patients.

Abdominal Pain↗

Review article: manipulation of cell death--the development of novel strategies for the treatment of gastrointestinal disease.

The mechanisms underlying cell death are reviewed in order to propose new targets for the therapy of gastrointestinal disease. Necrosis is a set of precise biochemical and cellular lesions which culminate in cell destruction. A number of potential targets for drug therapy are discussed which will inhibit necrosis, including preservation of cellular ATP by inhibition of poly(ADP-ribose) polymerase. Such therapies may be useful either as adjuncts to other therapeutic modalities such as immunosuppressive agents for the treatment of inflammatory conditions or on their own for organ preservation prior to organ transplantation. Either excessive apoptosis or failure of apoptosis plays an important role in a variety of gastrointestinal diseases. Failure of apoptosis is of particular importance in the development of colorectal cancer. Mutations or deletions of p53, bcl-2 and myc prevents the appropriate deletion of malignant cells and causes resistance to anti-cancer drugs which act by the induction of apoptosis. Correction of these genetic defects or replacement of their function is a major strategy in cancer prevention and therapy. It is concluded that manipulation of cell death processes is an important new area for gastrointestinal research.

Adenosine Triphosphate↗

The measurement of Ascaris suum protein by radioimmunoassay in sera from patients with helminthiasis and with gastrointestinal diseases.

In this study, we have developed a reliable radioimmunoassay (RIA) for Ascaris suum protein (Asp) and have measured the serum concentration of Asp in control subjects and in patients with helminthiasis and a variety of gastrointestinal diseases. The cross-reactivities of Asp antibody with other helminth worm antigens were also measured by RIA. Ascaris lumbricoides contained approximately the same amount of Asp antigenic substance as did Ascaris suum. Toxocara canis had a high concentration of a substance partially cross-reactive with Asp. Small amounts of substance cross-reacting with Asp were also exhibited by Anisakis larvae, Schistosoma japonicum and Taenia saginata. However, no cross-reactivities of Fasciola hepatica and Paragonimus westermani with Asp were observed in this study. Almost all the serum levels of Asp from normal control subjects were below the sensitivity of this RIA (10 ng/ml). High concentrations of Asp were observed in sera from patients with ascariasis (64.5 +/- 18.8 ng/ml: mean +/- S.E.), anisakiasis (75.2 +/- 28.0 ng/ml), toxocariasis (78.4 +/- 31.3 ng/ml) and schistosomiasis japonica (14.3 +/- 3.4 ng/ml). Asp levels in sera from patients with other helminthiasis were not significantly high. From these findings, it was suggested that RIA for Asp may not be specific for diagnosis of ascariasis, but might be a suitable screening method for patients with some kinds of helminthiasis. Interestingly, high concentrations of Asp were also observed in sera from patients with ulcerative colitis (24.8 +/- 2.5 ng/ml) and Crohn's disease (19.8 +/- 5.2 ng/ml), but Asp levels from 7 other gastrointestinal diseases seemed not to be significantly high. These findings remain unexplained but may derive from cross-reactivities between helminthic and gut mucosal antigens.

Animals↗

Circulating ghrelin levels in patients with various upper gastrointestinal diseases.

The stomach is the main source of circulating ghrelin. Plasma concentrations of this hormone in patients with various upper gastrointestinal diseases remain undetermined. Thus we measured plasma ghrelin levels by radioimmunoassay in 225 subjects, including 134 Helicobacter pylori-infected and 91 uninfected subjects. They included 67 patients with chronic gastritis (CG), 26 with benign gastric polyp (BGP), 24 with gastric ulcer (GU), 24 with reflux esophagitis (RE), 18 with duodenal ulcer (DU), 28 with acute gastritis (AG), 23 with gastric cancer (GC), and 39 who had normal mucosa on upper endoscopy (N). Plasma pepsinogen I and II levels were also measured. The extent of gastritis was assessed endoscopically. Ghrelin levels differed significantly among the different disease groups. Plasma ghrelin concentrations were lowest in the CG group, followed by the GU group, and highest in the AG patients. There was a significant difference in the levels between differentiated and undifferentiated GC. Ghrelin concentrations in BGP, RE, and DU patients were comparable to those in the N group. Ghrelin circulating levels were lower in H. pylori-positive than -negative individuals, but the significant differences among disease groups were still observed in H. pylori-infected and uninfected populations. Ghrelin concentrations correlated positively with plasma pepsinogen I levels and I/II ratios and inversely with the extent of H. pylori-related gastritis. Plasma ghrelin levels varied widely in diverse conditions of the upper digestive tract, reflecting the inflammatory and atrophic events of the background gastric mucosa. Further investigation is warranted to unravel the mechanisms of the high circulating ghrelin levels in certain upper gastrointestinal diseases.

Adult↗

Management of gastrointestinal disease in liver transplant recipients.

Gastrointestinal complications and diseases are common in liver transplant recipients. One must have a working knowledge of gastrointestinal disorders that existed before and de novo disease that occurs after transplantation. It is important to separate those routine conditions unrelated to transplantation from those either exacerbated or specifically related to the transplant surgery or immune suppression. The most frequent disorders encountered are related to medications, infections, and exacerbations of pre-existing gastrointestinal pathology.

Cytomegalovirus Infections↗

Significance of CA 72.4 serum levels in gastrointestinal diseases.

In order to evaluate the usefulness of Ca 72.4 tumor associated antigen assay in gastrointestinal diseases, we have studied 751 patients suffering from benign (376) and neoplastic (375) digestive diseases and 305 normal controls. The cut-off point was fixed at 6 U/ml. The Ca 72.4 assay, with the proposed method, provides additional information only in gastric cancers; the positivity of the marker in gastric neoplasms is 38.4% and the specificity vs gastric ulcers and atrophic gastritis is 99%. In six patients with gastric cancer, the Ca 72.4 is the only positive test. The most striking observation to be made from the current study is a no good sensitivity of the marker for gastrointestinal cancers (29.6% vs 35.7 and 37.6% for CEA and Ca 19-9 respectively), but rather the excellent specificity of the Ca 72.4 immunoassay with respect to being gastrointestinal diseases (98.7%), vs values of specificity for CEA and Ca 19-9 of 94 and 92%. In conclusion, the high specificity of this marker for gastrointestinal neoplasms may be very interesting in follow-up studies. In fact, an elevation of serum levels of Ca 72.4 should always be taken seriously.

Adult↗

New imaging techniques for the evaluation of gastrointestinal diseases.

This article provides an overview of recently developed, noninvasive imaging modalities for the evaluation of gastrointestinal disease processes. The advent of spiral computed tomography, magnetic resonance cholangiopancreatography and conventional magnetic resonance imaging has facilitated the noninvasive assessment of pancreaticobiliary disease. Magnetic resonance cholangiopancreatography provides projectional images of the biliary tree and pancreatic duct, similar to those achieved by direct cholangiography, without the need to administer contrast medium. Spiral computed tomographic colonography provides virtual colonoscopic images of the colonic mucosa, allowing the detection of polyps without the risk associated with colonoscopy.

Caroli Disease↗

Acute terminal ileitis associated with pneumococcal bacteremia: case report and review of pneumococcal gastrointestinal diseases.

In this report, we describe a patient with acute terminal ileitis due to Streptococcus pneumoniae, review 3 previously reported cases of isolated enteritis due to S. pneumoniae, and summarize the English-language literature on primary and secondary pneumococcal gastrointestinal diseases. Various theories have been advanced to explain the pathogenesis of this rare and potentially life-threatening form of pneumococcal infection, but the mechanism by which S. pneumoniae causes gastrointestinal disease is still unknown.

Acute Disease↗

[Use of organic forms of selenium in nutrition of patients with gastrointestinal diseases].

Selenium level was determined in sera of 27 patients including 15 patients with chronic gastrointestinal diseases and 12 patients with intestinal malabsorption after some kinds of stomach or small intestine resection. Deficiency of this trace element was found in 5 patients and suboptimal concentration in 4 patients in the first group and in 3 and 5 patients of second group respectively. Supplementation of patients with 45 mg of selenium organic form based on autolysis extract of selenious baker's yeast resulted in increase of selenium level in 23 (85%) patients including all of them with selenium deficiency or suboptimal level. It was concluded about high bioavailability of selenium in supplement studied. Perturbed intestinal absorption after surgical resection of stomach or small intestine may be considered as an indication for prophylactic taking of organic selenium form preparation.

Adolescent↗

Fibrinolytic activity in plasma from horses with gastrointestinal diseases: changes associated with diagnosis, surgery, and outcome.

Plasma fibrinolytic activity was evaluated over 5 consecutive days in 59 horses admitted to the Large Animal Teaching Hospital with acute gastrointestinal diseases. Only horses hospitalized for at least 5 days were included in the study. Tissue plasminogen activator (tPA) and plasminogen activator inhibitor type-1 (PAI-1) were quantitated using standard chromogenic activity assays. Statistical analyses were performed using analysis of variance; differences were considered significant when P < or = .05. Activity of PAI-1, the primary endogenous inhibitor of fibrinolysis, was significantly increased on hospital days 2, 4, and 5 in horses that died, when compared with those that were discharged from the hospital. Plasma PAI-1 activity was not different at admission, but was significantly increased on hospital days 2 and 3 in horses that underwent surgery, when compared with those that did not, suggesting an acute phase response to surgical intervention. Horses with strangulating intestinal lesions had significantly increased PAI-1 activity on day 3, while PAI-1 activity was significantly greater in horses with inflammatory conditions at the time of admission, when compared with horses with strangulating or nonstrangulating/noninflammatory lesions. Among all horses, PAI-1 activity was significantly higher and tPA activity was significantly lower on day 2 when compared with other hospital days. These results suggest that fibrinolysis is inhibited early in the course of inflammatory gastrointestinal diseases and in response to surgery. In addition, among all horses, the prognosis for survival was poor for those with persistently increased PAI-1 activity, reflecting treatment failure and the loss of hemostatic regulation.

Acute Disease↗

Hepatic changes and serum ferritin in pancreatic cancer and other gastrointestinal diseases: the role of cholestasis.

Serum ferritin, prealbumin, pseudocholinesterase, alpha-1-antitrypsin and caeruloplasmin were determined in control subjects and patients with pancreatic cancer, chronic pancreatitis or extra-pancreatic disease mainly of gastrointestinal origin, in order to investigate the different hepatic changes which influence serum ferritin in chronic pancreatic and other digestive diseases. Increased circulating ferritin was found in pancreatic cancer and extra-pancreatic disease when compared to controls. Correlations were detected between ferritin and the other proteins investigated and between ferritin and total bilirubin, alkaline phosphatase and alanine aminotransferase. Multiple regression analysis demonstrated that cholestasis accounts for 45% of circulating ferritin, the acute-phase response accounted for 18% and decreased liver function accounted for 11%. We conclude that the increase in serum ferritin in chronic pancreatic and other gastrointestinal diseases largely depends on liver changes, with cholestasis probably playing a primary role.

Adult↗

Acute gastrointestinal disease in 27 New World camelids: clinical and surgical findings.

OBJECTIVE: To describe clinical and surgical findings from New World camelids with acute gastrointestinal disease. STUDY DESIGN: Retrospective study. ANIMAL POPULATION: 20 llamas and 7 alpacas. METHODS: Camelids were grouped based on surgical lesions. Clinical and surgical findings were compared between groups and between surviving and nonsurviving camelids. RESULTS: Twelve of 27 initial celiotomies and 3 of 4 repeat celiotomies were successful. Death occurred from euthanasia during surgery (nine camelids), peritonitis or sepsis (five), aspiration pneumonia (one), and respiratory distress (one). Survival was lowest after celiotomy for proximal obstruction (3 of 10 camelids), ruptured viscus (0 of 4), and necrotizing enteritis (0 of 2) and highest after celiotomy for distal obstruction (10 of 13) and septic peritonitis without ruptured viscus (2 of 2). Before surgery, camelids with proximal obstruction had significantly lower (P < .05) serum chloride concentrations (median, 97 mEq/L) than those with distal obstruction (median, 109 mEq/L) or ruptured viscus (median, 117 mEq/L). Serum bicarbonate concentration also was highest (median, 34.6 mEq/L) and often greater than 28 mEq/L in camelids with proximal obstruction. Camelids with distal obstruction had significantly lower (P < .05) nucleated cell counts in peritoneal fluid (median, 700 cells/microL) than those with ruptured viscus (median, 20,600 cells/microL) or septic peritonitis (median, 88,300 cells/microL). CONCLUSIONS: Camelids with proximal obstruction often had hypochloremic metabolic alkalosis. Camelids with distal obstruction had less metabolic derangement and tissue compromise and a higher survival rate. CLINICAL RELEVANCE: Awareness of the characteristics of the various types of acute gastrointestinal disease in camelids will augment veterinarians' ability to diagnose and treat these disorders.

Acute Disease↗

Comparison of dual-energy X-ray absorptiometry to four other methods to determine body composition in underweight patients with chronic gastrointestinal disease.

Assessment of body composition may provide important information about the nutritional status. The applicability of two safe and convenient methods for body composition analysis, bioelectrical impedance analysis (BIA) and dual-energy x-ray absorptiometry (DXA), in underweight patients with chronic gastrointestinal disease has been sparsely elucidated. Our objective was to compare measurements by DXA with four other methods. Furthermore, we compared total body water (TBW) by BIA using three different BIA equations with measurement of TBW by tritium dilution (TBW-3H2O). Nineteen clinically stable underweight patients with chronic gastrointestinal disease were included in the study (body mass index [BMI], 19.3 +/- 1.2 kg/m2). Body composition was assessed using total body potassium (TBK), isotope dilution of tritium (3H2O), anthropometry (skinfold thickness [SF]), BIA, and DXA. Fat-free mass (FFM) by DXA was in reasonable agreement with body composition measurements by TBK (mean difference(TBK-DXA) = -1.61 kg, r = .88, standard error of the estimate [SEE] = 4.66 kg) and 3H2O (mean difference(3H2O-DXA) = 0.98 kg, r = .93, SEE = 3.34 kg). Although mean values for FFM by DXA differed significantly versus BIA and SF, we found highly significant correlations between the measurements (r = .97 and r = .97, respectively). The mean TBW by BIA was overestimated by 1.9 and 3.1 L compared with TBW-3H2O when prediction equations for normal-weight subjects were used. We conclude that the DXA method is a valuable addition to the list of methods available for body composition studies in clinically stable underweight patients. Our data show that BIA equations for normal-weight subjects overestimated TBW in the patients studied.

Absorptiometry, Photon↗