[Nutrition of a patient with surgery of the digestive system].
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Atherosclerotic vascular disease can give rise to provoked or spontaneous cholesterol crystal embolization to organ systems. Lodging in downstream arterioles, these crystals can produce granuloma formation, infarction, ulceration, and perforation. Histologic sections of the tissue concerned invariably show pathognomonic empty needle-shaped clefts left by the crystals after processing of the material. In the digestive system these events can cascade to many and often misleading presentations. They can be the cause of massive bleeding, acute acalculous cholecystitis, pancreatitis, or teleangiectasis with chronic intractable blood loss. Owing to the progressive nature of the disease the treatment options described in this paper can only give temporary, but nevertheless often worthwhile relief.
The expression of p62 autoantigen and the frequency of p62 autoantibody have been reported in hepatocellular carcinoma (HCC) and many types of malignant tumors, respectively, but information regarding to the expression of p62 in other cancer tissues and the association of autoantibody to p62 with tumor behaviors is not available. In the current study, the expression of p62 in tissues and the appearance of p62 autoantibody in sera were detected by immunohistochemical staining and ELISA in four clinical types of digestive system cancers including gastric cancer, esophageal cancer, large intestine cancer and HCC, respectively. Interestingly, the immunohistochemistry staining of p62 has been shown in all of digestive canal tissues (stomach, esophagus, large intestine) including tissues with cancers, beside cancers and from non-malignant patients, whereas the frequencies were 62.5% and 0% in tissues with cancer and beside cancer in patients with HCC, respectively. Importantly, we found that the p62 expression and the frequency of autoantibody to p62 were associated to cell differentiation and tumor metastasis, respectively. These results suggest that the expression of p62 in tissues and the appearance of autoantibody to p62 in sera might be related to cell malignant manifestations. Moreover, p62 autoantibody is a significant marker for the prognosis of cancers and the evaluation of clinical treatments.
We prove that the focused ion beam (FIB) machine can be used as a microscope and as an in situ cutting device for tissue and cells. For the first time we obtain high-resolution ion images, complemented by electron imaging of different animal tissues both from uncoated and coated samples. In our study, we select the digestive system of Porcellio scaber (isopoda, crustacea) as a test system for FIB microscopy and in situ sample preparation. After the milling operation, some of the ultrastructural elements of hepatopancreatic cells can clearly be recognized. Also, FIB operation reveals significant differences in structural integrity between the apical and basal parts of hepatopancreatic cells, which have not been observed before by classical microscopy techniques. FIB microscopy and in situ sample preparation have advantages over classical microscopy techniques because of: 1. in situ site-specific 2-D sectioning and imaging of subsurface microstructures; 2. no need to embed the sample prior to sectioning; and 3. a wide range of magnifications while imaging the same sample.
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To determine the most optimal treatment of cancer patients, it is fundamental to classify human carcinomas according to their primary anatomical site of origin. As for some patients, it is difficult to identify cancers occurring at obscure location and overlapping adjacent sites. The aim of this study is to partition the primary site of 486 patients in cancers of the digestive system by the expression pattern of the mucins and cytokeratins typifying each site. The expressions of MUC1, MUC2, MUC5AC, MUC6, CK7, CK8, CK13, CK14, CK18, CK19 and CK20 were evaluated immunohistochemically in 426 adenocarcinomas and 60 hepatocellular carcinomas using the tissue-array method. The finding of MUC series showed their characteristics in case of MUC2 in the appendix cancer and MUC1 and 5AC in pancreas cancer. As for CKs 7, 13, and 19, and 20 had a feature in cancers of common bile duct, liver, and appendix, respectively. We classified cancers in 11 sites by characteristic expression of antibodies. The sensitivity, specificity, positive predictive value, and diagnostic efficacy of significant antibodies were calculated with deducing the dichotomous tree made by SPSS 10.0. Six of 11 antibodies, CK 7, CK13, CK19, CK20, MUC1, and MUC5AC distinguished 6 groups from 11 sites. We also executed the clustering of cancers to investigate total relationship among cancers. They fell into three categories, which corresponded to embryologic origin. Unlike other sites, the small intestine and colorectum cancers expressed significantly different patterns to their sublocations. Mucins and CKs showed expression patterns to classify the primary sites of digestive cancers and may be helpful in predicting the primary sites of digestive cancers.
In human beings, melatonin is secreted in a cyclic way by the pineal gland, although it has been detected in other tissues. Synthesis of melatonin takes place in the pinealocyte. It depends on adrenergic stimulation, and its secretion is related to the photoperiod in a circadian model of low activity during light phase and high activity at night time. Former studies aimed to establish the mechanisms by which melatonin carries out its biological function, proved the existance of high affinity binding sites. However, melatonin can pass through the plasmatic membrane; this property suggested a possible activity of the hormone inside the cell trough activation of nuclear receptors. Moreover, melatonin can act by itself as a potent oxygen-free-radical scavenger, which renders it a very strong antioxidant. It is currently accepted that melatonin plays an important role in numerous physiological processes. The gastrointestinal tract of numerous animal species contains melatonin, which is synthesized essentially by intestinal enterochrommaffin cells. Some investigations have revealed that its liberation follows also a circadian rhythm, although its secretion pattern might be influenced by nutritional factors. Receptors for melatonin have been identified in the digestive system, therefore the indolamine might play a leading role in different aspects of the vast digestive physiopathology. The hormone may interact with receptors and subsequently stimulate the synthesis of gastroprotective hormones and also exerts a direct defense on the epithelium, enhances submucosal blood flow and prevents the damage induced by ischemia followed by reperfusion. Moreover, studies have shown that treatment with melatonin reduces the severity of the lesions induced by NSAIDs on gastric mucosa suggesting a beneficial role of melatonin in preventing this gastropathy related to antiinflammatories.
The localization of immunoreactive PACAP (PACAP-IR) in the entire length of the sheep gastrointestinal tract and the pancreas was studied by an immunohistochemical method. PACAP-IR-containing nerve fibers innervated the longitudinal smooth muscle layer of the mucosa in the esophagus, stomach, and small and large intestines, the muscular layer of the stomach and intestine, Brunner's gland of the duodenum, and the walls of small arteries. PACAP-IR fibers also innervated the exocrine acini, islets of Langerhans, and the small arteries in the connective tissue septa of the pancreas. These findings suggest a regulatory role of PACAP in the digestive system.
General practitioners in the vicinity of Lake Velencei in Fejér County, Hungary, have reported an unusual pattern of recent cancer mortality. Our aim was to clarify whether the presumed mortality cluster is epidemiologically justified; whether it is restricted to the locations in question or also appears elsewhere in the county; and if it is associated with some particular disease group. County mortality from malignancies of the digestive system, other malignancies, and all other causes for the period 1994 to 1999 was analyzed in 15- to 64-year-old men and women, using conventional standardized mortality ratios and empirical Bayes estimates. A continuous surface was interpolated from settlement level data for mortality maps. A mortality cluster from men's digestive cancers is apparent north and east of Lake Velencei and also elsewhere in the county. Differences from the country average in the frequency of males' deaths from other malignancies are fairly limited. A number of problematic areas in men's mortality from other causes are identifiable, including some of the settlements under the primary focus. Women's digestive tract cancer mortality in the area of the men's cluster near Lake Velencei is below the national average. There are almost no differences from the country level in women's deaths from other malignancies. Female mortality from all other causes shows remarkable elevations in the south of the county. Our results suggest the possible role of geographically localized exposures. Men's high mortality from digestive tract cancers is a problem affecting a considerable area of the county, necessitating further investigation. Continued search for causes is also warranted by some estimates of exceptionally high death rates in women from causes other than malignancies.
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Intra-arterial continuous infusion of antineoplastic agents was carried out for 90 patients with cancer of the digestive system at our clinic during the past 16 years. These patients had inoperable, advanced or recurrent tumors in various organs: stomach, colorectum, liver, pancreas and others. 5-fluorouracil, mitomycin C, adriamycin and others were infused, singly or in combination, into the aorta (81 patients), or iliac (3) and hepatic (6) artery over periods varying from 2 to 197 days. Partial response was revealed in 41% of the overall patients, no change in 28% and progressive disease in 31%. There were significant differences in anti-tumor effects and survival curves between terminal and non-terminal patients, or between patients with and without long-term infusion (p less than 0.05-0.005). These results suggest that the performance status of patients and the infusion period both influence the anti-tumor or long-survival effect obtained by this therapy.