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[The state of the gastrointestinal tract in reactive arthritis].

The gastrointestinal tract status (GIT) was evaluated in 23 reactive arthritis (RA) patients: in 17 after intestinal infection, in 2 after urogenital infection, and in 4 after mixed infection. All the examined were found to have signs of diffuse variously pronounced chronic inflammation of the small and large intestine, impaired barrier function of the stomach, liver disorders, and moderate-severe intestinal dysbacteriosis with developing transitory bacteraemia in most severe cases. The GIT changes were correlated with the severity of the RA course. In 20 control-group patients not afflicted with joint disease and operated on for cicatricial stricture of the oesophagus, no signs of chronic inflammation of the mucosa were revealed in the biopsy samples of the large and small intestine. The obtained results may be indicative of the role played by the GIT in the development of pathogenic processes in RA.

Adult↗

Neoplasms of the bovine gastrointestinal tract.

Neoplasms of the bovine gastrointestinal tract are rare, possibly because of the low age of the sample population (slaughtered cattle). Forestomach neoplasia (papilloma/squamous cell carcinoma) has a high incidence in cattle from northern England and Scotland because of the mutagenic effects of bracken fern consumption and its interaction with BPV-4. Lymphosarcoma in the abomasum occurs in 41 per cent of cattle with lymphosarcoma, the most common bovine neoplasm in the United States. Small intestinal adenocarcinoma is associated with the papilloma/squamous cell carcinoma complex in the forestomach in England and Scotland, but occurs sporadically in other geographic locations. These lesions may be amenable to surgery, but death from metastatic disease occurs within 1 year. Neoplasms of the large intestine are rarely reported, but usually are adenocarcinoma. Adenoma and fibroma of the rectum may produce clinical signs of tenesmus and rectal prolapse. In general, neoplasia in cattle carries a poor prognosis because of early metastasis of adenocarcinoma and the high fatality of lymphosarcoma. Forestomach fibroma may be treated surgically with success, and palliative surgery for focal small intestinal tumors may be rewarding in individual cases.

Animals↗

Damaged epithelia regenerated by bone marrow-derived cells in the human gastrointestinal tract.

Studies have shown that bone marrow cells have the potential to differentiate into a variety of cell types. Here we show that bone marrow cells can repopulate the epithelia of the human gastrointestinal tract. Epithelial cells of male donor origin were distributed in every part of the gastrointestinal tract of female bone marrow transplant recipients. Donor-derived epithelial cells substantially repopulated the gastrointestinal tract during epithelial regeneration after graft-versus-host disease or ulcer formation. Regeneration of gastrointestinal epithelia with donor-derived cells in humans shows a potential clinical application of bone marrow-derived cells for repairing severely damaged epithelia, not only in the gastrointestinal tract but also in other tissues.

Adult↗

Efficacy of endoscopic surveillance of the upper gastrointestinal tract following distal gastrectomy for early gastric cancer.

BACKGROUND/AIMS: How endoscopy can be used in the follow-up of the upper gastrointestinal tract in patients who underwent gastrectomy for early gastric cancer remains unclear. METHODOLOGY: Two-hundred and ten patients (137 males and 73 females, aged at initial gastrectomy 27-86, average age 56.5) were followed in the present study. Results of follow-up endoscopy of all patients, pathologic diagnoses of secondary tumors and interval between gastrectomy and detection of secondary tumor were reviewed. Cumulative incidence rate of second tumors in the upper gastrointestinal tract was then analyzed. RESULTS: Secondary tumor was observed by follow-up endoscopy in 7 patients including two gastric, one esophageal, one duodenal carcinoma and 3 gastric adenomas. The interval between initial gastrectomy and diagnosis of secondary tumor ranged from 20 to 71 months (average 51.7 months). All carcinomas were early stage and localized within the mucosa. Three patients with secondary cancer were successfully treated by endoscopic mucosal resection. The cumulative incidence rate of secondary cancer in the gastric remnant, esophagus and duodenum at six years after initial gastrectomy was 1.0, 0.8 and 0.5%, respectively. The overall incidence rate of secondary tumors of the upper gastrointestinal tract at six years after distal gastrectomy was 4.1%. CONCLUSIONS: The present findings indicate that annual follow-up endoscopy of the upper gastrointestinal tract after gastrectomy for early gastric cancer can be introduced to detect carcinoma at an early stage, thus improving the survival rate of gastrectomy patients.

Aged↗

Localization of neurokinin B receptor in mouse gastrointestinal tract.

AIM: To observe the location of neurokinin receptor (NK3r) in the mouse gastrointestinal tract. METHODS: The abdomens of 8 male Kunming mice were opened under anaesthesia with sodium pentobarbital. The exposed gut organs were kept moisture and temperature at the same time. Then the esophagus,jejulum, ileum, and colon, etc were respectively cut and the segments from the stomach to the distal colon were opened along the mesenteric border. A circular 4mm-6mm enteric part(pieces of 1 cm(2) were to be prepared) and mucosa and submucosa were removed, then the longitudinal muscle layer was pulled off from the circular muscle layer under microphotograph. They were rinsed in 50 nmol x L(-1) potassium phosphate-buffered saline(PBS). Immunohistochemistry and immunoreactive fluorescence were used in the staining procedures. RESULTS: There was NK3r-Like(-Li) positive material on the smooth muscle cells of the esophagus, stomach, and intestines and other regions. The nerve cell bodies with immunoreactivity for NK3r were mainly distributed in the submucousal nerve plexus or myenteric nerve plexus of the gastrointestinal tract except for the esophagus, stomach and rectum. The reaction product was located on the surface of the nerve cell plasma. It was occasionally observed in the cell plasma endosomes, but was very weakly stained. Among the NK3-like positive neurons in the plexus,the morphological type in many neurons appeared like Dogiel II type cells. Some neuron cell bodies were big, having many profiles, some were long ones or having grading structure. Cell body diameter was about 10 microm-46 microm and 8 microm-42 microm in myenteric plexus and submucous plexus. CONCLUSION: This study not only described the distribution of neurokinin B receptor in the mouse gut, but also provided a morphological basis for deducing the functional identity of the NK3r-LI immunoreactivity neurons, suggesting the possibility that these neurons were closely related to gastrointestinal tract contraction and relaxing activity.

Animals↗

[Diagnosis and therapy of leiomyoma of the upper gastrointestinal tract].

Leiomyoma of the upper gastrointestinal tract is a "soft tissue tumor" and is a rare and benign lesion. The incidence of leiomyoma in the upper G-I tract is 4% of all tumors of the esophagus and 1% of the stomach. However it is difficult to differentiate leiomyoma from leiomyoblastoma and malignant leiomyosarcoma. For this reason some surgeons prefer the resection of the tumor to enucleation. Between 1984 and 1994, 24 patients with leiomyoma were treated at the Department of Surgery of the University Charité (esophagus n = 4, stomach n = 18, ileum n = 2) by local enucleation/excision in 11 cases and by wide resection of the tumor in 13 cases. In the further follow-up (after 36-84 months) there was no lethality or local recurrence.

Adult↗

Inverted diverticula of the gastrointestinal tract.

Inverted diverticula of the gastrointestinal tract are rare. This paper briefly presents the roentgen findings of an inverted Meckel's diverticulum and is the first reported case of the roentgen appearance of an inverted colonic diverticulum.

Adult↗

Membrane glycoproteins shed in defence of the cells of the gastrointestinal tract.

The cells lining the gastrointestinal tract are exposed to various potentially harmful agents, including plant lectins and microorganisms. It is proposed that glycoproteins within the mucus layer of the gut protect against these agents. A hypothesis is presented that membrane glycoproteins are shed and, within the mucus close to the cell surface, block the binding of lectins or attachment of microorganisms to membrane receptors. A model is presented that demonstrates that such blocking can be achieved by soluble glycoproteins. The implications of this hypothesis in health and disease are discussed.

Bacterial Physiological Phenomena↗

Physiological and pharmacological interventions in radionuclide imaging of the tubular gastrointestinal tract.

Radionuclide studies of the gastrointestinal tract (GI) are used to measure GI function and to detect anatomic lesions such as Meckel's diverticuli. A variety of physiological and pharmacological interventions have been applied to both types of studies to gain a better understanding of GI function and to improve detection of disease. This article will review interventions useful in imaging the tubular GI tract. Discussed are the measurement of GI motility and function by gastric emptying and imaging studies for GI bleeding including the Meckel's scan. Interventions involving the hepatobiliary system are covered elsewhere in this issue.

Cimetidine↗

Endoscopic incision of postoperative stenoses in the upper gastrointestinal tract.

Membrane-like upper gastrointestinal stenoses, such as may occur after surgery, can be treated by making radial diathermy incisions, producing an increased caliber and a smooth, supple wall at the site of the stenosis. This method has been used in six patients with stenoses after various operations on the upper gastrointestinal tract, including two esophageal and two gastric anastomoses, one gastroplasty, and one pyloric stenosis. The result was favorable in all cases except the pyloric stenosis.

Adult↗

Protozoan parasites that infect the gastrointestinal tract.

Protozoa that infect the gastrointestinal tract include the deadly parasite Entamoeba histolytica;Giardia lamblia, the most common cause of waterborne disease outbreaks; and the large group of spore-forming parasites that share a green algae symbiont and a predilection for causing chronic diarrhea in immunocompromised persons. Some recent advances in the epidemiology, pathogenesis, diagnosis, and treatment of the diseases caused by these protozoa are discussed in this review.

Journal Article↗

Cholera toxin and Salmonella typhimurium induce different cytokine profiles in the gastrointestinal tract.

Salmonella infection of the gastrointestinal tract (GT) results in fluid secretion and inflammation. In contrast, cholera toxin (CT) induces fluid secretion but no inflammation. Using a murine ligated intestinal loop model, we investigated cytokine production (interleukin-1 [IL-1], IL-2, IL-4, IL-6, IL-10, gamma interferon, and tumor necrosis factor alpha) in the GT following exposure to these agents. Salmonella typhimurium induced a Th1-like cytokine profile in loops obtained from either nonimmune mice or Salmonella-immunized mice. CT induced only IL-6 and IL-10 production in ligated loops from nonimmune mice but induced a Th2-like cytokine profile in ligated loops obtained from CT-immunized mice. These results show that CT and S. typhimurium induce very different cytokine profiles in the GT.

Animals↗

[Subcutaneous emphysema in gastrointestinal tract perforation].

Perforation of the gastrointestinal tract can lead to retroperitoneal abscess formation. Clinical signs and symptoms are often non-characteristic. In undetected cases the first sign of perforation may be subcutaneous emphysema. The place where this first appears correlates with the localization of the perforation. The pathogenetic mechanisms and clinical features are discussed, with reference to a case report.

Aged↗

[Molecular carcinogenesis of the upper gastrointestinal tract].

Carcinomas of the upper gastrointestinal tract have been intensively studied for decades in order to identify markers for a) design of simple blood tests to detect presence or recurrence of the disease, b) prediction of therapy response, c) identification of molecular targets for novel therapies. These aims have not yet been fully reached by analysing single genes. However, some genes, including E-cadherin that is altered in sporadic and familial cases of gastric cancer and interleukin 1-beta whose polymorphisms together with Helicobacter pylori infection are associated with an increased risk for gastric cancer, may have the potential for clinical use. In this review we summarize current data for the single gene approach and provide an overview for recent results from cDNA microarray studies.

Adenocarcinoma↗

Radiographic manifestations of anomalies of the gastrointestinal tract.

Congenital anomalies of the gastrointestinal tract can pose serious threats to the health of newborn infants and children. Perhaps nowhere has pediatric surgery had as dramatic an impact as in the care and treatment of these conditions. The pediatric radiologist works closely with the surgeon in evaluating these anomalies in young children. Plain radiographic films and contrast studies have been and remain the first step in studying these anomalies. Newer imaging modalities, however, also have made contributions to the continuing importance of the role of the radiologist in the diagnosis and care of children with these anomalies.

Digestive System↗

Crohn's disease of the upper gastrointestinal tract.

Involvement of the upper gastrointestinal tract by Crohn's disease is being recognized with increasing frequency. Gastroduodenal disease is more common, although esophageal disease is now noted infrequently as well. There is nearly always concomitant involvement of the small bowel or colon. Initial phases of the disease are manifested as superficial inflammatory changes of the mucosa but can progress to scarring and stenosis. Optimum double-contrast technique is necessary to detect these early lesions.

Crohn Disease↗

Physical activity and the gastrointestinal tract.

Measurement of the various gastrointestinal functions usually requires that a measuring instrument be placed in a certain position in the stomach or gut and that the instrument remains in the same position during the period of measurement. During physical activity it is often difficult to be sure that this requirement is fulfilled. This may in part be the reason why so little is known about the effects of physical activity on the gastrointestinal tract. The following article gives an overview of what is known and what has not been studied in this field. From what we already know we may conclude that these organs are only affected to a slight degree by physical activity.

Digestive System Physiological Phenomena↗

Neoplasms of the upper gastrointestinal tract.

Neoplasms of the upper gastrointestinal tract are generally detected by barium studies or endoscopy. Computed tomography remains the primary imaging modality for staging. Magnetic resonance imaging and endoscopic ultrasonography may also play an increasing role in evaluating these tumors.

Barium Sulfate↗