Mucosal surface areas and villous morphology of the small intestine of small mammals: functional interpretations.
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The number of neurons in the coeliacomesenteric ganglia and the myenteric and submucosal plexuses of the jejunum, ileum and small colon, and the pathological changes induced in them, were studied in various types of equine dysautonomia. In all forms of dysautonomia, severe and extensive neuron loss and damage occurred in the ileum. In acute and subacute dysautonomia, jejunal neuron loss and damage were severe, but in chronic cases significantly less loss or damage occurred. The damage followed the same pattern in the small colon but it was always less obvious than in the jejunum. The distribution of the damage was uniform within a segment of the intestine. In fatal cases of dysautonomia, the clinical severity and duration of illness seems, in most instances, to be related to the amount of neuronal disruption occurring in the jejunum. Severe disruption results in acute/subacute dysautonomia, while milder damage leads to the chronic form. No case of dysautonomia was encountered in which enteric neuron loss and damage occurred without significant neuronal disruption also occurring in the coeliacomesenteric ganglia. Heal neuronal damage and loss are not invariably worse than that in the jejunum, and the possible reasons for this, together with the relationship between neuronal damage and possible causes of dysautonomia, are discussed.
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The malignant non-Hodgkin-lymphoma is the main cause of spontaneous extraduodenal small intestine perforation. This rare incidence occurs as a consequence of an enteropathic associated affection manifested extranodally, mostly in the higher part of the jejunum. The diagnosis is made after a spontaneous perforation. The risk of a recurrent perforation is high. In a female patient we made the diagnosis not before resecting the small intestine.
PURPOSE: The aim of this study was to report on a rare cause of small-intestinal obstruction caused by small-intestinal enteroliths. METHODS: We present three different cases of enterolith formation in the small intestine. One occurred after nontropical sprue, one patient had multiple jejunal diverticula, and another patient had enterolith formation in a blind loop after a small-bowel side-to-side anastomosis. RESULTS: After initial conservative therapeutic approach all patients underwent surgery. In two patients the enteroliths were removed by ileotomy or jejunostomy. In the third patient the bowel anastomosis had to be revised after removal of the enterolith. CONCLUSION: Small-intestinal enteroliths may cause small-bowel obstruction. The first therapeutic approach is nonsurgical; however, if obstruction proceeds, surgical removal with or without revision of underlying pathology is necessary. We discuss the causes and therapeutic management of enteroliths and give a review of related literature.
It is the common view in Chinese traditional medicine that the small intestine is in the abdomen above the umbilicus and that the large intestine is in the abdomen below the umbilicus. However, our precise investigation clarified the following points. The first one is that the above view is found only in such anatomical descriptions as in the paragraphs of "Chang Wei" in the Ling Shu. The second one is that the opposite view is mentioned in the Su Wen, the Ling Shu, the Nan Ching, and the Chin Kuei Yao Lueh. According to this literature, the large intestine is in the abdomen above the umbilicus and the small intestine is in the abdomen below the umbilicus. We inferred the following points: 1) The former view results from the fact that biologically the organs connect in the order of the stomach, the small intestine and the large intestine. 2) The latter is based on the fact that the large intestine acutually occupies a great part of the upper part of the abdomen, and the small intestine occupies the lower part of the abdomen. In interpreting the literature of Chinese traditional medicine, it is necessary to consider these two different views of the intestines.
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The intestinal mucosa is among the mitotically most active tissues of the organism. Several authors described an alteration of the enterocytic proliferation after extensive small-bowel resection. Own autoradiographical investigations were carried out in the intestine of rats after subtotal small-bowel resection with and without additional operation for passage retardation. Not any different mitotic value was provable after one year in all rats with subtotal small-bowel resection in comparison to normal rats. From this follows that the adaptation of the residual intestine is already up concluded to this moment.
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A jejuno-ileostomy was created in rats, bupassing 85--90% of the small intestine, by means of a self-emptying blind loop. Control animals were subjected to laparotomy and suture-making of vie intestinal segments. At the end of the experiments, intestinal wet and dry weight and villus height were determined in the five different segments of the small intestine taken from both experimental and control animals. After 2 weeks, a significant hypertrophy occurred in the functioning part of the small intestine of the shunt-operated animals, while an atrophy occurred in the blind loop. In a shunt-operated group of animals, the normal anatomy was re-established after 2 weeks and the animals were sacrificed 4 weeks later and compared with (a) control animals, (b) shunt-operated animals. In the re-operated animals, the hypertrophic changes disappeared and, except for the increased wet weight of one jejunal and one ileal segment (p less than 0.05), there were no significant differences in comparison with the control animals. The villus height did not differ significantly from that of the control animals, except for the second jejunal segment, whicntestine of the rat, developing during the 2 weeks after establishment of a jejuno-ileal bypass, are reversible within 4 weeks.
Broiler chicks were fed diets supplemented with DL-methionine or DL-2-hydroxy-4-methyl-thiobutanoic acid. At 4 wk of age the chicks were subdivided into thermoneutral (22 degrees C) and heat-exposed (32 degrees C) groups and maintained under these conditions for 48 h. Highly purified 3H-L-methionine (3H-L-Met) and 3H-L-2-hydroxy-4-methyl-thiobutanoic acid (3H-L-HMB) were used to evaluate treatment effects on the small intestinal passage of sources of supplemental methionine and on the transport of methionine sources across purified small intestinal brush border vesicles. 3H-L-Met was efficiently absorbed in the upper regions of the small intestine; however, 2.5-3.5% of dietary 3H from birds fed 3H-L-Met remained unabsorbed in the distal small intestine. Dietary 3H (15%) initially associated with 3H-L-HMB was not absorbed during passage down the length of the gut. The HPLC analysis indicated that only 10% of the radiolabeled material remaining in the terminal ileum eluted at the time expected for HMB. Partial breakdown of HMB to nonabsorbed, nonmethionine products during passage down the small intestine may contribute to the difference in biopotency of the two sources of supplemental dietary methionine. Heat exposure did not affect in vivo small intestinal passage or in vitro transport of 3H-L-Met and 3H-L-HMB across small intestinal brush border membrane vesicles.
Vitamin A is a potent inducer for liver/bone/kidney alkaline phosphatase (L/B/K ALP) in a variety of tissues. However, the evidence for induction of L/B/K ALP by vitamin A in small intestine is limited. In this study, we investigated the influence of vitamin A on L/B/K ALP expression in rat small intestinal crypt IEC-6 cells and fetal rat small intestine. Treatment of IEC-6 cells with all-trans retinoic acid (RA) increased the levels of activity, protein and mRNA of L/B/K ALP, whereas enterocyte-specific proteins, including intestinal ALP, sucrase-isomaltase and glucose transporter-2, were not induced. The reverse transcription-polymerase chain reaction technique revealed that this L/B/K ALP transcript had the bone-type but not the liver-type leader exon. IEC-6 cells constitutively expressed mRNAs of all subtypes of retinoic acid receptor (RAR) and retinoid X receptor (RXR) at varied concentrations. Among these receptor mRNAs, RARbeta mRNA quickly responded to RA treatment, and the level was doubled within 4 h. Gel mobility shift assay showed that RA induced an RXRE-binding activity in IEC-6 cells. The L/B/K ALP transcript, expressed in fetal rat small intestine, also contained the bone-type leader exon. Intragastric administration of 10 mg retinyl acetate to pregnant rats from gestational d 7 to 15 increased the levels of this transcript and enzyme in 15-d fetal rat small intestine. Our results suggest that vitamin A may be an important regulator for L/B/K ALP expression in fetal rat small intestine as well as in IEC-6 cells.
The extracellular electrical activity of the stomach and small intestine of a macropodid marsupial was studied using chronically implanted bipolar electrodes. Recordings from the elongate, tubular, haustrated stomach showed triphasic slow waves with a frequency of 5.5/min, an amplitude of 120 microV and an aborad propagation rate of 3 mm/sec. Action potentials were recorded only from the pylorus. These occurred as bursts of six to fourteen consecutive spikes. Shortly after the period of regular spike activity occurred in the adjacent duodenum action potentials in the pylorus ceased, leaving only the slow wave present for up to 20 min. Both slow waves and action potentials were recorded from the small intestine. There was no decrease in the frequency of the slow wave from the duodenum to the ileum. The slow wave frequency was 26/min on the duodenum and 25/min on the ileum. These frequencies were not affected by fasting the animals. Migrating myoelectric complex activity of the small intestine comprising three distinct electrical patterns, occurred at regular intervals. This was only slightly affected by feeding.
Two studies were conducted to establish the effects of dietary lactose supplied from dried whey on the lactase activity in the contents of the small intestine and cecum as well as the mucosa of the small intestine. In the first study, feeding 0, 10, 25, or 40% dried whey for 120 days did not alter the mucosal lactase specific activity (mumoles galactose released/mg protein) in the duodenum, upper jejunum, or lower ileum. In the second study, total lactase activity in the small intestine was estimated from the total activity found in 10-cm segments of each meter of small intestine. Feeding a diet containing 40% whey continuously from weaning at 5 weeks of age or from 12 weeks of age did not alter the total lactase activity of pigs killed at 21 weeks of age. Dietary lactose tended to increase the lactase activity in the contents of the cecum and small intestine, but the increases were not always statistically significant. In the second study, Chester White pigs had approximately threefold greater mucosal lactase activities than that of Hampshires. These two breeds may be suitable models for detailed studies into the relationships between lactase deficiency and lactose intolerance.
BACKGROUND/AIMS: Gastrointestinal (GI) symptoms are common among patients with chronic renal failure (CRF). The pathogenesis of these symptoms is probably multifactorial. Our aims were to assess gastric and small intestinal motility and the prevalence of small intestinal bacterial overgrowth (SIBO) in order to clarify possible pathophysiological mechanisms behind these symptoms in CRF patients. METHODS: Twenty-two patients with CRF, 12 with GI symptoms and 10 without GI symptoms underwent antroduodenojejunal manometry. All patients with GI symptoms had diarrhea and half of them had abdominal pain, nausea and/or early satiety. Symptoms were unexplained by conventional investigations. Interdigestive motility was recorded for 5 h and postprandially for 1 h. Samples for culture from the small intestine were obtained through the manometry catheter. Results were compared with 34 healthy controls. RESULTS: On manometry, 11 CRF patients demonstrated neuropathic-like abnormalities, with no significant difference between the patients with (7/12) and without (4/10) GI symptoms. SIBO was seen in 8 CRF patients (36%), 3 with and 5 without GI symptoms (p = 0.15). Six of eleven (55%) of the CRF patients with neuropathic-like abnormalities had SIBO, compared to 2/11 (18%) in those without abnormalities on conventional analysis (p = 0.07). The propagation velocity of phase III was significantly faster in CRF patients with GI symptoms compared to CRF patients without symptoms and healthy controls (21.4 (16.4-54.7) vs. 8.1 (4.6-9.6) and 10.8 (7.2-21.6) cm/min, p = 0.007 and p = 0.019, respectively). We found a higher proportion of retrograde pressure waves in late phase II in the proximal duodenum in patients with and without GI symptoms, than in healthy controls (29 (17-38) and 16 (14-42) vs. 8 (0-24)%, p < 0.0001 and p = 0.0005, respectively). The number of long clusters during the fasting recording was higher in both patient groups than in controls (9 (5-21) and 11 (7-15) vs. 4 (2-9)/5, p = 0.046 and p = 0.002, respectively). CONCLUSION: In the small intestine, abnormal motility and bacterial overgrowth are common in patients with chronic renal failure. These alterations correlate poorly with GI symptoms, but disturbed intestinal motility might explain diarrhea in some of these patients.