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PubMed1976

[Endoscopy of postoperative hemorrhage in the upper gastrointestinal tract].

In hemorrhages from the upper gastrointestinal tract, emergency endoscopy is becoming more and more significant. Hemorrhages during the early postoperative stage, particularly in abdominal surgery, require particular attention due to the generally difficult postoperative situation. In most instances, intragastral hemorrhages are due to erosions and anastomotic bleeding. A detailed knowledge of the surgery performed may contribute to a quick and successful examination. Among the most important premises for a high rate of correct diagnoses are the experience of the examining physician as well as an early or immediate identification of the indications. In addition to the diagnostic significance, under favorable circumstances endoscopy makes possible definitive or temporary staunching of the bleeding by means of diathermy, laser beam or sclerotization.

Endoscopy↗
PubMed1991

Influence of hypergravity on the pH profile and proteolytic activity of the avian gastrointestinal tract.

The present study deals with the effect of hypergravity (2xg) on the pH and on the proteolytic activity in the digesta of the gastrointestinal tract of Japanese quails during intense growth. The birds were raised on a semisynthetic diet containing free amino acids (A) and a commercial diet (B). During days 35 till 40 post-hatching the quails were exposed to hypergravity (2xg) using a specially designed centrifuge. On days 40 (experimental group, 2xg) and 41 (control group, 1xg) the animals were sacrificed. The pH of the digesta in various segments of the gastrointestinal tract was measured by means of a semi-microelectrode. Total proteolytic activity was determined by means of azo-dye-modified proteins serving as general proteolytic substrates. Hypergravity leads in general to an alkalization of digesta in various parts of the gastrointestinal tract. In case of the gizzard and duodenum (diet A) and also in the distal jejunum (diet B) the differences are significant. With both diets, hypergravity leads to a considerable decrease in the total proteolytic activity. The reduction is most expressed in the duodenum and jejunum. Changes in the pH of digesta compensate for the decrease in the proteolytic activity. This may explain why hypergravity per se does not seem to impair growth of the Japanese quails.

Amino Acids↗
PubMed1980

Ultrasound patterns of disorders affecting the gastrointestinal tract.

A mass associated with the gastrointestinal tract was detected by sonography in 33 patients. Etiologies included primary or metastatic tumor; intussusception; inflammation secondary to bowel infarction, pancreatitis, or irradiation; and a dilated, fluid-filled gut related to retained gastric contents, obstruction, ileus, or an ileal bypass. Mesenteric or omental changes were identified with inflammation and frequently with metastatic disease. The diagnosis was confirmed by repeat sonography, abdominal radiography, barium examination of the small bowel, computed tomography, surgery, or autopsy. Ultrasound patterns are characteristic in tumor, intussusception, and inflammation; specific features allowing differentiation between tumor and inflammation are described. Colonic haustra, valvulae conniventes, or bowel contours and peristalsis on real-time sonography are helpful in identifying fluid-filled bowel loops.

Adult↗
PubMed2006

Corrosive injury to upper gastrointestinal tract: Still a major surgical dilemma.

In the developed and developing countries, corrosive injury to the gastrointestinal system as a consequence of either accidental ingestion or as a result of self-harm has become a less common phenomenon compared to decades ago. This could partly be attributed to the tighter legislation imposed by the government in these countries on detergents and other corrosive products and general public awareness. Most busy upper gastrointestinal surgical units in these countries, especially in the developed countries will only encounter a small number of cases per year. Up to date knowledge on the best management approach is lacking. In this article, we present our experience of two contrasting cases of corrosive injury to the upper gastrointestinal tract in our thoracic unit in the last 2 years and an up-to-date Medline literature search has been carried out to highlight the areas of controversies in the management of corrosive injuries of the upper gastrointestinal tract. We concluded that the main principle in managing such patients requires a good understanding of the pathophysiology of corrosive injury in order to plan both acute and future management. Each patient must be evaluated individually as the clinical picture varies widely. Signs and symptoms alone are an unreliable guide to injury.

Adult↗
PubMed2005

A candidate gene approach of immune mediators effecting the susceptibility to and severity of upper gastrointestinal tract diseases in relation to Helicobacter pylori and Epstein-Barr virus infections.

This review focuses on immunogenetic aspects of diseases of the upper gastrointestinal tract in which infectious agents may play a role in the aetiopathogenesis, such as Helicobacter pylori, Epstein-Barr virus (EBV) and HIV. Gastric adenocarcinoma is a common cancer all around the world, with declining incidences in Europe and high incidences in Asia and central and south America. Together with gastric atrophy and peptic ulcer disease, gastric adenocarcinoma belongs to the commonest upper gastrointestinal tract diseases. These diseases are multifactorial and factors such as smoking and dietary habits contribute to the pathogenesis. More recently, scientists have turned their eyes on the host. Functional polymorphisms in the genes regulating the host immune system may contribute to the susceptibility to and progression of disease. In multifactorial and polygenetic diseases, candidate gene studies of single nucleotide polymorphisms (SNPs) detect small to moderate relative risks. Unfortunately, only a few functional SNPs have been identified. The candidate gene approach can be seen as a useful first step in exploring causal pathways between genetic determinants and complex diseases such as those mentioned above. To date, little is known about the immunogenetics of upper gastrointestinal tract diseases. We review the literature on H. pylori, EBV and gene polymorphisms that affect key immune mediators influencing the pathogenesis of the inflammatory response, such as the genes that code for the IL-1 family, TNF-alpha, lymphotoxin alpha, and IL-10. IL-1, IL-10, lymphotoxin alpha and TNF-alpha polymorphisms increase the risk of upper gastrointestinal pathogenesis in H. pylori-infected patients, whereas IL-1 and TNF-alpha polymorphisms confer risk in EBV-infected patients.

Cytokines↗
PubMed1993

The globus syndrome: value of flexible endoscopy of the upper gastrointestinal tract.

Flexible endoscopy of the upper gastrointestinal tract usually does not form part of the primary diagnostic evaluation of the globus syndrome. In a prospective trial, a flexible endoscopy was performed in 51 globus patients with normal results of the laryngologic and radiographic examination. Pathologic findings requiring therapy were diagnosed in 70.6 per cent of cases. The most frequent findings were reflux oesophagitis (n = 24; 47 per cent) and hiatal hernia (n = 25; 49 per cent). In 16 cases (31.4 per cent) these were accompanied by other pathologic lesions. A total of 32 patients (62.7 per cent) suffered from oesophageal diseases as sole aetiologic factors of the globus syndrome, which led us to postulate a causative relationship in these cases. Flexible endoscopy therefore can contribute significantly to the differential diagnosis of the globus syndrome. It must be kept in mind, however, that there is a 'blind zone' for endoscopic assessment in a region of the hypopharynx, thus some indications may require rigid endoscopy.

Adult↗
PubMed2006

Pharmacological therapy of vascular malformations of the gastrointestinal tract.

Vascular malformation (AVM) in the gastrointestinal tract is an uncommon, but not rare, cause of bleeding and iron deficiency anemia, especially in an aging population. While endoscopic coagulative therapy is the method of choice for controlling bleeding, a substantial number of cases require additional therapy. Adjunctive or even primary phamacotherapy may be indicated in recurrent bleeding. However, there is little evidence-based proof of efficacy for any agent. The bulk of support is derived from anecdotal reports or case series. The present review compares the outcome of AVM after no intervention, coagulative therapy or focus on pharmacological agents. Most of the literature encompasses two common AVMs, angiodysplasia and hereditary hemorrhagic telangiectasia. Similarly, the bulk of information evaluates two therapies, hormones (estrogen and progesterone) and the somatostatin analogue octreotide. Of these, the former is the only therapy evaluated in randomized trials, and the results are conflicting without clear guidelines. The latter therapy has been reported only as case reports and case series without prospective trials. In addition, other anecdotally used medications are discussed.

Adrenal Cortex Hormones↗
PubMed2004

Gene expression profiling of the bovine gastrointestinal tract.

Basal gene expression levels across the bovine gastrointestinal tract (GI) were examined in an attempt to formulate genetic explanations for the differences in function that are known or thought to exist between the various regions. Gene expression along the tract was studied through the random sequencing of a total of 16 412 clones from seven tissue-specific cDNA libraries spanning its length. The expressed sequence tags (ESTs) within each library were clustered to reduce clone redundancy and obtain longer consensus sequences. BLASTN and BLASTX searches against the NCBI human RefSeq databases were used to find putative matches for the bovine sequences and gene ontology assignments were made. Notable similarities and differences in gene expression were observed among the various compartments of the GI tract of the bovine. Many of the prominent transcripts have yet to be reliably identified and the prominence of others may be worthy of further examination. This collection of ESTs represents an important resource for the future construction of a GI tract specific microarray for further gene expression studies.

Animals↗
PubMed1983

Immunocytochemical identification of polypeptide YY (PYY) cells in the human gastrointestinal tract.

Various parts of the human gastrointestinal tract were investigated immunocytochemically for the occurrence of polypeptide YY (PYY) and pancreatic polypeptide (PP). PYY-immunoreactive cells were observed in the lower part of the ileum, in the colon and in the rectum, and PP-immunoreactive cells were found in the colon and rectum. Both cell types were of the open type, i.e. they extended from the basal lamina to the gut lumen. PYY-immunoreactive cells were seen to emit cytoplasmic processes to the neighbouring goblet cells. This latter observation suggests that PYY cells may exert a paracrine action on the mucus-secreting goblet cells. Staining of consecutive thin plastic sections and staining of the same section simultaneously for two peptides showed that PYY-immunoreactivity did not occur in PP- or enteroglucagon-immunoreactive cells. On the ultrastructural level PYY-immunoreactivity was localized in basal granulated endocrine cells. These cells contained round or slightly oval electron dense granules with a mean diameter of 150 nm (range 100-300 nm).

Digestive System↗
PubMed1989

Serum copper levels in gastrointestinal tract (GIT) cancer.

Cancer of the gastrointestinal tract (GIT) is very commonly encountered in Kashmir Valley of India. Serum copper and ceruloplasmin levels were investigated in 75 patients with GIT cancer, 42 non-GIT cancer and 75 normal healthy controls. The mean serum copper in the control group was 1,078 (S.D. 0,296) mg/L, while in patients with GIT and non-GIT cancers, it was 1,738 (S.D. 0,675) and 1,449 (S.D. 0,501) mg/L. Copper in both types of cancers showed significant increase (p less than 0.001). It was significantly higher in GIT cancers (p less than 0.01) as compared to non-GIT cancers. Ceruloplasmin in controls was 379 (S.D. 51) mg/L, while in GIT and non-GIT cancer patients the values were 363 (S.D. 75) and 364 (S.D. 77) mg/L, respectively. No significant difference could be found in either of the groups. In Kashmir Valley, the copper content in body tissues is likely to be on the high side because copper utensils are widely used by the general population. Water and milk samples stored in copper vessels and salt tea prepared in copper vessels showed markedly high levels of copper.

Animals↗
PubMed1979

Exposure of rabbits to spores of Aspergillus fumigatus or Penicillium sp: survival of fungi and microscopic changes in the respiratory and gastrointestinal tracts.

Rabbits were exposed to spores of Aspergillus fumigatus by 1 of 2 routes: exposure to aerosols of dry spores or introduction of liquid suspensions of spores directly into the stomach. Rabbits also were exposed to aerosols containing spores of a Penicillium sp. Cultural and microscopic examinations of tissues from the respiratory and gastrointestinal tracts indicated fungi were distributed throughout the gastrointestinal tract of the rabbits within 1 hour after exposure to aerosols of A fumigatus or Penicillum spores. Viable A fumigatus and Penicillium were detected in lung tissues of rabbits for 2 or 3 weeks after inhalation of spores. Aspergillus fumigatus was isolated from the gastrointestinal tract no more than 1 week after aerosol exposure, and Penicillium, not beyond 48 hours. However, when large numbers of A fumigatus spores were introduced directly into the stomach, fungi were isolated from tissues for as long as 16 days after exposure even though the intestinal contents were negative 4 to 7 days after introduction of spores. Tests for precipitating antibody were negative, with one exception, among 26 rabbits surviving for 2 weeks or more. Microscopic changes were more pronounced in rabbits exposed to spores of A fumigatus than in rabbits exposed to Penicillium spores.

Animals↗
PubMed2006

Interventional therapy for acute hemorrhage in gastrointestinal tract.

AIM: To evaluate the diagnostic angiography and therapy for acute massive hemorrhage in gastrointestinal tract. METHODS: Twenty-five cases of acute hemorrhage in gastrointestinal tract admitted between April 2002 and September 2004 were reviewed and analyzed by angiography and embolotherapy. RESULTS: Fifteen patients were men and ten patients were women. The Seldinger technique and method of coaxial duct were used to get access to the bleeding region. PVA particles, gelfoam, and coils were used for embolism. All bleeding sites could be confirmed and were successfully embolized. Hemostasis was achieved in all the patients without bleeding again. The cure rate was 100%. CONCLUSION: Interventional therapy can not only ascertain the bleeding site, but also stop the bleeding . The method is simple and the effect is certain.

Acute Disease↗
PubMed2006

Killing the messenger in the nick of time: persistence of breast milk sCD14 in the neonatal gastrointestinal tract.

Human breast milk contains several proteins that supplement the newborn mucosal defense system and prevent gastrointestinal illnesses. One of these recently identified breast milk proteins is soluble CD14 (sCD14). By being an important component of the lipopolysaccharide (LPS) receptor complex, it has been suggested that breast milk sCD14 could stimulate the newborn immune system and help reduce gastrointestinal Gram-negative infections. However, to deliver its potential immune benefits to the neonate, sCD14 would have to survive the passage through the gastrointestinal tract and retain its biologic activity. We analyzed the presence of breast milk sCD14 in the neonatal digestive system and found breast milk sCD14 to be absent from the stools of breast-fed infants. In vitro digestion analysis with simulated gastric and pancreatic fluids revealed that sCD14 is likely to survive the pepsin digestion but is more prone to been nicked and digested by pancreatin. These findings suggest that the presence of intact breast milk sCD14 in the upper digestive system could promote innate immunity in this low bacteria density lumen. The low concentration of sCD14 in the LPS-rich environment of the distal gastrointestinal tract (i.e. commensal microflora) could prevent excessive inflammation.

Feces↗
PubMed1991

[Cell membrane binding components for constituents of the extracellular matrix: structural mediator of the epithelial matrix interaction in the gastrointestinal tract].

Growth, migration, differentiation and metabolic functions of the epithelium in the gastrointestinal tract are regulated by the extracellular matrix. Different cell membrane binding components including the integrins for constituents of the extracellular matrix are expressed in the epithelial cells. These cell membrane binding components may be structural mediators of cell-matrix interaction in the gastrointestinal tract. A characterization of this interaction is of great importance, not only to understand physiological processes, such as epithelial migration and differentiation, but also for the pathogenesis of healing processes (ulcer healing), immunologically mediated processes (adhesion of immunocompetent cells), and especially for tumor pathology (invasion and metastasis). Gastrointestinal diseases are characterized by alterations in the expression of cell membrane binding components for different constituents of the extracellular matrix. In chronic inflammatory bowel disease, a changed expression can be identified on epithelial cells and, in especially malignant transformation of epithelial cells resulted in a pathologic expression of cell adhesion molecules. Oncogenes may modify the expression and function of these cell membrane binding components in the course of malignant transformation. In animal models, it was possible to reduce the frequency of tumor invasion and metastasis and to achieve longer survival times by blocking the cell membrane binding components on malignant cells. An increasing understanding of the role of cell membrane binding components in the epithelium-matrix interaction will certainly also be translated in the future into new therapeutic concepts.

Cell Adhesion↗
PubMed2001

[Laparoscopic surgery of the upper gastrointestinal tract].

Laparoscopic surgery of the upper gastrointestinal tract is nowadays associated with little morbidity and mortality. Cardiomyotomy with semifundoplication for management of achalasia and the various forms of fundoplication for treatment of reflux syndrome have proved beneficial and have largely replaced conventional surgery. Independent of the operative approach, it has not yet been established with certainty whether gastroesophageal reflux can best be prevented by 360 degrees fundoplication or semifundoplication. A perforated peptic ulcer can be treated effectively by laparoscopic overstitching of omental patch-plasty, although the superiority of the laparoscopic method has yet to be proved. Benign lesions and early malignancies are currently resected laparoscopically, but the role of laparoscopy in the curative treatment of advanced gastric carcinoma remains to be clarified. Diagnostic laparoscopy is used to avoid unnecessary laparotomy in inoperable cancer and to ascertain whether neoadjuvant therapy is indicated in advanced gastric carcinoma.

Esophageal Diseases↗
PubMed1979

Occurrence and polymorphism of bombesin-like peptides in the gastrointestinal tract of birds and mammals.

The gastrointestinal tract of mammals and birds, especially stomach and upper small intestine, contains bombesin-like peptides. This has been unequivocally demonstrated by radioimmunoassay and bioassay. Concentrations of bombesin-like activity may range from a few ng to 500-600 ng per g fresh tissue. Last values refer to the chicken proventriculus, which has been the object of a more thorough investigation. The bombesin-like peptide of the chicken proventriculus showed a marked heterogeneity. All forms probably stem from a pro-bombesin, a large precursor molecule which is insoluble in methanol, acetone, and even boiling water, but may be cleaved by acid hydrolysis. Methanol extracts contain at least two forms of the bombesin-like peptide; HCl extracts at least three forms; HCl extracts of the residue of methanol extraction at least four forms. Whereas some forms--for example, the methanol extractable forms--probably pre-exist in the tissue, other forms may be artefacts arising from acid treatment. The various forms may be distinguished from each other not only by their elution profile, but also by bioassay. In fact, though all forms show the activity spectrum characteristic for the amphibian bombesin-like peptides, they present considerable quantitative differences in activity. Pro-bombesin(s) probably occur also in the rat and guinea-pig stomach; similarly, a clear-cut heterogeneity is appreciable for the bombesin-like peptide of the human gastric mucosa.

Animals↗
PubMed1990

Characterization and distribution of bombesin-like peptides in the rat brain and gastrointestinal tract.

Extracts of rat brain and gastrointestinal tract, analyzed by reverse-phase high-performance liquid chromatography and radioimmunoassay, contained two bombesin-like immunoreactivity peaks with similar retention times as porcine gastrin-releasing peptide (GRP) and its COOH-terminal decapeptide, neuromedin C or GRP(18-27). However, the GRP-like peptide peak did not elute with exactly the same retention time as porcine GRP. The highest concentration of bombesin-like immunoreactivity was found in extracts of antrum, whereas the lowest was found in whole brain. Neuromedin C was present at lower concentrations than the GRP in antrum, duodenum, and ileum, while similar amounts of each were found in brain.

Animals↗
PubMed1989

Studies on mucus biosynthesis in the gastrointestinal tract.

Mucin biosynthesis in the rat gastrointestinal tract was measured by following the incorporation of radioactive precursors, [3H] glucosamine, [3H] galactose and [3H] serine. The radioactive mucin was isolated by a combination of equilibrium centrifugation in a CsCl density gradient and gel-filtration or, by papain digestion and removal of digested peptides by dialysis. Radioactive precursors were incorporated into mucin by stomach, duodenum and colon in vivo and by stomach in organ culture in vitro. In the latter, incorporation was approximately 20-fold greater than in vivo, over 6 h. In all cases lower molecular weight non-mucin glycoprotein, of the same buoyant density as mucin, became radioactively labelled (non-dialysable) and usually accounted for the majority of the incorporated radioactivity. Acetylcholine, dibutyryl cAMP and secretin stimulated radioactive incorporation into both gastric mucin and non-mucin components with acetylcholine and dcAMP stimulating specifically [3H] glucosamine into gastric mucin. Using these conditions no stimulation of incorporation into gastric mucin of all three radioactive precursors could be obtained with topical PGE2. In some biosynthesis studies by others, methods used to precipitate radioactive mucins do not distinguish between mucin and lower sized material. This study points to the need for a reappraisal of existing methods using radioactive isotopes to study mucin biosynthesis.

Animals↗