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Balloon dilatation of upper gastrointestinal tract strictures.

Balloon dilatation has been performed in a series of 30 patients with strictures of the upper gastrointestinal tract over a period of 28 months. The technique of balloon dilatation is described and the results of follow-up are presented. Sixty per cent of patients have remained symptom-free following balloon dilatation. Twenty-seven per cent of patients have undergone regular repeated dilatations when symptoms have recurred. There were no complications from the technique. Balloon dilatation is a safe and acceptable alternative to conventional methods of bougienage in the management of upper gastrointestinal tract strictures.

Aged↗

Touch cytology, a useful diagnostic method for diagnosis of upper gastrointestinal tract infections.

Candida albicans, Campylobacter pylori, and Giardia lamblia are microorganisms that are frequently found in the upper gastrointestinal tract. A cytological smear of biopsies obtained at endoscopy was compared with the pathologic examination of biopsies. Candida albicans was found in 55 patients, Campylobacter pylori in 54, Giardia lamblia in 31; cytology was positive in 43, 46, and 22 cases, respectively, and biopsy in 29, 43, and 22 cases. Cytology was thus the only positive test in 26 cases with Candida albicans (47% of the 55 cases), in 11 cases of Campylobacter pylori (20%), and in nine cases of Giardia lamblia (29%). We believe that the cytological smear of biopsies (touch cytology) is a quick and sensitive method for diagnosing infections of the upper gastrointestinal tract, increasing the diagnostic yield obtained by biopsy alone.

Campylobacter Infections↗

Effect of barium sulfate on wound healing in the gastrointestinal tract of the rat.

PURPOSE: To study the effect of barium sulfate on wound healing in the gastrointestinal tract of the rat. MATERIALS AND METHODS: Sixty rats weighing approximately 320 g were divided into four groups: Fifteen control rats had gastric, small-bowel, and colonic incisions; 15 rats had gastric incision; 15 rats had small-bowel incision; and 15 rats had colonic incision. Barium sulfate was placed into the incision before closure in all rats except those in the control group, and the effects were documented clinically and histopathologically for 3 months. Autopsy was performed in five rats from each group at 1, 4, and 12 weeks. The incisions in the rats receiving barium sulfate were compared with those in the control rats. RESULTS: There was no difference in the clinical course (weight gain, activity, and viability) between the control and experimental groups. Early and late autopsy findings and histopathologic grading of healing and inflammatory response were similar for both the control and experimental groups. CONCLUSION: Under the conditions of this study, the effect of barium sulfate on visceral transmural wound healing in the gastrointestinal tract of the rat was minimal.

Abdominal Abscess↗

Non-invasive investigation of the upper gastrointestinal tract using technetium-99m.

The use of technetium-99m in the noninvasive investigation of the upper gastrointestinal tract is discussed with particular reference to the evolution of a method of assessing gastric function or gastric acid secretion non-invasively and to the applications of this method in the investigation of surgical patients with disease of the upper gastrointestinal tract. The assessment of maximal acid output and the insulin response is described and the use of the test in the diagnosis of pernicious anaemia, hypo- and hyperchlorhydric states, gastric cancer, hiatus hernia and Barrett's oesophagus, coeliac disease, Meckel's diverticulum, and abdominal aortic aneursym outlined. The use of chemicals labelled with this tracer in hepatobiliary scanning is briefly described.

Gastric Juice↗

[Histochemical reactions in the diagnosis of carcinoid of the gastrointestinal tract].

The comparative effectiveness of 6 histochemical reactions permitting to detect endocrine granules in cells of carcinoids in the gastrointestinal tract were studied. The most sensitive methods were found to include Grimelius argirophilic reaction, staining with toluidine blue after acidic hydrolysis (HCl-TB) and with lead hematoxyline (Pb-H). By these methods endocrine granules were found in all 29 carcinoids examined. A modification of Grimelius argirophilic reaction is described and recommendations for its application in diagnosis of carcinoids of the gastrointestinal tract, their emboli and micrometastases are given.

Carcinoid Tumor↗

Developmental expression of the tight junction protein, occludin, in the gastrointestinal tract of the chick embryo.

The developmental expression of occludin was studied biochemically in whole chick embryos to determine when intercellular tight junctions develop. Occludin mRNA was first detected after 3 days of incubation by the reverse transcriptase-polymerase chain reaction. On northern blot analysis, although occludin mRNA was not discernible in 3-day-old embryos, weak but clear expression was noted on day 4 of incubation and increased dramatically in 5-day-old embryos. Occludin was not detectable on days 3 or 4 of incubation by western blot analysis, and was first detected in 5-day-old embryos. In addition, the expression of occludin was examined immunohistochemically in the gastrointestinal tract of 3- to 21-day-old embryos. Immunoreactivity for occludin was not expressed on day 3 of incubation. On day 4 of incubation, weak immunoreactivity was demonstrated in the gastrointestinal tract, and gradually became stronger with development. By day 11 of incubation, a positive immunoreaction was obtained only on the apical surfaces of the epithelial cells, i.e., at the junctional complexes, while weak immunoreactivity was diffusely distributed throughout the epithelial cells. The possible roles of occludin in the developing gastrointestinal tract are discussed.

Animals↗

Bloodborne metastatic tumors to the gastrointestinal tract: CT findings with clinicopathologic correlation.

OBJECTIVE: In this essay, we illustrate the CT features of bloodborne metastases to the gastrointestinal tract from various malignancies with an emphasis on clinicopathologic correlation. CONCLUSION: Familiarity with CT findings of bloodborne metastases to the gastrointestinal tract and an understanding of the disease spread pattern in common primary cancers will be helpful not only in detecting metastatic disease but also in minimizing the possibility of mistaking metastasis for another metachronous malignancy.

Adult↗

Scanning electron microscopy of mucosal biopsies of the human upper gastrointestinal tract.

There have been comparatively few scanning electron microscopic studies of mucosal biopsies of the human upper gastrointestinal tract. This report deals with the results of scanning electron microscopy of 21 mucosal biopsies: 7 esophageal, 2 from the gastroesophageal junction, 3 gastric and 9 duodenal biopsies. Mucosal biopsies were obtained at the time of fiberoptic endoscopy and were placed immediately into 2.5% glutaraldehyde in phosphate buffer, pH 7.4. After post-fixation and removal of mucus, tissue was processed by means of the O-T-O method, Dehydrated, critical point dried with CO2 and examined at 20kV. Scanning electron microscopy (SEM) of mucosal biopsies of the esophagus shows a mosaic pattern. Cell borders are clearly demarcated and there are find microridges on the luminal surface. There are varying degrees of detachment and desquamation of the superficial cells. Acute esophagitis was observed in 2 of the biopsies. At the gastro-esophageal junction, the squamous epithelium of the esophagus abuts in a jagged manner upon the columnar epithelium of the stomach. The SEM appearance of the gastric mucosa is characterized by the presence of hillocks with central depressions formed by the gastric pits. Flattening of the hillocks and invagination into the gastric pits were seen in a biopsy of a fold at a Billroth I anastomosis. The villi of the duodenal mucosa form tongue-like of finger-like projections. The luminal surface of the absorptive cells has a dense covering of microvilli. The openings of goblet cells are studied on the mucosa as minute depressed foci. Varying degrees of an acute inflammatory reaction were present in 5 duodenal biopsies. It is concluded that SEM should prove to be of value as an aid in the diagnosis of mucosal biopsies of the human upper gastrointestinal tract.

Adult↗

Peptide hormone-like immunoreactivity in the gastrointestinal tract and endocrine pancreas of eleven teleost species.

The distribution of peptide hormone-like immunostaining in the gastrointestinal tract of 11 teleost species was investigated by immunofluorescence. Cells immunoreactive for somatostatin were found in the glandular epithelium of the stomach of four species and in the epithelium of the pyloric appendage of one species. The mid-gut epithelium contained cells reactive with antibodies to glucagon (three species), gastrin (five species), pancreatic polypeptide (five species), and substance P (two species). Cells immunoreactive for met-enkephalin were found in the epithelium of both the mid-gut and the stomach of six species. In six species in which the endocrine pancreas was investigated, insulin-, glucagon-, and somatostatin-like immunoreactivity was observed. Pancreatic polypeptide was definitely localised by immunostaining in cells of the endocrine pancreas of only one out of three species examined. Vasocative intestinal polypeptide-, neurotensin-, bombesin-, and enkephalin-like immunoreactivity was identified in the gastrointestinal nerve fibres in various species. In view of the considerable species variation found, caution should be exercised in generalising about the peptides present in the gastrointestinal tract of fish.

Animals↗

[Acute hemorrhagic gastritis as a cause of bleeding from the upper gastrointestinal tract].

In a material of 4560 panendoscopic investigations carried out in an endoscopy laboratory haemorrhages from the upper gastrointestinal tract were found in 201 cases. In 49 cases the cause of blood loss was acute haemorrhagic gastritis. Among them males accounted for 41% (mean age 35.6 years) and females for 59% (mean age 41.8 years). Acute haemorrhagic gastritis was associated with active peptic ulcer (20% of cases), portal hypertension (18%), which were, however, not the cause of haemorrhage. In only 19 cases (39%) acute haemorrhagic gastritis was not associated with any detectable pathological lesions in the upper gastrointestinal tract, adn massive haemorrhage appeared without any preceding symptoms. Considering the total number of bleedings haemorrhagic gastritis was the cause of massive bleeding in 10% of cases.

Acute Disease↗

Estrogen, progesterone and the gastrointestinal tract.

Administration of postmenopausal hormonal replacement therapy (HRT) is increasing. Both estrogen and progesterone have established effects upon the gastrointestinal tract. Our objective was to review the current literature and inform the primary care obstetrician-gynecologist of the physiologic and possible therapeutic effects of estrogen and progesterone upon the gastrointestinal tract. We performed a MEDLINE search of the English-language literature from 1966 through April 2000 utilizing the following keywords: estrogen, progesterone, oral contraceptives, hormonal replacement therapy, esophagus, stomach, peptic ulcer disease, gallbladder, irritable bowel syndrome, colon, inflammatory bowel disease, ischemic colitis and arteriovenous malformations. This review provides an abundance of data supporting that estrogen and progesterone have both beneficial and detrimental effects on the esophagus, stomach, gallbladder, and small and large intestine.

Digestive System↗

Validity of specifically applied rare earth elements and compartmental models for estimating flux of undigested plant tissue residues through the gastrointestinal tract of ruminants.

The validity of using rare earth elements as flow markers of undigested residues was evaluated by comparing mean gastrointestinal residence time (GMRT) of rare earths specifically applied to cottonseed hulls (CSH) to that of the indigestible fiber of CSH. Feces were collected from five lambs fed a mineral supplemented diet of CSH containing 52 g CP/kg DM and five lambs fed a CSH plus cottonseed meal diet (CSH+CSM) containing 123 g CP/kg DM. Rare earth elements (La, Yb, and Tb) specifically bound to CSH were included in the diet for a 5-d period and then deleted from the diet for a 3-d period. Following the last fecal collection, lambs were slaughtered for collection of digesta from segments of the gastrointestinal tract. Potentially indigestible NDF (PIF) was determined in diets and digesta from each segment of the gastrointestinal tract. Mean turnover rate, time delay, and GMRT for each rare earth element was estimated by fitting an age-dependent compartment model to profiles of markers appearing in the feces (compartmental model-marker method, CMM). The GMRT also was computed by the indigestible entity pool dilution method (IEPD) as grams of PIF in sampled segment/mean intake rate of PIF proceeding slaughter, g/h. The GMRT computed by the CMM and the IEPD methods did not significantly (P < 0.05) differ (99.6 vs 94.8 h and 58.9 vs 59.5 h for CMM vs IEPD and CSH and CSH+CSM diets, respectively). Regression of GMRT estimated for rare earths vs PIF yielded a highly significant regression (P = 0.001) with a regression coefficient of 0.94 +/- 0.016. It was concluded that rare earth elements applied to specific feeds are valid flow markers for the undigested residues derived from such marked feeds.

Animal Feed↗

Translocation of certain indigenous bacteria from the gastrointestinal tract to the mesenteric lymph nodes and other organs in a gnotobiotic mouse model.

Viable bacteria were not cultured from the mesenteric lymph nodes, spleens, or livers of specific-pathogen-free (SPF) mice. Viable enteric bacteria, primarily indigenous Escherichia coli and lactobacilli, were present in the mesenteric lymph nodes of gnotobiotic mice inoculated intragastrically with the whole cecal microflora from SPF mice but not in the nodes of control SPF mice similarly inoculated. These indigenous E. coli also were cultured from the mesenteric lymph nodes of 96% of gnotobiotic mice monoassociated with E. coli but from none of the mesenteric lymph nodes of SPF mice inoculated with the E. coli. Furthermore, viable E. coli were detected in the mesenteric lymph nodes of these monoassociated gnotobiotes for as long as 112 days after inoculation. Indigenous Lactobacillus acidophilus also translocated to the mesenteric lymph nodes of gnotobiotic mice monoassociated with L. acidophilus. Apparently, there are mechanisms active in SPF mice inhibiting translocation of indigenous bacteria from the gastrointestinal tract to the mesenteric lymph nodes, spleens, and livers, whereas these mechanisms are either absent or reduced in gnotobiotic mice. Indigenous E. coli maintained higher population levels in the gastrointestinal tracts of the gnotobiotes compared with their population levels in SPF mice, suggesting that high bacterial population levels might promote translocation of certain bacteria from the gastrointestinal lumen to the mesenteric lymph nodes. Gnotobiotic and SPF mice, therefore, provide experimental models for determining the nature of the mechanisms operating to confine indigenous bacteria to the gastrointestinal tract in normal, healthy animals.

Animals↗

Gene expression and localization of GABA(C) receptors in neurons of the rat gastrointestinal tract.

The effects of GABA in the CNS are mediated by three different GABA receptors: GABA(A), GABA(B) and GABA(C) receptors. GABA(A) and GABA(B) receptors, but not yet GABA(C) receptors, have been demonstrated in the enteric nervous system, where GABA has been proposed to be a transmitter. The purpose of this study was to determine whether GABA(C) receptors are present and thus may play a role in mediating the effects of GABA in the myenteric plexus of the rat gastrointestinal tract. We examined the expression of the three known GABA(C) receptor subunits, rho1, rho2 and rho3, in the rat duodenum, ileum and colon using the reverse transcriptase-polymerase chain reaction. We determined the localization of GABA(C) receptors in the myenteric plexus of these regions using two different antisera directed against GABA(C) receptor subunits. The polymerase chain reaction revealed that all three subunits were expressed in the gastrointestinal tract. When the layers of the intestine were separated and the layer containing myenteric neurons was assayed, the rho3 subunit was found in the ileum and colon, whereas rho1 was expressed in the duodenum and weakly in the colon and rho2 was expressed in the ileum. Immunocytochemistry revealed numerous labeled neurons in the myenteric plexus of each region. Colocalization showed that a large proportion of calbindin plus calretinin immunoreactive neurons (intrinsic primary afferent neurons) were immunoreactive for the GABA(C) receptor, and that 56% of nitric oxide synthase immunoreactive neurons (inhibitory motor neurons) exhibited the receptor. These results indicate that GABA(C) receptors of differing subunit compositions are expressed by neurons in the rat gastrointestinal tract. The effects of GABA on intrinsic sensory and on inhibitory motor neurons are likely to be mediated in part through GABA(C) receptors.

Animals↗

Metastatic lung carcinoma involving the gastrointestinal tract.

A review of 147 autopsies performed over a 4.5-year period on patients with a diagnosis of primary carcinoma of the lung revealed that 18 (12%) had metastatic lesions in the gastrointestinal tract. Fourteen had a single focus of gastrointestinal involvement, while four had multiple lesions in the gastrointestinal tract. Large cell carcinoma accounted for a large percentage (33%), out of proportion to the general occurrence of this cell type (12%). Twelve of the 18 patients had signs or symptoms suggesting gastrointestinal involvement but only four were diagnosed premortem. Gastrointestinal involvement in metastatic carcinoma of the lung occurs more frequently than realized and is often overlooked.

Adenocarcinoma↗

Antipropulsive effects of central and peripheral morphine in the rat gastrointestinal tract.

The antipropulsive effects of centrally or peripherally administered morphine have been examined at three levels of the rat gastrointestinal tract. Adult male rats were anaesthetized with pentobarbitone (50 mg kg-1 i.p.) and were implanted with an intraluminal catheter in either the proximal duodenum or mid-jejunum. Other animals were also implanted with a cannula in the right lateral cerebral ventricle. Gastric emptying and transit were determined selectively by measuring the progression of a radioactive chromium (CR-51) solution, given intragastrically for tests of gastric emptying or instilled into the proximal or distal intestinal catheter for determination of intestinal transit, 30 min after administration of morphine or saline given either subcutaneously (s.c.) or intracerebroventricularly (i.c.v.). Morphine given either s.c. (5 mg kg-1) or i.c.v. (30 micrograms, total dose) significantly inhibited gastric emptying and transit through bulk portions of the small intestine indicating that by either route it inhibits propulsion at all three levels of the gastrointestinal tract.

Animals↗

Effect of analgesic drugs on the electromyographic activity of the gastrointestinal tract and sphincter of Oddi and on biliary pressure.

Continuous biliary pressure and electromyographic activity of the sphincter of Oddi and gastrointestinal tract were recorded in conscious opossums following administration of analgesic drugs. Morphine, meperidine, and pentazocin increased significantly the duration of the migrating motor complex (MMC) cycle. Periods of 1-2 minutes of intense burst of spike potentials were seen in the sphincter of Oddi and duodenum following administration of morphine (8 experiments), meperidine (6 experiments), and pentazocin (3 experiments). The biliary pressure in the control studies was similar to that following administration of all analgesics in the animals with gallbladder and following instillation of tramadol, metamizol, and acetylsalicylic acid in animals with no gallbladder. However, the biliary pressure was significantly higher following administration of morphine, meperidine, and pentazocin in the animals with no gallbladder. It is concluded from this study that morphine, meperidine, and pentazocin may cause important disturbances in the motility of the sphincter of Oddi and gastrointestinal tract. These myoelectric disturbances may cause an increase in the biliary pressure in animals that have been subjected to cholecystectomy, but not in animals with intact gallbladder. The gallbladder may accommodate the bile produced by the liver during periods of sphincter of Oddi dysfunction and thus impede an increase in the biliary pressure.

Ampulla of Vater↗

[Studies on relationship between immunodeficiency in HIV-infected people and condition of upper gastrointestinal tract mucosa, prevalence of mycosis and Helicobacter pylori infection].

HIV infection leads to progressive deterioration of immunity. Upper gastrointestinal symptoms are often reported in patients with this infection. The aim of the study was to evaluate morphological changes in upper gastrointestinal tract mucosa and prevalence of opportunistic infections and Helicobacter pylori in HIV-infected people in relationship to the degree of immunosupression. We studied 94 HIV-infected patients with dyspeptic symptoms, 47 suffered from severe immunodeficiency expressed by low CD4+ lymphocyte count below 200/ mm3. Control group consisted of 52 non HIV-infected patients. During endoscopy, gastrointestinal tract mucosa was evaluated and biopsy samples were taken from gastric body and antrum for histopathological analysis and rapid urease test. In patients with CD4+ lymphocyte count below 200/mm3, endoscopic examination revealed significantly more frequent esophageal candidiasis (36%); whereas reflux esophagitis (13%) was significantly less often diagnosed in comparison to the rest of the patients. Duodenitis and duodenal erosions were also less frequent in them. Prevalence of Helicobacter pylori infection in gastric antrum was significantly lower in HIV-infected patients with severe immunodeficiency (40%) in comparison to the rest of the patients (72%) and control group (69%). Chronic active gastritis of the antral mucosa was less frequent in HIV-infected patients with CD4+ lymphocyte count below 200/mm3.

AIDS-Related Opportunistic Infections↗