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PubMed1975

[Problems of extensive resection of small intestine in newborn infants and infants].

Massive resection of the small intestine in neonates and infants is mostly necessitated as a result of atresias, stenosis or circulatory disorders. At this period of life, the term "sub-total resection of the small intestine" is not applied in a standard way. Most authors use it when the residual small intestine is 75 cm or less in lenght. The survival prospects after sub-total resection of the small intestine are determined not only by the absolute length of the remaining small intestine; it is important which part can be preserved. Distal resections lead to a particularly serious malabsorption syndrome. In ileal resections, lipid absorption is disturbed owing to the lack of absorption of bile acids. A chologenous diarrhea results. The absorption functions (which are largely eliminated directly after the operation) recover in a regular pattern. The more orally localized functions (carbohydrate) recover more quickly than the more distally localized (lipid absorption). Surgical measures to slow the passage of intestinal contents have been applied with varying success in animal experiments. Clinical experience is largely lacking (only five cases). Various mechanisms for compensation after extensive resection of the small intestine in neonates (increase in length of the intestine, mucosal hypertrophy or greater cell density) are being discussed. These are only occasionally observed and the factors on which they depend are mostly obscure.

Age Factors↗

PubMed1984

Nontraumatic perforation of the small intestine.

Nontraumatic perforation of the small intestine is very rare in western countries, while typhoid fever is the most common cause of such perforation in other parts of the world. A series spanning 24 years is reviewed, comprising 112 adults with perforation of the small intestine resulting in peritonitis. Perforations due to Crohn's disease, strangulation, postoperative complications and malignancy are not included. Causes of perforation were ingested foreign body (24 cases), radiotherapy (18), potassium chloride medication (13), diverticula of the small bowel (10), Zollinger-Ellison syndrome (2), and tuberculosis, actinomycosis and intrauterine contraceptive device (each in 1 case). The etiology could only be suspected in 13 cases and in 31 it was unknown. Difficulties in making the preoperative diagnosis contributed to lateness of surgical intervention. Mortality (23%) was related to patient age and cause of the perforation. The series permitted no conclusions concerning relationship between surgical method and mortality rate, but it is recommended that the method be adapted from case to case, depending on the etiology of the perforation.

Adult↗

PubMed1993

[Primary lymphoma of the small intestine].

Lymphomas of the small bowel are rare tumors with few characteristics. Clinical and radiological diagnosis is difficult, because they may be confused by inflammatory or neoplastic forms, especially in primary involvement of the small intestine. Observation of three cases of primary extranodal lymphomas of the small bowel prompted a review of problems relating to the histology, clinical manifestations and the staging classification. This system is an important aid in the evaluation of the treatment and prognosis of these forms.

Adolescent↗

PubMed1985

Characterization of a microsomal fraction from rat small intestine for metabolic activation of some promutagens.

Rat small intestine possesses cytochrome P-450 mixed function oxidase activity and is thus potentially capable of activating procarcinogens during absorption. The low spontaneous tumour incidence at this site may be due partially to the detoxification activity of the intestinal mucosa. To study the contribution of the intestine to the metabolism of foreign chemicals, microsomes have been obtained from rat small intestine by a procedure facilitating recovery of preparations with consistently high enzyme activities and abilities to activate some selected promutagens in the Salmonella mutagenicity assay. Intestinal microsomes from animals with and without pretreatment with inducers have been used for investigations of biochemical properties and ability to activate several mutagens in the Salmonella plate incorporation assay. The effects of microsomal protein concentration and inhibitors were also studied. The results are compared with data obtained using liver microsomes from the same animals. Despite the induction of lower numbers of revertants, intestinal microsomes were at least as efficient as liver preparations for the activation of all the promutagens used when the data were corrected for cytochrome P-450 contents. Differences in dose-response curves for certain mutagens using liver and intestinal microsomes are discussed in relation to variation in metabolism of promutagens. Activation was linearly dependent on microsomal protein concentration, for both liver and small intestinal microsomes. The intestine was generally less susceptible to the effects of cytochrome P-450 and P-448 inducers, although sensitivity to orally administered phenobarbitone was increased by extending treatment times. SKF525A and beta-naphthoflavone inhibited microsomes from both sources, equal inhibition being observed for each type following incorporation of the inhibitor, although they differed in their ability to activate 2-acetylaminofluorene in the presence of the deacylase inhibitor, NaF. The data are discussed in relation to the possible role of the small intestine in metabolic activation in vivo and the utility of microsomes therefrom for the in vitro detection of putative dietary carcinogens.

2-Acetylaminofluorene↗

PubMed2006

Diagnosis and treatment of small intestinal bleeding: retrospective analysis of 76 cases.

AIM: To investigate the causes of small intestinal bleeding as well as its diagnosis and therapeutic approaches. METHODS: A retrospective analysis was conducted according to the clinical records of 76 patients with small intestinal bleeding admitted to our hospital in the past 5 years. RESULTS: In these patients, tumor was the most frequent cause of small intestinal bleeding (37/76), followed by Mecke's diverticulum (21/76), angiopathy (15/76) and ectopic pancreas (3/76). Of the 76 patients, 21 were diagnosed by digital subtraction angiography, 13 by barium and air double contrast X-ray examination of the small intestine, 11 by 99mTc-sestamibi scintigraphy of the abdominal cavity, 6 by enteroscopy of the small intestine, 21 by laparoscopic laparotomy, and 4 by exploratory laparotomy. Although all the patients received surgical treatment, most of them (68/76) received part enterectomy covering the diseased segment and enteroanastomosis. The follow-up time ranged from 1 year to 5 years. No case had recurrent alimentary tract bleeding or other complications. CONCLUSION: Tumor is the major cause of small intestinal bleeding followed by Meckel's diverticulum and angiopathy. The main approaches to definite diagnosis of small intestinal bleeding include digital subtraction angiography, 99mTc-sestamibi scintigraphy of the abdominal cavity, barium and air double contrast X-ray examination of the small intestine, laparoscopic laparotomy or exploratory laparotomy. Part enterectomy covering the diseased segment and enteroanastomosis are the most effective treatment modalities for small intestinal bleeding.

Adolescent↗

PubMed1978

[Late results of the interintestinal anastomosis condition after congenital obstruction of the small intestine].

The data concerning the late results of resection of the small intestine carried out for congenital small intestine ileus in 43 newborns are set forth. The results of an experimental study on 75 puppies subjected to resection of the small intestine with application of various anastomoses are covered in the article. The evaluation of late results suggests that end-to-end anastomosis is the best one; end-to-side anastomosis gives fair results, while side-to-side anastomosis is the least physiological one as it results in the formation of big "blind ducts", and the longlasting stasis of intestinal contents in these "blind ducts" leads to the development of various complication. The children, who underwent the small intestine resection, should be under dispensary and periodic clinical observation.

Adolescent↗

PubMedDate not supplied

Protective effect of prostaglandins on the methotrexate induced damage of small intestine in rats.

Methotrexate (MTX) treatment causes the damage of the small intestine, resulting in malabsorption. The aim of this study was to investigate the effect of prostaglandins (PGs), prostaglandin E1 (PGE1) and prostaglandin I2 (PGI2) analogues, on the MTX-induced damage of rat small intestine by examining the permeability of the small intestinal epithelium. The rats were treated as follows: MTX (15 mg/kg/day), MTX and PGE1/PGI2 analogues (0.5 and 5 micrograms/kg/twice a day), PGE1/PGI2 analogues alone, and sterile saline (control). All drugs were given orally for 5 days. The intestinal permeability of fluorescein isothiocyanate labeled dextran with average molecular mass 4.4 KDa (FD-4) was examined to evaluate the dysfunction of the small intestine by the in vitro everted small intestine technique. The permeation clearance of FD-4 obtained from the in vitro experiment of the MTX-treated rats increased remarkably, but that of the MTX and PGE1/PGI2 analogue-treated rats was significantly lower than that of the MTX-treated rats. These results indicated that PGE1 or PGI2 analogues possibly alleviated the MTX-induced damage of the small intestine of rats.

Alprostadil↗

PubMed1987

Effect of chronic ethanol ingestion on enterocyte turnover in rat small intestine.

Whether chronic ethanol ingestion significantly damages the small intestine remains controversial. To clarify this we have analysed the morphology of the small intestinal epithelium and quantified its renewal in chronically ethanol fed rats. Twenty adult male rats were pair fed for 28 days a nutritionally adequate liquid diet containing either ethanol as 36% of total calories or an isocaloric diet in which fat substituted for ethanol. Crypt cell production rate was determined in the jejunum and ileum by the metaphase arrest method. Weight gain and small intestinal morphology were similar in ethanol fed and control rats, but enterocyte turnover was significantly reduced in the jejunum (p less than 0.05) and ileum (p less than 0.01) of the ethanol fed rats. This effect of ethanol on the small intestine is probably systemic rather than local, because the changes in jejunum and ileum were similar, and it may contribute to the development of malnutrition in chronic alcoholics.

Animals↗

PubMed2004

Functional CCR9 expression is associated with small intestinal metastasis.

In general, metastases to the small intestine are rare, and mostly occur in melanoma. CCR9 has been shown to be the principal chemokine receptor for the thymus expressed chemokine (TECK), a chemokine selectively expressed in the small intestine and thymus. Here we show that CCR9 is highly expressed on melanoma cells and all melanoma cell lines isolated from small intestinal metastases, and on a proportion of cell lines from other sites. Only melanoma cells and cell lines from small intestinal metastases, however, were responsive to the CCR9 ligand TECK, as assessed by receptor downregulation and by actin polymerization. CCR9 expression was also found on the adenocarcinoma cell line CaCo-2 expressing characteristics of enterocytic differentiation, but not on any other cell line isolated from colorectal, breast, and lung cancer. Our data provide evidence that the aberrant functional cell surface expression of an organ-specific chemokine receptor is associated with metastasis to this site. The regulation of receptor function seems to be a critical step in the metastatic process.

Actins↗

PubMed2001

Intestinal digestion of dietary and endogenous proteins along the small intestine of calves fed soybean or potato.

This study was conducted to investigate the quantitative and qualitative changes in dietary and endogenous protein components along the small intestine of calves. They were fed milk replacers in which protein was provided either by skim milk powder alone, as control diet, or by skim milk powder and a soy concentrate, a partially hydrolyzed soy protein isolate, or a potato protein concentrate (1:1 on a CP basis). The calves were continuously infused with the liquid milk substitute diets into the abomasum. Duodenal, jejunal, and ileal digesta were collected through T-piece cannulas. Digestibility (corrected for total endogenous protein) of dietary protein and the concentration of dietary, host endogenous, and bacterial proteins were estimated from the AA composition of digesta using multiple linear regression. The apparent digestibility of feed components increased linearly between the duodenum and the ileum. It was lower with the diets containing plant protein than with the control, especially at the ileum (85% for CP with soy concentrate, 73% with soy isolate, and 81% with potato concentrate vs 91% with skim milk powder). The real digestibility of dietary protein at the ileum was estimated to be 96, 95, 94, and 99%, respectively, for each of the dietary components. The partition of protein components in digesta between dietary, nonspecific endogenous, specific host endogenous, and(or) specific bacterial proteins varied along the small intestine and between diets at a given site. Intestinal apparent reabsorption of host endogenous protein was estimated to be equivalent to at least 86% of the jejunum flow. To conclude, the lower apparent digestibility of the plant protein sources studied resulted more from an enhanced loss of host and bacterial endogenous proteins than from decreased hydrolysis of dietary protein and absorption of their AA.

Amino Acids↗

PubMed2003

Small intestinal morphology and activity of intestinal peptidases in piglets around weaning.

The effect of weaning on small intestinal morphology and the activities of three intestinal peptidases was investigated from 3 days prior to weaning to 9 days post-weaning in 64 piglets. Villous height, crypt depth and mitotic counts were determined at three positions along the small intestine. The activities of aminopeptidase N, dipeptidylpeptidase IV and gamma-glutamyl transpeptidase were measured at five positions along the small intestine. The villous height was maximal on the day of weaning. Post-weaning, the villi shortened at the proximal positions of the small intestine and the minimal length was observed on day 3 after weaning. Villous height did not decrease distally in the small intestine. Increased crypt depth was observed from 3-7 days post-weaning at all positions examined. Mitotic counts showed increased proliferative activity in the crypts from the third day post-weaning. Weaning influenced the activity of aminopeptidase N and dipeptidylpeptidase IV. The activities declined until day 3 post-weaning. After that, the activities increased and they had reached pre-weaning values by day 9 post-weaning. Weaning had only minor effect on the activity of gamma-glutamyl transpeptidase. In summary, weaning induced changes in small intestinal morphology and enzyme activity. The changes were maximal on day 3 post-weaning and during the following days, a gradual recovery of the small intestine was observed.

Aging↗

PubMed1979

[Intestinal invagination caused by lipoma of the small intestine].

A case of ileo-colic invagination caused by lipoma of the last loop of the small intestine is reported. The anatomo-clinical features of this neoformation are illustrated and stress is laid on certain special aspects: the rarity (about 300 cases have been described in the literature), the lack of symptomatology and its insidious development without pathognomonic sign up to the occurrence of occlusive episodes. The surgery carried out and the result obtained are reported.

Adult↗

PubMed1981

[Microcirculatory bed of the rat small intestine after nerve reflex isolation].

Intravital biomicroscopy of small intestinal wall vessels was used in experiments on rats undergoing total neuroreflex isolation of the small intestine to study the time course of changes in the diameter of intramural arterioles and venules of the first, second, third and fourth grades. It was demonstrated that neuroreflex isolation of the small intestine is accompanied by long-term deranged coordination of the vascular bed. These shifts appeared to be the earliest and the most significant in the major part of resistive vessels, determining the hydrostatic pressure in the capillaries and shifts in histohematic barriers, as well as in specific functions of the small intestine.

Animals↗

PubMed2006

A novel non-invasive biomarker for assessment of small intestinal mucositis in children with cancer undergoing chemotherapy.

BACKGROUND: Small intestinal mucositis is a common side-effect following high-dose chemotherapy, causing patients to experience pain and abdominal complications often leading to extended stays in hospital. A biomarker to detect these small intestinal changes does not exist in clinical practice. This study aimed to assess the noninvasive 13C-Sucrose breath test (SBT) to detect small intestinal damage associated with mucositis in pediatric cancer patients having chemotherapy. PATIENTS AND METHODS: Small intestinal function was assessed in 15 pediatric cancer patients and 26 healthy children. Subjects were studied for small intestinal permeability (SIP; lactulose/rhamnose), digestive and absorptive capacity (SBT; sucrose), and oro-cecal transit time (OCTT; lactulose), by ingesting two sugar drinks containing the respective sugars. Combined tests were carried out at baseline, day 1, day 3-5 and day 6-9, and in healthy individuals on two separate occasions. A total of 25 cycles of chemotherapy were assessed. Breath samples for the SBT were collected every 15 min for 3 h (expressed as % cumulative dose at 90 min (CD)), a 5 h urine collection for SIP and breath hydrogen determined every 30 min for three hours for OCTT. RESULTS: Clinical mucositis occurred in seven of the 25 cycles of chemotherapy (28%). No significant difference was observed for SIP and OCTT. The SBT %CD at 90 min was significantly lower in the mucositis group compared to the unaffected group and controls at baseline (p<0.05). Patients who developed mucositis maintained a significantly lower %CD, for all test points (p<0.05) compared to the unaffected patients. In patients who developed mucositis the SBT was below the reference range of the controls at all time points. CONCLUSION: The findings show for the first time that it is possible to noninvasively detect and monitor gut damage associated with chemotherapy-induced mucositis in pediatric cancer patients.

Adolescent↗

PubMed1987

Small intestinal fluid absorption in the rat during haemorrhage and its importance for plasma refill.

Small intestinal net fluid absorption and its importance for plasma volume restitution during a slow, stepwise haemorrhage was studied in rats. A continuous administration of a Krebs-glucose solution into the intestinal lumen increased the tolerated maximal bleeding volume from 31 to 70% of initial total blood volume. The 'small intestinal' autotransfusion rate, i.e. the rate of fluid mobilized from the intestinal lumen into the vascular compartment, was calculated to 2.3 ml h-1 100 cm-2 small intestinal serosal surface. 'Small intestinal' autotransfusion is proposed to be an important mechanism in the defence line against hypovolaemia. Haemorrhage induced a 40% increase in small intestinal net fluid absorption. This increase was abolished after pretreatment with Captopril, an angiotensin-converting enzyme blocker. Post-ganglionic denervation of the small intestine reduced, but did not abolish, the stimulatory effect of haemorrhage on net fluid absorption. These results indicate that both a direct nervous component and the renin-angiotensin system are of importance for the increase in small intestinal net fluid absorption observed after haemorrhage.

Acid-Base Equilibrium↗

PubMed2004

Population-based study of small intestinal atresia and stenosis, Hawaii, 1986-2000.

Atresia and stenosis are some of the most common birth defects affecting the small intestine. Few population-based studies have examined the epidemiology of small intestinal atresia/stenosis. Eighty-two cases of small intestinal atresia/stenosis were identified through a population-based birth defects registry in Hawaii during 1986-2000. The relationships of various clinical and demographic factors with small intestinal atresia/stenosis and duodenal atresia/stenosis were examined. The small intestinal atresia/stenosis and duodenal atresia/stenosis rates were 2.9 per 10,000 live births [95% confidence interval (CI) 2.3-3.6] and 1.3 per 10,000 live births (95% CI 1.0-1.9), respectively. No secular trend was observed (P = 0.067 and 0.090, respectively). Maternal age risk for small intestinal atresia/stenosis was U-shaped, while duodenal atresia/stenosis rates were highest with maternal age of 35 years or more. Small intestinal atresia/stenosis was substantially more common among Far East Asians than Caucasians [rate ratio (RR) 1.96, 95% CI 1.24-2.94]. Duodenal atresia/stenosis risk was higher in Hawaii County than in Honolulu County (RR 2.55, 95% CI 1.10-5.02). Small intestinal atresia/stenosis was also associated with low birth weight (RR 11.50, 95% CI 8.05-15.92), low gestational age (RR 8.60, 95% CI 6.34-11.41) and multiple births (RR 3.79, 95% CI 1.39-8.24). In conclusion, this study found associations between small intestinal atresia/stenosis and maternal age, maternal race/ethnicity, county of residence, birth weight, gestational age and plurality, but not delivery period. Many of the associations between small intestinal atresia/stenosis and other factors noted in this investigation were similar to those reported by other studies.

Adolescent↗

PubMed1994

Recursive running DCT algorithm and its application in adaptive filtering of surface electrical recording of small intestine.

A rhythmic electrical signal is present in the human small intestine and can be recorded using surface electrodes. Surface electrical recordings of the small intestine contain severe interference that obscures the electrical signal of the small intestine. An adaptive system is proposed in the paper for the enhancement of the small-intestinal signal. To obtain better performance, adaptive signal enhancement is performed in the transform domain using a discrete cosine transform (DCT). A fast recursive algorithm is developed for the calculation of running DCT. The computational complexity of the proposed recursive algorithm is only 2/N (N = length of the adaptive filter) of the direct calculation of the running DCT. A series of simulations are conducted to investigate the performance of the proposed transform-domain adaptive filtering using DCT in comparison with time-domain adaptive filtering and with transform-domain adaptive filtering using a discrete Fourier transform (DFT). The parameters of the proposed adaptive system are optimised, and their effects on system performance are investigated. The application of the proposed method for the enhancement of the small-intestinal signal is presented and discussed.

Algorithms↗

PubMed2006

Expression of CD147 and monocarboxylate transporters MCT1, MCT2 and MCT4 in porcine small intestine and colon.

Lactate, formed mainly in the stomach and small intestines, and short-chain fatty acids (SCFAs) formed in the colon, are ionised and require transporter proteins such as monocarboxylate transporters (MCTs) for absorption. The amounts of MCT1, MCT2, MCT4 and CD147, an ancillary protein for MCT1 and MCT4, were measured by immunoblotting the small intestine and colon of 40 pigs (Landrace, Yorkshire and LandracexYorkshire). MCT1 and MCT4 were found in both small intestine and colon, but MCT2 only in the small intestine. In both small intestine and colon, Yorkshire pigs had more CD147 than Landrace pigs, while no interbreed differences were found in MCT isoforms. Since CD147 is essential for the activity of MCT1 and MCT4, the breed difference suggests that MCT activity is higher in Yorkshire than in Landrace pigs. The absence of MCT2 in the colon suggests that it is mainly a lactate transporter, while MCT1 and MCT4 facilitate the transport of both lactate and SCFA.

Amino Acid Sequence↗