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PubMed2000

CT interpretation of gastrointestinal tract diseases.

Most inflammatory, neoplastic and vascular disorders manifest bowel wall thickening on computed tomography (CT). Therefore, it is very important to understand the patterns of bowel wall involvement (degree, length, symmetry and contrast enhancement patterns) in each category to make a correct diagnosis. Observing extraluminal changes also help to classify the primary causes of pathological conditions involving the gastrointestinal tract. Adequate CT examinations with optimal opacification of the gastrointestinal tract are essential not only to avoid false positive findings but also to detect subtle or minimal lesions. If findings for establishing a diagnosis are equivocal, the use of combined findings increases the diagnostic accuracy of CT.

Gastrointestinal Diseases↗
PubMed2004

Distribution of mRNA that codes for subtypes of adrenergic receptors in the gastrointestinal tract of dairy cows.

OBJECTIVE: To describe the distribution of mRNA that codes for 9 subtypes of adrenergic receptors in the digestive tract of dairy cows. SAMPLE POPULATION: Fresh full-thickness wall specimens from the abomasum (fundus, corpus, and antrum), ileum, cecum, proximal loop of ascending colon, and 4 locations of the spiral colon collected from 10 healthy cows at slaughter. PROCEDURE: Concentrations of mRNA that code for 9 subtypes of adrenergic receptors in the bovine gastrointestinal tract (alpha1A, alpha1B, alpha1D, alpha2AD, alpha2B, alpha2C beta1, beta2, and beta3) were measured by use of a quantitative real-time reverse transcription-polymerase chain reaction assay. Results were reported in relation to mRNA expression of the housekeeping gene glyceraldehyde phosphate dehydrogenase (GAPDH). RESULTS: Mean mRNA contents of adrenergic receptors in the bovine digestive tract were low (range, 0.00006% to 5.04% of GAPDH). Distribution of receptor subtypes was similar in all tissues, with lowest expression of alpha1D receptors, followed by alpha2B, alpha2C, beta3, alpha1B, alpha1A, beta1, and beta2 in the abomasum, whereas alpha2AD and beta2 in the intestines were highest. In comparison with the intestines, relative concentrations of mRNA for receptors beta2 and beta3 were significantly lower in the abomasum. CONCLUSIONS AND CLINICAL RELEVANCE: Relative concentrations of mRNA that code for adrenergic receptors differed among receptor subtypes and among locations in the bovine gastrointestinal tract. Comparison of these values established in healthy cattle with results for cows with motility disorders, such as abomasal displacement and cecal dilatation, may lead to improved therapeutic or prophylactic approaches for these diseases.

Analysis of Variance↗
PubMedDate not supplied

Mucosal pathology of the upper gastrointestinal tract associated with intensive chemotherapy in children: vitamin A supplements do not prevent lesions.

Intensive chemotherapy (ICT) for a malignant disease in children may be associated with clinically significant mucosal lesions of the upper gastrointestinal tract. This prospective and randomized study was conducted to evaluate more thoroughly the mucosal damage and to find out whether vitamin A therapy might prevent the development of these lesions. Gastroduodenoscopy and non-invasive methods were used to examine a consecutive series of 20 patients (10 females, 10 males, aged 1-15 years) 4 weeks after initiating the therapy regimen. Half of the patients were randomized to take vitamin A supplements for 6 weeks. During a follow-up of 6 weeks, 13 (65%) reported some symptoms of the gastrointestinal (GI) tract, diarrhea and mouth pain being most prominent. Endoscopic abnormalities were found in 13 (65 %) subjects: esophagitis in 10, erosive duodenitis in 8, and gastritis in 7. Histologically, 11 subjects had duodenitis, 5 had gastritis, 3 had eosinophilic esophagitis, and 2 had lymphocytic esophagitis. Both endoscopic and histological abnormalities of the duodenum showed a close relationship with long-term (more than 2 weeks) granulocytopenia. The 4 patients with the most extensive endoscopic abnormalities were treated with HCl inhibitors, and re-endoscopy performed 4-8 weeks later showed complete recovery. The sugar permeability values, measured as the lactulose/mannitol ratio were comparable to the values obtained in the controls, and lactose intolerance was found in only 3 (20%) of the 15 children able to perform the breath test. Both the incidence of the reported GI symptoms and the endoscopically or histologically observed GI lesions were similar in the subjects randomized to take vitamin A supplements as in the controls. In this study, two-thirds of children with ICT showed erosive mucosal lesions of the upper gastrointestinal tract, and vitamin A therapy failed to prevent them. Endoscopic examination is recommended if a patient has severe symptoms indicative of mucosal pathology.

Adolescent↗
PubMed2005

Radical scavenging activity and stability of betalains from Beta vulgaris hairy root culture in simulated conditions of human gastrointestinal tract.

Stability and radical scavenging activity of betalains, biosynthesized by Beta vulgaris hairy root culture were investigated at different pH values, bile salts concentration, as well as at the in vitro conditions of gastrointestinal tract. It was established that pH below 3 and concentrations of the bile salts up to 4% had no great influence on betalains stability. At the in vitro conditions of gastrointestinal tract betalains are relatively stable, as their radical scavenging activity decrease from 75% inhibition of 2,2-diphenyl-1-picrylhydrazyl (DPPH*) to about 38%.

Beta vulgaris↗
PubMed1988

Application of immunohistochemistry to the isolated mucosa of the mouse gastrointestinal tract, with special reference to somatostatin cells.

In the present study, in order to easily grasp whole images of somatostatin (D) cells, the isolated mucosa of the mouse gastrointestinal tract was immunohistochemically treated. The present study revealed that: (1) in the stomach, small-intestinal villi and colon, about 20% of the D cells extrude basal cytoplasmic processes, showing terminal expansions in many cases; on the other hand, in the crypts of the small intestine, few D cells possess basal processes, and (2) in the stomach, there is no determined tendency in the direction of the basal processes of the D cells; on the other hand, in the small-intestinal villi and colon, most D cell basal processes run toward the villus base and colon crypt bottoms. The direction of the basal processes of the D cells in the gastrointestinal tract seems to be mostly in favor of the migration pattern of epithelial cells described previously. It is likely that, if the targets of the D cells are near the D cells, the basal process is not necessary for local secretion of somatostatin. During migration, however, D cells might extrude basal processes to keep relationships with their targets.

Animals↗
PubMedDate not supplied

Vascular lesions of the gastrointestinal tract.

Vascular lesions of the gastrointestinal (GI) tract include arterio-venous malformations as angiodysplasia and Dieulafoy's lesion, venous ectasias (multiple phlebectasias and haemorroids), teleangiectasias which can be associated with hereditary hemorrhagic teleangiectasia (HHT), Turner's syndrome and systemic sclerosis, haemangioma's, angiosarcoma's and disorders of connective tissue affecting blood vessels as pseudoxanthoma elasticum and Ehlers-Danlos's disease. As a group, they are relatively rare lesions that however may be a major source of upper and lower gastrointestinal bleeding. Clinical presentation is variable, ranging from asymptomatic cases over iron deficiency anaemia to acute or recurrent bleeding that may be life-threatening. Furthermore, patients may present with other symptoms, e.g. pain, dysphagia, odynophagia, the presence of a palpable mass, intussusception, obstruction, haemodynamic problems resulting from high cardiac output, lymphatic abnormalities with protein loosing enteropathy and ascites, or dermatological and somatic features in syndromal cases. Diagnosis can usually be made using endoscopy, sometimes with additional biopsy. Barium radiography, angiography, intraoperative enteroscopy, tagged red blood cell scan, CT-scan and MRI-scan may offer additional information. Treatment can be symptomatic, including iron supplements and transfusion therapy or causal, including therapeutic endoscopy (laser, electrocautery, heater probe or injection sclerotherapy), therapeutic angiography and surgery. The mode of treatment is of course depending on the mode of presentation and other factors such as associated disorders. If endoscopic or angiographic therapy is impossible and surgical intervention not indicated, pharmacological therapy may be warranted. Good results have been reported with different drugs, albeit most of them have not been tested in large trials.

Connective Tissue Diseases↗
PubMed2005

Endocrine tumours of the gastrointestinal tract: Chemotherapy.

Malignant neuroendocrine tumours are less sensitive to chemotherapy than other epithelial malignancies. If chemotherapy is considered, tumours of pancreatic origin have a higher sensitivity than tumours from the gastrointestinal tract ('carcinoids'). Chemotherapy with streptozocin combinations and with dacarbazine should be considered in patients with progressive malignant neuroendocrine tumours of the pancreas. A favourable response to chemotherapy can be expected in up to 60% of patients receiving a combination of streptozocin plus doxorubicin, and in up to 40% of patients receiving dacarbazine. A survival benefit has been shown for streptozocin combinations. Treatment regimens are effective in functioning and non-functioning tumours. The response to treatment cannot be predicted. Poorly differentiated neuroendocrine tumours, independent of their origin, respond to a combination of etoposide plus cisplatin. Chemotherapy is, however, almost ineffective in patients with well-differentiated neuroendocrine tumours originating in the gastrointestinal tract ('carcinoids').

Antibiotics, Antineoplastic↗
PubMed1992

Pharmacodynamic effects of Sandostatin in the gastrointestinal tract.

Somatostatin (SST) is widely distributed throughout the human gastrointestinal system. There, it is found in neurons and fibers of both the submucosal and myenteric plexus and the pancreas, and also in the D cells of the stomach, gut, and pancreatic islets. Whereas in the intestinal nervous system, duodenum, and pancreas, somatostatin-14 (SST-14) appears to be the predominant molecular form, the endocrine-type D cells of the intestine primarily contain somatostatin-28 (SST-28). SST peptides may act very differently at different sites, as hormones, paracrine substances, or neurotransmitters. Because of this complexity of action, very little is known about the physiological effects of SST in the gastrointestinal tract. In contrast, the pharmacological actions of natural synthetic SST have been thoroughly studied and have given rise to many therapeutic applications. Octreotide, an analogue with a longer half-life and higher potency, has greatly facilitated the clinical application of SST. This review deals with the pharmacological effects of octreotide on different gastrointestinal functions. The SST analogue exerts a long-lasting inhibitory action on gastric acid, pancreatic enzyme, bicarbonate secretion, and on bile flow. It also inhibits stimulated intestinal secretion, ie, the release of neuropeptides from the gut and pancreas. It can also prolong orocecum transit time and prevent gallbladder contraction. It inhibits absorption of nutrients and exerts inhibitory effects on splanchnic hemodynamics. It is because of these actions that SST has attracted so much attention in the treatment of different gastrointestinal disorders.

Biological Transport↗
PubMed1995

Effect of weaning diet on the ecology of adherent lactobacilli in the gastrointestinal tract of the pig.

Sixteen pigs were included in an investigation of the effects of weaning and weaning diet on the ecology of adherent Lactobacillus species in the gastrointestinal tract. At 28 d of age four pigs were killed and were designated as the preweaning control (PW). Four pigs remained on the sow (Sow), four pigs were fed a corn-soy-lactose (CSL) diet, and the remaining four pigs were fed a corn-soy (CS) diet. Pigs from the latter three treatments were killed at 38 d of age. Tissue samples were taken from the pars esophagus, ileum, and cecum and the adherent lactobacilli were enumerated using Rogosa SL agar. Bacterial colonies were randomly selected from Rogosa SL agar plates and speciated using cell type, morphology, and substrate fermentation tests. The species data were used to calculate the Shannon, Simpson, and evenness diversity indices. Shannon and Simpson diversity index values when averaged across tissues were lower (P < .05) for PW than for postweaning treatments (Sow, CSL, and CS) and lower (P < .05) when pigs receiving sow's milk (PW and Sow) were compared with pigs receiving the dry diets (CSL and CS). The diversity of adherent Lactobacillus is altered by the form of the diet fed to weanling pigs, and statistical ecological methods provide a powerful way of analyzing the ecology of the gastrointestinal tract.

Animals↗
PubMed2005

Endoscopic membranectomy with a high-frequency-wave snare/cutter for membranous stenosis in the upper gastrointestinal tract.

BACKGROUND/PURPOSE: As endoscopic equipment and instruments have been improved, the indication for endoscopic surgery has been extended. The authors achieved endoscopic membranectomy for congenital membranous stenosis in the upper gastrointestinal tract. METHODS: Case 1 was a 3-year-old girl with membranous stenosis in the descending duodenum. Case 2 was a 1-year-old boy with esophageal membranous stenosis. In case 1, a flexible endoscope with a banding chamber, the inside of which had a tiny groove for a high-frequency-wave snare, was inserted into the duodenum. The diaphragm was drawn into the chamber by endoscopic suction and tied with the snare around its base, then dissected by electrifying the snare. In case 2, the diaphragm was resected with a high-frequency-wave cutter, assisted by a balloon catheter pulling up the diaphragm from the distal side. RESULTS: In both cases, the stenosis was released adequately without complications, and oral feeding was restarted in a day after the procedure. CONCLUSIONS: Endoscopic membranectomy using a high-frequency wave snare/cutter was achieved safely and effectively in 2 children with congenital membranous stenosis in the upper gastrointestinal tract.

Child, Preschool↗
PubMed2003

The effect of Shen-Fu on gastrointestinal tract injury and its potential mechanism during cardio-pulmonary bypass in patients undergoing cardiac surgery.

OBJECTIVE: To investigate the effect of Shen-Fu (SF) injection on gastrointestinal tract injury and its potential mechanism. METHODS: Thirty-eight patients undergoing elective open heart surgery were assigned to Group C (control group, n=18) and Group SF (n=20) randomly. In Group SF, the patients received intravenous injection of SF (0.5 ml/kg) at the beginning of the surgery followed by a continuous infusion of 100 ml SF (1.0 ml/kg) solution diluted by saline at a rate of 0.004 ml x Kg(-1) x min(-1) with a Grasby pump. The control group was injected with normal saline in the same volume. Gastric intramucosal pH (pHi), activity of blood diamine oxidase (DAO), and concentrations of blood LPS and IL-6 were measured before CPB (S0) and 1 h (S1) and 2 h (S2) after aortic declamping, respectively. RESULTS: In Group C, pHi value was significantly lower at S1 and S2 than at S0 (mean P<0.01) and blood DAO and concentrations of LPS and IL-6 were significantly higher at S1 and S2 than at S0 (mean P<0.01). In Group SF, pHi was obviously lower at S1 and S2 than at S0 (P<0.05) but LPS and IL-6 levels and DAO were higher at S0 (mean P<0.05). Blood DAO and LPS level demonstrated significant negative correlations with pHi (mean P<0.01) while LPS concentration showed a positive correlation with blood DAO (P<0.01) and IL-6 concentration (P<0.05). At S1 and S2 after aortic declamping, the levels of pHi were higher in Group SF than in Group C (mean P<0.01 ) but DAO and LPS and IL-6 levels were significantly lower in Group SF than in Group C (P<0.01). CONCLUSIONS: SF has a protective effect on gastrointestinal tract and can reduce inflammatory actions.

Adolescent↗
PubMed1989

[Fiber-optic endoscopy of the lower gastrointestinal tract in children].

Between 1978 and 1985 565 lower gastrointestinal endoscopies were performed in children. In 221 cases the cause of rectal bleeding was explored, in 227 the suspicion of colitis and in 25 of polyposis was verified. To evaluate the results of treatment (polypectomy, surgical procedures and medical therapy in inflammatory bowel disease) 121 examinations were done. With increasing experience the complete colonoscopy was performed more often. In 1985 coecum and ileum terminale was reached in almost all children in whom it was needed (75% of all examinations). The inflammatory changes were revealed on 230 occasions. In 78 cases colon polyps and in 27 vascular changes were found. The most common cause rectal bleeding were colon polyps (66 cases) and inflammatory changes (554 cases). Less common were vascular changes (10 cases). 32% false negative and 16% false positive results of colonoscopy in diagnosis colitis were obtained when the results of visual findings were compared with histopathological findings. Colonoscopy performed by an experienced colonoscopist rather avoiding general anesthesia is a safe and useful procedure in diagnosing lower gastrointestinal tract diseases in children. The evaluation of colitis should be based on visual findings with biopsy confirmation.

Adolescent↗
PubMed2001

Endoscopic band ligation of Dieulafoy-like lesions in the upper gastrointestinal tract.

BACKGROUND AND STUDY AIMS: Endoscopic band ligation (EBL) is currently considered to be the treatment of choice for esophageal variceal bleeding. This study reports on the efficacy and safety of EBL in patients with Dieulafoy-like bleeding lesions in the upper gastrointestinal tract. PATIENTS AND METHODS: Between December 1994 and February 2000, 23 patients with upper gastrointestinal tract hemorrhage (median age 58, range 28-75) were treated using EBL. EBL was used as a rescue therapy in four patients and as the initial treatment in 19 patients. RESULTS: The site of bleeding was the stomach in 10 patients, Billroth II anastomosis in 10, the first part of the duodenum in one, the second part of the duodenum in one, and the jejunum in one patient. Endoscopic band ligation was successful in 22 of the 23 patients. The remaining patient, a young man with a Dieulafoy-like lesion in the jejunum, had recurrent bleeding on day 5 after EBL and underwent elective surgery. CONCLUSIONS: Endoscopic band ligation is an effective and safe endoscopic treatment for Dieulafoy-like lesions. It is easy to use and relatively inexpensive.

Adult↗
PubMed1999

Limited effect of refined carbohydrate dietary supplementation on colonization of the gastrointestinal tract of healthy subjects by Candida albicans.

BACKGROUND: Infections due to Candida albicans occur readily in situations in which ample glucose is available. In mice, dietary refined carbohydrate supplementation leads to higher rates of Candida growth in the gastrointestinal tract and favors mucosal invasion. OBJECTIVE: The modulating properties of dietary carbohydrate supplementation on colonization of the human gastrointestinal tract by C. albicans were evaluated. DESIGN: A 2-step study was conducted in 28 healthy volunteers. First, we determined the subjects' habitual uptake of refined carbohydrates and correlated these data with the C. albicans blastoconidia concentration in the mouth washes and feces of subjects with no intervention. Second, we compared C. albicans counts in the specimens before, during, and after a high-sugar diet. RESULTS: No correlation between C. albicans counts in the specimens and the habitual uptake of refined carbohydrates was observed. A high-sugar diet did not increase the frequency of C. albicans-positive samples, the number of subjects positive for C. albicans in the mouth washes, or the concentration of candidal blastoconidia in the samples of the 28 subjects. However, in selected subjects with elevated counts of oral C. albicans, we observed an increase in fecal C. albicans counts in response to the diet. CONCLUSIONS: The effect of adding a high amount of refined carbohydrates to the diet of healthy human subjects has a limited influence on Candida colonization. Follow-up studies should define whether selected patient groups might benefit from dietary restriction of refined carbohydrates.

Adolescent↗
PubMed1995

Immunohistochemical distribution of chromogranins A and B and secretogranin II in neuroendocrine tumours of the gastrointestinal tract.

The aim of the present study was to investigate immunohistochemically the distribution of chromogranin A, chromogranin B, and secretogranin II in a series of 152 neuroendocrine tumours of the gastrointestinal tract. Tumour tissues from 25 argyrophil gastric carcinoids, 18 gastrin and 5 somatostatin-producing tumours, 4 'gangliocytic paragangliomas', 49 classical argentaffin and 2 L cell appendiceal carcinoids, 27 classical ileal carcinoids, 17 rectal carcinoids, and 5 poorly differentiated neuroendocrine tumours of the stomach and rectum were immunostained with antibodies against chromogranin A, chromogranin B, and secretogranin II. Chromogranin A was the major granin expressed in gastric carcinoids and in serotonin-producing carcinoids of the appendix and the ileum. In contrast, strong chromogranin B and secretogranin II immunoreactivity was found in rectal carcinoids, in which chromogranin A was rarely expressed. Since chromogranin A is a widely used marker for neuroendocrine differentiation, it is of diagnostic importance that some gastrin-producing tumours, 'gangliocytic paragangliomas', poorly differentiated neuroendocrine carcinomas, and appendiceal L cell carcinoids completely lacked chromogranin A positivity. It is concluded that the various neuroendocrine tumours of the gastrointestinal tract show distinctly different patterns of granin expression, probably reflecting their histogenetical origin.

Chromogranin A↗
PubMed1984

A randomized prospective trial comparing the value of intravenous and preincisional cefamandole in reducing postoperative sepsis after operations upon the gastrointestinal tract.

A prospective randomized trial comparing prophylaxis with a single dose of cefamandole given intravenously and preincisionally with no antibiotics in patients who underwent elective and emergency operations upon the gastrointestinal tract has shown a significant reduction in the frequency of wound infections in patients receiving preincisional antibiotics over both control and intravenous groups. Fewer postoperative infections of the chest occurred in patients receiving antibiotics by either route, with hospital stay also being significantly reduced for patients who received prophylactic antibiotics before emergency operations. Preincisional cefamandole is effective in reducing postoperative sepsis after operations upon the gastrointestinal tract.

Adult↗
PubMed2006

Influence of gastrointestinal tract disease on pharmacokinetics of lidocaine after intravenous infusion in anesthetized horses.

OBJECTIVE: To determine the disposition of lidocaine after IV infusion in anesthetized horses undergoing exploratory laparotomy because of gastrointestinal tract disease. ANIMALS: 11 horses (mean +/- SD, 10.3 +/- 7.4 years; 526 +/- 40 kg). PROCEDURE: Lidocaine hydrochloride (loading infusion, 1.3 mg/kg during a 15-minute period [87.5 microg/kg/min]; maintenance infusion, 50 microg/kg/min for 60 to 90 minutes) was administered IV to dorsally recumbent anesthetized horses. Blood samples were collected before and at fixed time points during and after lidocaine infusion for analysis of serum drug concentrations by use of liquid chromatography-mass spectrometry. Serum lidocaine concentrations were evaluated by use of standard noncompartmental analysis. Selected cardiopulmonary variables, including heart rate (HR), mean arterial pressure (MAP), arterial pH, PaCO2, and PaO2, were recorded. Recovery quality was assessed and recorded. RESULTS: Serum lidocaine concentrations paralleled administration, increasing rapidly with the initiation of the loading infusion and decreasing rapidly following discontinuation of the maintenance infusion. Mean +/- SD volume of distribution at steady state, total body clearance, and terminal half-life were 0.70 +/- 0.39 L/kg, 25 +/- 3 mL/kg/min, and 65 +/- 33 minutes, respectively. Cardiopulmonary variables were within reference ranges for horses anesthetized with inhalation anesthetics. Mean HR ranged from 36 +/- 1 beats/min to 43 +/- 9 beats/min, and mean MAP ranged from 74 +/- 18 mm Hg to 89 +/- 10 mm Hg. Recovery quality ranged from poor to excellent. CONCLUSIONS AND CLINICAL RELEVANCE: Availability of pharmacokinetic data for horses with gastrointestinal tract disease will facilitate appropriate clinical dosing of lidocaine.

Anesthesia↗