Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Duodenum”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,099 records · Page 61Linked to original sources

Dietary fats and properties of endoplasmic reticulum: II. Dietary lipid induced changes in activities of drug metabolizing enzymes in liver and duodenum of rat.

Rats were fed cholesterol, cacao butter, or olive oil diets to determine the effect of dietary lipids on the rate of drug biotransformation in the liver and duodenum. The cholesterol rich diet maintained the hepatic aryl hydrocarbon hydroxylase activity at the same level as did the standard diet. Rats fed olive oil and cacao butter diets showed lower hepatic aryl hydrocarbon hydrorylase activity. The p-nitroanisole O-demethylase activity was doubled in hepatic microsomes of rats fed the high cholesterol diet when compared to rats fed the standard diet. The hepatic uridine diphosphate glucuronosyltransferase activity showed different patterns depending on the in vitro treatment of the microsomal membranes. If the enzyme activity was assayed from the native, untreated microsomes, an increase in the measurable uridine diphosphate glucuronosyl transferase activity was found in rats having cholesterol rich diet. After the in vitro activation of membrane-bound uridine diphosphate glucuronosyltransferase by trypsin, the increase in measurable activity was 10 fold in the group fed the standard diet, 6 fold in group fed cholesterol, 4 fold in group fed cacao butter, and 3 fold in group fed olive oil. Trypsin digestion of microsomes increased the measurable uridine diphosphate glucuronosyltransferase activity less in rats fed diets rich in neutral fats than those fed the standard diet. In the duodenal mucosa, lipid diets decreased the activities of drug hydroxylation and glucuronidation.

Animals↗

Radiographic and clinical sequelae of the duodenocolic anatomic relationship: two cases of Crohn's disease with fistulization to the duodenum.

The posterior surface of the proximal transverse colon and the anterior surface of the descending duodenum are intimately related. The clinical importance of this apposition is re-emphasized with presentation of two cases which had the uncommon phenomenon of benign duodenocolic fistula. These two rare cases of duodenocolic fistulas secondary to Crohn's disease are added to the literature. It is also suggested that in some cases, duodenal mucosal alterations with adjacent Crohn's disease of the colon might be the result of reactive inflammatory changes, and do not necessarily indicate continuous extension of the granulomatous disease.

Adult↗

Effects of epidermal growth factor on alkaline secretion and mucus formation in rat duodenum exposed to luminal acid.

The effect of epidermal growth factor (EGF) on alkaline secretion and mucus formation which serve as defenses against mucosal injury was investigated using a perfusion system of the proximal duodenum in rats in situ. In control rats, intravenous or intraduodenal administration of EGF (1 or 10 micrograms/kg/hr) had no effect on mucosal alkaline secretion at high (pH 2.5-3.0) or low (pH 3.0-5.5) luminal acidities. In cysteamine-treated rats (250 mg/kg weight, intramuscular injection), mucosal alkaline secretion by intravenous EGF (10 micrograms/kg/hr) increased significantly only at levels of high luminal acidity, whereas that by intraduodenal EGF (10 micrograms/kg/hr) increased greatly at both high and low luminal acidities. Analysis by a color image processor revealed that cysteamine greatly reduced the PAS-stained mucus in the duodenal mucosa and in Brunner's glands. Intraduodenal administration of EGF significantly increased the PAS-stained mucus in the duodenal mucosa, but not in Brunner's glands. These results indicate that EGF exerts the cytoprotective effect by stimulating alkaline secretion and mucus formation in the duodenal mucosa.

Animals↗

[Duodenum-preserving pancreas head resection-an operative technique for retaining the organ in the treatment of chronic pancreatitis].

Chronic pancreatitis is an inflammatory disease characterized by the progressive conversion of pancreatic parenchyma to fibrous tissue. The most frequent causes are alcohol overconsumption and anatomic variants such as pancreas divisum, cholelithiasis, and individual genetic predisposition. The process of fibrosis with consecutive loss of pancreatic parenchyma leads to exocrine insufficiency and maldigestion and, in advanced stages of the disease, to diabetes mellitus. Beside exocrine and endocrine malfunction, mechanical complications occur such as the formation of pancreatic pseudocysts and duodenal and common bile duct obstruction. About 50% of patients with chronic pancreatitis need surgical intervention due to untreatable chronic pain. As recent investigations suggest that the head of the pancreas triggers the chronic inflammatory process, resection of this inflammatory mass must be regarded as pivotal in any surgical intervention. Radical techniques such as the Whipple procedure are undoubtedly successful regarding pain reduction but, even in its pylorus-preserving variant, associated with high postoperative morbidity due to a large loss of pancreatic parenchyma and the absence of duodenal passage. Thirty years ago, H.G. Beger described for the first time the technique of duodenum-preserving pancreatectomy, which better combines resection of the pancreatic head with low morbidity. Over the years, different variations of the original Beger technique (Frey, Izbicky, Berne modification) have been developed, and the excellent results obtained with these methods underline that organ-sparing techniques should be preferred in the surgical treatment of chronic pancreatitis.

Chronic Disease↗

Spontaneous false aneurysm of the gastroduodenal artery in a hemophilic patient ruptured into the duodenum: case report.

Pseudoaneurysms of the splanchnic arteries are rare causes of gastrointestinal bleeding. We report a case of a spontaneous gastroduodenal artery false aneurysm ruptured into the duodenum in a patient with hemophilia. The diagnosis was confirmed by spiral computed tomography and magnetic resonance angiography. The patient died from massive gastrointestinal bleeding.

Abdominal Pain↗

Balloon catheter sphincteroplasty and biliary stone expulsion into the duodenum in patients with an indwelling T tube.

BACKGROUND: To present an alternate approach for treating residual biliary stones in patients with indwelling T tube that uses the immature tract created by the T tube to carry out both sphincteroplasty and expulsion of the calculi with the same angioplasty balloon catheter. METHODS: This technique was performed in five patients. Access to the bile duct was through an 8-Fr T tube. First a guidewire was inserted and advanced beyond the obstructing stone to the duodenal lumen. The T tube was removed over the guidewire, and a balloon catheter was introduced. Sphincteroplasty was carried out. Then the balloon was deflated and retracted to a position proximal to the stone. It was then reinflated and used to push the stone, expelling it into the duodenum. RESULTS: In all cases, all biliary stones were expelled without pain, in a single session, and with no immediate complications. All patients showed rapid clinical and analytic improvement. During clinical and echographic follow-up of 2-22 months (mean = 12.4 months), there were no complications or relapses. CONCLUSIONS: Our limited experience indicates that sphincteroplasty and expulsion of biliary stones with angioplasty balloon catheters through the T tube immature tract is a simple, safe, low-cost technique that gives good results.

Aged↗

Comparison of local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy (frey procedure) and duodenum-preserving resection of the pancreatic head (beger procedure).

The etiology of pain in chronic pancreatitis may be ductal hypertension, increased parenchymal pressure, or neural damage. It is difficult to assess the severity of pain in this patient population, a problem made more challenging by the frequency of narcotic dependency. Therapeutic interventions developed to relieve the pain of chronic pancreatitis include denervation of the pancreas, decompression of the main duct of the pancreas, resection of part or all of the diseased pancreas, and reduction of pancreatic secretion. Operative intervention for patients with chronic pain is indicated when severe pain, complications of pain, or potential malignancy are present. The operations that consistently provide long-lasting pain relief all have in common resection of all or a portion of the head of the pancreas. Adverse effects on exocrine and endocrine function, nutrition, and quality of life are related to the amount of pancreas resected. The ideal procedure should be easy to perform, have a low morbidity and mortality rate, provide long-lasting pain relief, and not augment endocrine and exocrine insufficiency. No single operation fulfills this ideal. The local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy (LR-LPJ) proposed by Frey and the duodenum-preserving resection of the head of the pancreas (DPHR) proposed by Beger are discussed. The conceptualization, development, and technique of LR-LPJ are discussed, and comparisons of patient outcomes are made with the outcomes of other procedures for chronic pancreatitis.

Chronic Disease↗

Common bile duct stones detected after cholecystectomy: advancement into the duodenum via the percutaneous route.

PURPOSE: To report our experience in the use of percutaneous extraction of common bile duct stones detected in the post-cholecystectomy period. METHODS: Forty-two patients in whom endoscopic cannulation and/or sphincterotomy had failed or could not be done due to several reasons underwent balloon dilatation of the ampulla of Vater and subsequent advancement of the stones via the percutaneous transhepatic route or T-tube tract. RESULTS: The procedure was successful in 42 cases. In three patients, stones were crushed in the common bile duct and pushed as fragments into the duodenum. In all cases transient adverse effects were observed. There were no major complications. All cases were checked with ultrasonography for 6 months after the procedure. CONCLUSION: Percutaneous extraction of common bile duct stones is an effective method of treatment with a high success rate, low complication rate and shorter hospital stay. It may serve as an alternative method in cases where endoscopic removal of stones fails.

Adult↗

The transhepatic route for the placement of a duodenojejunal stent: application in a postoperative closed loop obstruction of the duodenum.

A patient who had undergone gastric resection for carcinoma, had closed loop obstruction of the duodenum due to neoplasia at the duodenojejunal junction. The obstruction was relieved successfully by transhepatic placement of a duodenojejunal stent. We were compelled to use the transhepatic route because a Roux-Y reconstruction had been performed. Transhepatic placement may be the only chance of palliation in a small subset of patients with malignant intestinal obstruction.

Digestive System Surgical Procedures↗

Retained surgical sponge with migration into the duodenum and persistent duodenal fistula.

Migration of a retained surgical sponge into the bowel is a rare cause of bowel obstruction. Thus far, there have not been any reports that the site of initial migration of the sponge was identified by imaging studies or surgical exploration because the onset of symptoms is usually delayed. Unique about the case presented herein is that a barium meal follow-through study revealed a duodenal fistula that had developed after uneventful cholecystectomy due to a retained surgical sponge that had migrated into the duodenum and obstructed the distal jejunum. Imaging findings are presented and discussed.

Duodenal Diseases↗

Localization of thrombomodulin in pericryptal fibroblasts of the rat duodenum.

Thrombomodulin (TM) contributes to the inactivation of thrombin which activates protein C, a major anticoagulant and anti-inflammatory protein. This report describes the distribution and localization of TM in the rat duodenum by light and electron microscopic immunohistochemistry. In addition to the endothelium of the entire vasculature, TM was found on the non-vascular structures, cellular networks of pericryptal fibroblasts surrounding the bases of the glandular crypts. TM was localized on the plasma membrane of the pericryptal fibroblasts which existed in the pericryptal spaces between the basal lamina of the epithelium and the collagenous sheets around the base of the crypt. TM-immunoreactive pericryptal fibroblasts were stellate-shaped cells and contacted with each other by their cytoplasmic processes forming an anastomosing syncytium around the base of the crypt. In contrast to pericryptal fibroblasts, TM was not localized in subepithelial fibroblasts in the villi or smooth muscle cells in the lamina muscularis mucosae and the muscularis. The functional significance of TM in pericryptal fibroblasts is discussed.

Animals↗

Migration of endoclip into duodenum. A rare complication after laparoscopic cholecystectomy.

The long-term effect of spilled clips within the abdominal cavity after laparoscopic cholecystectomy is unknown. However, most surgeons agree that the migration of clips has limited clinical consequences. A few cases have been reported of clips that have migrated into the common bile duct, causing stone formation and/or obstructions. We present a case of gallstone pancreatitis treated with laparoscopic cholecystectomy that was complicated by bile leakage from the cystic duct stump 1 day after the procedure. Although the leaking stump sealed itself spontaneously after the placement of a biliary stent, a clip had migrated directly to the superior wall of the first portion of the duodenum. Herein the details of the patient's history are presented. We also discuss the possible mechanisms of clip migration and describe some preventive measures.

Bile↗

Duodenum-preserving pancreatic head resection (DPPHR) in chronic pancreatitis: its rationale and results.

Persistent, uncontrolled pain is the most common indication for surgery in chronic pancreatitis. In the presence of an inflammatory mass in the pancreatic head or in pancreatic head-related complications of chronic pancreatitis, resection procedures are inevitable. The Whipple procedure, originally introduced for malignant lesions of the periampullary region, is commonly employed, although it represents surgical over-treatment in a benign pancreatic disorder. In this article, we discuss our long experience with duodenum-preserving pancreatic head resection (Beger procedure) for chronic pancreatitis. Prospective, randomized controlled trials suggest that this organ- and function-preserving procedure should be the gold standard for the surgical treatment of pancreatic head-related complications of chronic pancreatitis.

Adult↗

Neuropeptide contents in the duodenum of non-obese diabetic mice.

Twelve pre-diabetic and 12 diabetic female NOD mice aged 22-24 weeks were studied. As controls, 12 female BALB/cJ of the same age and sex were used. The duodenal content of several neuropeptides, namely vasoactive intestinal polypeptide (VIP), neurotensin, neuropeptide Y (NPY), galanin, gastrin-releasing peptide (GRP) and enkephalin was determined by radioimmunoassay of tissue extracts. The VIP content in duodenal extracts from both pre-diabetic and diabetic NOD mice was significantly higher than that of the controls. The enkephalin content of the duodenum of diabetic mice was significantly higher than that of the controls, while no significant difference was found between the controls and pre-diabetic mice. There was no statistically significant difference between controls and NOD mice regarding the duodenal content of neurotensin, NPY, galanin or GRP. It has been suggested that the high duodenal content of VIP appears to be primary to the onset of diabetes and that the high enkephalin content may be attributable to the diabetic state. The changes in the duodenal content of VIP and enkephalin reported here in an animal model for diabetes type I might be of relevance for the gastrointestinal complications occurring in human diabetes.

Animals↗

Iron and cadmium uptake by duodenum of hypotransferrinaemic mice.

Absorption from food is an important route for entry of the toxic metal, cadmium, into the body. Both cadmium and iron are believed to be taken up by duodenal enterocytes via the iron regulated, proton-coupled transporter, DMT1. This means that cadmium uptake could be enhanced in conditions where iron absorption is increased. We measured pH dependent uptake of (109)Cd and (59)Fe by duodenum from mice with an in vitro method. Mice with experimental (hypoxia, iron deficiency) or hereditary (hypotransferrinaemia) increased iron absorption were studied. All three groups of mice showed increased (59)Fe uptake (p<0.05) compared to their respective controls. Hypotransferrinaemic and iron deficient mice exhibited an increase in (109)Cd uptake (p<0.05). Cadmium uptake was not, however, increased by lowering the medium pH from 7.4 to 6. In contrast, (59)Fe uptake (from (59)FeNTA(2)) and ferric reductase activity was increased by lowering medium pH in control and iron deficient mice (p<0.05). The data show that duodenal cadmium uptake can be increased by hereditary iron overload conditions. The uptake is not, however, altered by lowering medium pH suggesting that DMT1-independent uptake pathways may operate.

Animals↗

Isolating and maintaining highly polarized primary epithelial cells from normal human duodenum for growth as spheroid-like vesicles.

A method is described for the three-dimensional (3-D) in vitro culture of nontransformed gastrointestinal epithelial cells from the human duodenal mucosa. Biopsies obtained from human duodenum were finely minced. The tissue fragments were suspended in culture medium supplemented with 5% fetal calf serum and the appropriate antibiotics. The suspended mucosal fragments generated spheroid-like multicellular vesicles consisting of highly prismatic absorptive and goblet cells retaining most of the histological features of the tissue in vivo. We performed immunocytochemical studies to determine the origin of the vesicles using monoclonal antibodies against EP4. The histochemistry of the vesicles showed alkaline phosphatase activity. Ultrastructural studies revealed that these cells exhibit characteristics of normal duodenal cells in vivo: apical microvilli, glycocalyx, tight junctions and desmosomes, lateral membrane interdigitations, mucous droplets, and a well-developed Golgi apparatus. An overgrowth of the vesicles by fibroblasts was not seen during cultivation. In contrast with the two-dimensional cell cultures grown on artificial supports, the vesicle cells show organization similar to that of natural epithelia. The polarization and cytoarchitecture of normal gastrointestinal epithelial cells cultured as 3-D vesicles are comparable to those known for the native tissue. This study was undertaken to provide a morphological baseline for subsequent infection experiments.

Antibodies, Monoclonal↗

Active secretion of calcium, sodium and chloride by adult rat duodenum in vitro.

Active secretion of Ca2+ is observed from the serosal to the mucosal surface across adult rat duodenum in vitro when absorptive Ca2+ flux is saturated by a high [Ca2+]. Sodium and chloride are spontaneously secreted by this tissue with Cl secretion apparently accounting for about one-third of the short-circuit current when there is no absorptive co-transport of Na+.

Animals↗

ATP-dependent calcium transport and its correlation with Ca2+ -ATPase activity in basolateral plasma membranes of rat duodenum.

Isolated basolateral plasma membrane vesicles from rat duodenum epithelial cells exhibit ATP-dependent calcium-accumulation and Ca2+ -dependent ATPase activity. Calcium accumulation stimulated by ATP is prevented by the calcium ionophore A23187, inhibited 80% by 0.1 mM orthovanadate but is not effected by oligomycin. Calcium accumulation is not observed with the substrate beta-gamma-(CH2)-ATP, ADP and p-nitrophenyl phosphate. Kinetic studies reveal an apparent Km of 0.2 microM Ca2+ and a Vmax of 5.3 nmol Ca2+/min per mg protein for the ATP-dependent calcium-uptake system. Calmodulin and phenothiazines have no effect on calcium accumulation in freshly prepared membranes, but small effects are inducible after a wash with a 5 mM EGTA. The kinetic parameters of Ca2+ -ATPase are: Km = 0.25 microM Ca2+ and Vmax = 19.2 nmol Pi/min per mg protein. Three techniques, osmotic shock, treatment with Triton X-100 or the channel-forming peptide alamethicin, reveal that about 40% of the vesicles are resealed. Assuming that half of the resealed vesicles have an inside-out orientation, the Vmax of ATP-dependent calcium uptake amounts to 25 nmol Ca2+/min per mg protein and of the Ca2+ -ATPase to 23 nmol Pi/min per mg protein. The close correlation between kinetic parameters of Ca2+ -ATPase and ATP-dependent calcium-transport strongly suggests that both systems are expressions of a Ca2+ -pump located in duodenal basolateral plasma membranes.

Adenosine Triphosphate↗