[Spontaneous activity and poststimulation histograms of diencephalic neurons of the rat after intero- and exteroceptive stimulation].
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Action Potentials↗
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Results for “STOMACH DILATATION”
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Diffuse eosinophilic gastroenteritis: an adult form of allergic gastroenteropathy. Report of a case with probable protein-losing enteropathy.
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Adult↗
[Treatment of peptic stenosis of the oesophagus by plicature of the fundus, in the thorax with dilatation of the stenosis during operation. Report of 14 cases (author's transl)].
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Adult↗
Fusiform dilatations of the esophagus secondary to protracted distention and emetogenic injury.
We report the case of a 74-year-old woman who presented with a 2-year history of dysphagia, weight loss, nausea, and vomiting. She was diagnosed as having secondary achalasia due to external compression probably by a tumor of the lower part of the esophagus. At autopsy, however, no tumor was found at that site, whereas a pancreatic microcystic serous adenoma and multiple gastric leiomyomata--one of which occupied the pyloric sphincter area leading to gastric outlet obstruction--were noted. The esophagus displayed two fusiform dilatations located at the lower and midportions, the latter being associated with rupture and necrosis of the muscularis and adventitial wall layers. The lower dilatation showed only attenuation of the muscularis, without necrosis. The epithelium was intact in both dilatations. This was an unusual series of pathogenetic events, leading from gastric outlet obstruction to secondary achalasia and protracted vomiting, followed by spontaneous partial esophageal wall rupture (a variant of intramural hematoma) or atrophy of the muscularis, morphologically evident as fusiform dilatations.
Adenoma↗
Surgical treatment for caustic ingestion injury of the pharynx, larynx, and esophagus.
A 45-year-old female drank Sunpole (9.5% hydrochloric acid), an acidic toilet cleaner, in a suicide attempt. Notwithstanding intravenous administration of steroids and bougienage dilation, corrosive changes progressed. The patient underwent surgery for severe caustic ingestion injury of the pharynx, larynx, and esophagus. Colon bypass surgery from the left vallecula to the stomach was performed. Excellent results, both in deglutition and phonation, were obtained. We report on the case and stress several points of importance in dealing with severe caustic ingestion injuries.
Caustics↗
Afferent loop syndrome complicated by a duodenal phytobezoar after Billroth-II subtotal gastrectomy.
We illustrate a rare late onset (10 yr) complication of gastric surgery with a combination of afferent loop syndrome and a large duodenal bezoar. The patient underwent a subtotal gastrectomy with Billroth II gastrojejunal anastomosis for benign peptic ulcer 10 yr ago. It was not until several days before this presentation that he suffered from epigastralgia and abdominal distension. Leukocytosis and abnormal blood biochemistry were found including amylase, lipase, alkaline phosphatase, total bilirubin, GOT, and GPT in which amylase was markedly elevated to 1188 U/L. Abdominal ultrasound scan and especially CT scan confirmed the diagnosis of a large bezoar in the dilated duodenal afferent loop. To our knowledge, the rare entity in our case is the first reported in the literature.
Abdominal Pain↗
Effect of tissue non-specific alkaline phosphatase in maintenance of structure of murine colon and stomach.
The gastrointestinal tract of mammals secretes a phospholipid-rich membrane that is enriched in alkaline phosphatase (AP) and surfactant proteins (surfactant-like particle, SLP). The production of this particle is stimulated in the small intestine by fat feeding and in cultured cells in vitro by transfection with intestinal alkaline phosphatase (IAP). To test whether tissue non-specific alkaline phosphatase (TNAP) was a factor in stimulating surfactant-like particle production in stomach and colon (tissues expressing TNAP), mice lacking this enzyme were studied. Mice were harvested at 8 days of life, when body weight of homozygous animals (TNAP -/-) was about half that of congenic controls (TNAP +/+) or heterozygotes (TNAP +/-), but before seizures had begun. No difference in content of the major SLP protein (65 kDa) by Western blotting or immunocytochemistry was seen in stomach or colon of TNAP -/- vs. TNAP +/+ animals, but the content was only about half in the IAP-expressing small bowel. Transmission electron microscopy of the TNAP -/- small bowel showed large dilated lysosomes and residual bodies. Colonocytes and gastric surface epithelial cells from the same animals showed mitochondria containing homogeneous dense inclusions, consistent with neutral lipid. In the underweight homozygous animals, there was a decrease in the neuronal content of submucosal ganglia in the jejunum and ileum and of myenteric ganglia in the jejunum of TNAP -/- animals. These findings suggest that (1) TNAP is not important in maintaining surfactant-like particle content of tissues that express TNAP, (2) normal fat absorption is important in maintaining SLP content in the small intestine, and (3) TNAP is important in the maintenance of some intestinal structures, and perhaps their function.
Alkaline Phosphatase↗
Argon plasma coagulation and the future applications for dual-mode endoscopic probes.
Argon plasma coagulation (APC) is a thermoablative technique increasingly being used in endoscopy. Since its introduction, the flexible APC probe has been employed by endoscopists throughout the world. APC has helped change the endoscopic management of many gastrointestinal (GI) diseases, including hemorrhagic proctitis, watermelon stomach, bleeding peptic ulcer, and colonic varices. Endoscopists and surgeons are creatively combining standard and new electrosurgical techniques with APC. For instance, APC used in combination with piecemeal polypectomy, endoscopic mucosal resection, balloon dilatation for strictures, and plasma welding of bleeding vessels after sclerotherapy injection are among the recent innovative techniques reported. Other emerging innovations using APC that are being considered include endoscopic en bloc resection of mucosal and submucosal tumors of the GI tract, endoscopic mucosal resection supplemented with APC for high-grade dysplasia and early GI cancers, endoscopic repair of anastomotic strictures, and welding GI fistula tracts. As such, endoscopists require more efficient and cost-effective multifunctional thermoablative probes. This review discusses the development and the potential application of dual-mode plasma endoscopic probes in fulfilling these emerging needs.
Argon↗
Structural and morphometric analysis of murine small intestine after indomethacin administration.
Indomethacin, a nonsteroidal anti-inflammatory drug, induces the formation of gastrointestinal ulceration both in experimental animals and in humans. A study of indomethacin-induced ulcers in the mouse showed that two doses of indomethacin, each administered subcutaneously at 85 mg/kg body weight, induced well-defined gastrointestinal ulcers in C57 mice, accompanied by inflammatory and vascular changes in the stomach and small intestine. Maximal damage was observed 20 h after the second dose of indomethacin. Morphometric analysis identified changes in all compartments of the small intestine. There was a marked reduction in the length of the small intestine, intestinal dilatation, a significant decrease in villous height, with the formation of subepithelial blisters or blebs within villi, and submucosal vascular dilatation. There was no change in the number of villi or of submucosal arterioles or in the total amount of muscle present in the wall of the intestine. The tissue changes identified in this study may have implications for gut function at specific periods during indomethacin treatment.
Animals↗
Differential diagnosis of operable disease of the esophagus.
The time interval between ingestion and regurgitation and the stage of digestion in regurgitated food may be factors helpful in diagnosing disease of the esophagus. In most cases diagnosis can be made by x-ray alone, but where x-ray evidence is insufficient esophagoscopy is often justified.X-ray investigation for foreign bodies should include films of the neck. Cough is a common symptom of the presence of foreign bodies; obstruction may result from inflammation or edema. Perforation is most often caused by foreign bodies or by instrumentation. Esophagoscopy is hazardous in this condition and the findings are not likely to affect the course of treatment. Hiatal hernia, although probably occurring to some degree in 10 per cent of adults, seldom causes symptoms. Inflammation resulting from hernial obstruction may be mistaken for carcinoma. Esophageal carcinoma occurs most frequently in elderly persons and in men more than in women. Operation is necessary in many cases to prevent starvation. The postoperative mortality rate is as low as 11 to 24 per cent, and the proportion of five-year survivals is increasing. Achalasia or cardiospasm can generally be recognized by x-ray appearance. Bouginage is the usual treatment, but operation may be necessary. Late regurgitation of food is a common symptom of esophageal diverticulum. Atresia in a newborn infant is a dangerous condition. The effect of any of the four types of anomaly is the same: diversion of fluids from the stomach to the bronchi. Coughing, choking and cyanosis are the common symptoms in a newborn infant. Hematemesis may arise from a number of causes; esophageal hemorrhage most commonly is owing to varicosity from portal hypertension. Esophagoscopy is the quickest and safest method of determining whether hematemesis is of esophageal origin.
Adult↗
A retrospective study of conservative treatment of gastric dilatation-volvulus in the dog.
A retrospective study of 103 dogs with gastric dilatation-volvulus (GDV) treated conservatively during the period 1985-1989 was performed. The date and number of recurrences, and the date and cause of death along with breed, age and sex were collected from clinic records and from a questionnaire sent to the owners (77% response). The treatment consisted of emptying the stomach with a stomach tube, gastrocentesis if necessary and treating shock. All of the affected dogs were from moderate to large sized breeds and the study showed that particular breeds appear to be predisposed to GDV. The average age was 7.2 years and there was no gender predisposition. Sixty-six per cent of the dogs survived the initial treatment and 50% of the dogs were still alive 1 month after treatment. Thirty-nine dogs (71%) received recurrence between 5-760 days after initial treatment. Fifty-six per cent had recurrence within 3 months and all except 2 dogs, within 1 year. Data for the time of death, regardless of cause, was available for 68 dogs. Of these 59 (81%) died within a year after initial treatment. Conservative treatment was found to be an adequate life-saving procedure in the acute stage of GDV, but could not alone prevent recurrence of the disease.
Age Distribution↗
Closed pyloroduodenal digital dilatation as a complementary drainage procedure to truncal vagotomy.
Out of a total of 300 consecutive cases of duodenal ulcer undergoing surgery, 51 patients were treated by truncal vagotomy and a closed pyloroduodenal digital dilatation. A peroperative assessment of the pyloroduodenal canal was carried out, and in patients with a mobile, supple duodenum showing minimal scarring a standard drainage procedure was not considered necessary. In these patients it was possible to perform a closed pyloroduodenal digital dilatation using the two thumbs to achieve an effective dilatation of 20-30 mm. Post-operative clinical evaluation (Modified Visick grading) and "special" barium meal revealed 86% of patients in Grade I and II at the end of two years (maximum follow-up 3.5 yrs.), with no evidence of lasting gastric stasis. The method is easy, safe and simple. It maintains the anatomical and physiological integrity of the pyloroduodenal ring thereby obviating the hazards of an "incontinent" stomach. Its main limitation appears to be its restricted selectivity and in the present series it could be carried out in about 17% of cases.
Dilatation↗
Leukotriene D4 and the cerebral vasculature in vivo and in vitro.
The effects of leukotriene D4 (LTD4), a component of the slow reacting substance of anaphylaxis (SRS-A), and the putative SRS-A antagonist FPL 55712 were studied on cerebral arteries in vivo and in vitro. Intracarotid injection of LTD4 (1-15 nmols/kg) into the cerebral vasculature of the anaesthetised rat constricted internal and external carotid, facio-lingual and stapedial arteries for up to 40 minutes. LTD4 at 3 nmol/kg caused a slight fall in heart rate, and at 6 and 12 nmol/kg, an increase in diastolic (but not systolic) blood pressure was observed. In some experiments, constriction was followed by dilatation (possibly due to enhanced prostacyclin synthesis). FPL 55712 (0.3 to 30 nmols/kg) injected in the same manner caused both constriction and dilatation of rat cerebral arteries. In vitro experiments were performed on isolated human intracranial arteries (basilar, vertebral and Circle of Willis) obtained at autopsy, and on the isolated rat stomach fundus. LTD4 (2 x 10(-9) to 2 x 10(-7) M) caused sustained contractions of isolated human intracranial arteries. FPL 55712 (up to 4 x 10(-7) M) failed to antagonise the vasoconstrictor effects of LTD4, and higher concentrations (8 x 10(-6) to 8 x 10(-5) M) directly relaxed cerebral arteries. In contrast, FPL 55712 (2 x 10(-8) M) was a competitive antagonist of the contractile effects of LTD4 on the isolated rat fundus. This data suggests that the cerebral arterial leukotriene receptor differs from the peripheral smooth muscle receptor typified by the guinea-pig ileum and rat fundus preparations. Furthermore, leukotrienes may be involved in pathological vasoconstriction of various vascular beds after immunological reaction and trauma.
Animals↗
Primary paraesophageal hernia in children.
BACKGROUND: Paraesophageal hernias are uncommon in children and are distinctively different from the more common sliding hiatus hernias and those occurring after antireflux surgery in anatomy, pathology, symptoms, complications, and management. We reviewed a single institution's experience with the pathology of paraesophageal hernias. METHODS: We conducted a retrospective analysis of patient records. RESULTS: Fifty-nine children with paraesophageal hernias were treated during a 42-year period. Their mean age at presentation was 23.4 months (range, 1 day to 11 years). Presenting complaints were recurrent chest infections (n = 32), vomiting (n = 24), symptomatic anemia (n = 20), failure to thrive (n = 18), and dysphagia (n = 6). Five children were asymptomatic, and their diagnosis was established when they were investigated for incidentally noted asymptomatic anemia (n = 3), scoliosis (n = 2), and mumps (n = 1). Radiology typically showed cystic masses in the posterior mediastinum in the right lower chest and occasionally had an air-fluid level in the cystic mass or a dilated esophagus. None presented with strangulation or hematemesis. All patients were operated on. Surgical findings included a peritoneal lined sac and herniation through a widened diaphragmatic hiatus, containing the stomach and at times the transverse colon, spleen, and small bowel. The hernial sac usually occurred on the right. Principles of surgery included reduction of the contents, partial excision of the sac, crural approximation, and a fundoplication in 39 patients. No fundoplication was done in the earlier years in 20 patients, of whom 12 had recurrent reflux symptoms. Postoperative complications were bowel obstruction (n = 6), intussusception (n = 3), dysphagia (n = 3), breakdown of the repair (n = 3), and pneumothorax (n = 1). There was one mortality caused by preoperative aspiration. CONCLUSION: Paraesophageal hernias in children are uncommon and most likely caused by a congenital defect. They are associated with considerable morbidity. Strangulation is not a feature. Principles of repair are well established and should include an antireflux procedure.
Child↗
The toxicity of repeated exposures to rolipram, a type IV phosphodiesterase inhibitor, in rats.
Rolipram is a selective inhibitor of Type IV phosphodiesterase isozymes (PDE IV) which is often used as a baseline comparator for compounds in this class. To document the toxicological effects of rolipram, it was administered to female rats at 0, 10, 30 or 100 mg/kg/day orally for up to 2 weeks. One treatment-related death in the 100 mg/kg/day dose group was observed on day 3, and all rats at this dose level were considered moribund and euthanatized on day 5. Several clinical signs were observed in treated rats, including increased salivation, slight distention of the abdomen, emaciated appearance, and ataxia. After 14 days of treatment, the rats were necropsied and tissues examined microscopically. A number of compound-related histopathological changes were observed in rats receiving 30 or 100 mg/kg/day. Myocardial degeneration and necrosis, endocardial fibrosis, epicarditis, and arteritis/periarteritis of intramural and extramural coronary arteries were observed in the heart. A necrotizing vasculitis and inflammation were observed in the mesentery and interstitial areas of the liver, affecting medium-sized portal arteries and veins. Focal necrosis was also observed in the glandular mucosa of the stomach at these 2 dose levels. Other treatment-related effects included squamous hyperplasia and hyperkeratosis with or without ulceration in the nonglandular stomach of at least one animal from all treatment groups. Enlarged salivary glands were noted at necropsy in animals treated with 100 mg/kg/day, and this finding correlated microscopically with dilatation and degeneration of ducts and acini in the sublingual gland with secondary inflammation and edema. The results of this study demonstrate that rolipram, a selective inhibitor of the type IV class of PDE, can cause effects on the heart and vasculature of rats which heretofore have been ascribed only to selective inhibitors of the PDE III class of isozymes. Therefore, these organs should be closely examined in studies with other PDE IV inhibitors. In addition, the gastrointestinal tract and salivary glands were sites for rolipram-induced toxicity and may be targets of other PDE IV inhibitors.
Animals↗
Clinical and epidemiological features of syphilis in pregnant women: the course and outcome of pregnancy.
Clinical and epidemiological features of syphilis and the course and outcome of pregnancy were studied in 155 pregnant women infected with syphilis; 95 (61%) women were unemployed, 47% were unmarried. Syphilis proceeded without clinical manifestations in 121 cases (78%). Discordant results of complement fixation (Wassermann) test, precipitation test, Treponema pallidum immobilization test, and fluorescent antibody test were observed in 22 (14%) of the women. Pregnancy pathology was observed in 75 cases (48.8%) and more often appeared as anemia in 49 (31.5%), stillborn in 46 (29.8%) and toxicosis in 44 (28.4%). Fetal ultrasonic stigmas of infection were evident in 23 cases (49%). There was distension of the brain ventricle system and hepatomegaly each in 1 case (2%), transvascular infiltration of liver in 2 cases (4%), dilation of intestinal loops, gastromegaly, ventriculomegaly and petrifaction in lungs each in 1 case; ultrasonic changes in vessels of organs: of the liver in 4 cases (8%), intestines and stomach in 16 cases (32%), lungs in 4 cases (8%), kidneys in 10 cases (21%) and of the ventricular system in 9 cases (19%). Fetus development retardation was revealed in 3 cases (6%), fetal hypoxia in 1 (2%), hypohydrosis in 2 (4%) and hydropsy in 1 case (2%). The pregnancy pathology in women with syphilis was considered not pathognomonic.
Adolescent↗
Adenocarcinoma arising in gastric heterotopic pancreas: a case report.
A heterotopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare. We describe the second case of adenocarcinoma arising in a gastric heterotopic pancreas of an asymptomatic 35-yr-old man in Korea. Esophagogastroduodenoscopy revealed a submucosal tumor with an irregular central umbilication in the gastric antrum. A wedge resection specimen demonstrated a submucosal oligolocular cystic mass (1.7 x 1.4 x 1.2 cm) with a solid portion. Microscopically, the cystic portion was composed of dilated pancreaticobiliary type ducts with adjacent small foci of periductal glandular structures. The adenocarcinoma components in the solid area infiltrated the proper muscle and the overlying mucosa of the stomach. The transitional area between the benign ductal structures and the adenocarcinoma component was found. The follow-up course was uneventful 5 months postoperatively.
Adenocarcinoma↗
[Telescopic anastomosis in esophageal and gastric surgery].
In 1991 we tried to adopt the telescopic anastomosis technique which had been used in bowel surgery made with the esophagus. In our method a 1.5-2 cm long stump of the distal esophagus is laid in the lumen end-to-side of the other organ (stomach, jejunum, large bowel). The oral the worst blood supplied part of the stomach has also removed and an end-to-end anastomosis has been made. We used this method in 125 patients until the end of 1997. In 89 cases during esophageal resections, and from it in 36 cases the anastomoses were made and-to-end, in 36 cases during total gastrectomies were made telescopic anastomosis leakage in the neck that healed after conservative treatment. We noticed advanced ischemic necrosis of the stomach used for replacement in 4 cases. Two of these patients healed after operative treatment. After gastrectomies all anastomosis healed without any complication. In 6 cases occurred anastomotic stenosis always after anastomotic leakage. 3 patients could be treated with dilatation, in 3 cases had to make reoperations due to stenosis. The authors emphasize that the method is simple, made in single lawyer, the sutures are not drained the lumen. They have not got strong opinion about the propensity for stenosis due to few cases.
Adult↗