The diagnostic accuracy of the roentgen examination in diseases of the upper gastrointestinal tract.
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Gastrointestinal Diseases↗
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Amino acid use by the gastrointestinal tract of sheep given lucerne forage.
Essential amino acid (EAA) utilization by gastrointestinal tract (GIT) tissues has been investigated in sheep given 800 and 1,200 g/day lucerne pellets. Animals prepared with indwelling catheters into the aorta and the portal drained viscera plus cannulas into the small intestine were infused with mixed U-13C-labeled amino acid or (1-13C]leucine tracers into the jugular vein or directly into the small intestine. GIT sequestration of EAA from arterial and luminal AA pools was determined from tracer and tracee arterioportal concentration differences at both levels of intake. Proportional tracer 13C-labeled EAA extraction of the arterial supply, on first pass across the GIT during jugular infusion, ranged from 0.063 for histidine to 0.126 for leucine. Recovery of intestinally infused tracer 13C-EAA at the portal vein ranged from 0.61 for histidine to 0.83 for valine. These data were independent of intake. Calculated rates of tracee sequestration by GIT tissues represented 0.45-0.65 of whole body EAA flux, except for histidine, for which the values were much lower (0.25-0.32). With the exception of phenylalanine, more than 0.8 of the EAA used by the GIT was extracted from circulating blood, thus calling into question the theory that GIT tissues make preferential use of EAA during absorptive metabolism, restricting supply to peripheral tissues such as skeletal muscle (growth) or mammary glands (lactation). Instead the GIT seems to compete very successfully with these tissues for circulating blood EAA.
Amino Acids, Essential↗
The role of surgery in the prevention of familial cancer syndromes of the gastrointestinal tract.
Familial predisposition is a well-recognised risk factor in many gastrointestinal cancers. New developments in molecular genetics may contribute to the identification of cancer-prone families. Recognition of familial clustering and genetic testing can identify other members of the family with a high potential risk for cancer development. Appropriate surveillance mechanisms and management protocols may be initiated in order to prevent cancer and/or to detect cancer at an early stage. In the present article, various types of familial cancer of the gastrointestinal tract are reviewed and surgical, diagnostic and therapeutic issues for the management of esophageal, gastric, colorectal, and pancreatic cancer are emphasized.
Digestive System Neoplasms↗
Corynebacterium kutscheri invasiveness of the gastrointestinal tract in young mice.
Corynebacterium kutscheri invasiveness of the tissues of the gastrointestinal tract in mice was investigated by the fluorescent antibody technique. The invasion was clearly recognized in 3-week-old mice infected intragastrically along with gastric mucin and a subcutaneous dose of cortisone; 10(7) organisms caused a notable invasion of the gastric and duodenal tissues. Furthermore, marked bacterial invasion of the large intestine appeared in mice challenged perorally with 7 x 10(7) organisms.
Animals↗
Endoscopic sonography of the upper gastrointestinal tract and pancreas.
Endoscopic sonography is a new approach to visualizing upper gastrointestinal lesions. The sonographic device, which incorporates a sonographic transducer mounted on a standard fiberoptic endoscope, makes it possible to obtain high-resolution images of mucosal and mural lesions of the gastrointestinal tract, as well as of adjacent masses. This technique has substantially improved preoperative staging of esophageal and gastric cancers. In addition, high-resolution sonographs of the pancreas can be obtained without degradation by overlying bowel gas, making identification of small, previously occult lesions of the pancreatic head possible. We have used endoscopic sonography in staging esophageal, gastric, and pancreatic cancers in more than 200 patients. This essay illustrates our experience with this new technique.
Endoscopy, Digestive System↗
Endosonographic diagnosis of submucosal upper gastrointestinal tract tumors.
Endoscopic ultrasound (EUS) was performed in 37 patients with upper gastrointestinal tract submucosal tumors (SMT). Fourteen of these were located in the esophagus, 20 in the stomach, and 3 in the duodenum. In 26 patients histologic confirmation was achieved by operation (n = 15) or biopsy/puncture (n = 11). EUS was able to visualize all tumors and, with one exception, determined their originating wall layer correctly. It became evident that myogenic tumors arise from the echo-poor layers (second layer and fourth--that is, muscularis propria) and that other lesions, such as cysts or fibromas, originate from the third, echo-rich layer (submucosa). Tumor size was correctly (+/- less than 5 mm) predicted in 87% of cases. Computed tomography, performed in 22 patients, was successful in visualizing the SMT in only two-thirds of cases. No single endosonographic criterion could be obtained which enabled accurate differentiation between benign and malignant SMT. However, from a clinical point of view, it seems reasonably safe to regard smaller (less than 3 cm), smoothly demarcated SMT as benign and follow them up by repeated EUS, especially in patients at risk for surgery. Larger masses (greater than 5 cm) and those with irregular borders should be suspected of being malignant. In the future, application of new, small ultrasound probes that can be used during conventional endoscopy (two SMT were visualized successfully) may greatly simplify the procedure.
Diagnosis, Differential↗
Phlegmonous inflammation of gastrointestinal tract autopsy study of three cases.
Three cases of Phlegmonous inflammation of gastrointestinal tract detected at necropsy are described. Predisposing factors were seen in all three cases. These were chronic alcoholism with submissive hepatic necrosis (HbsAg and HbcAg positive) in Case 1, Indian Childhood cirrhosis in Case 2 and acute on chronic Budd Chiari syndrome in Case 3. In case 1 and 3 the inflammation was limited to the large intestine where as in Case 2 it was seen both in the stomach and large intestine. In two of the three cases blood culture grew Staphylococcus aureus (Case 1) and gram negative organisms (Case 2).
Adult↗
[Internal fistula of the gastrointestinal tract].
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Fistula↗
[Early carcinomas of the upper gastrointestinal tract: diagnostic problems].
Problems arising when diagnosing biopsy material from the upper gastrointestinal tract are encountered in particular with changes that might minic a carcinoma. In the squamous epithelium of the oesophagus, such problem lesions are viral infections, regenerative changes in reflux disease, and pseudoepitheliomatous hyperplasia in subepithelial lesion. In Barrett's mucosa, regenerative changes are often overdiagnosed as low grade dysplasia, and will-differentiated adenocarcinomas underdiagnosed as high grade dysplasia. In the stomach, the regenerative mucosa at the margins of erosions and ulcers--in particular in the case of NSAID/ASA-induced lesions--is the most common cause of the wrong diagnosis of carcinoma. Such misdiagnoses can usually be avoided by taking careful account of the endoscopic findings. In the case of doubt, a second pathological opinion, an extensive endoscopy/biopsy follow-up examination (after treatment), or a diagnostic endoscopic mucosectomy, is to be recommended.
Anti-Inflammatory Agents, Non-Steroidal↗
An immunohistochemical study on the distribution of endocrine cells in the gastrointestinal tract of the musk shrew, Suncus murinus.
The endocrine cells in the gastrointestinal tract of the musk shrew were studied immunohistochemically. Eleven kinds of endocrine cells, immunoreactive for serotonin, somatostatin, gastrin, cholecistokinin, gastric inhibitory polypeptide, motilin, secretin, neurotensin, pancreatic glucagon, enteroglucagon and bovine pancreatic polypeptide, were revealed. In the stomach, serotonin-, somatostatin-, gastrin-, pancreatic glucagon- and enteroglucagon-immunoreactive cells were detected. The first three types of cells predominated and were more abundant in the pyloric glands than in the other stomach regions. In the small intestine, all types of endocrine cells were found, each having different distributions and relative frequencies. In the large intestine, 10 types of endocrine cells except cholecystokinin-immunoreactive cells were detected. Serotonin- and bovine pancreatic polypeptide-immunoreactive cells were more numerous in the large intestine than in the small intestine.
Animals↗
Malignant fibrous histiocytoma of the gastrointestinal tract in a patient with neurofibromatosis.
Malignant fibrous histiocytoma (MFH) of the gastrointestinal tract is extremely rare. A case of MFH of the colon associated with neurofibromatosis is presented. MFH is a high-grade soft-tissue sarcoma of fibroblast cell origin with a strong propensity for metastasis and recurrence. Immunochemical markers help to differentiate MFH from other sarcomas. The most successful treatment of MFH is surgical extirpation. Adjuvant chemotherapy and radiotherapy have not been definitively shown to be of value.
Colonic Neoplasms↗
Vitamin B12 absorption in some selected pathological states of the gastrointestinal tract.
The absorption of vitamin B12 in selected pathological states of the gastrointestinal tract was studied. Schilling test was performed with 37 kBq (1 microCi) of 57Co-labelled vitamin B12 as an analysis of urinary radioactivity. No increase in cobalamin absorption was present after exogenous IF had been administrated to patients after resection of the upper part the stomach and total gastrectomy. This suggests that there is another factor likely to affect vitamin B12 absorption.
Adult↗
Local actions of trimebutine on canine gastrointestinal tract.
The local actions of trimebutine on the circular muscle of canine gastrointestinal tract were studied after close intraarterial injection. The effects resembled those of metenkephalin at all sites. In stomach, trimebutine had no excitatory effects, but inhibited responses mediated by cholinergic post-ganglionic nerves. In small intestine, trimebutine stimulated the quiet gut by probably both neural and direct smooth muscle mechanisms, and it inhibited the field-stimulated phasic contractions. In large intestine, trimebutine had no excitatory actions and only weak inhibitory actions on the field-stimulated gut. Excitatory actions most likely seem to use the mu or delta receptors while inhibitory actions may focus on kappa opiate receptors.
Animals↗
Interventional procedures in the gastrointestinal tract in children.
Significant growth and innovation in interventional procedures involving the gastrointestinal tract has occurred over the last 15 years. The authors discuss historical background, procedural planning, sedation, and monitoring during the procedure, technique, postprocedural care, and potential procedural complications in the pediatric population.
Child↗
Regional permeability of salmon calcitonin in isolated rat gastrointestinal tracts: transport mechanism using Caco-2 cell monolayer.
The objective of the study was to determine the region of maximum permeation of salmon calcitonin (sCT) through the gastrointestinal tract and to investigate the mechanism of permeation. For regional permeability determination, male Sprague-Dawley rats (250-300 g) were anesthetized and the gastrointestinal tissues were isolated. Stomach, duodenum, jejunum, ileum, or colon tissues were mounted on Navicyte side-by-side diffusion apparatus. Salmon calcitonin solutions (50 microm in phosphate-buffered saline, pH 7.4, 37 degrees C) were added to the donor side, and the samples were removed from the receiver compartment and analyzed by competitive radioimmunoassay (RIA). For mechanistic studies, Caco-2 cells were grown on Transwell inserts (0.4-microm pore size, 0.33 cm2 area) in a humidified 37 degrees C incubator (with 5% CO2). Transport experiments were conducted for sCT solutions (50 microm in Dulbecco's modified eagle's medium [DMEM], pH 7.4) from the apical-to-basolateral (A-to-B) direction and B-to-A direction at 37 degrees C and from the A-to-B direction at 4 degrees C. Cell monolayer integrity was monitored by mannitol permeability and transepithelial electrical resistance (TEER) measurements. The permeability coefficients (x 10(-9), cm/sec) for sCT through rat stomach, duodenum, jejunum, ileum, and colon tissues were 0.482 +/- 0.086, 0.718 +/- 0.025, 0.830 +/- 0.053, 1.537 +/- 0.32, and 0.934 +/- 0.15, respectively. The region of maximum sCT permeability is ileum followed by colon, jejunum, duodenum, and stomach. The permeability coefficients (x 10(-6), cm/sec) for sCT through Caco-2 cell monolayer were 8.57 +/- 2.34 (A-to-B, 37 degrees C), 8.01 +/- 1.22 (A-to-B, 4 degrees C), and 6.15 +/- 1.97 (B-to-A, 37 degrees C). The mechanism of its permeation is passive diffusion through the mucosa as determined from the Caco-2 monolayer permeability of sCT.
Animals↗
Radiologic spectrum of opportunistic infections of the upper gastrointestinal tract.
Clinical findings and barium studies were reviewed in 34 patients with upper gastrointestinal opportunistic infections, including two with gastric involvement. The spectrum of radiologic features is presented with particular attention to early subtle findings such as disturbance of esophageal motility and tiny marginal filling defects. While most cases are due to Candida albicans, other organisms may also invade the upper gastrointestinal tract in the debilitated host.
Adult↗
Graft-versus-host disease of the gastrointestinal tract.
Forty-two gastrointestinal examinations performed in 24 patients with a history of bone marrow transplantation were analyzed retrospectively. All patients were clinically suspected of a graft-versus-host disease (GVHD) involving the alimentary tract. No specific abnormalities were found in the esophagus or the stomach. Radiographic features of a GVHD of the small bowel are: edema of mucosal folds in ileum and jejunum; effacement of folds towards the ileum; thickening of the bowel wall, and spasms and stenosis with prestenotic dilatation. In the active phase the bowel appears to be shortened. A short transit time was not a specific finding. Follow-up examinations showed partial regression of these findings. Radiological findings in the colon consisted of loss of haustration, thumbprinting, spasms and ulcerations.
Adolescent↗
Expression of group II phospholipase A2 in the human gastrointestinal tract.
BACKGROUND: It has been suggested that group II phospholipase A2 (PLA2-II) plays an essential role in inflammation, but the cellular source(s) of the enzyme is (are) largely unknown. EXPERIMENTAL DESIGN: Expression of PLA2-II was analyzed in human gastrointestinal tract at both protein and mRNA levels. Both normal tissues and specimen from patients with a few different common gastrointestinal disorders were analyzed. RESULTS: Expression of PLA2-II mRNA was seen in the Paneth cells but not in any other cell type of the intestinal tract. Blood vessel walls showed PLA2-II immunoreactivity but were negative in in situ hybridization for PLA2-II mRNA. CONCLUSIONS: It was concluded that nonpancreatic group II PLA2 is synthesized and stored by Paneth cells, whereas other cell types of the gastrointestinal tract seem incapable of synthesis of this enzyme. The positive immunoreaction in vascular structures may reflect the entry of circulating PLA2-II into vessel walls rather than local production of the enzyme.
Blotting, Northern↗