Spontaneous fistulization of hepatic hydatid cyst into the duodenum: an exceptional complication

International Nuclear Information System (INIS)

Daldoul, S.; Moussi, A.; Zaouche, A.

2013-01-01

Hydatid disease is a worldwide zoonosis and is localized in the liver in most cases. Its complications are numerous and include those related to the compression of adjacent viscera, infection of the cyst's contents or perforation of the cyst. Spontaneous rupture of the hepatic hydatid cyst into the duodenum is an extremely rare complication. The communication is, typically, not discovered until surgery. We present two cases of perforation of a liver cyst into the duodenum. One of them was diagnosed pre-operatively by a barium study. The surgical treatment of the lesion and its complications was complex but successful in both cases. (author)

Large gangliocytic paraganglioma of the duodenum: A rare entity.

Science.gov (United States)

Hernández, Alejandra Gordillo; Lanuza, Eduardo Dominguez-Adame; Matias, Auxiliadora Cano; Huertas, Rosario Perez; Rodriguez, Katherine Maria Gallardo; Perez, Purificacion Gallinato; Mompean, Fernando Oliva

2015-08-27

Gangliocytic paragangliomas are rare tumors that almost exclusively occur within the second portion of the duodenum. Although these tumors generally have a benign clinical course, they have the potential to recur or metastasize to regional lymph nodes. The case report presented here describes a 57-year-old female patient with melena, progressive asthenia, anemia, and a mass in the second-third portion of the duodenum that was treated by local excision. The patient was diagnosed with a friable bleeding tumor. The histologic analysis showed that the tumor was a 4 cm gangliocytic paraganglioma without a malignant cell pattern. In the absence of local invasion or distant metastasis, endoscopic resection represents a feasible, curative therapy. Although endoscopic polypectomy is currently considered the treatment of choice, it is not recommended if the size of the tumor is > 3 cm and/or there is active or recent bleeding. Patients diagnosed with a gangliocytic paraganglioma should be closely followed-up for possible local recurrence.

X-ray diagnostics. Stomach and duodenum. Adults

International Nuclear Information System (INIS)

1981-04-01

The standard deals with X-ray diagnostics of stomach and duodenum in patients on completion of the 14th year of life. It includes information on indications, contraindications, prerequisites and preparations as well as on application and appropriate dosage of contrast media. Parameters on focussing, imaging conditions and on the program of taking radiographies are outlined. The necessity of special examinations according to findings as well as measures concerning radiation protection and hygiene are presented

Radiology of the stomach and duodenum

International Nuclear Information System (INIS)

Freeman, A.H.; Sala, E.

2008-01-01

A number of imaging techniques, many of them complementary, are used in the investigation and treatment of disorders of the stomach and duodenum. Optimal patient treatment requires a thorough knowledge of the application of these techniques, as well as a sound understanding of pathology of the stomach and its presenting symptomatology. This well-illustrated book covers the various investigative methods in detail, discussing their advantages and disadvantages and explaining their role in specific settings. It will be of great value to both trainee and experienced radiologists, and should assist in promoting effective and judicious patient management. (orig.)

Intraluminal erosion of laparoscopic gastric band tubing into duodenum with recurrent port-site infections.

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Cintolo, Jessica A; Levine, Marc S; Huang, Stephanie; Dumon, Kristoffel

2012-01-01

Intraluminal erosion of a laparoscopic gastric band into the stomach has been reported as a complication of laparoscopic adjustable gastric banding. To our knowledge, however, intraluminal erosion of the band tubing into the duodenum has not been described. We report a 46-year-old man in whom a laparoscopic adjustable gastric band tubing eroded into the duodenal lumen, causing recurrent port-site infections. This complication was diagnosed on upper endoscopy and also, in retrospect, on an upper gastrointestinal barium study and computed tomography. The patient underwent surgical removal of the band and tubing, with a primary duodenal repair, and made a complete recovery without complications. Erosion of laparoscopic band tubing into the duodenum should be included in the differential diagnosis for recurrent port-site infections after laparoscopic adjustable gastric banding. Radiographic or endoscopic visualization of the intraluminal portion of the tubing may be required for confirmation. Definitive treatment of this complication entails surgical removal of the tubing from the duodenum.

Features of Clinical Course of Perforated Ulcers of Stomach and Duodenum in Children

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A.G. Zaporozhchenko

2013-11-01

Full Text Available We examined 52 patients aged from 14 to 17 years with perforated ulcer of stomach and the duodenum, operated using laparoscopic and open ways. It is established, that perforated ulcer of stomach and the duodenum in children onset suddenly, the are characterized by absence of «ulcer anamnesis» and clinical picture of acute peritonitis in 77 % of children. Maximum efficiency of diagnosis of perforated gastric and duodenal ulcers is achieved by using a comprehensive diagnostic program that includes the use of phased diagnostic measures in accordance with their resolution in each case.

Perforated Duodenum – An Unusual Etiology of Fournier's Disease: A Case Report

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Yung-Chin Lee

2003-12-01

Full Text Available Fournier's disease, a form of necrotizing fasciitis, is a rapidly progressing subcutaneous infection of the male genitalia. We report a case of Fournier's disease with the unusual etiology of a perforated duodenum. This patient suffered from progressive right scrotal swelling after percutaneous transhepatic cholangeal drainage. Scrotal exploration revealed a large abscess with muscle necrosis that had spread up to the right retroperitoneal space. Radiologic studies and second abdominal exploration documented the origin as a perforated duodenum. The pus distribution in this case suggested that the infection process differed from that in previous reports. In future cases of Fournier's disease involving previous abdominal events, we recommend that abdominal origins be carefully surveyed before scrotal exploration.

Stomach and duodenum ulcer: comparing the efficiency of three laser therapeutic techniques

Science.gov (United States)

Myslovich, L. V.

2001-04-01

An investigation was made of how effective various therapeutic techniques are in treating stomach and duodenum ulcers. The investigation was made on 105 patients (70 patients were affected by duodenum ulcer and 25 patients suffered from stomach ulcer). Three different complex laser therapeutic techniques were compared with each other and with a generally accepted drug treatment. It was found that the most pronounced therapeutic effect was observed in patients administered a complex laser technique that included drug therapy, the intravenous laser irradiation of blood, and the focal-segmental laser therapy. This complex laser therapy enabled ulcer scarring within 8 to 15 days after the beginning of the treatment (with the average scarring term of 9 days).

Clinical application of duodenum-preserving pancreatic head resection

OpenAIRE

ZHOU Songqiang

2018-01-01

Objective To investigate the indications and therapeutic effect of duodenum-preserving pancreatic head resection (DPPHR). Methods A retrospective analysis was performed for the clinical data of 17 patients who underwent DPPHR in Fujian Provincial Hospital from January 2013 to February 2017. Among these patients, 6 had chronic pancreatitis with pancreatic duct stones, 2 had chronic pancreatitis with pancreatic pseudocyst, 3 had solid pseudopapillary tumor of the pancreatic head, 3 had intraduc...

Pancreas-sparing duodenectomy for an obstructive adenocarcinoma of the duodenum.

Science.gov (United States)

Lam, D; Croome, Kp; Hernandez-Alejandro, R

2012-08-01

A duodenal adenocarcinoma arising from the junction of the second and third portion of the duodenum, which was resected by pancreas-sparing duodenectomy, is reported. The completely obstructing tumour was circumferential and measured 6.5cm x 3.5cm x 1.0 cm. There was no evidence of pancreas invasion, nor any lymph node metastasis. Pancreas-sparing duodenectomy was performed, with dissection of the pancreaticoduodenal lymph nodes. The proximal duodenum was transected just distal to the ampula of Vater and jejunum was transected just distal to the ligament of Treitz. A hand-sewn side-to-side anastomosis for the duodenojejunostomy was performed. There were no postoperative complications. Pathology reported a duodenal adenocarcinoma resected with negative margins. Pancreaticoduodenectomy is the treatment of choice for a duodenal adenocarcinoma, however, pancreas-sparing duodenectomy may be a safe alternative for duodenal tumours not involving the 2(nd) portion, especially in elderly patients with multiple medical comorbidities. © JSCR.

[Duodenum-preserving total pancreatic head resection and pancreatic head resection with segmental duodenostomy].

Science.gov (United States)

Takada, Tadahiro; Yasuda, Hideki; Nagashima, Ikuo; Amano, Hodaka; Yoshiada, Masahiro; Toyota, Naoyuki

2003-06-01

A duodenum-preserving pancreatic head resection (DPPHR) was first reported by Beger et al. in 1980. However, its application has been limited to chronic pancreatitis because of it is a subtotal pancreatic head resection. In 1990, we reported duodenum-preserving total pancreatic head resection (DPTPHR) in 26 cases. This opened the way for total pancreatic head resection, expanding the application of this approach to tumorigenic morbidities such as intraductal papillary mucinous tumor (IMPT), other benign tumors, and small pancreatic cancers. On the other hand, Nakao et al. reported pancreatic head resection with segmental duodenectomy (PHRSD) as an alternative pylorus-preserving pancreatoduodenectomy technique in 24 cases. Hirata et al. also reported this technique as a new pylorus-preserving pancreatoduodenostomy with increased vessel preservation. When performing DPTPHR, the surgeon should ensure adequate duodenal blood supply. Avoidance of duodenal ischemia is very important in this operation, and thus it is necessary to maintain blood flow in the posterior pancreatoduodenal artery and to preserve the mesoduodenal vessels. Postoperative pancreatic functional tests reveal that DPTPHR is superior to PPPD, including PHSRD, because the entire duodenum and duodenal integrity is very important for postoperative pancreatic function.

Bouveret syndrome: gallstone ileus of the duodenum.

Science.gov (United States)

Englert, Zachary P; Love, Katie; Marilley, Mark D; Bower, Curtis E

2012-10-01

This is a case of a 59-year-old woman with Bouveret syndrome. An initial endoscopic approach to management is described. Gallstone ileus occurs when a gallstone passes from a cholecystoduodenal fistula or a choledochoduodenal fistula into the gastrointestinal tract and causes obstruction, usually at the ileocecal valve. Bouveret syndrome is a variant of gallstone ileus where the gallstone lodges in the duodenum or pylorus causing a gastric outlet obstruction. The endoscopic and surgical management of this process are important to keep in mind and may be evolving as endoscopic therapies improve.

Adenocarcinoma of the third portion of the duodenum in a man with CREST syndrome

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Fragulidis Georgios

2008-10-01

Full Text Available Abstract Background CREST (Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasias syndrome has been rarely associated with other malignancies (lung, esophagus.This is the first report of a primary adenocarcinoma of the third portion of the duodenum in a patient with CREST syndrome. Case presentation A 54-year-old male patient with CREST syndrome presented with colicky postprandial pain of the upper abdomen, diminished food uptake and a 6-Kg-body weight loss during the previous 2 months. An ulcerative lesion in the third portion of the duodenum was revealed during duodenoscopy, with a diagnosis of adenocarcinoma on biopsy specimen histology. The patient underwent a partial pancreatoduodenectomy. No adjuvant therapy was instituted and follow-up is negative for local recurrence or metastases 21 months postoperatively. Conclusion CREST syndrome has been associated with colon cancer, gastric polyps, familial adenomatous polyposis (FAP syndrome and Crohn's disease; however, this is the first report of a primary adenocarcinoma of the duodenum in a patient with CREST syndrome. However, any etiologic relationship remains to be further investigated.

Global transcriptional response to Hfe deficiency and dietary iron overload in mouse liver and duodenum.

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Alejandra Rodriguez

2009-09-01

Full Text Available Iron is an essential trace element whose absorption is usually tightly regulated in the duodenum. HFE-related hereditary hemochromatosis (HH is characterized by abnormally low expression of the iron-regulatory hormone, hepcidin, which results in increased iron absorption. The liver is crucial for iron homeostasis as it is the main production site of hepcidin. The aim of this study was to explore and compare the genome-wide transcriptome response to Hfe deficiency and dietary iron overload in murine liver and duodenum. Illumina arrays containing over 47,000 probes were used to study global transcriptional changes. Quantitative RT-PCR (Q-RT-PCR was used to validate the microarray results. In the liver, the expression of 151 genes was altered in Hfe(-/- mice while dietary iron overload changed the expression of 218 genes. There were 173 and 108 differentially expressed genes in the duodenum of Hfe(-/- mice and mice with dietary iron overload, respectively. There was 93.5% concordance between the results obtained by microarray analysis and Q-RT-PCR. Overexpression of genes for acute phase reactants in the liver and a strong induction of digestive enzyme genes in the duodenum were characteristic of the Hfe-deficient genotype. In contrast, dietary iron overload caused a more pronounced change of gene expression responsive to oxidative stress. In conclusion, Hfe deficiency caused a previously unrecognized increase in gene expression of hepatic acute phase proteins and duodenal digestive enzymes.

Mucosa-associated Lymphoid Tissue Lymphoma Presenting with Bowel Obstruction of the Duodenum and Small Bowels: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Ryu, Guen Ho; Hong, Seong Sook; Kim, Jung Hoon; Chang, Yun Woo; Choi, Duek Lin; Hwang, Jung Hwa; Kwon, Kui Hyang [Soonchunhyang University Hospital, Seoul (Korea, Republic of)

2010-01-15

The occurrence of primary duodenal mucosa associated lymphoid tissue (MALT) lymphoma is extremely rare, and more so is the obstruction of the duodenum for the MALT lymphoma. We describe the small bowel follow through and CT findings in an uncommon case of MALT lymphoma presenting with bowel obstruction of the 2nd portion of the duodenum and small bowels.

Mucosa-associated Lymphoid Tissue Lymphoma Presenting with Bowel Obstruction of the Duodenum and Small Bowels: A Case Report

International Nuclear Information System (INIS)

Ryu, Guen Ho; Hong, Seong Sook; Kim, Jung Hoon; Chang, Yun Woo; Choi, Duek Lin; Hwang, Jung Hwa; Kwon, Kui Hyang

2010-01-01

The occurrence of primary duodenal mucosa associated lymphoid tissue (MALT) lymphoma is extremely rare, and more so is the obstruction of the duodenum for the MALT lymphoma. We describe the small bowel follow through and CT findings in an uncommon case of MALT lymphoma presenting with bowel obstruction of the 2nd portion of the duodenum and small bowels

Roll seat belt induced injury of the duodenum.

Science.gov (United States)

Bergqvist, D; Hedelin, H

1976-05-01

A case of duodenal rupture with a roll three-point seatbelt is described. It is apparently the seventh reported case of duodenal rupture in safety belt users. A female driver fell asleep, and her car went off the road, rolling forward in a ditch, slowing slightly, and then came to a sudden stop. The rupture was unusual: on the first part of duodenum, intraperitoneal, and longitudinal. The rupture mechanism is discussed, and the deficiencies of the roll seatbelt pointed out in accidents like the one described.

CYSTIC DEGENERATION OF THE DUODENUM ASSOCIATED WITH CHRONIC PANCREATITIS

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A. G. Kriger

2016-01-01

Full Text Available Inflammatory cystic lesion of the descending part of the duodenum, mainly in the field of small duodenal papilla in chronic pancreatitis (CP is described as “duodenal dystrophy” (DD. The pathogenesis of this condition has not been studied and treatment strategy is not defined.Purpose. Investigation of cystic inflammatory transformation of duodenal wall pathogenesis in patients with CP, described as a DD, and evaluate the clinical ef ficiency of surgical treatment.Material and methods. Eighty two patients with DD were retrospectively included over 12 years. The diagnosis of DD was established by transabdominal ultrasound, CT, MRI and endosonography. Initially, all patients were treated conservatively. 74 patients required surgical treatment subsequently after conservative treatment with a median duration of 2 years. 34 patients underwent pancreaticoduodenectomy (PD, 21 patients underwent duodenum resection, 15 – duodenum preserving pancreatic head resection of (DPPHR. 4 patients underwent palliative operations. Diagnosis of CP and DD was verified by histological study of surgical specimens. Not operated patients (8 are under observation. Long-term results of surgical treatment were evaluated in 47 patients with a median follow-up was 49.9 months.Results. Histological examination resulted that in 69.9% of DD was related with groove pancreatitis, with ectopic pancreatic tissue – in 30.1%. DD was associated with CP in 92.6% of cases. Clinical presentation of DD was not related with etiology and showed typical symptoms of CP: abdominal pain occurred in 98.8% of patients, body weight loss – 61.7%, duodenal obstruction – 35.8%, biliary hypertension – 34.1%. The overall morbidity was 35.1%. Overall postoperative mortality was 1.37% (1 patient. 66% of patients had no clinical symptoms postoperatively, a significantimprovement – 32%, no effect – 2%.Conclusion. The most cases of DD is related with groove pancreatitis, less �

Gangliocytic paraganglioma of duodenum metastatic to lymph nodes and liver and extending into the retropancreatic space

DEFF Research Database (Denmark)

Amin, S M; Albrechtsen, N Wewer; Forster, J

2013-01-01

Gangliocytic paraganglioma (GP) is a rare benign neuroendocrine tumour found most often in the duodenum. To our knowledge, only a dozen cases of possibly malignant duodenal GP with local lymph node metastasis and only one case with liver metastasis have previously been published. Herein, we report...... an unusual case of GP of the duodenum spreading to the retropancreatic space and metastatic to the liver and lymph nodes. Additionally, the present tumour secreted pancreatic polypeptide (PP) which was detected in the serum during the follow-up period. We suggest that serum PP could be a valuable marker...

Application of an Artificial Stomach-Duodenum Reduced Gastric pH Dog Model for Formulation Principle Assessment and Mechanistic Performance Understanding.

Science.gov (United States)

Lee, Chen-Ming; Luner, Paul E; Locke, Karen; Briggs, Katherine

2017-08-01

The objective of this study was to develop an artificial stomach-duodenum (ASD) dissolution model as an in vitro evaluation tool that would simulate the gastrointestinal physiology of gastric pH-reduced dogs as a method to assess formulations for a poorly soluble free acid compound with ng/mL solubility. After establishing the ASD model with well-controlled duodenum pH, 5 formulations each applying different solubilization principles were developed and their performance in the ASD model and in vivo in dogs was evaluated. Excellent correlations were obtained between dog area under the curve (AUC) and ASD AUC of 5 formulations evaluated with simulated intestinal fluid (r 2  = 0.987) and fasted-state simulated intestinal fluid (r 2  = 0.989) as the duodenum dissolution medium, indicating that the approach of infusing NaOH into duodenum compartment to maintain duodenum pH of an ASD worked properly in simulating gastric pH-reduced dog. Raman spectroscopy was used to study drug dissolution kinetics associated with different solubilization principles and the results suggested that the solubilization principles performed as designed. Spectroscopic results also identified that the compound formed a gel during dissolution and hypromellose maintained the drug-gelled state to avoid further solid form conversion. The implication of the compound physical gelation to drug dissolution kinetics and in vivo exposure are discussed. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

[Influence of the comorbidity diseases and risk factors on development of the combined peptic ulcer of the stomach and the duodenum].

Science.gov (United States)

Stepanishcheva, L A; Sarsenbaeva, A S; Fattakhova, N V

2013-01-01

To define influence of the comorbidity diseases and risk factors of development of the combined peptic ulcer of a stomach and duodenum. As a result of carried-out poll and inspection 250 patients with an exacerbation of a peptic ulcer were surveyed. Patients were distributed in 3 groups of observation depending on localization of ulcerative process. At all surveyed questioning was carried out, data on hereditary load, smoking, alcohol intake, existence of somatopathies were specified, clinic-morphological implications of a peptic ulcer were studied. The peptic ulcer of a stomach is characteristic for women (72.1%) and develops mainly aged from 45 till 59 years (60.3%). Peptic ulcer of duodenum men (76.3%) suffer mainly, the debut is the share in most cases of age from 18 to 44 years (79.1%). The combined canker of a stomach and duodenum meets at males (61.2%) more often, is initially involved in process ulcerogenesis by duodenum generally aged from 30 till 44 years (64.2%), accession of a canker of a stomach happens is delayed (at 38.8% within 16 and more years). In the analysis of risk factors at patients with the combined peptic ulcer of a stomach and duodenum depending on existence or absence specific to this category of patients of a background from such comorbidity diseases as IBS, HOBL and widespread osteochondrosis taped that larger prevalence of smoking (100%) and as the use (50%) and the excessive use (50%), alcohol are characteristic for the patients having a high comorbidity (a combination of three above nosologies). The greatest interest in respect of possible communication with formation of the combined peptic ulcer of a stomach and duodenum is represented by IBS, HOBL and osteochondrosis. And major factors of risk were smoking, the excessive alcohol intake, the burdened heredity.

Togetherness of the Multiple Diverticulosis of the First Part of the Duodenum with Neurofibromatosis Type I: A Case Report

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Ozgur Turk

2014-04-01

Full Text Available Duedonal diverticulosis is common in clinical practice. Most of duedonal diverticulosis is located at the second part of duodenum; incidence is reported as 67%, incidence of third and forth part is %20. Multiple diverticulosis of the first part of the duodenum is a rare case. There is not any knowledge togetherness of neurofibromatosis type 1 and duedonal diverticulosis. Here we reported incidentally diagnosed multiple diverticulosis of duodenum that is located in the first part in a neurofibromatosis type 1 patient with multiple neurofibromatosis nodules. Neurofibromatosis could affect various organs. Along the digestive system carcinoid tumors and neuroendocrine tumors are more encountered diseases. Endoscopic examinations and abdominal imaging may be useful for the diagnosis of gastrointestinal coexisting disease in neurofibromatosis type 1 . In conclusion neurofibromatosis type 1 could affect multiple systems and it should evaluate carefully.

Increased Intraepithelial Vα24 Invariant NKT Cells in the Celiac Duodenum

Science.gov (United States)

Montalvillo, Enrique; Bernardo, David; Martínez-Abad, Beatriz; Allegretti, Yessica; Fernández-Salazar, Luis; Calvo, Carmen; Chirdo, Fernando G.; Garrote, José A.; Arranz, Eduardo

2015-01-01

Celiac Disease (CD) is an interferon (IFN)γ-mediated duodenal hypersensitivity to wheat gluten occurring in genetically predisposed individuals. Gluten-free diet (GFD) leads to a complete remission of the disease. Vα24-restricted invariant NKT (iNKT) cells are important to maintain immune homeostasis in the gut mucosa because of their unique capacity to rapidly produce large quantities of both T-helper (Th)1 and Th2 cytokines upon stimulation. We studied the presence of these cells in the CD duodenum. Duodenal biopsies were obtained from 45 untreated-CD patients (uCD), 15 Gluten Free Diet-CD patients (GFD-CD), 44 non-inflamed non-CD controls (C-controls) and 15 inflamed non-CD controls (I-controls). Two populations from Spain and Argentina were recruited. Messenger RNA (mRNA) expression of Vα24-Jα18 (invariant TCRα chain of human iNKT cells), IFNγ and intracellular transcription factor Forkhead Box P3 (Foxp3), and flow cytometry intraepithelial lymphocyte (IEL) profile were determined. Both uCD and GFD-CD patients had higher Vα24-Jα18 mRNA levels than non-CD controls (I and C-controls). The expression of Vα24-Jα18 correlated with Marsh score for the severity of mucosal lesion and also with increased mRNA IFNγ levels. uCD and GFD-CD patients had decreased mRNA expression of FoxP3 but increased expression of Vα24-Jα18, which revealed a CD-like molecular profile. Increased numbers of iNKT cells were confirmed by flow cytometry within the intraepithelial lymphocyte compartment of uCD and GFD-CD patients and correlated with Vα24-Jα18 mRNA expression. In conclusion, we have found an increased number of iNKT cells in the duodenum from both uCD and GFD-CD patients, irrespective of the mucosal status. A CD-like molecular profile, defined by an increased mRNA expression of Vα24-Jα18 together with a decreased expression of FoxP3, may represent a pro-inflammatory signature of the CD duodenum. PMID:26529008

TU-AB-BRA-11: Indications for Online Adaptive Radiotherapy Based On Dosimetric Consequences of Interfractional Pancreas-To-Duodenum Motion in MRI-Guided Pancreatic Radiotherapy

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Mittauer, K; Rosenberg, S; Geurts, M; Bassetti, M; Wojcieszynski, A; Harari, P; Labby, Z; Hill, P; Paliwal, B; Bayouth, J [University of Wisconsin, School of Medicine and Public Health, Madison, WI (United States); Chen, I; Henke, L; Kashani, R; Parikh, P [Washington University School of Medicine, St. Louis, MO (United States); Olsen, J [University of Colorado- Denver, Aurora, CO (United States)

2016-06-15

Purpose: Dose limiting structures, such as the duodenum, render the treatment of pancreatic cancer challenging. In this multi-institutional study, we assess dosimetric differences caused by interfraction pancreas-to-duodenum motion using MR-IGRT to determine the potential impact of adaptive replanning. Methods: Ten patients from two institutions undergoing MRI-guided radiotherapy with conventional fractionation (n=5) or SBRT (n=5) for pancreatic cancer were included. Initial plans were limited by duodenal dose constraints of 50 Gy (0.5 cc)/31 Gy (0.1 cc) for conventional/SBRT with prescriptions of 30 Gy/5 fractions (SBRT) and 40–50 Gy/25 fractions (conventional). Daily volumetric MR images were acquired under treatment conditions on a clinical MR-IGRT system. The correlation was assessed between interfractional GTV-to-duodenum positional variation and daily recalculations of duodenal dose metrics. Positional variation was quantified as the interfraction difference in Hausdorff distance from simulation baseline (ΔHD) between the GTV and proximal duodenal surface, or volume overlap between GTV and duodenum for cases with HD{sub 0}=0 (GTV abutting duodenum). Adaptation was considered indicated when daily positional variations enabled dose escalation to the target while maintaining duodenal constraints. Results: For fractions with ΔHD>0 (n=14, SBRT only), the mean interfraction duodenum dose decrease from simulation to treatment was 44±53 cGy (maximum 136 cGy). A correlation was found between ΔHD and dosimetric difference (R{sup 2}=0.82). No correlation was found between volume of overlap and dosimetric difference (R{sup 2}=0.31). For 89% of fractions, the duodenum remained overlapped with the target and the duodenal dose difference was negligible. The maximum observed indication for adaptation was for interfraction ΔHD=11.6 mm with potential for adaptive dose escalation of 136 cGy. Conclusion: This assessment showed that Hausdorff distance was a reasonable

TU-AB-BRA-11: Indications for Online Adaptive Radiotherapy Based On Dosimetric Consequences of Interfractional Pancreas-To-Duodenum Motion in MRI-Guided Pancreatic Radiotherapy

International Nuclear Information System (INIS)

Mittauer, K; Rosenberg, S; Geurts, M; Bassetti, M; Wojcieszynski, A; Harari, P; Labby, Z; Hill, P; Paliwal, B; Bayouth, J; Chen, I; Henke, L; Kashani, R; Parikh, P; Olsen, J

2016-01-01

Purpose: Dose limiting structures, such as the duodenum, render the treatment of pancreatic cancer challenging. In this multi-institutional study, we assess dosimetric differences caused by interfraction pancreas-to-duodenum motion using MR-IGRT to determine the potential impact of adaptive replanning. Methods: Ten patients from two institutions undergoing MRI-guided radiotherapy with conventional fractionation (n=5) or SBRT (n=5) for pancreatic cancer were included. Initial plans were limited by duodenal dose constraints of 50 Gy (0.5 cc)/31 Gy (0.1 cc) for conventional/SBRT with prescriptions of 30 Gy/5 fractions (SBRT) and 40–50 Gy/25 fractions (conventional). Daily volumetric MR images were acquired under treatment conditions on a clinical MR-IGRT system. The correlation was assessed between interfractional GTV-to-duodenum positional variation and daily recalculations of duodenal dose metrics. Positional variation was quantified as the interfraction difference in Hausdorff distance from simulation baseline (ΔHD) between the GTV and proximal duodenal surface, or volume overlap between GTV and duodenum for cases with HD_0=0 (GTV abutting duodenum). Adaptation was considered indicated when daily positional variations enabled dose escalation to the target while maintaining duodenal constraints. Results: For fractions with ΔHD>0 (n=14, SBRT only), the mean interfraction duodenum dose decrease from simulation to treatment was 44±53 cGy (maximum 136 cGy). A correlation was found between ΔHD and dosimetric difference (R"2=0.82). No correlation was found between volume of overlap and dosimetric difference (R"2=0.31). For 89% of fractions, the duodenum remained overlapped with the target and the duodenal dose difference was negligible. The maximum observed indication for adaptation was for interfraction ΔHD=11.6 mm with potential for adaptive dose escalation of 136 cGy. Conclusion: This assessment showed that Hausdorff distance was a reasonable metric to use to

Induction of metallothionein(s) in organ-cultured duodenum: relationship to 1α,25-(OH)2-D3-induced CaBP synthesis

International Nuclear Information System (INIS)

Corradino, R.A.; Fullmer, C.S.; Frelier, E.; Maxwell, S.

1979-01-01

The embryonic chick duodenum contains no vitamin D-induced, calcium-binding protein (CaBP). However, when maintained in organ culture, the duodenum responds to 1α,25-(OH) 2 -D 3 in the culture medium by de novo synthesis of CaBP. Studies with this system have provided evidence that CaBP is directly involved in calcium transport at least at the mucosal surface. The present paper extends previous observations on the effects of the extremely toxic environmental pollutant, cadmium. Cadmium was found to inhibit 1α,25-(OH) 2 -D 3 -mediated responses in the organ-cultured duodenum, i.e., CaBP biosynthesis and 45 Ca uptake at the mucosal surface. Cadmium also stimulated concomitent production of a specific metallothionein (MT). Zinc had similar actions in inhibiting CaBP and stimulating Mt biosynthesis

Benign submucosal lesions of the stomach and duodenum: Imaging characteristics with endoscopic and pathologic correlation

International Nuclear Information System (INIS)

Oh, Jong Young; Nam, Kyung Jin; Choi, Jong Cheol; Cho, Jin Han; Yoon, Seong Kuk; Choi, Sun Seob; Kwon, Hee Jin; Yoon, Jung Hee; Kim, Su Jin

2008-01-01

Benign submucosal lesions of the stomach and duodenum are occasionally encountered during endoscopy. But endoscopy has its limitations in the diagnosis and differentiation of these lesions, because submucosal lesions are often difficult to visualize at endoscopy due to minimal change of the overlying mucosa. Furthermore, endoscopic biopsy may not always yield adequate tissue for diagnosis due to the submucosal location of the lesions. For this reason, the role of radiologic imaging is important in the diagnosis of submucosal lesions of the stomach and duodenum. Recent advances in computed tomography (CT) and sonographic technology are helpful in narrowing the differential diagnosis of gastroduodenal submucosal lesions. In contrast to endoscopy and barium studies, CT or ultrasonography (US) provides information about both the gastric wall and the extragastric extent of the disease. Arterial phase contrast enhanced CT enables us to discriminate a mass of submucosal from that of a mucosal origin in the differential diagnosis of gastric or duodenal lesions. Although endoscopic sonography has been considered the better modality in the diagnosis of gastroduodenal submucosal lesions, transabdominal sonography can still be an alternative method to endoscopic sonography in assessing of the origin and character of the submucosal lesions. Some gastroduodenal submucosal lesions have similar radiologic findings that make differentiation difficult. But despite overlaps in radiologic findings, some lesions have characteristic radiologic features that may suggest a specific diagnosis. Knowledge of the differential diagnosis of benign submucosal lesions in the stomach and duodenum may promote correct diagnosis and appropriate treatment

Fluid mechanical consequences of pendular activity, segmentation and pyloric outflow in the proximal duodenum of the rat and the guinea pig

Science.gov (United States)

de Loubens, Clément; Lentle, Roger G.; Love, Richard J.; Hulls, Corrin; Janssen, Patrick W. M.

2013-01-01

We conducted numerical experiments to study the influence of non-propagating longitudinal and circular contractions, i.e. pendular activity and segmentation, respectively, on flow and mixing in the proximal duodenum. A lattice-Boltzmann numerical method was developed to simulate the fluid mechanical consequences for each of 22 randomly selected sequences of high-definition video of real longitudinal and radial contractile activity in the isolated proximal duodenum of the rat and guinea pig. During pendular activity in the rat duodenum, the flow was characterized by regions of high shear rate. Mixing was so governed by shearing deformation of the fluid that increased the interface between adjacent domains and accelerated their inter-diffusion (for diffusion coefficients approx. less than 10−8 m² s−1). When pendular activity was associated with a slow gastric outflow characteristic of post-prandial period, the dispersion was also improved, especially near the walls. Mixing was not promoted by isolated segmentative contractions in the guinea pig duodenum and not notably influenced by pylorus outflow. We concluded that pendular activity generates mixing of viscous fluids ‘in situ’ and accelerates the diffusive mass transfer, whereas segmentation may be more important in mixing particulate suspensions with high solid volume ratios. PMID:23536539

Fluid mechanical consequences of pendular activity, segmentation and pyloric outflow in the proximal duodenum of the rat and the guinea pig.

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de Loubens, Clément; Lentle, Roger G; Love, Richard J; Hulls, Corrin; Janssen, Patrick W M

2013-06-06

We conducted numerical experiments to study the influence of non-propagating longitudinal and circular contractions, i.e. pendular activity and segmentation, respectively, on flow and mixing in the proximal duodenum. A lattice-Boltzmann numerical method was developed to simulate the fluid mechanical consequences for each of 22 randomly selected sequences of high-definition video of real longitudinal and radial contractile activity in the isolated proximal duodenum of the rat and guinea pig. During pendular activity in the rat duodenum, the flow was characterized by regions of high shear rate. Mixing was so governed by shearing deformation of the fluid that increased the interface between adjacent domains and accelerated their inter-diffusion (for diffusion coefficients approx. less than 10(-8) m² s(-1)). When pendular activity was associated with a slow gastric outflow characteristic of post-prandial period, the dispersion was also improved, especially near the walls. Mixing was not promoted by isolated segmentative contractions in the guinea pig duodenum and not notably influenced by pylorus outflow. We concluded that pendular activity generates mixing of viscous fluids 'in situ' and accelerates the diffusive mass transfer, whereas segmentation may be more important in mixing particulate suspensions with high solid volume ratios.

Experiment on metoclopramide (reglan) application in the radiodiagnosis of diseases of the stomach and duodenum

International Nuclear Information System (INIS)

Korolyuk, I.P.; Petrushkin, V.I.

1980-01-01

It is suggested to use metoclopramide (reglan) which is introduced in a dose of 10 ml 10 min before the study intramuscularly at radio X-ray examination of the stomach and duodenum. Peroral application of the drug is not effective. The authors' experience is based on the drug application in 19 healthy persons and 89 patients with the diseases of stomach and duodenum. In patients with gastric ulcer reglan helped in the detection of the niche symptom. The use of the drug facilitated visualization of the pylorus in the case of its organic stenosis. In patients with ulcer of the duodenal bulb after introduction of reglan a better contrasting of the intestine was observed which promoted to the niche detection. An antiemetic property of reglan which can be used in patients, who do not tolerate barium suspension is also pointed out

Effects of L-glutamine supplementation on the myenteric neurons from the duodenum and cecum of diabetic rats

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Jacqueline Nelisis Zanoni

2011-03-01

Full Text Available CONTEXT: Peripheral neuropathy is one of the chronic complications of diabetes mellitus and is directly related to gastrointestinal consequences of the disease. Myenteric neurons are affected in some pathological conditions such as diabetic neuropathy. The imbalance between cellular antioxidants and free radicals, leading to an increase in oxidative stress, is considered one of the main factors responsible for neuronal damages in diabetes. Drugs that reduce the oxidative stress may play a significant role in the treatment of neurological complications of diabetes mellitus. OBJECTIVE: To evaluate the effect of L-glutamine supplementation on the myenteric neurons from the cecum and duodenum of Wistar rats with streptozotocin-induced diabetes mellitus. METHODS: The animals were divided in four groups (n = 5: non-treated normoglycemics, normoglycemics treated with L-glutamine, non-treated diabetics and diabetics treated with L-glutamine from the 4th day of diabetes induction on. The amino acid L-glutamine was added to their diet at 1%. Giemsa's technique was employed to stain the myenteric neurons. We determined the cell body area of 500 neurons in each group studied. The quantitative analysis was performed by sampling in an area of 16.6 mm² in the cecum and 3.6 mm² in the duodenum of each animal. RESULTS: After the supplementation with L-glutamine in the duodenum, we observed a preservation of neuronal density in groups normoglycemic and diabetic (P<0.05. We also observed a preservation of the cell bodies area in diabetic animals (group treated with L-glutamine (P<0.05. In the cecum, that preservation was not evident. CONCLUSION: Supplementation with L-glutamine (1% promoted a neuroprotective effect on the myenteric neurons from the duodenum of rats, both in terms of natural aging and of diabetes mellitus.

Effect of chronic aspirin ingestion on epithelial proliferation in rat fundus, antrum, and duodenum

International Nuclear Information System (INIS)

Eastwood, G.L.; Quimby, G.F.

1972-01-01

We studied the effect of chronic aspirin ingestion on gastroduodenal epithelial proliferation by feeding rats aspirin in the drinking water. A control group of rats received plain water. At the end of 4 wk, [3H]-thymidine was given intravenously to label proliferating cells, and the rats were killed 1 h later. Sections of fundus, antrum, and proximal duodenum were processed for light autoradiography. We found that chronic aspirin ingestion stimulated epithelial proliferation in fundic mucosa but had no effect in the antrum. In the duodenum, aspirin increased proliferation in the lowest four crypt-cell positions, which most likely indicates an increase in stem-cell production. None of the tissues contained evidence of inflammation or ulceration. The proliferative effects of aspirin may help explain the previously observed phenomenon of mucosal adaptation in the rat after repeated exposure to aspirin. Further, if human gastroduodenal epithelium responds in a similar manner to chronic aspirin exposure, the effects on proliferation may explain in part the distribution of aspirin-associated ulcers

The standard biphasic-contrast examination of the stomach and duodenum

International Nuclear Information System (INIS)

Op den Orth, J.O.

1979-01-01

A standard examination has been developed, called biphasic, because it combines the advantages of positive-contrast and double-contrast techniques. The theoretical background and technique of this examination are described and the basic interpretation of double-contrast studies stated. General remarks on the results and on the complementary role of radiological examination and endoscopy are included. A quantitative study of standard biphasic-contrast examinations in patients over a period of 3 years is presented. Finally a radiological atlas of common lesions of the stomach and duodenum is given. (C.F.)

Assessment of the mutagenic potential of hexavalent chromium in the duodenum of big blue® rats.

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Thompson, Chad M; Young, Robert R; Dinesdurage, Harshini; Suh, Mina; Harris, Mark A; Rohr, Annette C; Proctor, Deborah M

2017-09-01

A cancer bioassay on hexavalent chromium Cr(VI) in drinking water reported increased incidences of duodenal tumors in B6C3F1 mice at exposures of 30-180ppm, and oral cavity tumors in F344 rats at 180ppm. A subsequent transgenic rodent (TGR) in vivo mutation assay in Big Blue® TgF344 rats found that exposure to 180ppm Cr(VI) in drinking water for 28days did not increase cII transgene mutant frequency (MF) in the oral cavity (Thompson et al., 2015). Herein, we extend our analysis to the duodenum of these same TgF344 rats. At study termination, duodenum chromium levels were below either the limit of detection or quantification in control rats, but were 24.6±3.8μg/g in Cr(VI)-treated rats. The MF in control (23.2×10 -6 ) and Cr(VI)-treated rats (22.7×10 -6 ) were nearly identical. In contrast, the MF in the duodenum of rats exposed to 1-ethyl-1-nitrosourea for six days (study days 1, 2, 3, 12, 19, 26) increased 24-fold to 557×10 -6 . These findings indicate that mutagenicity is unlikely an early initiating event in Cr(VI)-induced intestinal carcinogenesis. Copyright © 2017 Elsevier Inc. All rights reserved.

Emergency pancreatoduodenectomy (whipple procedure) for massive upper gastrointestinal bleeding caused by a diffuse B-cell lymphoma of the duodenum: report of a case.

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Stratigos, Panagiotis; Kouskos, Efstratios; Kouroglou, Maria; Chrisafis, Ioannis; Fois, Lucia; Mavrogiorgis, Anastasios; Axiotis, Efthimios; Zamtrakis, Sotirios

2007-01-01

We herein report a rare case of a massive upper gastrointestinal (GI) bleeding, caused by high-grade diffuse B-cell lymphoma of the duodenum, secondary to immunoproliferative small intestinal disease (IPSID) and treated with an emergency partial pancreatoduodenectomy. A 42-year-old man was admitted to our hospital because of hematemesis. Upper GI endoscopy was unrevealing because of the copious bleeding. Initially, the patient underwent conservative treatment, thus resulting in the temporary cessation of the bleeding. Later, the hemorrhage massively relapsed. An urgent abdominal ultrasound raised the suspicion of a large, possibly bleeding, neoplasm of the duodenum, which was finally confirmed by abdominal computed tomography. The patient underwent an emergency laparotomy, during which a partial pancreatoduodenectomy was performed (Whipple procedure). Histologically, the tumor was a high-grade B-cell lymphoma of the duodenum. The nearby small intestinal mucosa was suggestive of IPSID. A massive upper GI hemorrhage from a high-grade B-cell non-Hodgkin lymphoma of the duodenum, which develops secondary to IPSID, is a very rare clinical demonstration of this disease. Our case is one of the few reports in the English literature, for which the Whipple procedure has been performed as a curative treatment.

[Effect of prokinetic agents on the electrical activity of stomach and duodenum in rats].

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Li, Fujun; Zou, Yiyou; Huang, Tianhui

2009-07-01

To determine the effect of prokinetic agents such as domperidone, mosapride, clarithromycin, and itopride on the electrical activity of the stomach and duodenum in SD rats,and also to explore the mechanism. The organism functional experiment system BL-420E was used to record the myoelectrical activity in the stomach and duodenum of SD rats in all groups using domperidone, mosapride, itopride, clarithromycin, and physiological saline on the interdigestive phase. The effect of the prokinetic agents on the amplitude and frequency of gastric and duodenal electromyogram in the SD rats was compared. The antagonists such as atropine, phentolamine, and propranolol were added to investigate the mechanism of action with all prokinetic agents. All prokinetic agents increased the amplitude and frequency of gastric and duodenal fast waves in the SD rats(Pitopride was the most obvious among the 3 groups (Pitopride, and physiological saline were inhibited by atropine(PItopride, mosapride, domperidone, and clarithromycin can increase the amplitude and frequency of gastric and duodenal fast waves in the SD rats. The mechanism may be related to cholinergic receptors, but not adrenergic receptors.

Diagnosis, treatment and prognosis of neuroendocrine tumor in stomach and duodenum

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Xiang-yao WANG

2016-04-01

Full Text Available Objective 　To investigate the clinicopathological characteristics and prognosis of patients with neuroendocrine tumor in stomach and duodenum for early diagnosis. Methods 　The clinical, endoscopic and pathological data of 20 patients admitted to the PLA General Hospital from Jan. 2012 to Jan. 2015 and diagnosed as gastric and duodenal neuroendocrine tumor were collected for retrospective analysis. The histopathological classification of the disease was made according to the WHO 2010 Classification of the Neuroendocrine Neoplasms. Result 　Ten male and 10 female patients aged between 35 and 77 (mean 55.5±10.6 years old were recruited in the present study. Tumor located in the stomach in 13 cases, and in duodenum in 7 cases. The maximum diameter of the tumor was 0.2-2.5cm. Endoscopic features included polypoid protrusion, hemispheric submucosal protrusion, and mucosal erosion. All the patients were treated endoscopically, among them, four patients were treated with electrocoagulation and electrosection, 10 by endoscopic resection (EMR, and 6 by endoscopic submucosal dissection (ESD. In one patient, surgical excision was done after ESD. Biopsy under gastroscopy and endoscopic ultrasonography were conducive to the diagnosis and treatment. According to the histopathological classification, 19 cases were classified as NET grade 1, and another one as NET grade 2. The follow-up study showed no metastasis and recurrence. Conclusions 　The early diagnosis and treatment for gastric and duodenal neuroendocrine tumor can lead to satisfactory results. DOI: 10.11855/j.issn.0577-7402.2016.03.12

Duodenum Histomorphology and Performance as Influenced by Dietary Suplementation of Turmeric (Curcuma longa), Garlic (Allium sativum) and its Combinations as a Feed Additives in Broilers

OpenAIRE

Purwanti, Sri; -, Zuprizal; Yuwanta, Tri; -, Supadmo

2014-01-01

Abstract. This research was conducted to evaluate the effect of turmeric water extract, garlic and combination turmeric and garlic as a feed additive in the broiler diet on performance, and duodenum histomorphology. Affectivity of treatments was assessed by addition of phytobiotic (control, 015% zinc bacitracin, 2.5% TE, 2.0% GE, 2.5% TGE) which were arranged in a Completely Randomized Design with 4 replications. The variables measured were duodenum histomorphology (villi height, villi surfac...

Mechanism for enhanced absorption of a solid dispersion formulation of LY2300559 using the artificial stomach duodenum model.

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Polster, Christopher S; Wu, Sy-Juen; Gueorguieva, Ivelina; Sperry, David C

2015-04-06

An artificial stomach duodenum (ASD) model has been used to demonstrate the performance difference between two formulations of LY2300559, a low-solubility acidic developmental drug. The two formulations investigated were a conventional high-shear wet granulation (HSWG) formulation and a solid dispersion formulation. A pharmacokinetic study in humans demonstrated the enhanced performance of the solid dispersion formulation relative to the HSWG formulation. The Cmax and AUC of the solid dispersion was 2.6 and 1.9 times greater, respectively, compared to the HSWG formulation. In the ASD, the solid dispersion formulation performance was characterized by three main phases: (1) rapid release in the stomach, creating a supersaturated concentration of drug, (2) precipitation in the stomach, and (3) rapid redissolution of the precipitate in the duodenum to concentration levels that are supersaturated relative to crystalline drug. A series of complementary experiments were employed to describe this performance behavior mechanistically. Imaging experiments with a pH indicating dye showed that local pH gradients from meglumine in the solid dispersion formulation were responsible for creating a high initial supersaturation concentration in the stomach. Upon dissipation of meglumine, the drug precipitated in the stomach as an amorphous solid. Because the precipitated drug is in an amorphous form, it can then rapidly redissolve as it transits to the more neutral environment of the duodenum. This unexpected sequence of physical state changes gives a mechanistic explanation for the enhanced in vivo performance of the solid dispersion formulation relative to the HSWG formulation.

X-ray diagnostic features of giant bleeding ulcers in the stomach and duodenum

International Nuclear Information System (INIS)

Shcherbatenko, M.K.; elina, I.E.

1997-01-01

The study was based on the analysis of clinical, X-ray, and morphological examinations made in 64 patients with giant gastric and duodenal ulcers. The methods of X-ray examinations and the X-ray symptomatology of giant ulcers of the stomach and duodenum is given. Gastroscopic and X-ray examinations were comparative analyzed. The paper gives evidence that the X-ray examination has many advantages in estimating the size and ratio of ulcers to the adjacent organs and tissues. The paper outlines giant duodenal ulcers. 9 refs., 5 figs

Management of Locally Advanced Renal Cell Carcinoma with Invasion of the Duodenum

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Andrew T. Schlussel

2013-01-01

Full Text Available Renal cell carcinoma (RCC is rare but aggressive, with greater than 20% of patients presenting with stage III or IV, disease. Surgical resection of the primary tumor regardless of stage is the treatment of choice, and en bloc resection of involved organs provides the only potential chance for cure. This case report describes a patient with metastatic right-sided RCC with invasion of the inferior vena cava and duodenum managed by en block resection and pancreaticoduodenectomy. This report will review the workup and treatment of locally advanced RCC, as well as the role of cytoreductive nephrectomy in the setting of metastatic disease.

Activation of neural cholecystokinin-1 receptors induces relaxation of the isolated rat duodenum which is reduced by nitric oxide synthase inhibitors

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S.R. Martins

2006-02-01

Full Text Available Cholecystokinin (CCK influences gastrointestinal motility, by acting on central and peripheral receptors. The aim of the present study was to determine whether CCK has any effect on isolated duodenum longitudinal muscle activity and to characterize the mechanisms involved. Isolated segments of the rat proximal duodenum were mounted for the recording of isometric contractions of longitudinal muscle in the presence of atropine and guanethidine. CCK-8S (EC50: 39; 95% CI: 4.1-152 nM and cerulein (EC50: 58; 95% CI: 18-281 nM induced a concentration-dependent and tetrodotoxin-sensitive relaxation. Nomeganitro-L-arginine (L-NOARG reduced CCK-8S- and cerulein-induced relaxation (IC50: 5.2; 95% CI: 2.5-18 µM in a concentration-dependent manner. The magnitude of 300 nM CCK-8S-induced relaxation was reduced by 100 µM L-NOARG from 73 ± 5.1 to 19 ± 3.5% in an L-arginine but not D-arginine preventable manner. The CCK-1 receptor antagonists proglumide, lorglumide and devazepide, but not the CCK-2 receptor antagonist L-365,260, antagonized CCK-8S-induced relaxation in a concentration-dependent manner. These findings suggest that CCK-8S and cerulein activate intrinsic nitrergic nerves acting on CCK-1 receptors in order to cause relaxation of the rat duodenum longitudinal muscle.

Age-related structural changes in the myenteric nervous plexus ganglion along the anterior wall of the proximal human duodenum: A morphometric analysis

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Mandić Predrag

2013-01-01

Full Text Available Background/Aim. Aging is one of the most complex biological processes which probably affect structure and function of the enteric nerve system. However, there is not much available information on this topic, particularly in humans. The aim of this study was to investigate the influence of aging on the structure of the myenteric ganglia in the anterior wall of the human proximal duodenum. Methods. We examined the myenteric ganglia in the proximal duodenal anterior wall specimens obtained from 30 cadaver persons aged from 20 to 84 years. Tissue samples were classified into three age groups: 20-44, 45-64 and 65-84 years. After standard histological preparation, specimens were stained with HE, Cresyl Violet and AgNO3. Morphometric analysis of all the specimens, using a multipurpose test system M42, was performed. The data were subjected to the ttest. Results. The myenteric ganglia of very old humans contains an empty space, i.e. the respective parts of ganglia show a decreased number of neuron as compared to younger population. The average number of neuron per cm2 of the duodenum in the youngest people (20-44 years was 69,370 ± 1,750.00, in the people aged 45-64 years 69,211 ± 1,573.33, and in the oldest persons (65-84 years 57,951 ± 1,291.52. The loss of neurons in the oldest persons was 16.46%. The applied statistic test demonstrated a significant difference between the observed groups (p < 0.0001. Conclusion. Aging does not induce changes in size and surface of neurons in the ganglia, but it decreases the number of neurons. The nerve structures in the elderly are partly emptied of bodies of nerve cells (“empty ganglions”, which indicates the existence of changed myenteric ganglia in the duodenum. These changes could be related to the duodenum motility disorder associated with aging.

[Traumatic rupture of the pancreas and duodenum in pre-existing penetrating duodenal ulcer].

Science.gov (United States)

Schröder, W; Krüger, I; Mönig, S P; Hölscher, A H

2000-01-01

Pancreatic injuries are rare complications after blunt abdominal trauma and usually the result of a direct force separating the pancreatic body in front of the vertebral column. This case report describes the uncommon event of a severe pancreatic and duodenal injury (stage IV b of Lukas) in which the combination of a direct force and the setting of a preexisting penetrating ulcer of the duodenum caused the extent of the pancreatic and duodenal injury [9]. Because of the preexisting lesion a Whipple procedure had to be performed. This case report demonstrates the influence of chronic abdominal diseases on the outcome of blunt abdominal trauma.

X-ray examination of the stomach and duodenum in patients with ulcer disease after vagotomy

International Nuclear Information System (INIS)

Pavlovskij, M.P.; Vdovichenko, V.I.; Matlam, L.G.

1987-01-01

A roentgenological and endoscopical study is presented of the stomach and duodenum in 66 patients during remission and in 22 patients during exacerbation of ulcer disease from 6 months up to 5 years after organsaving operations using vagotomy. In the majority of patients the stomach was characterized by a large gas bubble, cascade-like torsion, deformation of the antral portion and duodenal bulb. In some patients thickenings of the gastric antral mucosa were noted. An endoscopically confirmed ulcer was revealed roentgenologically only in 50% of patients

[A Case of Performed Right Colectomy with Pancreato-Duodenectomy for Transverse Colon Cancer Invased to Duodenum].

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Udo, Ryutaro; Enomoto, Masanobu; Tsurui, Kazushige; Kuboyama, Yuu; Kuwabara, Hiroshi; Shigoka, Masatoshi; Ishizaki, Tetsuo; Katsumata, Kenji; Obikane, Hiyo; Tsuchida, Akihiko

2018-04-01

There is a clear consensus regarding the combined resection of organs with cancer invasion, patients with colon cancer. However, there are very few reports to our knowledge regarding the use of pancreato-duodenectomy(PD)for colon cancer patients with cancer invasion in the duodenum. We here report a colon cancer patient in whom we performed PD and right hemicolectomy, who showed favorable results with no recurrence. The patient was a 69-year-old woman. Her chief complaint was hypogastric pain. Her previous doctor performed colonoscopy and a colonoscopic biopsy, and detected a type 2 lesion, throughout the entire circumference of the transverse colon near the liver, and she was diagnosed with adenocarcinoma. From further imaging analyses, she was diagnosed as having transverse colon cancer with invasion into the superior mesenteric vein(SMV), duodenum, and pancreatic head, and No. 223 lymph node metastasis. The patient's cancer was concluded to be unresectable, and she underwent chemotherapy, namely mFOLFOX6 with cetuxiumab(Cmab). One course of mFOLFOX with Cmab, the patient decided to consult our hospital for a second opinion. We concluded that her cancer was resectable, so we performed PD, right hemicolectomy, and resection and reconstruction of a part of the SMV. The operation time was 5 hours 17 minutes, and total blood loss was 190 mL. The histopathological diagnosis was tub2, T4b(duodenum and, tissue surrounding the SMV), int, INF b, ly1, v2, PN1b, EX(+)/ND(PN+, v+), PM0(25 cm), DM0(14.3 cm), N1(1/ 20), H0, P0, M0, pStage III a. She was discharged 15 days after surgery with no complications, and thereafter received ajduvant chemotherapy(capecitabine with oxaliplatin)as an outpatient. After 3 courses, capecitabine with oxaliplatin was changed to capecitabine because she developed a nervous system disorder, and she was further treated for approximately about 6 months. She is doing well at the time of writing, with no recurrences for 2 years. We suggest that PD

Dynamics of COX-2 Content in Mucosa of the Stomach and Duodenum on the Background of Medical Correction of NSAID Gastropathy

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Yu.M. Stepanov

2013-02-01

Full Text Available The results of immune histochemical study of cyclooxygenase type 2 (COX-2 level in 120 patients with inflammatory and erosive lesions of the stomach and duodenum on the background of long-term use of non-steroid anti-inflammatory drugs (NSAIDs before and after treatment of damages of gastroduodenal zone are presented. Average level of COX-2 in patients with gastroduodenal lesions, caused by NSAIDs, decreased by 1.5 times and made up (2.02 ± 0.11 c.u. before treatment and (1.27 ± 0.09 c.u after treatment by the regimen № 1; it decreased by 2 times and made up (2.00 ± 0.16 c.u and (0.95 ± 0.09 c.u. relatively before and after the treatment by regimen № 2. Findings indicate the decrease of protective properties of the stomach and duodenum mucosa in case of a long-term use of NSAIDs.

A case of annular pancreas with Wirsung's duct encircling the duodenum: embryological hypothesis based on cholangiopancreatographic and immunohistochemical findings.

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Fukai, Manami; Kamisawa, Terumi; Horiguchi, Shin-Ichirou; Hishima, Tsunekazu; Kuruma, Sawako; Chiba, Kazuro; Koizumi, Satomi; Tabata, Taku; Nagao, Sayaka; Kikuyama, Masataka; Honda, Goro; Kurata, Masanao

2017-06-01

We present a resected case of annular pancreas in which Wirsung's duct encircled the duodenum and continued directly to the main pancreatic duct in the body and tail. Furthermore, Wirsung's duct coursed along the right side of the lower bile duct near the major duodenal papilla. Histologically, the islets of Langerhans in the annular pancreas were irregular in shape and were characterized by a striking abundance of pancreatic polypeptide (PP)-positive cells. The PP-rich area that encircled the duodenum was fused with the PP-poor area in the head of the pancreas. The following embryological hypothesis is proposed. The tip of the ventral pancreatic anlage adhered to the duodenal wall and stretched to form a ring during clockwise rotation. The rotation was incomplete, and the pancreatic duct did not cross over the lower bile duct. Since there was adequate ventral anlage in the lower part of the head of the pancreas, fusion between the ducts of the ventral and dorsal anlagen did not occur. The tip of the ventral anlage overgrew and adhered to the dorsal anlage, and the annular duct fused with the main duct of the dorsal anlage.

Gastro-oesophageal reflux associated with duodenum inversum: two case reports and a review of the literature.

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Patel, Dhiren; Agarwal, Roshani; Powell, William; Al-Ansari, Namir

2017-08-01

Gastro-oesophageal reflux disease (GORD) is a very common paediatric disorder and the majority of patients are treated successfully by primary care physicians. Two infants aged 2 months with GORD which did not respond to conventional medical management are reported; they were diagnosed with duodenum inversum. The first infant failed medical management and required Nissen's fundoplication to control his symptoms. The second infant improved on maximizing medical management without the need for a surgical procedure. These two cases highlight the need for further work-up in patients who do not respond to conventional GORD therapy and/or present with atypical clinical symptoms.

Innervation of Extrahepatic Biliary Tract, With Special Reference to the Direct Bidirectional Neural Connections of the Gall Bladder, Sphincter of Oddi and Duodenum in Suncus murinus, in Whole-Mount Immunohistochemical Study.

Science.gov (United States)

Yi, S-Q; Ren, K; Kinoshita, M; Takano, N; Itoh, M; Ozaki, N

2016-06-01

Sphincter of Oddi dysfunction is one of the most important symptoms in post-cholecystectomy syndrome. Using either electrical or mechanical stimulation and retrogradely transported neuronal dyes, it has been demonstrated that there are direct neural pathways connecting gall bladder and the sphincter of Oddi in the Australian opossum and the golden hamster. In the present study, we employed whole-mount immunohistochemistry staining to observe and verify that there are two different plexuses of the extrahepatic biliary tract in Suncus murinus. One, named Pathway One, showed a fine, irregular but dense network plexus that ran adhesively and resided on/in the extrahepatic biliary tract wall, and the plexus extended into the intrahepatic area. On the other hand, named Pathway Two, exhibiting simple, thicker and straight neural bundles, ran parallel to the surface of the extrahepatic biliary tract and passed between the gall bladder and duodenum, but did not give off any branches to the liver. Pathway Two was considered to involve direct bidirectional neural connections between the duodenum and the biliary tract system. For the first time, morphologically, we demonstrated direct neural connections between gall bladder and duodenum in S. murinus. Malfunction of the sphincter of Oddi may be caused by injury of the direct neural pathways between gall bladder and duodenum by cholecystectomy. From the viewpoint of preserving the function of the major duodenal papilla and common bile duct, we emphasize the importance of avoiding kocherization of the common bile duct so as to preserve the direct neural connections between gall bladder and sphincter of Oddi. © 2015 Blackwell Verlag GmbH.

Pancreaticoduodenectomy versus duodenum-preserving pancreatic head resection for the treatment of chronic pancreatitis.

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Zheng, Zhenjiang; Xiang, Guangming; Tan, Chunlu; Zhang, Hao; Liu, Baowang; Gong, Jun; Mai, Gang; Liu, Xubao

2012-01-01

The objective of this study was to assess the efficacy and safety of pancreaticoduodenectomy (PD) and duodenum-preserving pancreatic head resection (DPPHR) for the treatment of chronic pancreatitis (CP). The 123 patients with CP who underwent pancreatic head resection between January 2004 and June 2009 were retrospectively analyzed. The preoperative variables, operative data, postoperative complications, and follow-up information were examined. There were no significant differences in clinical and morphological characteristics, pain relief, and jaundice status between the PD and DPPHR groups. The duration of operation was shorter (251.8 [SD, 43.1] vs 324.5 [SD, 41.4] minutes, P endocrine insufficiency was higher in PD group as compared with DPPHR group. Both procedures are equally effective in pain relief, but DPPHR is superior to PD in operative data, postoperative morbidity, improving quality of life, and preservation of exocrine and endocrine function.

Digestion of isolated legume cells in a stomach-duodenum model: three mechanisms limit starch and protein hydrolysis.

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Bhattarai, Rewati R; Dhital, Sushil; Wu, Peng; Chen, Xiao Dong; Gidley, Michael J

2017-07-19

Retention of intact plant cells to the end of the small intestine leads to transport of entrapped macronutrients such as starch and protein for colonic microbial fermentation, and is a promising mechanism to increase the content of resistant starch in diets. However, the effect of gastro-intestinal bio-mechanical processing on the intactness of plant cells and the subsequent resistance to enzymatic digestion of intracellular starch and protein are not well understood. In this study, intact cells isolated from legume cotyledons are digested in a laboratory model which mimics the mechanical and biochemical conditions of the rat stomach and duodenum. The resulting digesta are characterised in terms of cell (wall) integrity as well as intracellular starch and protein hydrolysis. The cells remained essentially intact in the model with negligible (ca. 2-3%) starch or protein digestion; however when the cells were mechanically broken and digested in the model, the hydrolysis was increased to 45-50% suggesting that intact cellular structures could survive the mixing regimes in the model stomach and duodenum sufficiently to prevent digestive enzyme access. Apart from intact cell walls providing effective barrier properties, they also limit digestibility by restricting starch gelatinisation during cooking, and significant non-specific binding of α-amylase is observed to both intact and broken cell wall components, providing a third mechanism hindering starch hydrolysis. The study suggests that the preservation of intactness of plant cells, such as from legumes, could be a viable approach to achieve the targeted delivery of resistant starch to the colon.

[The spa-and-health resort-based rehabilitation of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation].

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Efimenko, N V; Kaĭsinova, A S

2014-01-01

To develop a new medical technology for the spa-and-health resort-based treatment of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation. A total of 100 patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation were available for the examination that included detailed investigations of the clinical picture, characteristics of the immune status, and psychological testing before and after a course of the spa-and-health resort-based treatment. The effectiveness of two therapeutic modalities was evaluated. One of them (control) prescribed to 50 patients consisted of standard antiulcer pharmacotherapy in combination with Essentuki Novaya drinking mineral water and carbon dioxide mineral baths, the other given to 50 patients included radon baths instead of carbon dioxide mineral baths. The combined application of drinking mineral waters, radon baths, and standard antiulcer pharmacotherapy produced the most conspicuous clinical effect in the framework of spa-and-health resort-based rehabilitation of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation as confirmed by positive dynamics of their psychoemotional status in 97.7% of the cases, regression of pain syndrome (91.5%), and improvement of humoral and cellular immunity (94%). An important result of the spa-and-health resort-based rehabilitation is the intensification of the reparative processes in gastroduodenal mucosa responsible for the healing of ulcers and erosions in 94.7% of the patients. The spa-and-health resort-based rehabilitation is a pathogenetically sound and efficacious approach to the management of the patients presenting with frequently recurring erosive and ulcerative lesions in the

Noncontiguous finished genome sequence and description of Fusobacterium massiliense sp. nov. isolated from human duodenum

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M. Mailhe

2017-03-01

Full Text Available The strain Marseille-P2749T (= CSUR P2749=DSM 103085 was isolated as part of culturomics study from a liquid duodenum sample from a French man. Bacterial cells were Gram-negative bacilli, fusiform shaped and non–spore forming, and they grew in microaerophilic and anaerobic atmosphere. Its genome is 1 809 169 bp long and contains 1646 protein-coding genes. The DNA G+C content was 27.33 mol%. This strain exhibited a 95.9% sequence similarity with Fusobacterium periodonticum, the phylogenetically closest species with standing in nomenclature. Strain Marseille-P2749T is suggested to be a novel species belonging to the genus Fusobacterium, for which the name Fusobacterium massiliense sp. nov. is proposed.

Clinical application of duodenum-preserving pancreatic head resection

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ZHOU Songqiang

2018-01-01

Full Text Available Objective To investigate the indications and therapeutic effect of duodenum-preserving pancreatic head resection (DPPHR. Methods A retrospective analysis was performed for the clinical data of 17 patients who underwent DPPHR in Fujian Provincial Hospital from January 2013 to February 2017. Among these patients, 6 had chronic pancreatitis with pancreatic duct stones, 2 had chronic pancreatitis with pancreatic pseudocyst, 3 had solid pseudopapillary tumor of the pancreatic head, 3 had intraductal papillary mucinous neoplasm, 2 had serous cystadenoma of the pancreatic head, and 1 had mucinous cystadenoma of the pancreatic head. Results The time of operation was 200-360 minutes (mean 304.0±45.3 minutes, and the intraoperative blood loss was 50-500 ml (mean 267.5±116.1 ml. No patient died in the perioperative period. After surgery, 5 experienced biochemical leak, 2 experienced grade B pancreatic fistula, no patient experienced grade C pancreatic fistula, and 1 experienced gastroplegia; all these patients were cured and discharged after conservative treatment. The length of postoperative hospital stay was 17-78 days (mean 30.8±14.3 days. The 17 patients were followed up for 2 months to 4 years after surgery, and no patient experienced tumor recurrence, new-onset diabetes, dyspepsia, or common bile duct stenosis after surgery. Conclusion Besides ensuring the complete resection of tumor, DPPHR can reduce the incidence rate of surgical trauma and complications and shorten the time of operation and the length of hospital stay. Compared with pancreaticoduodenectomy, DPPHR can better preserve the endocrine and exocrine functions of the pancreas and improve patients′ postoperative quality of life.

Optimizing the villi visualization by tethered capsule OCT endomicroscopy for comprehensive imaging of human duodenum (Conference Presentation)

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Dong, Jing; Gora, Michalina J.; Beaulieu-Ouellet, Emilie; Queneherve, Lucille H.; Grant, Catriona N.; Rosenberg, Mireille; Nishioka, Norman S.; Fasano, Alessio; Tearney, Guillermo J.

2017-02-01

Celiac disease (CD) affects around 1% of the global population and can cause serious long-term symptoms including malnutrition, fatigue, and diarrhea, amongst others. Despite this, it is often left undiagnosed. Currently, a tissue diagnosis of CD is made by random endoscopic biopsy of the duodenum to confirm the existence of microscopic morphologic alterations in the intestinal mucosa. However, duodenal endoscopic biopsy is problematic because the morphological changes can be focal and endoscopic biopsy is plagued by sampling error. Additionally, tissue artifacts can also an issue because cuts in the transverse plane can make duodenal villi appear artifactually shortened and can bias the assessment of intraepithelial inflammation. Moreover, endoscopic biopsy is costly and poorly tolerated as the patient needs to be sedated to perform the procedure. Our lab has previously developed technology termed tethered capsule OCT endomicroscopy (TCE) to overcome these diagnostic limitations of endoscopy. TCE involves swallowing an optomechanically-engineered pill that generates 3D images of the GI tract as it traverses the lumen of the organ via peristalsis, assisted by gravity. In several patients we have demonstrated TCE imaging of duodenal villi, however the current TCE device design is not optimal for CD diagnosis as the villi compress when in contact with the smooth capsule's wall. In this work, we present methods for structuring the outer surface of the capsule to improve the visualization of the villi height and crypt depth. Preliminary results in humans suggest that new TCE capsule enables better visualization of villous architecture, making it possibly to comprehensively scan the entire duodenum to obtain a more accurate tissue diagnosis of CD.

ChroPac-Trial: Duodenum-preserving pancreatic head resection versus pancreatoduodenectomy for chronic pancreatitis. Trial protocol of a randomised controlled multicentre trial

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Schlitt Hans

2010-04-01

Full Text Available Abstract Background A recently published systematic review indicated superiority of duodenum-preserving techniques when compared with pancreatoduodenectomy, for the treatment of patients with chronic pancreatitis in the head of the gland. A multicentre randomised trial to confirm these results is needed. Methods/Design ChroPac aims to investigate differences in quality of life, mortality and morbidity during 24 months after surgery (duodenum-preserving pancreatic head resection versus pancreatoduodenectomy in patients with chronic pancreatitis of the pancreatic head. ChroPac is a randomised, controlled, observer and patient blinded multicentre surgical trial with two parallel comparison groups. The primary outcome measure will be the average quality of life during 24 months after surgery. Statistical analysis is based on the intention-to-treat population. Analysis of covariance will be applied for the intervention group comparison adjusting for age, centre and quality of life before surgery. Level of significance is set at 5% (two-sided and sample size (n = 100 per group is determined to assure a power of 90%. Discussion The ChroPac trial will explore important outcomes from different perspectives (e.g. surgeon, patient, health care system. Its pragmatic approach promises high external validity allowing a comprehensive evaluation of the surgical strategy for treatment of patients with chronic pancreatitis. Trial registration Controlled-trials.com ISRCTN38973832

Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection

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Kazuto Kishimoto; Akira Hokama; Tetsuo Hirata; Yasushi Ihama; Manabu Nakamoto; Nagisa Kinjo; Fukunori Kinjo; Jiro Fujita

2008-01-01

AIM: To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis (5. stercoralis) hyperinfection.METHODS: Over a period of 23 years (1984-2006), we investigated 25 patients with 5. stercoralis hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for strongyloidiasis. The clinical and endoscopic findings were analyzed retrospectively.RESULTS: Twenty-four (96%) of the patients investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1 (HTLV-1) infection. The abnormal endoscopic findings, mainly edematous mucosa, white villi and erythematous mucosa, were observed in 23 (92%) patients. The degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal biopsy. The endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative (Endoscopic severity score: 4.86 ± 2.47 vs 2.71 ± 1.38, P ＜ 0.05).CONCLUSION: Our study clearly demonstrates that, in addition to stool analysis, endoscopic observation and biopsies are very important. We also emphasize that 5. stercoralis and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions.

Emergency pancreatoduodenectomy for complex injuries of the pancreas and duodenum.

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Krige, Jake E; Nicol, Andrew J; Navsaria, Pradeep H

2014-11-01

This single-centre study evaluated the outcome of a pancreatoduodenectomy for Grade 5 injuries of the pancreas and duodenum. Prospectively recorded data of patients who underwent a pancreatoduodenectomy for trauma at a Level I Trauma Centre during a 22-year period were analysed. Nineteen (17 men and 2 women, median age 28 years, range 14-53 years) out of 426 patients with pancreatic injuries underwent a pancreatoduodenectomy (gunshot n = 12, blunt trauma n = 6 and stab wound n = 1). Nine patients had associated inferior vena cava (IVC) or portal vein (PV) injuries. Five patients had initial damage control procedures and underwent a definitive operation at a median of 15 h (range 11-92) later. Twelve had a pylorus-preserving pancreatoduodenectomy (PPPD) and 7 a standard Whipple. Three patients with APACHE II scores of 15, 18, 18 died post-operatively of multi-organ failure. All 16 survivors had Dindo-Clavien grade I (n = 1), grade II (n = 7), grade IIIa (n = 2), grade IVa (n = 6) post-operative complications. Factors complicating surgery were shock on admission, number of associated injuries, coagulopathy, hypothermia, gross bowel oedema and traumatic pancreatitis. A pancreatoduodenectomy is a life-saving procedure in a small cohort of stable patients with non-reconstructable pancreatic head injuries. Damage control before a pancreatoduodenectomy will salvage a proportion of the most severely injured patients who have multiple injuries. © 2014 International Hepato-Pancreato-Biliary Association.

Effects of dietary symbiotic supplementation on growth performance and duodenum histology of Japanese quail (Coturnix coturnix Japonica reared in different flooring systems

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Isa Coskun

Full Text Available ABSTRACT The objective of this study was to determine the effect of dietary symbiotic supplementation on the growth performance and duodenum histological parameters of quail reared in different flooring systems. A total of 160 mixed-sex healthy quail (47±0.32 g aged 14 days were used in a 2 × 2 factorial experimental design with four replicates, each including five males and five females. Two flooring systems (wire floor as control and wood shavings bedding and two dietary treatments (symbiotic supplementation and no supplementation were tested. Birds were transferred to four-tier cages for the trial. Each kilogram of the commercial diet included 224 g crude protein and 3,080 kcal metabolizable energy. The experiment lasted 21 days. Daily weight gain and gastrointestinal tract weight were statistically higher in the wood shavings and wood shavings + symbiotic-supplemented groups than in control group. Villi length was higher in the wood shavings + symbiotic and symbiotic-supplemented groups than in control and wood shavings groups. The wood shavings groups had longer villi than control group. Villi width was higher in wood shaving + symbiotic-supplemented groups compared with the other treatment groups. The litter system of wood shavings and symbiotic supplementation provide better growth performance to quail by developing their duodenum histomorphological parameters and digestive tract.

[A case of recurrent transverse colon cancer invading the pancreas and duodenum successfully treated with biliary and duodenal stenting].

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Tonooka, Toru; Yoshioka, Shigeru; Shiobara, Masayuki; Wakatsuki, Kazuo; Kataoka, Masaaki; Arai, Shuka; Miyazawa, Kotaro; Nakada, Shinichiro; Kita, Kazuhiko; Saito, Hirofumi; Nomoto, Hiromasa; Usui, Masatoshi; Yabiki, Masashi; Ota, Yuki; Oeda, Yoshio

2013-11-01

We report a case of recurrent transverse colon cancer invading the pancreas and duodenum that was successfully treated with biliary and duodenal stenting. A 46-year-old man underwent ascending colostomy for the treatment of obstructive transverse colon cancer with hepatic metastasis. Chemotherapy achieved a partial response, but the levels of tumor markers later began to rise again. He then underwent right hemicolectomy and partial hepatectomy. Post-operative chemotherapy was administered, but the recurrent tumor caused obstructive jaundice and duodenal obstruction. These were successfully treated with biliary and duodenal stenting, and the patient was able to remain at home and maintain his quality of life.

Fructus ligustri lucidi ethanol extract improves bone mineral density and properties through modulating calcium absorption-related gene expression in kidney and duodenum of growing rats.

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Feng, Xin; Lyu, Ying; Wu, Zhenghao; Fang, Yuehui; Xu, Hao; Zhao, Pengling; Xu, Yajun; Feng, Haotian

2014-04-01

Optimizing peak bone mass in early life is one of key preventive strategies against osteoporosis. Fructus ligustri lucidi (FLL), the fruit of Ligustrum lucidum Ait., is a commonly prescribed herb in many kidney-tonifying traditional Chinese medicinal formulas to alleviate osteoporosis. Previously, FLL extracts have been shown to have osteoprotective effect in aged or ovariectomized rats. In the present study, we investigated the effects of FLL ethanol extract on bone mineral density (BMD) and mechanical properties in growing male rats and explored the underlying mechanisms. Male weaning Sprague-Dawley rats were randomized into four groups and orally administrated for 4 months an AIN-93G formula-based diet supplementing with different doses of FLL ethanol extract (0.40, 0.65, and 0.90 %) or vehicle control, respectively. Then calcium balance, serum level of Ca, P, 25(OH)2D3, 1,25(OH)2D3, osteocalcin (OCN), C-terminal telopeptide of type I collagen (CTX-I), and parathyroid hormone, bone microarchitecture, and calcium absorption-related genes expression in duodenum and kidney were analyzed. The results demonstrated that FLL ethanol extract increased BMD of growing rats and improved their bone microarchitecture and mechanical properties. FLL ethanol extract altered bone turnover, as evidenced by increasing a bone formation maker, OCN, and decreasing a bone resorption maker, CTX-I. Intriguingly, both Ca absorption and Ca retention rate were elevated by FLL ethanol extract treatment, possibly through the mechanisms of up-regulating the transcriptions of calcitropic genes in kidney (1α-hydroxylase) and duodenum (vitamin D receptor, calcium transporter calbindin-D9k, and transient receptor potential vanilloid 6). In conclusion, FLL ethanol extract increased bone mass gain and improved bone properties via modulating bone turnover and up-regulating calcium absorption-related gene expression in kidney and duodenum, which could then activate 1,25(OH)2D3-dependent calcium

Burkitt's lymphoma of the duodenum in a patient with AIDS Linfoma de Burkitt do duodeno em um paciente com AIDS

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Marcelo Corti

2007-06-01

Full Text Available Non-Hodgkin's lymphoma of B-cell type is the second most common neoplasm after Kaposi's sarcoma, among patients with human immunodeficiency virus infection. Most non-Hodgkin's lymphoma cases that are associated with acquired immunodeficiency syndrome involve extranodal sites, especially the digestive tract and the central nervous system. We report a case of primary lymphoma of the duodenum in a patient with AIDS. Upper gastrointestinal endoscopy revealed pseudopolypoid masses found in the second portion of the duodenum. A complete diagnostic study including histological, immunohistochemical and virological analyses showed high-grade B-cell Burkitt's lymphoma. The Epstein-Barr virus genome was detected in biopsies by immunohistochemical and in situ hybridization.O linfoma não-Hodgkin de células B é a segunda neoplasia mais comum em pacientes com infecção pelo vírus da imunodeficiência humana depois do sarcoma de Kaposi. A maioria dos casos de linfoma não-Hodgkin associados com a síndrome da imunodeficiência adquirida envolve locais extraganglionares, especialmente o trato digestivo e o sistema nervoso central. Nós relatamos um caso de linfoma primário do duodeno em um paciente com AIDS. Uma endoscopia digestiva alta mostrou massas pseudopolipóides encontradas na segunda porção do duodeno. Um estudo diagnóstico completo incluindo exames histológicos, imunohistoquímicos e virológicos mostrou um linfoma de células B tipo Burkitt. Detectou-se genoma do vírus Epstein-Barr em biópsias por hibridização in situ e imuno-histoquímica.

Hydrocortisone and Vitamin D3 stimulation of 32Psub(i)-phosphate accumulation by organ-cultured chick embryo duodenum

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Corradino, R.A.

1979-01-01

Either vitamin D 3 (or 1 α,25-(OH) 2 -D 3 ) or hydrocortisone (HC) stimulated phosphate accumulation by organ-cultured embryonic chick duodenum. In combination, these two steroids stimulated phosphate uptake synergistically. Phosphate accumulation appeared to be independent of other vitamin D 3 -stimulated processes: CaBP concentration, cAMP concentration, or alkaline phosphataseactivity. L-phenylalanine, a reported alkaline phosphate inhibitor, when added to the culture medium progressively inhibited either D 3 - or HC-stimulated phosphate uptake subsequent to culture, but did not inhibit the synergistic action under these conditions L-phenylalanine had no consistent effect on alkaline phosphotase activity but unexpectedly, greatly inhibited vitamin D 3 - stimulated CaBP concentration, but only in the absence of HC. Some limited suggestion of an intestinal phosphoprotein sensitve to either vitamin D 3 or HC was observed. (orig.) [de

Five-year follow-up of a prospective non-randomised study comparing duodenum-preserving pancreatic head resection with classic Whipple procedure in the treatment of chronic pancreatitis.

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Möbius, C; Max, D; Uhlmann, D; Gumpp, K; Behrbohm, J; Horvath, K; Hauss, J; Witzigmann, H

2007-05-01

Three prospective randomised studies were conducted to compare pancreatoduodenectomy (PD) with duodenum-preserving pancreatic head resection (DPPHR) in patients suffering from chronic pancreatitis (cP). In these three series, the superiority of the duodenum-preserving technique with regard to quality of life (QOL) and pain relief has been demonstrated. Long-term follow-up investigations have not been published so far. The present paper reports on a 5-year follow-up study of a prospective, non-randomised trial comparing classic Whipple procedure (PD) with Beger DPPHR. Seventy patients were initially enrolled in this study. Fifty-one patients were left for the present long-term outcome analysis (PD, n = 24; DPPHR, n = 27). The follow-up included the following parameters: QOL, pain intensity, endocrine and exocrine function, and body mass index (BMI). The median follow-up was 63.5 (range 56-67) months. Two patients in the DPPHR group and none in the PD group underwent a re-operation. The QOL scores of the relevant symptom scales (nausea, pain, diarrhoea) and functional parameters (physical status, working ability, global QOL) were significantly better in the DPPHR group than in the PD group. Pain intensity as self-assessed by the patients was less pronounced in the DPPHR group (P Whipple procedure in terms of QOL and pain intensity as self-assessed by the patients.

Na+-coupled bicarbonate transporters in duodenum, collecting ducts and choroid plexus.

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Praetorius, Jeppe

2010-01-01

Epithelia cover the internal and external surfaces of the organism and form barriers between the various compartments. Some of these epithelia are specialized for effective transmembrane or even transepithelial movement of acid-base equivalents. Certain epithelia with a high rate of HCO3- transport express a few potent Na+-coupled acid-base transporters to gain a net HCO3- movement across the epithelium. Examples of such epithelia are renal proximal tubules and pancreatic ducts. In contrast, multiple Na+-coupled HCO3- transporters are expressed in other HCO3- secreting epithelia, such as the duodenal mucosa or the choroid plexus, which maintain suitable intracellular pH despite a variable demand for secreting HCO3-. In the duodenum, the epithelial cells must secrete HCO3- for neutralization of the gastric acid, and at the same time prevent cellular acidification. During the neutralization, large quantities of CO2 are formed in the duodenal lumen, which enter the epithelial cells. This would tend to lower intracellular pH and require effective counteracting mechanisms to avoid cell death and to maintain HCO3- secretion. The choroid plexus secretes the cerebrospinal fluid (CSF) and controls the pH of the otherwise poorly buffered CSF. The pCO2 of CSF fluctuates with plasma pCO2, and the choroid plexus must regulate the HCO3- secretion to minimize the effects of these fluctuations on CSF pH. This is done while maintaining pH neutrality in the epithelial cells. Thus, the Na+-HCO3- cotransporters appear to be involved in HCO3- import in more epithelia, where Na+/H+ exchangers were until recently thought to be sufficient for maintaining intracellular pH.

The diagnosis and therapeutic gain using US, CT and MRI. Submucosal tumors in stomach and duodenum

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Miyamoto, Shinichi; Nawano, Shigeru; Tajiri, Hisao; Boku, Narikazu; Muto, Manabu; Ohtsu, Atsushi; Yoshida, Shigeaki [National Cancer Center, Kashiwa, Chiba (Japan). Hospital East; Moriyama, Noriyuki

1999-02-01

The usefulness of the ultrasonography (US), the computed tomography (CT) and the magnetic resonance imaging (MRI) was examined. The subjects were 19 patients with submucosal leiomyoma and leiomyosarcoma in the stomach and duodenum which had surgery and were histologically diagnosed in the National Cancer Center Hospital. The detectability of the primary foci was 50% (8/16) in US, and 93% (13/14) in EUS (the endoscopic ultrasonography) which makes the structure of the stomach wall and the continuity of tumors clear. CT could detect the primary foci in 94% (16/17) and was excellent to know not only the presence of the remote metastases but also the exact size and expanse of the tumors. In all cases of leiomyoma, tumors were leiomyosarcoma when the internal structure was diagnosed to be heterogeneous by both EUS and CT, or either of them. The qualitative image diagnosis is not always easy in gastrointestinal submucosal tumors, but it is important to generally diagnose by the combination with several examinations in order to select the suitable therapeutic method. (K.H.)

Gastrointestinal stromal tumour of the duodenum in childhood: a rare case report

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Chiarugi, Massimo; Galatioto, Christian; Lippolis, Piero; Zocco, Giuseppe; Seccia, Massimo

2007-01-01

Gastrointestinal stromal tumours (GISTs) are uncommon primary mesenchymal tumours of the gastrointestinal tract mostly observed in the adults. Duodenal GISTs are relatively rare in adults and it should be regarded as exceptional in childhood. In young patients duodenal GISTs may be a source of potentially lethal haemorrhage and this adds diagnostic and therapeutic dilemmas to the concern about the long-term outcome. A 14-year-old boy was referred to our hospital with severe anaemia due to recurrent episodes of upper gastrointestinal haemorrhage. Endoscopy, small bowel series, scintigraphy and video capsule endoscopy previously done elsewhere were negative. Shortly after the admission, the patient underwent emergency surgery for severe recurrence of the bleeding. At surgery, a 4 cm solid mass arising from the wall of the fourth portion of the duodenum was identified. The invasion and the erosion of the duodenal mucosa was confirmed by intra-operative pushed duodenoscopy. The mass was resected by a full-thickness duodenal wall excision with adequate grossly free margins. Immunohistochemical analysis of the specimen revealed to be positive for CD117 (c-KIT protein) consistent with a diagnosis of GIST. The number of mitoses was < 5/50 HPF. Mutational analysis for c-KIT/PDGFRA tyrosine kinase receptor genes resulted in a wildtype pattern. The patient had an uneventful course and he has remained disease-free during two years of follow-up. Duodenal GISTs in children are very rare and may present with massive bleeding. Cure can be achieved by complete surgical resection, but even in the low-aggressive tumours the long-term outcome may be unpredictable

Expression of nutrient transporters in duodenum, jejunum, and ileum of Eimeria maxima-infected broiler chickens.

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Fetterer, Raymond H; Miska, Katarzyna B; Jenkins, Mark C; Wong, Eric A

2014-10-01

The uptake of amino acids is mediated by active transporters located on the basolateral and brush border membranes of intestinal epithelial cells. The current study investigated the expression of amino acid transporters (AAT) and other genes in the intestine of chicks infected with Eimeria maxima. At 7-day postinfection (PI), tissue from each intestinal segment (duodenum, jejunum, and ileum) was taken from birds inoculated with 3 × 10(3) oocysts/bird and processed to recover RNA. Analysis of gene expression was performed using real-time reverse transcription polymerase chain reaction (qRT-PCR). Results were given as relative expression using β₂-microglobulin as an endogenous control. All the genes studied were expressed in three segments of the intestines, and expression of the genes was altered by infection with E. maxima. Even though the jejunum is considered the parasite's primary predilection site, there was no segment-related difference in expression of most of the genes studied. The antimicrobial peptide (LEAP2) was downregulated in all three segments of the intestine. The results also demonstrate that transporters associated with brush border membranes were downregulated while transporters associated with the basolateral membranes were upregulated and that E. maxima alters the expression of AAT and LEAP2 throughout the small intestine.

Duodenum inclusion in alimentary transit for preventing or correcting nutritional deficiencies resulting from Roux-en-y gastric bypass in obesity treatment.

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Ceneviva, Reginaldo

2016-01-01

Nutritional and metabolic complications can develop after Roux-en-Y gastric bypass (RYGB) when there is an exaggerated response to the anatomical and functional changes or when there is inadequate nutritional supplementation. Severe malnutrition is rare, but deficiencies of vitamin B12, iron, calcium and thiamin, metabolic bone disease and gallstones are common after RYGB. Shortage of vitamin B12, iron, calcium and also cholelithiasis are caused at least partially by excluding the duodenum and proximal jejunum from food transit. We designed a new procedure, with the maintenance of the duodenum and proximal jejunum in the gastrointestinal transit through interposition of jejunal loop, as a primary operation to prevent such deficiencies or as corrective surgery for severe malnutrition after RYGB with failure in responding to conservative treatment. Complicações nutricionais e metabólicas podem se desenvolver após a derivação gástrica em Y de Roux (DGYR) quando há uma resposta exagerada às mudanças anatômicas e funcionais ou quando há suplementação nutricional inadequada. A desnutrição grave é rara, mas deficiências de vitamina B12, ferro, cálcio e tiamina, doença óssea metabólica e cálculos biliares são comuns após a DGYR. Dessas deficiências mencionadas, a de vitamina B12, de ferro, de cálcio e também a colelitíase, são causadas, ao menos parcialmente, pela exclusão do duodeno e jejuno proximal. Um novo procedimento com a manutenção do duodeno e do jejuno proximal no trânsito gastrointestinal, mediante interposição de alça jejunal, foi idealizado como operação primária para prevenir essas deficiências ou como cirurgia corretiva de desnutrição grave após DGYR com falha na resposta a exaustivas tentativas de tratamento conservador.

Effect of surfactants, gastric emptying, and dosage form on supersaturation of dipyridamole in an in vitro model simulating the stomach and duodenum.

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Mitra, A; Fadda, H M

2014-08-04

The purpose of this study was to investigate the influence of gastric emptying patterns, surfactants, and dosage form on the supersaturation of a poorly soluble weakly basic drug, dipyridamole, using an in vitro model mimicking the dynamic environment of the upper gastrointestinal tract, and, furthermore, to evaluate the usefulness of this model in establishing correlations to in vivo bioavailability for drugs with solubility/dissolution limited absorption. A simulated stomach duodenum model comprising four compartments was used to assess supersaturation and precipitation kinetics as a function of time. It integrates physiologically relevant fluid volumes, fluid transfer rates, and pH changes of the upper GI tract. Monoexponential gastric emptying patterns simulating the fasted state were compared to linear gastric emptying patterns simulating the fed state. The effect of different surfactants commonly used in oral preparations, specifically, sodium lauryl sulfate (SLS), poloxamer-188, and polysorbate-80, on dipyridamole supersaturation was investigated while maintaining surface tension of the simulated gastric fluids at physiological levels and without obtaining artificial micellar solubilization of the drug. The supersaturation behavior of different dose strengths of dipyridamole was explored. Significant levels of dipyridamole supersaturation were observed in the duodenal compartment under all the different in vivo relevant conditions explored. Dipyridamole supersaturation ratios of up to 11-fold have been observed, and supersaturation has been maintained for up to 120 min. Lower duodenal concentrations of dipyridamole were observed under linear gastric emptying patterns compared to mononexponential gastric emptying. The mean duodenal area under concentration-time curves (AUC60min) for the dipyridamole concentration profile in the duodenal compartment is significantly different for all the surfactants explored (P stomach duodenum model can provide a reliable and

Unusual Development of Iatrogenic Complex, Mixed Biliary and Duodenal Fistulas Complicating Roux-en-Y Antrectomy for Stenotic Peptic Disease of the Supraampullary Duodenum Requiring Whipple Procedure: An Uncommon Clinical Dilemma.

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Polistina, Francesco A; Costantin, Giorgio; Settin, Alessandro; Lumachi, Franco; Ambrosino, Giovanni

2010-10-23

Complex fistulas of the duodenum and biliary tree are severe complications of gastric surgery. The association of duodenal and major biliary fistulas occurs rarely and is a major challenge for treatment. They may occur during virtually any kind of operation, but they are more frequent in cases complicated by the presence of difficult duodenal ulcers or cancer, with a mortality rate of up to 35%. Options for treatment are many and range from simple drainage to extended resections and difficult reconstructions. Conservative treatment is the choice for well-drained fistulas, but some cases require reoperation. Very little is known about reoperation techniques and technical selection of the right patients. We present the case of a complex iatrogenic duodenal and biliary fistula. A 42-year-old Caucasian man with a diagnosis of postoperative peritonitis had been operated on 3 days earlier; an antrectomy with a Roux-en-Y reconstruction for stenotic peptic disease was performed. Conservative treatment was attempted with mixed results. Two more operations were required to achieve a definitive resolution of the fistula and related local complications. The decision was made to perform a pancreatoduodenectomy with subsequent reconstruction on a double jejunal loop. The patient did well and was discharged on postoperative day 17. In our experience pancreaticoduodenectomy may be an effective treatment of refractory and complex iatrogenic fistulas involving both the duodenum and the biliary tree.

Unusual Development of Iatrogenic Complex, Mixed Biliary and Duodenal Fistulas Complicating Roux-en-Y Antrectomy for Stenotic Peptic Disease of the Supraampullary Duodenum Requiring Whipple Procedure: An Uncommon Clinical Dilemma

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Francesco A. Polistina

2010-10-01

Full Text Available Complex fistulas of the duodenum and biliary tree are severe complications of gastric surgery. The association of duodenal and major biliary fistulas occurs rarely and is a major challenge for treatment. They may occur during virtually any kind of operation, but they are more frequent in cases complicated by the presence of difficult duodenal ulcers or cancer, with a mortality rate of up to 35%. Options for treatment are many and range from simple drainage to extended resections and difficult reconstructions. Conservative treatment is the choice for well-drained fistulas, but some cases require reoperation. Very little is known about reoperation techniques and technical selection of the right patients. We present the case of a complex iatrogenic duodenal and biliary fistula. A 42-year-old Caucasian man with a diagnosis of postoperative peritonitis had been operated on 3 days earlier; an antrectomy with a Roux-en-Y reconstruction for stenotic peptic disease was performed. Conservative treatment was attempted with mixed results. Two more operations were required to achieve a definitive resolution of the fistula and related local complications. The decision was made to perform a pancreatoduodenectomy with subsequent reconstruction on a double jejunal loop. The patient did well and was discharged on postoperative day 17. In our experience pancreaticoduodenectomy may be an effective treatment of refractory and complex iatrogenic fistulas involving both the duodenum and the biliary tree.

CT appearance of the duodenum and mesenteric vessels in children with normal and abnormal bowel rotation

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Taylor, George A. [Harvard Medical School and Children' s Hospital Boston, Department of Radiology, Boston, MA (United States)

2011-11-15

Demonstration of the third duodenal segment (D3) in retroperitoneal location has been recently proposed as a method for excluding malrotation. This study was performed to determine whether a retroperitoneal third duodenal segment can reliably exclude malrotation. CTs of 38 patients with proven malrotation and 100 patients without malrotation were evaluated for the location of the duodenum/proximal small bowel, and the relationship of the superior mesenteric vein (SMV) to superior mesenteric artery (SMA). The D3 segment was in normal retroperitoneal location in 100% of control patients, compared to 2.5% or (1 of 38) of patients with malrotation. Nine of 11 patients (91%) with malrotation imaged prior to surgery had the proximal bowel in an abnormal location, while all 100 control patients had it in a normal location. The SMV was in normal relationship to the SMA in 11/38 patients (29%) with malrotation, compared to 79% of normal controls. In 10 controls, a branch of the SMV was partially wrapped around the SMA, potentially mimicking partial mesenteric volvulus. A retroperitoneal location of the D3 segment makes the diagnosis of malrotation unlikely but not impossible. Additional imaging of the duodenojejunal junction or cecum may be necessary to reliably exclude intestinal malrotation. (orig.)

CT appearance of the duodenum and mesenteric vessels in children with normal and abnormal bowel rotation

International Nuclear Information System (INIS)

Taylor, George A.

2011-01-01

Demonstration of the third duodenal segment (D3) in retroperitoneal location has been recently proposed as a method for excluding malrotation. This study was performed to determine whether a retroperitoneal third duodenal segment can reliably exclude malrotation. CTs of 38 patients with proven malrotation and 100 patients without malrotation were evaluated for the location of the duodenum/proximal small bowel, and the relationship of the superior mesenteric vein (SMV) to superior mesenteric artery (SMA). The D3 segment was in normal retroperitoneal location in 100% of control patients, compared to 2.5% or (1 of 38) of patients with malrotation. Nine of 11 patients (91%) with malrotation imaged prior to surgery had the proximal bowel in an abnormal location, while all 100 control patients had it in a normal location. The SMV was in normal relationship to the SMA in 11/38 patients (29%) with malrotation, compared to 79% of normal controls. In 10 controls, a branch of the SMV was partially wrapped around the SMA, potentially mimicking partial mesenteric volvulus. A retroperitoneal location of the D3 segment makes the diagnosis of malrotation unlikely but not impossible. Additional imaging of the duodenojejunal junction or cecum may be necessary to reliably exclude intestinal malrotation. (orig.)

[ENDOSCOPIC ANATOMY AND MORPHOLOGICAL CHANGES OF THE GASTRODUODENAL JUNCTION IN ULCER OF THE DUODENUM].

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Kolesnikova, E V; Dronova, O B; Kagan, Il; Tretjakov, A A; Kogan, E L

2015-01-01

To Improve the diagnosis of duodenal ulcer and preneoplastic changes of gastroduodenal transition. 112 patients with duodenal ulcer, 208 healthy pearsons of three age periods: second period of mature age, elderly and senile age were examined. Video endoscopy equipment company "OLYMPUS" (Japan), morphological methods and the determination of Helicobacter pylori (Hp) were used. The connecting line of gastric and duodenal mucous membrane can be located on the gastric side of the pylorus (13% in normal cases and 22.3% in cases of ulcer disease), on pylorus and go into the bulbus of duodenum (87% and 77.7 %, respectively), in cases of duodenal ulcer the connecting line more often has jagged and tongue-shaped form. Mucous membrane forms folds in prepyloric part of the stomach most often on the front wall in healthy pearsons in 14.4% of cases, in patients with duodenal ulcer--in 75.9%. The number of folds decreases with age. HP, atrophy, intestinal metaplasia of the mucous membrane is more often found in duodenal ulcer disease--76.8%, 69.7% and 62.5% comparing with healthy persons: 51.4%, 5.3% and 47.7% respectively. Frequency of preneoplastic changes increases with age. The individual differences of the mucous membrane of the gastroduodenal transition are identified. They are expressed in the particular location and shape of the connecting line of gastric and duodenal mucous membranes in normal cases and in cases of ulcer disease in different age groups. Some endoscopic changes requiring biopsy and morphological studies are revealed.

Pancreatic Polypeptide Cell Proliferation in the Pancreas and Duodenum Coexisting in a Patient With Pancreatic Adenocarcinoma Treated With a GLP-1 Analog.

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Talmon, Geoffrey A; Wren, J David; Nguyen, Christophe L; Pour, Parviz M

2017-07-01

A partial pancreaticogastrodudenectomy was performed on a 66-year old man with type 2 diabetes mellitus because of an invasive, moderately differentiated adenocarcinoma in the head of the pancreas. In the adjacent grossly normal tissue of the uncinate process, there was a massive proliferation of pancreatic polypeptide (PP) cells confined to this region and showed invasive pattern. Strikingly, in the heaped area of his duodenum, there was a strikingly large number of PP, glucagon, a few insulin cells in a mini-islet-like patterns composed of glucagon and insulin cells. Among the etiological factors, the possible long-lasting effects of the GLP-1 analog, with which the patient was treated, are discussed. This is the first report in the literature of both the coexistence of a pancreatic adenocarcinoma and invasive PPoma and the occurrence of PP and insulin cells in human duodenal mucosa.

Effect of niacin supplementation on rumen fermentation characteristics and nutrient flow at the duodenum in lactating dairy cows fed a diet with a negative rumen nitrogen balance.

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Aschemann, Martina; Lebzien, Peter; Hüther, Liane; Südekum, Karl-Heinz; Dänicke, Sven

2012-08-01

The aim of the present experiment was to ascertain if a daily niacin supplementation of 6 g/cow to lactating dairy cow diets can compensate for the decrease in rumen microbial fermentation due to a negative rumen nitrogen balance (RNB). A total of nine ruminally and duodenally fistulated lactating multiparous German Holstein cows was used. The diets consisted of 10 kg dry matter (DM) maize silage and 7 kg DM concentrate and differed as follows: (i) Diet RNB- (n = 6) with energy and utilisable crude protein (CP) at the duodenum (uCP) according to the average requirement of the animals, but with a negative RNB (-0.41 g N/MJ metabolisable energy [ME]); (ii) Diet RNB0 (n = 7) with energy, uCP, and RNB (0.08 g N/MJ ME) according to the average requirement of the animals; and (iii) Diet NA (nicotinic acid; n = 5), which was the same diet as RNB-, but supplemented with 6 g niacin/d. The negative RNB affected the rumen fermentation pattern and reduced ammonia content in rumen fluid and the daily duodenal flows of microbial CP (MP) and uCP. Niacin supplementation increased the apparent ruminal digestibility of neutral detergent fibre. The efficiency of microbial protein synthesis per unit of rumen degradable CP was higher, whereby the amount of MP reaching the duodenum was unaffected by niacin supplementation. The number of protozoa in rumen fluid was higher in NA treatment. The results indicated a more efficient use of rumen degradable N due to changes in the microbial population in the rumen when niacin was supplemented to diets deficient in RNB for lactating dairy cows.

Gene expression profiling reveals candidate genes related to residual feed intake in duodenum of laying ducks.

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Zeng, T; Huang, L; Ren, J; Chen, L; Tian, Y; Huang, Y; Zhang, H; Du, J; Lu, L

2017-12-01

Feed represents two-thirds of the total costs of poultry production, especially in developing countries. Improvement in feed efficiency would reduce the amount of feed required for production (growth or laying), the production cost, and the amount of nitrogenous waste. The most commonly used measures for feed efficiency are feed conversion ratio (FCR) and residual feed intake (RFI). As a more suitable indicator assessing feed efficiency, RFI is defined as the difference between observed and expected feed intake based on maintenance and growth or laying. However, the genetic and biological mechanisms regulating RFI are largely unknown. Identifying molecular mechanisms explaining divergence in RFI in laying ducks would lead to the development of early detection methods for the selection of more efficient breeding poultry. The objective of this study was to identify duodenum genes and pathways through transcriptional profiling in 2 extreme RFI phenotypes (HRFI and LRFI) of the duck population. Phenotypic aspects of feed efficiency showed that RFI was strongly positive with FCR and feed intake (FI). Transcriptomic analysis identified 35 differentially expressed genes between LRFI and HRFI ducks. These genes play an important role in metabolism, digestibility, secretion, and innate immunity including (), (), (), β (), and (). These results improve our knowledge of the biological basis underlying RFI, which would be useful for further investigations of key candidate genes for RFI and for the development of biomarkers.

Stimulation of a Cd-binding protein, and inhibition of the vitamin D-dependent calcium-binding protein, by zinc or cadmium in organ-cultured embryonic chick duodenum

International Nuclear Information System (INIS)

Corradino, R.A.; Fullmer, C.S.

1980-01-01

Embryonic chick duodenum maintained in organ culture responds to 1 α,25-dihydroxy vitamin D 3 in the culture medium by de novo synthesis of a specific calcium-binding protein (CaBP). The addition of Cd 2+ (3-5 x 10 -5 M) or Zn 2+ (10 -5 -10 -4 M) to the medium inhibited CaBP, but stimulated biosynthesis of a Cd-binding protein (CdBP). CdBP in duodenal homogenate supernatants was assessed in two ways: first, by its 109 Cd-binding activity ( 109 CdBA) using a competitive ion exchange procedure; and, second, by the extent of [ 35 S]-cystine incorporation into a specific peak or band after gel filtration or analytical polyacrylamide disc gel electrophoresis, respectively. Regardless of whether cadmium- or zinc-stimulated, the 35 S-labeled CdBP - the only protein significantly labeled under the conditions employed - migrated identically upon gel filtration and electrophoresis, and comigrated with purified chick liver Cd-metallothionein. Neither actinomycin D nor α-amanitin, in concentrations sufficient to severely inhibit CaBP, significantly reduced CdBP production. However, cycloheximide did inhibit either Cd 2+ - or Zn 2+ -stimulated CdBP by about 50% at an inhibitor concentration which abolished CaBP. The inhibitor studies, coupled with the observations of extensive incorporation of [ 35 S]cystine into CdBP, suggest that the metals stimulated biosynthesis by a mechanism operating at the translational level. The organ-cultured duodenum seems well suited for studies of the regulation of CdBP biosynthesis especially since it responds predictably to the steroid hormone, 1α,25-dihydroxy vitamin D 3 , in the induction of another specific protein, CaBP, at the transcriptional level. The biosynthesis of CaBP thus may serve as a convenient control in studies of CdBP production under various experimental conditions

CARCINOID TUMOR OF THE DUODENUM: a rare tumor at an unusual site. Case series from a single institution

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Jaques WAISBERG

2013-03-01

Full Text Available Context Duodenal carcinoids are extremely rare, and their characteristics and biological behavior have not been fully elucidated. Objective To analyze the clinicopathological characteristics of patients with resected duodenal carcinoids. Methods Twenty patients (12 females and 8 males were investigated. Their average age was 66.4 ± 5.8 years old (43 to 88 years old. The data corresponding to the clinical picture, diagnosis, treatment, and prognosis of patients with duodenal carcinoid tumors subjected to resection over a period of 18 years (1993-2011 were analyzed. Results The most common symptoms were dyspepsia (50% and epigastric pain (45% followed by weight loss (10% and vomiting (5%. Carcinoid syndrome was not observed in any patient. The lesion was located on the first part of the duodenum in 15 (75% patients, the second part in 4 (20% patients, and the third part in 1 (5% patient. The diagnosis of a carcinoid tumor was established through an endoscopic excision biopsy in 19 (95% patients and an histopathological examination of the surgical specimen in 1 (5% patient. The average tumor size was 1.1 cm ± 0.4 cm (0.3 cm to 6.0 cm. Nineteen (95% patients were initially treated by endoscopic resection of the duodenal lesion. One patient (5%, whose tumor was on the third part of the duodenum underwent a duodenectomy of the third and fourth duodenal parts and duodenojejunal anastomosis. The duodenal carcinoid resection margin was involved in four (20% patients. Four (20% patients were subjected to a partial gastrectomy to fully remove the lesion. The tumor was restricted to the submucosal layer in 16 (80% cases, and it penetrated into the muscular layer in 4 (20% cases. All patients exhibited positive chromogranin A, neuron-specific enolase, and/or synaptophysin immunostaining. The average duration of the follow-up period was 39.6 months (3 to 96 months. Twelve (60% of the 20 cases in this series are alive without any evidence of active

Effect of gastric pH on the pharmacokinetics of a BCS class II compound in dogs: utilization of an artificial stomach and duodenum dissolution model and GastroPlus,™ simulations to predict absorption.

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Bhattachar, Shobha N; Perkins, Everett J; Tan, Jeffrey S; Burns, Lee J

2011-11-01

Dogs are one of the most commonly used non-rodent species in toxicology studies and are known to have basal stomach pH ranging from 2 to 7 in the fasted state. Thus absorption and resulting plasma exposure of weakly basic compounds administered as crystalline suspensions to dogs are often variable. LY2157299 is a potent and selective transforming growth factor (TGF)-beta receptor type 1 kinase (TGF-βRI) inhibitor that displayed variable absorption in early dog studies. This molecule is a weakly basic Biopharmaceutics Classification System (BCS)Class II compound, and depends on the rate and extent of dissolution to drive oral absorption. An artificial stomach and duodenum (ASD) dissolution model was utilized to evaluate potential effect of gastric pH on the absorption of suspension and buffered solution formulations. GastroPlus™ was also employed to predict the magnitude of gastric pH changes on LY2157299 absorption. The ASD experiments demonstrated that administration of a buffered acidic solution could improve the potential for absorption by normalizing gastric pH and enabling supersaturation in the duodenum. GastroPlus™ modeling suggested that direct modulation of gastric pH could lead to marked changes in bioavailability. Pharmacokinetic experiments were conducted in dogs to evaluate the effect of gastric pH modification on plasma exposure. The data were qualitatively consistent with the predictions. Copyright © 2011 Wiley-Liss, Inc.

16S rRNA gene pyrosequencing reveals bacterial dysbiosis in the duodenum of dogs with idiopathic inflammatory bowel disease.

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Suchodolski, Jan S; Dowd, Scot E; Wilke, Vicky; Steiner, Jörg M; Jergens, Albert E

2012-01-01

Canine idiopathic inflammatory bowel disease (IBD) is believed to be caused by a complex interaction of genetic, immunologic, and microbial factors. While mucosa-associated bacteria have been implicated in the pathogenesis of canine IBD, detailed studies investigating the enteric microbiota using deep sequencing techniques are lacking. The objective of this study was to evaluate mucosa-adherent microbiota in the duodenum of dogs with spontaneous idiopathic IBD using 16 S rRNA gene pyrosequencing. Biopsy samples of small intestinal mucosa were collected endoscopically from healthy dogs (n = 6) and dogs with moderate IBD (n = 7) or severe IBD (n = 7) as assessed by a clinical disease activity index. Total RNA was extracted from biopsy specimens and 454-pyrosequencing of the 16 S rRNA gene was performed on aliquots of cDNA from each dog. Intestinal inflammation was associated with significant differences in the composition of the intestinal microbiota when compared to healthy dogs. PCoA plots based on the unweighted UniFrac distance metric indicated clustering of samples between healthy dogs and dogs with IBD (ANOSIM, pmicrobial groups, which bear resemblance to dysbiosis reported in humans with chronic intestinal inflammation. These bacterial groups may serve as useful targets for monitoring intestinal inflammation.

The morphological changes of mucous membrane of stomach and duodenum of contractor organization personnel, which works in radiation hazard conditions at the object Shelter of Chornobyl NPP.

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Sushko, V O; Nezgovorova, G A; Degtjarova, L V; Kolosynska, O O; Gromadska, V M

2015-12-01

Аim: The determination of morphological features of stomach and duodenum mucous of membrane (MM) damage at a personnel that works in radiation hazard conditions at the object of "Shelter" of Chornobyl NPP (OS) by the endoscopic monitoring with biopsy material inspection from a gastro-duodenal zone on the stages of check - in (InC) and the special medical control (SpC). the complex clinical-endoscopic and morphological examination with the biopsy of MM of stomach and duodenum in 126 workers of OS (man in the age from 20 to 59) was carried out. Doses of external radiation exposure were from 0,14 to 79,6 mSv, доза internal radiation exposure were from 0,1 to 3 mSv/Results: For the personnel of OS contract organisations differently directed pathomorphological changes of MM at InC and increase of frequency of their exposure at an inspection during SC, that generally correspond to chronic H.pylori-associated pangastritis with violation of microcirculation and trophism, disregeneration changes of epithelial layer. for the personnel of contract organizations, which participated in radiation hazard works on ОS a presence of chronic H.pylori-associated pangastritis with the increase of frequency of atrophic changes of MM (nonmetaplastic or metaplastic type) and development of erosive-ulcerous defects of gastro-duodenal zone was founded out.For workers, who had previous influence of ionizing irradiation the greater frequency of disregeneration (hyperplasia / intestinal metaplasia) changes of epithelium that accordingly promotes the risk of neoplasmes transformations was clarified.Providing of EGDFS (at a necessity with the biopsy of MM) is at InC and next stages of medical control for personnel, that executes radiation hazard works on ОS is the highly informative evidential and necessary method of inspection for determination of form and degree of pathological changes of overhead departments of gastrointestinal tract for warning of progress of disease and development

Trolox reduces the effect of ethanol on acetylcholine-induced contractions and oxidative stress in the isolated rabbit duodenum El Trolox reduce el efecto del etanol sobre las contracciones inducidas a la acetilcolina y el estrés oxidativo en duodeno aislado de conejo

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Diego S. Fagundes

2011-08-01

Full Text Available Trolox is a hydrophilic analogue of vitamin E and a free radical scavenger. Ethanol diminishes the amplitude of spontaneous contractions and acetylcholine (ACh-induced contractions in rabbit duodenum. The aim of this work was to study the effect of Trolox on the alterations induced by ethanol on contractility and lipid peroxidation in the duodenum. The duodenal contractility studies in vitro were carried out in an organ bath and the levels of malondialdehyde and 4-hydroxyalkenals (MDA+4-HAD were measured by spectrophotometry. Trolox increased the reduction induced by ethanol on the amplitude of spontaneous contractions in longitudinal muscle but not in circular muscle. Trolox 4 mM decreased the effects of ethanol on ACh-induced contractions and on MDA+4-HDA concentrations. We conclude that Trolox might prevent oxidative stress induced by ethanol in the duodenum.El Trolox es un análogo hidrofílico de la vitamina E y un agente que secuestra radicales libres. El etanol disminuye la amplitud de las contracciones espontáneas y las contracciones inducidas a la acetilcolina en el duodeno de conejo. El objetivo de este trabajo era estudiar el efecto del Trolox en las alteraciones inducidas por el etanol sobre la contractilidad y la peroxidación lipídica en el duodeno. Los estudios de contractilidad duodenal in vitro se realizaron en un baño de órganos y los niveles de MDA+4-HDA se midieron por espectofotometría. El Trolox aumentó la reducción inducida por el etanol sobre la amplitud de las contracciones espontáneas en el músculo longitudinal pero no en el músculo circular de duodeno. El Trolox 4 mM redujo los efectos del etanol sobre las contracciones inducidas a la acetilcolina y sobre las concentraciones de MDA+4-HDA. Se concluye que el Trolox podría prevenir el estrés oxidativo inducido por el etanol en el duodeno.

[Treatment and prevention of erosive and ulcerative lesions in the stomach and duodenum caused by intake of non-steroidalanti-inflammatory drugs].

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Luzina, E V

2014-01-01

Therapy with non-steroidal anti-inflammatory drugs (NSAIDs) is a diffcult task. Good anti-inflammatory effect increases the risk of gastrointestinal complications with a frequency of 10-50%. The risk further increases with age (above 60-70 yr), the history of ulcer disease concomitant intake of acetylsalicylic acid, anticoagulants, and glucocorticosteroids. Long-term antisecretory therapy with proton pump inhibitors, e.g., esomeprazole, was shown to be an effective prophylactic tool. This drug maintains the intragastric pH value above 4 for 15 hr on the average. The risk of erosive and ulceraive lesions in the stomach and duodenum significantly decreases by selective cyclooxygenase-2 inhibitors, e.g., coxibs, that however increase the risk of thrombotic cardiovascular complications. The author proposes recommendations on the use of NSAIDs in the patients at risk of serious gastrointestinal and cardiovascular pathology. Naproxen in combination with proton pitmp inhibitors is the drug of choice among NSAIDs. Vimovo is a fixed combination of naproxen and esomeprazole. Results of comparative studies on the efficacy of vimovo and celecoxib are presented along with the data on the safety of this. combination compared with that of naproxen monotherapy

Scintigraphy by sup 99m Tc-in vivo labeled red blood cells. Detection of gastrointestinal bleeding following duodenum-preserving resection of the head of the pancreas. Die Szintigraphie mit sup 99m Tc-in-vivo-markierten Erythrozyten. Nachweis einer intestinalen Blutung nach duodenumerhaltender Pankreaskopfresektion

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Brecht-Krauss, D. (Ulm Univ. (Germany, F.R.). Abt. Nuklearmedizin); Schnarkowski, P.; Friedrich, J.M. (Ulm Univ. (Germany, F.R.). Abt. Roentgendiagnostik)

1990-09-01

Following resection of the head of the pancreas while preserving the duodenum a gastrointestinal haemorrhage was localised by red blood cells labeled in vivo with technetium-99m. The previously performed endoscopy and angiography were normal. The haemorrhage in the region of the pancreaticojejunal anastomosis was confirmed intraoperatively. If intermittent bleedings are suspected, scintigraphy should be performed as a routine measure besides endoscopy and angiography. (orig.).

Primary Pure Squamous Cell Carcinoma of the Gallbladder Locally Invading the Liver, Duodenum, and Stomach: A Case Report and Literature Review

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Aldrin C. Alpuerto

2017-01-01

Full Text Available Primary pure squamous cell carcinoma (SCC of the gallbladder is an exceptionally rare type of tumor that comprises only 1% of all gallbladder cancer. SCC of the gallbladder portends a worse prognosis than the more common adenocarcinoma variant because of its aggressive invasion to local structures and because it is often diagnosed at an advanced stage. Owing to its rarity, diagnosis and management can be challenging. Herein, we present the case of a 75-year-old female complaining of abdominal pain, nausea, and vomiting. Computed tomography and ultrasonography results of the abdomen were consistent with acute cholecystitis and cholelithiasis. Histologic evaluation of the resected mass revealed a malignant tumor with prominent keratinization, confirming the diagnosis of an invasive primary pure SCC of the gallbladder. Microscopic examination showed direct infiltration to the liver, duodenum, and stomach. This case report describes the hospital course of a patient with SCC of the gallbladder and suggests that gallbladder cancer should be considered as part of the differential diagnosis in elderly patients presenting with acute cholecystitis. In addition, this article will review existing literature to examine the utility of different diagnostic techniques and treatment modalities available in the management of gallbladder cancer.

Pancreatite aguda devida a hematoma intramural do duodeno por uso de anticoagulante Acute pancreatitis due to intramural hematoma of the duodenum by use of anticoagulant therapy

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Samer FARHOUD

2001-01-01

Full Text Available Racional - A hemorragia intramural espontânea do duodeno causada por complicações da terapêutica anticoagulante é rara e seu tratamento controverso. Objetivo -- Apresentar a experiência advinda do tratamento de doente com essa condição clínica. Relato do caso - Expõe-se o caso de uma mulher de 71 anos de idade, que há 3 meses fazia uso de anticoagulante oral para tratamento de trombose venosa profunda dos membros inferiores. Apresentou-se com cefaléia e dores abdominais intensas no andar superior do abdome, associadas a náuseas e vômitos. Os exames laboratoriais e de imagem comprovaram o diagnóstico de surto agudo de pancreatite, decorrente de hematoma intramural de duodeno. Os valores de protrombina (49,7 s e o sangramento de tecidos moles cervicais e urinário, sugeriam complicação da terapêutica anticoagulante. Resultados - A terapêutica conservadora foi efetiva, tendo a doente recebido alta, assintomática, no 10º dia de internação. Conclusão - É recomendado o emprego do anticoagulante em doses menores nos doentes de risco e adequado controle dos parâmetros da coagulação. Acredita-se ser ideal a conduta conservadora e recomenda-se a cirurgia somente nos casos que evoluem com complicações.Background - Spontaneous intramural hemorrhage of the duodenum due to anticoagulant therapy is rare and the treatment is controversial. Objective - To present the acquired knowledge with the treatment of these disease. Case report - A 71-year-old women receiving for a 3 month period an anticoagulant therapy presented cervical bleeding of soft tissues and symptoms of acute pancreatitis and high small bowel obstruction. Early noninvasive diagnosis by computed tomographic scan was possible and conservative therapy proved successful in complete resolution of the pancreatitis and obstructive symptoms, with resumption of oral intake in the fourth day of treatment. The frequency of bleeding in high risk patients during warfarin therapy

Myenteric neuronal plasticity induced by Toxoplasma gondii (genotype III on the duodenum of rats

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Rodrigo M. Papazian-Cabanas

2012-09-01

Full Text Available The effects of acute and chronic infection caused by Toxoplasma gondii on duodenal myenteric neurons were analyzed. Eighteen rats were assigned into four groups: Acute Control Group (ACG, n=4; Acute Experimental Group (AEG, n=4; Chronic Control Group (CCG, n=5; and Chronic Experimental Group (CEG, n=5. Rats from the AEG and CEG were inoculated orally with 105 genotype III (BTU-II strain tachyzoites of T. gondii isolated from a dog with neurological signs. Acute groups were killed after 24 hours after the inoculation and the chronic groups after 30 days. Whole-mount from the duodenum were stained with Giemsa. The population density of myenteric neurons, as well the body cell, nuclear and cytoplasmic area were analyzed. Both acute and chronic toxoplasmic infection did not provoke neuronal loss. On the other hand, plastic alterations were observed: decreasing of the nuclear and cytoplasmic area during the acute phase and neuronal hypertrophy during the chronic phase.Foram analisados os efeitos da infecção aguda e crônica provocada pelo Toxoplasma gondii sobre os neurônios mientéricos do duodeno. Dezoito ratos foram divididos em quatro grupos: Grupo Controle Agudo (GCA, n= 4, Grupo Experimental Agudo (GEA, n=4, Grupo Controle Crônico (GCC, n=5 e Grupo Experimental Crônico (GEC, n=5. Os animais do GEA e GEC receberam por via oral 10 5 taquizoítos de Toxoplasma gondii da cepa BTUII (genótipo III isolada de um cão com sintomatologia neurológica. Os grupos agudos foram submetidos à eutanásia após 24 horas e os crônicos após 30 dias da inoculação. Preparados totais do duodeno foram corados com Giemsa. A densidade populacional dos neurônios mientéricos, bem como a área do corpo celular, núcleo e citoplasma foram analisados. Ambas, as infecções toxoplásmicas aguda e crônica não provocaram a perda neuronal. Por outro lado, alterações plásticas foram observadas: diminuição da área nuclear e citoplasmática durante a fase

Duodenum preserving pancreatectomy in chronic pancreatitis: Design of a randomized controlled trial comparing two surgical techniques [ISRCTN50638764

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Reidel Margot A

2006-05-01

Full Text Available Abstract Background Chronic pancreatitis is an inflammatory disease which is characterized by an irreversible conversion of pancreatic parenchyma to fibrous tissue. Beside obstructive jaundice and pseudocyst formation, about half of the patients need surgical intervention due to untreatable chronic pain during the course of the disease. In most of the patients with chronic pancreatitis, the head of the pancreas is the trigger of the chronic inflammatory process. Therefore, resection of pancreatic head tissue must be the central part of any surgical intervention. However, it is unclear to which extent the surgical procedure must be radical in order to obtain a favourable outcome for the patients. Design A single centre randomized controlled, superiority trial to compare two techniques of duodenum preserving pancreatic head resection. Sample size: 65 patients will be included and randomized intraoperatively. Eligibility criteria: All patients with chronic pancreatitis and indication for surgical resection and signed informed consent. Cumulative primary endpoint (hierarchical model: duration of surgical procedure, quality of life after one year, duration of intensive care unit stay, duration of hospital stay. Reference treatment: Resection of the pancreatic head with dissection of the pancreas from the portal vein and transsection of the gland (Beger procedure. Intervention: Partial Resection of the pancreatic head without transsection of the organ and visualization of the portal vein (Berne procedure. Duration: September 2003-October 2007. Organisation/responsibility The trial is conducted in compliance with the protocol and in accordance with the moral, ethical, regulatory and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989 and the Good Clinical Practice guideline (GCP. The Center for Clinical Studies of the Department of Surgery Heidelberg is responsible for planning, conducting and final

Long-term Outcomes Favor Duodenum-preserving Pancreatic Head Resection over Pylorus-preserving Pancreaticoduodenectomy for Chronic Pancreatitis: A Meta-analysis and Systematic Review.

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Sukharamwala, Prashant B; Patel, Krishen D; Teta, Anthony F; Parikh, Shailraj; Ross, Sharona B; Ryan, Carrie E; Rosemurgy, Alexander S

2015-09-01

Pylorus-preserving pancreaticoduodenectomy (PPPD) and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis. This meta-analysis was undertaken to compare the long-term outcomes of DPPHR versus PPPD in patients with chronic pancreatitis. A systematic literature search was conducted using Embase, MEDLINE, Cochrane, and PubMed databases on all studies published between January 1991 and January 2013 reporting intermediate and long-term outcomes after DPPHR and PPPD for chronic pancreatitis. Long-term outcomes of interest were complete pain relief, quality of life, professional rehabilitation, exocrine insufficiency, and endocrine insufficiency. Other outcomes of interest included perioperative morbidity and length of stay (LOS). Ten studies were included comprising of 569 patients. There was no significant difference in complete pain relief (P = 0.24), endocrine insufficiency (P = 0.15), and perioperative morbidity (P = 0.13) between DPPHR and PPPD. However, quality of life (P insufficiency (P = 0.005), and LOS (P = 0.00001) were significantly better for patients undergoing DPPHR compared with PPPD. In conclusion, there is no significant difference in endocrine insufficiency, postoperative pain relief, and perioperative morbidity for patients undergoing DPPHR versus PPPD. Improved intermediate and long-term outcomes including LOS, quality of life, professional rehabilitation, and preservation of exocrine function make DPPHR a more favorable approach than PPPD for patients with chronic pancreatitis.

16S rRNA gene pyrosequencing reveals bacterial dysbiosis in the duodenum of dogs with idiopathic inflammatory bowel disease.

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Jan S Suchodolski

Full Text Available BACKGROUND: Canine idiopathic inflammatory bowel disease (IBD is believed to be caused by a complex interaction of genetic, immunologic, and microbial factors. While mucosa-associated bacteria have been implicated in the pathogenesis of canine IBD, detailed studies investigating the enteric microbiota using deep sequencing techniques are lacking. The objective of this study was to evaluate mucosa-adherent microbiota in the duodenum of dogs with spontaneous idiopathic IBD using 16 S rRNA gene pyrosequencing. METHODOLOGY/PRINCIPAL FINDINGS: Biopsy samples of small intestinal mucosa were collected endoscopically from healthy dogs (n = 6 and dogs with moderate IBD (n = 7 or severe IBD (n = 7 as assessed by a clinical disease activity index. Total RNA was extracted from biopsy specimens and 454-pyrosequencing of the 16 S rRNA gene was performed on aliquots of cDNA from each dog. Intestinal inflammation was associated with significant differences in the composition of the intestinal microbiota when compared to healthy dogs. PCoA plots based on the unweighted UniFrac distance metric indicated clustering of samples between healthy dogs and dogs with IBD (ANOSIM, p<0.001. Proportions of Fusobacteria (p = 0.010, Bacteroidaceae (p = 0.015, Prevotellaceae (p = 0.022, and Clostridiales (p = 0.019 were significantly more abundant in healthy dogs. In contrast, specific bacterial genera within Proteobacteria, including Diaphorobacter (p = 0.044 and Acinetobacter (p = 0.040, were either more abundant or more frequently identified in IBD dogs. CONCLUSIONS/SIGNIFICANCE: In conclusion, dogs with spontaneous IBD exhibit alterations in microbial groups, which bear resemblance to dysbiosis reported in humans with chronic intestinal inflammation. These bacterial groups may serve as useful targets for monitoring intestinal inflammation.

Surgical treatment of pancreas divisum causing chronic pancreatitis: the outcome benefits of duodenum-preserving pancreatic head resection.

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Schlosser, W; Rau, B M; Poch, B; Beger, H G

2005-01-01

Pancreas divisum (PD) represents a duct anomaly in the pancreatic head ducts, leading frequently leading to recurrent acute pancreatitis (rAP) or chronic pancreatitis (CP). Based on endoscopic retrograde cholangiopancreatography, pancreas divisum can be found in 1% to 6% of patients with pancreatitis. The correlation of this abnormality with pancreatic disease is an issue of continuing controversy. Because of the underlying duct anomalies and major pathomorphological changes in the pancreatic head, duodenum-preserving pancreatic head resection (DPPHR) offers an option for causal treatment. Thirty-six patients with pancreatitis caused by PD were treated surgically. Thirty patients suffered from CP, 6 from rAP. The mean duration of the disease was 47.5 and 49.8 months, respectively. The age at the time of surgery was 39.2 years in the CP group, and 27.6 years in the rAP group. Median hospitalization since diagnosis was 18.8 weeks for CP patients and 24.6 weeks for rAP patients. Previous procedures performed in these patients included endoscopic papillotomy (30%), duct stenting (14%), and surgical treatment (17%). The median preoperative pain score was 8 on a visual analog scale. According to the classification of pancreas divisum, 10 patients demonstrated a complete PD, 25 had a functionally incomplete PD, and 1 had a dorsal duct type. The pain status as well as the endocrine (oral glucose tolerance test) and exocrine (pancreolauryl test) function were evaluated preoperatively and early and late postoperatively with a median follow-up time of 39.3 months. There was no operative-related mortality. The follow-up was 100%; 4 patients died (1 from suicide, 1 from cardiac arrest, and 2 from cancer of the esophagus). Fifty percent of the patients were completely pain-free, 31% had a significant reduction of pain with a median pain score of 2 (P pancreatitis with a need for hospitalization. DPPHR reduced pain and preserved the endocrine function in the majority of patients

Penetrating injuries to the duodenum: An analysis of 879 patients from the National Trauma Data Bank, 2010 to 2014.

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Phillips, Bradley; Turco, Lauren; McDonald, Dan; Mause, Alison; Walters, Ryan W

2017-11-01

Despite wide belief that the duodenal Organ Injury Scale has been validated, this has not been reported in the published literature. Based on clinical experience, we hypothesize that the American Association for Surgery of Trauma Organ Injury Scale (AAST-OIS) for duodenal injuries can independently predict mortality. Our objectives were threefold: (1) describe the national profile of penetrating duodenal injuries, (2) identify predictors of morbidity and mortality, and (3) validate the duodenum AAST-OIS as a statistically significant predictor of mortality. Using the Abbreviated Injury Scale 2005 and International Classification of Diseases-9th Rev.-Clinical Modification (ICD-9-CM) E-codes, we identified 879 penetrating duodenal trauma patients from the National Trauma Data Bank between 2010 and 2014. We controlled patient-level covariates of age, biological sex, systolic blood pressure (SBP), Glasgow Coma Scale (GCS) score, pulse, Injury Severity Score (ISS), and Organ Injury Scale (OIS) grade. We estimated multivariable generalized linear mixed models to account for the nesting of patients within trauma centers. Our results indicated an overall mortality rate of 14.4%. Approximately 10% of patients died within 24 hours of admission, of whom 76% died in the first 6 hours. Patients averaged approximately five associated injuries, 45% of which involved the liver and colon. Statistically significant independent predictors of mortality were firearm mechanism, SBP, GCS, pulse, ISS, and AAST-OIS grade. Specifically, odds of death were decreased with 10 mm Hg higher admission SBP (13% decreased odds), one point higher GCS (14.4%), 10-beat lower pulse (8.2%), and 10-point lower ISS (51.0%). This study is the first to report the national profile of penetrating duodenal injuries. Using the National Trauma Data Bank, we identified patterns of injury, predictors of outcome, and validated the AAST-OIS for duodenal injuries as a statistically significant predictor of morbidity

[Pancreatic functional status after wedge resection of the duodenal wall and para-pancreatic micro-irrigation].

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Voskanian, S E; Naĭdenov, E V

2011-01-01

To study influence parapancreatic microirrigation on morphological and functional condition of a pancreas and transformations of enzymatic activity of blood serum and enzymatic activity of lymph of a chest lymphatic channel after an operative trauma of a duodenum. Research is executed on 140 not purebred dogs which have been divided into six groups and united in two series. In the first series (30 dogs) were studied changes pancreatic exosecretion in the postoperative period of resection of duodenum (group 1.1), in the postoperative period of resection of duodenum with preliminary infiltration of a parapancreatic tissue of 0.5% by a solution of Novocain (group 1.2) and after resection of duodenum with application parapancreatic microirrigation (group 1.3). In the second series (110 dogs) were studied frequency of development of acute pancreatitis, enzymatic activity of blood serum and enzymatic activity of lymph of thoracal lymphatic duct after resection of duodenum (group 2.1) and in the postoperative period of resection of duodenum with preliminary infiltration of a parapancreatic tissue of 0.5% by a solution of Novocain (group 2.2) and after resection of duodenum with application parapancreatic microirrigation (group 2.3). Application parapancreatic microirrigation does not lead to oppression pancreatic exosecretion at the first o'clock after duodenotomy, and substantially reduces the pancreatic hypersecretion observed in the postoperative period of resection of a duodenum. In addition, application parapancreatic microirrigation reduces frequency of development of acute pancreatitis and promotes less expressed increase enzymatic activity of blood serum and enzymatic activity of lymph thoracal lymphatic duct at development of the given complication after operational trauma of duodenum in comparison with resection of duodenum and after a resection of a duodenum executed against infiltration of a parapancreatic tissue of 0.5% by a solution of Novocain.

Effect of short-term sequential administration of nonsteroidal anti-inflammatory drugs on the stomach and proximal portion of the duodenum in healthy dogs.

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Dowers, Kristy L; Uhrig, Samantha R; Mama, Khursheed R; Gaynor, James S; Hellyer, Peter W

2006-10-01

To evaluate effects of injection with a nonsteroidal anti-inflammatory drug (NSAID) followed by oral administration of an NSAID on the gastrointestinal tract (GIT) of healthy dogs. 6 healthy Walker Hounds. In a randomized, crossover design, dogs were administered 4 treatments consisting of an SC injection of an NSAID or control solution (day 0), followed by oral administration of an NSAID or inert substance for 4 days (days 1 through 4). Treatment regimens included carprofen (4 mg/kg) followed by inert substance; saline (0.9% NaCl) solution followed by deracoxib (4 mg/kg); carprofen (4 mg/kg) followed by carprofen (4 mg/kg); and carprofen (4 mg/kg) followed by deracoxib (4 mg/kg). Hematologic, serum biochemical, and fecal evaluations were conducted weekly, and clinical scores were obtained daily. Endoscopy of the GIT was performed before and on days 1, 2, and 5 for each treatment. Lesions were scored by use of a 6-point scale. No significant differences existed for clinical data, clinicopathologic data, or lesion scores in the esophagus, cardia, or duodenum. For the gastric fundus, antrum, and lesser curvature, an effect of time was observed for all treatments, with lesions worsening from before to day 2 of treatments but improving by day 5. Sequential administration of NSAIDs in this experiment did not result in clinically important gastroduodenal ulcers. A larger study to investigate the effect of sequential administration of NSAIDs for longer durations and in dogs with signs of acute and chronic pain is essential to substantiate these findings.

Cysteamine induces cholecystokinin release from the duodenum. Evidence for somatostatin as an inhibitory paracrine regulator of cholecystokinin secretion in the rat

International Nuclear Information System (INIS)

Abucham, J.; Reichlin, S.

1990-01-01

To determine whether cholecystokinin secretion is regulated by endogenous somatostatin, somatostatin deficiency was induced in vivo with cysteamine (250 mg/kg body wt, IV) or anti-somatostatin antiserum in anaesthetized rats and in vitro with cysteamine (30 micrograms/mL) in a rat duodenum-incubation system. Cholecystokinin secretion was assessed in vivo by measuring amylase in duodenal perfusates collected at 10-minute intervals for 1 hour and in vitro by a carboxy-terminal radioimmunoassay. Cysteamine induced a marked decrease in duodenal immunoreactive somatostatin both in vivo (50%) and in vitro (60%). The rate of amylase secretion increased from 9.7 +/- 2.1 U (mean +/- SE) to 28.0 +/- 4.8 U at 20 minutes (P less than 0.001). The cholecystokinin-receptor antagonist CR-1392 abolished amylase response for 30 minutes, whereas the more potent antagonists Asperlicin (18.0 mg/kg body wt, IV) and L-364,718 (0.25 mg/kg body wt, IV) caused prolonged blockade. The rate of amylase secretion in gastrectomized animals increased from 7.2 +/- 2.0 U to 15.0 +/- 2.2 U 20 minutes after cysteamine administration (P less than 0.01), indicating that the effect was not due to the presence of gastrin. In vitro, cysteamine caused a nearly fourfold increase in cholecystokinin secretion compared with controls (63.1 +/- 4.9 vs. 15.2 +/- 3.7, respectively; P less than 0.001). In vivo immunoneutralization of circulating somatostatin with a high-affinity and high-capacity antiserum produced no significant change in the rate of amylase secretion. These results suggest that cholecystokinin secretion is tonically inhibited by somatostatin and that this effect is mediated by locally secreted (paracrine) but not by circulating somatostatin

[STUDY OF THE VARIABILITY OF THE CARDIAC RHYTHM IN RAILROAD EMPLOYEES, WHO SUFFER BY STOMACH ULCER AND DUODENUM, ASSOCIATED AND NONASSOCIATED WITH THE INFECTION HELICOBACTER PYLORI].

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Shelekhova, Yu V; Hramtsova, N A; Onuchina, E V; Kuklin, S G

2015-01-01

To estimate the Heart rate variability (HRV), by the method of daily kholterovskogo monitoring in the workers of rail transport (RT). A total of 93 persons working in the East Siberian Railway. The main group (CG) consisted of 27 patients with gastric ulcer (GU) and duodenal ulcer (DU) contamination without Helicobacter infection. The first group of clinical comparison (GCS 1) included 36 patients with gastric ulcer and duodenal with contamination of infection H. pylori. The second group of clinical comparison (GCS 2) consisted of 30 employees VT held preventive medical examination, without contamination of Helicobacter infection is not suffering from gastric ulcer and duodenum. With the analysis of spectral and time characteristics HRV in Haug is revealed the explicit displacement of vegetative homeostasis with the prevalence of the sympathetic component of regulation, which is restored against the background of treatment. Meanwhile in GKS1 the indices of vegetative regulation had parasympathetic directivity, they were more close to the standard and did not change after conducting of the eradikatsionnoy therapy. The greatest unbalance of sympathetic and parasympathetic nervous system is observed in patients, workers (RT), who suffer SU and UD in the absence of the contamination of H. pylori. The use of a method of study VCR in the conditions of the absence of H. pylori infection can make it possible to form the group of risk of development SU and UD in workers RT.

Use of /sup 141/Ce as a particulate digesta flow tracer in ruminants. II. Behavior of the tracer at the duodenum and in the feces

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Poncet, C [INRA Centre de Recherches Zootechniques et Veterinaires, Theix, 63 - Beaumont (France)

1976-01-01

A ration of 600 g chopped hay and 150 g ground sorghum is given twice daily to sheep fitted with a rumen cannula and a duodenal reentrant cannula. /sup 141/Ce flow rate at the duodenum and in the feces is compared to flow rate of stained hay particles after ingestion of a single labelled meal. After an adaptation period during which both daily meals are labelled, variations in /sup 141/Ce concentration are then measured in the duodenal and fecal dry matter. The tracer is used to estimate dry mater digestibility indirectly. Duodenal data show that the mean retention time of /sup 141/Ce in the rumen is about 15% less than that of stained particles. The meal after the radioactive one momentarily depresses /sup 141/Ce excretion rate while it accelerates that of the stained particles. Mean retention time in the whole gastro-intestinal tract of a meal of 600 g chopped hay 150 g ground sorghum is 40.4+-3.8 h or 32.4+-3.7 h, depending on whether stained particles or /sup 141/Ce is used. All the /sup 141/Ce ingested is recovered in the feces. Mean recovery of /sup 141/Ce in the feces excreted during 200 hours after dosage is 100.2+-5.0%. After a period of adaptation where all meals are radioactive, feces of 2 sheep are sampled either by total collection or directly in the rectum. Dry matter digestibility does not differ whether calculated from total collection or by the indirect method using /sup 141/Ce.

Quantitative cholescintigraphy in the assessment of choledochoduodenal bile flow

International Nuclear Information System (INIS)

Cicala, M.; Scopinaro, F.; Corazziari, E.; Vignoni, A.; Viscardi, A.; Habib, F.I.; Torsoli, A.

1991-01-01

Quantitative cholescintigraphy has been proposed as a noninvasive method to assess function of the sphincter of Oddi in cholecystectomized subjects. The present study evaluated several quantitative cholescintigraphic variables to assess their time-related variability as well as their capability to detect delay of choledochoduodenal bile flow. Cholescintigraphy with 2,6-diethylphenylcarbahoylmethyl diacetic acid 99mTc was performed in 24 cholecystectomized patients with recurrent biliary-like pain, laboratory evidence of bile stasis, normal hepatocellular function tests, and no evidence of choledocholithiasis. The study was also performed in 26 asymptomatic cholecystectomized subjects and repeated at 2-week intervals during identical experimental conditions in 10 of them. Of the following quantitative cholescintigraphic variables investigated, (a) hepatic T peak, (b) 50% hepatic retention (T peak, 1/2), (c) percent hepatic retention at 30 minutes, (d) percent hepatic retention at 40 minutes, (e) vein-hepatic hilum transit time, (f) vein-duodenum transit time, and (g) hepatic hilum-duodenum transit time, only the hepatic hilum-duodenum transit time showed a statistically significant correlation between the duplicate studies. Only vein-duodenum transit time and hepatic hilum-duodenum transit time discriminated the symptomatic from the asymptomatic patients; of the two variables, however, hepatic hilum-duodenum transit time showed less intrasubject variability and no overlap between the two groups of patients. Hepatic hilum-duodenum transit time showed a positive linear correlation with the maximum diameter of the choledochus. It is concluded that in cholecystectomized patients, the hepatic hilum-duodenum transit time appears to detect a delay of bile flow into the intestine better than any other cholescintigraphic variable

Short and long-term post-operative outcomes of duodenum preserving pancreatic head resection for chronic pancreatitis affecting the head of pancreas: a systematic review and meta-analysis.

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Jawad, Zaynab A R; Tsim, Nicole; Pai, Madhava; Bansi, Dev; Westaby, David; Vlavianos, Panagiotis; Jiao, Long R

2016-02-01

To evaluate the short and long term outcomes of duodenum preserving pancreatic head resection (DPPHR) procedures in the treatment of painful chronic pancreatitis. A systematic literature search was performed to identify all comparative studies evaluating long and short term postoperative outcomes (pain relief, morbidity and mortality, pancreatic exocrine and endocrine function). Five published studies fulfilled the inclusion criteria including 1 randomized controlled trial comparing the Beger and Frey procedure. In total, 323 patients underwent surgical procedures for chronic pancreatitis, including Beger (n = 138) and Frey (n = 99), minimal Frey (n = 32), modified Frey (n = 25) and Berne's modification (n = 29). Two studies comparing the Beger and Frey procedure were entered into a meta-analysis and showed no difference in post-operative pain (RD = -0.06; CI -0.21 to 0.09), mortality (RD = 0.01; CI -0.03 to 0.05), morbidity (RD = 0.12; CI -0.00 to 0.24), exocrine insufficiency (RD = 0.04; CI -0.10 to 0.18) and endocrine insufficiency (RD = -0.14 CI -0.28 to 0.01). All procedures are equally effective for the management of pain for chronic pancreatitis. The choice of procedure should be determined by other factors including the presence of secondary complications of pancreatitis and intra-operative findings. Registration number CRD42015019275. Centre for Reviews and Dissemination, University of York, 2009. Copyright © 2015 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

The Potency of Ethanolic Extract of Sauropus androgynus (L.) Merr Leaves as Therapeutic herbal of Rats (Rattus norvegicus) Peptic Ulcer Model Induced by Aspirin

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Roosdiana, A.; Yudandi, S. A.; Erika, A.

2018-01-01

Peptic ulcer is an erosion of the mucosa gaster and duodenum. Aspirin can increase the activity of ROS in duodenum leading to be oxidative stress condition, followed by the increase expression of TNF-α and changes in the duodenum histopathology. Ethanolic extract from Sauropus androgynus (L.) Merr leaves contains flavonoid compound that act as antioxidants. The research aimed to study the therapeutic effect of Sauropus androgynus (L.) Merr leaves towards the expression of TNF-α and the duodenum histopathology. The study used five groups: the negative control group, the positive control group (peptic ulcer), and three therapeutic groups. Peptic ulcer induced by aspirin 200 mg/kg BW given orally once a day for five days. The therapeutic group (dose 16.2 mg/200 g BW, 32.4 mg/200 g BW, 48.6 mg/200 g BW) administrated orally once a day for fourteen days. Expression of TNF-α were analyzed by ANOVA followed by Tukey test (α=5%) and histopathology description of duodenum were analyzed descriptive qualitative. The result showed that treatment of the ethanolic extract from Sauropus androgynus (L.) Merr leaves at dose 48.6 mg/200 g BW was the effective dosage. The conclusion of this research indicate that ethanolic extract from Sauropus androgynus (L.) Merr leaves can be used as alternative therapy peptic ulcer towards decrease the expression of TNF-α and repair duodenum histopathology such as structure of epithelial duodenum, vile and decrease of inflammatory cell and vascular vasodilatation

Adenocarcinoma primário de duodeno

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Hamilton Petry de Souza

Full Text Available Primary adenocarcinoma of the duodenum is an extremely rare disease, and represents only 0.35 % of all gastrointestinal malignies. Early detection of the disease is dificult because doesn't have pathognomonic simptoms. The Whipple procedure is the optimal method of treatment. The authors relate one case of a adenocarcinoma of the duodenum in a 65- year-old white female with a history of abdominal pain for a six-month period, associated with postprandial fullness, vomiting and weight loss. Endoscopy showed a elevated tumor in the second part of the duodenum, with partial obstruction of the lumen. Histological study of endoscopic biopsies reveled a moderare differentiated adenocarcinoma of the duodenum. The treatment was surgical. The authors comment on the more important aspects of this pathology.

EGD - esophagogastroduodenoscopy

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... lining of the esophagus becomes inflamed or swollen) Gastritis (lining of the stomach and duodenum is inflamed ... from a condition called esophageal ring Tumors or cancer in the esophagus, stomach, or duodenum (first part ...

[The prevalence of dupA (duodenal ulcer-promoting gene) of Helicobacter pylori in children and adolescents--own observation].

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Parzecka, Monika; Szaflarska-Popławska, Anna; Gasiorowska, Joanna; Gorzkiewicz, Marta; Grzybowski, Tomasz

2013-05-01

The strains of Helicobacter pylori are described by many common features which determine their virulence. The genes which are connected with much higher virulence of some strains are vacA, cagA, oipA, dupA. Duodenal Ulcer Promoting Gene--dupA is the new virulence factor coexisting with a duodenum ulcer. There is a rationale that shows a protective character of dupA with reference to a stomach cancer. The dupA gene probably causes increasingly higher releasing of pro-infectious IL-8 via stomach cells and it influences the production of IL-12 and other cytokines. The aim of the study was to determine the frequency of dupA gene's appearance in the Polish children's group and in the Polish teenagers' group infected with H. pylori. The research was also aimed to determine the coexistence of dupA gene and duodenum ulcer disease or erosion infection of duodenum's mucous membrane. The endoscopic examination of the upper part of digestive duct was performed in 119 qualified patients with dyspeptic symptoms and with suspicion of stomach and duodenum's mucous membrane infection. The segments were taken for histopathological identification of H. pylori and for genetic indicating via PCR method. To confirm the presence of H. pylori in the extract the amplification of DNA fragment sized 860 pz was used. The presence of dupA gene was detected by PCR reaction with using the starters which include the fragment of jhp0917-jhp0918 sequence in the plastic H. pylori's genome area. To confirm the infection the urea breathing test was taken. 88 patients confirm the infection of H. pylori. The presence of dupA gene was found in 20 patients--a group A (22.7%), whereas in 68 patients dupA gene was not found--a group B (77.2%). Pathological changes in duodenum was found in 20 patients infected with H. pylori (22.7%), included 4 patients in the group A (20%) and 16 in the group B (23.5%). There was an infection (swelling, redness, congestion) in duodenum was found in the group A in all cases

Annular pancreas (image)

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Annular pancreas is an abnormal ring or collar of pancreatic tissue that encircles the duodenum (the part of the ... intestine that connects to stomach). This portion of pancreas can constrict the duodenum and block or impair ...

The immune cell composition in Barrett's metaplastic tissue resembles that in normal duodenal tissue.

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Alexandra Lind

Full Text Available BACKGROUND AND OBJECTIVE: Barrett's esophagus (BE is characterized by the transition of squamous epithelium into columnar epithelium with intestinal metaplasia. The increased number and types of immune cells in BE have been indicated to be due to a Th2-type inflammatory process. We tested the alternative hypothesis that the abundance of T-cells in BE is caused by a homing mechanism that is found in the duodenum. PATIENTS AND METHODS: Biopsies from BE and duodenal tissue from 30 BE patients and duodenal tissue from 18 controls were characterized by immmunohistochemistry for the presence of T-cells and eosinophils(eos. Ex vivo expanded T-cells were further phenotyped by multicolor analysis using flowcytometry. RESULTS: The high percentage of CD4(+-T cells (69±3% (mean±SEM/n = 17, by flowcytometry, measured by flowcytometry and immunohistochemistry, and the presence of non-activated eosinophils found in BE by immunohistochemical staining, were not different from that found in duodenal tissue. Expanded lymphocytes from these tissues had a similar phenotype, characterized by a comparable but low percentage of αE(CD103 positive CD4(+cells (44±5% in BE, 43±4% in duodenum of BE and 34±7% in duodenum of controls and a similar percentage of granzyme-B(+CD8(+ cells(44±5% in BE, 33±6% in duodenum of BE and 36±7% in duodenum of controls. In addition, a similar percentage of α4β7(+ T-lymphocytes (63±5% in BE, 58±5% in duodenum of BE and 62±8% in duodenum of controls was found. Finally, mRNA expression of the ligand for α4β7, MAdCAM-1, was also similar in BE and duodenal tissue. No evidence for a Th2-response was found as almost no IL-4(+-T-cells were seen. CONCLUSION: The immune cell composition (lymphocytes and eosinophils and expression of intestinal adhesion molecule MAdCAM-1 is similar in BE and duodenum. This supports the hypothesis that homing of lymphocytes to BE tissue is mainly caused by intestinal homing signals rather than to an

Pancreas-preserving total duodenectomy: a 10-year experience

DEFF Research Database (Denmark)

Penninga, Luit; Svendsen, Lars Bo

2011-01-01

Traditionally, severe pathology of the duodenum has been treated by a pancreaticoduodenectomy using Whipple's operation. Pancreas-preserving total duodenectomy (PPTD) was introduced in the late 1990s as an alternative to Whipple's operation for selected diseases of the duodenum. We report our 10...

Practical Guidance on How to Handle Levodopa/Carbidopa Intestinal Gel Therapy of Advanced PD in a Movement Disorder Clinic

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Pedersen, Stephen Wørlich; Clausen, Jesper Bøje; Gregerslund, Mie Manon

2012-01-01

, (Duodopa®, Abbott Laboratories) is delivered continuously through a percutaneous endoscopic gastrostomy with the inner tube placed in the duodenum by means of a device (CADD legacy Duodopa pump (CE 0473)). The therapy implies continuous dopaminergic delivery directly to the duodenum and is therefore...

Reflexogenic relaxation gastroduodenography by the acupuncture method

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Rabkin, I.Kh.; Tsibulyak, V.N.; Mnatsakyan, K.A.; Kondorskaya, I.L.; Galkina, T.V.

The communication is based upon the results of x-ray examination of the stomach and duodenum in 63 patients with stenoses of the pyloroduodenal zone, cicatrical deformities of the duodenal bulb, bulbar ulcer, duodenal organic lesions, and functional stenosis of the loop. First a routine X-ray examination of the stomach and duodenum was performed using barium-water mixture, then followed acupuncture aimed at hypotension in the definite points of the floor of the auricle where branches of the vagus innervating the stomach and duodenum are located. As distinct from pharmacological relaxation this method produces a purpose-oriented selective effect.

Reflexogenic relaxation gastroduodenography by the acupuncture method

International Nuclear Information System (INIS)

Rabkin, I.Kh.; Tsibulyak, V.N.; Mnatsakyan, K.A.; Kondorskaya, I.L.; Galkina, T.V.

1985-01-01

The communication is based upon the results of x-ray examination of the stomach and duodenum in 63 patients with stenoses of the pyloroduodenal zone, cicatrical deformities of the duodenal bulb, bulbar ulcer, duodenal organic lesions, and functional stenosis of the loop. First a routine X-ray examination of the stomach and duodenum was performed using barium-water mixture, than followed acupuncture aimed at hypotension in the definite points of the floor of the auricle where branches of the vagus innervating the stomach and duodenum are located. As distinct from pharmacological relaxation this method produces a purpose-oriented selective effect

Upper digestive stenosis due to a hydatid cyst of the liver.

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Jarrar, Mohamed Salah; Ben Hadj Khalifa, Mohamed Habib; Toumi, Radhouane; Ghrissi, Rafik; Elghali, Mohamed Amine; Khenissi, Abdelmajid; Hamila, Fehmi; Letaief, Rached

2015-03-01

The complications of the hydatid cyst of the liver are dominated by infection and rupture. The compression of adjacent organs (mainly the inferior vena cava, the portal vein and the bile ducts) can be seen, when the cyst is located in the dome, in the hilum or within the hepatic parenchyma. Upper digestive stenosis by compression of the duodenum by the hydatid cyst is an exceptional complication. A 63 year-old patient had, for two months, upper digestive stenosis associated with a sensation of weight in the right hypochondrium. Digestive endoscopy showed an extrinsic compression of the second portion of the duodenum. Biopsies were negative. Abdominal CT showed up a hydatid cyst in the segment VI of the liver, adhering to the duodenum, with an exo-vesiculation compressing it. The patient was operated on: There was a hydatid cyst of the right lateral sector compressing the duodenum. A partial intralamellar pericystectomy was performed. Hydatid cyst of the liver, a parasitic disease described as benign, may give mechanical complications related to compression of adjacent organs (especially the bile ducts and veins). Compression of the digestive tract is exceptional. This is due to the proximity of the cyst to the duodenum and the thickness of the cyst wall.

Axitinib for preoperative downstaging of renal cell carcinoma with sarcomatoid differentiation and direct invasion of the duodenum and inferior vena cava: a case report

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Yuki H

2014-02-01

Full Text Available Hideo Yuki,1,* Takao Kamai,1,* Keiichi Kubota,2 Hideyuki Abe,1 Daisaku Nishihara,1 Tomoya Mizuno,1 Akinori Masuda,1 Hironori Betsunoh,1 Masahiro Yashi,1 Yoshitatsu Fukabori,1 Ken-Ichiro Yoshida1 1Department of Urology, 2Department of Gastroenterological Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan *These authors contributed equally to this manuscript Background: Renal cell carcinoma (RCC with sarcomatoid differentiation is invasive, refractory to treatment, and has a higher mortality. Therefore, systemic therapy is still challenging, and the curative resection of localized or locally advanced RCC with sarcomatoid differentiation is very important. Axitinib is a potent and selective second-generation vascular endothelial growth factor receptor tyrosine kinase inhibitor with improved safety and tolerability. Axitinib is generally recommended as second-line therapy for advanced RCC because the phase III axitinib versus sorafenib in advanced RCC (AXIS trial demonstrated that it achieved longer progression-free survival than sorafenib in patients with metastatic RCC after failure of an approved first-line regimen. Methods: We present a 73-year-old man who had a large (13 cm in diameter right RCC with sarcomatoid differentiation that directly invaded the duodenum and inferior vena cava. The patient presented with gastrointestinal bleeding, was unable to eat solid food, and had become emaciated. Thus, his classification was poor risk with anemia, hypercalcemia, and poor performance status, according to the Memorial Sloan-Kettering Cancer Center criteria. He seemed unlikely to survive if radical nephrectomy, cavotomy with thrombectomy, and pancreatoduodenectomy were performed. To reduce the tumor burden and potential operative complications, we administered axitinib as first-line neoadjuvant therapy. Results: Six weeks of treatment reduced the tumor burden without causing severe toxicities. Subsequently, radical right nephrectomy, cavotomy

Novel deployment of a covered duodenal stent in open surgery to facilitate closure of a malignant duodenal perforation

Directory of Open Access Journals (Sweden)

Psaila Josephine

2009-10-01

Full Text Available Abstract Background Its a dilemma to attempt a palliative procedure to debulk the tumour and/or prevent future obstructive complications in a locally advanced intra abdominal malignancy. Case presentation A 38 year old Vietnamese man presented with a carcinoma of the colon which had invaded the gallbladder and duodenum with a sealed perforation of the second part of the duodenum. Following surgical exploration, it was evident that primary closure of the perforated duodenum was not possible due to the presence of unresectable residual tumour. Conclusion We describe a novel technique using a covered duodenal stent deployed at open surgery to aid closure of a malignant duodenal perforation.

Stimulatory effect of Coca-Cola on gastroduodenal HCO3- secretion in rats.

Science.gov (United States)

Sasaki, Y; Aihara, E; Ise, F; Kita, K; Takeuchi, K

2007-10-01

We examined the effect of various carbonated beverages, especially Coca-Cola, on the HCO3- secretion in the rat stomach and duodenum. Under urethane anaesthesia, a chambered stomach or a proximal duodenal loop was perfused with saline, and HCO3- secretion was measured at pH 7.0 using a pH-stat method and by adding 2 mM HCl. The amount of CO2 contained in these beverages was about 4-7 g/mL. Coca-Cola topically applied to the mucosa for 10 min significantly increased the HCO3- secretion in both the stomach and the duodenum. The HCO3- response in the duodenum was totally abolished by indomethacin and also partially inhibited by acetazolamide, an inhibitor of carbonic anhydrase. Likewise, the response in the stomach was also markedly inhibited by either acetazolamide or indomethacin. The mucosal application of Coca-Cola increased the PGE2 contents in both the stomach and the duodenum. Other carbonated beverages, such as sparkling water, Fanta Grape or cider, also increased the HCO3- secretion in these tissues. These results suggest that Coca-Cola induces HCO3- secretion in both the stomach and the duodenum, and these responses may be attributable to both the intracellular supply of HCO3- generated via carbonic anhydrase, and endogenous PGs, probably related to the acidic pH of the solution.

Duodenal leiomyoma. A case report. Leiomyome duodenal. Apports de l'imagerie a propos d'un cas

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Benziane, K.; Ballorain, X.; Kalfon, M. (Hopital Camille Guerin, 86 -Chatellerault (France)); Vandermarcq, P. (Hopital Jean-Bernard, 86 - Poitiers (France))

1994-05-01

A leiomyoma of the duodenum was revealed by chronic anaemia. Radiography, echography and computed tomography provided images leading to the diagnosis of a 11 cm regular, homogenous sub-serous tumour of the duodenum without loco-regional or distant extension. The radiographic images suggested a benign tumour confirmed by the pathology examination. (authors). 22 refs.

Case Report: Use of a circular stapler for Billroth I anastomosis after ...

African Journals Online (AJOL)

After separating the stomach from the duodenum, we anastomosed the posterior wall of the stomach to the duodenum by introducing the circular stapler through the part of the stomach that was to be resected. Then we separated the distal part of the stomach with a linear stapler, and so completed the distal gastric resection.

Invitro Studies on the Mechanism of Cellular Interactions of Some ...

African Journals Online (AJOL)

Gel filtration chromatography with 65Zn labelling of the soluble cytoplasm from rat duodenum mucosa were used to investigate the intracellular events between zinc and copper as well as zinc and iron. Copper taken up by the duodenum mucosal tissue at the same time with 65Zn prevented maximum 65Zn binding to ...

Case report of primary intestinal lymphangiectasia diagnosed in an octogenarian by ileal intubation and by push enteroscopy after missed diagnosis by standard colonoscopy and EGD.

Science.gov (United States)

Cappell, Mitchell S; Edhi, Ahmed; Amin, Mitual

2018-01-01

Primary intestinal lymphangiectasia (PIL) is a rare, presumably congenital lesion that is usually diagnosed in patients lymphangiectasia. EGD with intubation to mid-descending duodenum revealed no significant lesions, but subsequent enteroscopy demonstrated lesions in distal duodenum/proximal jejunum similar to those in terminal ileum characteristic of lymphangiectasia. Histopathologic analysis of lesions of terminal ileum/distal duodenum demonstrated dilated mucosal vessels, confirmed as lymphatic vessels by immunohistochemistry. PIL was diagnosed after excluding secondary causes of intestinal lymphangiectasia. Patient placed on standard PIL diet: oral supplements of medium-chain triglycerides, a high protein diet, supplements of fat-soluble vitamins, and avoiding long-chain fatty acids, with marked clinical improvement. This work shows that: 1)-standard EGD and colonoscopy may miss characteristic lesions of PIL, 2)-enteroscopy or terminal ileal intubation at colonoscopy may be required for the diagnosis because lesions are typically located in distal duodenum/jejunoileum; and 3)-PIL can first present in the very elderly even with symptoms of short duration. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Laparoscopic management of Bouveret syndrome.

Science.gov (United States)

Newton, Richard Charles; Loizides, Sofronis; Penney, Nicholas; Singh, Krishna Kumar

2015-04-22

Bouveret syndrome is a proximal form of gallstone ileus where a large gallstone lodges in the pylorus or proximal duodenum, having passed through a bilioenteric fistula that has formed secondary to previous cholecystitis. We describe the laparoscopic extraction of a giant 'Bouveret' gallstone from the duodenum of an elderly man with morbid obesity. 2015 BMJ Publishing Group Ltd.

Civilian duodenal gunshot wounds: surgical management made simpler.

Science.gov (United States)

Talving, Peep; Nicol, Andrew J; Navsaria, Pradeep H

2006-04-01

Low-velocity gunshot wounds cause most civilian duodenal injuries. The objective of this study was to describe a simplified surgical algorithm currently in use in a South African civilian trauma center and to verify its validity by measuring morbidity and mortality. A retrospective chart review of patients with duodenal gunshot injuries during the study period January 1999 to December 2003 was performed. Data points accrued included patient demographics, admission hemodynamic status and resuscitative measures, laparotomy damage control procedures, methods of surgical repair of the duodenal injury, associated injuries, length of intensive care and hospital stays, complications, and mortality. A total of 75 consecutive patients with gunshot injuries to the duodenum were reviewed. Primary repair was performed in 54 patients (87%), resection and reanastomosis in 7 (11%), and pancreatoduodenectomy in 1 (2%) during the initial phases. The overall morbidity and mortality were 58% and 28%, respectively. Duodenum-related complications were recorded in nine (15%) patients: two duodenal fistulas, one duodenal obstruction, and six cases of suture-line dehiscence. Overall and duodenum-related morbidity rates in patients with combined pancreatoduodenal injuries were 83% and 17%, respectively. Duodenum-related mortality occurred in three (4.8%) patients. Most civilian low-velocity duodenal gunshot injuries treated with simple primary repair result in overall morbidity, mortality, and duodenum-related complication rates comparable to those in reports where more complex surgical procedures were employed. Primary repair is also applicable for most combined pancreatic and duodenal gunshot injuries.

Adenoma viloso com transformação carcinomatosa da ampola de Vater

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Guilherme Pinto Bravo Neto

Full Text Available Villous adenomas of the duodenum and ampulla of Vater are uncommon, but they have been diagnosed more frequently with the increasing use of upper gastrointestinal endoscopy. Differential diagnosis with villous adenocarcinoma may be difficult. The authors present a case of a 47-year-old man with a giant villous adenoma of the duodenum, with intermittent jaundice, that was treated by pancreatoduodenectomy.

Ultrastructural analysis of kidney, liver and duodenum isolated from treated rats with Ginkgo Biloba extract and effects of this medicinal plant on the biodistribution of the padiopharmaceutical sodium pertechnetate

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Silvana Ramos Farias Moreno

2008-12-01

Full Text Available Ginkgo biloba extract (EGb has been used to treat memory and concentration deficits, acts as platelet activating factor antagonism and prevents against damages caused by free radicals. EGb is a standardized extract that contains 24% flavonoids and 6% terpenoids. The aim of this work was to evaluate the possible influence of an EGb on the ultrastructure of some organs isolated from rats and on the biodistribution of sodium pertechnetate (99mTcO4Na. The animals were treated with EGb and after six days, received 99mTcO4Na. The organs were isolated and fixed for ultrastructural analysis. The results showed that EGb has modified the ultrastructure of kidney, liver and duodenum and altered the biodistribution of 99mTcO4Na (PO extrato de Ginkgo Biloba extract (EGb tem sido usado para tratar dificuldades de concentração, memória, age como antagonista do fator de ativação de plaquetas e previne contra danos causados por radicais livres. EGb é um extrato padronizado com 24% de flavonóides e 6% de lactonas terpênicas. O objetivo deste estudo foi avaliar o efeito de um EGb na ultraestrutura de alguns órgãos isolados de ratos e na biodistribuição do radiofármaco pertecnetato de sódio (99mTcO4Na. Os animais foram tratados com EGb e após 6 dias receberam 99mTcO4Na. Os órgãos foram isolados e a radioatividade determinada. Os tecidos foram fixados para microscopia eletrônica. Os resultados mostraram que EGb alterou a ultraestrutura do rim, figado e duodeno e modificou a biodistribuição do 99mTcO4Na. Sugerimos que substâncias presentes no EGb poderiam agir diretamente ou gerar metabólitos capazes de promover alterações na biodistribuição e na morfologia de órgãos em nível ultraestrutural.

A roentgenologic study of diverticular throughout the entire gastrointestinal tract

International Nuclear Information System (INIS)

Sohn, Myung Hee; Song, Ho Young; Lim, Kyu Yeob

1983-01-01

Diverticulum is considered as a common lesion involving any gastrointestinal tract from the pharynx to the rectum. We reviewed 5,806 cases of upper G-I series and 801 cases of double contrast barium enema during the period from Jan.1978 to Dec. 1981 in the Department of Radiology, School of Medicine, Jeonbug National University Hospital to analyze diverticula of the entire gastrointestinal tract. The results were as follows: 1. Roentgen examination of 5,806 esophagus, stomachs, duodenums and small bowels, and 801 colons during the past four years: diverticula of the esophagus, 60 cases (1.0%); diverticula of the stomach, 42 cases (0.7%); diverticula of the duodenum, 358 cases (6.2%); diverticula of the small bowel, 20 cases (0.3%); diverticula of the colon, 26 cases (3.2%). The location of diverticula in order of frequency was duodenum, colon, esophagus, stomach and small bowel. 2. The most common site of diverticula of each gastrointestinal tract was as follows: diverticula of the esophagus, middle portion (84.7%); diverticula of the stomach, the cardia (59.5%); diverticula of the duodenum, the second portion (81.3%); diverticula of the small bowel, the jejunum (96.4%)-especially the larger percentage were observed at the upper jejunum near the ligament of Treitz; diverticula of the colon, the right sided colon (80.8%)-the cecum and ascending colon (57.1%). 3. Diverticula may occur at any age. The majority of diverticula of the entire gastrointestinal tract were observed over 40 years of age. Especially in diverticula of the duodenum and colon, their frequency increase with age. 4. Duodenal diverticula were observed more frequently in woman than in man but in diverticula of the esophagus, stomach, small bowel and colon, male was more frequently affected. 5. The size of diverticula of the entire gastrointestinal tract was variable. The majority of diverticula of the esophagus, stomach, duodenum and small bowel were intermediate in size (10-49 mm). Diverticula of

Нарушения гемодинамики и моторики при язвенной болезни желудкаи двенадцатиперстной кишки

OpenAIRE

Халимов, Э.; Сигал, З.

2003-01-01

Peculiarities of motility and blood flow in various parts of stomach and duodenum depending on ulcerous process localization are studied by the intraoperative transilluminational hemomotordynamic control method. In peptic ulcer the hemomotor-dynamic function of stomach and duodenum is disturbed and nature of these changes depends on ulcer localization. Unequal reduction of hemomotor-dynamic function in all parts of stomach explains development of peptic ulcer. Peculiarities of hemo-motordynam...

Gastroduodenal Morphology and Related Symptoms in Chronic Alcoholics

Directory of Open Access Journals (Sweden)

T. Hauge

1997-01-01

Full Text Available Twenty-four chronic alcoholics admitted to hospital for detoxification after a drinking spree were examined by upper gastrointestinal endoscopy. Biopsy specimens were taken from corpus/fundus, antrum and duodenum for tissue histology (eosin stain. From the duodenum villus index and ultrastructure (scanning electron microscopy, SEM were also performed. As a control group 12 subjectively healthy non-alcoholics referred to upper gastrointestinal endoscopy mainly for dyspepsia were chosen.

Annular pancreas in adult: a case report

International Nuclear Information System (INIS)

Moreira Neto, M.

1992-01-01

A case of a patient complaining of recurrent symptomatology of the upper abdomen and sub occlusion of the gastrointestinal tract with stenosis of the second portion of duodenum and mass evolving the head of pancreas at echographic study, confirmed by CT is presented. Contrasted oral studies confirmed that the mass evolved the stenotic segment, suggesting annular pancreas. Surgery confirmed the presence of annular pancreas surrounding the second portion of duodenum. (author)

Consolidating duodenal and small bowel toxicity data via isoeffective dose calculations based on compiled clinical data.

Science.gov (United States)

Prior, Phillip; Tai, An; Erickson, Beth; Li, X Allen

2014-01-01

To consolidate duodenum and small bowel toxicity data from clinical studies with different dose fractionation schedules using the modified linear quadratic (MLQ) model. A methodology of adjusting the dose-volume (D,v) parameters to different levels of normal tissue complication probability (NTCP) was presented. A set of NTCP model parameters for duodenum toxicity were estimated by the χ(2) fitting method using literature-based tolerance dose and generalized equivalent uniform dose (gEUD) data. These model parameters were then used to convert (D,v) data into the isoeffective dose in 2 Gy per fraction, (D(MLQED2),v) and convert these parameters to an isoeffective dose at another NTCP (D(MLQED2'),v). The literature search yielded 5 reports useful in making estimates of duodenum and small bowel toxicity. The NTCP model parameters were found to be TD50(1)(model) = 60.9 ± 7.9 Gy, m = 0.21 ± 0.05, and δ = 0.09 ± 0.03 Gy(-1). Isoeffective dose calculations and toxicity rates associated with hypofractionated radiation therapy reports were found to be consistent with clinical data having different fractionation schedules. Values of (D(MLQED2'),v) between different NTCP levels remain consistent over a range of 5%-20%. MLQ-based isoeffective calculations of dose-response data corresponding to grade ≥2 duodenum toxicity were found to be consistent with one another within the calculation uncertainty. The (D(MLQED2),v) data could be used to determine duodenum and small bowel dose-volume constraints for new dose escalation strategies. Copyright © 2014 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Technetium-99m BIDA biliary scintigraphy in the evaluation of the jaundiced patient

International Nuclear Information System (INIS)

Lee, A.W.; Ram, M.D.; Shih, W.J.; Murphy, K.

1986-01-01

Biliary scintigraphy using 99mTc p-butyl acetanilidiminodiacetic acid (BIDA) was performed as part of the diagnostic evaluation on 96 patients with jaundice (serum bilirubin greater than 2 mg/dl) to assess its value in this group of patients. The results of scintigraphy revealed no obstruction to the flow of the scintigraphic agent into the duodenum in 54 patients, delayed appearance of the agent (normal upper limit 60 min) in the duodenum indicating partial obstruction in 22 patients, and complete obstruction of the duct demonstrated by absence of agent in the duodenum in 20 patients. The findings were correlated with the final diagnosis and the overall results show accuracy of 92.7%, sensitivity of 97.3%, and specificity of 89.8%. Biliary scintigraphy was thus found to be useful in differentiating nonobstructive, partially obstructive, and completely obstructive causes of jaundice

Stereomicroscopic and ultrastructural characterization of propionitrile-induced duodenal ulcer in the rat

DEFF Research Database (Denmark)

Poulsen, Steen Seier

1978-01-01

Acute duodenal ulcer produced by subcutaneous injection of propionitrile in rats was studied by stereo, light, and electron microscopy in order to gain insight into the localization and mechanism of initial cell injury. Stereomicroscopy revealed an initial fissuring and splitting of the tips...... of the villus folds within 4 hours after two injections of propionitrile. This was followed by sloughing of the epithelium, shortening and effacement of the villus folds, and within 24 hours the appearance of discrete ulcers in the mucosa of the proximal duodenum. In most of the rats, two ulcers developed......: the first and larger ulcer was on the antimesenteric side of the duodenum, and the other, a small and more superficial one, was on the opposite wall. Ultrastructural lesions appeared in the absorptive epithelial cells of the proximal duodenum within 5 hours following a single dose of propionitrile...

[Endoscopic ultrasound guided rendezvous for biliary drainage].

Science.gov (United States)

Knudsen, Marie Høxbro; Vilmann, Peter; Hassan, Hazem; Karstensen, John Gésdal

2015-04-27

Endoscopic retrograde cholangiography (ERCP) is currently standard treatment for biliary drainage. Endoscopic ultrasound guided rendezvous (EUS-RV) is a novel method to overcome an unsuccessful biliary drainage procedure. Under endoscopic ultrasound guidance a guidewire is passed via a needle from the stomach or duodenum to the common bile duct and from there on to the duodenum enabling ERCP. With a relatively high rate of success EUS-RV should be considered as an alternative to biliary drainage and surgical intervention.

Deterioration of duodenal lymphangiectasia after radiotherapy for gastric MALT lymphoma

Science.gov (United States)

Iwamuro, Masaya; Tanaka, Takehiro; Kanzaki, Hiromitsu; Kawano, Seiji; Kawahara, Yoshiro; Iwasaki, Yoshiaki; Okada, Hiroyuki

2017-01-01

A 68-year-old Japanese woman underwent radiotherapy for gastric lymphoma. Although lymphangiectasia was sparsely observed in the second portion of the duodenum before radiotherapy, the number of pinpoint white spots obviously increased after the treatment. Although the duodenal lymphangiectasia gradually progressed, the patient had no features of protein-losing enteropathy. This case highlights the importance of endoscopic observation of the duodenum after irradiation to the abdomen as radiotherapy may secondarily cause intestinal lymphangiectasia. PMID:28798810

The intestinal leiomyoblastoma and its classification as benign or malignant neoplasm; Report on a rare case of benign multiple leiomyosarcoma finally developing into a malignant tumour. Intestinales Leiomyoblastom - gutartig oder boesartig; Der seltene Fall eines gutartigen Leiomyoblastoms mit dreifacher Lokalisation und einer protrahierten malignen Entartung

Energy Technology Data Exchange (ETDEWEB)

Beck, A. (Inst. fuer Roentgendiagnostik und Nuklearmedizin, Krankenanstalten Konstanz (Germany)); Lieke, M. (Abt. Roentgendiagnostik, Freiburg Univ. (Germany)); Mundinger, A. (Abt. Roentgendiagnostik, Freiburg Univ. (Germany)); Adler, H.P. (Pathologisches Inst., Freiburg Univ. (Germany))

1993-04-01

A symptom-causing duodenal stenosis diagnosed in a 47-year-old patient was found to be attributable to a malignant leiomyoblastoma. Ultrasonography, computerized tomography and MRI permitted a space-occupying process to be detected in the duodenum and a further tumour in the jejunum could be revealed by examinations of gastrointestinal transit. The presence of a total of three substantial tumours, one each in duodenum, jejunum and ileum, was however proven by angiography alone. (orig./MG)

Varioliform erosions in the stomach and duodenum

Energy Technology Data Exchange (ETDEWEB)

Lotz, W.; Schulz, D.; Munkel, G.

1984-04-01

One thousand five hundred and eighty-three patients who were x-rayed for dyspepsia showed varioliform erosions in 15.3%. Men had an incidence of 9.8%, almost twice as common as in women (5.5%). Mucosal polyps, usually of the hyperplastic type, occurred in 2.4%. 15% of patients with gastric ulcers and 16% of patients with duodenal ulcers had varioliform erosions. On the other hand, amongst patients with erosions, 11% had gastric ulcers and 8.3% duodenal ulcers. The definitions of erosion which have been given in the literature are partly contradictory, and are discussed. Varioliform erosions, also known as complete erosions, may be acute or chronic. They are the third most common cause of bleeding from the upper gastrointestinal tract. With modern radiological methods of examining the stomach, they are no longer a rare finding. 5 figs.

Varioliform erosions in the stomach and duodenum

International Nuclear Information System (INIS)

Lotz, W.; Schulz, D.; Munkel, G.

1984-01-01

One thousand five hundred and eighty-three patients who were x-rayed for dyspepsia showed varioliform erosions in 15.3%. Men had an incidence of 9.8%, almost twice as common as in women (5.5%). Mucosal polyps, usually of the hyperplastic type, occurred in 2.4%. 15% of patients with gastric ulcers and 16% of patients with duodenal ulcers had varioliform erosions. On the other hand, amongst patients with erosions, 11% had gastric ulcers and 8.3% duodenal ulcers. The definitions of erosion which have been given in the literature are partly contradictory, and are discussed. Varioliform erosions, also known as complete erosions, may be acute or chronic. They are the third most common cause of bleeding from the upper gastrointestinal tract. With modern radiological methods of examining the stomach, they are no longer a rare finding. (orig.) [de

"Ductal adenocarcinoma in anular pancreas".

Science.gov (United States)

Benassai, Giacomo; Perrotta, Stefano; Furino, Ermenegildo; De Werra, Carlo; Aloia, Sergio; Del Giudice, Roberto; Amato, Bruno; Vigliotti, Gabriele; Limite, Gennaro; Quarto, Gennaro

2015-09-01

The annular pancreas is a congenital anomaly in which pancreatic tissue partially or completely surrounds the second portion of the duodenum. Its often located above of papilla of Vater (85%), rarely below (15%). This pancreatic tissue is often easily dissociable to the duodenum but there is same cases where it the tissue is into the muscolaris wall of the duodenum. We describe three case of annular pancreas hospitalized in our facility between January 2004 and January 2009. There were 2 male 65 and 69 years old respectively and 1 female of 60 years old, presented complaining of repeated episodes of mild epigastric pain. Laboratory tests (including tumor markers), a direct abdomen X-ray with enema, EGDS and total body CT scan were performed to study to better define the diagnosis. EUS showed the presence of tissue infiltrating the muscle layer all around the first part of duodenum. Biopsies performed found the presence of pancreatic tissue with focal areas of adenocarcinoma. Subtotal gastrectomy with Roux was performed. The histological examinations shows an annular pancreas of D1 with multiple focal area of adenocarcinoma. (T1aN0M0). We performed a follow up at 5 years. One patients died after 36 months for cardiovascular hit. Two patients, one male and one female, was 5-years disease-free. Annular pancreas is an uncommon congenital anomaly which usually presents itself in infants and newborn. Rarely it can present in late adult life with wide range of clinical severities thereby making its diagnosis difficult. Pre-operative diagnosis is often difficult. CT scan can illustrate the pancreatic tissue encircling the duodenum. ERCP and MRCP are useful in outlining the annular pancreatic duct. Surgery still remains necessary to confirm diagnosis and bypassing the obstructed segment. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Tumor-like tuberculosis

International Nuclear Information System (INIS)

Kim, Soon Yong

1975-01-01

It was known that some of the abdominal tuberculosis can produce tumor-like appearance clinically and radiologically. But these were mainly masses formed in mesenteric and retroperitoneal lymph nodes. The author has experienced the gastrointestinal tuberculosis resembling to a neoplastic process. In the gastric tuberculosis, irregular narrowing and filling defect with mucosal distortion and occasional shoulder effect could be seen in pyloric antrum. Deformity of proximal portion of duodenum was noted in most cases. Difficulty in differential diagnosis from the gastric cancer might be encountered. If duodenum was not involved. No definite sign of mucosal destruction involved area and associated deformity of duodenum was suggestive of an inflammatory lesion. If there is any tuberculous changes in small bowel, than gastric tuberculosis is more likely. There was the tuberculosis of descending duodenum or pancreaticoduodenal group of lymph nodes revealed cancer-like appearance. Long irregular narrowing with nodular filling defect and mucosal distortion or inverted 3 sign was evident. Differential diagnosis from cancer in duodenum or pancreas could not be made radiographically. Short annular stenosis and nodular filling defect with shoulder effect in both ends of stenosis was noted in some of small bowel tuberculosis. The findings were very resemble to malignancy. There was a case of huge hepatoma-like tuberculosis formed a large irregular mass by lymph nodes and adjacent organs. Chest film was not much help in the differential diagnosis. In many cases of the gastrointestinal tuberculosis, radiological findings were resembled to a neoplastic process. Since none of radiologic findings are specific enough to allow one to make a definitive diagnosis of the gastrointestinal tuberculosis and since type of the gastrointestinal tuberculosis could be cured by chemotherapy, careful analyzation of clinical features is emphasized before surgery.

Xanthophylls increased HDLC level and nuclear factor PPARγ, RXRγ and RARα expression in hens and chicks.

Science.gov (United States)

Gao, Y-Y; Jin, L; Peng, H; Xu, L-H; Wang, Q-X; Ji, J; Wang, C-K; Bi, Y-Z

2018-02-01

This study was designed to investigate effects of xanthophylls on serum lipid profile (triglyceride, TG; cholesterol, CHO; high-density lipoprotein cholesterol, HDLC; and low-density lipoprotein cholesterol, LDLC) and nuclear factor (peroxisome proliferator-activated receptor gamma, PPARγ; PPAR gamma coactivator 1 alpha, PGC1α; retinoid X receptor gamma, RXRγ; and retinoic acid receptor alpha, RARα) gene expression of breeding hens and chicks. In experiment 1, 432 hens were divided into three groups and fed diets supplemented with 0 (as control group), 20 or 40 mg/kg xanthophylls. Blood was sampled at 7, 14, 21, 28 and 35 days of trial. Liver, duodenum, jejunum and ileum were sampled at 35 days of trial. Results showed that serum HDLC level of hens was increased after dietary 40 mg/kg xanthophyll addition for 21, 28 and 35 days, while serum TG, CHO and LDLC were not affected. Xanthophyll addition also increased PPARγ expression in jejunum, RXRγ expression in duodenum and jejunum, and RARα expression in liver and duodenum. Experiment 2 was a 2 × 2 factorial design. Male chicks hatched from 0 or 40 mg/kg xanthophyll diet of hens were fed diet containing either 0 or 40 mg/kg xanthophylls. Liver, duodenum, jejunum and ileum were sampled at 0, 7, 14 and 21 days after hatching. Blood samples were also collected at 21 days. Results showed that in ovo xanthophylls elevated PPARγ in duodenum and jejunum, and RXRγ and RARα in liver of chicks mainly within 1 week after hatching, while dietary xanthophylls increased serum HDLC level and PPARγ and RXRγ in liver from 2 weeks onwards. In conclusion, our research suggested xanthophylls can regulate serum lipid profile and nuclear factor expression in hens and chicks. © 2017 Blackwell Verlag GmbH.

Tumor-like tuberculosis

Energy Technology Data Exchange (ETDEWEB)

Kim, Soon Yong [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

1975-06-15

It was known that some of the abdominal tuberculosis can produce tumor-like appearance clinically and radiologically. But these were mainly masses formed in mesenteric and retroperitoneal lymph nodes. The author has experienced the gastrointestinal tuberculosis resembling to a neoplastic process. In the gastric tuberculosis, irregular narrowing and filling defect with mucosal distortion and occasional shoulder effect could be seen in pyloric antrum. Deformity of proximal portion of duodenum was noted in most cases. Difficulty in differential diagnosis from the gastric cancer might be encountered. If duodenum was not involved. No definite sign of mucosal destruction involved area and associated deformity of duodenum was suggestive of an inflammatory lesion. If there is any tuberculous changes in small bowel, than gastric tuberculosis is more likely. There was the tuberculosis of descending duodenum or pancreaticoduodenal group of lymph nodes revealed cancer-like appearance. Long irregular narrowing with nodular filling defect and mucosal distortion or inverted 3 sign was evident. Differential diagnosis from cancer in duodenum or pancreas could not be made radiographically. Short annular stenosis and nodular filling defect with shoulder effect in both ends of stenosis was noted in some of small bowel tuberculosis. The findings were very resemble to malignancy. There was a case of huge hepatoma-like tuberculosis formed a large irregular mass by lymph nodes and adjacent organs. Chest film was not much help in the differential diagnosis. In many cases of the gastrointestinal tuberculosis, radiological findings were resembled to a neoplastic process. Since none of radiologic findings are specific enough to allow one to make a definitive diagnosis of the gastrointestinal tuberculosis and since type of the gastrointestinal tuberculosis could be cured by chemotherapy, careful analyzation of clinical features is emphasized before surgery.

Imaging of common bile duct by linear endoscopic ultrasound

Institute of Scientific and Technical Information of China (English)

Malay; Sharma; Amit; Pathak; Abid; Shoukat; Chittapuram; Srinivasan; Rameshbabu; Akash; Ajmera; Zeeshn; Ahamad; Wani; Praveer; Rai

2015-01-01

Imaging of common bile duct(CBD) can be done by many techniques. Endoscopic retrograde cholangiopancreaticography is considered the gold standard for imaging of CBD. A standard technique of imaging of CBD by endoscopic ultrasound(EUS) has not been specifically described. The available descriptions mention different stations of imaging from the stomach and duodenum. The CBD lies closest to duodenum and choice of imaging may be restricted to duodenum for many operators. Generally most operators prefer multi station imaging during EUS and the choice of selecting the initial station varies from operator to operator. Detailed evaluation of CBD is frequently the main focus of imaging during EUS and in such situations multi station imaging with a high-resolution ultrasound scanner may provide useful information. Examination of the CBD is one of the primary indications for doing an EUS and it can be done from five stations:(1) the fundus of stomach;(2) body of stomach;(3) duodenal bulb;(4) descending duodenum; and(5) antrum. Following down the upper 1/3rd of CBD can do imaging of entire CBD from the liver window and following up the lower 1/3rd of CBD can do imaging of entire CBD from the pancreatic window. This article aims at simplifying the techniques of imaging of CBD by linear EUS.

Dosimetric benefit of adaptive re-planning in pancreatic cancer stereotactic body radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Li, Yongbao [Department of Engineering Physics, Tsinghua University, Key Laboratory of Particle & Radiation Imaging (Tsinghua University), Ministry of Education, Beijing (China); Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX (United States); Hoisak, Jeremy D.P.; Li, Nan; Jiang, Carrie [Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Tian, Zhen [Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX (United States); Gautier, Quentin; Zarepisheh, Masoud [Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Wu, Zhaoxia; Liu, Yaqiang [Department of Engineering Physics, Tsinghua University, Key Laboratory of Particle & Radiation Imaging (Tsinghua University), Ministry of Education, Beijing (China); Jia, Xun [Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX (United States); and others

2015-01-01

Stereotactic body radiotherapy (SBRT) shows promise in unresectable pancreatic cancer, though this treatment modality has high rates of normal tissue toxicity. This study explores the dosimetric utility of daily adaptive re-planning with pancreas SBRT. We used a previously developed supercomputing online re-planning environment (SCORE) to re-plan 10 patients with pancreas SBRT. Tumor and normal tissue contours were deformed from treatment planning computed tomographies (CTs) and transferred to daily cone-beam CT (CBCT) scans before re-optimizing each daily treatment plan. We compared the intended radiation dose, the actual radiation dose, and the optimized radiation dose for the pancreas tumor planning target volume (PTV) and the duodenum. Treatment re-optimization improved coverage of the PTV and reduced dose to the duodenum. Within the PTV, the actual hot spot (volume receiving 110% of the prescription dose) decreased from 4.5% to 0.5% after daily adaptive re-planning. Within the duodenum, the volume receiving the prescription dose decreased from 0.9% to 0.3% after re-planning. It is noteworthy that variation in the amount of air within a patient's stomach substantially changed dose to the PTV. Adaptive re-planning with pancreas SBRT has the ability to improve dose to the tumor and decrease dose to the nearby duodenum, thereby reducing the risk of toxicity.

Xanthophyll supplementation reduced inflammatory mediators and apoptosis in hens and chicks.

Science.gov (United States)

Gao, Y-Y; Jin, L; Ji, J; Sun, B-L; Xu, L-H; Wang, Q-X; Wang, C-K; Bi, Y-Z

2016-05-01

This study investigated effects of xanthophylls (containing 40% lutein and 60% zeaxanthin) on gene expression of inflammatory mediators ( [] and []) and apoptosis ( [] and ) of breeding hens and chicks. In Exp. 1, 432 hens were divided into 3 groups and fed diets supplemented with 0 (as the control group), 20, or 40 mg/kg xanthophylls. The liver, duodenum, jejunum, and ileum were sampled after 35 d. Results showed that 40 mg/kg of xanthophyll addition decreased in the liver, in the liver and duodenum, and in the liver and jejunum while increasing level in the liver and jejunum. Experiment 2 was a 2 × 2 factorial design. Male chicks hatched from hens fed 0 or 40 mg/kg xanthophyll diets were fed diets containing either 0 or 40 mg/kg xanthophylls. The liver, duodenum, jejunum, and ileum were sampled at 0, 7, 14, and 21 d after hatching. Results showed that in ovo xanthophylls reduced inflammatory mediators and apoptosis in the liver, duodenum, and jejunum of chicks mainly within 1 wk after hatching, whereas dietary xanthophylls only decreased expression in the liver from 2 wk onward. These results underlined important anti-inflammatory and antiapoptotic effects of maternal but not progeny dietary xanthophylls. In conclusion, xanthophylls can suppress inflammatory mediators and apoptosis in different tissues of hens and chicks.

Travmatik pankreatoduodenal yaralanmalarda acil Whipple ameliyatı ne kadar güvenlidir?

OpenAIRE

Kumar, Navin; Rehmani, Babar; Verma, R. K.

2014-01-01

Whipple ameliyatı, endoskopi sırasındaki duodenum travmaları, kanamalı duodenal tümörler ve pankreas-duodenum travmalarında acil şartlarda yapılması gerekebilir. Bu durumda morbidite ve mortalite oranı yüksektir. Bu yazıda, travmaya bağlı olarak grade 4 pankreatikoduodenal yaralanma oluşan bir hastada başarılı bir şekilde yapılan Whipple ameliyatlı bir hasta sunulmuştur.

[Persistent duodenal septum in an adult].

Science.gov (United States)

Helwing, E; Echtermeyer, V; Otten, G

1977-02-01

A case of duodenal obstruction by a congenital duodenal web in a 34-year-old woman is presented. A mucosal diaphragm obstructed the duodenum. It showed an excentric opening of 0.8 cm diameter, but the dilated diaphragm caused a total stop during the last months. Despite a typical history, exact X-ray, and endoscopic examination, the correct preoperative diagnosis was not found, because nobody thought it possible, that a mucosal diapharm of the duodenum could persist for 34 years.

Congenital Membrane Causing Duodenal Obstruction and Malpositioning of the Descending Colon

Directory of Open Access Journals (Sweden)

Chee-Chee Koh

2013-08-01

Full Text Available A congenital membrane without intestinal malrotation is a rare cause of duodenal obstruction. Here we present an 11-year-old girl who had suffered from intermittent abdominal cramping pain and vomiting for more than 5 years. The image studies, including a plain abdomen roentgenogram and sonogram, showed no definite diagnosis. The upper gastrointestinal series and small bowel series showed the contrast was static over the third portion of the duodenum and the descending colon pulled up toward the epigastric area. Laparoscopic exploration revealed a congenital membrane extending from the right-side paraduodenal peritoneum through the third portion of the duodenum to the descending colon, which had caused obstruction of the third portion of the duodenum and malpositioning of the descending colon. To the best of our knowledge, this is the first case report in the literature where a congenital membrane caused both duodenal obstruction and malpositioning of the descending colon.

Transfer of terpenes from essential oils into cow milk

DEFF Research Database (Denmark)

Lejonklev, J.; Løkke, M.M.; Larsen, M.K.

2013-01-01

The objective of this study was to investigate the transfer of volatile terpenes from caraway seed and oregano plant essential oils into cow's milk through respiratory and gastrointestinal exposure. Essential oils have potential applications as feed additives because of their antimicrobial...... properties, but very little work exists on the transfer of their volatile compounds into milk. Lactating Danish Holstein cows with duodenum cannula were used. Gastrointestinal exposure was facilitated by infusing the essential oils, mixed with deodorized sesame oil, into the duodenum cannula. Two levels were...

Anti-ulcer Activity.

Science.gov (United States)

2016-01-01

This chapter explains the procedure of ethanol-induced ulcer to check the protective effect of drugs over induced ulcer in rats. Ulcer is defined as the erosion in the lining of the stomach or duodenum and is caused by the disruptions of the gastric mucosal defence and repair systems. Ulceration of stomach is called gastric ulcer and that of duodenum is called duodenal ulcer and together peptic ulcer. In clinical practice, peptic ulcer is one of the most prevalent gastrointestinal disorders, which commonly occurs in developed countries.

Intestinal lymphangiectasia associated with recurrence of histiocytosis X.

Science.gov (United States)

Hui, C K

2011-09-01

Intestinal lymphangiectasia may occur as a primary congenital disorder or a secondary disorder. Secondary lymphangiectasia could be associated with diseases such as abdominal carcinoma, retroperitoneal fibrosis or chronic pancreatitis. This is the first reported case of intestinal lymphangiectasia associated with recurrent histiocytosis X. This case report illustrates the need for more prospective, well-designed studies to determine the natural history and outcome of intestinal lymphangiectasia in the duodenum. Hopefully, these studies will also help clinicians identify which group of patients with intestinal lymphangiectasia in the duodenum is more likely to have a secondary cause.

Calcium absorption in vitamin D deficient chickens using radiocalcium as tracer

International Nuclear Information System (INIS)

Sasangka, Bintara Her

1984-01-01

An experiment to study the absorption of calcium through the duodenum of vitamin D deficient chickens was conducted using radiocalcium as tracer. In this experiment twenty chickens were reared from one day old chicken until one month and maintained on rachitogenic diet. Vitamin D was given to ten chickens orally fourty eight hours prior to the administration of radiocalcium. The result of this experiment indicated that the absorption of calcium in the duodenum was higher in chickens provided with vitamin D compared to those without vitamin D (P≤0.01). (author)

Influence of hydrocolloidal silver nanoparticles on gastrointestinal microflora and morphology of enterocytes of quails

DEFF Research Database (Denmark)

Sawosz, Ewa; Binek, Marian; Grodzik, Marta

2007-01-01

The objective of the present study was to examine the effects of hydrocolloidal silver nanoparticles (Ag-nano) on microbial profile of caecum and morphology of enterocytes in duodenum of Japanese quail, as a model animal for poultry. Quails (Coturnix coturnix japonica) (10 d old) were randomly...... killed and samples of duodenum and caeca microflora were collected. This initial investigation demonstrated that silver nanoparticles did not influence emphatically microflora of quail caecum; however, water containing 25 mg/kg of Ag-nano significantly increased the population of lactic acid bacteria...

Peculiarities of roentgenosemiotics of ulcerous disease in different age groups

International Nuclear Information System (INIS)

Kinoshenko, Yu.T.; Reztsova, N.S.

1984-01-01

Roentgenomorphological and functional signs of stomach and duodenum ulcer disease was studied in different age groups in 382 patients that were subjected to a complex of clinico-laboratory and roentgenological examinations. It is concluded that in different age groups ulcerous disease of stomach and duodenum is characterized by a considerable peculiarities of roengenomorphologic characters. In some age groups disclosed are characteristic symptomocomplexes of roentgenofunctional shifts typical of ulcers of different localisations. It is shown that there is a regular relation between the type of functional shifts, age of a patient and location of ulcers

Pathophysiological analysis of hepatobiliary function on sup(99m)Tc-labeled-cholescintigram

Energy Technology Data Exchange (ETDEWEB)

Oyama, K; Hayashi, S; Kogure, T; Hirakawa, K; Akaike, A [Tokyo Univ. (Japan). Faculty of Medicine

1979-05-01

sup(99m)Tc-pylidoxylideneisoleucine (PI) was injected into 106 patients in order to study the mechanism of bile accumulation in the gallbladder in analysis of the visualization time of the gallbladder, intrahepatic bile duct, common bile duct and duodenum on sup(99m)Tc-PI cholescintigrams relating to hepatobiliary function. In cases of normal hepatobiliary function, sup(99m)Tc-PI is rapidly cleared from the blood by hepatocytes and is rapidly excreted through the biliary tree into the duodenum. The common bile duct was seen within 15 min of injection in 93.5% of the patients, the gallbladder within 20 min in 80.8%, the intrahepatic bile duct within 20 min in 96.3%, and the duodenum within 30 min in 58%. Marked accumulation of sup(99m)Tc-PI was noted in the gallbladder within 30 min. In cases of hepatobiliary dysfunction, the duodenum is visualized earlier than the gallbladder and intrahepatic bile duct, and the visualization ratio of the gallbladder and intrahepatic bile duct is decreased with an increased degree of hepatobiliary dysfunction. In regard to serum bilirubin level, the gallbladder was seen up to 3.5 mg%, the intrahepatic bile duct up to 4.0 mg% and the common bile duct up to 22.6 mg%. The duodenum was seen in all but two cases of complete obstruction of the common bile duct. In regard to meal time, marked accumulation of sup(99m)Tc-PI in the gallbladder was seen within 30 min and re-dilatation was seen with in 90 min after the beginning of contraction. In cases of normal hepatobiliary function, the gallbladder was seen in over 70% of the cases more than two hours after meals. This study shows that the hepatobiliary tract can be easily imaged by sup(99m)Tc-PI in proportion to hepatobiliary function and that this agent may be useful in the diagnosis of abnormal hepatobiliary tract and the jaundiced patient with hyperbilirubinemias. (Bell, E.).

Intestinal mucosa development in broiler chickens fed natural growth promoters

Directory of Open Access Journals (Sweden)

ERL Pelicano

2005-12-01

Full Text Available This study evaluated the use of probiotics and prebiotics on the histological and morphological indexes of the intestinal mucosa of broilers at 21 days of age. Thirty-six birds were randomly distributed in a 3 x 3 factorial arrangement, considering 3 probiotics and prebiotics sources in the diet. There were 9 treatments with 4 repetitions. Diet treatments were: 1 - Control (without growth promoters; 2 - Bacillus subtilis-based probiotic (Pro 1; 3 - Probiotic (Pool based on Lactobacillus acidophilus and casei, Streptococcus lactis and faecium, Bifidobacterium bifidum and Aspergillus oryzae (Pro 2; 4 - Prebiotic based on Phosphorylated Mannanoligosaccharide (MOS and Organic Acidifier (OA (Pre 1; 5 - MOS-based prebiotic (Pre 2; 6 - Pro 1 + Pre 1; 7 - Pro 1 + Pre 2; 8 - Pro 2 + Pre 1; 9 - Pro 2 + Pre 2. Higher villus height (VH (p<0.01 were seen in the duodenum of birds fed diets without prebiotics, whereas birds fed Bacillus subtilis-based probiotic and birds fed prebiotic based on MOS and OA showed higher VH (p<0.01 in jejunum and ileum. Greater crypt depths (CD (p<0.01 were observed in the duodenum, jejunum and ileum of birds receiving B. subtilis, and in the duodenum and jejunum of birds fed diets without prebiotics. Significant interaction (p<0.01 between the evaluated factors was seen for both, VH and CD, in the three intestinal portions. Greater VH was obtained in duodenum, jejunum and ileum with the use of probiotics and prebiotics and greater CD with the use of probiotics, in relation to the control group. There was no difference in villus density (VD between birds fed diets without additives or diets containing probiotics and prebiotics. Nevertheless, there was a significant interaction (p<0.05 between the evaluated factors for VD in the duodenum. Concluding, beneficial effects were seen in histological indexes of the intestinal mucosa with the use of probiotics and prebiotics at 21 days of age.

Duodenal ileus caused by a calf feeding nipple in a cow

Directory of Open Access Journals (Sweden)

Gerspach Christian

2011-01-01

Full Text Available Abstract Background The aim of this report was to describe duodenal obstruction caused by a rubber foreign body in a cow. Case Presentation The clinical, biochemical and ultrasonographic findings in a five-year-old Swiss Braunvieh cow with duodenal ileus caused by a calf feeding nipple are described. The main clinical signs were anorexia, ruminal tympany, decreased faecal output and abomasal reflux syndrome. Ultrasonographic examination revealed reticular hyperactivity and a dilated duodenum. A diagnosis of duodenal ileus was made and the cow underwent right-flank laparotomy, which revealed a dilation of the cranial part of the duodenum because of obstruction by a pliable foreign body. This was identified via enterotomy as a calf feeding nipple. The cow was healthy at the time of discharge four days after surgery and went on to complete a successful lactation. Conclusions To our knowledge, this is the first description of duodenal obstruction by a calf feeding nipple. This is an interesting case, which broadens the spectrum of the causes of duodenal ileus, which is usually caused by obstruction of the duodenum by a phytobezoar.

Intermittent fasting modulates IgA levels in the small intestine under intense stress: a mouse model.

Science.gov (United States)

Lara-Padilla, Eleazar; Godínez-Victoria, Marycarmen; Drago-Serrano, Maria Elisa; Reyna-Garfias, Humberto; Arciniega-Martínez, Ivonne Maciel; Abarca-Rojano, Edgar; Cruz-Hernández, Teresita Rocío; Campos-Rodríguez, Rafael

2015-08-15

Intermittent fasting prolongs the lifespan and unlike intense stress provides health benefits. Given the role of the immunoglobulin A (IgA) in the intestinal homeostasis, the aim of this study was to assess the impact of intermittent fasting plus intense stress on secretory IgA (SIgA) production and other mucosal parameters in the duodenum and ileum. Two groups of six mice, with intermittent fasting or fed ad libitum for 12weeks, were submitted to a session of intense stress by a bout of forced swimming. Unstressed ad libitum fed or intermittently fasted groups were included as controls. After sacrifice, we evaluated intestinal SIgA and plasma adrenal hormones, lamina propria IgA+ plasma-cells, mRNA expression of polymeric immunoglobulin receptor, α- and J-chains in the liver and intestinal mucosa, as well as pro- (tumor necrosis factor-α, interleukin-6 and Interferon-γ) and anti- (interleukin-2, -4, -10 and transforming growth factor-β) inflammatory cytokines in mucosal samples. Under intense stress, intermittent fasting down- or up-modulated the levels of most parameters in the duodenum and ileum, respectively while up-regulated corticosterone levels without affecting epinephrine. Our data suggest intermittent fasting plus intense stress elicited neuroendocrine pathways that differentially controlled IgA and pIgR expression in duodenum and ileum. These findings provide experimental foundations for a presumable impact of intermittent fasting under intense stress on the intestinal homeostasis or inflammation by triggering or reducing the IgA production in ileum or duodenum respectively. Copyright © 2015 Elsevier B.V. All rights reserved.

Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer

Energy Technology Data Exchange (ETDEWEB)

Lens, Eelco, E-mail: e.lens@amc.uva.nl; Horst, Astrid van der; Versteijne, Eva; Tienhoven, Geertjan van; Bel, Arjan

2015-07-01

Purpose: The midventilation (midV) approach can be used to take respiratory-induced pancreatic tumor motion into account during radiation therapy. In this study, the dosimetric consequences for organs at risk and tumor coverage of using a midV approach compared with using an internal target volume (ITV) were investigated. Methods and Materials: For each of the 18 patients, 2 treatment plans (25 × 2.0 Gy) were created, 1 using an ITV and 1 using a midV approach. The midV dose distribution was blurred using the respiratory-induced motion from 4-dimensional computed tomography. The resulting planning target volume (PTV) coverage for this blurred dose distribution was analyzed; PTV coverage was required to be at least V{sub 95%} >98%. In addition, the change in PTV size and the changes in V{sub 10Gy}, V{sub 20Gy}, V{sub 30Gy}, V{sub 40Gy}, D{sub mean} and D{sub 2cc} for the stomach and for the duodenum were analyzed; differences were tested for significance using the Wilcoxon signed-rank test. Results: Using a midV approach resulted in sufficient target coverage. A highly significant PTV size reduction of 13.9% (P<.001) was observed. Also, all dose parameters for the stomach and duodenum, except the D{sub 2cc} of the duodenum, improved significantly (P≤.002). Conclusions: By using the midV approach to account for respiratory-induced tumor motion, a significant PTV reduction and significant dose reductions to the stomach and to the duodenum can be achieved when irradiating pancreatic tumors.

Duodenal and ileal glucose infusions differentially alter gastrointestinal peptides, appetite response, and food intake: a tube feeding study.

Science.gov (United States)

Poppitt, Sally D; Shin, Hyun Sang; McGill, Anne-Thea; Budgett, Stephanie C; Lo, Kim; Pahl, Malcolm; Duxfield, Janice; Lane, Mark; Ingram, John R

2017-09-01

Background: Activation of the ileal brake through the delivery of nutrients into the distal small intestine to promote satiety and suppress food intake provides a new target for weight loss. Evidence is limited, with support from naso-ileal lipid infusion studies. Objective: The objective of the study was to investigate whether glucose infused into the duodenum and ileum differentially alters appetite response, food intake, and secretion of satiety-related gastrointestinal peptides. Design: Fourteen healthy male participants were randomly assigned to a blinded 4-treatment crossover, with each treatment of single-day duration. On the day before the intervention (day 0), a 380-cm multilumen tube (1.75-mm diameter) with independent port access to the duodenum and ileum was inserted, and position was confirmed by X-ray. Subsequently (days 1-4), a standardized breakfast meal was followed midmorning by a 90-min infusion of isotonic glucose (15 g, 235 kJ) or saline to the duodenum or ileum. Appetite ratings were assessed with the use of visual analog scales (VASs), blood samples collected, and ad libitum energy intake (EI) measured at lunch, afternoon snack, and dinner. Results: Thirteen participants completed the 4 infusion days. There was a significant effect of nutrient infused and site (treatment × time, P appetite, and decreased ad libitum EI at a subsequent meal. Although glucose to the duodenum also suppressed appetite ratings, eating behavior was not altered. This trial was registered at www.anzctr.org.au as ACTRN12612000429853. © 2017 American Society for Nutrition.

Evidence against a systemic humoral factor controlling the intestinal compensatory response following X-irradiation

International Nuclear Information System (INIS)

Sharp, J.G.; Osborne, J.W.; Iowa Univ., Iowa City

1981-01-01

The investigation was devised to determine whether changes noted in the unirradiated duodenum and colon of single rats after X-irradiation of only the exteriorized rat jejunum and ileum are mediated by a systemic humoral factor. Littermate Holtzman male rats were joined in parabiosis and one month later, the temporarily exteriorized jejunum and ileum of one member was exposed to 1.000 R of 250 kVp X-irradiation. Two days after X-irradiation, and 1, 12 and 24 h after 1 μCi/g bodyweight 3 H-thymidine was injected i.p. rats were sacrificed and appropriate tissues removed. Single rats which had the exteriorized jejunum and ileum irradiated were studied from 1-3 days after irradiation. Crypt cell migration rates were determined employing autoradiography. Tritium content and columnar cell migration rate in duodenum and colon of unirradiated rats compared to irradiated rats indicated that irradiation of one member of the pair had no effect on tritium incorporation or epithelial cell migration in the duodenum or colon of the unirradiated partner. Epithelial cell proliferation and crypt cell migration were increased in unirradiated duodenum and colon of single intestine-irradiated rats. Essentially the same changes were seen in the irradiated member of a parabiotic pair, but none of these changes were noted in the unirradiated member. The absence of stimulation in the unirradiated parabiont suggests that either a systemic humoral factor is not present after X-irradiation or is not present in sufficient concentration to be detected by these methods. (orig./MG)

Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer

International Nuclear Information System (INIS)

Lens, Eelco; Horst, Astrid van der; Versteijne, Eva; Tienhoven, Geertjan van; Bel, Arjan

2015-01-01

Purpose: The midventilation (midV) approach can be used to take respiratory-induced pancreatic tumor motion into account during radiation therapy. In this study, the dosimetric consequences for organs at risk and tumor coverage of using a midV approach compared with using an internal target volume (ITV) were investigated. Methods and Materials: For each of the 18 patients, 2 treatment plans (25 × 2.0 Gy) were created, 1 using an ITV and 1 using a midV approach. The midV dose distribution was blurred using the respiratory-induced motion from 4-dimensional computed tomography. The resulting planning target volume (PTV) coverage for this blurred dose distribution was analyzed; PTV coverage was required to be at least V 95% >98%. In addition, the change in PTV size and the changes in V 10Gy , V 20Gy , V 30Gy , V 40Gy , D mean and D 2cc for the stomach and for the duodenum were analyzed; differences were tested for significance using the Wilcoxon signed-rank test. Results: Using a midV approach resulted in sufficient target coverage. A highly significant PTV size reduction of 13.9% (P<.001) was observed. Also, all dose parameters for the stomach and duodenum, except the D 2cc of the duodenum, improved significantly (P≤.002). Conclusions: By using the midV approach to account for respiratory-induced tumor motion, a significant PTV reduction and significant dose reductions to the stomach and to the duodenum can be achieved when irradiating pancreatic tumors

CT of the stomach and duodenum. Pt. 1

International Nuclear Information System (INIS)

Ziedses des Plantes, B.G. Jr.; Falke, T.H.M.; Tjon Tjauw Liem, B.

1983-01-01

A survey is provided of the CT appearance of the normal and postoperative stomach based on a retrospective study on 262 patients. The results were compared with those of conventional barium meal examination. Detailed understanding of the CT anatomy of the normal and postoperative stomach, as well as familarity with the usual pitfalls, are imperative to guarantee correct interpretation of pathology. (orig.)

Investigation of protein digestibility and amino acid absorption in different segments of porcine digestive tract. 5

International Nuclear Information System (INIS)

Krawielitzki, K.; Voelker, T.; Hennig, U.; Wuensche, J.; Bock, H.D.; Zebrowska, T.; Buraczewska, L.

1979-01-01

In 4 pigs (live weight 63 kg) with re-entrance cannulae in the duodenum as well as in the ileocecal region intake, excretion and flow rate of protein, methionine and 35 S were measured after supplementary oral application of 35 S-methionine to a wheat-wheat gluten-lysine diet and a protein-free diet, respectively, over a period of 7 days. For both the N and the methionine metabolism patterns were outlined according to the measured values and with the aid of a compartment model. The endogenous and exogenous levels of proteins and methionine in the duodenum, ileum and feces were estimated

Method of reinfusion of UV-irradiated autoblood in the treatment of peptic ulcer

International Nuclear Information System (INIS)

Murashko, V.V.; Sklyarova, M.A.; Shakhidul, Kh.; Gilis, R.Ya.; Karandashov, V.I.

1989-01-01

Efficiency of the reinfusion method for autoblood irradiated by UV-rays during the treatment of 40 patients with peptic ulcer of duodenum and 8 patients with peptic ulcer of stomach is studied. It isestablished that the method above promotes the fast improvement of state of health in patients, the normalization of sleep, appetite, the disappearance of asthenias, aches and the reduction of time of ulcer cicatrization up to 14±4 days. It is supposed that high efficiency of the method is caused by the improvement of microcirculation and trophicity of mucous membrane of stomach and duodenum

Rare Case of Duodenal Metastasis From Pulmonary Squamous Cell Carcinoma

Directory of Open Access Journals (Sweden)

Zain Memon DO

2017-10-01

Full Text Available Pulmonary squamous cell carcinoma is the second most common non–small cell malignancy of the lung. It commonly metastasizes to the adrenal glands, bone, liver, brain, and kidneys. Most occurrences of metastatic squamous cell carcinoma involving the gastrointestinal tract originate from primary lung tumors. Metastasis to the duodenum, however, is exceedingly rare, with very few cases of stomach or duodenal involvement described in the literature. We report the case of a patient with stage IV pulmonary squamous cell carcinoma metastasizing to the duodenum with an uncommon presentation to add to the paucity of literature available regarding this rare finding.

SU-D-BRA-06: Duodenal Interfraction Motion with Abdominal Compression

International Nuclear Information System (INIS)

Witztum, A; Holyoake, D; Warren, S; Partridge, M; Hawkins, M

2016-01-01

Purpose: To quantify the effect of abdominal compression on duodenal motion during pancreatic radiotherapy. Methods: Seven patients treated for pancreatic cancer were selected for analysis. Four patients were treated with abdominal compression and three without. The duodenum was contoured by the same physician on each CBCT (five CBCTs for patients with compression, four for non-compression patients). CBCTs were rigidly registered using a soft tissue match and contours were copied to the delivered plans which were all radical (BED > 50 Gy). The distance between the duodenum on the planning CT and each CBCT was quantified by calculating the root mean square (RMS) distance. The DVHs of each abdominal compression patient was converted to an EQD2 DVH (alpha/beta = 10) using an in-house tool and volumes receiving at least 25, 35, 45, and 50 Gy were recorded. Results: The maximum variation in duodenal volumes on the CBCTs for the four abdominal compression patients were 19.1 cm 3 (32.8%), 19.1 cm 3 (20.6%), 19.9 cm 3 (14.3%), and 12.9 cm 3 (27.3%) compared to 15.2 cm 3 (17.6%), 34.7 cm 3 (83.4%), and 56 cm 3 (60.2%) for non-compression patients. The average RMS distance between the duodenum on the planning CT and each CBCT for all abdominal compression patients was 0.3 cm compared to 0.7 cm for non-compressed patients. The largest (and average) difference between the planning CT and CBCTs in volume of duodenum receiving more than 25, 35, 45 and 50 Gy for abdominal compression patients was 11% (5%), 9% (3%), 9% (2%), and 6% (1%). Conclusion: Abdominal compression reduces variation in volume and absolute position of the duodenum throughout treatment. This is seen as an improvement but does not eliminate the need to consider dosimetric effects of motion. Abdominal compression is particularly useful in SBRT when only a few fractions are delivered. Alon Witztum is supported by an MRC/Gray Institute DPhil Studentship. Daniel Holyoake is supported by a CRUK/Nuffield Clinical

SU-D-BRA-06: Duodenal Interfraction Motion with Abdominal Compression

Energy Technology Data Exchange (ETDEWEB)

Witztum, A; Holyoake, D; Warren, S; Partridge, M; Hawkins, M [CRUK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford (United Kingdom)

2016-06-15

Purpose: To quantify the effect of abdominal compression on duodenal motion during pancreatic radiotherapy. Methods: Seven patients treated for pancreatic cancer were selected for analysis. Four patients were treated with abdominal compression and three without. The duodenum was contoured by the same physician on each CBCT (five CBCTs for patients with compression, four for non-compression patients). CBCTs were rigidly registered using a soft tissue match and contours were copied to the delivered plans which were all radical (BED > 50 Gy). The distance between the duodenum on the planning CT and each CBCT was quantified by calculating the root mean square (RMS) distance. The DVHs of each abdominal compression patient was converted to an EQD2 DVH (alpha/beta = 10) using an in-house tool and volumes receiving at least 25, 35, 45, and 50 Gy were recorded. Results: The maximum variation in duodenal volumes on the CBCTs for the four abdominal compression patients were 19.1 cm{sup 3} (32.8%), 19.1 cm{sup 3} (20.6%), 19.9 cm{sup 3} (14.3%), and 12.9 cm{sup 3} (27.3%) compared to 15.2 cm{sup 3} (17.6%), 34.7 cm{sup 3} (83.4%), and 56 cm{sup 3} (60.2%) for non-compression patients. The average RMS distance between the duodenum on the planning CT and each CBCT for all abdominal compression patients was 0.3 cm compared to 0.7 cm for non-compressed patients. The largest (and average) difference between the planning CT and CBCTs in volume of duodenum receiving more than 25, 35, 45 and 50 Gy for abdominal compression patients was 11% (5%), 9% (3%), 9% (2%), and 6% (1%). Conclusion: Abdominal compression reduces variation in volume and absolute position of the duodenum throughout treatment. This is seen as an improvement but does not eliminate the need to consider dosimetric effects of motion. Abdominal compression is particularly useful in SBRT when only a few fractions are delivered. Alon Witztum is supported by an MRC/Gray Institute DPhil Studentship. Daniel Holyoake is

Re-description of a genetically typed, single oocyst line of the turkey coccidium, Eimeria dispersa Tyzzer, 1929.

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El-Sherry, S; Ogedengbe, M E; Hafeez, M A; Sayf-Al-Din, M; Gad, N; Barta, J R

2017-10-01

The Briston strain of Eimeria dispersa Tyzzer, 1929 was isolated originally from a commercial turkey flock from Briston, Norfolk, UK. A single oocyst-derived line of E. dispersa was propagated and used to re-describe biological and morphological features of E. dispersa in the turkey. Oocysts of the Briston strain measured 26 ± 1.1 μm (24-28) by 21 ± 1 μm (19-23); these were larger than oocysts described originally by Tyzzer in 1929 (22.75 by 18.84 μm) but within dimensions (26.07 by 21.04 μm) reported by Hawkins (1952) in his description of E. dispersa isolated from turkeys. In the present study, endogenous development started mainly in duodenum and upper jejunum and then spread down toward the lower jejunum. A few parasites were detected in the ileum beginning 96 h post-infection; only few gamonts were observed in the cecal neck area at 120 h, and no parasites were detected in cecal pouches or rectum. Four asexual generations were observed before the start of gametogony, and only one large type of first generation meront was detected in duodenum and upper jejunum at 32 h. This strain has a prepatent period of 120 h. The Briston strain of E. dispersa is a mildly pathogenic coccidium. Duodenum and jejunum of infected birds were slightly dilated and paler in color than of uninfected controls. There was whitish green mucoid material in the lumen of the duodenum and jejunum. The mucosa looked slightly congested and edematous with a few scattered petechial hemorrhages.

[Surgical treatment of rare combination of intestinal malrotation with secondary lymphangiectasia].

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Morozov, D A; Pimenova, E S; Tatochenko, V K; Bakradze, M D; Gadliya, D D; Morozova, O L; Talalaev, A G

2015-01-01

The rare combination of intestinal lymphangiectasia with malrotation of the duodenum in a child of three months of life is described. Basing on the literature review only 3 similar cases were described in the world practice. The boy with protein-losing enteropathy was examined at Moscow Scientific Centre of Children's Health. The child had vomiting, diarrhea, loss in body weight, hypoproteinemia, lymphopenia. The infectious nature of the disease was excluded. It had been suggested the Waldman desease (primary intestinal lymphangiectasia). The prognosis for such disease is unfavorable. An examination of the child was continued against the backdrop of ongoing symptomatic therapy. Complete physical examination included monitoring laboratory blood tests, X-ray examination with contrast, CT-scan, gastroduodenoscopy with biopsy of the mucosa of the small intestine. Malrotation duodenum with the recurrent mid-gut volvulus with the development of secondary intestinal lymphangiectasia was diagnosed. Modern methods of examination and multidisciplinary approach made it possible to diagnose the case. Operation to eliminate fixation duodenum resulted in the recovery of the patient. At the present time the child grows and develops according to age and does not require treatment. The prognosis for this disease is regarded as favorable.

Surgical Strategy in Bouveret's Syndrome. A Case Report

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Dénes Márton István

2016-06-01

Full Text Available Bouveret's syndrome is a high mechanical obstruction due to impaction of a gallstone into the duodenum, through a cholecystoduodenal fistula. It belongs to a larger group of gallstone ileus, a disease which occurs after developing a fistula between the gallbladder and the gastrointestinal tract. This is a rare complication of gallstones but because it appears in elderly people, it has a high morbidity and mortality. Patients have various symptoms and the treatment is individualized. We present here a case of a 67 years old patient, admitted in emergency, presenting symptoms of high bowel obstruction, with onset 5 days before admission. Abdominal ultrasound reveals a 5 cm stone that seems to be in the gallbladder, gastric stasis and at gastroscopy appears a foreign body impacted in the duodenum. After a short preparation the patient underwent surgery. We found a dilated stomach and a large cholecystoduodenal fistula with an impacted gallstone in the duodenum. We performed one stage surgery: cholecystectomy, extraction of the stone and suturing of the fistula. We reestablished the continuity of the intestinal tract. We performed also an ileostomy for feeding the patient and protecting the anastomoses. The postoperative evolution was favorable.

Needle catheter duodenostomy: a technique for duodenal alimentation of birds.

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Goring, R L; Goldman, A; Kaufman, K J; Roberts, C; Quesenberry, K E; Kollias, G V

1986-11-01

A technique for duodenal alimentation (needle catheter duodenostomy) of birds was developed, using the domestic pigeon (Columba livia) as the experimental model. A needle catheter was inserted into the descending duodenum of 5 pigeons and was secured to the body wall and dorsum of each bird. A liquid diet was administered daily (in equal amounts of 0, 4, 8, 12, and 16 hours) for 14 days without adverse effects. On day 15, the catheters were removed, and the birds immediately resumed normal consumption of a pigeon ration and water diet. Although 4 of the 5 birds had minor weight loss, dietary alterations probably could be used on an individual basis to alleviate this problem. After oral alimentation was resumed, the 5 birds exceeded their initial body weight within 7 days. Four weeks after catheter removal, positive-contrast radiographic evaluations indicated that the duodenum of each pigeon appeared normal. Needle catheter duodenostomy was a viable method of alimentation in the domestic pigeon. This technique should be applicable for other avian species requiring bypass of the upper gastrointestinal tract proximal to the region of catheter insertion in the duodenum.

Initiation of the migrating myoelectric complex in dogs.

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Bueno, L; Rayner, V; Ruckebusch, Y

1981-01-01

1. Contractile and spike activity in the conscious dog were recorded from strain gauge force transducers and electrodes chronically implanted on the antrum, duodenum and jejunum. The pattern of activity was related to the time elapsed after feeding a daily meal, both in intact dogs and in dogs with antro-jejunal or oesophago-duodenal anastomoses. 2. From 8 to 10 h after feeding, transient reductions of the continuous antral spiking activity were recorded while phases of regular spiking activity (RSA) and contractions developed on the proximal intestine. 3. About 18 h after feeding, the post-prandial antral activity became intermittent, each period of contractions being accompanied by the duodenal development of a RSA phase. 4. The RSA phases were still initiated on the duodenum after an antro-jejunal anastomosis and after gastrectomy. 5. It is concluded that phases of RSA of the migrating myoelectric complex are initiated in the proximal part of the small intestine rather than in the stomach. It is suggested that the RSA phase exerts an inhibitory effect on the antrum which may serve to reduce the flow of digesta through the pylorus when the ability of the duodenum to receive chyme is restricted. PMID:7320868

[Surgical tactics in duodenal trauma].

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Ivanov, P A; Grishin, A V

2004-01-01

Results of surgical treatment of 61 patients with injuries of the duodenum are analyzed. The causes of injuries were stab-incised wounds in 24 patients, missile wound -- in 7, closed abdominal trauma -- in 26, trauma of the duodenum during endoscopic papillosphincterotomy -- in 4. All the patients underwent surgery. Complications were seen in 32 (52.5%) patients, 21 patients died, lethality was 34.4%. Within the first 24 hours since the trauma 7 patients died due to severe combined trauma, blood loss, 54 patients survived acute period of trauma, including 28 patients after open trauma, 26 -- after closed and 4 -- after trauma of the duodenum during endoscopic papillosphincterotomy. Diagnostic and surgical policies are discussed. Results of treatment depending on kind and time of surgery are regarded. It is demonstrated that purulent complications due to retroperitoneal phlegmona, traumatic pancreatitis, pneumonia are the causes of significant number of unfavorable outcomes. Therefore, it is important to adequately incise and drainage infected parts of retroperitoneal fat tissue with two-lumen drainages. Decompression through duodenal tube is the effective procedure for prophylaxis of suture insufficiency and traumatic pancreatitis. Suppression of pancreatic and duodenal secretion with octreotid improves significantly surgical treatment results.

NSAID gastropathy and enteropathy: distinct pathogenesis likely necessitates distinct prevention strategies.

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Wallace, John L

2012-01-01

The mechanisms underlying the ability of nonsteroidal anti-inflammatory drugs (NSAIDs) to cause ulceration in the stomach and proximal duodenum are well understood, and this injury can largely be prevented through suppression of gastric acid secretion (mainly with proton pump inhibitors). In contrast, the pathogenesis of small intestinal injury induced by NSAIDs is less well understood, involving more complex mechanisms than those in the stomach and proximal duodenum. There is clear evidence for important contributions to NSAID enteropathy of enteric bacteria, bile and enterohepatic recirculation of the NSAID. There is no evidence that suppression of gastric acid secretion will reduce the incidence or severity of NSAID enteropathy. Indeed, clinical data suggest little, if any, benefit. Animal studies suggest a significant exacerbation of NSAID enteropathy when proton pump inhibitors are co-administered with the NSAID. This worsening of damage appears to be linked to changes in the number and types of bacteria in the small intestine during proton pump inhibitor therapy. The distinct mechanisms of NSAID-induced injury in the stomach/proximal duodenum versus the more distal small intestine likely dictate distinct strategies for prevention. © 2011 The Author. British Journal of Pharmacology © 2011 The British Pharmacological Society.

Simplified pancreatoduodenectomy for complex blunt pancreaticoduodenal injury

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FENG Xin-fu

2013-10-01

Full Text Available 【Abstract】A 34-year-old man admitted to our department with complex blunt pancreaticoduodenal injury after a car accident. The wall of the first, second, and third portions of the duodenum was extensively lacerated, and the pancreas was longitudinally transected along the superior mesenteric vein-portal vein trunk. The pancreatic head and the uncinate process were devitalized and the distal common bile duct and the proximal main pancreatic duct were completely detached from the Vater ampulla. The length of the stump of distal common bile located at the cut surface of remnant pancreas was approximately 0.6 cm. A simplified Kausch-Whipple’s procedure was performed after debridement of the devitalized pancreatic head and resection of the damaged duodenum in which the stump of distal common bile duct and the pancreatic remnant were embedded into the jejunal loop. Postoperative wound abscess appeared that eventually recovered by conservative treatment. During 16 months follow-up the patient has been stable and healthy. A simplified pancreaticoduodenectomy is a safe alternative for the Whipple procedure in managing complex pancreaticoduodenal injury in a hemodynamically stable patient. Key words: Pancreaticoduodenectomy; Abdominal injuries; Pancreas; Duodenum

EFSA CEF Panel (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2015. Scientific Opinion on Flavouring Group Evaluation 208 Revision 1 (FGE.208Rev1): Consideration of genotoxicity data on representatives for 10 alicyclic aldehydes with the a,b-unsaturation in ring / side-chain and precursors from chemical subgroup 2.2 of FGE.19

DEFF Research Database (Denmark)

Beltoft, Vibe Meister; Nørby, Karin Kristiane

genotoxicity studies on p-mentha-1,8-dien-7-al [FL-no: 05.117], the representative substance for FGE.19 subgroup 2.2. This substance was tested in vivo in a combined micronucleus assay in bone marrow and Comet assay in liver and duodenum. It did not induce any increase in micronucleated polychromatic...... erythrocytes of the bone marrow of male rats in the micronucleus test and it did not induce DNA damage in duodenum of the same animals as analysed by the Comet assay. The Comet assay performed in liver shows a positive result and therefore the Panel concluded that p-mentha-1,8-dien-7-al [FL-no: 05...

Application of genomic densitometry for calculating the relative population of Escherichia Coli in the intestine of broiler chicks

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A.R Seidavi

2009-05-01

Full Text Available In this study, the densitometry technique for calculating of the relative population of Escherichia coli in various segments of the intestine of broiler chicks was evaluated. Following preparation of the intestinal contents, the process of extraction and purification of DNA from the contents of duodenum, jejunum, ileum and cecum was undertaken. A specific polymerase chain reaction (PCR using two pairs of primers was employed to detect Escherichia coli and total bacteria present in the gastrointestinal tract of the chicks. Specific bands of E.coli were obtained using densitometry and Gel Proc Analyzer software based on linear regression with extrapolation. E.coli populations at different ages were also determined in various segments of the gastrointestinal tract of the chicks. The Results of this experiment indicated that 0.000004%, 0.07%, 0.64% and 2.51% of total bacteria present in the duodenum, jejunum, ileum and cecum respectively consisted of E.coli. Also, E.coli constitutes 1.76, 0.01 and 0.80% of the total intestinal bacteria of chicks at 4, 14 and 30 days of age respectively. Furthermore, it was shown that at 4 days of age, 0.30, 2.05 and 3.97% of the total bacteria present in the jejunum, ileum and cecum respectively were from E.coli species and this bacteria was absent in the duodenum. At 14 days of age these figures were 0.000009%, 0.00011% and 0.08% respectively while at 30 days of age 0.00011%, 0.009% and 2.40% of all bacteria in the duodenum, ileum and cecum were E.coli species and this bacteria was absent in the jejunum. In conclusion, the densitometry method based on PCR results can be regarded as a useful tool for densitometry the relative population E.coli in the gastrointestinal tract of poultry.

A dosimetric comparison of proton and photon therapy in unresectable cancers of the head of pancreas

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Thompson, Reid F.; Zhai, Huifang; Both, Stefan; Metz, James M.; Plastaras, John P.; Ben-Josef, Edgar, E-mail: Edgar.Ben-Josef@uphs.upenn.edu [University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Mayekar, Sonal U. [Thomas Jefferson University, Philadelphia, Pennsylvania 19107 (United States); Apisarnthanarax, Smith [University of Washington, Seattle, Washington 98109 (United States)

2014-08-15

Purpose: Uncontrolled local growth is the cause of death in ∼30% of patients with unresectable pancreatic cancers. The addition of standard-dose radiotherapy to gemcitabine has been shown to confer a modest survival benefit in this population. Radiation dose escalation with three-dimensional planning is not feasible, but high-dose intensity-modulated radiation therapy (IMRT) has been shown to improve local control. Still, dose-escalation remains limited by gastrointestinal toxicity. In this study, the authors investigate the potential use of double scattering (DS) and pencil beam scanning (PBS) proton therapy in limiting dose to critical organs at risk. Methods: The authors compared DS, PBS, and IMRT plans in 13 patients with unresectable cancer of the pancreatic head, paying particular attention to duodenum, small intestine, stomach, liver, kidney, and cord constraints in addition to target volume coverage. All plans were calculated to 5500 cGy in 25 fractions with equivalent constraints and normalized to prescription dose. All statistics were by two-tailed paired t-test. Results: Both DS and PBS decreased stomach, duodenum, and small bowel dose in low-dose regions compared to IMRT (p < 0.01). However, protons yielded increased doses in the mid to high dose regions (e.g., 23.6–53.8 and 34.9–52.4 Gy for duodenum using DS and PBS, respectively; p < 0.05). Protons also increased generalized equivalent uniform dose to duodenum and stomach, however these differences were small (<5% and 10%, respectively; p < 0.01). Doses to other organs-at-risk were within institutional constraints and placed no obvious limitations on treatment planning. Conclusions: Proton therapy does not appear to reduce OAR volumes receiving high dose. Protons are able to reduce the treated volume receiving low-intermediate doses, however the clinical significance of this remains to be determined in future investigations.

Tracing of the Bile-chemotactic migration of juvenile Clonorchis sinensis in rabbits by PET-CT.

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Tae Im Kim

2011-12-01

Full Text Available BACKGROUND: Adult Clonorchis sinensis live in the bile duct and cause clonorchiasis. It is known that the C. sinensis metacercariae excyst in the duodenum and migrate up to the bile duct through the common bile duct. However, no direct evidence is available on the in vivo migration of newly excysted C. sinensis juveniles (CsNEJs. Advanced imaging technologies now allow the in vivo migration and localization to be visualized. In the present study, we sought to determine how sensitively CsNEJs respond to bile and how fast they migrate to the intrahepatic bile duct using PET-CT. METHODOLOGY/PRINCIPAL FINDINGS: CsNEJs were radiolabeled with (18F-fluorodeoxyglucose ((18F-FDG. Rabbits with a gallbladder contraction response to cholecystokinin-8 (CCK-8 injection were pre-screened using cholescintigraphy. In these rabbits, gallbladders contracted by 50% in volume at an average of 11.5 min post-injection. The four rabbits examined were kept anesthetized and a catheter inserted into the mid duodenum. Gallbladder contraction was stimulated by injecting CCK-8 (20 ng/kg every minute over the experiment. Anatomical images were acquired by CT initially and dynamic PET was then carried out for 90 min with a 3-min acquisition per frame. Twelve minutes after CCK-8 injection, about 3,000 (18F-FDG-labeled CsNEJs were inoculated into the mid duodenum through the catheter. Photon signals were detected in the liver 7-9 min after CsNEJs inoculation, and these then increased in the whole liver with stronger intensity in the central area, presenting that the CsNEJs were arriving at the intrahepatic bile ducts. CONCLUSION: In the duodenum, CsNEJs immediately sense bile and migrate quickly with bile-chemotaxis to reach the intrahepatic bile ducts by way of the ampulla of Vater.

Supplementation of xanthophylls decreased proinflammatory and increased anti-inflammatory cytokines in hens and chicks.

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Gao, Yu-Yun; Xie, Qing-Mei; Jin, Ling; Sun, Bao-Li; Ji, Jun; Chen, Feng; Ma, Jing-Yun; Bi, Ying-Zuo

2012-11-28

The present study investigated the effects of xanthophylls (containing 40 % of lutein and 60 % of zeaxanthin) on proinflammatory cytokine (IL-1β, IL-6, interferon (IFN)-γ and lipopolysaccharide-induced TNF-α factor (LITAF)) and anti-inflammatory cytokine (IL-4 and IL-10) expression of breeding hens and chicks. In Expt 1, a total of 432 hens were fed diets supplemented with 0 (as the control group), 20 or 40 mg/kg xanthophylls (six replicates per treatment). The liver, duodenum, jejunum and ileum were sampled at 35 d of the trial. The results showed that both levels of xanthophyll addition decreased IL-1β mRNA in the liver and jejunum, IL-6 mRNA in the liver, IFN-γ mRNA in the jejunum and LITAF mRNA in the liver compared to the control group. Expt 2 was a 2 × 2 factorial design. Male chicks hatched from 0 or 40 mg/kg xanthophyll diet of hens were fed a diet containing either 0 or 40 mg/kg xanthophylls. The liver, duodenum, jejunum and ileum were collected at 0, 7, 14 and 21 d after hatching. The results showed that in ovo xanthophylls decreased proinflammatory cytokine expression (IL-1β, IL-6, IFN-γ and LITAF) in the liver, duodenum, jejunum and ileum and increased anti-inflammatory cytokine expression (IL-4 and IL-10) in the liver, jejunum and ileum mainly at 0-7 d after hatching. In ovo effects gradually vanished and dietary effects began to work during 1-2 weeks after hatching. Dietary xanthophylls modulated proinflammatory cytokines (IL-1β, IL-6 and IFN-γ) in the liver, duodenum, jejunum and ileum and anti-inflammatory cytokine (IL-10) in the liver and jejunum mainly from 2 weeks onwards. In conclusion, xanthophylls could regulate proinflammatory and anti-inflammatory cytokine expression in different tissues of hens and chicks.

SURVIVAL OF MICROORGANISMS FROM MODERN PROBIOTICS IN MODEL CONDITIONS OF THE INTESTINE

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Kabluchko TV

2017-03-01

Full Text Available Introduction. The staye of intestinal microflora affects the work of the whole organism. When composition of normal ibtestine microflora changes, its restoration is required. In our days a wide variety of probiotic drugs are available on the market which can be used to solve this problem. Most bacteria having probiotic properties represent the families Lactobacillus and Bifidobacterium, which have poor resistance to acidic content of the stomach and toxic effects of bile salts. Various studies have clearly shown that in a person with normal acidic and bile secretion, the lactobacilli and bifidobacteria are not detected after the passage through the duodenum, i.e., they perish before reaching the small intestines. In this study we compared the survival of different microorganisms which are contained in 9 probiotic drugs in a model of gastric and intestinal environments. Material and methods. In the laboratory of SI: “Mechnikov Institute Microbiology and Immunology, National Ukrainian Academy Medical Sciences" the in vitro experiments have been evaluated to test the ability of different probiotic bacteria which were contained in 9 probiotic drugs to survive the impact of the model environment of the stomach and duodenum. Bacillus coagulans persistence was evaluated under impact of simulated environment of the stomach and duodenum, it also was assessed by the quantity of CFU by incubation on culture medium. The following were studied: Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus reuteri, Lactobacillus casei, Lactobacillus plantarum, Lactobacillus bulgaricus, Bifidobacterium bifidum, Bifidobacterium longum , Bifidobacterium breve, Bifidobacterium infantis, Bifidobacterium animalis subsp. Lactis BB-12, Saccharomyces boulardii, Bacillus coagulans, Bacillus clausii, Enterococcus faecium. Microorganisms were incubated for 3 hours in a model environment of the stomach (pepsin 3 g / l, hydrochloric acid of 160 mmol / l, pH 2

Ultrasonographic abdominal anatomy of healthy captive caracals (Caracal caracal).

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Makungu, Modesta; du Plessis, Wencke M; Barrows, Michelle; Koeppel, Katja N; Groenewald, Hermanus B

2012-09-01

Abdominal ultrasonography was performed in six adult captive caracals (Caracal caracal) to describe the normal abdominal ultrasonographic anatomy. Consistently, the splenic parenchyma was hyperechoic to the liver and kidneys. The relative echogenicity of the right kidney's cortex was inconsistent to the liver. The gall bladder was prominent in five animals and surrounded by a clearly visualized thin, smooth, regular echogenic wall. The wall thickness of the duodenum measured significantly greater compared with that of the jejunum and colon. The duodenum had a significantly thicker mucosal layer compared with that of the stomach. Such knowledge of the normal abdominal ultrasonographic anatomy of individual species is important for accurate diagnosis and interpretation of routine health examinations.

Characteristics of Clinico-pathologic Presentations of Chronic Gastroduodenitis in Children with Lambliasis Invasion

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Matveeva O.V.

2012-03-01

Full Text Available The analysis of anamnestic and clinical indices, and also morphological investigation of biopsy materials of mucous coat of stomach and duodenum in children with chronic gastroduodenitis of different etiology including lambliasis invasion is carried out with the purpose of detecting features of clinicopathologic presentations of chronic gastroduodenitis in children with and without lambliasis invasion. Material and methods. 100 patients (50 children with confirmed lambliasis invasion and 50 patients without lambliasis invasion aged from 2 up to 16 were under observation. The material for histologic study was received as a result of fibrogastroduodenoscopy carried out with target biopsy of fundic, antrum and duodenum mucosa. Results. As a result of the findings moderate pains sited in epigastric and periumbilical regions are characteristic for children with lambliasis invasion; irradiation and cramping characteristics of pains are typical. Conclusion. Manifestation of pains is not connected with the time of day and food intake, manifestation of seasonal prevalence is not typical as well, and progression of inflammatory process in the mucous coat of the stomach and duodenum is declared itself as a diffuse gastritis of the fundic part, a diffuse gastritis of the antral part, subatrophic duodenitis with cyst formation of Brunner's glands, and also the presence of eosinophilic leucocytes in the cellular infiltrate

Efek Penggunaan Sinbiotik Terhadap Kondisi Miklofora dan Histologi Usus Ayam Sentul Jantan

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Eko Fauzi Hartono

2016-10-01

ABSTRACT. Symbiotic is a combination of probiotic and prebiotic used to improve microflora in digestive system. This study aims to evaluate the symbiotic usage as a feed additive toward the number of lactic acid bacteria, Escherichia coli, the height and the width of villi. Treatment R0 = Diet control, R1 Natural Symbiotic (2%, R2 = Natural Symbiotic (4%, R3 = Natural Symbiotic (6%, R4 = Commercial Symbiotic (2%, R5 = Commercial Symbiotic (4%, R6 = Commercial Symbiotic (6%. Statistical analysis uses ANOVA (Analysis of Variant, while further test uses orthogonal contrast. The result showed that the given symbiotic was significantly (P<0,05 effect toward the condition of intestinal microflora, it increases the number of lactic acid bacteria and decreases Escherichia coli, as well as the treatment (P<0,05 toward histology of the height and the width of intestinal villi. As the conclusion, the use of 2% of natural symbiotic increases the amount of lactic acid bacteria in duodenum, jejunum, and ileum, but reduces Escherichia coli in ileum, the height of intestinal villi in duodenum and the width of intestinal villi in ileum, and administered 4% of commercial symbiotic increases the height of intestinal villi in duodenum, jejunum, ileum and the width of intestinal villi in ileum.

Glycopattern analysis of acidic secretion in the intestine of the red-eared slender turtle; Trachemys scripta elegans (Testudines: Emydidae).

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Scillitani, Giovanni; Mentino, Donatella; Mastrodonato, Maria

2017-10-01

The secretion of the goblet cells in the intestine of Trachemys scripta elegans was studied in situ by histochemical methods to analyze the diversity of sugar chains, with particular regard to the acidic glycans. Conventional histochemical stains (Periodic acid-Schiff, Alcian Blue pH 2.5, High Iron Diamine) and binding with ten FITC-labelled lectins combined with chemical and enzymatic pre-treatments were used to characterize the oligosaccharidic chains. The intestine can be divided into three regions, i.e. a duodenum, a small intestine and a large intestine. Goblet cells were observed in all the three tracts and presented an acidic secretion. WGA, LFA, PNA and SBA binding was observed only after desulfation. Glycans secreted by the three tracts consist mainly of sulfosialomucins with 1,2-linked fucose, mannosylated, glucosaminylated and subterminal galactosyl/galactosaminylated residuals. Differences among tracts are quantitative rather than qualitative, with sulfated, galactosaminylated and glycosaminylated residuals increasing from duodenum to large intestine, and galactosylated and fucosylated residuals showing an opposite trend. Variation is observed also between apices and bases of villi in both duodenum and small intestine, where sulphation decreases from the base to the apex and glycosylation shows an opposite trend. Functional implication of these findings is discussed in a comparative context. Copyright © 2017 Elsevier Ltd. All rights reserved.

Unusual Upper Gastrointestinal Bleeding due to Late Metastasis from Renal Cell Carcinoma: A Case Report

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Wen-Tsan Chang

2004-03-01

Full Text Available A case of recurrent massive upper gastrointestinal bleeding originating from metastatic renal cell carcinoma is reported. A 63-year-old woman underwent right nephrectomy 9 years previously and experienced no recurrence during follow-up. A gradually enlarging ulcerative tumor over the bulb of the duodenum and four subsequent episodes of massive bleeding from this tumor occurred between June 2001 and March 2002. The patient underwent surgery in April 2002 for intractable bleeding from the tumor. Renal cell carcinoma metastasis to the duodenum was confirmed from the surgical specimen. Upper gastrointestinal bleeding due to malignancy is very rare and the duodenum is the least frequently involved site. Furthermore, a solitary late renal cell carcinoma metastasis 9 years after a nephrectomy is extremely uncommon. This case suggests that life-long follow-up of renal cell carcinoma patients is necessary, owing to unpredictable behavior and the possibility of long disease-free intervals. In nephrectomized patients suffering from gastrointestinal bleeding, complete evaluation, especially endoscopic examination, is indicated. The possibility of late recurrent renal cell carcinoma metastasis to the gastrointestinal tract should be kept in mind, although it is rare. If the patient is fit for surgery, metastatectomy is the first choice of treatment.

Infectious complications following duodenal and/or pancreatic trauma.

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Tyburski, J G; Dente, C J; Wilson, R F; Shanti, C; Steffes, C P; Carlin, A

2001-03-01

Patients with pancreatic and/or duodenal trauma often have a high incidence of infectious complications. In this study we attempted to find the most important risk factors for these infections. A retrospective review of the records of 167 patients seen over 7 years (1989 through 1996) at an urban Level I trauma center for injury to the duodenum and/or pancreas was performed. Fifty-nine patients (35%) had isolated injury to the duodenum (13 blunt, 46 penetrating), 81 (49%) had isolated pancreatic trauma (18 blunt, 63 penetrating), and 27 (16%) had combined injuries (two blunt, 25 penetrating). The overall mortality rate was 21 per cent and the infectious morbidity rate was 40 per cent. The majority of patients had primary repair and/or drainage as treatment of their injuries. Patients with pancreatic injuries (alone or combined with a duodenal injury) had a much higher infection rate than duodenal injuries. The patients with duodenal injuries had significantly lower penetrating abdominal trauma indices, number of intra-abdominal organ injuries, and incidence of hypothermia. On multivariate analysis independent factors associated with infections included hypothermia and the presence of a pancreatic injury. Although injuries to the pancreas and duodenum often coexist it is the pancreatic injury that contributes most to the infectious morbidity.

War, traffic and iatrogenic injuries of D3 duodenal segment

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Ignjatović Dragan

2005-01-01

Full Text Available Background. Injuries of the duodenum at the level of aortomesenteric clamp (segment D3 are with a high incidence of death due to the development of fistula and peritonitis. In three successfully managed cases, we applied the biliary surgery method. Case reports. All three cases were with the injuries of D3 duodenal segment. The first patient suffered from the blast perforation of duodenum at the level of the aortomesenteric clamp which occurred at the 7th day after the injury. The second patient suffered from the duodenal injury caused in a traffic accident. The third patient suffered from an iatrogenic injury at the beginning of D3 duodenal segment inflicted during ureterolithotomy. The described surgical procedure included basically the suture to narrow the site of the injury, then lateroterminal anastomosis with the Roux-en-Y jejunal flexure and, finally, the placement of a silicone prosthesis starting from the duodenum through the site of injury and the Roux-en-Y out. Octreotide and the total parenteral nutrition were administered to the patients postoperatively. Conclusion. The use of the releasing silicone prosthesis in all three patients provided the repair of the site of the injury with anastomosed Reux-en-Y jejunum.

Brunner’s Gland Hamartoma: A Rare Cause of Gastrointestinal Bleeding – Case Report and Review of the Literature

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David R Stolpman

2002-01-01

Full Text Available An unusual cause of upper gastrointestinal bleeding is described in a previously healthy 45-year-old man who was admitted to hospital with weakness and fatigue, and had experienced an episode of melena two days before admission. His medical and surgical history was unremarkable. Upon admission to hospital, he showed evidence of iron-deficiency anemia, with a hemoglobin concentration of 61 g/L (normal range 135 to 175 g/L, a mean corpuscular volume of 73 fL (normal range 85.0 to 95.0 fL and a ferritin concentration of 1.0 µg/L (normal range in males 15 to 400 µg/L. Upper gastrointestinal endoscopy revealed a 3.5 cm ulcerated submucosal mass in the third portion of the duodenum, for which mucosal biopsies were nondiagnostic. A subsequent endoscopic ultrasound revealed a 2.7×4.0 cm hyperechoic, cystic, submucosal tumour in the third portion of the duodenum. Endoscopic ultrasound-guided fine needle aspiration revealed no malignant cells. The patient eventually underwent a resection of the third portion of his duodenum. Surgical pathology revealed that this tumour was a Brunner’s gland hamartoma, 4.5 cm in its greatest dimension.

Gastric-emptying tests

International Nuclear Information System (INIS)

Brown, M.L.; Malagelada, J.R.

1983-01-01

Mechanisms regulating gastric emptying have been characterized through many decades of experimental work. Both central and peripheral mechanisms are important. Central mechanisms are related to the center of vomiting and are probably influenced by psychologic and emotional factors. Peripheral mechanisms are located at both sides of the pylorus. Gastric mechanisms are stimulatory and are triggered mainly by distention of the stomach, although hormonal mechanisms may also participate (gastrin). However, with complex, nutrient-containing meals, the intragastric volume is not the primary determinant of gastric emptying. Inhibitory mechanisms of the gut are more important. The key factors are the pH, osmolality, and nutrient content of the chyme being emptied into the duodenum. Osmotic and pH-sensitive receptors are thought to reside in the duodenum. On the other hand, receptors triggered by nutrients extend much more distally into the duodenum and are sensitive to nutrient composition and load. Protein, carbohydrates, and lipids all inhibit gastric emptying, although the lipids are probably the most potent inhibitors. If the duodenal load or the characteristics of the emptying material are not adequate, inhibitory mechanisms will reduce gastric emptying at the expense of expanding the intragastric volume. It is therefore not possible to dissociate postprandial gastric emptying from postprandial gastric secretion

Evaluation of the marker technique for measurement of exocrine pancreatic secretion rate

International Nuclear Information System (INIS)

Rune, S.J.; Worning, H.

1985-01-01

A secretin-cholecystokinin test was performed in 103 patients, representing both normal and reduced exocrine pancreatic function. The duodenum was intubated with a triple-lumen tube. The gastric and duodenal contents were aspirated separately and sampled in 10-min. periods. An inert, water-soluble marker ( 58 Co-vitamin B 12 dissolved in isotonic saline) was infused at a constant rate into the duodenum. Exocrine panreatic secretion was stimulated by continuous intravenous infusion of secretin for 60 min. and a combination of secretin and cholecystokinin for another 60 min. The total recovery of the infused marker was 80%. The concentration of marker in the aspriate did not vary significantly between consecutive 10-min. periods during the last 20 min. of the secretin stimulation period, or during the last 50 min. of the combined secretin-cholecystokinin stimulation period, indicating a steady secretion rate into the duodenum. By means of the marker, concentrations in the aspirate, the duodenal volumes were calculated and found to vary significantly less than the aspirated volumes. This finding demonstrates that the duodenal volume calculated from the recovery of an inert marker, is a closer estimate of the true volume than that obtained by the usual apsiration technique without a volume indicator

Intestinal permeability of forskolin by in situ single pass perfusion in rats.

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Liu, Zhen-Jun; Jiang, Dong-bo; Tian, Lu-Lu; Yin, Jia-Jun; Huang, Jian-Ming; Weng, Wei-Yu

2012-05-01

The intestinal permeability of forskolin was investigated using a single pass intestinal perfusion (SPIP) technique in rats. SPIP was performed in different intestinal segments (duodenum, jejunum, ileum, and colon) with three concentrations of forskolin (11.90, 29.75, and 59.90 µg/mL). The investigations of adsorption and stability were performed to ensure that the disappearance of forskolin from the perfusate was due to intestinal absorption. The results of the SPIP study indicated that forskolin could be absorbed in all segments of the intestine. The effective permeability (P (eff)) of forskolin was in the range of drugs with high intestinal permeability. The P (eff) was highest in the duodenum as compared to other intestinal segments. The decreases of P (eff) in the duodenum and ileum at the highest forskolin concentration suggested a saturable transport process. The addition of verapamil, a P-glycoprotein inhibitor, significantly enhanced the permeability of forskolin across the rat jejunum. The absorbed fraction of dissolved forskolin after oral administration in humans was estimated to be 100 % calculated from rat P (eff). In conclusion, dissolved forskolin can be absorbed readily in the intestine. The low aqueous solubility of forskolin might be a crucial factor for its poor oral bioavailability. © Georg Thieme Verlag KG Stuttgart · New York.

Programmed cell death and cell extrusion in rat duodenum

DEFF Research Database (Denmark)

Schauser, Kirsten; Larsson, Lars-Inge

2005-01-01

The small intestinal epithelium is continously renewed through a balance between cell division and cell loss. How this balance is achieved is uncertain. Thus, it is unknown to what extent programmed cell death (PCD) contributes to intestinal epithelial cell loss. We have used a battery...... of techniques detecting the events associated with PCD in order to better understand its role in the turnover of the intestinal epithelium, including modified double- and triple-staining techniques for simultaneously detecting multiple markers of PCD in individual cells. Only a partial correlation between TUNEL...... positivity for DNA fragmentation, c-jun phosphorylation on serine-63, positivity for activated caspase-3 and apoptotic morphology was observed. Our results show that DNA fragmentation does not invariable correlate to activation of caspase-3. Moreover, many cells were found to activate caspase-3 early...

Symptomatic Primary (AL Amyloidosis of the Stomach and Duodenum

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Reidar Fossmark

2013-01-01

Full Text Available Primary (AL amyloidosis of the gastrointestinal tract is relatively rare, and symptomatic amyloidosis of the stomach is even more seldom. We present the case of a patient who was referred to upper endoscopy because of weight loss, nausea, and vomiting. Large areas of intramucosal hemorrhages were seen, and biopsies resulted in profuse bleeding stopped with endoscopic clips. The biopsies showed amyloid depositions and further workup revealed that the patient also had cardiac and neuropathic involvements. The patient started treatment with dexamethasone, melphalan and bortezomib. After treatment was started the nausea and epigastric discomfort improved, and a reduction in the biochemical markers troponin T, NT-proBNP, and M-component was observed. Gastric amyloidosis is rarely seen at upper endoscopy in patients without a previously established diagnosis, but the unusual endoscopic findings and bleeding tendency after biopsy should be kept in mind by gastroenterologists.

Bile produced in the liver (image)

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... duct system that creates, transports, stores, and releases bile into the duodenum for digestion includes the liver, gallbladder, and bile ducts (named the cystic, hepatic, common, and pancreatic ...

Effects of dietary supplementation of Artemisia argyi aqueous extract on antioxidant indexes of small intestine in broilers.

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Zhao, Fei; Shi, Binlin; Sun, Dengsheng; Chen, Hongyan; Tong, Manman; Zhang, Pengfei; Guo, Xiaoyu; Yan, Sumei

2016-09-01

The present study was conducted to investigate the effect of Artemisia argyi aqueous extract (AAE) on antioxidant indexes in the small intestine. A total of 192 Arbor Acre broiler chickens (one-day-old) were randomly divided into 4 treatments with 6 replicates of 8 chickens. These 4 diets were formulated by adding 0, 500, 1,000 and 2,000 mg/kg AAE to the basal diet. The results showed as follows: 1) compared with the control, the total antioxidant capacity (T-AOC) in ileum for the 2,000 mg/kg treatment group was significantly increased at 21 days of age ( P  < 0.05); the T-AOC levels in jejunum and ileum were significantly increased in broilers supplemented with 500 mg/kg AAE at 42 days of age ( P  < 0.05), and the T-AOC levels in jejunum and ileum were significantly improved in 1,000 mg/kg treatment group ( P  < 0.01). 2) At 21 days of age, supplementation of 500 mg/kg AAE significantly increased the catalase (CAT) activity of small intestine, and the glutathione peroxidase (GSH-Px) activity of jejunum was improved ( P  < 0.01), meanwhile, the GSH-Px activity of duodenum and the total superoxide dismutase (T-SOD) activity of duodenum and jejunum were significantly higher than those of the control group ( P  < 0.05); supplementation of 1,000 mg/kg AAE significantly increased the CAT activity of duodenum and ileum and the GSH-Px activity of duodenum and jejunum ( P  < 0.05), and the ileum GSH-Px activity was significantly increased ( P  < 0.01); supplementation of 2,000 mg/kg AAE significantly increased the CAT activity of duodenum and ileum ( P  < 0.05). At 42 days of age, supplementation of 500 mg/kg AAE significantly increased the GSH-Px activity of ileum and the T-SOD activity of duodenum ( P  < 0.05), meanwhile, the T-SOD activity of jejunum was significantly increased ( P  < 0.01); supplementation of 1,000 mg/kg AAE significantly increased the CAT activity of jejunum and the T-SOD activity of ileum ( P  < 0.01), and the GSH

A Giant Brunneroma Causing Gastrointestinal Bleeding and Severe Anemia Requiring Transfusion and Surgery

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Nicola C. Frenkel

2017-01-01

Full Text Available Brunner’s gland hamartoma, also called hyperplasia, adenoma, and Brunneroma, is an extremely rare benign proliferative lesion of Brunner’s glands in the duodenum. While being mostly small and asymptomatic, they can result in gastrointestinal bleeding and obstruction. We report the case of a 54-year-old man presenting with melena and severe anemia requiring blood transfusion. CT scans showed a large mass of 8 cm in diameter, presumably arising in the duodenum. Endoscopic biopsies were not conclusive. As we were unable to determine the nature of the mass preoperatively and due to the severe symptoms, its size, and the uncertain malignant potential, a classic Whipple procedure was performed. The resected specimen showed extensive proliferation of Brunner’s glands without signs of malignancy.

Use of green fluorescent protein to monitor Lactobacillus plantarum in the gastrointestinal tract of goats.

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Han, Xufeng; Wang, Lei; Li, Wei; Li, Bibo; Yang, Yuxin; Yan, Hailong; Qu, Lei; Chen, Yulin

2015-01-01

The experiment aimed to specifically monitor the passage of lactobacilli in vivo after oral administration. The green fluorescent protein (GFP) gene was cloned downstream from the constitutive p32 promoter from L. lactis subsp. cremoris Wg2. The recombinant expression vector, pLEM415-gfp-p32, was electroporated into Lactobacillus plantarum (L. plantarum) isolated from goat. Green fluorescent protein (GFP) was successfully expressed in L. plantarum. After 2 h post-administration, transformed Lactobacillus could be detectable in all luminal contents. In the rumen, bacteria concentration initially decreased, reached the minimum at 42 h post-oral administration and then increased. However, this concentration decreased constantly in the duodenum. This result indicated that L. plantarum could colonize in the rumen but not in the duodenum.

[Successful repair of complete pancreatic rupture and subtotal duodenal avulsion after blunt abdominal trauma in childhood--a case report].

Science.gov (United States)

Knoop, M; Vorwerk, T

2003-03-01

We report the case of a 12-year-old boy who presented after a bicycle accident with handlebar injury of the epigastrium with clinical signs of hollow visceral injury and elevated pancreatic enzymes. Upon emergency laparotomy, a complete rupture of the pancreatic isthmus and a nearly total transsection of the postpyloric duodenum were encountered (Grade IV according to Lucas). Reconstruction consisted of reanastomosis of the proximal duodenum, closure of the distal end of the pancreatic head and internal drainage of the left pancreas into a Roux-en-Y jejunal loop. The postoperative course was uneventful. For rare traumatic pancreaticoduodenal lesions only individual surgical concepts are promising depending on the extent of damage. However, effort should be made to preserve as much pancreatic tissue as possible.

An Unusual Cause of Duodenal Obstruction: Persimmon Phytobezoar.

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Fan, Shengxian; Wang, Jing; Li, Yousheng

2016-12-01

Duodenal phytobezoar, an unusual cause of acute duodenal obstruction, is rarely seen. The most common cause of this type of bezoar is persimmon. It frequently arises from underlying gastrointestinal tract pathologies (gastric surgery, etc.). Here, we report the case of a 66-year-old man who had undergone distal gastrectomy with Billroth I reconstruction for gastric cancer and experienced severe epigastric discomfort, abdominal pain, and vomiting for a few days. The abdominal computed tomography scan showed a large-sized mass in the horizontal portion of the duodenum. On following endoscopic examination, a large phytobezoar was revealed in the duodenum. He was treated with endoscopic fragmentation combined with nasogastric Coca-Cola. The patient tolerated the procedure well and resumed a normal oral diet 3 days later.

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1Department of Surgery, Nelson R Mandela School of Medicine, College of Health Sciences, University of .... (closed). Fractured tibia. (compound). Duodenum. Small intestine. Bladder ... Inter-loop abscess .... management: a case series.

Acquired Duodenal Obstruction in Children

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Jen-Hung Chien

2008-10-01

Full Text Available Traumatic intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction in children, and a high degree of suspicion is therefore required to make an early and accurate diagnosis. We report a 6-year-old boy whose epigastrium was impacted by the handlebar of his bicycle during a traffic accident. The boy then experienced epigastralgia. Six days later, progressive bilious vomiting suggestive of gastrointestinal obstruction was noted. Imaging studies revealed a large hematoma extending from the fourth portion of the duodenum to the jejunum. Conservative methods of treatment failed to manage his condition. He underwent laparoscopic surgery to evacuate the hematoma. We also report a case of duodenal obstruction in a previously healthy 2-year-old girl who presented for the first time with acute symptoms of proximal intestinal obstruction. Contrast examinations showed apparent barium retention over the stomach and proximal duodenum. She underwent surgery due to persistent obstruction, and a mushroom-like foreign body was detected embedded in the orifice of the windsock duodenal web. After duodenoduodenostomy and removal of the bezoar, she had a smooth recovery and tolerated feeding well. We conclude that blunt abdominal trauma and incomplete duodenal obstruction, such as that caused by duodenal web, should be considered as possible causes of acquired proximal gastrointestinal obstruction in previously healthy children, despite their rarity.

Determination of nitrogen absorption and endogenous nitrogen secretion in the digestive tract of pigs fed with nitrogen-15-labelled dried whey

International Nuclear Information System (INIS)

Gebhardt, G.; Souffrant, W.; Koehler, R.; Zebrowska, T.

1977-01-01

Two fistulated pigs weighing between 15kg and 54kg were given experimental diets containing 15 N-labelled dried whey. The labelled experimental diets were given once only. Samples of the digesta were taken from the duodenum and terminal ileum at various intervals of time up to 48h after feeding the labelled protein feed. The digesta were separated into the four following fractions: Residue on centrifugation, proteins, peptides and free amino acids. The secretion of endogenous nitrogen in the duodenum was 12.5g/24h in pigs having a live weight of 50kg. The endogenous nitrogen was found to be relatively uniformly distributed among the four fractions. The rate of secretion of endogenous nitrogen showed a continuous decrease during 24h. The secretion of endogenous nitrogen in the terminal ileum was 54 to 60mg of nitrogen per kilogram live weight. After passage through the small intestine the greater part of the free amino acids in digesta was of exogenous origin. In the protein fraction most came from endogenous proteins. A true absorption of 17% of nitrogen was determined in the duodenum. The amount of nitrogen absorbed in the terminal part of the small intestine was, on average, 90% relative to the nitrogen intake. The true digestibility calculated with the amount of 15 N in food and faeces was 98%. (author)

Abdominal ultrasonographic manifestation of Henoch-schonlein purpura

International Nuclear Information System (INIS)

Eun, Hyo Won; Kim, Mi Sung; Kang, Beoung Chul; Lee, Sun Wha

1998-01-01

The purpose of this study was to describe the ultrasonographic features and assess the diagnostic value of sonography in the evaluation of children with Henoch-Schonlein purpura. Between October 1993, and Febuary 1998, 67 children with Henoch-Schonlein purpura underwent abdominal ultrasonography, which in 13 was used for follow up. Bowel wall thickness and location, pattern of color Doppler signal in the thickened bowel wall, the size and location of enlarged mesenteric lymph node and the presence of ascites were evaluated. In 42 cases(63%), sonographic findings were positive, and indicated mesenteric lymphadenopathy(n=3D21), small bowel wall thickening(n=3D20), and ascites(n=3D17). Thickened bowels were demonstrated at the ileum in 11 cases, the jejunum in five, the duodenum in one, and combined wall thickening at the duodenum and jejunum in two;thickening of the duodenum and ileum was seen in one case. Thickness varied from 3 to 10 mm(mean:6.5 mm). On follow-up sonography, regression of bowel wall thickening was observed earlier than that of mesenteric lymphadenopathy or ascites, and correlated well with improved abdominal symptoms. Abdominal ultrasonographic manifestations of Henoch-Schonlein purpura were bowel wall thickening, mesentric lymphadenopathy and ascites. Sonography was a simple and useful method for the evaluation of gastrointestinal manifestation of Henoch-Schonlein purpura.=20

A study on the angle between the abdominal aorta and the superior mesenteric artery by 3D image reconstruction

International Nuclear Information System (INIS)

Kim, Young Keun; Choi, Sung Kwan

2003-01-01

SMAS (Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum (transverse portion ), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP (maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software (Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05 ± 15.87 .deg. on average, and that the angle in men (53.64 ± 16.57 .deg.) is higher than in women (46.46 ± 14.98 .deg. ). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS

The use of dilute calogen[reg] as a fat density oral contrast medium in upper abdominal computed tomography, compared with the use of water and positive oral contrast media

International Nuclear Information System (INIS)

Ramsay, Duncan W.; Markham, Derrian H.; Morgan, Bruno; Rodgers, Peter M.; Liddicoat, Amanda J.

2001-01-01

AIM: Oral contrast media are commonly given prior to computed tomography (CT) examination of the upper abdomen. Although positive oral contrast media are normally used, there is increasing interest in using negative agents such as water and less commonly fat density products. The aim of this study was to compare a positive oral contrast medium, water, and a diluted emulsion of arachis oil (Calogen[reg], a fat density food supplement) for assessment of the upper abdomen. MATERIALS AND METHODS: Seventy-one patients referred for upper abdominal CT were randomized to receive either 500 ml water, 2% sodium diatrizoate or a dilute suspension of Calogen[reg]. The CT images were scored independently by three radiologists. Distension and anatomical identification was assessed for the stomach, duodenum and jejunum; with anatomical identification recorded for the pancreas, retroperitoneum, liver, gallbladder and spleen. RESULTS: Dilute Calogen[reg] produced a significant improvement (P < 0.01) in distension and anatomical visualization of the stomach and proximal duodenum. Only minimal differences were demonstrated between the three contrast media for visualization of more distal small bowel or identification of the other upper abdominal viscera. Significantly more artifacts were caused by positive contrast media than with the Calogen[reg] mixture. CONCLUSION: A dilute suspension of Calogen[reg] as an oral contrast medium is recommended when disease is suspected within the stomach or proximal duodenum. Ramsay, D.W. et al. (2001)

Adenocarcinoma arising in a heterotopic pancreas (Heinrich type III: a case report

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Egashira Yutaro

2010-02-01

Full Text Available Abstract Introduction Heterotopic pancreatic cancer in the duodenum is a very rare disease. Only twelve cases have been reported worldwide to date. We report a rare case of malignant transformation of heterotopic pancreas (Heinrich type III in the duodenum with long-term survival of the patient, and review the 12 cases in the literature. Case presentation A 75-year-old Japanese man was admitted to our hospital complaining of nausea and vomiting. Endoscopy and upper gastrointestinal contrast study showed marked duodenal stenosis. A pylorus-preserving pancreaticoduodenectomy was performed. Histopathological examination of the surgically resected specimen showed malignant transformation of heterotopic pancreas (Heinrich type III in the duodenum. The postoperative course was uneventful, and the patient was discharged from the hospital on postoperative day 30. He is well and shows no signs of recurrence at the time of writing, six years after the surgery. Conclusion Adenocarcinoma arising within the heterotopic pancreas appears to be rare. It is difficult to obtain a correct diagnosis preoperatively. The management of heterotopic pancreas depends on the presence or absence of symptoms. If the patient is asymptomatic or benign, conservative treatment with regular follow-up is recommended. When the patient is symptomatic or there is a suspicion of malignancy, surgical management with intra-operative frozen section diagnosis is indicated.

HEXAMITIASIS (Hexamita eleagridis IN TURKEY COMMERCIAL FARMS IN YUCATÁN, MÉXICO

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Ronald Santos Ricalde

2014-12-01

Full Text Available The objective of the study was to estimate the prevalence and to describe the lesions and signs found in an outbreak of Hexamita meleagridis in three turkey farms in Yucatan, Mexico. Three hundred randomly selected, turkeys were sacrificed and their intestines explored for lesions associated with H. Meleagridis infection. Also, gut content, feces samples and fresh intestine smears were taken to determine the presence of H. Meleagridis parasites. Macroscopic lesions such as the presence of congested areas, and watery and foamy content in duodenum, presence of gases, fetid odor and the presence of watery and yellowish feces in the caeca were identified. The overall prevalence of H. Meleagridis was 25.3% and there was not association of the parasite with sex, age or farm. However, the thickening of some sections of the duodenum (52.3%, the presence of congested areas (23%, the watery and yellowish content of the duodenum (24.3%, the presence of gas (21.0%, fetid odor of the content (22.3%, and the watery and yellowish feces of the caeca (20.0% were associated with H. meleagridis Presence of H. meleagridis in those farms was confirmed. Diarrhea signs and intestine lesions observed in the sacrificed turkeys were associated to hexamitiasis infection. Sex, age and farm were not associated with the presence of H. meleagridis.

Peptides reproducibly released by in vivo digestion of beef meat and trout flesh in pigs.

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Bauchart, Caroline; Morzel, Martine; Chambon, Christophe; Mirand, Philippe Patureau; Reynès, Christelle; Buffière, Caroline; Rémond, Didier

2007-12-01

Characterisation and identification of peptides (800 to 5000 Da) generated by intestinal digestion of fish or meat were performed using MS analyses (matrix-assisted laser desorption ionisation time of flight and nano-liquid chromatography electrospray-ionisation ion trap MS/MS). Four pigs fitted with cannulas at the duodenum and jejunum received a meal exclusively made of cooked Pectoralis profundus beef meat or cooked trout fillets. A protein-free meal, made of free amino acids, starch and fat, was used to identify peptides of endogenous origin. Peptides reproducibly detected in digesta (i.e. from at least three pigs) were evidenced predominantly in the first 3 h after the meal. In the duodenum, most of the fish- and meat-derived peptides were characteristic of a peptic digestion. In the jejunum, the majority of peptides appeared to result from digestion by chymotrypsin and trypsin. Despite slight differences in gastric emptying kinetics and overall peptide production, possibly in relation to food structure and texture, six and four similar peptides were released after ingestion of fish or meat in the duodenum and jejunum. A total of twenty-six different peptides were identified in digesta. All were fragments of major structural (actin, myosin) or sarcoplasmic (creatine kinase, glyceraldehyde-3-phosphate dehydrogenase and myoglobin) muscle proteins. Peptides were short ( digestion, some of them can be reproducibly observed in intestinal digesta.

Rat duodenal motility in vitro: Prokinetic effects of DL-homocysteine thiolactone and modulation of nitric oxide mediated inhibition

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Stojanović Marija

2013-01-01

Full Text Available Homocysteine is a significant but modifiable risk factor for vascular diseases. As gastrointestinal smooth musculature is similar to blood vessel muscles, we investigated how elevated homocysteine levels affect nitric oxide-mediated neurotransmission in the gut. There is accumulated evidence that a dysfunction of NO neurons in the myenteric plexus may cause various diseases in the gastrointestinal tract such as achalasia, diabetic gastroparesis and infantile hypertrophic pyloric stenosis. In the present study, we aimed to assess the effects of homocysteine on NO-mediated responses in vitro, and to examine the effects of DL-homocysteine thiolactone on the spontaneous motility of rat duodenum and nitrergic neurotransmission. DL-homocysteine thiolactone concentration of 10 μmol/L leads to the immediate increase in tone, amplitude and frequency of spontaneous movements in isolated rat duodenum. L-NAME (30 μmol/L leads to an increase in basal tone, amplitude and frequency of spontaneous contractions. The relaxations induced by EFS were significantly reduced in duodenal segments incubated in DL-homocysteine thiolactone compared with the control group. EFS-induced relaxations were inhibited by L-NAME in both experimental and control groups. These results suggest that a high level of homocysteine causes an important impairment of non-adrenergic non-cholinergic innervation of the rat duodenum. [Projekat Ministarstva nauke Republike Srbije, br. 175043

Idiopathic Retroperitoneal Hematoma

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Tomoyuki Abe

2010-09-01

Full Text Available A 34-year-old female presented with sudden onset of severe abdominal pain in a flank distribution. A large mass was palpable in the right upper quadrant on physical examination. Abdominal contrast-enhanced computed tomography showed a well-defined, right-sided, retroperitoneal cystic lesion located between the abdominal aorta and the inferior vena cava (IVC. The tumor size was 55 × 58 mm, and it compressed the gallbladder and the duodenum. Upper gastrointestinal radiography revealed a stricture of the second portion of the duodenum by the tumor. T2-weighted magnetic resonance imaging showed that the whole part was hyperintense with hypointense rims, but the inner was partially hypointense. Based on the radiological findings, the preoperative differential diagnosis included retroperitoneal teratoma, Schwannoma, abscess, and primary retroperitoneal tumor. On laparotomy, the tumor was located in the right retroperitoneal cavity. Kocher maneuver and medial visceral rotation, which consists of medial reflection of the upper part of right colon and duodenum by incising their lateral peritoneal attachments, were performed. Although a slight adhesion to the IVC was detected, the tumor was removed safely. Thin-section histopathology examination detected neither tumor tissues nor any tissues such as adrenal gland, ovarian tissue, or endometrial implants. The final pathological diagnosis was idiopathic retroperitoneal hematoma; the origin of the bleeding was unclear. The patient was discharged without any complication 5 days after the operation.

Somatostatin ontogenesis in the gastrointestinal and pancreatic tract: study in normal rats and during a induced diabetes in neonates rats

International Nuclear Information System (INIS)

Cunha, M.C.

1980-01-01

The ontogenic studies of somatostatin of pancreas, ileum and duodenum of Wistar rats and the rats with induced diabetes were done. The radioimmunologic method to dose the somatostatin was used. (L.M.J.)

Enteroclysis

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... remove any removable dental work, such as appliances, bridges, or retainers. If you are, or think you' ... Maher MM. The duodenum and small intestine. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, ...

Vomiting blood

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... the mouth into the esophagus, stomach and duodenum) Rectal examination Tube through the nose into the stomach ... Copyright 1997-2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing ...

Bile Reflux

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... the upper part of your small intestine (duodenum). Bile reflux into the stomach Bile and food mix ... properly, and bile washes back into the stomach. Bile reflux into the esophagus Bile and stomach acid ...

Synchronous gastric and duodenal metastases from head and neck squamous cell carcinoma: a unique presentation of upper gastrointestinal bleeding.

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Tarangelo, Nicholas P; Kistler, C Andrew; Daitch, Zachary; Jiang, Wei; Quirk, Daniel M

2018-01-01

Metastatic disease to the stomach or duodenum is an infrequent diagnosis, and head and neck squamous cell carcinoma (HNSCC) is one of the least common primary malignancies that lead to gastric or duodenal metastases. We report the case of a 65-year-old man with human immunodeficiency virus infection and previously diagnosed HNSCC who presented with melena. The patient had a percutaneous endoscopic gastrostomy tube placed 3 months prior to his presentation. Laboratory testing was significant for normocytic anemia and a digital rectal examination was positive for melena. Esophagogastroduodenoscopy revealed numerous cratered nodules with contact bleeding in the stomach as well as the duodenum that appeared malignant. Biopsies of the gastric and duodenal nodules were positive for p40 and CK 5/6, consistent with metastatic squamous cell carcinoma.

Crocodile jaw sign

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Brij Sharma

2016-01-01

Full Text Available This teaching image highlights the CT abdominal imaging finding of 'crocodile jaw sign' which should raise concern about the presence of an incomplete annular pancreas which causes partial encasement of the duodenum.

Heartburn Ulcers

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Press, Harry C.; Cantwell, Kathleen G.

1987-01-01

Since esophagitis is increasing in frequency, the authors reviewed case histories of patients with this disorder. The importance of radiographic examination of the stomach and duodenum in patients with esophagitis (heartburn) is stressed. PMID:3430645

Upper GI Bleeding in Children

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Upper GI Bleeding in Children What is upper GI Bleeding? Irritation and ulcers of the lining of the esophagus, stomach or duodenum can result in upper GI bleeding. When this occurs the child may vomit blood ...

A Steroid-resistant Cryptogenic Multifocal Ulcerous Stenosing Enteritis

African Journals Online (AJOL)

2018-05-22

May 22, 2018 ... consists of nutrition supplement, systemic steroids, intestinal resection, or balloon ... onset at early ages involved gastric and duodenum, who had a mutation in cytosolic ... cancer or death has been reported. In this situation,.

Iron-Deficiency Anemia

Medline Plus

Full Text Available ... donation Frequent blood tests, especially in infants and small children Heavy menstrual periods Injury or surgery Urinary ... in the duodenum, the first part of the small intestine just beyond the stomach. Even if you ...

Functional changes after pancreatoduodenectomy: Diagnosis and treatment

NARCIS (Netherlands)

T.C. Tran; J.J.B. van Lanschot (Jan); M.J. Bruno (Marco); C.H.J. van Eijck (Casper)

2009-01-01

textabstractRelatively little is known about the gastrointestinal function after recovery of a pancreatoduodenectomy. This review focuses on the functional changes of the stomach, duodenum and pancreas that occur after pancreatoduodenectomy. Although the mortality in relation to

Iron-Deficiency Anemia

Medline Plus

Full Text Available ... leaving cells where it is stored or from being absorbed in the duodenum, the first part of ... treatments for iron-deficiency anemia. Living With After being diagnosed with iron-deficiency anemia, it is important ...

Iron-Deficiency Anemia

Medline Plus

Full Text Available ... from being absorbed in the duodenum, the first part of the small intestine just beyond the stomach. ... bleeding in the esophagus, stomach, and the first part of the small intestine. A tube with a ...

A large gastrointestinal stromal tumor of duodenum: a case report

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Hadi Ahmadi Amoli

2014-01-01

Case presentation: The patient is a forty six years old man. He complained of frequent colic pain in left upper quadrant of abdomen for two months before admitting to the hospital. The pain resolved spontaneously after a few hours. This situation almost has been repeated every week. The patient had severe repeated melena and faint for two weeks. As soon as the patient was entered the Sina Hospital in 2012, supportive care was started. Then upper gastrointestinal endoscopy was performed for him and the bleeding point was detected. Also abdominal and pelvic computed tomography with oral and intravenous contrast was done. Finally the patient was operated on tumor diagnosis in duodenal area according to classic Whipple procedure. Conclusion: Gastrointestinal bleeding is the most common symptom of gastrointestinal stromal tumors. The bleeding is minimal and chronic. It will be progress to sudden and severe bleeding. Diagnosis is done by upper gastrointestinal endoscopy and biopsy. The large tumors with high mitotic

Different effect of doxycycline and enrofloxacin on ca¬thelicidin-3 mRNA expression in chickens with or without probiotics supplementati

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I. Pavlova

2017-12-01

Full Text Available The function of immune system of poultry has a significant impact on poultry husbandry sustainabi¬lity. Therefore the aim of this study was to investigate the effect of lactic acid bacteria administered with enrofloxacin or doxycycline on expression levels of antimicrobial peptide cathelicidin-3 (CATH3 at mRNA level in the duodenum, jejunum and liver of broilers. A day-old Ross (n=24 and Duc (n=24 chickens were included in experiments with enrofloxacin and doxycycline, respectively. They were divided into four groups (n=6 for each experiment: control, supplemented with probiotics (15 days via feed, 5 days after hatching, treated with either enrofloxacin or doxycycline (10 mg.kg-1 for 5 days, via drinking water and treated with antibiotic and probiotics. Expression levels of CATH3 mRNA in liver, duodenum and jejunum were determined by RT-PCR and were statistically evaluated by Mann-Whitney test.Administration of probiotics led to insignificant down-regulation of CATH3 mRNA in the investigated tissues. The combination of doxycycline with probiotics led to statistically significant down-regulation of CATH3 mRNA in the duodenum (P<0.01. Statistically significant up-regulation of mRNA of the studied gene was found in the jejunum of enrofloxacin treated Ross chickens. The data suggest the existence of an interaction between antibiotics and innate immunity. Further evaluation in infected poultry would shed more light on the pharmacodynamics of antibacterials.

Effects of different levels of protein supplements in the diet of early-weaned yaks on growth performance, intestinal development, and immune response to tuberculosis

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Haibo Zhang

2015-06-01

Full Text Available This study was conducted to determine the effects of different levels of crude protein (CP supplements to the diet of early-weaned yaks on their growth performance, intestinal development, and immune response. Forty 3-month-old weaned yaks were selected and assigned to four dietary groups (Control, 17, 19 and 21% CP. Dietary CP supplements had a significant effect on average daily gain (ADG, crypt depth (CD (duodenum, jejunum and ileum, villous height (VH (duodenum, jejunum and ileum and CD/VH (jejunum and ileum. Average daily gain, CD (duodenum, jejunum and ileum and VH (ileum showed quadratic increases as the dietary CP increased, whereas CD/VH (jejunum and ileum ratios showed quadratic decreases. Blood urea nitrogen (BUN, glucose (GLU, immunoglobulin G (IgG, IgM, interleukin-1 (IL-1, IL-2, tumor necrosis factor (TNF-α, and interferon (IFN-γ concentrations increased significantly, whereas albumin (ALB, alanine aminotransferase (ALT and aspartate aminotransferase (AST decreased significantly with dietary CP supplements. Dietary CP supplements significantly increased the concentrations of IL-6, TNF-α, IFN-γ and the nuclear factor of activated T cell transcription factor (NFAT for gene expression. As the dietary CP supplements increased, IL-6, IFN-γ and NF-AT gene expression showed quadratic increases. These results showed that the appropriate dietary CP supplementation improved the growth performance and intestinal development of earlyweaned yaks and thus that the CP supplements were beneficial and enhanced the humoral immunity response of yaks.

Oral administration of Saccharomyces boulardii alters duodenal morphology, enzymatic activity and cytokine production response in broiler chickens.

Science.gov (United States)

Sun, Yajing; Rajput, Imran Rashid; Arain, Muhammad Asif; Li, Yanfei; Baloch, Dost Muhammad

2017-08-01

The present study evaluated the effects of Saccharomyces boulardii on duodenal digestive enzymes, morphology and cytokine induction response in broiler chicken. A total of 200 birds were allotted into two groups (n = 100) and each group divided into five replications (n = 20). The control group was fed basal diet in addition to antibiotic (virginiamycin 20 mg/kg), and treatment group received (1 × 10 8  colony-forming units/kg feed) S. boulardii in addition to basal diet lasting for 72 days. The results compared to control group revealed that adenosine triphosphatase, gamma glutamyl transpeptidase, lipase and trypsin activities were higher, while, no significant improvement was observed in amylase activities in the duodenum of the treatment group. Moreover, morphological findings showed that villus height, width and number of goblet cells markedly increased. Additionally, transmission electron microscopy visualized that villus height, width and structural condensation significantly increased in the treatment group. The immunohistological observations showed increased numbers of immunoglobulin A (IgA)-positive cells in the duodenum of the treatment group. Meanwhile, cytokine production levels of tumor necrosis factor-α, interleukin (IL)-10, transforming growth factor-β and secretory IgA markedly increased, and IL-6 statistically remained unchanged as compared to the control group. These findings illustrated that initial contact of S. boulardii to the duodenum has significant impact in improving enzymatic activity, intestinal morphology and cytokine response in broiler chicken. © 2016 Japanese Society of Animal Science.

Influence of delayed placement and dietary lysine levels on small intestine morphometrics and performance of broilers

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JRG Franco

2006-12-01

Full Text Available This experiment studied the influence of delayed placement (HI and digestible lysine level (DL on the morphometrics of the intestinal mucosa and on the performance of broilers. A total number of 1,705 Cobb 500 male chicks were used in a completely randomized experimental design in a factorial arrangement with four HI (12, 24, 36 and 48h, and two DL level in the starter diet (1.143 and 1.267%, with four replicates and 55 birds per experimental unit. The amino acids methionine-cystine, threonine, and tryptophan were balanced according to the ideal protein (IP concept. Small intestine morphometrics was evaluated using histology slides of the duodenum and jejunum. There was no interaction between HI and DL levels for any of the studied parameters. The 1.143% level of DL promoted better performance results at 21 and 42 days of age, as well as higher duodenum and jejunum crypt depth, and duodenum villi height at 21 days of age. HI negatively influenced the morphometrics of the small intestine during the starter phase, and the performance of broilers up to 42 days of age. There was no effect of the treatments on yolk sac utilization or abdominal fat percentage. It was concluded that the use of 1.143% DL and HI of 12 hours promoted better development of the small intestine mucosa up to 21 days of age, and broiler performance at market age.

Nutritional management of a complicated surgical patient by means ...

African Journals Online (AJOL)

magnesium and selenium deficiency. Short bowel syndrome13, ..... (CCK) which is produced by the endocrine cells in the duodenum and upper jejunum.2 CCK ... and pancreatic enzymes, as well as bile acid which is necessary for optimal EN ...

Iron-Deficiency Anemia

Medline Plus

Full Text Available ... duodenum, the first part of the small intestine just beyond the stomach. Even if you have enough ... clamping of your newborn’s umbilical cord at the time of delivery. This may help prevent iron-deficiency ...

Peptic Ulcer

Science.gov (United States)

A peptic ulcer is a sore in the lining of your stomach or your duodenum, the first part of your ... Comes and goes for several days or weeks Peptic ulcers happen when the acids that help you digest ...

Effects of lethal dose of γ-irradiation on intestinal enzymes of the pigeons Columba livia intermedia Strickland

International Nuclear Information System (INIS)

Gadhia, P.K.

1979-01-01

Effect of γ-irradiation with lethal dose (1000 rads) on alkaline phosphatase and glucose-6-phosphatase have been studied in two different regions (duodenum and ileum) of small intestine of pigeons. The enzymes were studied at different intervals like 2, 4, 6 and 8 days after irradiation. The sp. activities of enzyme increased significantly both in duodenum and ileum. However, significant increase in alkaline phosphatase and glucose-6-phosphatase were observed at the 2nd and the 4th days post-irradiation respectively. The increase in enzyme activities may present de novo synthesis of these enzymes after lethal dose of irradiation. The histologic picture revealed that after the 4th day of irradiation, the number of goblet cells increased and after the 6th day crypt-villus system was destroyed completely as compared to sham-irradiated pigeons. (author)

Effects of lethal dose of. gamma. -irradiation on intestinal enzymes of the pigeons Columba livia intermedia Strickland

Energy Technology Data Exchange (ETDEWEB)

Gadhia, P.K. (South Gujarat Univ., Surat (India). Dept. of Biosciences); Shah, V.C. (Gujarat Univ. School of Sciences, Ahmedabad (India))

1979-09-01

Effect of ..gamma..-irradiation with lethal dose (1000 rads) on alkaline phosphatase and glucose-6-phosphatase have been studied in two different regions (duodenum and ileum) of small intestine of pigeons. The enzymes were studied at different intervals like 2, 4, 6 and 8 days after irradiation. The sp. activities of enzyme increased significantly both in duodenum and ileum. However, significant increase in alkaline phosphatase and glucose-6-phosphatase were observed at the 2nd and the 4th days post-irradiation respectively. The increase in enzyme activities may present de novo synthesis of these enzymes after lethal dose of irradiation. The histologic picture revealed that after the 4th day of irradiation, the number of goblet cells increased and after the 6th day crypt-villus system was destroyed completely as compared to sham-irradiated pigeons.

Gastroduodenal Intussusception Caused by a Peutz- Jeghers Polyp in a Young Child: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Roh, Jae Eun; Cho, Bum Sang; Lee, Seung Young; Jeon, Min Hee; Lee, Ji Hyuk; Lee, Ho Chang; Koo, Ji Hae [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

2010-09-15

Gastroduodenal intussusception is a rare condition caused by the prolapse of a gastric tumor with subsequent invagination of a portion of the gastric wall into the duodenum. Various gastric lesions including adenoma, lipoma, leiomyoma, hamartoma, adenocarcinoma, gastrointestinal stromal tumor (GIST), and as in our case a Peutz- Jeghers polyp, can serve as a lead point of intussusception. Only three cases of gastroduodenal intussusception secondary to a Peutz-Jeghers polyp have been reported. We experienced a case of gastroduodenal intussusception in a 36-month-old boy who presented with intermittent nonbilious vomiting, abdominal pain, and anemia. An abdominal ultrasound and contrast enhanced CT scan showed gastrointestinal intussusception and a mass-like lesion in the second portion of duodenum. A laparotomy revealed a 7x8 cm sized mass at the gastric body, which was pathologically confirmed as a Peutz-Jeghers polyp

Superior mesenteric artery syndrome following initiation of cisplatin-containing chemotherapy: a case report

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Ushiki Atsuhito

2012-01-01

Full Text Available Abstract Introduction Superior mesenteric artery syndrome is a rare cause of upper intestinal obstruction resulting from compression of the duodenum by the superior mesenteric artery and abdominal aorta. Case presentation We describe a case of superior mesenteric artery syndrome in a 61-year-old Japanese man with non-small cell lung cancer who had been treated with cisplatin-containing chemotherapy and had lost 7 kg in weight. The diagnosis was confirmed by the typical findings of abdominal computed tomography showing distended stomach resulting from compression of the third portion of the duodenum and reduction of an aortomesenteric distance and aortomesenteric angle. Conclusions This case highlights the importance of considering the possibility of superior mesenteric artery syndrome in patients treated with chemotherapy, especially those presenting with a low body mass index and showing weight loss during chemotherapy.

Duodenal perforation during percutaneous nephrolithotomy (PCNL ...

African Journals Online (AJOL)

A. Bansal

2016-06-03

Jun 3, 2016 ... Calculus;. Duodenum;. Injury;. Paediatric;. Percutaneous nephrolithotomy. Abstract. Introduction: Colonic perforations are known complications of percutaneous nephrolithotomy (PCNL). However, to the best of our knowledge, small bowel perforation has rarely been reported.. Observation: We report the ...

Stages of Gastrointestinal Carcinoid Tumors

Science.gov (United States)

... used: Endoscopic resection : Surgery to remove a small tumor that is on the inside lining of the GI tract. An endoscope is inserted through the mouth and passed through the esophagus to the stomach and sometimes, the duodenum . An ...

General Information about Gastrointestinal Carcinoid Tumors

Science.gov (United States)

... used: Endoscopic resection : Surgery to remove a small tumor that is on the inside lining of the GI tract. An endoscope is inserted through the mouth and passed through the esophagus to the stomach and sometimes, the duodenum . An ...

Treatment Option Overview (Gastrointestinal Carcinoid Tumors)

Science.gov (United States)

... used: Endoscopic resection : Surgery to remove a small tumor that is on the inside lining of the GI tract. An endoscope is inserted through the mouth and passed through the esophagus to the stomach and sometimes, the duodenum . An ...

In silico design of cyclic peptides as influenza virus, a subtype H1N1 ...

African Journals Online (AJOL)

Arli Parikesit

2012-06-28

Jun 28, 2012 ... 8 ribonucleic acid (RNA) segments, while type C has seven RNA segments. ... proved that the molecular dynamic simulated structures of M2 that the ..... fluid in the stomach and duodenum, whereas the straight peptide of the ...

ISSN 2073 East Cent. Afr. j. surg.

African Journals Online (AJOL)

DELL

Background: Cholelithiasis is a very common condition which may be complicated by the ... surgeons tried to push CBDS into the duodenum.8,9,10 The rate of retained .... biliary anatomy at operation to help avoid or recognize bile duct injury.

Localization of xanthine oxidoreductase activity using the tissue protectant polyvinyl alcohol and final electron acceptor Tetranitro BT

NARCIS (Netherlands)

Kooij, A.; Frederiks, W. M.; Gossrau, R.; van Noorden, C. J.

1991-01-01

We have detected xanthine oxidoreductase activity in unfixed cryostat sections of rat and chicken liver, rat duodenum, and bovine mammary gland using the tissue protectant polyvinyl alcohol, the electron carrier 1-methoxyphenazine methosulfate, the final electron acceptor Tetranitro BT, and

Small Bowel Bleeding

Science.gov (United States)

... pouchings in the wall of the colon), or cancer. Upper GI (esophagus, stomach, or duodenum) bleeding is most often due ... begins transmitting images of the inside of the esophagus, stomach, and small bowel to a ... Bowel Disease Irritable Bowel Syndrome ...

Gastro-oesophageal reflux: an overview of the pharmacotherapeutic ...

African Journals Online (AJOL)

... stomach empties into the duodenum, and relieving the discomfort caused by heartburn. ... Family history. • Obesity ... occurring two or more times a week in patients under the age of. 50 with no other ... Stress-related mucosal injury. The acid ...

Expression of digestive enzymes and nutrient transporters in Eimeria-challenged broilers.

Science.gov (United States)

Su, S; Miska, K B; Fetterer, R H; Jenkins, M C; Wong, E A

2015-03-01

Avian coccidiosis is a disease caused by the intestinal protozoa Eimeria. The site of invasion and lesions in the intestine is species-specific, for example E. acervulina affects the duodenum, E. maxima the jejunum, and E. tenella the ceca. Lesions in the intestinal mucosa cause reduced feed efficiency and body weight gain. The growth reduction may be due to changes in expression of digestive enzymes and nutrient transporters in the intestine. The objective of this study was to compare the expression of digestive enzymes, nutrient transporters and an antimicrobial peptide in broilers challenged with either E. acervulina, E. maxima or E. tenella. The genes examined included digestive enzymes (APN and SI), peptide and amino acid transporters (PepT1, ASCT1, b(0,+)AT/rBAT, B(0)AT, CAT1, CAT2, EAAT3, LAT1, y(+)LAT1 and y(+)LAT2), sugar transporters (GLUT1, GLUT2, GLUT5 and SGLT1), zinc transporter (ZnT1) and an antimicrobial peptide (LEAP2). Duodenum, jejunum, ileum and ceca were collected 7 days post challenge. E. acervulina challenge resulted in downregulation of various nutrient transporters or LEAP2 in the duodenum and ceca, but not the jejunum or ileum. E. maxima challenge produced both downregulation and upregulation of nutrient transporters and LEAP2 in all three segments of the small intestine and ceca. E. tenella challenge resulted in the downregulation and upregulation of nutrient transporters and LEAP2 in the jejunum, ileum and ceca, but not the duodenum. At the respective target tissue, E. acervulina, E. maxima and E. tenella infection caused common downregulation of APN, b(0,+)AT, rBAT, EAAT3, SI, GLUT2, GLUT5, ZnT1 and LEAP2. The downregulation of nutrient transporters would result in a decrease in the efficiency of protein and polysaccharide digestion and uptake, which may partially explain the weight loss. The downregulation of nutrient transporters may also be a cellular response to reduced expression of the host defense protein LEAP2, which would

Synthesis of microbial nitrogen compounds in the rumen and their digestion in the small intestine

International Nuclear Information System (INIS)

Smith, R.H.; Salter, D.N.; McAllan, A.B.; Williams, A.P.

1976-01-01

Pathways and efficiency of NPN utilization were studied after introducing isonitrogenous feeds containing urea labelled with 15 N with or without groundnut protein into the rumen of the young steer. The 15 N abundance in rumen ammonia decreased from 1 h after the dose whereas that in suspended bacteria (only a small part of the total population but regarded, with reservation, as representative) increased to a peak value at 3-5 h. Patterns of incorporation into different nitrogen constituents of the bacteria indicated that part of the 15 N first moved rapidly into a labile pool, which included amide nitrogen, and then moved from this pool into other amino acids. Different amino acids were labelled to different extents (lowest for proline and arginine, highest for aspartic acid and alanine), presumably as different amounts of pre-formed amino acids were used in protein synthesis. Differences largely disappeared when the diet with urea as the only nitrogen source was given. Estimates of microbial 15 N recovery at the duodenum confirmed earlier findings that overall incorporation was least when the latter diet was given, and no improvement was seen when the urea was given in three doses over 4 h instead of in a single dose. Lactosyl, like glucosyl, ureide was degraded fairly slowly in the rumen and is being studied as a possible NPN source likely to yield simultaneous ammonia and energy for microbial growth. Studies on the origin and composition of nitrogen compounds entering the duodenum showed that the RNA of rumen bacteria (labelled with 32 P) contributed 82-109% of the RNA entering the duodenum of the steer. It was also shown that protecting dietary casein with formaldehyde reduced its degradability in the rumen to such an extent that a deficiency of fermentable nitrogen in that organ ensued. In other experiments with two calves receiving flaked maize and hay, net digestibility of nitrogen compounds between duodenum and ileum was about 60%. True digestibility

Peritonitis secondary to traumatic duodenal laceration in the presence of a large pancreatic pseudocyst: a case report

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Seenath Marlon M

2011-10-01

Full Text Available Abstract Introduction A pancreatic pseudocyst is a common sequela of severe acute pancreatitis. Commonly, it presents with abdominal pain and a mass in the epigastrium several weeks after the acute episode and can be managed conservatively, endoscopically or surgically. We report a patient with a pancreatic pseudocyst awaiting endoscopic therapy who developed a life-threatening complication following a rather innocuous trauma to the abdomen. Case presentation A 23-year-old Asian male student presented as an emergency with an acute abdomen a week after a minor trauma to his upper abdomen. The injury occurred when he was innocently punched in the abdomen by a friend. He experienced only moderate discomfort briefly at the time. His past medical history included coeliac disease and an admission four months previously with severe acute pancreatitis. He was hospitalized for 15 days; his pancreatitis was thought to be due to alcohol binge drinking on weekends. Ultrasound scanning showed no evidence of gallstone disease. Five days after the trauma, he became anorexic, lethargic and feverish and started vomiting bilious content. Seven days post-trauma, he presented to our emergency department with severe abdominal pain. An emergency laparotomy was performed where a transverse linear duodenal laceration was found at the junction of the first and second part of his duodenum, with generalized peritonitis. His stomach and duodenum were stretched over a large pancreatic pseudocyst posterior to his stomach. It was postulated that an incomplete duodenal injury (possibly a serosal tear occurred following the initial minor trauma, which was followed by local tissue necrosis at the injury site resulting in a delayed presentation of generalized peritonitis. Conclusion This is the first reported case of a traumatic duodenal laceration following minor blunt trauma in the presence of a large pancreatic pseudocyst. Minor blunt abdominal trauma in a normal healthy adult

SU-E-J-142: Performance Study of Automatic Image-Segmentation Algorithms in Motion Tracking Via MR-IGRT

International Nuclear Information System (INIS)

Feng, Y; Olsen, J.; Parikh, P.; Noel, C; Wooten, H; Du, D; Mutic, S; Hu, Y; Kawrakow, I; Dempsey, J

2014-01-01

Purpose: Evaluate commonly used segmentation algorithms on a commercially available real-time MR image guided radiotherapy (MR-IGRT) system (ViewRay), compare the strengths and weaknesses of each method, with the purpose of improving motion tracking for more accurate radiotherapy. Methods: MR motion images of bladder, kidney, duodenum, and liver tumor were acquired for three patients using a commercial on-board MR imaging system and an imaging protocol used during MR-IGRT. A series of 40 frames were selected for each case to cover at least 3 respiratory cycles. Thresholding, Canny edge detection, fuzzy k-means (FKM), k-harmonic means (KHM), and reaction-diffusion level set evolution (RD-LSE), along with the ViewRay treatment planning and delivery system (TPDS) were included in the comparisons. To evaluate the segmentation results, an expert manual contouring of the organs or tumor from a physician was used as a ground-truth. Metrics value of sensitivity, specificity, Jaccard similarity, and Dice coefficient were computed for comparison. Results: In the segmentation of single image frame, all methods successfully segmented the bladder and kidney, but only FKM, KHM and TPDS were able to segment the liver tumor and the duodenum. For segmenting motion image series, the TPDS method had the highest sensitivity, Jarccard, and Dice coefficients in segmenting bladder and kidney, while FKM and KHM had a slightly higher specificity. A similar pattern was observed when segmenting the liver tumor and the duodenum. The Canny method is not suitable for consistently segmenting motion frames in an automated process, while thresholding and RD-LSE cannot consistently segment a liver tumor and the duodenum. Conclusion: The study compared six different segmentation methods and showed the effectiveness of the ViewRay TPDS algorithm in segmenting motion images during MR-IGRT. Future studies include a selection of conformal segmentation methods based on image/organ-specific information

SU-E-J-142: Performance Study of Automatic Image-Segmentation Algorithms in Motion Tracking Via MR-IGRT

Energy Technology Data Exchange (ETDEWEB)

Feng, Y; Olsen, J.; Parikh, P.; Noel, C; Wooten, H; Du, D; Mutic, S; Hu, Y [Washington University, St. Louis, MO (United States); Kawrakow, I; Dempsey, J [Washington University, St. Louis, MO (United States); ViewRay Co., Oakwood Village, OH (United States)

2014-06-01

Purpose: Evaluate commonly used segmentation algorithms on a commercially available real-time MR image guided radiotherapy (MR-IGRT) system (ViewRay), compare the strengths and weaknesses of each method, with the purpose of improving motion tracking for more accurate radiotherapy. Methods: MR motion images of bladder, kidney, duodenum, and liver tumor were acquired for three patients using a commercial on-board MR imaging system and an imaging protocol used during MR-IGRT. A series of 40 frames were selected for each case to cover at least 3 respiratory cycles. Thresholding, Canny edge detection, fuzzy k-means (FKM), k-harmonic means (KHM), and reaction-diffusion level set evolution (RD-LSE), along with the ViewRay treatment planning and delivery system (TPDS) were included in the comparisons. To evaluate the segmentation results, an expert manual contouring of the organs or tumor from a physician was used as a ground-truth. Metrics value of sensitivity, specificity, Jaccard similarity, and Dice coefficient were computed for comparison. Results: In the segmentation of single image frame, all methods successfully segmented the bladder and kidney, but only FKM, KHM and TPDS were able to segment the liver tumor and the duodenum. For segmenting motion image series, the TPDS method had the highest sensitivity, Jarccard, and Dice coefficients in segmenting bladder and kidney, while FKM and KHM had a slightly higher specificity. A similar pattern was observed when segmenting the liver tumor and the duodenum. The Canny method is not suitable for consistently segmenting motion frames in an automated process, while thresholding and RD-LSE cannot consistently segment a liver tumor and the duodenum. Conclusion: The study compared six different segmentation methods and showed the effectiveness of the ViewRay TPDS algorithm in segmenting motion images during MR-IGRT. Future studies include a selection of conformal segmentation methods based on image/organ-specific information

Chronic effect of vagotomy in the morphometry of the myenteric plexus of rats' duodenum Efeito crônico da vagotomia sobre a morfometria do plexo mioentérico do duodeno de ratos

Directory of Open Access Journals (Sweden)

Carlos Roberto Martins-Júnior

2010-09-01

Full Text Available BACKGROUND: The gastrointestinal disorders have been associated with morphological alterations in the myenteric nervous plexus. AIM: To evaluate, through morphometric studies, the chronic effects of the subdiaphragmatic trunk vagotomy on the nervous plexus. METHODS: Fifteen male exemplars of Wistar Rattus novergicus weighing about 150g, distributed into three groups, have been used: control (n=5, Sham (n=5 and vagotomized (n=5. The animals were sacrificed after 30 and 90 days post surgery. Fragments of duodenum were fixed in Bouin solution, embedded into paraffin and stained with HE and PAS. Morphometric analysis was performed by a Carl Zeiss KM 450 image system. The following aspects were observed: the density of nervous cells per linear micrometer (µm (ND; the area of perikarya (µm² (NA; the number of satellite cells per µm (SCD; and the number of satellite cells per neuron (SC/N. The averages were compared with the help of "software" program Sigma Plus through two way - ANOVA and Tuckey post-test. RESULTS: Denervation increased SC/N (pRACIONAL: As disfunções gastrintestinais têm sido associadas à alterações morfológicas no plexo nervoso mioentérico. OBJETIVO: Avaliar através do estudo morfométrico, os efeitos crônicos da vagotomia troncular subdiafragmática sobre esse plexo nervoso. MÉTODOS: Foram utilizados 15 exemplares machos de Rattus novergicus da variedade Wistar, com cerca de 150 g, distribuídos nos grupos controle (n=5, Sham (n=5 e vagotomizados (n=5. Os animais foram sacrificados depois de 30 e 90 dias após as operações. Em seguida, fragmentos do duodeno foram fixados em solução de Bouin, incluídos em parafina e corados por HE e PAS. A análise morfométrica foi realizada por meio do sistema de análise de imagem Carl Zeiss KM 450. Foram observados: a densidade de células nervosas por micrômetro linear (µm; a área dos pericários (µm²; o número de células satélites por µm; e o número de células sat

Activity and immunohistochemical localization of porphobilinogen deaminase in rat tissues

DEFF Research Database (Denmark)

Jørgensen, P E; Erlandsen, E J; Poulsen, Steen Seier

2000-01-01

the activity and the immunohistochemical localization of PBGD in the following tissues of wistar female rats: brain, heart, submandibular gland, liver, kidney, pancreas, ovary, stomach, duodenum, jejunum, ileum, colon and musculature. The PBGD activity varied considerably among the tissues. It was highest...

Validation of protein evaluation systems by means of milk production experiments with dairy cows.

NARCIS (Netherlands)

Straalen, van W.M.; Salaün, C.; Veen, W.A.G.; Rypkema, Y.S.; Hof, G.; Boxem, T.J.

1994-01-01

Protein evaluation systems (crude protein (CP), digestible crude protein (DCP), protein digested in the intestine (PDI), amino acids truly absorbed in the small intestine (AAT), absorbed protein (AP), metabolizable protein (MP), crude protein flow at the duodenum (AAS) and digestible protein in

A rare association between dextrogastria, duodenal web, and ...

African Journals Online (AJOL)

... the radiologic investigation for bilious vomiting and feeding intolerance, revealing congenital duodenal stenosis and dextrogastria. During surgery, the association of the dextrogastria with the duodenal web situated in the second part of the duodenum was established. Keywords: dextrogastria, duodenal web, malrotation ...

Role of delayed gastric emptying in the pathogenesis of cysteamine-induced duodenal ulcer in the rat

DEFF Research Database (Denmark)

Poulsen, Steen Seier

1982-01-01

. After 4 h this pool of undiluted gastric secretions gradually is emptied into the duodenum, where the mucosal resistance is reduced by inhibition of the secretory activity of Brunner's glands, and ulceration rapidly develops. The time relationship is supported by histopathologic findings...

A Giant Brunneroma Causing Gastrointestinal Bleeding and Severe Anemia Requiring Transfusion and Surgery

NARCIS (Netherlands)

Frenkel, Nicola C; Laclé, Miangela M; Borel Rinkes, Inne H M; Molenaar, IQ; Hagendoorn, Jeroen

2017-01-01

Brunner's gland hamartoma, also called hyperplasia, adenoma, and Brunneroma, is an extremely rare benign proliferative lesion of Brunner's glands in the duodenum. While being mostly small and asymptomatic, they can result in gastrointestinal bleeding and obstruction. We report the case of a

Solubilisation of poorly water-soluble drugs during in vitro lipolysis of medium- and long-chain triacylglycerols

DEFF Research Database (Denmark)

Christensen, Janne Ørskov; Schultz, Kirsten; Mollgaard, Birgitte

2004-01-01

The partitioning of poorly soluble drugs into an aqueous micellar phase was exploited using an in vitro lipid digestion model, simulating the events taking place during digestion of acylglycerols in the duodenum. The aqueous micellar phase was isolated after ultracentrifugation of samples obtaine...

Conversion of Percutaneous Cholecystostomy to Endoscopic Gallbladder Stenting by Using the Rendezvous Technique.

Science.gov (United States)

Nam, Kwangwoo; Choi, Jun-Ho

2017-05-01

We report the successful conversion of percutaneous cholecystostomy (PC) to endoscopic transpapillary gallbladder stenting (ETGS) with insertion of an antegrade guidewire into the duodenum. An 84-year-old man presented with severe acute cholecystitis and septic shock. He had significant comorbidities, and emergent PC was successfully performed. Subsequent ETGS was attempted but unsuccessful owing to difficulties with cystic duct cannulation. However, via the PC tract, the guidewire was passed antegradely into the duodenum, and ETGS with a double-pigtail plastic stent was successfully performed with the rendezvous technique. The PC tube was removed, and no recurrence was reported during the 17-month follow-up period. Conversion of PC to ETGS is a viable option in patients with acute cholecystitis who are not candidates for surgery. Antegrade guidewire insertion via the PC tract may increase the success rate of conversion and decrease the risk of procedure-related complications.

Conversion of Percutaneous Cholecystostomy to Endoscopic Gallbladder Stenting by Using the Rendezvous Technique

Directory of Open Access Journals (Sweden)

Kwangwoo Nam

2017-05-01

Full Text Available We report the successful conversion of percutaneous cholecystostomy (PC to endoscopic transpapillary gallbladder stenting (ETGS with insertion of an antegrade guidewire into the duodenum. An 84-year-old man presented with severe acute cholecystitis and septic shock. He had significant comorbidities, and emergent PC was successfully performed. Subsequent ETGS was attempted but unsuccessful owing to difficulties with cystic duct cannulation. However, via the PC tract, the guidewire was passed antegradely into the duodenum, and ETGS with a double-pigtail plastic stent was successfully performed with the rendezvous technique. The PC tube was removed, and no recurrence was reported during the 17-month follow-up period. Conversion of PC to ETGS is a viable option in patients with acute cholecystitis who are not candidates for surgery. Antegrade guidewire insertion via the PC tract may increase the success rate of conversion and decrease the risk of procedure-related complications.

Lectin histochemistry of goblet cell sugar residues in the gut of the chick embryo and of the newborn.

Science.gov (United States)

Bryk, S G; Sgambati, E; Gheri Bryk, G

1999-04-01

The anlage of duodenum, ileum and colon were removed from chick embryos of day 8-21 of incubation and from 1-day-old chicks. A battery of seven different horseradish peroxidase-conjugated lectins (PNA, SBA, DBA, Con A, WGA, LTA and UEAI) was used to study the carbohydrate residues of the glycoconjugates in the goblet cells of the three parts of the intestine. The main results can be summarized as follows: differences in lectin binding were absent in the proximal and distal parts of the duodenum, ileum and colon. Lectin histochemistry showed differences among the three intestinal segments for the time of appearance of the oligosaccharides in the goblet mucus. In the colonic goblet cells of 1-day-old chicks, LTA and UEAI lectins showed two different types of linkage of alpha-L-fucose. This is the first demonstration of UEAI reactive sites in Gallus domesticus.

Effect of a crude sulfated polysaccharide from Halymenia floresia (Rhodophyta on gastrointestinal smooth muscle contractility

Directory of Open Access Journals (Sweden)

José Ronaldo Vasconcelos Graça

2011-10-01

Full Text Available The aim of this work was to study the effect of Halymenia floresia (Hf on duodenum contractility, and on experimental protocols of gastric compliance (GC in rats. Fraction Hf2s exhibited a concentration-dependent myocontractile effect (EC50 12.48 µg/ml, and an inhibitory effect after consecutive washing. The contractile response promoted by Hf2s in the duodenum strips was completely inhibited by verapamil, and the effects were prevented in the presence of Ca2+-free medium. The pretreatment with atropine prevented the Hf2s myocontractile effect. Hf2s was also capable to decrease the GC (from 3.8±0.06 to 3.4±0.13 ml, P<0.05, which did not return to basal levels after more 50 min of observation. These results indicated that the algal polysaccharide possessed in vitro and in vivo gastrointestinal effects.

Triple-Tube-Ostomy: A Novel Technique for the Surgical Treatment of Iatrogenic Duodenal Perforation

Directory of Open Access Journals (Sweden)

Nobuaki Fujikuni

2011-12-01

Full Text Available Although duodenal perforation is currently an infrequent complication of medical procedures, its incidence in the future predictably will increase as endoscopic treatment of duodenal neoplasms becomes more frequently used. In some cases, duodenal perforation is difficult to treat even surgically. We report here a novel technique called ‘triple-tube-ostomy’ for the treatment of iatrogenic duodenal perforation. Since November 2009, there have been three cases of iatrogenic perforation of the duodenum, due to various causes, which we have treated with our novel technique. The main principles of the technique are biliary diversion, decompression of the duodenum, and early enteral nutrition. All patients who underwent the triple-tube-ostomy procedure had good postoperative courses, with few complications. The novel surgical technique we describe in this report is safe, reliable, easy to learn and perform, and led to a good postoperative course in all cases where we performed it.

Blueberry juice used per os in upper abdominal MR imaging: composition and initial clinical data

Energy Technology Data Exchange (ETDEWEB)

Karantanas, A.H. [Department of CT-MRI, Larissa General Hospital (Greece); Papanikolaou, N.; Gourtsoyiannis, N. [Medical School, University of Crete, Heraklion (Greece); Kalef-Ezra, J. [Department of Medical Physics, Medical School, University of Ioannina (Greece); Challa, A. [Medical School, University of Ioannina (Greece)

2000-06-01

The aim of this study was to evaluate the use of a commercially available blueberry juice (BJ) both as a positive and negative oral contrast agent and to present the exact contents of paramagnetic ions. The concentration of Mn and Fe were determined in tinned myrtilles in syrup (atomic absorption). Nine healthy volunteers and 12 patients (age range 20-65 years) were examined using a 1-T MR scanner before and after per os administration of 430 ml of BJ. A qualitative analysis of signal alterations in the stomach, duodenum, and proximal small intestine was performed. In addition, a quantitative analysis was assessed in terms of signal-to-noise ratio calculation. The mean concentration (x {+-} SD) of the ions found in the content of the three cans were 3.3 {+-} 0.4 {mu}g/g for iron and 20.6 {+-} 2.6 {mu}g/g for manganese. Based on the qualitative evaluation, signal alteration on T1-weighted images after administration of BJ was statistically significant in the stomach and duodenum, but not in the proximal small bowel. Signal alteration on T2-weighted images was not statistically significant in any part of the gastrointestinal tract. The quantitative analysis of the T1- and T2 shortening showed that BJ is efficient with only T1-weighted sequences, and this applied to the stomach, duodenum, and proximal small bowel. Blueberry juice can be used as an oral contrast agent in upper abdominal MR for T1-weighted imaging. (orig.)

Blueberry juice used per os in upper abdominal MR imaging: composition and initial clinical data

International Nuclear Information System (INIS)

Karantanas, A.H.; Papanikolaou, N.; Gourtsoyiannis, N.; Kalef-Ezra, J.; Challa, A.

2000-01-01

The aim of this study was to evaluate the use of a commercially available blueberry juice (BJ) both as a positive and negative oral contrast agent and to present the exact contents of paramagnetic ions. The concentration of Mn and Fe were determined in tinned myrtilles in syrup (atomic absorption). Nine healthy volunteers and 12 patients (age range 20-65 years) were examined using a 1-T MR scanner before and after per os administration of 430 ml of BJ. A qualitative analysis of signal alterations in the stomach, duodenum, and proximal small intestine was performed. In addition, a quantitative analysis was assessed in terms of signal-to-noise ratio calculation. The mean concentration (x ± SD) of the ions found in the content of the three cans were 3.3 ± 0.4 μg/g for iron and 20.6 ± 2.6 μg/g for manganese. Based on the qualitative evaluation, signal alteration on T1-weighted images after administration of BJ was statistically significant in the stomach and duodenum, but not in the proximal small bowel. Signal alteration on T2-weighted images was not statistically significant in any part of the gastrointestinal tract. The quantitative analysis of the T1- and T2 shortening showed that BJ is efficient with only T1-weighted sequences, and this applied to the stomach, duodenum, and proximal small bowel. Blueberry juice can be used as an oral contrast agent in upper abdominal MR for T1-weighted imaging. (orig.)

Costs of treating bleeding and perforated peptic ulcers in The Netherlands.

Science.gov (United States)

de Leest, Helena; van Dieten, Hiske; van Tulder, Maurits; Lems, Willem F; Dijkmans, Ben A C; Boers, Maarten

2004-04-01

Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs includes perforations and bleeds. Several preventive strategies are being tested for cost-effectiveness, but little is known about the costs of the complications they are trying to prevent. We estimated the direct costs of hospital treatment of bleeding and perforated ulcers in a university hospital, from data in discharge letters and the hospital management information system. Eligible patients had been treated in the VU University Medical Center between January 1997 and August 2000 for an ulcer bleed or perforation (International Classification of Diseases code 531-4). Resource use comprised hospitalization days and diagnostic and therapeutic interventions. Insurance claim prices determined the costs from the payers' perspective. In a secondary analysis we excluded resource use that was clearly related to the treatment of comorbid illness. Fifty-three patients with a bleeding (n = 35) or perforated ulcer (n = 15) or both (n = 3) were studied, including 14 with comorbidity; 22 complications occurred in the stomach, 29 in the duodenum, one in both stomach and duodenum, and one after partial gastrectomy. A simultaneous bleed and perforation was most expensive (26,000 euro), followed by perforation (19,000 euro) and bleeding (12,000 euro). A bleed in the duodenum was more expensive than in the stomach (13,000 euro vs 10,000 euro), while the opposite was seen for perforations (13,000 euro vs 21,000 euro). Comorbidity increased costs substantially: even after correction for procedures unrelated to the ulcer complication, comorbidity more than doubled the costs of treatment. Treatment of complicated ulcers is expensive, especially in patients with comorbid conditions.

Randomized clinical trial: Effective gluten degradation by Aspergillus niger-derived enzyme in a complex meal setting.

Science.gov (United States)

König, Julia; Holster, Savanne; Bruins, Maaike J; Brummer, Robert J

2017-10-12

The Aspergillus niger-derived prolyl endoprotease (AN-PEP) has previously been shown to degrade gluten in healthy subjects when added to an intragastrically infused meal. The current study investigated the efficacy of AN-PEP in a physiological meal setting. In this randomized placebo-controlled crossover study, 18 gluten-sensitive subjects consumed a porridge containing 0.5 g gluten together with two tablets either containing a high or low dose of AN-PEP, or placebo. Gastric and duodenal content was sampled over 180 minutes, and areas under the curve of gluten concentrations were calculated. The primary outcome, i.e. success rate of high dose AN-PEP defined as at least 50% gluten degradation compared to placebo in the duodenum, was achieved in 10 of 13 comparisons. In the stomach, gluten levels were reduced from 176.9 (median, interquartile range 73.5-357.8) to 22.0 (10.6-50.8, p = 0.001) in the high dose and to 25.4 μg × min/ml (16.4-43.7, p = 0.001) in the low dose. In the duodenum, gluten levels were reduced from 14.1 (8.3-124.7) in the placebo to 6.3 (3.5-19.8, p = 0.019) in the high dose and to 7.4 μg × min/ml in the low dose (3.8-12.0, p = 0.015). Thus even in a physiological meal setting, AN-PEP significantly degraded most gluten in the stomach before it entered the duodenum.

Endoscopic ultrasonography-guided rendezvous technique.

Science.gov (United States)

Tsuchiya, Takayoshi; Itoi, Takao; Sofuni, Atsushi; Tonozuka, Ryosuke; Mukai, Shuntaro

2016-04-01

Endoscopic retrograde cholangiopancreatography (ERCP) requires deep biliary cannulation. When deep biliary cannulation is failed, the endoscopic ultrasonography rendezvous technique (EUS-RV) is a useful salvage method. From the previous 15 articles that included 382 EUS-RV cases, the overall success rate of EUS-RV is 81 % with a complication rate of 10 %. In EUS-RV, the bile duct is punctured under EUS guidance and a guidewire is advanced into the duodenum via the papilla. The EUS scope is then switched to a duodenoscope and inserted into the bile duct over the guidewire exiting the papilla, or the guidewire is grasped with forceps and passed through the working channel; the catheter can then be inserted through the papilla over the wire. There are three puncture routes for EUS-RV: transgastric puncture of the intrahepatic bile duct (IHBD), transduodenal puncture of the extrahepatic bile duct (EHBD) via the proximal duodenum (D1), and transduodenal puncture of the EHBD via the second portion of the duodenum (D2). The puncture route for each patient should be selected based on the patient condition. GW selection for EUS-RV is critical, a hydrophilic GW is useful for this procedure. Although EUS-RV is now performed relatively routinely in a few high-volume centers, procedure standardization and the development of exclusive devices for EUS-RV are still underway. The development of exclusive devices for EUS-RV and prospective comparative studies with other salvage methods are needed to truly evaluate the procedure's usefulness and safety.

Dual-phase CT findings of groove pancreatitis

Energy Technology Data Exchange (ETDEWEB)

Zaheer, Atif, E-mail: azaheer1@jhmi.edu [The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21231 (United States); Pancreatitis Center, Division of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21231 (United States); Haider, Maera, E-mail: mhaider3@jhmi.edu [The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21231 (United States); Kawamoto, Satomi, E-mail: skawamo1@jhmi.edu [The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21231 (United States); Hruban, Ralph H., E-mail: rhruban1@jhmi.edu [Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, the Johns Hopkins University School of Medicine, Baltimore, MD 21231 (United States); Fishman, Elliot K., E-mail: efishma1@jhmi.edu [The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21231 (United States)

2014-08-15

Purpose: Groove pancreatitis is a rare focal form of chronic pancreatitis that occurs in the pancreaticoduodenal groove between the major and minor papillae, duodenum and pancreatic head. Radiologic appearance and clinical presentation can result in suspicion of malignancy rendering pancreaticoduodenectomy inevitable. This study reports dual phase CT findings in a series of 12 patients with pathology proven groove pancreatitis. Materials and methods: Retrospective review of preoperative CT findings in 12 patients with histologically proven groove pancreatitis after pancreaticoduodenectomy. Size, location, attenuation, presence of mass or cystic components in the pancreas, groove and duodenum, calcifications, duodenal stenosis and ductal changes were recorded. Clinical data, laboratory values, endoscopic ultrasonographic and histopathological findings were collected. Results: Soft tissue thickening in the groove was seen in all patients. Pancreatic head, groove and duodenum were all involved in 75% patients. A discrete lesion in the pancreatic head was seen in half of the patients, most of which appeared hypodense on both arterial and venous phases. Cystic changes in pancreatic head were seen in 75% patients. Duodenal involvement was seen in 92% patients including wall thickening and cyst formation. The main pancreatic duct was dilated in 7 patients, with an abrupt cut off in 3 and a smooth tapering stricture in 4. Five patients had evidence of chronic pancreatitis with parenchymal calcifications. Conclusion: Presence of mass or soft tissue thickening in the groove with cystic duodenal thickening is highly suggestive of groove pancreatitis. Recognizing common radiological features may help in diagnosis and reduce suspicion of malignancy.

Uroguanylin levels in intestine and plasma are regulated by nutritional status in a leptin-dependent manner.

Science.gov (United States)

Folgueira, C; Sanchez-Rebordelo, E; Barja-Fernandez, S; Leis, R; Tovar, S; Casanueva, F F; Dieguez, C; Nogueiras, R; Seoane, L M

2016-03-01

Uroguanylin (UGN) is a 16 amino acid peptide produced mainly by intestinal epithelial cells. Nutrients intake increases circulating levels of prouroguanylin that is processed and converted to UGN to activate the guanylyl cyclase 2C receptor (GUCY2C). Given that the UGN-GUCY2C system has been proposed as a novel gut-brain endocrine axis regulating energy balance, the aim of the present study was to investigate the regulation of UGN protein levels in duodenum and circulating levels in lean and obese mice under different nutritional conditions and its potential interaction with leptin. Swiss, C57BL/6 wild-type and ob/ob male adult mice under different nutritional conditions were used: fed ad libitum standard diet (control); 48 h fasting (fasted); 48 h fasting followed by 24 h of feeding (refed); and fed high-fat diet (45 %) during 10 weeks. In addition, peripheral leptin administration was performed. Intestinal uroguanylin expression was studied by Western blot analysis; plasma levels were measured by ELISA. Food deprivation significantly reduced plasma UGN levels, which were correlated with the lower protein levels of UGN in duodenum. These effects were reverted after refeeding and leptin challenge. Consistently, in ob/ob mice UGN expression was decreased, whereas leptin treatment up-regulated UGN levels in duodenum in these genetically modified mice compared to WT. Diet-induced obese mice displayed increased UGN levels in intestine and plasma in comparison with lean mice. Our findings suggest that UGN levels are correlated with energy balance status and that the regulation of UGN by nutritional status is leptin-dependent.

Moving and fusion of the pancreatic buds in the rat embryos during the embryonic period (carnegie stages 13-17) by a three-dimensional computer-assisted reconstruction.

Science.gov (United States)

Godlewski, Guilhem; Gaubert, Jacques; Cristol-Gaubert, Renée; Radi, Maïada; Baecker, Volker; Travo, Pierre; Prudhomme, Michel; Prat-Pradal, Dominique

2011-10-01

The purpose of the present study was to illustrate the modality of rotation of ventral and dorsal pancreatic buds by three-dimensional (3D) reconstructions in the rat embryos, during the Carnegie stages 13-17. Serial sections of thirty rat embryos stages 13-17, were observed. The embryos were fixed in Bouin's solution, dehydrated, and paraffin embedded. The sections, 7 μm thick, were cut in longitudinal or transverse planes and were stained alternately by hematoxylin-eosin or Heindenhain' azan. The images were digitalized by Canon Camera 350 EOS D. The 3D reconstruction was performed by computer using Cell Image Analyser software. The two pancreatic buds ventral and dorsal, were clearly identified at stage 13, in anterior and posterior position, respectively, in relation to the duodenum. In stage 15, the duodenum started its rotation of 90° clockwise. The ventral bud moved 90° from the midline to the right. In stage 16, the ventral pancreas continued its rotation until 180° in posterior position behind the duodenum. In stage 17, the two pancreatic buds were related closely to the ventral part of the portal vein. The two buds began to merge. The anterior face of the pancreas's head was arising from the dorsal pancreatic bud. The rest of the head including the omental tuberosity and the uncinate process emanated from the ventral pancreatic bud. The use of 3D reconstruction of the pancreas of rat embryos illustrates the modality of the two pancreatic buds rotation and fusion. This method explains the final position of the pancreas.

Laparoscopic treatment of a phytobezoar in the duodenal diverticulum – Report of a case

Science.gov (United States)

Pergel, Ahmet; Yucel, Ahmet Fikret; Aydin, Ibrahim; Sahin, Dursun Ali

2012-01-01

INTRODUCTION Primer small intestine bezoar is seen rarely. It frequently arises from underlying small intestine pathologies (diverticle, tumor, stricture etc.). We report a very rare case of disopyrobezoar in the duodenal diverticulum, a kind of phytobezoar caused by persimmons, which was treated laparoscopically. PRESENTATION OF CASE The 47-year-old patient applied to polyclinic with complaints of epigastric tenderness, occasional distension, and acid regurgitation. In endoscopical examination, impacted bezoar was determined in the diverticulum in the duodenum. Because it is too hard, it was unable to remove endoscopically. On the abdominal tomography, a smooth-bounded non-homogeneous mass including gas and soft tissue areas in the 2nd portion of the duodenum was detected. A barium meal confirmed the presence of a 5 cm diameter diverticulum on the lateral wall of the second portion of the duodenum. It also showed an intraluminalfilling defect as well as the mottled appearance of the bezoar. Learned from history of the patient, that the patient consumed over persimmon in childhood. DISCUSSION Generally, duodenal diverticles are asymptomatic. Surgical treatment is rarely necessary because of complications such as bleeding, perforation, abdominal pain, bezoar formation. As well as using methods such as gastric lavage, enzymatic dissolution, endoscopical fragmentation in the treatment of phytobezoar, their chances of success are low because its structure is rigid. Usually, surgical intervention is required. CONCLUSION For the treatments of bezoar cases located in the small intestine, laparoscopic surgical method is a safe and feasible method in selected cases. PMID:22659120

Laparoscopic treatment of a phytobezoar in the duodenal diverticulum - Report of a case.

Science.gov (United States)

Pergel, Ahmet; Yucel, Ahmet Fikret; Aydin, Ibrahim; Sahin, Dursun Ali

2012-01-01

Primer small intestine bezoar is seen rarely. It frequently arises from underlying small intestine pathologies (diverticle, tumor, stricture etc.). We report a very rare case of disopyrobezoar in the duodenal diverticulum, a kind of phytobezoar caused by persimmons, which was treated laparoscopically. The 47-year-old patient applied to polyclinic with complaints of epigastric tenderness, occasional distension, and acid regurgitation. In endoscopical examination, impacted bezoar was determined in the diverticulum in the duodenum. Because it is too hard, it was unable to remove endoscopically. On the abdominal tomography, a smooth-bounded non-homogeneous mass including gas and soft tissue areas in the 2nd portion of the duodenum was detected. A barium meal confirmed the presence of a 5cm diameter diverticulum on the lateral wall of the second portion of the duodenum. It also showed an intraluminalfilling defect as well as the mottled appearance of the bezoar. Learned from history of the patient, that the patient consumed over persimmon in childhood. Generally, duodenal diverticles are asymptomatic. Surgical treatment is rarely necessary because of complications such as bleeding, perforation, abdominal pain, bezoar formation. As well as using methods such as gastric lavage, enzymatic dissolution, endoscopical fragmentation in the treatment of phytobezoar, their chances of success are low because its structure is rigid. Usually, surgical intervention is required. For the treatments of bezoar cases located in the small intestine, laparoscopic surgical method is a safe and feasible method in selected cases. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Pancreaticoduodenal injuries: Re-evaluating current management ...

African Journals Online (AJOL)

Background. Pancreaticoduodenal injuries are uncommon owing to the protected position of the pancreas and duodenum in the retroperitoneum. Management depends on the extent of injury. This study was undertaken to document outcome of pancreaticoduodenal injuries and to re-evaluate our approach. Patients and ...

Pancreatic bicarbonate secretion involves two proton pumps

DEFF Research Database (Denmark)

Novak, Ivana; Wang, Jing; Henriksen, Katrine L.

2011-01-01

Pancreas secretes fluid rich in digestive enzymes and bicarbonate. The alkaline secretion is important in buffering of acid chyme entering duodenum and for activation of enzymes. This secretion is formed in pancreatic ducts, and studies to date show that plasma membranes of duct epithelium expres...

Idiopathic gastric perforation in an asplenic infant | Olsen | African ...

African Journals Online (AJOL)

Introduction: The cause of idiopathic gastric perforations in neonates remains unknown. Perforations of the abdominal oesophagus, stomach and duodenum in infants and children are the rarest type of intestinal perforations. There are 21 reported cases of an idiopathic gastric rupture in nonneonates. Case Report: A ...

Age-dependent alterations in Ca2+ homeostasis: Role of TRPV5 and TRPV6

NARCIS (Netherlands)

M. van Abel (Monique); S. Huybers (Sylvie); J.G. Hoenderop (Joost); A.W.C.M. Kemp (Annemiete); J.P.T.M. van Leeuwen (Hans); R.J.M. Bindels (René)

2006-01-01

textabstractAging is associated with alterations in Ca2+ homeostasis, which predisposes elder people to hyperparathyroidism and osteoporosis. Intestinal Ca2+ absorption decreases with aging and, in particular, active transport of Ca2+ by the duodenum. In addition, there are age-related changes in

Detection of fecal residue on poultry carcasses by laser induced fluorescence imaging techniques

Science.gov (United States)

The potential use of laser-induced fluorescence imaging techniques was investigated for the detection of diluted fecal matters from various parts of the digestive tract, including colon, ceca, small intestine, and duodenum, on poultry carcasses. One of the challenges for using fluorescence imaging f...

Combined pancreatic and duodenal transection injury: A case report

Directory of Open Access Journals (Sweden)

Simbarashe Gift Mungazi

2017-01-01

Conclusion: Combined pancreatic and duodenal injuries are rare and often fatal. Early identification, resuscitation and surgical intervention is warranted. Because of the large number of possible combinations of injuries to the pancreas and duodenum, no one form of therapy is appropriate for all patients.

Endoskopisk ultralydskanning af maligne tumorer i øvre abdomen

DEFF Research Database (Denmark)

Mortensen, M B; Hovendal, C P; Pedersen, S A

1993-01-01

Endoscopic ultrasonography (EUS) of the upper gastrointestinal tract is a newly developed, non-invasive investigational method. It combines the direct optical picture of the endoscope with a simultaneous ultrasonographic image of the whole wall of the oesophagus, stomach and duodenum as well as o...

Expression of avian beta-defensins in the intestine of Eimeria-challenged chickens

Science.gov (United States)

Avian coccidiosis is caused by the intracellular protozoa Eimeria. The site of invasion and lesions in the intestine is species-specific; for example, E. acervulina mainly affects the duodenum, E. maxima the jejunum, and E. tenella the ceca. Lesions in the intestinal mucosa reduce feed efficiency a...

Mammalian Toxicity of Munitions Compounds. Phase II. Effects of Multiple Doses Part II. 2,4-Dinitrotoluene

Science.gov (United States)

1978-11-01

ml. All incubations were carried out for 18 hours at 37*C. After incubation, enzyme activity was terminated by extraction with 5 volumes of CHC13-MeOH...except rat), salivary gland, liver, gallbladder (except rats), pancreas, esophagus, fundic and pyloric stomach, duodenum, Jejunum, ileum, cecum

Age-dependent alterations in Ca2+ homeostasis: role of TRPV5 and TRPV6.

NARCIS (Netherlands)

Abel, M. van; Huybers, S.; Hoenderop, J.G.J.; Kemp, J.W.C.M. van der; Leeuwen, J.P.P.M. van; Bindels, R.J.M.

2006-01-01

Aging is associated with alterations in Ca2+ homeostasis, which predisposes elder people to hyperparathyroidism and osteoporosis. Intestinal Ca2+ absorption decreases with aging and, in particular, active transport of Ca2+ by the duodenum. In addition, there are age-related changes in renal Ca2+

Sustained glucagon-like peptide-2 infusion is required for intestinal adaptation, and cessation reverses increased cellularity in rats with intestinal failure

DEFF Research Database (Denmark)

Koopmann, Matthew C; Chen, Xueyan; Holst, Jens Juul

2010-01-01

in duodenum and jejunum mucosal dry mass, protein, DNA, and sucrase activity compared with TPN control. The increased jejunum cellularity reflected significantly decreased apoptosis and increased crypt mitosis and crypt fission due to GLP-2. When GLP-2 infusion stopped at 7 days, these effects were reversed...

Real-time TaqMan polymerase chain reaction to quantify the effects ...

African Journals Online (AJOL)

TaqMan polymerase chain reaction was developed to quantify the number of Bifidobacterium. We used this assay to detect genomic DNA of Bifidobacterium in the intestinal tract digesta of piglets, including duodenum, jejunum, ileum, cecum and colon. Our results indicated that, developed new real-time quantitative PCR ...

Laparoscopic diagnostic findings in atypical intestinal malrotation in ...

African Journals Online (AJOL)

We present our experience with laparoscopic management of atypical presentations of intestinal malrotation in children, describing laparoscopic findings in these ... Thirty-six patients (90%) were found to have definite laparoscopic findings in the form of markedly dilated stomach and first part of duodenum, ectopic site of ...

Melatonin is a redundant entraining signal in the rat circadian system

Czech Academy of Sciences Publication Activity Database

Houdek, Pavel; Nováková, Marta; Polidarová, Lenka; Sládek, Martin; Sumová, Alena

2016-01-01

Roč. 83, Jul (2016), s. 1-5 ISSN 0018-506X R&D Projects: GA ČR(CZ) GA14-07711S Institutional support: RVO:67985823 Keywords : melatonin * pinealectomy * suprachiasmatic nucleus * liver * duodenum * clock gene Subject RIV: ED - Physiology Impact factor: 3.378, year: 2016

Duodenal versus jejunal biopsies in suspected celiac disease

NARCIS (Netherlands)

Thijs, WJ; van Baarlen, J; Kleibeuker, JH; Kolkman, JJ

2004-01-01

Background and Study Aims: In the past, small-bowel biopsies for diagnosis of celiac disease were taken from the jejunum with a suction capsule, but nowadays most physicians take endoscopic biopsies from the distal duodenum. To validate that practice we compared the diagnostic yield of endoscopic

ERCP

Science.gov (United States)

... through the mouth. It goes through the esophagus (food pipe) and stomach until it reaches the duodenum (the part of the small intestine that is closest to the stomach). You should not feel discomfort, and may have little memory of the test. You may gag as the ...

Decision analysis in the management of duodenal adenomatosis in familial adenomatous polyposis

NARCIS (Netherlands)

Vasen, H. F.; Bülow, S.; Myrhøj, T.; Mathus-Vliegen, L.; Griffioen, G.; Buskens, E.; Taal, B. G.; Nagengast, F.; Slors, J. F.; de Ruiter, P.

1997-01-01

Patients with familial adenomatous polyposis are not only at high risk of developing adenomas in the colorectum but a substantial number of patients also develop polyps in the duodenum. Because treatment of duodenal polyps is extremely difficult and it is unknown how many patients ultimately develop

Obesity And Laboratory Diets Affects Tissue Malondialdehyde (MDA) Levels In Obese Rats

Science.gov (United States)

Chowdhury, Parimal; Scott, Joseph; Holley, Andy; Hakkak, Reza

2010-04-01

This study was conducted to investigate the interaction of obesity and laboratory diets on tissue malondialdehyde levels in rats. Female Zucker obese and lean rats were maintained on either regular grain-based diet or purified casein diet for two weeks, orally gavaged at day 50 with 65 mg/kg DMBA and sacrificed 24 hrs later. Malondialdehyde (MDA) levels were measured in blood and harvested tissues. Data were recorded as mean ± SEM and analyzed statistically. Results show that the obese group on purified casein diet had reduction of MDA levels in the brain, duodenum, liver, lung and kidney tissues as compared to lean group, p <0.05. Obese group on grain-based diet showed significant increase in MDA levels only in the duodenum, p <0.05. We conclude that dietary intervention differentially affects the oxidative markers in obese rats. It appears that purified casein diets were more effective than grain-based diet in reduction of oxidative stress in obese rats.

Scientific opinion of Flavouring Group Evaluation 205 Revision 1 (FGE.205Rev1): consideration of genotoxicity data on representatives for 13 α,β-unsaturated aliphatic ketones with terminal double bonds and precursors from chemical subgroup 1.2.2 of FGE.19

DEFF Research Database (Denmark)

Beltoft, Vibe Meister; Nørby, Karin Kristiane

The EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids (CEF Panel) was requested to consider in the Flavouring Group Evaluation 205 (FGE.205), the additional data on genotoxicity submitted by the Industry on two representative substances, oct-1-en-3-one [FL-no: 07.......081] and pent-1-en-3-one [FL-no: 07.102], from subgroup 1.2.2 of FGE.19. The Panel concluded that both substances were weakly genotoxic in bacteria with pent-1-en-3-one being the most potent (previously available data). In these assays, the representative substances were highly cytotoxic with a steep toxicity...... of the representative substances, pent-1-en-3-one, in an in vivo Comet assay on the first site of contact (e.g. the stomach or duodenum) and on the liver. The Industry has now submitted new data, a combined micronucleus and Comet assay for pent-1-en-3-one, with scoring in the liver and duodenum, and an Ames test...

Penyakit Peptik dan Misoprostol

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Mariana Raini

2012-10-01

Full Text Available Peptic mucus synthesize especially prostaglandine E2 and I2. Prostaglandine E2 and I2 can impede acid secrete and stimulate mucus and bicarbonate secretion. Misoprostof, a synthetic methyl ester analogue of prostaglandin is both a powerful inhibitor of gastric secretion and is able to protect the gastroduodenal mucosa from damage. Misoprostol and other prostaglandine derivatives can be alternative drug of peptic ulcer relapse because the metyl ester of prostaglandin exert an antisecretion and protective effects on peptic mucus. The clinical effectiveness of misoprostol is comparable to cimethidin in short term treatment of peptic and duodenum ulcer as well as reducing duodenal ulcer relapse. Misoprostol may prevent gastrointestinal and peptic ulcer in long term treatment of Non Steroid Anti Jnflamation Drug. The side effect of misoprostol is cervix maturation and uterotonic. This article describe misoprostol effictiveness on peptic and duodenum ulcer treatment.   Key Words: Misoprostol, Peptik ulcer, Sitoproteksi

Pancreas preserving total duodenectomy for complex duodenal injury.

Science.gov (United States)

Wig, Jai Dev; Kudari, Ashwinikumar; Yadav, Thakur Deen; Doley, Rudra Prasad; Bharathy, Kishore Gurumoorthy Subramanya; Kalra, Naveen

2009-07-06

To assess the feasibility and safety of a pancreas-preserving total duodenectomy in the management of severe duodenal injury caused by abdominal trauma. Two patients with both extensive injury of the duodenum and diffuse peritonitis underwent pancreas preserving total duodenectomy at our tertiary care centre. These two young male patients (age 20 and 22 years) presented 2 days and 6 hours respectively following blunt abdominal trauma. The duodenum was almost completely separated from the pancreas. Ampulla was seen as a button on the pancreas. Following total duodenectomy, reconstruction was performed by suturing the jejunum to the head of the pancreas anteriorly and posteriorly away from the ampulla (invagination of the pancreas into the jejunum). There were no complications attributable to the procedure. Both patients are well on follow up. A Pancreas-preserving total duodenectomy offers a safe alternative to the Whipple procedure in managing complex duodenal injury. This procedure avoids unnecessary resection of the adjacent pancreas and anastomosis to undilated hepatic and pancreatic ducts.

Case of radiation gastroduodenitis caused by /sup 60/Co-irradiation therapy for hepatoma

Energy Technology Data Exchange (ETDEWEB)

Nishikawa, H; Hayashi, N; Morise, K; Tunekawa, J; Kaneshiro, K [Nagoya Univ. (Japan). Faculty of Medicine

1981-02-01

A 56-year-old man with hepatoma, who had been treated with total 3,960 rad of /sup 60/Co-irradiation 2 months previously, was readmitted to the hospital because of fever and anemia. Following admission, he passed tarry stools every day. Barium meal examination revealed esophageal varices and erosive gastritis of the antrum. At endoscopy, many hemorrhagic erosions were found in the gastric antrum and the first part of duodenum, which were located in the irradiation area. Since repeated blood transfusion failed to improve anemia, a complete fasting with intravenous hyperalimentation and antacid therapy were started. Two months later, feeding was started and thereafter continued without any appreciable GI bleeding or worsening of anemia. Endoscopic examination at this time revealed only a few erosions scattered over the edematous antral mucosa as well as the proximal duodenum. IVH, antacids and abstinence from food seem to be an effective measure in the treatment of radiation injury of the gut.

Scintigraphic estimation of the duodeno-gastric reflux in the unclerous disease

International Nuclear Information System (INIS)

Kopanski, Z.; Cienciala, A.; Micherdzinski, J.; Brandys, J.; Zastepa, P.; Witkowska, B.

1993-01-01

The analysis includes 58 patients with an ulcer in the duodenum, 40 patients with an ulcer in the stomach, and 13 persons making up the control group. In all patients submitted to the ratio-isotopic estimation of the duodeno-gastric reflux as well as to the chromatographic determination of the concentration of bile acids and lysolecithin in the gastric juice, an almost identically frequent occurrence of the reflux of the duodeno gastric contents into the ulcer of the stomach and of the duodenum was confirmed. It was shown that half of the ulcers of the stomach originate without the participation of the duodeno gastric reflux. It was also established that the average total concentrations of bile acids and lysolecithin are very high in the gastric juice, and in some even statistically significant cases, in the ulcer of the stomach in comparison with the remaining analysed groups of patients. (author). 17 refs, 4 figs

Scintigraphic estimation of the duodeno-gastric reflux in the unclerous disease; Scyntygraficzna ocena refluksu dwunastniczo-zoladkowego w chorobie wrzodowej

Energy Technology Data Exchange (ETDEWEB)

Kopanski, Z.; Cienciala, A.; Micherdzinski, J. [Szpital Wojskowy, Cracow (Poland); Brandys, J. [Uniwersytet Jagiellonski, Cracow (Poland); Zastepa, P.; Witkowska, B.

1993-12-31

The analysis includes 58 patients with an ulcer in the duodenum, 40 patients with an ulcer in the stomach, and 13 persons making up the control group. In all patients submitted to the ratio-isotopic estimation of the duodeno-gastric reflux as well as to the chromatographic determination of the concentration of bile acids and lysolecithin in the gastric juice, an almost identically frequent occurrence of the reflux of the duodeno gastric contents into the ulcer of the stomach and of the duodenum was confirmed. It was shown that half of the ulcers of the stomach originate without the participation of the duodeno gastric reflux. It was also established that the average total concentrations of bile acids and lysolecithin are very high in the gastric juice, and in some even statistically significant cases, in the ulcer of the stomach in comparison with the remaining analysed groups of patients. (author). 17 refs, 4 figs.

Handlebar Hernia With Jejunal and Duodenal Injuries: A Case Report

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Ching-Wen Huang

2004-09-01

Full Text Available Traumatic abdominal wall hernia is an uncommon complication of abdominal blunt trauma. Handlebar hernia is even more infrequent. To the best of our knowledge, there are fewer than 30 cases of handlebar hernia reported in the English literature. Associated intra-abdominal injuries are infrequent. We present a case of handlebar hernia with jejunal and duodenal injuries. Emergency surgical intervention included primary repair of the disrupted musculofascial defect and injuries of the duodenum and jejunum. Bile- stained discharge from the drain tube was noted, so a second operation was performed about 7 days after the first. Leakage from the sutured jejunal perforation and another irregular perforation in the posterior wall of the fourth portion of the duodenum were noted. The two perforations were debrided and repaired. The muscular and fascial defects were debrided and closed with interrupted sutures. The patient recovered smoothly and was discharged 30 days after the blunt injury. No other major complication was noted 11 months after surgery.

Early Rupture of an Ultralow Duodenal Stump after Extended Surgery for Gastric Cancer with Duodenal Invasion Managed by Tube Duodenostomy and Cholangiostomy

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Konstantinos Blouhos

2013-01-01

Full Text Available When dealing with gastric cancer with duodenal invasion, gastrectomy with distal resection of the duodenum is necessary to achieve negative distal margin. However, rupture of an ultralow duodenal stump necessitates advanced surgical skills and close postoperative observation. The present study reports a case of an early duodenal stump rupture after subtotal gastrectomy with resection of the whole first part of the duodenum, complete omentectomy, bursectomy, and D2+ lymphadenectomy performed for a pT3pN2pM1 (+ number 13 lymph nodes adenocarcinoma of the antrum. Duodenal stump rupture was managed successfully by end tube duodenostomy, without omental patching, and tube cholangiostomy. Close assessment of clinical, physical, and radiological signs, output volume, and enzyme concentration of the tube duodenostomy, T-tube, and closed suction drain, which was placed near the tube duodenostomy site to drain the leak around the catheter, dictated postoperative management of the external duodenal fistula.

[Post traumatic injuries of the duodenum and/or pancreas. Perioperative management].

Science.gov (United States)

Beye, M D; Kane, O; Diouf, E; Ndoye, M D; Ndiaye, P I; Fall, B; Sall, B K

2002-01-01

The duodenal and/or pancreatic lesions rarely occur during abdominal contusions, this, because of the deep and retroperitoneal position of the duodeno-pancreatic entity. These lesions occur mostly in the young adults and occur mostly on violent trauma, hence the high frequency of associated lesions. Their management is well codified and the prognosis depends on the degree of pancreatic damage. The authors reporting of 3 cases of duodenaland or post-traumatic lesion, in a retrospective study. The after therapeutic management necessitated a pre-operative reanimation, simple duodenal suturing in the 3 cases with relearning gastrotomy, alimentation jejenostomy and closing of thepyloric sphincter,with association of cholostomy in one of the cases. The pancreatic lesions of type contusion observed in 2 cases necessitated simple drainage of the pancreatic sector without resection. The evolution was favourable in 2 cases. One case of death was noted in a patient who developed acute pancreatis.

Perforated gastric and duodenal ulcers in an urban African population

African Journals Online (AJOL)

Background: Perforations of the stomach and duodenum are frequent causes of acute generalized peritonitis in our environment. This is a prospective study of 331 cases of gastric and duodenal perforations. Study design: A consecutive series of adult patients admitted and treated for acute generalized peritonitis due to ...

Expression of digestive enzymes and nutrient transporters in Eimeria-challenged broilers

Science.gov (United States)

Avian coccidiosis is a disease caused by the intestinal protozoa Eimeria. The site of invasion and lesions in the intestine is species-specific, for example E. acervulina affects the duodenum, E. maxima the jejunum, and E. tenella the ceca. Lesions in the intestinal mucosa cause reduced feed effic...

Radiological aspects of Crohn's disease in small intestine: iconographic assay

International Nuclear Information System (INIS)

Barros, Nestor de; Juliano, Adriana G.; Polizini, Jose M.R.; Rejtman, Debora; Cerri, Giovanni Guido; Rocha, Manoel de Souza

1999-01-01

The authors present the radiological features of Crohn's disease in small intestine as ways of differential diagnosis of others diseases of duodenum and adjacent organs. In this differentiation or confirmation of Crohn's disease the US and TC have proven to be clinically efficacious in the identification of lesions

Effect of oral administration of Gnidia Stenophylla Gilg aqueous root ...

African Journals Online (AJOL)

Microscopic evaluation of sections of the stomach, duodenum and jejunum of the mice treated with 400 mg/kg body weight did not show any histopathological change. In the mice treated with 800 mg/kg body weight, however, the GIT sections revealed cytoplasmic vacuolation, hydropic degeneration and excessive erosion ...

Megaduodenum og obstipation efter operation for kongenit tyndtarmsatresi

DEFF Research Database (Denmark)

Karstensen, John; Raahave, Dennis; Kirkegaard, Preben

2011-01-01

A 33 year-old female presented with constipation and a right-sided palpable abdominal mass, suspected to be the colon. The colonic transit time was prolonged, but the dilated organ was a mega duodenum that had developed after surgery for three jejunal atresies performed one day after birth...

Phase-II study on stereotactic radiotherapy of locally advanced pancreatic carcinoma

DEFF Research Database (Denmark)

Høyer, Morten; Roed, Henrik; Sengeløv, Lisa

2005-01-01

, scored less nausea, pain, or needed less analgesic drugs at 3 months after treatment. Four patients suffered from severe mucositis or ulceration of the stomach or duodenum and one of the patients had a non-fatal ulcer perforation of the stomach. CONCLUSIONS: SRT was associated with poor outcome...

Heineke-Mikulicz Pyloroplasty- The Observer Error in the ...

African Journals Online (AJOL)

examinations were arranged in a random fashion on unex- posed film. ... in detail the changes in the radiological appearances of the antrum and duodenal bulb that may follow Heineke-Mikulicz pyloroplasty. But we have on occasion seen barium-meal films in which the appearances of the duodenum following pylo-.

GENERAL SURGERY

African Journals Online (AJOL)

Cruveilhier J. Anatomie pathologique du corps humain. Paris: JB Balliere, 1835. 3. Goldman RL. Hamartomatous polyp of Brunner's gland. Gastroenterology. 1963;44:57-62. 4. Kellogg EL. Intussusception of the duodenum caused by adenoma originating in Brunner's glands. Med J Record. 1931;134:440-2. 5. Lempke RE.

Effect of Long-Term Hypodynamy on Alkaline Phosphatase Activity of Small Intestine in Japanese Quail Chicks

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Ľ. Lenhardt

2007-01-01

Full Text Available The functional development of the small intestine was investigated in Japanese quail chicks subjected to simulated microgravity (hypodynamy on the second day after hatching and reared under these conditions to 63 days of age. On days 5, 7, 14, 21, 28, 35, 42, 56 and 63 the activity of brush-border-bound alkaline phosphatase (AP in the duodenum and jejunum were determined in experimental animals as well as in control quail chicks housed in a floor box during these periods. As compared with control quails the experimental animals displayed a significantly increased enzyme activity until day 42 in the duodenum and day 35 in the jejunum (P < 0.001 whereas in older quails no significant enzymatic differences between these groups was found. However, a decrease in food consumption due to a partial physical constraint cannot be excluded. Moreover, the results suggested that the activity of AP in the control birds did not change substantially during all the periods examined. In contrast, in older hypodynamy quail the AP activity significantly decreased in the duodenum on days 56 and 63 and in the jejunum on days 42, 56 and 63, respectively. These results indicate that a the enhanced intestinal function in early periods of life may reflect the higher sensitivity of small intestine to simulated weightlessness, b the decrease of the AP activity in older animals to the level of controls might be considered as a part of intestinal mechanisms involved in adaptation of quail chicks to long-term hypodynamy, c different activity of AP in the small intestine of Japanese quail may not have resulted only from hypodynamy but also due to decreased food intake.

Clinicoradiological appraisal of ‘paraduodenal pancreatitis’: Pancreatitis outside the pancreas!

International Nuclear Information System (INIS)

Arora, Ankur; Rajesh, S; Mukund, Amar; Patidar, Yashwant; Thapar, Shalini; Arora, Asit; Bhatia, Vikram

2015-01-01

Paraduodenal pancreatitis (PP) is a unique form of focal chronic pancreatitis that selectively involves the duodenum and aberrant pancreatic tissue located near the minor papilla (beyond the pancreas proper). The pseudotumoral nature of the disease often generates considerable clinical quandary and patient apprehension, and therefore merits a better understanding. The present study appraises the clinicoradiological manifestations of PP in 33 patients. Clinical, laboratory, and radiological manifestations of 33 patients of PP treated in gastroenterology/hepatology and hepato-pancreatico-biliary surgery units during June 2010-August 2014 were retrospectively reviewed. All patients were young to middle-aged men (100%) with history of alcohol abuse (93.9%) and/or smoking (42.4%), who presented either with acute or gradually worsening abdominal pain (90.9%). Pancreatic enzymes and serum tumor markers remained normal or were mildly/transiently elevated. Cystic variant was detected in 57.6% (solid in 42.4%); the disease remained confined to the groove/duodenum (pure form) in 45.4%. Medial duodenal wall thickening with increased enhancement was seen in 87.87 and 81.81%, respectively, and duodenal/paraduodenal cysts were seen in 78.78%. Pancreatic calcifications and biliary stricture were seen 27.3% patients. Peripancreatic arteries were neither infiltrated nor encased. PP has a discrete predilection for middle-aged men with history of longstanding alcohol abuse and/or smoking. Distinguishing imaging findings include thickening of the pancreatic side of duodenum exhibiting increased enhancement with intramural/paraduodenal cysts. This may be accompanied by plate-like scar tissue in the groove region, which may simulate groove pancreatic carcinoma. However, as opposed to carcinoma, the peripancreatic arteries are neither infiltrated nor encased, rather are medially displaced

[Pancreaticoduodenectomy performed in a patient with transverse colon cancer associated with a duodenal fistula - a case report].

Science.gov (United States)

Koumori, Keisuke; Makino, Hironobu; Kametaka, Hisashi; Fukada, Tadaomi; Seike, Kazuhiro; Koyama, Takashi

2014-11-01

A 71-year-old man with a positive fecal occult blood test was diagnosed with transverse colon cancer and referred to our hospital. Colonoscopy revealed type II transverse colon cancer with circumferential involvement. Contrast-enhanced computed tomography (CT)revealed a tumor with an unclear boundary in the pancreas. No metastases to the liver or lungs were detected, and there were no significantly enlarged regional lymph nodes. During open surgery, the tumor of the transverse colon was found to have formed a mass in the pancreatoduodenum, and it was difficult to separate them. As curative resection was considered possible, resections of both the pancreatoduodenum and transverse colon cancer were performed. Laboratory findings revealed fistula formation between the transverse colon cancer and the duodenum. The cancer was diagnosed as stageII, T4bN0M0, and R0 surgery was successfully performed. The patient was alive without recurrence 14- months after the surgery. Colorectal cancer is more likely to advance locally and directly invade the surrounding organs. However, fistula formation with the duodenum has rarely been reported, occurring at an estimated incidence of 0.1%. Such tumors are typically large; however, metastases rates to the lymph nodes are low. Histopathological examination of the resected specimen revealed a severe inflammatory adhesion, and fistula formation between the traverse colon and the duodenum. There was no evidence of invasion of the lymphatic system or blood vessels, which enabled us to perform a high curative surgery. We propose that it is important to consider high curative resection with positive lymph node dissection for cases of colorectal cancer associated with duodenal fistula formation.

Electrocautery-induced localized colonic injury elicits increased levels of pro-inflammatory cytokines in small bowel and decreases jejunal alanine absorption.

Science.gov (United States)

Barada, Kassem; Mourad, Fadi H; Noutsi, Bakiza; Saadé, Nayef E

2015-01-01

Colitis is associated with functional abnormalities in proximal non-inflamed gut areas, but animal models to study small bowel dysfunction in colitis have limitations. This study aims to determine small intestinal alanine absorption and cytokine expression in a novel model of colonic ulceration induced by electro-cautery. A descending colon ulcer was induced in rats by a bipolar electro-cautery probe. Ulcer score was determined using Satoh's criteria. Jejunal alanine absorption was measured immediately and at different time intervals post ulcer induction. Levels of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) protein and m-RNA were determined in mucosal scrapings obtained from the colon, duodenum, jejunum and ileum at various time intervals after colonic ulcer induction. The mean ulcer score was 3 up to 48h, followed by healing by 96h post ulcer induction. Small bowel histology was normal throughout. Jejunal alanine absorption was reduced by 12-34% immediately and up to 72h after cautery and returned to normal at 96h. IL-1 and TNF-α mRNA increased significantly in the colon, duodenum, jejunum and ileum 3h post electro-cautery and returned to normal at 48h, while that of IL-6 increased significantly at 48h post ulcer induction. Similarly, IL-1, IL-6 and TNF-α protein levels increased in the duodenum, jejunum, ileum and colon up to 48h post ulcer induction. Electrically induced localized colonic injury increased production of pro-inflammatory cytokines in non-inflamed segments of the small intestine and was associated with derangements of jejunal absorptive function. Copyright © 2014 Elsevier Ltd. All rights reserved.

Identification of matrix metalloproteinase-2 and -9 activities within the intestinal mucosa of dogs with chronic enteropathies.

Science.gov (United States)

Hanifeh, Mohsen; Rajamäki, Minna Marjaana; Syrjä, Pernilla; Mäkitalo, Laura; Kilpinen, Susanne; Spillmann, Thomas

2018-03-12

Matrix metalloproteinases (MMPs) 2 and 9 are zinc- and calcium-dependent endopeptidases involved in the breakdown and reconstitution of extracellular matrix under both physiological and pathological conditions. Mucosal MMP-2 and -9 activities have been reported to be upregulated in the intestine of humans with inflammatory bowel disease (IBD), and in animal models of IBD. However, their involvement in the pathogenesis of canine chronic enteropathies (CE) is unknown. This study investigated mucosal pro- and active MMP-2 and -9 activities in dogs with CE and healthy dogs using gelatin zymography, and also to determine the association of their activities in dogs with CE with the canine IBD activity index (CIBDAI), histopathologic findings, the clinical outcome, and hypoalbuminemia. Intestinal mucosal samples from duodenum, ileum, colon, and cecum were collected from 40 dogs with CE and 18 healthy Beagle dogs. In dogs with CE, the number of samples positive for mucosal pro- and active MMP-2 was significantly higher in the duodenum (P < 0.0001 and P = 0.011, respectively), ileum (P = 0.002 and P = 0.018, respectively), and colon (P < 0.0001 and P = 0.002, respectively), compared with healthy controls. Mucosal pro-MMP-9-positive samples in the duodenum and colon were significantly more frequent in dogs with CE than in healthy dogs (P = 0.0004 and P = 0.001, respectively). Despite the presence of mucosal samples positive for active MMP-9 in the intestinal segments of dogs with CE, the difference compared to healthy controls did not reach statistical significance. None of the intestinal mucosal samples in healthy dogs showed gelatinolytic activity corresponding to the control bands of active MMP-2 and -9. Mucosal active MMP-9 activities displayed a significant positive association with the severity of neutrophil infiltration in the duodenum (P = 00.040), eosinophils in the cecum (P = 00.037), and the CIBDAI score for ileum samples

Proposal of a new technique for bile duct reconstruction after iatrogenic injury: study in dogs and review of the literature Reconstrução da via biliar após lesão iatrogênica, proposta de nova técnica: estudo em cães e revisão da literatura

Directory of Open Access Journals (Sweden)

Eduardo Crema

2007-06-01

Full Text Available PURPOSE: Interposition of a jejunal tube between the common bile duct and duodenum. METHODS: Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg, were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum. RESULTS: The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct. CONCLUSION: The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.OBJETIVO: Interposição de um tubo de jejuno entre o colédoco e o duodeno. MÉTODOS: Foram utilizados cinco cães adultos, sem raça definida, de ambos os sexos, com peso médio de 22,3 Kg (18 e 26,5 Kg. Após provocar icterícia obstrutiva pela ligadura do colédoco distal, após uma semana, praticou-se confecção do tubo de jejuno de 2,5 cm de extensão, que foi realizado com um segmento de alça retirado a 15 cm do ângulo de Treitz e a interposição do tubo entre o colédoco e o duodeno. RESULTADOS: Os animais tiveram boa evolução clínica e não apresentaram complicações. Notou-se total integração entre a mucosa da via biliar, do tubo e do duodeno e redução significativa dos valores da bilirrubina total e da fosfatase alcalina após seis semanas, quando comparado com os valores após uma semana de ligadura do colédoco. CONCLUSÃO: O tubo de jejuno interposto entre a via biliar dilatada e o duodeno, apresentou boa integração anatômica e reduziu os

Upper gastrointestinal tract bleeding in Ilorin, Nigeria - a report of 30 ...

African Journals Online (AJOL)

Upper gastrointestinal tract bleeding in Ilorin, Nigeria - a report of 30 cases. A.B Olokoba, L.B Olokoba, A.A.G Jimoh. Abstract. Background: Upper gastrointestinal tract bleeding refers to blood loss within the intraluminal gastrointestinal tract from any location between the upper oesophagus to the duodenum at the ligament ...

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African Journals Online (AJOL)

Dr Olaleye

(200ppm). After 24hr fast, gastric acid secretion was measured using the continuous perfusion method of. Ghosh and Schild (1958), modified by Amure and. Ginsburg (1964). Animals where anaesthetized with pentobarbital (35 mg/kg i.p) and a midline laparotomy was made to expose the stomach and duodenum. A semi-.

Primary follicular lymphoma of the small intestine: alpha4beta7 expression and immunoglobulin configuration suggest an origin from local antigen-experienced B cells

NARCIS (Netherlands)

Bende, Richard J.; Smit, Laura A.; Bossenbroek, Janneke G.; Aarts, Wilhelmina M.; Spaargaren, Marcel; de Leval, Laurence; Boeckxstaens, Guy E. E.; Pals, Steven T.; van Noesel, Carel J. M.

2003-01-01

Primary follicular lymphoma of the gastrointestinal tract (GI-FL) is a rare so far poorly studied entity. We analyzed four FL cases located in the small intestine and duodenum to gain insight in their pathogenesis and to find an explanation for their low tendency to disseminate outside the GI tract.

Vascularized pedicle jejunal graft for closure of large duodenal defect in a dog.

Science.gov (United States)

Massie, Anna; McFadden, Michael

2016-11-01

A Labrador retriever dog was presented for intestinal obstruction resulting in devitalization of portions of the duodenum. A severe perforation, accounting for 70% duodenal circumference, was present at the level of the duodenal papilla. A vascularized jejunal graft was used to close the perforation, representing novel utilization of this grafting technique.

Case report

African Journals Online (AJOL)

raoul

2011-12-18

Dec 18, 2011 ... 3. Figures. Figure 1: Contrast barium radiography showing an obstructed third part of the duodenum . Proximal to the obstruction a dilated duodenal bulb and stomach was found: classically known as “double bubble” sign. References. 1. Zyromski NJ, Sandoval JA, Pitt HA, Ladd AP, Fogel EL, Mattar WE, ...

Radiological aspects of Crohn's disease in small intestine: iconographic assay; Aspectos radiologicos da doenca de Crohn no intestino delgado: ensaio iconografico

Energy Technology Data Exchange (ETDEWEB)

Barros, Nestor de; Juliano, Adriana G.; Polizini, Jose M.R.; Rejtman, Debora; Cerri, Giovanni Guido; Rocha, Manoel de Souza [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia

1999-12-01

The authors present the radiological features of Crohn's disease in small intestine as ways of differential diagnosis of others diseases of duodenum and adjacent organs. In this differentiation or confirmation of Crohn's disease the US and TC have proven to be clinically efficacious in the identification of lesions.

DIETARY FISH OIL-INDUCED CHANGES IN INTRAHEPATIC CHOLESTEROL TRANSPORT AND BILE-ACID SYNTHESIS IN RATS

NARCIS (Netherlands)

SMIT, MJ; TEMMERMAN, AM; WOLTERS, H; KUIPERS, F; BEYNEN, AC; VONK, RJ

Hepatic cholesterol metabolism was studied in rats fed purified diets supplemented (9% wt/wt) with either fish oil (FO) (n-3 fatty acids) or corn oil (CO) (n-6 fatty acids) for 4 wk. Rats were equipped with permanent catheters in heart, bile duct, and duodenum to allow studies under normal feeding

The effect of cysteamine on the Brunner gland secretion in the rat

DEFF Research Database (Denmark)

Poulsen, Steen Seier

1981-01-01

in the natural defence of the duodenal mucosa, and this study has been performed to determine the effect of cysteamine and pentagastrin on the Brunner glands in the rat. The proximal duodenum was isolated in situ and drained by a polyethylene tube. The secretion was studied for two 5-h periods after...

[The role of nitric oxide on the dysfunction of intestinal motility in rats subjected to hemorrhagic shock].

Science.gov (United States)

Zhang, Yu-ping; Wang, Xiao-rong; Zhao, Xiao-qi; Qiao, Hai-xia

2013-09-01

To determine the role of nitric oxide (NO) in intestinal motility dysfunction in rats subjected to hemorrhagic shock (HS). Sixteen male Wistar rats were randomly and equally divided into two groups. The HS model of rat was induced by bleeding from femoral artery. After animal models were made, different inducers were added, and duodenum samples were harvested for the determination of contractile response to acetylcholine (ACh) in vitro, activities of inducible nitric oxide synthase (iNOS), contents of NO in tissue, and morphological changes. The spontaneous contraction of intestinal smooth muscle and contractile response induced by ACh were significantly decreased at 180 minutes in HS group, compared with control group, the contractile response induced by ACh of intestinal smooth muscle was decreased by almost 60% (0.40±0.11 g×mm(-2)×s(-1) vs. 1.00±0.20 g×mm(-2)×s(-1), Phydrochloride (L-NAME) could significantly restore the suppressed contractile response of smooth muscle strips obtained from HS rats (0.97±0.25 vs. 0.40±0.11, P0.05). Compared with those of control group, iNOS activities (2.295±0.310 U/g vs. 1.319±0.322 U/g) and NO contents (2.880±0.353 μmol/g vs. 1.505±0.387 μmol/g) in duodenum of HS rats were both significantly increased (both P<0.01). Under light microscopy, the most significant morphological change in duodenum following HS was the infiltration of obvious inflammatory cells. The NO produced by the overexpression of iNOS induced by HS involves in the motility dysfunction of intestine through the mechanism of cyclic guanosine monophosphate (cGMP) system. Moreover, NO-mediated infiltration of inflammatory cells in tissue may also contribute to the development of motility dysfunction of intestine following HS.

The ethanol-induced stimulation of rat duodenal mucosal bicarbonate secretion in vivo is critically dependent on luminal Cl-.

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Anna Sommansson

Full Text Available Alcohol may induce metabolic and functional changes in gastrointestinal epithelial cells, contributing to impaired mucosal barrier function. Duodenal mucosal bicarbonate secretion (DBS is a primary epithelial defense against gastric acid and also has an important function in maintaining the homeostasis of the juxtamucosal microenvironment. The aim in this study was to investigate the effects of the luminal perfusion of moderate concentrations of ethanol in vivo on epithelial DBS, fluid secretion and paracellular permeability. Under thiobarbiturate anesthesia, a ∼30-mm segment of the proximal duodenum with an intact blood supply was perfused in situ in rats. The effects on DBS, duodenal transepithelial net fluid flux and the blood-to-lumen clearance of 51Cr-EDTA were investigated. Perfusing the duodenum with isotonic solutions of 10% or 15% ethanol-by-volume for 30 min increased DBS in a concentration-dependent manner, while the net fluid flux did not change. Pre-treatment with the CFTR inhibitor CFTRinh172 (i.p. or i.v. did not change the secretory response to ethanol, while removing Cl- from the luminal perfusate abolished the ethanol-induced increase in DBS. The administration of hexamethonium (i.v. but not capsazepine significantly reduced the basal net fluid flux and the ethanol-induced increase in DBS. Perfusing the duodenum with a combination of 1.0 mM HCl and 15% ethanol induced significantly greater increases in DBS than 15% ethanol or 1.0 mM HCl alone but did not influence fluid flux. Our data demonstrate that ethanol induces increases in DBS through a mechanism that is critically dependent on luminal Cl- and partly dependent on enteric neural pathways involving nicotinic receptors. Ethanol and HCl appears to stimulate DBS via the activation of different bicarbonate transporting mechanisms.

Immunohistochemical characterization of gastrointestinal macrophages/phagocytes in dogs with inflammatory bowel disease (IBD) and non-IBD dogs.

Science.gov (United States)

Wagner, Anna; Junginger, Johannes; Lemensieck, Frederik; Hewicker-Trautwein, Marion

2018-03-01

Intestinal Mϕ play a pivotal role in the maintenance of gut homeostasis, but can also contribute to inflammation such as inflammatory bowel disease (IBD). In contrast to human tissues, little is known about phenotypes of Mϕ in the canine gastrointestinal tract. Therefore, an immunohistochemical study was performed using Abs against Mϕ-associated molecules (Cluster of differentiation (CD)64, CD163, CD204, ionized calcium-binding adaptor molecule 1, L1 Ag, and MHC II) on stomach, duodenum, jejunum, ileum and colon from non-IBD dogs. In addition, marker-expression in the stomach, duodenum and colon of the non-IBD dogs was compared to that in dogs with IBD. Results revealed predominance of resident Mϕ displaying an anti-inflammatory phenotype represented by expression of CD163 as well as CD204 in the gut of non-IBD dogs with high Mϕ numbers especially present in the small intestinal villus area. Compared to non-IBD tissue counterparts, stomach, duodenum, and colon from dogs with IBD showed reduced Mϕ numbers with the exception of slightly increased numbers of CD64+ Mϕ. Correlation analyses between marker-expression of Mϕ and the Canine Inflammatory Bowel Disease Activity Index as well as histological scores failed to reveal relevant relationships. The present study provides evidence of the canine steady state gastrointestinal tract being dominated by Mϕ with anti-inflammatory properties maintaining gut homeostasis. A significant reduction in these resident Mϕ may reflect disturbances in homeostatic capacity that could contribute to the development of canine IBD. In contrast to human IBD and murine disease models, infiltration of pro-inflammatory Mϕ does not significantly contribute to the inflammatory process of canine IBD, which may illustrate possible species-specific differences in IBD pathogenesis. Copyright © 2018 Elsevier B.V. All rights reserved.

Choline Alleviates Parenteral Nutrition-Associated Duodenal Motility Disorder in Infant Rats.

Science.gov (United States)

Zhu, Jie; Wu, Yang; Guo, Yonggao; Tang, Qingya; Lu, Ting; Cai, Wei; Huang, Haiyan

2016-09-01

Parenteral nutrition (PN) has been found to influence duodenal motility in animals. Choline is an essential nutrient, and its deficiency is related to PN-associated organ diseases. Therefore, this study was aimed to investigate the role of choline supplementation in an infant rat model of PN-associated duodenal motility disorder. Three-week-old Sprague-Dawley male rats were fed chow and water (controls), PN solution (PN), or PN plus intravenous choline (600 mg/kg) (PN + choline). Rats underwent jugular vein cannulation for infusion of PN solution or 0.9% saline (controls) for 7 days. Duodenal oxidative stress status, concentrations of plasma choline, phosphocholine, and betaine and serum tumor necrosis factor (TNF)-α were assayed. The messenger RNA (mRNA) and protein expression of c-Kit proto-oncogene protein (c-Kit) and membrane-bound stem cell factor (mSCF) together with the electrophysiological features of slow waves in the duodenum were also evaluated. Rats on PN showed increased reactive oxygen species; decreased total antioxidant capacity in the duodenum; reduced plasma choline, phosphocholine, and betaine; and enhanced serum TNF-α concentrations, which were reversed by choline intervention. In addition, PN reduced mRNA and protein expression of mSCF and c-Kit, which were inversed under choline administration. Moreover, choline attenuated depolarized resting membrane potential and declined the frequency and amplitude of slow waves in duodenal smooth muscles of infant rats induced by PN, respectively. The addition of choline to PN may alleviate the progression of duodenal motor disorder through protecting smooth muscle cells from injury, promoting mSCF/c-Kit signaling, and attenuating impairment of interstitial cells of Cajal in the duodenum during PN feeding. © 2015 American Society for Parenteral and Enteral Nutrition.

Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

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Baldini, Elizabeth H., E-mail: ebaldini@partners.org [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Bosch, Walter [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Roberge, David [Department of Radiation Oncology, Centre Hospitalier de l' Universite de Montreal, Montreal, Quebec (Canada); Haas, Rick L.M. [Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam (Netherlands); Catton, Charles N. [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Olsen, Jeffrey R. [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Deville, Curtiland [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Chen, Yen-Lin [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Finkelstein, Steven E. [Translational Research Consortium, 21st Century Oncology, Scottsdale, Arizona (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Wang, Dian [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States)

2015-08-01

Purpose: The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials: Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions: For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed.

Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps

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Tescher Paul

2010-04-01

Full Text Available Abstract Background Familial adenomatous polyposis (FAP is a hereditary disorder characterized by polyposis along the gastrointestinal tract. Information on adenoma status below the duodenum has previously been restricted due to its inaccessibility in vivo. Capsule Endoscopy (CE may provide a useful adjunct in screening for polyposis in the small bowel in FAP patients. This study aims to evaluate the effectiveness of CE in the assessment of patients with FAP, compared to other imaging modalities for the detection of small bowel polyps. Method 20 consecutive patients with previously diagnosed FAP and duodenal polyps, presenting for routine surveillance of polyps at The Royal Melbourne Hospital were recruited. Each fasted patient initially underwent a magnetic resonance image (MRI of the abdomen, and a barium small bowel follow-through study. Capsule Endoscopy was performed four weeks later on the fasted patient. An upper gastrointestinal side-viewing endoscopy was done one (1 to two (2 weeks after this. Endoscopists and investigators were blinded to results of other investigations and patient history. Results Within the stomach, upper gastrointestinal endoscopy found more polyps than other forms of imaging. SBFT and MRI generally performed poorly, identifying fewer polyps than both upper gastrointestinal and capsule endoscopy. CE was the only form of imaging that identified polyps in all segments of the small bowel as well as the only form of imaging able to provide multiple findings outside the stomach/duodenum. Conclusion CE provides important information on possible polyp development distal to the duodenum, which may lead to surgical intervention. The place of CE as an adjunct in surveillance of FAP for a specific subset needs consideration and confirmation in replication studies. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12608000616370

Intestinal digestibility of long-chain fatty acids in lactating dairy cows: A meta-analysis and meta-regression.

Science.gov (United States)

Boerman, J P; Firkins, J L; St-Pierre, N R; Lock, A L

2015-12-01

The objective of this analysis was to examine the intestinal digestibility of individual long-chain fatty acids (FA) in lactating dairy cows. Available data were collated from 15 publications containing 61 treatments, which reported total and individual FA duodenal flows and calculations of intestinal digestibility. All studies involved lactating dairy cows, and estimates of digestibility were based on measurements either between the duodenum and ileum (18 treatments) or between the duodenum and feces (43 treatments). Fatty acid digestibility was calculated for C16:0, C18:0, C18:1 (cis and trans isomers), C18:2, and C18:3. Digestibility of C18:0 was lower than for C18:1 and C18:3, with no difference in digestibility between saturated FA (C16:0 and C18:0). We weighted the studies by the reciprocal of the variance to generate best-fit equations to predict individual FA digestibility based on duodenal flow of FA and dietary independent variables. The flow of C18:0 negatively affected the digestibility of C18:0 and was also included in the best-fit equations for all other 18-carbon FA using duodenal flow characteristics. The type of fat supplemented had an effect on digestibility of individual FA, with whole seeds having reduced digestibility. Our meta-analysis results showed minimal differences in the digestibility of individual FA. However, C18:0 flow through the duodenum had a negative effect on the digestibility of several individual FA, with the largest negative effect on C18:0 digestibility. The mechanisms that reduce C18:0 absorption at high concentrations are unknown and warrant further investigation. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Small intestinal digestion of raw cornstarch in cattle consuming a soybean hull-based diet is improved by duodenal casein infusion.

Science.gov (United States)

Brake, D W; Titgemeyer, E C; Bailey, E A; Anderson, D E

2014-09-01

Six duodenally and ileally cannulated steers were used in 3 sequential studies to measure 1) basal nutrient flows from a soybean hull-based diet, 2) small intestinal digestibility of raw cornstarch continuously infused into the duodenum, and 3) responses of small intestinal starch digestion to duodenal infusion of 200 or 400 g/d casein. Our objective was to evaluate responses in small intestinal starch digestion in cattle over time and to measure responses in small intestinal starch digestion to increasing amounts of MP. On average, cattle consumed 3.7 kg/d DM, 68 g/d dietary N, and 70 g/d dietary starch. Starch flow to the duodenum was small (38 g/d), and N flow was 91 g/d. Small intestinal digestibility of duodenal N was 57%, and small intestinal digestion of duodenal starch flow was extensive (92%). Small intestinal starch digestibility was 34% when 1.5 kg/d raw cornstarch was continuously infused into the duodenum. Subsequently, cattle were placed in 1 of 2 replicated Latin squares that were balanced for carryover effects to determine response to casein infusions and time required for adaptation. Duodenal infusion of casein linearly increased (P ≤ 0.05) small intestinal starch digestibility, and small intestinal starch digestion adapted to infusion of casein in 6 d. Ethanol-soluble starch and unpolymerized glucose flowing to the ileum increased linearly (P ≤ 0.05) with increasing infusion of casein. Plasma cholecystokinin was not affected by casein infusion, but circulating levels of glucose were increased by casein supplementation (P ≤ 0.05). Responses in small intestinal starch digestion in cattle adapted to casein within 6 d, and increases in duodenal supply of casein up to 400 g/d increased small intestinal starch digestion in cattle.

Predictive factors for gastroduodenal toxicity based on endoscopy following radiotherapy in patients with hepatocellular carcinoma

Energy Technology Data Exchange (ETDEWEB)

Yoon, H. [Sungkyunkwan Univ., Seoul (Korea, Republic of). Dept. of Health Sciences and Technology; Oh, D.; Park, H.C.; Han, Y.; Lim, D.H. [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of). Dept. of Radiation Oncology; Kang, S.W. [Korea Univ., Seoul (Korea, Republic of). Dept. of Radiologic Science; Paik, S.W. [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of). Dept. of Medicine

2013-07-15

Purpose: The aim of this work was to determine predictive factors for gastroduodenal (GD) toxicity in hepatocellular carcinoma (HCC) patients who were treated with radiotherapy (RT). Patients and methods: A total of 90 HCC patients who underwent esophagogastroduodenoscopy (EGD) before and after RT were enrolled. RT was delivered as 30-50 Gy (median 37.5 Gy) in 2-5 Gy (median 3.5 Gy) per fraction. All endoscopic findings were reviewed and GD toxicities related to RT were graded by the Common Toxicity Criteria for Adverse Events, version 3.0. The predictive factors for the {>=} grade 2 GD toxicity were investigated. Results: Endoscopic findings showed erosive gastritis in 14 patients (16 %), gastric ulcers in 8 patients (9 %), erosive duodenitis in 15 patients (17 %), and duodenal ulcers in 14 patients (16 %). Grade 2 toxicity developed in 19 patients (21 %) and grade 3 toxicity developed in 8 patients (9 %). V{sub 25} for stomach and V{sub 35} for duodenum (volume receiving a RT dose of more than x Gy) were the most predictive factors for {>=} grade 2 toxicity. The gastric toxicity rate at 6 months was 2.9 % for V{sub 25} {<=} 6.3 % and 57.1 % for V{sub 25} > 6.3 %. The duodenal toxicity rate at 6 months was 9.4 % for V{sub 35} > 5.4 % and 45.9 % for V{sub 35} > 5.4 %. By multivariate analysis including the clinical factors, V{sub 25} for stomach and V{sub 35} for duodenum were the significant factors. Conclusion: EGD revealed that GD toxicity is common following RT for HCC. V{sub 25} for the stomach and V{sub 35} for the duodenum were the significant factors to predict {>=} grade 2 GD toxicity. (orig.)

Paracetamol as a Post Prandial Marker for Gastric Emptying, A Food-Drug Interaction on Absorption.

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R Bartholomé

Full Text Available The use of paracetamol as tool to determine gastric emptying was evaluated in a cross over study. Twelve healthy volunteers were included and each of them consumed two low and two high caloric meals. Paracetamol was mixed with a liquid meal and administered by a nasogastric feeding tube. The post prandial paracetamol plasma concentration time curve in all participants and the paracetamol concentration in the stomach content in six participants were determined. It was found that after paracetamol has left the stomach, based on analysis of the stomach content, there was still a substantial rise in the plasma paracetamol concentration time curve. Moreover, the difference in gastric emptying between high and low caloric meals was missed using the plasma paracetamol concentration time curve. The latter curves indicate that (i part of the paracetamol may leave the stomach much quicker than the meal and (ii part of the paracetamol may be relatively slowly absorbed in the duodenum. This can be explained by the partition of the homogenous paracetamol-meal mixture in the stomach in an aqueous phase and a solid bolus. The aqueous phase leaves the stomach quickly and the paracetamol in this phase is quickly absorbed in the duodenum, giving rise to the relatively steep increase of the paracetamol concentration in the plasma. The bolus leaves the stomach relatively slowly, and encapsulation by the bolus results in relatively slow uptake of paracetamol from the bolus in the duodenum. These findings implicate that paracetamol is not an accurate post prandial marker for gastric emptying. The paracetamol concentration time curve rather illustrates the food-drug interaction on absorption, which is not only governed by gastric emptying.ClinicalTrials.gov NCT01335503 Nederlands Trial Register NTR2780.

Plutonium and neptunium absorption from the gastrointestinal tract of neonatal baboons

International Nuclear Information System (INIS)

Lataillade, Ghislaine; Duserre, Claude; Rateau, Gerard; Verry, Monique; Fritsch, Paul; Metivier, Henri

1992-06-01

Nineteen baboons aged 1 to 310 days were given oral doses of 238 Pu citrate or 239 Np nitrate. Gastrointestinal (GI) absorption of Pu and Np were higher than those observed in adults. The values of Pu GI absorption were 0.22% at 1 d, 0.17% at 17 d then about 0.10% until 177 d of age. From 195 d onwards, GI absorption was about 0.02% vs adult values (0.008%). GI absorption of neptunium decreased rapidly with age from 1.71% at 4 d to 0.14% at 6 d and remained at this value until 26 d. From 77 d onwards Np GI absorption was decreased to adult value (0.042%). Gastrointestinal retention associated with GI absorption was small, below 0.4% for Pu and 0.2% for Np. Np and Pu was mainly retained in the small intestine. Pu was retained in the ileum wall till 66 d, and afterwards in the duodenum wall. Histological study of Pu retention showed that it was confined to the macrophages under the ileum villi epithelial cells. Np did not seem to have a well-defined retention compartment. Retention occurred first in the ileum wall up to 6 d, afterwards it was divided between the ileum and duodenum walls up to 77 d and finally, between the duodenum and jejunum walls from 132 days of age onwards. The study shows a difference between Np and Pu GI absorption in neonatal baboons. Np GI absorption decreased to adult value in less than 3 months whereas Pu GI absorption decreased to adult value within 195 days. Our Pu results demonstrated that, the tenfold increase of actinides gastrointestinal transfer proposed by ICRP up to 12 months of age in newborn humans seems acceptable. (authors) [fr

Dynamic MR cholangiography after fatty meal loading. Cystic contractility and dynamic evaluation of biliary stasis

International Nuclear Information System (INIS)

Omata, Takayuki; Saito, Kazuhiro; Kotake, Fumio; Mizokami, Yuji; Matsuoka, Takeshi; Abe, Kimihiko

2002-01-01

Dynamic MR cholangiography was conducted on patients with cholelithiasis or choledocholithiasis who had consumed a fatty test meal (Molyork) and the cystic contractility and dynamics of biliary stasis was evaluated. The subjects were 25 with intracystic cholelithiasis, 10 with choledocholithiasis and 10 normal controls. For an imaging sequence, the rapid acquisition with relaxation enhancement (RARE) method was employed and imaging was conducted for 40 min (every 30 s following Molyork administration) without breath-holding. The gallbladder contraction ratio was computed and the contractile ratio for the common bile duct was calculated. To determine the bile flow to the duodenum, the high-intensity signal, indicating the flow from the lower common bile duct, and perfusion of the duodenum were observed in dynamic mode on the monitor with the naked eye and interpreted as positive bile flow. The frequency of this flow was visually monitored. The gallbladder contractile ratio was significantly reduced in patients with cholelithiasis or choledocholithiasis compared with the controls. In a comparison with the normal controls, no sequential changes were noted in the mean contractile ratio of the common bile duct of the patients with cholelithiasis or choledocholithiasis. The mean frequency of bile flow observed for each 40 min period was 13±2.4, 6±2.2, and 4±1.3 times for the controls, those with intracystic cholelithiasis, and those with choledocholithiasis, respectively. Compared with the controls, the latter two patient groups showed evident reductions in the frequency of bile flow to the duodenum (p<0.001). Dynamic MRC combined with Molyork loading makes it possible to compute cystic contractile ratios and perform a dynamic examination of bile flow under non-invasive, near-physiological conditions. (author)

Gastrointestinal viral load and enteroendocrine cell number are associated with altered survival in HIV-1 infected individuals.

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Guido van Marle

Full Text Available Human immunodeficiency virus type 1 (HIV-1 infects and destroys cells of the immune system leading to an overt immune deficiency known as HIV acquired immunodeficiency syndrome (HIV/AIDS. The gut associated lymphoid tissue is one of the major lymphoid tissues targeted by HIV-1, and is considered a reservoir for HIV-1 replication and of major importance in CD4+ T-cell depletion. In addition to immunodeficiency, HIV-1 infection also directly causes gastrointestinal (GI dysfunction, also known as HIV enteropathy. This enteropathy can manifest itself as many pathological changes in the GI tract. The objective of this study was to determine the association of gut HIV-1 infection markers with long-term survival in a cohort of men who have sex with men (MSM enrolled pre-HAART (Highly Active Antiretroviral Therapy. We examined survival over 15-years in a cohort of 42 HIV-infected cases: In addition to CD4+ T cell counts and HIV-1 plasma viral load, multiple gut compartment (duodenum and colon biopsies were taken by endoscopy every 6 months during the initial 3-year period. HIV-1 was cultured from tissues and phenotyped and viral loads in the gut tissues were determined. Moreover, the tissues were subjected to an extensive assessment of enteroendocrine cell distribution and pathology. The collected data was used for survival analyses, which showed that patients with higher gut tissue viral load levels had a significantly worse survival prognosis. Moreover, lower numbers of serotonin (duodenum and somatostatin (duodenum and colon immunoreactive cell counts in the gut tissues of patients was associated with significant lower survival prognosis. Our study, suggested that HIV-1 pathogenesis and survival prognosis is associated with altered enteroendocrine cell numbers, which could point to a potential role for enteroendocrine function in HIV infection and pathogenesis.

Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

International Nuclear Information System (INIS)

Baldini, Elizabeth H.; Abrams, Ross A.; Bosch, Walter; Roberge, David; Haas, Rick L.M.; Catton, Charles N.; Indelicato, Daniel J.; Olsen, Jeffrey R.; Deville, Curtiland; Chen, Yen-Lin; Finkelstein, Steven E.; DeLaney, Thomas F.; Wang, Dian

2015-01-01

Purpose: The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials: Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions: For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed

Testing the absorption of the extracts of Coreopsis tinctoria Nutt. in the intestinal canal in rats using an Ussing chamber.

Science.gov (United States)

Wang, Jian; Aierken, Guzhalinuer; Li, Xinxia; Li, Linlin; Mao, Xinmin

2016-06-20

Coreopsis tinctoria Nutt mainly distributed in Hetian region of Xinjiang at an altitude of 3000m, which is used as Uyghur traditional medicine because of its clearing heat, promoting circulation and removing toxicity and antihypertension, ect. effect. This research was to study the four ingredients in the extracts of Coreopsis tinctoria Nutt. that are absorbed in different intestinal segments in rats to lay the foundation for further study on the effective constituents, tissue distribution, metabolism, and spectrum-effect relationships of these extracts. High, medium, and low concentrations were prepared according to their pharmacological effects. Quantitative analysis multi-components by single marker was used to test the cumulative absorption volume Q, absorption rate constant Ka, and apparent permeability coefficient Papp of the four main ingredients in C. tinctoria Nutt. extract in different intestinal segments in rats using a Ussing chamber model and high-performance liquid chromatography. The Papp of chlorogenic acid and flavanomarein in the duodenum, jejunum, ileum, and colon were 1.0×10(-6) to 10×10(-6)cms(-1). Papp of marein in the duodenum and jejunum was <1.0×10(-6), and was 1.0×10(-6) to 10×10(-6)cms(-1) in the ileum and colon. Papp of 3,5-O-dicaffeoylquinic acid in the duodenum was <1.0×10(-6)cms(-1), while it was 1.0×(1)0(-6) to 10×10(-6)cms(-1) in the jejunum, ileum, and colon. All four chemical components of the plant extract can be absorbed by the intestinal canal of rats, which conforms to zero-order absorption; the ileum presented the best absorption. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Distribution and characterisation of CCK containing enteroendocrine cells of the mouse small and large intestine

DEFF Research Database (Denmark)

Fakhry, Josiane; Wang, Joyce; Martins, Patricia

2017-01-01

but positive cells were rare in the rectum. Immunoreactive EEC were as common in the caecum and proximal colon as they were in the duodenum and jejunum. CCK gene transcripts were found in the mucosa throughout the intestine but mRNA for gastrin, a hormone that can bind some anti-CCK antibodies, was only found...

Duodenorenal Fistula as a Complication of Radiofrequency Ablation of Hepatic Metastasis of Renal Cell Carcinoma

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Arman Erkan

2017-06-01

Full Text Available Duodenorenal fistula is a rare condition. The right kidney and the second part of the duodenum are in close anatomic proximity. Although unusual, fistulae can occur between these two anatomic structures. We report a patient who presented with duodenorenal fistula after radiofrequency ablation for renal cell carcinoma and its hepatic metastasis.

Superior mesenteric artery syndrome: case report | Jani | East ...

African Journals Online (AJOL)

Superior Mesenteric Artery Syndrome (SMAS) is caused by trapping of the third part of the duodenum between Superior Mesenteric Artery (SMA) and aorta as result of narrowing of the angle between the two vessels due to acute loss of mesenteric fat which is secondary to rapid weight loss. A fifteen year old caucasian ...

Effect Of Ethanolic Extract From Elaeophorbia drupifera Leaves On ...

African Journals Online (AJOL)

However, regional differences occurred in the responsiveness of the tissue preparations. The ED50 values were found to be 25.12, 44.67 and 15.85 μg/ml for the duodenum, jejunum and ileum respectively. Certain conditions such as calcium availability and increase in bath temperature favoured the action of the extract on ...

Trematoda: Echinostomatidae

African Journals Online (AJOL)

1995-08-18

Aug 18, 1995 ... tron microscopy. The species belongs to the 43-spined. Echinoparyphium group which is characterised by a collar spine arrangement of 5-5-3-3-27. A natural infection of six parasites was found in the duodenum of the cattle egret. Bubulcus ihis collected from the same area. However, owing to insufficient ...

The peculiarities of macroscopic status of the upper gastrointestinal tract mucosa in patients with hepatic and extrahepatic portal hypertension

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Stepanov Yu.M.

2018-03-01

Full Text Available Identification of endoscopic signs of concomitant pathology of the upper gastrointestinal tract allows to determine the tactics of managing patients with different forms of portal hypertension (PG. The analysis of macroscopic picture of esophagus, stomach and duodenum mucosa was carried out in 104 patients with portal hypertension (88 patients with hepatic portal hypertension, 46 – with extrahepatic portal hypertension, 16 – without portal hypertension. The frequency of changes in the esophagus, specific for gastroesophageal reflux disease did not differ significantly in the researched groups. The frequency and severity of varicose veins of the esophagus were diagnosed more often in patients with hepatic form of portal hypertension (OR=10.0, p<0.05. The predominance of different pathological changes of the gastric mucosa in patients with extrahepatic form of portal hypertension was revealed. Portal gastropathy in this group was 5.3 times higher than in patients with hepatic hypertension and 21 times higher than in the III group (without portal hypertension (p<0.01. There were no significant differences of endoscopic picture of the duodenum mucosa between the researched groups.

Modern strategy of diagnostics and treatment of NSAID-induced enteropathy in elderly

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Lipatova Т.Е.

2015-03-01

Full Text Available The aim of the research is to improve the efficiency of diagnosis and treatment of NSAID-induced enteropathy at elderly patients with chronic pain (osteoarthritis, dorsopathy. Material and Methods. 300 elderly with osteoarthritis or dorsopathies regularly (8 weeks or more receiving diclofenac at 75 mg per day were inspected. Clinical features, morphology, components of the diffuse endocrine system of the small intestine were studied. Results. It is defined, that at elderly patients with regular use of NSAIDs in 25% of cases postbulbar erosive duodenitis, in 75% of cases inflammatory and atrophic changes of the distal duodenum were diagnosed. Diagnosis of NSAID-induced enteropathy at elderly should include faecal calprotectin and morphology analysis of postbulbar area of the duodenum. Use meloxicam and sulfasalazine at older patients helps to eliminate or reduce intestinal dyspepsia, malabsorption, and intestinal inflammation on the results of faecal calprotectin and of histology of the small intestine. Conclusion. Elderly patients are at high-risk group for NSAID-induced enteropathy due to functional disturbances in the neuroendocrine system of the small intestine.

PERFIL ELETROFORÉTICO DAS PROTEÍNAS SÉRICAS E DO LÍQUIDO PERITONEAL DE EQUINOS SUBMETIDOS À OBSTRUÇÃO EXPERIMENTAL DO DUODENO, ÍLEO E CÓLON MAIOR

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Paula Alessandra Di Filippppo

2010-12-01

Full Text Available Aiming at evaluating the electrophoresis profile of serum and peritoneal protein in horses submitted to an experimental model of intestinal obstruction, 24 animals were divided into four groups: instrumented control (GI, duodenum obstruction (GII, ileum obstruction (GIII and large colon obstruction (GIV. Blood and peritoneal fluid samples were collected before the surgical procedures (T0, 3h after the obstruction (Ti and 1, 3, 12, 24, 72, 120 and 168h after reperfusion (Tr. After sample centrifuging and fractioning, total protein were determined by biuret method, and the proteic fractions were separated by electrophoresis in agarose gel. Alterations were observed in serum and peritoneal concentrations of α, β and γ globulins on the studied animals. The changes occurred due to the intestinal inflammatory process caused by the obstruction model and the surgical trauma, associated to laparotomy. Animals submitted to duodenum and ileum obstruction showed higher serum and peritoneal concentrations of acute phase proteins. The electrophoretic separation of proteins included in the peritoneal liquid is more sensible when compared to the serum concentration to the diagnosis of abdominal inflammatory process.

Middle-preserving pancreatectomy for advanced transverse colon cancer invading the duodenun and non-functioning endocrine tumor in the pancreatic tail.

Science.gov (United States)

Noda, Hiroshi; Kato, Takaharu; Kamiyama, Hidenori; Toyama, Nobuyuki; Konishi, Fumio

2011-02-01

A 73-year-old female was referred to our hospital with a diagnosis of advanced transverse colon cancer with severe anemia and body weight loss. Preoperative evaluations, including colonoscopy, gastroduodenoscopy, and computed tomography, revealed not only a transverse colon cancer massively invading the duodenum, but also a non-functioning endocrine tumor in the pancreatic tail. We performed middle-preserving pancreatectomy (MPP) with right hemicolectomy for these tumors with a curative intent. After the resection, about 6 cm of the body of the pancreas was preserved, and signs of diabetes mellitus have not appeared. The postoperative course was complicated by a grade B pancreatic fistula, but this was successfully treated with conservative management. After a 33-day hospital stay, the patient returned to daily life without signs of pancreatic exocrine insufficiency. Although the long-term follow-up of the patient is indispensable, in this case, MPP might be able to lead to the curative resection of transverse colon cancer massively invading the duodenum and non-functioning endocrine tumor in the pancreatic tail with preservation of pancreatic function.

An Unusual Presentation of Annular Pancreas: A Case Report

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Saleheh Ala

2015-01-01

Full Text Available Abstract Annular pancreas (AP is a rare congenital malformation resulting from failure of pancreas ventral anlage rotation with the duodenum. This leads to a ring of pancreatic tissue that envelops the duodenum. Clinical manifestations of AP most commonly develop in infancy or early childhood but can present at any age. The diagnosis of AP, usually suggested by an upper GI series or abdominal CT scan, but surgery is considered the gold standard diagnostic method. Surgical bypass of the annulus in all patients with symptomatic AP is recommended. We report a one year old girl who presented with intermittent, non projectile, non bilious vomiting that occurred 1h to 2h after feeding since neonatal period. Upper GI contrast study demonstrates, a dilated duodenal bulb associated with narrowing of post bulbar area. The patient underwent surgical correction of the obstruction. A bypass of the ectopic pancreas tissue was performed by duodenoduodenostomy. Considering the rarity of this congenital abnormality, presenting with chronic partial duodenal obstruction, and its successful correction by surgical means have prompted us to report the case.

Red kidney bean (Phaseolus vulgaris lectin stimulation increases the number of enterochromaffin cells in the small intestine of suckling piglets

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Zacharko-Siembida Anna

2014-06-01

Full Text Available The quantities and distribution patterns of serotonin-immunoreactive (serotonin-IR enterochromaffin cells (EC were studied immunohistochemically in the small intestine of suckling piglets stimulated with red kidney bean lectin, and in nonstimulated, control animals. The co-expression patterns of serotonin with somatostatin (SOM or corticotropin releasing-factor (CRF were also studied. After the lectin treatment, the increased numbers of EC were noted in the duodenum of experimental animals. Lectin stimulation did not change the proportions of EC in the jejunum and ileum. In the duodenal epithelium of the lectin-stimulated piglets, the vast majority of serotonin-IR EC were distributed at the basis of crypts. After the lectin administration, the proportions of serotonin-IR/SOM-IR EC were statistically similar in all sections of the small intestine. No upregulation of CRF was found in duodenal, jejunal, and ileal EC of lectin-treated animals. The findings demonstrated that red kidney bean lectin increased the serotonin reservoir in the duodenum, and thus may be an effective stimulant of the gut maturation in suckling mammals.

Duodenal Wedge Resection for Large Gastrointestinal Stromal Tumour Presenting with Life-Threatening Haemorrhage

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Alexander Shaw

2013-01-01

Full Text Available Background. Duodenal gastrointestinal stromal tumours (GISTs are an uncommon malignancy of the gastrointestinal (GI tract. We present a case of life-threatening haemorrhage caused by a large ulcerating duodenal GIST arising from the third part of the duodenum managed by a limited duodenal wedge resection. Case Presentation. A 61-year-old patient presented with acute life-threatening gastrointestinal bleeding. After oesophagogastroduodenoscopy failed to demonstrate the source of bleeding, a 5 cm ulcerating exophytic mass originating from the third part of the duodenum was identified at laparotomy. A successful limited wedge resection of the tumour mass was performed. Histopathology subsequently confirmed a duodenal GIST. The patient remained well at 12-month followup with no evidence of local recurrence or metastatic spread. Conclusion. Duodenal GISTs can present with life-threatening upper GI haemorrhage. In the context of acute haemorrhage, even relatively large duodenal GISTs can be treated by limited wedge resection. This is a preferable alternative to duodenopancreatectomy with lower morbidity and mortality but comparable oncological outcome.

Intraduodenal and intrajejunal administration of the herbal medicine, dai-kenchu-tou, stimulates small intestinal motility via cholinergic receptors in conscious dogs.

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Jin, X L; Shibata, C; Naito, H; Ueno, T; Funayama, Y; Fukushima, K; Matsuno, S; Sasaki, I

2001-06-01

The aim of the present study was to study the effect and mechanism of action of intraduodenal and intrajejunal dai-kenchu-to, an herbal medicine clinically effective for uncomplicated postoperative adhesive intestinal obstruction, on upper gastrointestinal motility. Five mongrel dogs were equipped with four strain-gauge force transducers on the antrum, duodenum, and proximal and distal jejunum to measure contractile activity. Dai-kenchu-to (0.5, 1.5, and 3.0 g) was administered into the duodenal or proximal jejunal lumen. The effect of atropine, hexamethonium, phentolamine, propranolol, and ondansetron on intraduodenal and intrajejunal dai-kenchu-to-induced contractions was studied. Plasma motilin was measured by specific radioimmunoassay. Intraduodenal and intrajejunal dai-kenchu-to induced phasic contractions in the duodenum and proximal jejunum, respectively, and those contractions migrated distally. Phasic contractions induced by intraduodenal and intrajejunal dai-kenchu-to were inhibited by atropine and hexamethonium at all sites. Plasma motilin was not affected by dai-kenchu-to. Intraduodenal and intrajejunal dai-kenchu-to stimulates upper gastrointestinal motility at and distal to the administration sites through cholinergic receptors.

Comparative evaluation of radiation damage to the intestine in laboratory animals differing in radiosensitivity

International Nuclear Information System (INIS)

Fedotova, M.I.; Belousova, O.I.

1975-01-01

The total number of cells in the duodenum of animals differing by radiosensitivity (Wistar rats, guinea pigs and rabbits) was determined at the time of the maximum fall in the quantity of such cells after irradiation with doses from 100 to 5000 R. The dynamics of cell number after 900, 1200 and 5000 R irradiation was also studied. The fall in the cell number was dose-dependent in the dose range of 1200 to 1500 R and the extent of devastation for a single dose varied with the species. A two-fold decrease in the cell number (CD 50 ) was observed at 500, 650 and 750 R for rats, rabbits and guinea pigs, respectively. Increasing the dose from 1500 to 5000 R did not result in any further fall of duodenum cell number in rats and guinea pigs (1200 R was the absolutely lethal dose for rabbits). The devastation process was the most rapid and pronounced in rats; in rabbits, and especially in guinea pigs, it developed slower and to a lesser extent

A SEVERE CASE OF ACUTE NECROTIC PANCREATITIS CAUSED BY DUODENAL CYST DUPLICATION

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Gabriel Constantinescu

2018-03-01

Full Text Available Introduction. Duodenal duplication cyst (DDC is a rare congenital malformation that appears in the embryonic development of the digestive tract. It is a benign condition usually diagnosed in infancy and early childhood, being a rare and difficult diagnosis in adult population. DDC is a recognized cause of duodenal obstruction, acute pancreatitis, obstructive jaundice and even digestive hemorrhage. Case presentation. We report the case of a young adult male with abdominal pain history, who presents with recurrent episodes of acute severe necrotic pancreatitis. The abdominal computed tomography scan revealed a Balthazar C necrotic pancreatitis with partial thrombosis of the splenic vein and a cystic mass in the second part of the duodenum. The endoscopic ultrasonography (EUS established that the duodenal cystic lesion came from the second layer, meaning the submucosa. We performed endoscopic cystotomy with complete evacuation of the fluid content into the duodenum, with favorable clinical outcome. Conclusions. The particularity of the case is represented by the low incidence of this pathology and the rare form of presentation, meaning acute pancreatitis probably from pancreatic ductular hypertension caused by the DDC.

Malignant sigmoidoduodenal fistula.

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Shapey, I M; Mahmood, K; Solkar, M H

2014-01-01

Duodenocolic fistula is a rare complication of malignant colonic disease especially when involving and originating from the sigmoid colon. We aim to discuss the unusual clinical presentation of this case as well as the investigation and management of duodenocolic fistulas. A 91 year old lady presented as an emergency to a general surgical service at a District General Hospital with diarrhoea, vomiting and weight loss. Computed Tomography (CT) reported a large ovarian cyst elevating the sigmoid colon into immediate proximity of the duodenum. Adenocarcinoma was confirmed on histology obtained by colonoscopy. A classic apple core lesion with fistulating tract from the sigmoid colon to the duodenum was synchronously demonstrated on barium enema. Sigmoido-duodenal fistulae represent a complex manifestation of gastrointestinal pathologies. Management options must be considered in the context of patient wishes, their co-morbidities, and predicted post-operative outcome. In most cases this is likely to represent a non-operative approach, however surgical resection may benefit selected cases on occasion. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Antimicrobial resistance in Escherichia coli isolated from different parts of the digestive tract of sheep

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E. Afshari-Safavi

2017-09-01

Full Text Available In order to evaluate differences in resistance patterns of Escherichia coli isolated from different parts of sheep digestive tract, the intestinal tracts of 24 sheep were sampled at various locations (duode-num, jejunum, caecum, colon and rectum after slaughter. Samples were cultured on MacConkey agar and obtained colonies were confirmed as E. coli based on the biochemical tests results. Isolates were tested for antimicrobial agent susceptibility to 10 antibiotics (colistin, gentamicin, oxytetracycline, trimethoprim-sulfamethoxazole, amoxicillin-clavulanic acid, enrofloxacin, ampicillin, cephotaxime, neomycin and florfenicol, using disc diffusion method. The tested E. coli resistant to colistin, ampicillin and amoxicillin-clavulanic acid were isolated more frequently from large intestine (rectum than from small intestine (duodenum (P<0.05. In conclusion, antimicrobial resistance pattern of generic E. coli inhabiting the intestinal tract of sheep depends on sampling location, which should be considered in interpreting the results of antimicrobial resistance tests of E. coli isolated from the faecal samples and generalising results to bacteria colonised in other parts of the digestive tract

Effect of serotonin on small intestinal contractility in healthy volunteers

DEFF Research Database (Denmark)

Hansen, M.B.; Arif, F.; Gregersen, H.

2008-01-01

The physiological significance of serotonin released into the intestinal lumen for the regulation of motility is unknown in humans. The aim of this study was to evaluate the effect of serotonin infused into the lumen of the gastric antrum, duodenum or the jejunum, on antro-duodeno-jejunal contrac......The physiological significance of serotonin released into the intestinal lumen for the regulation of motility is unknown in humans. The aim of this study was to evaluate the effect of serotonin infused into the lumen of the gastric antrum, duodenum or the jejunum, on antro......-duodeno-jejunal contractility in healthy human volunteers. Manometric recordings were obtained and the effects of either a standard meal, continuous intravenous infusion of serotonin (20 nmol/kg/min) or intraluminal bolus infusions of graded doses of serotonin (2.5, 25 or 250 nmol) were compared. In addition, platelet......-depleted plasma levels of serotonin, blood pressure, heart rate and electrocardiogram were evaluated. All subjects showed similar results. Intravenous serotonin increased migrating motor complex phase In frequency 3-fold and migrating velocity 2-fold. Intraluminal infusion of serotonin did not change contractile...

Studies of the radioprotective properties of nicotinyl compounds, aspartic acid, glutamic acid and methionine

International Nuclear Information System (INIS)

Itzel-Kietzmann, V.M.

1986-01-01

Radioprotective properties of sodium salts of nicotinyl aspartic acid, nicotinyl methionyl aspartic acid and nicotinyl glutamic acid were tested in mice (NMRI). Experimental animals were irradiated by rayage (9,5 Gy). Parameters were: survival rate, peritoneal fluid cell count, weight and DNA concentration of spleen, hepatic DNA polymerase activity and rate of protein synthesis, lactate dehydrogenase activity in serum, maltase, sucrase and leucine aminopeptidase activitiy in duodenum and jejunum. Following results were obtained: 1. There was no significant difference in survival rate of treated and untreated animals. In treated animals only a short prolongation of survival time was observed. 2. After irradiation a quick reduction of splenic weight and DNA concentration was measured. 3. A reduction of DNA polymerase activity in liver was observed in treated and untreated mice. The rate of hepatic protein synthesis was similar in all animals. A final decrease was observed. 4. Variable activities of maltase, sucrase and leucine aminopeptidase activity in duodenum and jejunum indicated no radioprotective effect of tested substances. In conclusion of these results the tested substances show no significant radioprotective properties. (orig.) [de

[Brunners gland hiperplasia. Report of two cases].

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Padilla Ruiz, Maykel

2014-04-01

Brunner's gland hyperplasia is an infrequent benign injury located on the first or second portion of the duodenum. The disease spectrum includes diffuse nodular hyperplasia, circumscribed nodular hyperplasia, and Brunner's gland adenoma. We report two cases, one with an adenoma of Brunner's glands as a duodenal polyp and the other as a diffuse nodular hyperplasia of the duodenal bulb.

The effects of a ration change from a total mixed ration to pasture on rumen fermentation, volatile fatty acid absorption characteristics, and morphology of dairy cows

NARCIS (Netherlands)

Schären, M.; Seyfang, G.M.; Steingass, H.; Dieho, K.; Dijkstra, J.; Hüther, L.; Frahm, J.; Beineke, A.; Soosten, von D.; Meyer, U.; Breves, G.; Dänicke, S.

2016-01-01

To investigate the effect of the change from a concentrate and silage-based ration (total mixed ration, TMR) to a pasture-based ration, a 10-wk trial (wk 1-10) was performed, including 10 rumen- and duodenum-fistulated German Holstein dairy cows (182 ± 24 d in milk, 23.5 ± 3.5 kg of milk/d; mean

Protein and starch digestion in steers fed feedlot diets differing in ...

African Journals Online (AJOL)

Department of Livestock Science, University of Pretoria, Pretoria, 0002 Republic of South Africa. Twelve steers fistulated in the rumen and duodenum were allocated to one of three diets and fed 80g DM/kg WO.75/d. The diets consisted of .... 2.1: 1. 1 Calorie 3000. 2 Premix contained vitamins, trace minerals, salt, NaHC03,.

Intraoperative Gastric Suctioning and Postoperative Nausea, Retching, and Vomiting.

Science.gov (United States)

1984-07-01

of Anesthesiologists CTZ -chemoreceptor trigger zone IV - intravenous kg. - kilogram LES - lower esophageal sphincter Mzg. -milligram ml. -milliliter...the stomach or duedenum * . -= provides the strongest stimulus for vomiting" (Guyton, 1981). Sensory impulses originating in the upper gastro ...duodenum may cause nausea and can result in intestinal contraction during gastric relax- ... , ation allowing reflux of intestinal contents into the

Laparoscopic management of superior mesentric artery syndrome: A case report and review of literature

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Makam Ramesh

2008-01-01

Full Text Available Superior mesentric artery syndrome is a rare cause of high small bowel obstruction, caused by compression of the transverse part of the duodenum in between the superior mesentric artery and aorta. Patients present with chronic abdominal pain, vomiting and weight loss. We report a case of superior mesenteric artery syndrome, managed laparoscopically with laparoscopic duodenojejunostomy.

Iron Malabsorption in a Patient With Large Cell Lymphoma Involving the Duodenum

Science.gov (United States)

1992-01-01

hemoglobin. The lymphomas (5-7). The presenting symptoms mimic chest radiograph in May demonstrated an anterior me- those of celiac disease and include...compounded the anemia in a pa- tion in celiac disease were reversible by the institution tient with diffuse large cell lymphoma involving the of a gluten...etiologies (usually 2-3 h) is expected in patients who are iron (e.g., celiac disease , pancreatic insufliciency). however, deficient and have normal

Inflammatory fibroid polyp in the duodenum of a common marmoset (Callithrix jacchus).

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Yokouchi, Yusuke; Imaoka, Masako; Sayama, Ayako; Jindo, Toshimasa; Sanbuissho, Atsushi

2013-01-01

A 32-month-old male common marmoset had a firm and white-colored mass in the duodenal wall. The cut surface was smooth and grayish white in color. Histologically, the mass consisted of a proliferation of spindle cells with an oval to spindle-shaped nucleus and scant eosinophilic cytoplasm in a loose myxoid or fibrotic background. Most of the lesion displayed no specific growth pattern whereas some of the cells concentrated around the vessels and created an onion-bulb structure. Additionally, marked inflammatory cellular infiltration, mainly eosinophils, was observed throughout the lesion. Immunohistochemically, the spindle cells were positive for vimentin, α-smooth muscle actin, fascin, and cyclin D1, and negative for S-100, factor VIII-related antigen, and c-kit. These histological and immunohistochemical features did not meet any differential diagnoses such as gastrointestinal stromal tumor, inflammatory myofibroblastic tumor, solitary fibrous tumor/hemangiopericytoma, smooth muscle tumor, schwannoma, and hemangiosarcoma. Collectively, the authors diagnosed the mass as a lesion that corresponded to an inflammatory fibroid polyp (IFP) in humans. IFP is defined as a mesenchymal proliferation composed of spindle stromal cells, small blood vessels, and inflammatory cells, particularly eosinophils, and is currently classified as a nonneoplastic lesion. To the best of our knowledge, this is the first case of spontaneous IFP in nonhuman primates.

Dissolution enhancement of curcumin via curcumin-prebiotic inulin nanoparticles.

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Fares, Mohammad M; Salem, Mu'taz Sheikh

2015-01-01

Dissolution enhancement of curcumin via prebiotic inulin designed to orally deliver poorly water-soluble curcumin at duodenum low acidity (pH 5.5) was investigated. Different prebiotic inulin-curcumin nanoparticles were synthesized in ethanol-water binary system at different pre-adjusted pH values. Characterization via FTIR, XRD and TGA revealed the formation of curcumin-inulin conjugates, whereas surface morphology via SEM and TEM techniques implied the formation of nanoparticle beads and nanoclusters. Prebiotic inulin-curcumin nanoparticles prepared at pH 7.0 demonstrated a maximum curcumin dissolution enhancement of ≈90% with respect to 30% for curcumin alone at pH 5.5. Power law constant values were in accordance with dissolution enhancement investigations. All samples show Fickian diffusion mechanism. XRD investigations confirm that inulin maintain its crystalline structure in curcumin-inulin conjugate structure, which confirms that it can exert successfully its prebiotic role in the gastrointestinal (GI) tract. Therefore, the use of curcumin-inulin nanoparticles can perform dual-mission in the GI tract at the duodenum environment; release of 90% of curcumin followed by prebiotic activity of inulin, which will probably play a significant role in cancer therapeutics for the coming generations.

Co-administration of Bacillus subtilis RJGP16 and Lactobacillus salivarius B1 strongly enhances the intestinal mucosal immunity of piglets.

Science.gov (United States)

Deng, Jun; Li, Yunfeng; Zhang, Jinhua; Yang, Qian

2013-02-01

Probiotics, including Bacillus spp. and Lactobacillus, are potential replacements for low dose in-feed antibiotics for pig. This study aimed to evaluate the effect of the co-administration of Bacillus subtilis RJGP16 and Lactobacillus salivarius B1 as potential probiotics to stimulate local immune responses. Thirty two newborn piglets were divided into four groups and orally administrated with different combination of probiotics (none; RJGP16; B1; RJGP16 and B1) at the age of 0, 7 and 11 days. We analysed the parameters of the mucosal immunity of piglets a week after weaning. Our results showed that the gene expression of interleukin (IL)-6 in the duodenum and ileum, porcine beta-defensins (pBD)-2 in the duodenum were significantly increased (p<0.01) with co-administration of the RJGP16 and B1. Also the expression and release of TLR-2 and the number of immunoglobulin (Ig) A producing cells were increased (p<0.01). The results demonstrate that the co-administration of the two bacteria stimulate a more intense mucosal immunity than the administration of each bacterium alone. Copyright © 2012 Elsevier Ltd. All rights reserved.

Percutaneous trans-papillary elimination of common bile duct stones using an existing gallbladder drain for access.

Science.gov (United States)

Atar, Eli; Neiman, Chaim; Ram, Eduard; Almog, Mazal; Gadiel, Itai; Belenky, Alexander

2012-06-01

The presence of stones in the common bile duct (CBD) may cause complications such as obstructing jaundice or ascending cholangitis, and the stones should be removed. To assess the efficacy of percutaneous elimination of CBD stones from the gallbladder through the papilla. During a 4 year period, six patients (five men and one woman, mean age 71.5 years) who had CBD stones and an existing gallbladder drain underwent percutaneous stone push into the duodenum after balloon dilatation of the papilla, with a diameter equal to that of the largest stone. Access into the CBD was from the gallbladder, using an already existing percutaneous gallbladder drain (cholecystostomy tube). Each patient had one to three CBD stones measuring 7-14 mm. Successful CBD stone elimination into the duodenum was achieved in five of the six patients. The single failure occurred in a patient with choledochal diverticulum, who was operated successfully. There were no major or minor complications during or after the procedures. Trans-cholecystic CBD stone elimination is a safe and feasible percutaneous technique that utilizes existing tracts, thus obviating the need to create new percutaneous access. This procedure can replace endoscopic or surgical CBD exploration.

Transcriptome Analysis of Three Sheep Intestinal Regions reveals Key Pathways and Hub Regulatory Genes of Large Intestinal Lipid Metabolism.

Science.gov (United States)

Chao, Tianle; Wang, Guizhi; Ji, Zhibin; Liu, Zhaohua; Hou, Lei; Wang, Jin; Wang, Jianmin

2017-07-13

The large intestine, also known as the hindgut, is an important part of the animal digestive system. Recent studies on digestive system development in ruminants have focused on the rumen and the small intestine, but the molecular mechanisms underlying sheep large intestine metabolism remain poorly understood. To identify genes related to intestinal metabolism and to reveal molecular regulation mechanisms, we sequenced and compared the transcriptomes of mucosal epithelial tissues among the cecum, proximal colon and duodenum. A total of 4,221 transcripts from 3,254 genes were identified as differentially expressed transcripts. Between the large intestine and duodenum, differentially expressed transcripts were found to be significantly enriched in 6 metabolism-related pathways, among which PPAR signaling was identified as a key pathway. Three genes, CPT1A, LPL and PCK1, were identified as higher expression hub genes in the large intestine. Between the cecum and colon, differentially expressed transcripts were significantly enriched in 5 lipid metabolism related pathways, and CEPT1 and MBOAT1 were identified as hub genes. This study provides important information regarding the molecular mechanisms of intestinal metabolism in sheep and may provide a basis for further study.

Inflammatory myofibroblastic tumor in the head of the pancreas with anorexia and vomiting in a 69-year-old man: A case report.

Science.gov (United States)

Ding, Ding; Bu, Xianmin; Tian, Feng

2016-08-01

Inflammatory myofibroblastic tumor (IMT) is a rare condition of unclear etiology that is commonly observed in the lung but rarely in the pancreas. WHO classified IMT as a potentially malignant or aggressive tumor. In the present report, the case of a 69-year-old male patient with an IMT in the head of the pancreas, who experienced anorexia, nausea and vomiting, is presented. The patient's clinical symptoms were nonspecific, and the imaging findings revealed a hypovascularized pancreatic mass with stenosis of the descending duodenum. The electronic endoscopy findings revealed protruding lesions in the duodenal bulb and the descending duodenum. Biopsies of the mass were conducted with an electronic endoscope, but were not diagnostic. Subsequent duodenopancreatectomy aided in determining a pathological diagnosis of IMT, based on the histology and immunohistochemistry results. The patient experienced a recovery without further incident, as observed during a regular follow-up 3 years later. IMT in the head of the pancreas is rare, particularly in adults. In the present study, an extremely rare case of IMT involving the head of the pancreas in an adult patient is presented, and the therapeutic options for this condition are discussed.

Presence of 25(OH)D deficiency and its effect on vitamin D receptor mRNA expression.

Science.gov (United States)

Goswami, R; Mondal, A M; Tomar, N; Ray, D; Chattopadhyay, P; Gupta, N; Sreenivas, V

2009-03-01

Vitamin D and its metabolites act through vitamin D receptor (VDR). We hypothesized that subjects with low serum 25(OH)D levels but normal PTH might have increased VDR expression. VDRmRNA expression was assessed by real time PCR in duodenal mucosa and PBMC (peripheral blood mononuclear cells) in 45 subjects with normal duodenoscopy and in PBMC alone in 48 healthy volunteers with hypovitaminosis D. 25(OH)D, PTH and VDRmRNA expression in PBMC was reassessed after 8 weeks of oral cholecalciferol (60 000 IU per week) in a subset (n=23) of healthy volunteers. The VDRmRNA expressions in the duodenum and PBMC were significantly correlated (r=0.42), but the expression was 13 times higher in the former than the latter. The mean VDRmRNA expression was similar in 25(OH)D-deficient subjects with or without PTH elevation, both in the duodenum and PBMC. The PBMC VDRmRNA expression showed no significant change after cholecalciferol supplementation. A weak correlation coefficient between duodenal mucosa and PBMC VDRmRNA suggests that caution needs to be exercised while using the latter as a surrogate for other sites.

A case of pancreatic neuroendocrine tumor in a patient with neurofibromatosis-1

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Nishi Takeshi

2012-07-01

Full Text Available Abstract Patients with neurofibromatosis-1 (NF-1 sometime develop neuroendocrine tumors (NET. Although these NETs usually occur in the duodenum or peri-ampullary region, they occasionally grow in the pancreas (PNET. A 62-year-old man with NF-1 had mild liver dysfunction and was admitted to our hospital for further examination. An abdominal contrast-enhanced computed tomography scan demonstrated a 30-mm tumor in the head of the pancreas. The scan showed an invasion of the tumor into the duodenum, and biopsy under an endoscopic ultrasonography indicated that the tumor was a NET. A subtotal stomach-preserving pancreaticoduodenectomy was performed. Macroscopically, the pancreatic tumor was white and elastic hard. Microscopically, tumor cells were composed of ribbons, cords, and solid nests with an acinus-like structure. The tumor was diagnosed as NET G2 according to the WHO classification (2010. The product of theNF-1 gene, i.e., neurofibromin, was weakly positive in the tumor cells, suggesting that the tumor was induced by a mutation in the NF-1 gene. This is the seventh case of PNET arising in NF-1 patients worldwide.

Effect of corticosterone on gene expression of feed intake regulatory peptides in laying hens.

Science.gov (United States)

Liu, Lei; Song, Zhigang; Sheikhahmadi, Ardashir; Jiao, Hongchao; Lin, Hai

2012-08-01

The present study was conducted to explore the effects of corticosterone (CORT) on the regulation of appetite-associated genes in laying hens. Forty eight laying hens were randomly divided into two groups: one received subcutaneous injection of CORT (2mg/kg body weight, CORT-exposed) and the other received sham-treatment (Control). Treatment of hens with CORT stimulated an increase (P0.05) on the mRNA levels of neuropeptide Y (NPY), corticotropin-releasing hormone (CRH), melanocortin receptor 4 and 5 (MCR-4 and MCR-5) and cholecystokinin (CCK) in the hypothalamus when compared with control hens. However, the expression of pro-opiomelanocortin (POMC), agouti-related protein (AgRP) and melanocortin recepter 1 (MCR-1) were significantly (Phens. Treatment of laying hens with CORT had no significant (P>0.05) effect on the mRNA levels of CCK in the glandular stomach and the duodenum, and those of ghrelin in the glandular stomach, the duodenum and the jejunum. However, the mRNA levels of CCK in the jejunum and the ileum, and those of ghrelin in the ileum were significantly (Pfeeding status of CORT-exposed laying hens. Copyright © 2012 Elsevier Inc. All rights reserved.

[Injuries of pancreatoduodenal organs].

Science.gov (United States)

Ivanov, P A; Grishin, A V; Korneev, D A; Ziniakov, S A

2003-01-01

Ten-year experience of treatment of 213 patients with trauma of the pancreas and 56 patients with trauma of the duodenum is analyzed. Combined injury of other organs was seen in 80% patients. Diagnostic policy included intraoperative revision in open abdominal trauma and dynamic observation with US, roentgenography, CT and laboratory tests in closed trauma wich doesn't require urgent surgery. The diagnosis was verified during laparoscopy and contrast duodenography. Surgical treatment results in patients with trauma of the pancreas depending on the variant of surgery are analyzed. The role of drug treatment of traumatic pancreatitis with 5-ftoruracil and octreotid is stressed. It is demonstrated that these principles allowed us to reduce complications rate to 11.7% and lethality to 6.7% from 71.7% and 37.0% respectively. It is established that suturing of duodenal wall on the decompressive nasoduodenal tube is effective within 6 hours after trauma. Later, for prophylaxis of suture insufficiency the duodenum must be switched off. Adequate drainage and depression of secretion with octreotid are very important for success of surgery. In this approach there were no cases of sutures insufficiency among 16 patients in the last 3 years.

[External pancreatic fistulas management].

Science.gov (United States)

Stepan, E V; Ermolov, A S; Rogal', M L; Teterin, Yu S

The main principles of treatment of external postoperative pancreatic fistulas are viewed in the article. Pancreatic trauma was the reason of pancreatic fistula in 38.7% of the cases, operations because of acute pancreatitis - in 25.8%, and pancreatic pseudocyst drainage - in 35.5%. 93 patients recovered after the treatment. Complex conservative treatment of EPF allowed to close fistulas in 74.2% of the patients with normal patency of the main pancreatic duct (MPD). The usage of octreotide 600-900 mcg daily for at least 5 days to decrease pancreatic secretion was an important part of the conservative treatment. Endoscopic papillotomy was performed in patients with major duodenal papilla obstruction and interruption of transporting of pancreatic secretion to duodenum. Stent of the main pancreatic duct was indicated in patients with extended pancreatic duct stenosis to normalize transport of pancreatic secretion to duodenum. Surgical formation of anastomosis between distal part of the main pancreatic duct and gastro-intestinal tract was carried out when it was impossible to fulfill endoscopic stenting of pancreatic duct either because of its interruption and diastasis between its ends, or in the cases of unsuccessful conservative treatment of external pancreatic fistula caused by drainage of pseudocyst.

Plasma extravasation mediated by lipopolysaccharide-induction of kinin B1 receptors in rat tissues

Directory of Open Access Journals (Sweden)

Paulo Roberto Wille

2001-01-01

Full Text Available The present study was performed to: (a evaluate the effects of kinin B1 (Sar{D-Phe8}-des-Arg9-BK; 10 nmol/kg and B2 (bradykinin (BK; 10 nmol/kg receptor agonists on plasma extravasation in selected rat tissues; (b determine the contribution of a lipopolysaccharide (LPS (100 μ g/kg to the effects triggered by B1 and B2 agonists; and (c characterize the selectivity of B1 ({Leu8}desArg9-BK; 10 nmol/kg and B2 (HOE 140; 10 nmol/kg antagonists as inhibitors of this kinin-induced phenomenon. B1 and B2 agonists were shown to increase plasma extravasation in the duodenum, ileum and also in the urinary bladder of the rat. LPS pretreatment enhanced the plasma extravasation mediated only by the B1 agonist in the duodenum, ileum, trachea, main and segmentar bronchi. These effects were prevented by the B1. but not the B2 antagonist. In normal rats, the B2 antagonist inhibited the effect of B2 agonist in all the tissues analyzed. However, in LPS-treated rats, the B2 antagonist was ineffective in the urinary bladder.

Gastroesophageal reflux demonstrated by hepatobiliary imaging in scleroderma

Energy Technology Data Exchange (ETDEWEB)

Sawaf, N.W.; Orzel, J.A.; Weiland, F.L.

1987-03-01

Radionuclide hepatobiliary imaging was performed on a patient with a longstanding history of scleroderma who presented with abdominal pain suggestive of biliary disease. Cystic duct patency was documented after 10 min with tracer accumulation in the second portion of the duodenum which failed to progress consistent with the duodenal hypomotility of scleroderma. The patient was given intravenous Kinevac resulting in gastroesophageal reflux of radionuclide.

Gastroesophageal reflux demonstrated by hepatobiliary imaging in scleroderma

International Nuclear Information System (INIS)

Sawaf, N.W.; Orzel, J.A.; Weiland, F.L.

1987-01-01

Radionuclide hepatobiliary imaging was performed on a patient with a longstanding history of scleroderma who presented with abdominal pain suggestive of biliary disease. Cystic duct patency was documented after 10 min with tracer accumulation in the second portion of the duodenum which failed to progress consistent with the duodenal hypomotility of scleroderma. The patient was given intravenous Kinevac resulting in gastroesophageal reflux of radionuclide

Cholecystitis of a duplicated gallbladder complicated by a cholecystoenteric fistula

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Huang, Brady K. [University of Rochester Medical Center, Department of Imaging Sciences, Rochester, NY (United States); Chess, Mitchell A. [University of Rochester Medical Center, Department of Imaging Sciences, Rochester, NY (United States); Advanced Imaging, Batavia, NY (United States)

2009-04-15

Gallbladder duplications are uncommon anatomic variants that are sometimes mistaken for other entities on imaging. We present a surgically confirmed case of cholecystitis in a ductular-type duplicated gallbladder complicated by the formation of an inflammatory fistula to the adjacent duodenum. Both US and magnetic resonance cholangiopancreatography were performed preoperatively, in addition to intraoperative cholangiography, which confirmed the presence of a duplicated gallbladder. (orig.)

Colonic perforations caused by migrated plastic biliary stents

International Nuclear Information System (INIS)

Virgilio, Edoardo; Pascarella, Agauido; Scandavini, Chiara Maria; Frezza, Barbara; Bocchetti, Tommaso; Balducci, Genoveffa

2015-01-01

Endoscopic insertion of plastic endoprostheses has become an integral part of the management of many benign and malignant diseases affecting the hepatobiliary and pancreatic system. Clogging and dislocation into the duodenum are the most frequently described complications following stent placement. Distal migration with or without perforation of the colon is an exceedingly rare phenomenon and the treatment is not well defined, as discussed below.

Colonic perforations caused by migrated plastic biliary stents

Energy Technology Data Exchange (ETDEWEB)

Virgilio, Edoardo; Pascarella, Agauido; Scandavini, Chiara Maria; Frezza, Barbara; Bocchetti, Tommaso; Balducci, Genoveffa [Faculty of Medicine and Psychology ' Sapienza' , St. Andrea Hospital, Rome (Italy)

2015-04-15

Endoscopic insertion of plastic endoprostheses has become an integral part of the management of many benign and malignant diseases affecting the hepatobiliary and pancreatic system. Clogging and dislocation into the duodenum are the most frequently described complications following stent placement. Distal migration with or without perforation of the colon is an exceedingly rare phenomenon and the treatment is not well defined, as discussed below.

Roux-en-Y duodenojejunostomy in the treatment of Bouveret syndrome.

Science.gov (United States)

Erlandson, Michael D; Kim, Anthony W; Richter, Harry M; Myers, Jonathan A

2009-09-01

Bouveret syndrome is a rare complication of cholelithiasis occurring when a gallstone passes through a cholecystoduodenal or choledochoduodenal fistula and lodges in the pylorus or proximal duodenum causing a gastric outlet obstruction. The case of a 70-year-old male who developed Bouveret syndrome is presented, and the management of this presentation of gallstone ileus by Roux-en-Y duodenojejunostomy is discussed in detail.

Polybezoar in a child with Down's Syndrome after corrective surgery of congenital duodenal stenosis

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Arlart, I

1980-11-01

Case report of a mongoloid child (Trisomie 21), age 9, operated on in his neonatal period for congenital stenosis of the duodenum; now presenting with acute clinical signs of gastric outlet obstruction and increasing weight loss. Radiologic work-up showed this to be due to a large gastric and duodenal polybezoar, claimed to be due to emotional disturbance as part of this patients primary disease.

Polybezoar in a child with Down's Syndrome after corrective surgery of congenital duodenal stenosis

International Nuclear Information System (INIS)

Arlart, I.

1980-01-01

Case report of a mongoloid child (Trisomie 21), age 9, operated on in his neonatal period for congenital stenosis of the duodenum; now presenting with acute clinical signs of gastric outlet obstruction and increasing weight loss. Radiologic work-up showed this to be due to a large gastric and duodenal polybezoar, claimed to be due to emotional disturbance as part of this patients primary disease. (orig.) [de

Radiologic findings of annular pancreas divisum : a case report

International Nuclear Information System (INIS)

Choi, Dong Sik; Lee, Dong Ho; Ko, Young Tae; Han, Tae Il; Yoon, Youp; Dong, Suk Ho

1996-01-01

Annular pancreas divisum is a very rare congenital anomaly involving the coexistence of an annular pancreas and pancreatic divisum in one pancreas, and showing characteristic radiologic findings of ring-like pancreatic tissue surrounding the second portion of the duodenum and no evidence of connection between ventral and dorsal ductal systems. We described the radiologic findings of annular pancreas divisum, diagnosed by hypotonic duodenography, CT and ERCP

Nutrient digestibility parameters as a tool for analysis of the intestinal health of broiler chickens

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Anderson Mori

2016-09-01

Full Text Available The study was performed with the objective of verifying raw soy feed, oxidized oil feed, and a control group. Performance evaluation was done at 7, 14, and 21 days of age. Metabolism assay was carried out between the 17th and 20th days for nutrient digestibility analysis. On the 21st day, two birds per repetition were sent for necropsy and collection of intestine fragments (duodenum and jejunum for histomorphometric analysis. Eight to 14 days after treatment with Salmonella, individuals showed lower feed intake and feed conversion than the control group. Treatment with coccidiosis decreased all performance parameters in the control. Raw soybeans and oxidized oil induce lower weight gain and higher feed conversion compared to the control feed. Unlike after 14 days, at 21 days treatment with salmonella a decrease in weight gain was noted. For the group challenged by coccidiosis feed intake, the feed conversion remained lower than the control group. Undesirable effects on performance in the groups fed raw soybean and oxidized oil remained at up to 21 days. In the evaluation of digestibility, it was observed that raw soy had lower values for digestibility of dry matter, ether extract, and nitrogen balance due to intake. In addition, a lower ratio of villus:crypt measurements was observed. Lower villus height was found in the duodenum of the group challenged by coccidiosis. This group presented a positive correlation between the digestibility of ether extract and the duodenum, indicating that increased villus height implies an increased digestibility of ether extract. The results obtained for the jejunum showed a positive correlation with villus height in groups challenged by coccidiosis, raw soybeans, and oxidized oil; and to crypt depth in the group challenged with oxidized oil. The information obtained in the present study demonstrates that nutrient digestibility parameters can be useful tools for the analysis of the intestinal health of broiler

Sex differences in the gastrointestinal tract of rats and the implications for oral drug delivery.

Science.gov (United States)

Afonso-Pereira, Francisco; Dou, Liu; Trenfield, Sarah J; Madla, Christine M; Murdan, Sudaxshina; Sousa, Jõao; Veiga, Francisco; Basit, Abdul W

2018-03-30

Pre-clinical research often uses rodents as animal models to guide the selection of appropriate oral drug and dose selection in humans. However, traditionally, such research fails to consider the gastrointestinal differences between the sexes of rats and the impact on oral drug delivery. This study aimed to identify and characterise the potential sex-related differences in the gastrointestinal environment of sacrificed male and female Wistar rats. Their gastrointestinal tracts were excised and segmented into the stomach, duodenum, jejunum, ileum, caecum and colon. The respective contents and tissue sections were collected and analysed for pH, buffer capacity, surface tension, osmolality and relative P-glycoprotein (P-gp) expression. The pH in the stomach of females was found to be lower than in males. Female rats also exhibited a higher buffer capacity in the caecum and colon when compared with their male counterparts. Males were found to have a higher osmolality than females in the duodenum, ileum and colon. Significant sex differences (p < 0.05) in surface tension were observed in the ileum, where females exhibited a higher surface tension. Interestingly, female rats displayed significantly higher relative P-gp expression levels (p < 0.05) when compared with male rats in the duodenum (1.24 ± 0.85 vs. 0.36 ± 0.26), jejunum (1.45 ± 0.88 vs. 0.38 ± 0.26) and ileum (0.92 ± 0.43 vs. 0.40 ± 0.18) but not in the colon (0.5 ± 0.32 vs. 0.33 ± 0.16) segments. The work reported has demonstrated the stark physiological differences between male and female rats at a physiological level, indicating how the 'sex of the gut' could influence oral drug delivery. These findings, therefore, are of critical importance in pre-clinical research and drug development. Copyright © 2018 Elsevier B.V. All rights reserved.

Dosimetric Predictors of Duodenal Toxicity After Intensity Modulated Radiation Therapy for Treatment of the Para-aortic Nodes in Gynecologic Cancer

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Verma, Jonathan [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Sulman, Erik P.; Jhingran, Anuja [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tucker, Susan L. [Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Rauch, Gaiane M. [Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Eifel, Patricia J. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Klopp, Ann H., E-mail: aklopp@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2014-02-01

Purpose: To determine the incidence of duodenal toxicity in patients receiving intensity modulated radiation therapy (IMRT) for treatment of para-aortic nodes and to identify dosimetric parameters predictive of late duodenal toxicity. Methods and Materials: We identified 105 eligible patients with gynecologic malignancies who were treated with IMRT for gross metastatic disease in the para-aortic nodes from January 1, 2005, through December 31, 2009. Patients were treated to a nodal clinical target volume to 45 to 50.4 Gy with a boost to 60 to 66 Gy. The duodenum was contoured, and dosimetric data were exported for analysis. Duodenal toxicity was scored according to Radiation Therapy Oncology Group criteria. Univariate Cox proportional hazards analysis and recursive partitioning analysis were used to determine associations between dosimetric variables and time to toxicity and to identify the optimal threshold that separated patients according to risk of toxicity. Results: Nine of the 105 patients experienced grade 2 to grade 5 duodenal toxicity, confirmed by endoscopy in all cases. The 3-year actuarial rate of any duodenal toxicity was 11.7%. A larger volume of the duodenum receiving 55 Gy (V55) was associated with higher rates of duodenal toxicity. The 3-year actuarial rates of duodenal toxicity with V55 above and below 15 cm{sup 3} were 48.6% and 7.4%, respectively (P<.01). In Cox univariate analysis of dosimetric variables, V55 was associated with duodenal toxicity (P=.029). In recursive partitioning analysis, V55 less than 13.94% segregated all patients with duodenal toxicity. Conclusions: Dose-escalated IMRT can safely and effectively treat para-aortic nodal disease in gynecologic malignancies, provided that care is taken to limit the dose to the duodenum to reduce the risk of late duodenal toxicity. Limiting V55 to below 15 cm{sup 3} may reduce the risk of duodenal complications. In cases where the treatment cannot be delivered within these constraints

Biliary-duodenal anastomosis using magnetic compression following massive resection of small intestine due to strangulated ileus after living donor liver transplantation: a case report.

Science.gov (United States)

Saito, Ryusuke; Tahara, Hiroyuki; Shimizu, Seiichi; Ohira, Masahiro; Ide, Kentaro; Ishiyama, Kohei; Kobayashi, Tsuyoshi; Ohdan, Hideki

2017-12-01

Despite the improvements of surgical techniques and postoperative management of patients with liver transplantation, biliary complications are one of the most common and important adverse events. We present a first case of choledochoduodenostomy using magnetic compression following a massive resection of the small intestine due to strangulated ileus after living donor liver transplantation. The 54-year-old female patient had end-stage liver disease, secondary to liver cirrhosis, due to primary sclerosing cholangitis with ulcerative colitis. Five years earlier, she had received living donor liver transplantation using a left lobe graft, with resection of the extrahepatic bile duct and Roux-en-Y anastomosis. The patient experienced sudden onset of intense abdominal pain. An emergency surgery was performed, and the diagnosis was confirmed as strangulated ileus due to twisting of the mesentery. Resection of the massive small intestine, including choledochojejunostomy, was performed. Only 70 cm of the small intestine remained. She was transferred to our hospital with an external drainage tube from the biliary cavity and jejunostomy. We initiated total parenteral nutrition, and percutaneous transhepatic biliary drainage was established to treat the cholangitis. Computed tomography revealed that the biliary duct was close to the duodenum; hence, we planned magnetic compression anastomosis of the biliary duct and the duodenum. The daughter magnet was placed in the biliary drainage tube, and the parent magnet was positioned in the bulbus duodeni using a fiberscope. Anastomosis between the left hepatic duct and the duodenum was accomplished after 25 days, and the biliary drainage stent was placed over the anastomosis to prevent re-stenosis. Contributions to the successful withdrawal of parenteral nutrition were closure of the ileostomy in the adaptive period, preservation of the ileocecal valve, internal drainage of bile, and side-to-side anastomosis

Analysis of Dosimetric Parameters Associated With Acute Gastrointestinal Toxicity and Upper Gastrointestinal Bleeding in Locally Advanced Pancreatic Cancer Patients Treated With Gemcitabine-Based Concurrent Chemoradiotherapy

International Nuclear Information System (INIS)

Nakamura, Akira; Shibuya, Keiko; Matsuo, Yukinori; Nakamura, Mitsuhiro; Shiinoki, Takehiro; Mizowaki, Takashi; Hiraoka, Masahiro

2012-01-01

Purpose: To identify the dosimetric parameters associated with gastrointestinal (GI) toxicity in patients with locally advanced pancreatic cancer (LAPC) treated with gemcitabine-based chemoradiotherapy. Methods and Materials: The data from 40 patients were analyzed retrospectively. Chemoradiotherapy consisted of conventional fractionated three-dimensional radiotherapy and weekly gemcitabine. Treatment-related acute GI toxicity and upper GI bleeding (UGB) were graded according to the Common Toxicity Criteria Adverse Events, version 4.0. The dosimetric parameters (mean dose, maximal absolute dose which covers 2 cm 3 of the organ, and absolute volume receiving 10–50 Gy [V 10–50 ]) of the stomach, duodenum, small intestine, and a composite structure of the stomach and duodenum (StoDuo) were obtained. The planning target volume was also obtained. Univariate analyses were performed to identify the predictive factors for the risk of grade 2 or greater acute GI toxicity and grade 3 or greater UGB, respectively. Results: The median follow-up period was 15.7 months (range, 4–37). The actual incidence of acute GI toxicity was 33%. The estimated incidence of UGB at 1 year was 20%. Regarding acute GI toxicity, a V 50 of ≥16 cm 3 of the stomach was the best predictor, and the actual incidence in patients with V 50 3 of the stomach vs. those with V 50 of ≥16 cm 3 was 9% vs. 61%, respectively (p = 0.001). Regarding UGB, V 50 of ≥33 cm 3 of the StoDuo was the best predictor, and the estimated incidence at 1 year in patients with V 50 3 of the StoDuo vs. those with V 50 ≥33 cm 3 was 0% vs. 44%, respectively (p = 0.002). The dosimetric parameters correlated highly with one another. Conclusion: The irradiated absolute volume of the stomach and duodenum are important for the risk of acute GI toxicity and UGB. These results could be helpful in escalating the radiation doses using novel techniques, such as intensity-modulated radiotherapy, for the treatment of pancreatic

Structural evolution and tissue-specific expression of tetrapod-specific second isoform of secretory pathway Ca{sup 2+}-ATPase

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Pestov, Nikolay B., E-mail: korn@mail.ibch.ru [Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow 117871 (Russian Federation); Dmitriev, Ruslan I.; Kostina, Maria B. [Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow 117871 (Russian Federation); Korneenko, Tatyana V. [Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow 117871 (Russian Federation); Department of Physiology and Pharmacology, University of Toledo College of Medicine, 3000 Arlington Ave., Toledo, OH 43614 (United States); Shakhparonov, Mikhail I. [Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow 117871 (Russian Federation); Modyanov, Nikolai N., E-mail: nikolai.modyanov@utoledo.edu [Department of Physiology and Pharmacology, University of Toledo College of Medicine, 3000 Arlington Ave., Toledo, OH 43614 (United States)

2012-01-27

Highlights: Black-Right-Pointing-Pointer Full-length secretory pathway Ca-ATPase (SPCA2) cloned from rat duodenum. Black-Right-Pointing-Pointer ATP2C2 gene (encoding SPCA2) exists only in genomes of Tetrapoda. Black-Right-Pointing-Pointer Rat and pig SPCA2 are expressed in intestines, lung and some secretory glands. Black-Right-Pointing-Pointer Subcellular localization of SPCA2 may depend on tissue type. Black-Right-Pointing-Pointer In rat duodenum, SPCA2 is localized in plasma membrane-associated compartments. -- Abstract: Secretory pathway Ca-ATPases are less characterized mammalian calcium pumps than plasma membrane Ca-ATPases and sarco-endoplasmic reticulum Ca-ATPases. Here we report analysis of molecular evolution, alternative splicing, tissue-specific expression and subcellular localization of the second isoform of the secretory pathway Ca-ATPase (SPCA2), the product of the ATP2C2 gene. The primary structure of SPCA2 from rat duodenum deduced from full-length transcript contains 944 amino acid residues, and exhibits 65% sequence identity with known SPCA1. The rat SPCA2 sequence is also highly homologous to putative human protein KIAA0703, however, the latter seems to have an aberrant N-terminus originating from intron 2. The tissue-specificity of SPCA2 expression is different from ubiquitous SPCA1. Rat SPCA2 transcripts were detected predominantly in gastrointestinal tract, lung, trachea, lactating mammary gland, skin and preputial gland. In the newborn pig, the expression profile is very similar with one remarkable exception: porcine bulbourethral gland gave the strongest signal. Upon overexpression in cultured cells, SPCA2 shows an intracellular distribution with remarkable enrichment in Golgi. However, in vivo SPCA2 may be localized in compartments that differ among various tissues: it is intracellular in epidermis, but enriched in plasma membranes of the intestinal epithelium. Analysis of SPCA2 sequences from various vertebrate species argue that ATP2C2

Effects of intestinal muscular wrapping on remnant intestinal motility after massive small bowel resection in conscious canines.

Science.gov (United States)

Uchiyama, M; Iwafuchi, M; Yagi, M; Iinuma, Y; Kanada, S; Ohtaki, M; Yamazaki, S; Homma, S

2000-04-01

We searched the effect of the muscular valve on the management of short bowel syndrome. The motility of the remnant intestine with a special muscular valve after 80% massive distal small bowel resection (MSBR) was evaluated in conscious dogs. The valve (muscular ring) was made by the autointestinal muscle layer holding vascular pedicle. Interdigestive and postprandial bowel motility using bipolar electrodes and/or contractile strain gauge force transducers 2-4 weeks after the surgery, and data of this group (Group I) were compared to the motility in dogs after MSBR without valve construction (Group II) and in controls (Control). Results; Fasting duodenal migrating myoelectric (or motor) complexes (MMCs) in Group I occurred at longer intervals than in Control and almost similarly to those in Group II. MMCs arising from the duodenum were often interrupted before the jejunum above the valve and the anastomosis. The velocity of duodenal MMC propagation was slowed in every intestinal segment including that from the duodenum to the proximal jejunum, and to the jejunum above the anastomosis. Transit time in MSBR group (I and II) from the duodenum to the terminal ileum was extremely shorter than in Control, but there were no differences between in Groups I and II. The duration of the postprandial period without duodenal MMCs in Group I was significantly prolonged than in Control, but was shorter than that in Group II. The muscular valve was frequently activated, and the jejunum covered with the valve was contracted frequently which synchronized with the valve activity. It seemed the valve worked as sphincter. However, intestinal obstruction was not occurred through the jejunum covered by the valve. In conclusion, changes in gut motility after MSBR with the valve construction compensate for the shortened intestine and maintain the bowel content earlier postoperatively in comparison with the MSBR alone, and also contribute to the adaptive increase in the remnant intestinal

Promotion of ulcerative duodenitis in young ferrets by oral immunization with Helicobacter mustelae and muramyl dipeptide.

Science.gov (United States)

Whary, M T; Palley, L S; Batchelder, M; Murphy, J C; Yan, L; Taylor, N S; Fox, J G

1997-06-01

The purpose of this study was to determine whether oral immunization of ferret kits with a whole-cell sonicate of Helicobacter mustelae lysate (Hml) and the adjuvant muramyl dipeptide (MDP) would reduce the incidence of natural colonization with H. mustelae and the extent of Helicobacter-associated gastritis by enhancing the host mucosal immune response. Between the ages of 4 and 11 weeks, 44 ferret kits were gavaged with Hml and various doses of MDP. The extent of gastritis and duodenitis and the immune response to H. mustelae were evaluated. All kits became colonized naturally with H. mustelae and the majority developed mild to severe gastritis and duodenitis. Kits that received Hml with MDP developed significantly greater inflammation of the gastric antrum and duodenum, as compared to kits vaccinated with Hml alone. Vaccination with Hml and 50 micrograms of MDP was associated with severe lesions in the proximal duodenum characterized by accumulation of mononuclear inflammatory cells, mucosal erosion, and ulceration. Although serum antibody specific for H. mustelae in 4-week-old kits was approximately 50% of adult levels, a finding attributable to passively acquired maternal antibody, both systemic and mucosal antibody levels became depressed over time despite oral vaccination. The humoral immune response was sufficiently low to prevent detection of any significant dose effect of MDP on antibody levels among experimental groups. Oral vaccination of young ferrets with Hml and 50 micrograms MDP increased the risk of Helicobacter-associated mucosal ulceration in the proximal duodenum, which was associated with low humoral (but significant cell-mediated) immune responses to H. mustelae. In retrospect, the frequency of vaccination may have suppressed the systemic humoral immune response, thereby promoting mucosal damage by H. mustelae. The 50-microgram dose of MDP enhanced the cell-mediated immune response, which indirectly contributed to development of severe lesions

Exchange of nitrogenous substances between the body pool and the digestive tract in ruminants

International Nuclear Information System (INIS)

Boda, K.; Varady, J.; Havassy, I.; Kosta, K.; Fejes, J.; Kowalczyk, J.

1976-01-01

For a period of three months the only source of nitrogen in a group of sheep fed on a synthetic protein-free diet was perorally administered urea, and for a further period of three months intravenously administered urea. It was found that there was practically no variation in the weight of the animals and in the nitrogen balance. The total content of nitrogen and amino-nitrogen in the rumen with intravenous nitrogenous feeding showed that the rumen is adequately supplied with endogenous nitrogen. A clear-cut increase - by a factor of 2 - was observed in the endogenous metabolism as a whole. In experiments on sheep with a fistula of the rumen, duodenum or ileum, it was found that nitrogenous matter (total and microbic), synthesized from the 15 N of intravenously administered urea, is transported by the digestive apparatus with the common nitrogenous substances. In the rumen-duodenum part these substances are mainly secreted and in the intestinal part reabsorbed. Of the 15 N that passed through the duodenum, 73-84% was reabsorbed. Of the administered material, 4.8-5.7% was eliminated in the faeces. In experiments on sheep with an isolated intestine, it was observed that the secretion of blood urea, mainly in the forward part of the jejunum, is relatively high (3.4-3.9mg/h, whereas the rate of NH 3 production due to hydrolysis is relatively low (0.28-0.35mg/h). Of the 15 N-urea introduced via the fistula into the forward part of the jejunum, the average amount of 15 N remaining in the organism is 63%. Equal amounts of 15 N were eliminated in the urine, altogether 37%. It is assumed that the exchange of nitrogen between the digestive apparatus and the body pool is an important link in the nitrogen metabolism of ruminants. The blood urea and synthesized nitrogenous substances are important sources of nitrogen for digestive processes and for protein synthesis. The entire digestive apparatus participates in the utilization of ureal nitrogen. (author)

Structural evolution and tissue-specific expression of tetrapod-specific second isoform of secretory pathway Ca2+-ATPase

International Nuclear Information System (INIS)

Pestov, Nikolay B.; Dmitriev, Ruslan I.; Kostina, Maria B.; Korneenko, Tatyana V.; Shakhparonov, Mikhail I.; Modyanov, Nikolai N.

2012-01-01

Highlights: ► Full-length secretory pathway Ca-ATPase (SPCA2) cloned from rat duodenum. ► ATP2C2 gene (encoding SPCA2) exists only in genomes of Tetrapoda. ► Rat and pig SPCA2 are expressed in intestines, lung and some secretory glands. ► Subcellular localization of SPCA2 may depend on tissue type. ► In rat duodenum, SPCA2 is localized in plasma membrane-associated compartments. -- Abstract: Secretory pathway Ca-ATPases are less characterized mammalian calcium pumps than plasma membrane Ca-ATPases and sarco-endoplasmic reticulum Ca-ATPases. Here we report analysis of molecular evolution, alternative splicing, tissue-specific expression and subcellular localization of the second isoform of the secretory pathway Ca-ATPase (SPCA2), the product of the ATP2C2 gene. The primary structure of SPCA2 from rat duodenum deduced from full-length transcript contains 944 amino acid residues, and exhibits 65% sequence identity with known SPCA1. The rat SPCA2 sequence is also highly homologous to putative human protein KIAA0703, however, the latter seems to have an aberrant N-terminus originating from intron 2. The tissue-specificity of SPCA2 expression is different from ubiquitous SPCA1. Rat SPCA2 transcripts were detected predominantly in gastrointestinal tract, lung, trachea, lactating mammary gland, skin and preputial gland. In the newborn pig, the expression profile is very similar with one remarkable exception: porcine bulbourethral gland gave the strongest signal. Upon overexpression in cultured cells, SPCA2 shows an intracellular distribution with remarkable enrichment in Golgi. However, in vivo SPCA2 may be localized in compartments that differ among various tissues: it is intracellular in epidermis, but enriched in plasma membranes of the intestinal epithelium. Analysis of SPCA2 sequences from various vertebrate species argue that ATP2C2 gene radiated from ATP2C1 (encoding SPCA1) during adaptation of tetrapod ancestors to terrestrial habitats.

Hemogasometria de eqüinos submetidos à obstrução experimental do duodeno, íleo e cólon maior Blood gas analysis of horses submitted to experimental obstruction of duodenum, ileum and large colon

Directory of Open Access Journals (Sweden)

Paula Alessandra Di Filippo

2009-02-01

Full Text Available Visando estudar os parâmetros do equilíbrio ácido-base de eqüinos submetidos a um modelo experimental de obstrução intestinal, 24 animais foram distribuídos em quatro grupos, controle instrumentado (GI, obstrução do duodeno (GII, íleo (GIII e cólon maior (GIV. As amostras de sangue venoso foram coletadas antes das cirurgias (T0, durante as obstruções (T30ob-T180ob e após as desobstruções (T60des-T180des. Os eqüinos do GIV, no T30ob, e os eqüinos do GII, nos T60ob, T90ob e T120ob, apresentaram aumento do pH(v, da cHCO-3(vP e da cBase(v que, acrescidos do aumento da pCO2(v e da ctCO2(v, caracterizou a alcalose metabólica com compensação respiratória. Nos T90ob e T120ob, nos animais do GII, e no T180ob, nos animais do GIII, a pO2(v e a sO2(v tiveram comportamento semelhante. Os valores baixos apresentados pelos animais do GII foram associados à hipercapnia ou à hipoventilação, desencadeadas para a correção da alcalose metabólica. Entretanto, a hipoxemia apresentada pelos animais do GIII foi associada à hipovolemia presente neste período. As alterações ácido-base observadas constituem-se de alterações leves e temporárias, as quais não são capazes de predizer o diagnóstico das obstruções intestinais específicas em eqüinos com cólica. Entretanto, por relacionarem-se diretamente com a precocidade do distúrbio gastrintestinal, elas auxiliam o pesquisador no prognóstico.This study aimed to evaluate parameters of acid-base balance in horses submitted to an experimental model of intestinal obstruction. Twenty-four animals were divided in four groups: instrumented control (GI, duodenum obstruction (GII, ileum obstruction (GIII and large colon obstruction (GIV. Venous blood samples were collected before surgery (T0, during the obstruction (T30ob-T180ob and after unblocking procedures (T60des-T180des. Animals from GIV, at T30ob and animals from GII, at T60ob, T90ob and T120ob, presented higher values for pH(v, c

X-ray diagnostic features of acute bleeding ulcers of the stomach and duodenum

International Nuclear Information System (INIS)

Shcherbatenko, M.K.; Selina, I.E.; Chekalina, M.I.

1996-01-01

The paper is based on the analysis of clinical, X-ray, and morphological studies in 74 patients with massive gastrointestinal hemorrhage. The paper presents the specific features of X-ray studies of patients with bleeding gastroduodenal ulcers. X-ray studies shout be twice performed in these patients. The first study is conducted if gastroscopic findings are unclear, the repeated one is carried out while assessing changes in disease regression. X-ray diagnosis of bleeding ulcers is determined by their sites and the nature of an ulcerous process. The X-ray diagnosis of chronic callous gastric ulcers accompanied by hemorrhage was based on the detection of two direct symptoms of a niche on the gastric outlines and configuration and an inflammatory mound on the gastric outline and configuration. That of chronic bleeding ulcers of the duodenal bulb is based not only on searches niche, but other signs of the disease - the deformed organ, and the magnitude of a periprocess. 10 refs., 5 figs

Pancreatic Arteriovenous Malformation Involving the Duodenum Embolized with Ethylene-Vinyl Alcohol Copolymer (Onyx)

Energy Technology Data Exchange (ETDEWEB)

Grasso, Rosario Francesco, E-mail: r.grasso@unicampus.it; Cazzato, Roberto Luigi; Luppi, Giacomo; Faiella, Eliodoro; Del Vescovo, Riccardo; Giurazza, Francesco [University ' Campus Bio-Medico of Rome' , Department of Radiology (Italy); Borzomati, Domenico; Coppola, Roberto [University ' Campus Bio-Medico of Rome' , Department of General Surgery (Italy); Beomonte Zobel, Bruno [University ' Campus Bio-Medico of Rome' , Department of Radiology (Italy)

2012-08-15

Arteriovenous malformation (AVM) of the pancreas is a rare condition. Most patients are asymptomatic or alternatively may present with a wide spectrum of symptoms. Traditionally, surgery has been considered the treatment of choice; however, alternative approaches, such as transcatheter embolization (TAE), may be proposed. We report a case of a 48-year-old man with a pancreatic head AVM, presenting with upper abdominal pain and slight anemia. The patient refused surgery and underwent TAE by means of ethylene-vinyl alcohol copolymer (EVOH). At 3 months follow-up, the patient was able to eat regularly, with no residual pain and no signs of anemia.

[The semiotics of the pain and dyspeptic syndromes in motor disorders of the digestive organs in children and adolescents].

Science.gov (United States)

Dmytriieva, S M

1999-06-01

Overall 304 children and adolescents with gastro-duodenal pathology were studied for some aspects of clinical manifestations of the pain and dyspeptic syndromes as related to the character of disordered gastroduodenal motility by making use of techniques of phase polygastroduodenometry. Pathogenetic interrelationship was disclosed of clinical manifestations of the pain and dyspeptic syndromes according to the variant of gastroduodenal dysmotility (dysphasic hyper- or hypomotile dyskinesia of the stomach and duodenum).

Experience in stomic X-raying with CO2 generating Unibaryt-tablets

International Nuclear Information System (INIS)

Balogh, I.; Szlamka, I.; Szekely, M.

1983-01-01

In order to achieve optimal double contrast X-ray exposures of the stomach non selected patients with internal or surgical stomic diseases were given Unibaryt-tablets to test their efficiency. The generated CO 2 opend the stomic and upper duodenum plications very well without forming bubbles or foam and no artefacts appeared. The tablets taken together with the contrast medium were well tolerated by the patients. (orig.) [de

Progressive systemic scleroderma (A case report)

International Nuclear Information System (INIS)

Han, Jung Suh; Kwon, Chung Sik

1974-01-01

This is a report of a rare case of progressive systemic scleroderma involving the skin, lungs, bones, esophagus, duodenum, and colon in a 27 year old Korean female whose chief complaints were generalized edema, knee joint pain, hard and indurated skin lesions on the anterior chest, neck, both upper and lower extremities with loss of pain and touch sensation for one year. A review of literature is submitted

Y-shaped endoprosthesis stent. A new device for biliary drainage in malignant obstruction

Energy Technology Data Exchange (ETDEWEB)

Hauenstein, K H; Beck, A; Sontheimer, J; Krueger, H J; Salm, R

1988-05-01

Biliary decompression in cases of central tumorous biliary obstruction requires surgical or internal/external catheter bypass techniques. The development of a 14-F Y-shaped-polyurethane endoprosthesis stent provides the possibility to drain the left and right biliary system simultaneously. The endoprosthesis is placed by a combination of external transhepatic and endoscopic approach. The tip of the singular choledochal stent segment is placed within the choledochus or duodenum.

CLINICAL PRESENTATION, ETIOLOGY AND OUTCOME OF UPPE R GASTROINTESTINAL BLEED FROM A TERTIARY CARE HOSPITA L OF EAST SIKKIM: AN OBSERVATIONAL STUDY

OpenAIRE

Lok Bahadur; Mona; Dhakal

2013-01-01

ABSTRACT: Upper gastrointestinal bleeding refers to blood los s within the intraluminal gastrointestinal tract from any location between th e upper oesophagus to the duodenum at the level of the ligament of treitz. [1] It is a common medical emergency associated with significant morbidity and mortality. [2, 3] Bleeding from the u pper gastrointestinal tract is approximately five times more common than lower gastrointestinal tract . [4] The common causes includ...

Complications of percutaneous endoscopic gastrostomy-jejunostomy for levodopa/carbidopa infusion in advanced Parkinson's disease

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Ana Olivares

2012-03-01

Full Text Available Continuous infusions of levodopa directly into the duodenum-yeyunum is an effective therapy to reduce daily off time in an advanced stage of Parkinson's disease, but it is not without complications, particularly device related problems. We present our experience in three Spanish hospitals with these complications, including a severe case with migration, several decubitus ulcers, and one case of perforation of the bowel and finally death.

Atlarda Mide Ülseri Sendromuna Genel Bakış

OpenAIRE

KAYA KARASU, Gülşah; ONMAZ, Ali Cesur

2017-01-01

The purpose of this review was to provide information about formation of equine gastric ulcer syndrome(EGUS), the basic principles of diagnosis and treatment strategies (pharmacological treatment and the role of nutritionin treatment). EGUS is characterized by ulceration in the terminal esophagus, proximal (squamous) stomach, distal(glandular) stomach, and proximal duodenum. Diagnosis of EGUS requires a thorough history and physical examination.However, gastroscopy is the only definitive diag...

An Intestinal Occlusion Device for Prevention of Small Bowel Distention During Transgastric Natural Orifice Transluminal Endoscopic Surgery

OpenAIRE

Tomasko, Jonathan M.; Mathew, Abraham; Moyer, Matthew T.; Haluck, Randy S.; Pauli, Eric M.

2013-01-01

Background and Objectives: Bowel distention from luminal gas insufflation reduces the peritoneal operative domain during natural orifice transluminal endoscopic surgery (NOTES) procedures, increases the risk for iatrogenic injury, and leads to postoperative patient discomfort. Methods: A prototype duodenal occlusion device was placed in the duodenum before NOTES in 28 female pigs. The occlusion balloon was inflated and left in place during the procedure, and small bowel distension was subject...

Progressive systemic scleroderma (A case report)

Energy Technology Data Exchange (ETDEWEB)

Han, Jung Suh; Kwon, Chung Sik [Chonnam University College of Medicine, Kwangju (Korea, Republic of)

1974-10-15

This is a report of a rare case of progressive systemic scleroderma involving the skin, lungs, bones, esophagus, duodenum, and colon in a 27 year old Korean female whose chief complaints were generalized edema, knee joint pain, hard and indurated skin lesions on the anterior chest, neck, both upper and lower extremities with loss of pain and touch sensation for one year. A review of literature is submitted.

Small Bowel Obstruction due to Anomalous Congenital Bands in Children

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Basak Erginel

2016-01-01

Full Text Available Introduction. The aim of the study was to evaluate our children who are operated on for anomalous congenital band while increasing the awareness of this rare reason of intestinal obstruction in children which causes a diagnostic challenge. Patients and Methods. We retrospectively reviewed the records of fourteen children treated surgically for intestinal obstructions caused by anomalous congenital bands. Results. The bands were located between the following regions: the ascending colon and the mesentery of the terminal ileum in 4 patients, the jejunum and mesentery of the terminal ileum in 3 patients, the ileum and mesentery of the terminal ileum in 2 patients, the ligament of Treitz and mesentery of the jejunum in one patient, the ligament of Treitz and mesentery of the terminal ileum in one patient, duodenum and duodenum in one patient, the ileum and mesentery of the ileum in one patient, the jejunum and mesentery of the jejunum in one patient, and Meckel’s diverticulum and its ileal mesentery in one patient. Band excision was adequate in all of the patients except the two who received resection anastomosis for intestinal necrosis. Conclusion. Although congenital anomalous bands are rare, they should be considered in the differential diagnosis of patients with an intestinal obstruction.

Over-the-catheter precut to gain access to the biliary duct during ERCP rendezvous.

Science.gov (United States)

Manes, Gianpiero; Baratti, Cinzia; Ardizzone, Sandro; Ferla, Fabio; Spiropoulos, Jean; Corsi, Fabio; Foschi, Diego; Trabucchi, Emilio; Bianchi Porro, Gabriele

2008-10-01

Endoscopic retrograde cholangiopancreatography (ERCP) rendezvous during laparoscopic cholecystectomy is an efficient and safe method to treat cholecystocholedocholithiasis. Advancing a guidewire through the cystic duct into the duodenum and withdrawing it in the accessory channel of duodenoscope may be, however, laborious. Moreover, rendezvous performed in the typical manner needs the use of several costly accessories. We herein describe a simpler and cheaper method to gain access to the biliary duct at rendezvous. Twenty-four consecutive patients undergoing ERCP rendezvous during laparoscopic cholecystectomy were considered. A catheter was introduced in the cystic duct and advanced into the duodenum. Access to the bile duct was than achieved by means of a precut sphincterotomy performed over the catheter emerging from the papilla. Cannulation was successful in all but two patients, in whom ERCP was performed in the conventional manner. The only complication was a case of mild post-sphincterotomy bleeding. In comparison with the typical rendezvous technique our procedure allowed savings of about 250, since its performance only requires a catheter and a knife sphincterotome. Over-the-catheter precut during ERCP rendezvous is a feasible and safe method which avoids the need for the manipulation of several accessories and guidewires, and thus results in money and time savings.

Ranitidine Can Potentiate The Prokinetic Effect Of Itopride At Low Doses- An In Vitro Study.

Science.gov (United States)

Butt, Aroosa Ishtiaq; Khan, Bushra Tayyaba; Khan, Asma; Khan, Qamar-Uz-Zaman

2017-01-01

Gastroparesis and GERD occur concomitantly in 40 percent of the cases. Prokinetic drugs and acid blockers are employed as the main treatment modality. Ranitidine is an acid blocker with additional prokinetic activity and Itopride is a known prokinetic drug. This study was designed to observe the synergistic potentiating prokinetic effect of Ranitidine on itopride on isolated duodenum of rabbits. Ranitidine (10-5-10-3) and itopride (10-6-10-5) were added in increasing concentrations to isolated duodenum of rabbits and contractions were recorded on PowerLab Data acquisition unit AHK/214. Cumulative dose response curves were constructed. The potentiating prokinetic effect of Ranitidine on itopride was seen by using a fixed dose of ranitidine and cumulatively enhancing doses of itopride on iWorx. Ranitidine and itopride produced a dose dependent reversible contraction of the isolated tissue of rabbits with ranitidine showing a max response of 0.124mV and itopride showing a maximum response of 0.131mV. Ranitidine was able to potentiate the prokinetic effect of itopride at low doses but at high dose the effect began to wane off. Ranitidine and itopride produce a statistically significant synergistic potentiating prokinetic effect at low doses in vitro.

Metabolic fate of lactoferricin-based antimicrobial peptides: effect of truncation and incorporation of amino acid analogs on the in vitro metabolic stability.

Science.gov (United States)

Svenson, Johan; Vergote, Valentijn; Karstad, Rasmus; Burvenich, Christian; Svendsen, John S; De Spiegeleer, Bart

2010-03-01

A series of promising truncated antibacterial tripeptides derived from lactoferricin has been prepared, and their in vitro metabolic stability in the main metabolic compartments, plasma, liver, kidney, stomach, duodenum, and brain, has been investigated for the first time. The potential stabilizing effect of truncation, C-terminal capping, and introduction of the bulky synthetic amino acid biphenylalanine is also investigated. The drug-like peptides displayed large differences in half-lives in the different matrixes ranging from 4.2 min in stomach and duodenum to 355.9 min in liver. Kinetic analysis of the metabolites revealed that several different degrading enzymes simultaneously target the different peptide bonds and that the outcome of the tested strategies to increase the stability is clearly enzyme-specific. Some of the metabolic enzymes even prefer the synthetic modifications incorporated over the natural counterparts. Collectively, it is shown that the necessary antibacterial pharmacophore generates compounds that are not only potent antibacterial peptides, but excellent substrates for the main degrading enzymes. All the amide bonds are thus rapidly targeted by different enzymes despite the short peptidic sequences of the tested compounds. Hence, our results illustrate that several structural changes are needed before these compounds can be considered for oral administration. Strategies to overcome such metabolic challenges are discussed.

Effect of dietary organic zinc sources on growth performance, incidence of diarrhoea, serum and tissue zinc concentrations, and intestinal morphology in growing rabbits

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J.Y. Yan

2017-03-01

Full Text Available This study was conducted to evaluate the effect of dietary organic zinc (Zn sources on growth performance, the incidence of diarrhoea, serum and tissue Zn concentration, and intestinal morphology in growing rabbits. A total of 120 New Zealand White rabbits aged 35 d and with an initial body weight of 755±15 g, were randomly divided into 4 treatment groups for a 49 d feeding trial. Dietary treatments were designed with different Zn supplements as follows: (1 Control group: 80 mg/kg Zn as ZnSO4; (2 ZnLA group: 80 mg/kg Zn as Zn lactate; (3 ZnMet group: 80 mg/kg Zn as Zn methionine; (4 ZnGly group: 80 mg/kg Zn as Zn glycine. The results showed that, when compared with rabbits fed ZnSO4, supplementation with ZnLA improved (P4. Supplementing with ZnLA increased duodenum villi height (681.63 vs. 587.14 μm, P4, except that feeding ZnMet led to higher (P4. The results indicated that supplementation with 80 mg/kg Zn as ZnLA could improve growth performance, increase liver Zn concentration and enhance duodenum morphology, while reducing the incidence of diarrhoea in growing rabbits.

Neural regulation of duodenal alkali secretion: Effects of electrical field stimulation

International Nuclear Information System (INIS)

Crampton, J.R.; Gibbons, L.G.; Rees, W.D.W.

1988-01-01

The role of transmitters released from enteric neurons in regulating bicarbonate secretion by the proximal duodenum has been studied using electrical field stimulation (EFS). Stripped duodenal mucosa from Rana catesbeiana was mounted as an intact tube over circular platinum electrode,s and luminal alkalinization was measured by pH stat titration before, during, and after EFS. Transmucosal potential difference (PD) was simultaneously measured before and after EFS by paired electrodes. Square-wave pulses 50 V, 2 ms in duration, at 10 Hz were delivered in trains of 0.5 s at 1 Hz for periods of 15 min after stable basal secretion. This resulted in a 63 ± 27% increase in alkalinization that returned to basal values after cessation of the stimulus, without change in transmucosal PD. Serosal-to-lumen [ 3 H]mannitol flux was not affected. Repetition of the stimulus resulted in a similar responses for as long as the tissue remained viable. The response to EFS was abolished by tetrodotoxin and veratrine indicating that intrinsic neurons were responsible for mediating the effect. In addition, the effect was blocked by serosal dinitrophenol, indicating that the secretory response occurred by a metabolically dependent process. These results indicate that alkalinization by proximal duodenum may be controlled by neurotransmitter release from local enteric neurons

Neuroendocrine tumors and smoking

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Tanja Miličević

2016-12-01

Full Text Available Neuroendocrine cells are dispersed around the body and can be found within the gastrointestinal system, lungs, larynx, thymus, thyroid, adrenal, gonads, skin and other tissues. These cells form the so-called ''diffuse neuroendocrine system'' and tumors arising from them are defined as neuroendocrine tumors (NETs. The traditional classification of NETs based on their embryonic origin includes foregut tumors (lung, thymus, stomach, pancreas and duodenum, midgut tumors (beyond the ligament of Treitz of the duodenum to the proximal transverse colon and hindgut tumors (distal colon and rectum. NETs at each site are biologically and clinically distinct from their counterparts at other sites. Symptoms in patients with early disease are often insidious in onset, leading to a delay in diagnosis. The majority of these tumors are thus diagnosed at a stage at which the only curative treatment, radical surgical intervention, is no longer an option. Due to the increasing incidence and mortality, many studies have been conducted in order to identify risk factors for the development of NETs. Still, little is known especially when it comes to preventable risk factors such as smoking. This review will focus on smoking and its contribution to the development of different subtypes of NETs.

Bio-physical characteristics of gastrointestinal mucosa of celiac patients: comparison with control subjects and effect of gluten free diet-

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Villanacci Vincenzo

2011-11-01

Full Text Available Abstract Background Intestinal mucosa is leaky in celiac disease (CD, and this alteration may involve changes in hydrophobicity of the mucus surface barrier in addition to alteration of the epithelial barrier. The aims of our study were i to compare duodenal hydrophobicity as an index of mucus barrier integrity in CD patients studied before (n = 38 and during gluten- free diet (GFD, n = 68, and in control subjects (n = 90, and ii to check for regional differences of hydrophobicity in the gastro-intestinal tract. Methods Hydrophobicity was assessed by measurement of contact angle (CA (Rame Hart 100/10 goniometer generated by a drop of water placed on intestinal mucosal biopsies. Results CA (mean ± SD of distal duodenum was significantly lower in CD patients (56° ± 10° than in control subjects (69° ± 9°, p corpus > rectum > duodenum > oesophagus > ileum. Conclusions We conclude that the hydrophobicity of duodenal mucous layer is reduced in CD patients, and that the resulting decreased capacity to repel luminal contents may contribute to the increased intestinal permeability of CD. This alteration mirrors the severity of the mucosal lesions and is not completely reverted by gluten-free diet. Intestinal hydrophobicity exhibits regional differences in the human intestinal tract.

[Gastroesophageal reflux disease associated with duodenogastroesophageal reflux in patients with biliary pathology: the specific features of the course and esophagogastroduodenal microbial biocenosis].

Science.gov (United States)

Dzhulai, G S; Sekareva, E V; Chervinets, V M; Mikhailova, E S; Dzhulai, T E

2014-01-01

To study the specific features of the clinical course of gastroesophageal reflux disease (GERD) associated with duodenogastroesophageal reflux (DGER) in patients with chronic acalculous cholecystitis (CAC) and cholelithiasis (CL), as well as qualitative and quantitative characteristics. The clinical, morphological, motor tonic characteristics of the esophagogastroduodenal area, mucosal microbial biocenosis in the esophagus, stomach, and duodenum were studied in detail in 83 patients with GERD that was associated with DGER and ran concurrently with CAC or CL. Impaired duodenal propulsive activity as a concomitance of the signs of gastrostasis and duodenal dyskinesia with dyscoordination of both anthroduodenal and duodenojejunal propulsion and with the development of duodenogastric reflux and DGER, which in turn determine esophageal and gastric pH values is shown to be of importance in CAC and CL, which match GERD. Abnormal microbiocenosis in the upper digestive tract is characterized by the higher quantitative and qualitative content of the mucous microflora. Opportunistic microorganisms exhibit cytotoxic, hemolytic, lecithinase, caseinolytic, urease, and RNAase activities. The found specific features of the course of GERD associated with DGER in patients with biliary tract abnormalities lead us to search for novel therapeutic approaches based on the correction of digestive motor tonic disorders and abnormal microbiocenoses of the mucous flora in the esophagus, stomach, and duodenum.

Primary aortoduodenal fistula after radiotherapy. Report of a case

Energy Technology Data Exchange (ETDEWEB)

Oshima, Takeshi; Inoue, Hitoshi; Oshima, Akira; Minami, Tomohito; Matsumine, Takao [Tokyo Metropolitan Fuchu Hospital (Japan)

1999-10-01

Aortoduodenal fistula is a rare and life-threatening cause of gastrointestinal hemorrhage. The patient was a 44-year-old woman who repeated intermittent hematemesis and melena after hysterectomy, para-aortic lymph node dissection, and subsequent radiotherapy. Angiography revealed no bleeding point. Upper gastrointestinal endoscopy showed an ulcer at the third portion of the duodenum. Emergency laparotomy revealed an aortoduodenal fistula which was inferred to be caused by radiotherapy because no recurrence of malignancy was detected. After the fistula was closed, the patient repeated hematemesis and anal bleeding. She died of acute hemorrhagic shock, in spite of three operations including axillo-femoral bypass. We propose that radiation might have played a role in the pathogenesis of the aortoduodenal fistula in our case. The new case of primary aortoduodenal fistula following radiotherapy is added to four cases previously reported in the literature. Six cases in which the lesion of the duodenum could be demonstrated by endoscopy, have been reported in Japan. Aortoduodenal fistula should be considered as a probable diagnosis in patients presenting massive gastrointestinal hemorrhage after radiotherapy. Rapid surgical treatments are needed, and operative procedures to be considered include resection of the aorta with aortic stump closure and axillo-femoral bypass. (author)

Endoscopic Decompression and Marsupialization of A Duodenal Duplication Cyst

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Eliza I-Lin Sin

2018-06-01

Full Text Available Introduction: Duodenal duplication cysts are rare congenital foregut anomalies, accounting for 2%–12% of all gastrointestinal tract duplications. Surgical excision entails risk of injury to the pancreaticobiliary structures due to proximity or communication with the cyst. We present a case of duodenal duplication cyst in a 3 year-old boy who successfully underwent endoscopic decompression. Case report: AT is a young boy who first presented at 15 months of age with abdominal pain. There was one subsequent episode of pancreatitis. Ultrasonography showed the typical double wall sign of a duplication cyst and magnetic resonance cholangio-pancreatography showed a large 5 cm cyst postero-medial to the second part of the duodenum, communicating with the pancreaticobiliary system and causing dilatation of the proximal duodenum. He subsequently underwent successful endoscopic ultrasound guided decompression at 3 years of age under general anesthesia, and had an uneventful postoperative recovery. Conclusion: Endoscopic ultrasound guided assessment and treatment of gastrointestinal duplication cysts is increasingly reported in adults. To the best of our knowledge, only one case of endoscopic treatment of duodenal duplication cyst, in an older child, has been reported thus far in the paediatric literature. In this paper, we review the current literature and discuss the therapeutic options of this rare condition.

Early actions of cadmium in the rat and domestic fowl testis. II. Distribution of injected /sup 109/cadmium

Energy Technology Data Exchange (ETDEWEB)

Johnson, A D; Miller, W J

1970-01-01

Male rats and domestic fowl were injected with /sup 109/Cd. After anaesthesia, blood was taken from the exposed heart and also various tissues were taken. The level of /sup 109/Cd was determined in each tissue. In rats injected subcutaneously, there was a steady increase in the level of /sup 109/Cd for 40 min, followed by a drop in the whole testis, seminal vesicles, epididymis, skeletal muscle, heart, spleen, pancreas and liver. In the blood, the maximum level of /sup 109/Cd was reached at 10 min and dropped rapidly. In the ileum, duodenum, and kidney there was an increase for 80 min. In most tissues of the intraperitoneally-injected rats, /sup 109/Cd reached the highest level at 2.5 min and tended to decrease thereafter. The amount of /sup 109/Cd in the blood reached a peak at 5 min and then dropped. Liver levels rose continually, while in the kidney, ileum and duodenum, levels rose for 40 min, then tended to drop. In most tissues of the fowl, including the blood, the level of /sup 109/Cd rose gradually and dropped gradually. Levels in the kidney and liver showed a continual increase. 17 references, 6 figures.

Intestinal absorption and secretion of 65Zn in the rat

International Nuclear Information System (INIS)

Methfessel, A.H.; Spencer, H.

1974-01-01

A single dose of 65 Zn Cl 2 was given by intubation to the intact rat or was instilled into the lumen of ligated intestinal sacs to determine the absorption, or injected intravenously via the tail vein to determine intestinal secretion of 65 Zn. Results indicated that the small intestine plays a major role in the absorption and secretion of zinc and that aging decreases the absorption of zinc for the duodenum of the rat

Análisis fitoquímico y efecto sinérgico protector de las hojas de minthostachys mollis y malva sylvestris sobre la mucosa gástrica de rattus rattus var. albinus

OpenAIRE

Castillo Saavedra, Ericson Félix

2010-01-01

The peptic ulcer is a lesion that affects an area of the gastrointestinal mucose usually in the stomach or duodenum produced by a disbalance between defensives and protects factors. This report was oriented on determinating phytochemistry of Minthostachys mollis (Kunth) Griseb, Malva sylvestris L., and analyze if these plants in study had synergistic protect effect in the acute injure of gastric mucose induced by ethanol in Rattus rattus var. albinus. Phytochemical screening was realized usin...

Characterizing the bacterial microbiota in different gastrointestinal tract segments of the Bactrian camel

OpenAIRE

He, Jing; Yi, Li; Hai, Le; Ming, Liang; Gao, Wanting; Ji, Rimutu

2018-01-01

The bacterial community plays important roles in the gastrointestinal tracts (GITs) of animals. However, our understanding of the microbial communities in the GIT of Bactrian camels remains limited. Here, we describe the bacterial communities from eight different GIT segments (rumen, reticulum, abomasum, duodenum, ileum, jejunum, caecum, colon) and faeces determined from 11 Bactrian camels using 16S rRNA gene amplicon sequencing. Twenty-seven bacterial phyla were found in the GIT, with Firmic...

A Case of Sigmoid Colon Tuberculosis Mimicking Colon Cancer

OpenAIRE

Yu, Seong-Min; Park, Jong-Hwan; Kim, Min-Dae; Lee, Hee-Ryong; Jung, Peel; Ryu, Tae-Hyun; Choi, Seung-Ho; Lee, Il-Seon

2012-01-01

Tuberculosis of the sigmoid colon is a rare disorder. An 80-year-old man visited Bongseng Memorial Hospital for medical examination. A colonoscopy was performed, and a lesion in the sigmoid colon that was suspected to be colon cancer was found. A biopsy was performed, and tuberculous enteritis with chronic granulomatous inflammation was diagnosed. Intestinal tuberculosis is most frequent in the ileocecal area, followed by the ascending colon, transverse colon, duodenum, stomach, and sigmoid c...

[Serological tests of functional activity of the digestive system (gastrin, pepsinogen-I, trypsin), general IgE and serum cortisol levels in children with hepatitis A and B].

Science.gov (United States)

Kalagina, L S; Pavlov, Ch S; Fomin, Iu A

2013-01-01

The mild form of hepatitis A and B with children is attended by a functional activity of pancreatic gland (tripsin), mucous coats of stomach and duodenum (gastrin) which permits to consider them as a factor of the risk of digestive organs combined pathology starting with the disease acuity. Differences in gastrin levels with children depending on hepatitis etiology were specified. Highest levels of gastrin were observed with persons suffering from hepatitis B.

Vasoactive intestinal polypeptide (VIP) tissue distribution in the rat as measured by radioimmunoassay and by radioreceptorassay

International Nuclear Information System (INIS)

Besson, J.; Dupont, C.; Laburthe, M.; Bataille, D.; Rosselin, G.

1977-01-01

A new radioimmunoassay which allows the measurement of the rat vasoactive intestinal polypeptide, was performed. VIP is present in the whole digestive tract of rat, mainly between the duodenum and the colon. 1.5% of the total VIP is present in brain. The VIP-like immunoreactivity appears to correspond to biologically active molecule since a radioreceptorassay using liver plasma membranes as the target tissue, gives the same results as the radioimmunoassay [fr

Surgical strategies in the treatment of chronic pancreatitis: An updated systematic review and meta-analysis of randomized controlled trials.

Science.gov (United States)

Zhao, Xin; Cui, Naiqiang; Wang, Ximo; Cui, Yunfeng

2017-03-01

Chronic pancreatitis (CP) is a common and frequently occurring disease. Pancreaticoduodenectomy (PD), pylorus-preserving pancreaticoduodenectomy (PPPD), and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis. The Beger and Frey procedures are 2 main duodenum-preserving techniques in duodenum-preserving pancreatic head resection (DPPHR) strategies. We conducted this systematic review and meta-analysis to compare the clinical efficacy of DPPHR versus PD, the Beger procedure versus PD, the Frey procedure versus PD, and the Beger procedure versus the Frey procedure in the treatment of pancreatitis. The optimal surgical option for chronic pancreatitis is still under debate. The aim of this systematic review and meta-analysis was to evaluate the clinical efficacy of different surgical strategies for chronic pancreatitis. Five databases (PubMed, Medline, SinoMed, Embase, and Cochrane Library) were searched with the limitations of human subjects and randomized controlled trials (RCTs) text. Data were extracted by 2 of the coauthors independently and analyzed using the RevMan statistical software, version 5.3. Weighted mean differences (WMDs), risk ratios (RRs), and 95% confidence intervals (CIs) were calculated. Cochrane Collaboration's Risk of Bias Tool was used to assess the risk of bias. Seven studies involving a total of 385 patients who underwent the surgical treatments were assessed. The methodological quality of the trials ranged from low to moderate and included PD (n = 134) and DPPHR (n = 251 [Beger procedure = 100; Frey procedure = 109; Beger or Frey procedure = 42]). There were no significant differences between DPPHR and PD in post-operation mortality (RR = 2.89, 95% CI = 0.31-26.87, P = 0.36), pain relief (RR = 1.09, 95% CI = 0.94-1.25, P = 0.26), exocrine insufficiency (follow-up time > 60 months: RR = 0.91, 95% CI = 0.72-1.15, P�

What is the true supply of amino acids for a dairy cow?

Science.gov (United States)

Lapierre, H; Pacheco, D; Berthiaume, R; Ouellet, D R; Schwab, C G; Dubreuil, P; Holtrop, G; Lobley, G E

2006-03-01

Improving the prediction of milk protein yield relies on knowledge of both protein supply and requirement. Definition of protein/amino acid supply in ruminants is a challenging task, due to feedstuff variety and variability and to the remodeling of nutrient intake by the rumen microflora. The questions arise, therefore, how and where should we measure the real supply of AA in the dairy cow? This review will follow the downstream flow of AA from duodenum to peripheral tissue delivery, with a glance at the efficiency of transfer into milk protein. Duodenal AA flow comprises rumen undegradable feed, microbial protein, and endogenous secretions. Most attention has been directed toward definition of the first two contributions but the latter fraction can represent as much as 20% of duodenal flow. More information is needed on what factors affect its magnitude and overall impact. Once digested, AA are absorbed into the portal vein. The ratio of portal absorption to small intestinal apparent digestion varies among essential AA, from 0.43 (threonine) to 0.76 (phenylalanine), due to the contributions of preduodenal endogenous secretions to the digestive flow, non-reabsorption of endogenous secretions and gut oxidation of AA. Few data are available on these phenomena in dairy cows but the evidence indicates that they alter the profile of AA available for anabolic purposes. Recent comparisons of estimated duodenal flux and measured portal flux have prompted a revisit of the NRC (2001) approach to estimate AA flows at the duodenum. Changes to the model are proposed that yield predictions that better fit the current knowledge of AA metabolism across the gut. After absorption, AA flow first to the liver where substantial and differential net removal occurs, varying from zero for the branched-chain AA to 50% of portal absorption for phenylalanine. This process alters the pattern of net supply to the mammary gland. Overall, intermediary metabolism of AA between the duodenum and

Expression of host defense peptides in the intestine of Eimeria-challenged chickens.

Science.gov (United States)

Su, S; Dwyer, D M; Miska, K B; Fetterer, R H; Jenkins, M C; Wong, E A

2017-07-01

Avian coccidiosis is caused by the intracellular protozoan Eimeria, which produces intestinal lesions leading to weight gain depression. Current control methods include vaccination and anticoccidial drugs. An alternative approach involves modulating the immune system. The objective of this study was to profile the expression of host defense peptides such as avian beta-defensins (AvBDs) and liver expressed antimicrobial peptide 2 (LEAP2), which are part of the innate immune system. The mRNA expression of AvBD family members 1, 6, 8, 10, 11, 12, and 13 and LEAP2 was examined in chickens challenged with either E. acervulina, E. maxima, or E. tenella. The duodenum, jejunum, ileum, and ceca were collected 7 d post challenge. In study 1, E. acervulina challenge resulted in down-regulation of AvBD1, AvBD6, AvBD10, AvBD11, AvBD12, and AvBD13 in the duodenum. E. maxima challenge caused down-regulation of AvBD6, AvBD10, and AvBD11 in the duodenum, down-regulation of AvBD10 in the jejunum, but up-regulation of AvBD8 and AvBD13 in the ceca. E. tenella challenge showed no change in AvBD expression in any tissue. In study 2, which involved challenge with only E. maxima, there was down-regulation of AvBD1 in the ileum, AvBD11 in the jejunum and ileum, and LEAP2 in all 3 segments of the small intestine. The expression of LEAP2 was further examined by in situ hybridization in the jejunum of chickens from study 2. LEAP2 mRNA was expressed similarly in the enterocytes lining the villi, but not in the crypts of control and Eimeria challenged chickens. The lengths of the villi in the Eimeria challenged chickens were less than those in the control chickens, which may in part account for the observed down-regulation of LEAP2 mRNA quantified by PCR. Overall, the AvBD response to Eimeria challenge was not consistent; whereas LEAP2 was consistently down-regulated, which suggests that LEAP2 plays an important role in modulating an Eimeria infection. Published by Oxford University Press on

Biodistribution and endocytosis of ICAM-1-targeting antibodies versus nanocarriers in the gastrointestinal tract in mice

Directory of Open Access Journals (Sweden)

Mane V

2012-08-01

Full Text Available Viraj Mane,1 Silvia Muro1, 21Institute for Bioscience and Biotechnology Research, 2Fischell Department of Bioengineering, University of Maryland, College Park, MD, USAAbstract: Drug delivery to the gastrointestinal (GI tract is key for improving treatment of GI maladies, developing oral vaccines, and facilitating drug transport into circulation. However, delivery of formulations to the GI tract is hindered by pH changes, degradative enzymes, mucus, and peristalsis, leading to poor GI retention. Targeting may prolong residence of therapeutics in the GI tract and enhance their interaction with this tissue, improving such aspects. We evaluated nanocarrier (NC and ligand-mediated targeting in the GI tract following gastric gavage in mice. We compared GI biodistribution, degradation, and endocytosis between control antibodies and antibodies targeting the cell surface determinant intercellular adhesion molecule 1 (ICAM-1, expressed on GI epithelium and other cell types. These antibodies were administered either as free entities or coated onto polymer NCs. Fluorescence and radioisotope tracing showed proximal accumulation, with preferential retention in the stomach, jejunum, and ileum; and minimal presence in the duodenum, cecum, and colon by 1 hour after administration. Upstream (gastric retention was enhanced in NC formulations, with decreased downstream (jejunal accumulation. Of the total dose delivered to the GI tract, ~60% was susceptible to enzymatic (but not pH-mediated degradation, verified both in vitro and in vivo. Attenuation of peristalsis by sedation increased upstream retention (stomach, duodenum, and jejunum. Conversely, alkaline NaHCO3, which enhances GI transit by decreasing mucosal viscosity, favored downstream (ileal passage. This suggests passive transit through the GI tract, governed by mucoadhesion and peristalsis. In contrast, both free anti-ICAM and anti-ICAM NCs demonstrated significantly enhanced upstream (stomach and duodenum

Interfractional Dose Variations in Intensity-Modulated Radiotherapy With Breath-Hold for Pancreatic Cancer

Energy Technology Data Exchange (ETDEWEB)

Nakamura, Mitsuhiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Shibuya, Keiko, E-mail: kei@kuhp.kyoto-u.ac.jp [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Nakamura, Akira [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Shiinoki, Takehiro [Department of Nuclear Engineering, Kyoto University Graduate School of Engineering, Kyoto (Japan); Matsuo, Yukinori [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Nakata, Manabu [Clinical Radiology Service Division, Kyoto University Hospital, Kyoto (Japan); Sawada, Akira; Mizowaki, Takashi; Hiraoka, Masahiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan)

2012-04-01

Purpose: To investigate the interfractional dose variations for intensity-modulated radiotherapy (RT) combined with breath-hold (BH) at end-exhalation (EE) for pancreatic cancer. Methods and Materials: A total of 10 consecutive patients with pancreatic cancer were enrolled. Each patient was fixed in the supine position on an individualized vacuum pillow with both arms raised. Computed tomography (CT) scans were performed before RT, and three additional scans were performed during the course of chemoradiotherapy using a conventional RT technique. The CT data were acquired under EE-BH conditions (BH-CT) using a visual feedback technique. The intensity-modulated RT plan, which used five 15-MV coplanar ports, was designed on the initial BH-CT set with a prescription dose of 39 Gy at 2.6 Gy/fraction. After rigid image registration between the initial and subsequent BH-CT scans, the dose distributions were recalculated on the subsequent BH-CT images under the same conditions as in planning. Changes in the dose-volume metrics of the gross tumor volume (GTV), clinical target volume (CTV = GTV + 5 mm), stomach, and duodenum were evaluated. Results: For the GTV and clinical target volume (CTV), the 95th percentile of the interfractional variations in the maximal dose, mean dose, dose covering 95% volume of the region of structure, and percentage of the volume covered by the 90% isodose line were within {+-}3%. Although the volume covered by the 39 Gy isodose line for the stomach and duodenum did not exceed 0.1 mL at planning, the volume covered by the 39 Gy isodose line for these structures was up to 11.4 cm{sup 3} and 1.8 cm{sup 3}, respectively. Conclusions: Despite variations in the gastrointestinal state and abdominal wall position at EE, the GTV and CTV were mostly ensured at the planned dose, with the exception of 1 patient. Compared with the duodenum, large variations in the stomach volume receiving high-dose radiation were observed, which might be beyond the

Analysis of Dosimetric Parameters Associated With Acute Gastrointestinal Toxicity and Upper Gastrointestinal Bleeding in Locally Advanced Pancreatic Cancer Patients Treated With Gemcitabine-Based Concurrent Chemoradiotherapy

Energy Technology Data Exchange (ETDEWEB)

Nakamura, Akira [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Shibuya, Keiko, E-mail: kei@kuhp.kyoto-u.ac.jp [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Matsuo, Yukinori; Nakamura, Mitsuhiro; Shiinoki, Takehiro; Mizowaki, Takashi; Hiraoka, Masahiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan)

2012-10-01

Purpose: To identify the dosimetric parameters associated with gastrointestinal (GI) toxicity in patients with locally advanced pancreatic cancer (LAPC) treated with gemcitabine-based chemoradiotherapy. Methods and Materials: The data from 40 patients were analyzed retrospectively. Chemoradiotherapy consisted of conventional fractionated three-dimensional radiotherapy and weekly gemcitabine. Treatment-related acute GI toxicity and upper GI bleeding (UGB) were graded according to the Common Toxicity Criteria Adverse Events, version 4.0. The dosimetric parameters (mean dose, maximal absolute dose which covers 2 cm{sup 3} of the organ, and absolute volume receiving 10-50 Gy [V{sub 10-50}]) of the stomach, duodenum, small intestine, and a composite structure of the stomach and duodenum (StoDuo) were obtained. The planning target volume was also obtained. Univariate analyses were performed to identify the predictive factors for the risk of grade 2 or greater acute GI toxicity and grade 3 or greater UGB, respectively. Results: The median follow-up period was 15.7 months (range, 4-37). The actual incidence of acute GI toxicity was 33%. The estimated incidence of UGB at 1 year was 20%. Regarding acute GI toxicity, a V{sub 50} of {>=}16 cm{sup 3} of the stomach was the best predictor, and the actual incidence in patients with V{sub 50} <16 cm{sup 3} of the stomach vs. those with V{sub 50} of {>=}16 cm{sup 3} was 9% vs. 61%, respectively (p = 0.001). Regarding UGB, V{sub 50} of {>=}33 cm{sup 3} of the StoDuo was the best predictor, and the estimated incidence at 1 year in patients with V{sub 50} <33 cm{sup 3} of the StoDuo vs. those with V{sub 50} {>=}33 cm{sup 3} was 0% vs. 44%, respectively (p = 0.002). The dosimetric parameters correlated highly with one another. Conclusion: The irradiated absolute volume of the stomach and duodenum are important for the risk of acute GI toxicity and UGB. These results could be helpful in escalating the radiation doses using novel

Effects of energy and protein restriction, followed by nutritional recovery on morphological development of the gastrointestinal tract of weaned kids.

Science.gov (United States)

Sun, Z H; He, Z X; Zhang, Q L; Tan, Z L; Han, X F; Tang, S X; Zhou, C S; Wang, M; Yan, Q X

2013-09-01

Effects of energy, protein, or both energy and protein restriction on gastrointestinal morphological development were investigated in 60 Liuyang Black kids, which were sourced from local farms and weaned at 28 d of age. Weaned kids were randomly assigned to receive 1 of 4 dietary treatments (15 kids per treatment), which consisted of adequate nutrient supply (CON), energy restriction (ER), protein restriction (PR), or energy and protein restriction (EPR). The entire experiment included adaptation period (0 to 6 d), nutritional restriction period (7 to 48 d), and recovery period (49 to 111 d). Three kids from each group were killed at d 48 and 111, and the rumen, duodenum, jejunum, and ileum were harvested. On d 48 (end of nutritional restriction), lengths of the duodenum (P = 0.005), jejunum (P = 0.003), and ileum (P = 0.003), and weights of the rumen (P = 0.004), duodenum (P = 0.006), jejunum (P = 0.006), and ileum (P = 0.004) of kids in ER, PR, and EPR were less than those of kids in CON. Compared with CON, PR decreased papillae width (P = 0.03) and surface area (P = 0.05) of the rumen epithelium, villus surface area (P = 0.05), and N concentration (P = 0.02) of the jejunum mucosa on d 48. Compared with CON, EPR decreased papillae height (P = 0.001), width (P = 0.001), and surface area (P = 0.003), N concentration (P = 0.01), and the ratio of N to DNA (P = 0.03) of the rumen epithelium. Compared with CON, EPR also decreased villus height (P = 0.01), width (P = 0.006), and surface area (P = 0.006), N concentration (P kids in ER, PR, and EPR were still less than those of kids in CON; N concentrations of rumen epithelium of kids in PR (P = 0.01) and EPR (P = 0.001), and the ratio of N to DNA of jejunum mucosa of kids in EPR (P kids in CON. Results indicate that nutritional restriction of 6 wk can retard gastrointestinal morphological development for kids weaned at 28 d of age and retarded development remains evident, even after nutritional recovery of 9 wk.

Severe upper gastrointestinal bleeding in extraluminal diverticula in the third part of the duodenum

DEFF Research Database (Denmark)

Wilhelmsen, Michael; Andersen, Johnny Fredsbo; Lauritsen, Morten Laksafoss

2014-01-01

The successful management of upper gastrointestinal (GI) bleeding requires identification of the source of bleeding and when this is achieved the bleeding can often be treated endoscopically. However, the identification of the bleeding can be challenging due to the location of the bleeding...... or technical aspects. Therefore it might be necessary to use other measures than endoscopy such as CT angiography. Duodenal diverticula is a rare cause of upper GI bleeding and can be challenging to diagnose as they often require specialised endoscopy procedures such as endoscopy with a side-viewing scope....... This case describes the first successful management of this rare condition with an upper GI endoscopy with a colonoscope and afterwards intravascular coiling....

Radiologist's exposition during the radioscopy of the digestive tract in esophagus-gastro-duodenum studies

International Nuclear Information System (INIS)

Montanez, O.; Blanco, D.

1988-01-01

The results of personal dosimetry confirm that one of the most exposed groups to the ionizing radiations is those of Radiologists who work with radioscopy of the digestive tract. However, the particular conditions of the exposition complicate the interpretation of the reading for the values obtained on the dosimeter. In order to improve such interpretation, it has done simultaneous measurements with the routine dosimeter and with thermoluminescent dosimeters (TLD) of lithium fluoride(LiF). It has selected eight places on the worker's body and located such dosimeters, so that the dose was integrated during thirty studies. It could verify that, if the dosimeter is located in agreement with the recommendations of the International Commission of Radiological Protection(ICRP), the reading overestimates in several times the dose in whole body(or effective dose). It has also considered that the amount of such procedures done by the radiologist is limited in this case, by the effective dose

Upper gastrointestinal obstruction secondary to aortoduodenal syndrome owing to a noninflammatory abdominal aortic aneurysm.

LENUS (Irish Health Repository)

Cahill, Kevin

2012-01-31

Aortoduodenal syndrome is a rare complication of an abdominal aortic aneurysm wherein the aneurysm sac obstructs the patient\\'s duodenum. It presents with the symptoms of an upper gastrointestinal tract obstruction and requires surgical intervention to relieve it. Previously, gastric bypass surgery was advocated, but now aortic replacement is the mainstay of treatment. We report a case of a 67-year-old woman whose aortoduodenal syndrome was successfully managed and review the literature on this topic.

Anatomoclinical changes in a dog subjected to whole-body irradiation followed four days later by a partial ileectomy

International Nuclear Information System (INIS)

Neveux, Y.; Deloince, R.; Dubos, M.; Drouet, J.; Nguyen, T.L.

Various anatomoclinical changes observed in a dog subjected to gamma radiation at three doses (250, 300, 350 R) and to an ileectomy performed four days later, were described. A comparative study with a dog subjected to gamma radiation only, proved that radiation syndrome prognosis is increased by surgery. Pathological changes were evaluated as a function of radiation doses in hematopoietic organs (bone marrow, spleen, lymph nodes) and digestive tract (stomach, duodenum, small intestine, colon, liver) [fr

P-OTX: a PIT-1-interacting homeodomain factor expressed during anterior pituitary gland development.

OpenAIRE

Szeto, D P; Ryan, A K; O'Connell, S M; Rosenfeld, M G

1996-01-01

A novel OTX-related homeodomain transcription factor has been identified on the basis of its ability to interact with the transactivation domain of the pituitary-specific POU domain protein, Pit-1. This factor, referred to as P-OTX (pituitary OTX-related factor), is expressed in primordial Rathke's pouch, oral epithelium, first bronchial arch, duodenum, and hindlimb. In the developing anterior pituitary, it is expressed in all regions from which cells with distinct phenotypes will emerge in t...

Extra-Gastrointestinal Stromal Tumor of Retroperitoneal Origin: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Choi, Seung Joon; Kim, Hyung Sik; Park, Yul Ri; Choi, Hye Young [Dept. of Radiology, Gachon Medical Center, Gachon University of Medicine and Science, Incheon (Korea, Republic of)

2012-03-15

Extragastrointestinal stromal tumors (EGIST) are relatively rare, and cases originating in the retroperitoneum even rarer. We report a 60-year-old woman who presented with an EGIST originating in the retroperitoneum. Computed tomography results demonstrated a soft tissue mass on the right side of the retroperitoneum. The tumor abutted the duodenum, head of the pancreas, and right kidney. The mass was surgically proven to be a retroperitoneal tumor and histopathologically proven to be a retroperitoneal EGIST.

HEMATOMAS E PETÉQUIAS INTESTINAIS ASSOCIADA A ENTERITE PROXIMAL EM EQUINO PORTADOR DE SÍNDROME CÓLICA

OpenAIRE

Agostinho, Juliana Maria Avanci; Fafram; de Freitas, Fernanda Coutinho; Fafram; Lataro, Rita Aparecida; Fafram; de Moraes, Angélica Trazzi Bento; Fafram; Valente, Paula Pimentel; Fafram

2010-01-01

Characterized by manifestation of acute abdominal pain, the pain was more common source of gastrointestinal origin, the Colic Syndrome is one of the main diseases affecting the equine species. As a causeof abdominal pain manifestations appears to acute enteritis, an inflammatory disease of unknown etiology, involving mainly the duodenum. This paper reports the case of a horse race quarter mile seen at the Veterinary Hospital of FAFRAM showing signs of abdominal discomfort with the possible di...

New considerations on hydrogen peroxide and related substances as food additives in view of carcinogenicity.

Science.gov (United States)

Ito, R

1982-01-01

The use of hydrogen peroxide as a labile and safe food preservative in fish cake and boiled noodles has recently been restricted by the Japanese government, since hyperplasia has been found in the duodenum of mice after long-term peroral study. The action of compounds with resembling mode of action, potassium bromate as an improving agent in bread, and sodium chlorate as a weed killer are discussed in this paper in view of developmental and environmental pharmacology.

EFFECTS OF PLUMERIA OBTUSA LINN. IN PEPTIC ULCER INDUCED BY PYLORUS LIGATION & INDOMETHACIN

OpenAIRE

Amit Pratap Singh; Vaibhav Shukla; Piuesh Khare

2012-01-01

Peptic ulcer disease refers to pathological lesions and ulcers of any portion of gastrointestinal tract exposed to acid activated pepsin. Gastric ulcer refers to ulcer in the stomach where as duodenal ulcer is a ulcer found in duodenum of small intestine. Helicobacter pylori infection, a spiral shaped type of bacteria, is present in more than 90% of the patients with intestinal ulcers and more than 80% of patients with stomach ulcers. Helicobacter pylori weaken the protective mucous coating o...

Intestinal mucosa is a target tissue for pancreatic polypeptide

International Nuclear Information System (INIS)

Gilbert, W.R.; Kramer, J.L.; Frank, B.H.; Gingerich, R.L.

1986-01-01

Studies were carried out to identify mammalian tissues capable of specifically binding mammalian pancreatic polypeptide (PP). Bovine PP (bPP) radiolabeled with 125 I was purified by HPLC to yield [ 125 I]iodo-(Tyr-27) bPP. The label was injected into three pairs of fasted littermate dogs and allowed to circulate for 5 min. One of the dogs was a control which received an excess of unlabeled porcine PP to provide competition for receptor binding. Unbound bPP was removed by perfusion with Krebs-Ringer bicarbonate and the tissue fixed in situ with Karnovsky's fixative. Tissue samples from various organs were removed, weighed, and counted. The entire gastrointestinal tract demonstrated high levels of 125 I after injection of the labeled peptide. The duodenum, jejunum, ileum, and colon were the only tissues to exhibit specific binding of bPP. These tissues (mucosal and muscle layers) from experimental animals exhibited 31-76% higher binding than the corresponding tissues from the control animals. Sections of the gastrointestinal tract were scraped to separate the mucosal layer from the underlying muscle layer. The mucosal layer of the duodenum, jejunum, and ileum exhibited 145-162% increases in binding compared to the control animals. The muscle layer of these tissues demonstrated no significant increase. These findings demonstrate that mucosal layer of the small intestine is a target tissue for mammalian PP

Role of glucagon in intestinal hyperemia associated with early experimental diabetes mellitus

International Nuclear Information System (INIS)

Yrle, L.F.; Smith, J.K.; Benoit, J.N.; Granger, D.N.; Korthuis, R.J.

1988-01-01

The role of glucagon as a blood-borne mediator of the intestinal hyperemia associated with experimental diabetes mellitus was assessed in anesthetized fasted (18-24 h) rats 4 wk after the administration of streptozotocin or its vehicle. Selective removal of pancreatic glucagon from the circulation was accomplished by the intravenous administration of a highly specific glucagon antiserum. Blood flow to the gastrointestinal tract and kidneys was measured with radioactive microspheres using the reference sample technique. Blood flows were increased by at least 60% in each segment of the gastrointestinal tract of diabetic animals compared with control rats. Glucagon antiserum had no effect on blood flows in the gastrointestinal tract of control animals. However, the antiserum produced a significant reduction in blood flow to the stomach (26%), duodenum (25%), jejunum (12%), and kidneys (16%) in diabetic rats. There was no change in blood flow to the ileum or colon of diabetic animals with antiserum administration. The results of this study support the hypothesis that glucagon mediates a portion of the hyperemia noted in the stomach, duodenum, and jejunum. However, glucagon does not appear to play a role in the genesis of the hyperemia noted in more distal segments of the gastrointestinal tract (ileum and colon). A possible role for glucagon in the maintenance of renal blood flow in diabetic rats is suggested

Effects of Xylanase Supplementation on Growth Performance, Nutrient Digestibility and Non-starch Polysaccharide Degradation in Different Sections of the Gastrointestinal Tract of Broilers Fed Wheat-based Diets

Directory of Open Access Journals (Sweden)

L. Zhang

2014-06-01

Full Text Available This experiment was performed to investigate the effects of exogenous xylanase supplementation on performance, nutrient digestibility and the degradation of non-starch polysaccharides (NSP in different sections of the gastrointestinal tract (GIT of broilers fed wheat-based diets. A total of 120 7-day-old Arbor Acres broiler chicks were randomly allotted to two wheat-based experimental diets supplemented with 0 or 1.0 g/kg xylanase. Each treatment was composed of 6 replicates with 10 birds each. Diets were given to the birds from 7 to 21 days of age. The results showed that xylanase supplementation did not affect feed intake, but increased body weight gain of broiler at 21 day of age by 5.8% (pjejunum>duodenum>>gizzard> caecum. The supplementation of xylanse increased ileal isomaltriose concentration (p<0.05, but did not affect the concentrations of isomaltose, panose and 1-kestose in the digesta of all GIT sections. These results suggest that supplementation of xylanase to wheat-based diets cuts the arabinoxylan backbone into small fragments (mainly arabinose and xylose in the ileum, jejunum and duodenum, and enhances digestibilites of nutrients by decreasing digesta viscosity. The release of arabinose and xylose in the small intestine may also be the important contributors to the growth-promoting effect of xylanase in broilers fed wheat-based diets.

Target organs for avian pancreatic polypeptide

International Nuclear Information System (INIS)

Kimmel, J.R.; Pollock, H.G.

1981-01-01

The problem of the physiological function of pancreatic polypeptide (PP) has been approached by attempting to identify target organs. Avian PP (aPP) labeled with 125I at either the C-terminus (aPP-C) or the N-terminus (aPP-N) was injected into fasted chickens and allowed to circulate for 3-120 min. At the end of the equilibration period, the anesthetized bird was perfused first with saline, then with Buoin's solution. Samples of fixed tissue from various organs were collected, weighed, and counted. Control experiments consisted of coinjection of unlabeled aPP to compete for receptors. The rate of disappearance of aPP-N from plasma was greater than that of aPP-C. Binding of aPP-N by spleen, duodenum, ileum, pancreas, and bone marrow was markedly reduced by coinjection of unlabeled aPP. A similar but less marked reduction in binding was found in liver and proventriculus. aPP-C gave less conclusive results. The maximal competitive effect of unlabeled PP could be achieved in most cases with 30 microgram unlabeled aPP. It is concluded that pancreas, duodenum, ileum, spleen, and bone marrow, and probably liver and proventriculus, are target organs for aPP in the chicken and that the C-terminal region of aPP is involved in receptor binding

Gastrointestinal nitrogen turnover in sheep fed non-protein nitrogen and a phosphorus deficient diet

International Nuclear Information System (INIS)

Breves, G.; Hoeller, H.

1987-01-01

Sheep were fitted with rumen cannulas and re-entrant duodenal and T-shaped ileal cannulas and adapted to a semisynthetic phosphorus deficient diet providing approximately 0.96 g P/d and 14 g N/d, about half of which was in the form of urea-N. Phosphorus repletion was achieved by daily intraduodenal infusion of phosphate, bringing up the daily P supply to about 4.2 g. In P depletion, as well as in P repletion, a series of infusion periods of six days each were established with continuous intraruminal infusion of Cr-ethylenediaminetetra acetic acid as a fluid marker and 15 NH 4 Cl as a marker of microbial N. Gastrointestinal phosphorus and nitrogen balances were established and the net yield of microbial N in the rumen and the flow of microbial N into the duodenum were calculated. The following significant findings were obtained in P depleted sheep. The concentrations of P in plasma and in rumen fluid and the flow of P to the small intestines fell by 60 to 90%; the P balances became negative. The gastrointestinal balance and the flow of N before the large intestines were not affected, but N digestibility in the large intestines was reduced. The daily net yield of microbial N in the rumen was reduced by 27% and the daily flow of microbial N into the duodenum was reduced by 26%. (author)

Radioimmunoassay for serotin - methodology, basal and stimulated hormone concentration in plasma of rats, dogs, rabbits and humans

International Nuclear Information System (INIS)

Wittmann, J.K.

1983-01-01

A radioimmunoassay for measurement of secretin in the plasma of experimental animals and man has been developed by means of the so-called stripping procedure (pre-treatment of plasma with Quso). The detection limit is about 7 pg/ml at a final dilution of 1:630 000 and an equilibrium constant of 2.1x10 -11 L/M. By means of this system plasma secretin in the species examined can be measured reliably. The coefficients of variation are (percent): The within assay precision (intra-assay) 12, the between assay precision (inter-assay) 23. The median of basal venous plasma secretin are (pg/ml) dog 16, rabbit 0, rat (aorta) 0, rat (porta) 31, man 0. From these studies it is concluded that a) as a consequence of unspecific interference of plasma particles with the secretin RIA-system only a previous removal of these interfering factors leads to reliable test results; should this pre-requisite be neglected falsely too high results are to be expected; b) plasma secretin rises if there is either hydrochloric acid present in the duodenum or if gastric together with food particles reaches the duodenum; c) at least in the dog there may be different molecular species of secretin circulating in the peripherical plasma, however the biological role of these is unknown at present. (orig./TRV) [de

Congenital anomalies, hereditary diseases of the pancreas, acute and chronic pancreatitis; Entwicklungsstoerungen, angeborene Erkrankungen des Pankreas, akute und chronische Pankreatitis

Energy Technology Data Exchange (ETDEWEB)

Brambs, Hans-Juergen; Juchems, Markus [Universitaetsklinikum Ulm (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie

2011-06-15

The most important congenital anomalies include pancreas divisum, annular pancreas and ectopic pancreas. Patients with pancreas divisum may be more susceptible to acute or chronic pancreatitis and patients with an annular pancreas may develop duodenal stenosis. In pancreas divisum the key finding is the visualization of the main duct draining into the duodenum via the small papilla, separated from the common bile duct. Annular pancreas may show as a well defined ring of pancreatic tissue that encircles the duodenum. Ectopic pancreas is usually asymptomatic but may give rise to abdominal complaints and may be confused with submucosal tumors. Acute pancreatitis is classified as mild or severe. In mild forms ultrasound is the imaging modality of choice whereas in severe forms with extensive pancreatic and peripancreatic necroses computed tomography is the favored method. It is crucial to identify signs and criteria that come along with an increased risk of infection of the necroses. MRI plays an inferior role in the assessment of acute pancreatitis. Chronic pancreatitis is a longstanding inflammatory and fibrosing process causing pain and loss of function. Cross-section imaging is particularly in demand for the detection of complications and the differentiation from pancreatic cancer. Autoimmune pancreatitis is a unique form of chronic pancreatitis characterized by lymphoplasmacytic infiltration and fibrosis, and favourable response to corticosteroid treatment. (orig.)

Developmental expression and distribution of nesfatin-1/NUCB2 in the canine digestive system.

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Jiang, Shudong; Zhou, Weijuan; Zhang, Xingwang; Wang, Dengfeng; Zhu, Hui; Hong, Meizhen; Gong, Yajing; Ye, Jing; Fang, Fugui

2016-03-01

Nesfatin-1/NUCB2 is a neuropeptide that plays important roles in regulating food intake and energy homeostasis. The distribution of nesfatin-1/NUCB2 protein and mRNA has not been investigated in the canine digestive system. The present study was conducted to evaluate the expression of nesfatin-1/NUCB2 protein and NUCB2 mRNA in the canine digestive organs (esophagus, stomach, duodenum, jejunum, ileum, cecum, colon, rectum, liver and pancreas). The tissues of the digestive system were collected from dogs at different developmental stages (infantile, juvenile, pubertal and adult). Nesfatin-1/NUCB2 protein localization in the organs of adult dogs was detected by immunohistochemistry. The expression of NUCB2 mRNA at the four developmental stages was analyzed by real-time fluorescence quantitative PCR (qRT-PCR). Nesfatin-1/NUCB2 protein was distributed in the fundic gland region of the stomach, and the islet area and exocrine portions of the pancreas. However, NUCB2 mRNA was found in all digestive organs, although the expression levels in the pancreas and stomach were higher than those in liver, duodenum and other digestive tract tissues (Pdigestive organs. These findings provide the basis of further investigations to elucidate the functions of nefatin-1 in the canine digestive system. Copyright © 2015 Elsevier GmbH. All rights reserved.

Angiotensin receptors and angiotensin I-converting enzyme in rat intestine

International Nuclear Information System (INIS)

Duggan, K.A.; Mendelsohn, F.A.; Levens, N.R.

1989-01-01

The purpose of this study was to map the distribution of angiotensin II (ANG II) receptors and ANG I-converting enzyme (ACE) in rat intestine. ANG II binding sites were visualized by in vitro autoradiography using iodinated [Sar1, Ile8]ANG II. The distribution of ACE was mapped using an iodinated derivative of lisinopril. Male Sprague-Dawley rats were killed and the interior of the whole intestine washed with ice-cold saline. Segments of duodenum, jejunum, ileum, and colon were quickly frozen in a mixture of isopentane and dry ice. Twenty-micron frozen sections were thaw-mounted onto gelatin-coated slides, incubated with either ligand, and exposed to X-ray film. After exposure and subsequent development, the films were quantitated by computerized densitometry. ANG II receptors were most dense in the colon, followed by the ileum, duodenum, and jejunum. Within each segment of intestine, specific ANG II binding sites were localized exclusively to the muscularis. In contrast, ACE was present in both the mucosa and the muscularis. The colocalization of ANG II receptors and ACE may suggest a role for locally generated ANG II in the control of intestinal function. The luminal orientation of ACE in the mucosa of the small intestine may suggest that at this site ACE serves primarily to hydrolyze dietary peptides

Radiologic Percutaneous Gastrostomy in Nondistended Stomach: A Modified Approach

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Petrocelli, Francesco, E-mail: francesco.petrocelli@hsanmartino.it; Salsano, Giancarlo, E-mail: giancarlo.salsano@yahoo.it; Bovio, Giulio, E-mail: giulio.bovio@hsanmartino.it; Camerano, Francesco, E-mail: francesco.camerano@gmail.com; Utili, Alice, E-mail: aliceutili@gmail.com; Ferro, Carlo, E-mail: carlo.ferro@hsanmartino.it [IRCCS San Martino University Hospital, Department of Radiology and Interventional Radiology (Italy)

2016-07-15

IntroductionGastrostomy tube placement for patients requiring long-term nutritional support may be performed using different techniques including endoscopic, surgical, and percutaneous radiologically guided methods. Radiologically inserted gastrostomy (RIG), typically performed when percutaneous endoscopic gastrostomy is not possible, requires proper gastric distension that is achieved by insufflating air through a nasogastric tube. We describe a simple technique to prevent air escape from the stomach during gastrostomy tube placement. To the best of our knowledge, this technique has not yet been described in the literature.Materials and MethodsFour patients with unsuccessful percutaneous endoscopic gastrostomy were referred for fluoroscopic-guided gastrostomy. One patient had a pyriform sinus tumor and three had an ischemic stroke causing dysphagia. Gastric distention was not achieved in the patients due to air escaping into the bowel during the standard RIG procedure. A modified approach using a balloon catheter inflated in the pylorus to avoid air passing into the duodenum permitted successful RIG.ResultsThe modified RIG procedure was successfully carried out in all cases without complications.DiscussionInadequate air distension of the stomach is an unusual event that causes a failure of gastrostomy tube placement and an increased risk of both major and minor complications. The use of a balloon catheter inflated in the first part of the duodenum prevents the air passage into the bowel allowing the correct positioning of the gastrostomy.

Current surgical treatment for chronic pancreatitis.

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Aimoto, Takayuki; Uchida, Eiji; Nakamura, Yoshiharu; Yamahatsu, Kazuya; Matsushita, Akira; Katsuno, Akira; Cho, Kazumitsu; Kawamoto, Masao

2011-01-01

Chronic pancreatitis (CP) is a painful, yet benign inflammatory process of the pancreas. Surgical management should be individualized because the pain is multifactorial and its mechanisms vary from patient to patient. Two main pathogenetic theories for the mechanisms of pain in CP have been proposed: the neurogenic theory and the theory of increased intraductal/intraparenchymal pressures. The latter theory is strongly supported by the good results of drainage procedures in the surgical management of CP. Other possible contributing factors include pancreatic ischemia; a centrally sensitized pain state; and the development of complications, such as pseudocysts and stenosis of the duodenum or common bile duct. Common indications for surgery include intractable pain, suspicion of neoplasm, and complications that cannot be resolved with radiological or endoscopic treatments. Operative procedures have been historically classified into 4 categories: decompression procedures for diseased and obstructed pancreatic ducts; resection procedures for the proximal, distal, or total pancreas; denervation procedures of the pancreas; and hybrid procedures. Pancreaticoduodenectomy and pylorus-preserving pancreaticoduodenectomy, once the standard operations for patients with CP, have been replaced by hybrid procedures, such as duodenum-preserving pancreatic head resection, the Frey procedure, and their variants. These procedures are safe and effective in providing long-term pain relief and in treating CP-related complications. Hybrid procedures should be the operations of choice for patients with CP.

Stenting of the Cystic Duct in Benign Disease: A Definitive Treatment for the Elderly and Unwell

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Hersey, N., E-mail: naomi.hersey@sth.nhs.uk [Sheffield Teaching Hospitals NHS Trust, Department of Radiology, Northern General Hospital (United Kingdom); Goode, S. D., E-mail: s.goode@sheffield.sc.uk [Sheffield Teaching Hospitals NHS Trust, Sheffield Vascular Institute (United Kingdom); Peck, R. J., E-mail: robert.peck@sth.nhs.uk; Lee, F., E-mail: fred.lee@sth.nhs.uk [Sheffield Teaching Hospitals NHS Trust, Department of Radiology, Northern General Hospital (United Kingdom)

2015-08-15

PurposeThere have been few case reports describing cystic duct stent insertion in the management of acute cholecystitis secondary to benign disease with no case series published to date. We present our series demonstrating the role of cystic duct stents in managing benign gallbladder disease in those patients unfit for surgery.Materials and MethodsThirty three patients unfit for surgery in our institution underwent cystic duct stent insertion for the management of acute cholecystitis in the period June 2008 to June 2013. Patients underwent a mixture of transperitoneal and transhepatic gallbladder puncture. The cystic duct was cannulated with a hydrophilic guidewire which was subsequently passed through the common bile duct and into the duodenum. An 8Fr 12-cm double-pigtail stent was placed with the distal end lying within the duodenum and the proximal end within the gallbladder.ResultsTen patients presented with gallbladder perforation, 21 patients with acute cholecystitis, 1 with acute cholangitis and 1 with necrotising pancreatitis. The technical success rate was 91 %. We experienced a 13 % complication rate with 3 % mortality rate at 30 days.ConclusionCystic duct stent insertion can be successfully used to manage acute cholecystitis, gallbladder empyema or gallbladder perforations in those unfit for surgery and should be considered alongside external gallbladder drainage as a definitive mid-term treatment option.

Stenting of the Cystic Duct in Benign Disease: A Definitive Treatment for the Elderly and Unwell

International Nuclear Information System (INIS)

Hersey, N.; Goode, S. D.; Peck, R. J.; Lee, F.

2015-01-01

PurposeThere have been few case reports describing cystic duct stent insertion in the management of acute cholecystitis secondary to benign disease with no case series published to date. We present our series demonstrating the role of cystic duct stents in managing benign gallbladder disease in those patients unfit for surgery.Materials and MethodsThirty three patients unfit for surgery in our institution underwent cystic duct stent insertion for the management of acute cholecystitis in the period June 2008 to June 2013. Patients underwent a mixture of transperitoneal and transhepatic gallbladder puncture. The cystic duct was cannulated with a hydrophilic guidewire which was subsequently passed through the common bile duct and into the duodenum. An 8Fr 12-cm double-pigtail stent was placed with the distal end lying within the duodenum and the proximal end within the gallbladder.ResultsTen patients presented with gallbladder perforation, 21 patients with acute cholecystitis, 1 with acute cholangitis and 1 with necrotising pancreatitis. The technical success rate was 91 %. We experienced a 13 % complication rate with 3 % mortality rate at 30 days.ConclusionCystic duct stent insertion can be successfully used to manage acute cholecystitis, gallbladder empyema or gallbladder perforations in those unfit for surgery and should be considered alongside external gallbladder drainage as a definitive mid-term treatment option

Phytosterol ester processing in the small intestine: impact on cholesterol availability for absorption and chylomicron cholesterol incorporation in healthy humans[S

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Amiot, Marie Josèphe; Knol, Diny; Cardinault, Nicolas; Nowicki, Marion; Bott, Romain; Antona, Claudine; Borel, Patrick; Bernard, Jean-Paul; Duchateau, Guus; Lairon, Denis

2011-01-01

Phytosterols (plant sterols and stanols) can lower intestinal cholesterol absorption, but the complex dynamics of the lipid digestion process in the presence of phytosterol esters (PEs) are not fully understood. We performed a clinical experiment in intubated healthy subjects to study the time course of changes in the distribution of all lipid moieties present in duodenal phases during 4 h of digestion of meals with 3.2 g PE (PE meal) or without (control meal) PE. In vitro experiments under simulated gastrointestinal conditions were also performed. The addition of PE did not alter triglyceride (TG) hydrolysis in the duodenum or subsequent chylomicron TG occurrence in the circulation. In contrast, cholesterol accumulation in the duodenum aqueous phase was markedly reduced in the presence of PE (−32%, P < 0.10). In vitro experiments confirmed that PE reduces cholesterol transfer into the aqueous phase. The addition of PE resulted in a markedly reduced presence of meal-derived hepta-deuterated cholesterol in the circulation, i.e., in chylomicrons (−43%, PE meal vs. control; P < 0.0001) and plasma (−54%, PE meal vs. control; P < 0.0001). The present data show that addition of PE to a meal does not alter TG hydrolysis but displaces cholesterol from the intestinal aqueous phase and lowers chylomicron cholesterol occurrence in humans. PMID:21482714

Gastrointestinal Behavior of Weakly Acidic BCS Class II Drugs in Man--Case Study of Diclofenac Potassium.

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Van Den Abeele, Jens; Brouwers, Joachim; Mattheus, Ruben; Tack, Jan; Augustijns, Patrick

2016-02-01

This study aimed to investigate the gastrointestinal supersaturation and precipitation behavior of a weakly acidic Biopharmaceutics Classification System (BCS) Class II drug in healthy volunteers. For this purpose, a tablet containing 50 mg diclofenac potassium (Cataflam(®)) was predissolved in 240 mL of water and this solution was subsequently orally administered to five healthy volunteers under fasted and fed state conditions with or without concomitant use of a proton-pump inhibitor (PPI) (40 mg esomeprazole, Nexiam(®)). Subsequently, total diclofenac content and dissolved intraluminal drug concentrations as well as drug thermodynamic solubility were determined in gastrointestinal aspirates. In all volunteers, gastric supersaturation resulted in precipitation of diclofenac in the stomach. The extent of precipitation correlated well with gastric pH (r = - 0.78). pH dependency of precipitation was corroborated by the absence of precipitate in the stomach after coadministration of a meal and/or a PPI. Diclofenac was found to be fully dissolved in the duodenum in all test conditions. It can be concluded that substantial pH-dependent gastric precipitation of a weakly acidic BCS Class II drug administered as a solution occurs in humans. With regard to its implications for intestinal absorption, results suggest the instantaneous redissolution of gastric drug precipitate upon transfer to the duodenum. Copyright © 2016. Published by Elsevier Inc.

Effects of feeding blends of grains naturally contaminated with Fusarium mycotoxins on small intestinal morphology of turkeys.

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Girish, C K; Smith, T K

2008-06-01

An experiment was conducted to investigate the effects of feeding grains naturally contaminated with Fusarium mycotoxins on morphometric indices of duodenum, jejunum, and ileum in turkeys. The possible preventative effect of a polymeric glucomannan mycotoxin adsorbent (GMA) was also determined. Three hundred 1-d-old male turkey poults were fed wheat, corn, and soybean meal-based starter (0 to 3 wk), grower (4 to 6 wk), developer (7 to 9 wk), and finisher (10 to 12 wk) diets formulated with control grains, contaminated grains, and contaminated grains + 0.2% GMA. Morphometric indices were measured at the end of each growth phase and included villus height (VH), crypt depth, villus width, thicknesses of submucosa and muscularis, villus-to-crypt ratio, and apparent villus surface area (AVSA). At the end of the starter phase, feedborne mycotoxins significantly decreased the VH in the duodenum, and supplementation of the contaminated diet with GMA prevented this effect. The feeding of contaminated grains also reduced (P effects in jejunum and ileum. No effects of diets were seen on morphometric variables at the end of the developer and finisher phases. It was concluded that consumption of grains naturally contaminated with Fusarium mycotoxins results in adverse effects on intestinal morphology during early growth phases of turkeys, and GMA can prevent many of these effects.

Single dose oral ranitidine improves MRCP image quality: a double-blind study

International Nuclear Information System (INIS)

Bowes, M.T.; Martin, D.F.; Melling, A.; Roberts, D.; Laasch, H.-U.; Sukumar, S.; Morris, J.

2007-01-01

Aim: To investigate the possibility of whether a single 300 mg dose of ranitidine given orally 2-3 h before magnetic resonance cholangiopancreatography (MRCP) could reduce the signal from the stomach and duodenum, and thus increase the conspicuousness of the biliary tree. Materials and methods: Thirty-five volunteers (22 female, 13 male), (age range 21-50) were underwent MRCP in a double-blind, placebo-controlled, randomized, crossover trial on a Philips Intera 1.5 T machine using a phased array surface coil. Imaging was carried out in the coronal oblique plane. Six 40 mm sections were acquired at varying angles to delineate the biliary tree and pancreatic duct. The 70 examinations were blindly scored by three consultants experienced in cholangiography. Results: After ranitidine administration there was a significant decrease in signal from the stomach (mean = 17.7, p = 0.0005, CI 10, 25.3) and duodenum (mean = 18.4, p = 0.0005, 95%CI 9.6, 27.1) with a significant increase in conspicuousness of the distal common duct (mean = 7.7, p = 0.033, 95%CI 0.7, 14.7) and proximal common duct (mean = 8.7, p = 0.010 CI 2.2, 15.2). There were no adverse effects. Conclusion: Oral ranitidine is a cheap and effective agent to decrease signal from the upper gastrointestinal tract and to improve visibility of the biliary tree

Characterization of Intestinal Lactobacillus reuteri Strains as Potential Probiotics.

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Singh, Tejinder Pal; Kaur, Gurpreet; Malik, Ravinder Kumar; Schillinger, Ulrich; Guigas, Claudia; Kapila, Suman

2012-03-01

This study was conducted to evaluate the probiotic properties of Lactobacillus reuteri isolated from human infant feces (less than 3 months). Out of thirty-two representative L. reuteri strains isolated from the infant human feces, nine isolates (i.e. LR5, LR6, LR9, LR11, LR19, LR20, LR25, LR26 and LR34) showed survival in acid, bile and simulated stomach-duodenum passage conditions, indicating their high tolerance to gastric juice, duodenal juice and bile environments. The nine isolates did not show strong hydrophobic properties because the percentages of adhesion to the apolar solvent, n-hexadecane, did not exceed 40%, showing that their surfaces were rather hydrophilic. Functionality of these nine probiotic isolates was supported by their antagonistic activity and their ability to deconjugate bile salts. The safety of the nine indigenous L. reuteri isolates was supported by the absence of transferable antibiotic resistance determinants, DNase activity, gelatinase activity and hemolysis. The results obtained so far suggest that the nine strains are resistant to low pH, bile salts and duodenum juice, so they could survive when passing through the upper part of the gastrointestinal tract and fulfill their potential probiotic action in the host organism. According to these results, the L. reuteri strains isolated from human infant feces possess interesting probiotic properties that make them potentially good candidates for probiotics.

Radiologic diagnostic criteria of sphincter of oddi dysfunction: analysis of five cases confirmed by biliary manometry

International Nuclear Information System (INIS)

Auh, Yong Ho; Kim, Myung Hwan; Lim, Hyun Chul; Baek, Seung Yeon; Lee, Moon Gyu; Cho, Kyoung Sik; Sung, Hyun Kyung

1994-01-01

Biliary dyskinesia was considered as a wastebasket of quasi-biliary disease which could not be clearly explained under the basis of morphologic pathology. This entity was a source of confusion because of misconception and poor understanding. Recent introduction of biliary manometric technique enlightened some of these disorders. We evaluated the cholangiographic morphology of these disorders to clarify and to characterize the some characteristic findings, subsequently in order to help the diagnosis. Five cases were confirmed by this technique as sphincter of Oddi dysfunction for last 13 months. All patients were female and age range was 53 to 75 years old. All patients were suffered from intermittent and recurrent biliary type pain. ERCP showed five common findings. The common bile duct was dilated over 12 mm in all patients. Different from recurrent pyogenic cholangiohepatitis, intrahepatic ducts were proportionally dilated as extrahepatic ducts, in four patients and they branched normally and ductal wall was smooth. Transient or persistent meniscus sign was observed in four patients. All patients showed delayed emptying of contrast media from the common bile duct into the duodenum. Following IV injection of cholecystokinin, persistent meniscus disappeared and contrast media inflowed into the duodenum. Identification of all or some characteristic cholangiographic findings may eliminate a cumbersome and painful biliary manometric test for the diagnosis of sphincter of Oddi dysfunction

The Effect of Chrysonilia crassa Additive on Duodenal & Caecal Morphology, Bacterial & Fungal Number, and Productivity of Ayam Kampung

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Turrini Yudiarti

2012-10-01

Full Text Available Fungi is a microorganism that can live in gastrointestinal tract of chicken. One type of fungi is multicellular or filamentous fungi. C.crassa is a species of filamentous fungi that has been isolated in the earlier study and it showed the best probiotic potency in vitro. The obyective of this research was to study the effect of addition of dried culture of  C.crassa in feed on intestinal & caecal morphology, bacterial & fungal number, and  productivity of indigenous chicken (ayam kampung. Research used completely randomized design with four treatments. The treatments were the level of  dried culture in basal diet (0%, 0.25 %,  0.50 % and 0.75 %. Each treatment was replicated 5 times and each replicate consists of 10 chickens. The parameters observed were : villi morphology, number of bacteria and fungi in the duodenum and cecum of chickens aged 1, 21 and 35 days and productivity i.e. feed intake, final body weight and feed conversion. The results showed that 0.50% dried culture of C.crassa could increase the duodenal villi width, decreased the number of bacterial and fungal colonies in duodenum and caecum, but it did not increase productivity. The conclusion : C.crassa could stimulate the duodenal villi development and decreased the number of the bacteria and fungi in the gastrointestinal tract, yet it has no positive impact on the chicken productivity.

The Effect of Chrysonilia crassa Additive on Duodenal & Caecal Morphology, Bacterial & Fungal Number, and Productivity of Ayam Kampung

Directory of Open Access Journals (Sweden)

T. Yudiarti

2012-10-01

Full Text Available Fungi is a microorganism that can live in gastrointestinal tract of chicken. One type of fungi is multicellular or filamentous fungi. C.crassa is a species of filamentous fungi that has been isolated in the earlier study and it showed the best probiotic potency in vitro. The obyective of this research was to study the effect of addition of dried culture of C.crassa in feed on intestinal & caecal morphology, bacterial & fungal number, and productivity of indigenous chicken (ayam kampung. Research used completely randomized design with four treatments. The treatments were the level of dried culture in basal diet (0%, 0.25 %, 0.50 % and 0.75 %. Each treatment was replicated 5 times and each replicate consists of 10 chickens. The parameters observed were : villi morphology, number of bacteria and fungi in the duodenum and cecum of chickens aged 1, 21 and 35 days and productivity i.e. feed intake, final body weight and feed conversion. The results showed that 0.50% dried culture of C.crassa could increase the duodenal villi width, decreased the number of bacterial and fungal colonies in duodenum and caecum, but it did not increase productivity. The conclusion : C.crassa could stimulate the duodenal villi development and decreased the number of the bacteria and fungi in the gastrointestinal tract, yet it has no positive impact on the chicken productivity

[A patient treated with partial duodenectomy for invasive transverse colon cancer].

Science.gov (United States)

Notani, Hiroyuki; Kawamura, Toru; Sato, Taku; Hoshino, Akihiro; Sato, Yasushi; Nakajima, Akira

2013-11-01

The patient was an 83-year-old woman who visited our hospital with a chief complaint of weight loss. Duodenal invasion by transverse colon cancer was suspected on abdominal computed tomography( CT). An extramural tumor invading the second portion of the duodenum was noted on upper gastrointestinal endoscopy, and a circumferential type 2 lesion was observed in the transverse colon on lower intestinal endoscopy. The pathological diagnosis of both lesions was well-differentiated adenocarcinoma, and right hemicolectomy and partial duodenectomy were performed. The invaded duodenal region was located on the oral side of the papilla of Vater, and the resection involved approximately one-third of the circumference of the second portion of the duodenum and was approximately 5 cm in length. The jejunum was elevated using the Roux- en-Y method, and side-to-side duodenojejunostomy was performed for reconstruction. On histopathological examination, the lesion was diagnosed as SI, N0, Stage II. Tumor markers with elevated levels before surgery showed a rapid decrease to within normal ranges. No evidence of recurrence or metastasis has been observed for 3 years after surgery. Although pancreatoduodenectomy is the standard surgical procedure for duodenal tumorous lesions, this approach is very invasive for elderly patients. Partial duodenectomy may be a favorable treatment option for cancers invading other organs, as was the case for this patient.

The Effects of Agave fourcroydes Powder as a Dietary Supplement on Growth Performance, Gut Morphology, Concentration of IgG, and Hematology Parameters in Broiler Rabbits.

Science.gov (United States)

Iser, Maidelys; Martínez, Yordan; Ni, Hengjia; Jiang, Hongmei; Valdivié Navarro, Manuel; Wu, Xiaosong; Al-Dhabi, Naif Abdullah; Rosales, Manuel; Duraipandiyan, Veeramuthu; Fang, Jun

2016-01-01

This study was conducted to determine the effects of Agave fourcroydes powder as a dietary supplement on the growth performance, gut morphology, serum concentration of IgG, and the hematology parameters of broiler rabbits. A total of 32 rabbits [New Zealand × Californian] were weaned at 35 days. They were randomly selected for two dietary treatments (eight repetitions per treatment), which consisted of a basal diet and a basal diet supplemented with 1.5% dried-stem powder of A. fourcroydes . On day 60 from the initiation of treatment, gut histomorphology (duodenum and cecum), serum concentration of IgG, and hematology parameters were all measured. The results showed that A. fourcroydes powder supplementation improved ( P < 0.05) the ADFI, ADG, and final BW. Correspondingly, this treatment increased ( P < 0.05) the muscle and mucosa thickness and height and width of villi. However, duodenum crypts depth was lower ( P < 0.05) when rabbits were fed with this natural product, compared with the basal diet treatment. Results also indicated that the A. fourcroydes powder increased ( P < 0.05) the serum concentration of IgG but did not change the hematology parameters. This data indicates that A. fourcroydes powder, as a supplement, had beneficial effects on increasing the growth performance and serum concentration of IgG, as well as improving the gut morphology without affecting the hematology parameters in broiler rabbits.

The Effects of Agave fourcroydes Powder as a Dietary Supplement on Growth Performance, Gut Morphology, Concentration of IgG, and Hematology Parameters in Broiler Rabbits

Directory of Open Access Journals (Sweden)

Maidelys Iser

2016-01-01

Full Text Available This study was conducted to determine the effects of Agave fourcroydes powder as a dietary supplement on the growth performance, gut morphology, serum concentration of IgG, and the hematology parameters of broiler rabbits. A total of 32 rabbits [New Zealand × Californian] were weaned at 35 days. They were randomly selected for two dietary treatments (eight repetitions per treatment, which consisted of a basal diet and a basal diet supplemented with 1.5% dried-stem powder of A. fourcroydes. On day 60 from the initiation of treatment, gut histomorphology (duodenum and cecum, serum concentration of IgG, and hematology parameters were all measured. The results showed that A. fourcroydes powder supplementation improved (P<0.05 the ADFI, ADG, and final BW. Correspondingly, this treatment increased (P<0.05 the muscle and mucosa thickness and height and width of villi. However, duodenum crypts depth was lower (P<0.05 when rabbits were fed with this natural product, compared with the basal diet treatment. Results also indicated that the A. fourcroydes powder increased (P<0.05 the serum concentration of IgG but did not change the hematology parameters. This data indicates that A. fourcroydes powder, as a supplement, had beneficial effects on increasing the growth performance and serum concentration of IgG, as well as improving the gut morphology without affecting the hematology parameters in broiler rabbits.

Effects of milk components and food additives on survival of three bifidobacteria strains in fermented milk under simulated gastrointestinal tract conditions

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Małgorzata Ziarno

2015-11-01

Full Text Available Background: In the dairy industry, probiotic strains of Bifidobacterium are introduced into the composition of traditional starter cultures intended for the production of fermented foods, or sometimes are the sole microflora responsible for the fermentation process. In order to be able to reach the intestines alive and fulfil their beneficial role, probiotic strains must be able to withstand the acidity of the gastric juices and bile present in the duodenum. Objective: The paper reports effects of selected fermented milk components on the viability of three strains of bifidobacteria in fermented milk during subsequent incubation under conditions representing model digestive juices. Design: The viability of the bifidobacterial cells was examined after a 3-h incubation of fermented milk under simulated gastric juice conditions and then after 5-h incubation under simulated duodenum juice conditions. The Bifidobacterium strains tested differed in their sensitivity to the simulated conditions of the gastrointestinal juices. Results: Bifidobacterial cell viability in simulated intestinal juices was dependent on the strain used in our experiments, and product components acted protectively towards bifidobacterial cells and its dose. Conclusions: Bifidobacterial cells introduced into the human gastrointestinal tract as food ingredients have a good chance of survival during intestinal transit and to reach the large intestine thanks to the protective properties of the food components and depending on the strain and composition of the food.

Effect of intravenous amino acids on interdigestive antroduodenal motility and small bowel transit time.

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Gielkens, H A; van den Biggelaar, A; Vecht, J; Onkenhout, W; Lamers, C B; Masclee, A A

1999-02-01

Patients on total parenteral nutrition have an increased risk of developing gallstones because of gall bladder hypomotility. High dose amino acids may prevent biliary stasis by stimulating gall bladder emptying. To investigate whether intravenous amino acids also influence antroduodenal motility. Eight healthy volunteers received, on three separate occasions, intravenous saline (control), low dose amino acids (LDA), or high dose amino acids (HDA). Antroduodenal motility was recorded by perfusion manometry and duodenocaecal transit time (DCTT) using the lactulose breath hydrogen test. DCTT was significantly prolonged during LDA and HDA treatment compared with control. The interdigestive motor pattern was maintained and migrating motor complex (MMC) cycle length was significantly reduced during HDA compared with control and LDA due to a significant reduction in phase II duration. Significantly fewer phase IIIs originated in the gastric antrum during LDA and HDA compared with control. Duodenal phase II motility index was significantly reduced during HDA, but not during LDA, compared with control. Separate intravenous infusion of high doses of amino acids in healthy volunteers: (1) modulates interdigestive antroduodenal motility; (2) shortens MMC cycle length due to a reduced duration of phase II with a lower contractile incidence both in the antrum and duodenum (phase I remains unchanged whereas the effect on phase III is diverse: in the antrum phase III is suppressed and in the duodenum the frequency is increased); and (3) prolongs interdigestive DCTT.

Superior Mesenteric Artery Syndrome Improved by Enteral Nutritional Therapy according to the Controlling Nutritional Status Score.

Science.gov (United States)

Takehara, Kazuhiro; Sakamoto, Kazuhiro; Takahashi, Rina; Kawai, Masaya; Kawano, Shingo; Munakata, Shinya; Sugimoto, Kiichi; Takahashi, Makoto; Kojima, Yutaka; Fukunaga, Tetsu; Kajiyama, Yoshiaki; Kawasaki, Seiji

2017-01-01

Superior mesenteric artery syndrome (SMAS) is a relatively rare disease that involves bowel obstruction symptoms, such as vomiting and gastric distension, owing to the compression of the third portion of the duodenum from the front by the superior mesenteric artery (SMA) and from the rear by the abdominal aorta and the spine. SMAS is diagnosed on the basis of an upper gastrointestinal examination series indicating the obstruction of the third portion of the duodenum or a computed tomography scan indicating the narrowing of the branch angle between the aorta and the SMA (i.e., the aorta-SMA angle). Here, we report the case of a 78-year-old woman diagnosed with SMAS after a laparoscopic right hemicolectomy for cecal cancer, whose condition was improved by enteral nutritional therapy. We used her controlling nutritional status (CONUT) score as a nutrition assessment and noted the changes in the aorta-SMA angle over the course of the disease. This patient appeared to develop SMAS, on the basis of a worsened CONUT score and a decreased aorta-SMA angle, owing to the inflammation resulting from the intraoperative dissection of the tissues around the SMA and prolonged postoperative fasting. After the initiation of enteral nutritional therapy, the patient exhibited body weight gain and an improved aorta-SMA angle and CONUT score. Hence, assessment of the aorta-SMA angle and CONUT score is an important preoperative consideration.

Letrozole induced low estrogen levels affected the expressions of duodenal and renal calcium-processing gene in laying hens.

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Li, Qiao; Zhao, Xingkai; Wang, Shujie; Zhou, Zhenlei

2018-01-01

Estrogen regulates the calcium homeostasis in hens, but the mechanisms involved are still unclear fully. In this study, we investigated whether letrozole (LZ) induced low estrogen levels affected the calcium absorption and transport in layers. In the duodenum, we observed a significant decrease of mRNA expressions of Calbindin-28k (CaBP-28k) and plasma membrane Ca 2+ -ATPase (PMCA 1b) while CaBP-28k protein expression was declined in birds with LZ treatment, and the mRNA levels of duodenal transient receptor potential vanilloid 6 (TRPV6) and Na + /Ca 2+ exchanger 1 (NCX1) were not affected. Interestingly, we observed the different changes in the kidney. The renal mRNA expressions of TRPV6 and NCX1 were unregulated while the PMCA1b was down-regulated in low estrogen layers, however, the CaBP-28k gene and protein expressions were no changed in the kidney. Furthermore, it showed that the duodenal estradiol receptor 2 (ESR2) transcripts rather than parathyroid hormone 1 receptor (PTH1R) and calcitonin receptor (CALCR) played key roles to down-regulate calcium transport in LZ-treated birds. In conclusion, CaBP-28k, PMCA 1b and ESR2 genes in the duodenum may be primary targets for estrogen regulation in order to control calcium homeostasis in hens. Copyright © 2017 Elsevier Inc. All rights reserved.

Endoscopical appearances of nonsteroidal anti inflammatory drug (NSAID- enteropathy

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Marcellus Simadibrata

2005-12-01

Full Text Available Non Steroidal Anti Inflammatory Drugs (NSAID have been associated with a sudden and sustained rise in the incidence of gastrointestinal ulcer complications. The aim of the study was to reveal the endoscopical abnormalities found in the duodenum & proximal jejunum due to NSAID. Thirty eight patients taking NSAID for their arthritis or rheumatism were included in this study. Gastro-duodeno-jejunoscopy was done with Olympus PCF-10. The endoscopical appearances of NSAID entero gastropathy were evaluated with a scoring system. The NSAID-entero-gastropathy appearances were endoscopically seen as hyperemia, erosion and ulcer. From all patient recruited, 7.9% complaint of diarrhea and 71.1% complaint of dyspepsia. Endoscopically, in the duodenal bulb we found 79% cases of hyperemia, 39.5% cases of erosion and 7.9% cases of ulcer. In the second part (descending part of the duodenum we found 28.9% cases of hyperemia, 15.8% cases of erosion and 2.6% case of ulcer. In the jejunum, we found 7.9% cases of hyperemia, 2.6% case of erosion and no ulcer. It is concluded that the most frequent abnormal endoscopical appearances in NSAID- enteropathy was hyperemia. The most frequent site of NSAID-enteropathy abnormal findings was in the duodenal bulb. (Med J Indones 2005; 14: 225-9Keywords: NSAID-enteropathy, endoscopical appearances.

Effect of phytase supplementation on rumen fermentation characteristics and phosphorus balance in lactating dairy cows

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Laura Winter

2015-02-01

Full Text Available This study aimed to evaluate the effects of exogenous phytase on rumen fermentation characteristics, the phosphorus (P-flow at the duodenum and the P-balance in lactating dairy cows. For this purpose ruminal and duodenally fistulated cows were assigned to one of three dietary treatments: high P (HP diet (n=7 provided a total of 45 g/d of P, archived by a supplementation of dicalcium phosphate to the diet; low P (LP diet (n=5 provided 34 g/d of P without supplementation; LP+phytase (LP+PHY diet (n=5 provided 34 g/d of P supplemented with an exogenous phytase. Dry matter intake and milk yield were recorded daily. In the first week of a sampling period Pbalance was determined. Samples of ruminal fluid were taken and duodenal chyme was collected in the second sampling week. Ruminal pH and the concentration of volatile fatty acids were not different between the treatments. The HP-group shows a higher P-flow at the duodenum than other groups. No differences in apparent total tract P-digestibility were found between the treatments. The P-balance in the HP-group (2.6 g/d was higher compared to the LP (-3.2 g/d and LP+PHY (-3.0 g/d group. Overall, phytase supplementation had no effect on P-digestibility in lactating dairy cows.

Protective Effects of Ibuprofen and L-Carnitine Against Whole Body Gamma Irradiation-Induced Duodenal Mucosal Injury

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Meryem Akpolat

2011-03-01

Full Text Available Objective: Ibuprofen and L-carnitine have been demonstrated to provide radioprotective activity to the hamster against whole body sublethal irradiation. The purpose of this study is to test those antioxidant drugs, each of which has the capacity of inhibiting mucosal injury, as topical radioprotectants for the intestine. Material and Methods: The male hamsters were divided into the following four groups (n=6: group 1: control group, received saline, 1 ml/100 g by gavage, as placebo. Group 2: irradiated-control group, received whole body irradiation of 8 Gy as a single dose plus physiological saline. The animals in groups 3 and 4 were given a daily dose of 10 mg/kg of ibuprofen and 50 mg/kg of L-carnitine for 15 days respectively, before irradiation with a single dose of 8 Gy. Twenty-four hours after radiation exposure, the hamsters were sacrificed and samples were taken from the duodenum, and the histopatological determinations were carried out. Results: Morphologically, examination of the gamma irradiated duodenum revealed the presence of shortening and thickening of villi and flattening of enterocytes, massive subepithelial lifting. Pretreatment of ibuprofen and L-carnitine with irradiation reduced these histopathological changes. Conclusion: Ibuprofen and L-carnitine administrated by the oral route may be a good radioprotector against small intestinal damage in patients undergoing radiotherapy.

Death following the ingestion of detergent: an autopsy case with special regard to the histochemical findings.

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Kawamoto, Osamu; Ishikawa, Takaki; Oritani, Shigeki; Kuramoto, Yuko; Michiue, Tomomi; Maeda, Hitoshi

2013-06-01

We report an autopsy case of death due to accidental ingestion of a liquid laundry detergent with special regard to the histochemical findings. A female inpatient suffering from schizophrenia in a psychiatric institution, was found unconscious lying on the floor of her room, with a container of detergent nearby, and died despite intensive life-support measures. At autopsy, the stomach and duodenum contained whitish translucent foamy viscous fluid, and the mucous membranes, from the esophagus to the duodenum, had diffuse erosions with congestion and edema. There was otherwise no significant pathology other than signs of acute death and hemolysis. Toxicological investigations detected 1-methyl-4-prop-1-en-2-ylcyclohexene (detergent additive) in the gastric contents using headspace-gas chromatography/mass spectrometry, and a nonionic surfactant by a color identification test. Although these substances could not be detected in the blood, body fluid or viscera, histochemical examination using Oil red O demonstrated droplet-like staining in the pulmonary alveoli, suggesting aspiration of detergent, and similar staining in the vasculature of the lung, Kupffer cells of the liver, Bowman capsules of the kidney, and capillaries of the brain, suggesting the systemic effect of ingested/aspirated detergent. These findings were in keeping with death from ingestion of detergent and demonstrated the importance of preventing accidents such as this in healthcare facilities for elderly people.

Congenital anomalies, hereditary diseases of the pancreas, acute and chronic pancreatitis

International Nuclear Information System (INIS)

Brambs, Hans-Juergen; Juchems, Markus

2011-01-01

The most important congenital anomalies include pancreas divisum, annular pancreas and ectopic pancreas. Patients with pancreas divisum may be more susceptible to acute or chronic pancreatitis and patients with an annular pancreas may develop duodenal stenosis. In pancreas divisum the key finding is the visualization of the main duct draining into the duodenum via the small papilla, separated from the common bile duct. Annular pancreas may show as a well defined ring of pancreatic tissue that encircles the duodenum. Ectopic pancreas is usually asymptomatic but may give rise to abdominal complaints and may be confused with submucosal tumors. Acute pancreatitis is classified as mild or severe. In mild forms ultrasound is the imaging modality of choice whereas in severe forms with extensive pancreatic and peripancreatic necroses computed tomography is the favored method. It is crucial to identify signs and criteria that come along with an increased risk of infection of the necroses. MRI plays an inferior role in the assessment of acute pancreatitis. Chronic pancreatitis is a longstanding inflammatory and fibrosing process causing pain and loss of function. Cross-section imaging is particularly in demand for the detection of complications and the differentiation from pancreatic cancer. Autoimmune pancreatitis is a unique form of chronic pancreatitis characterized by lymphoplasmacytic infiltration and fibrosis, and favourable response to corticosteroid treatment. (orig.)

Duodenal mucosal protein kinase C-δ regulates glucose production in rats.

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Kokorovic, Andrea; Cheung, Grace W C; Breen, Danna M; Chari, Madhu; Lam, Carol K L; Lam, Tony K T

2011-11-01

Activation of protein kinase C (PKC) enzymes in liver and brain alters hepatic glucose metabolism, but little is known about their role in glucose regulation in the gastrointestinal tract. We investigated whether activation of PKC-δ in the duodenum is sufficient and necessary for duodenal nutrient sensing and regulates hepatic glucose production through a neuronal network in rats. In rats, we inhibited duodenal PKC and evaluated whether nutrient-sensing mechanisms, activated by refeeding, have disruptions in glucose regulation. We then performed gain- and loss-of-function pharmacologic and molecular experiments to target duodenal PKC-δ; we evaluated the impact on glucose production regulation during the pancreatic clamping, while basal levels of insulin were maintained. PKC-δ was detected in the mucosal layer of the duodenum; intraduodenal infusion of PKC inhibitors disrupted glucose homeostasis during refeeding, indicating that duodenal activation of PKC-δ is necessary and sufficient to regulate glucose homeostasis. Intraduodenal infusion of the PKC activator 1-oleoyl-2-acetyl-sn-glycerol (OAG) specifically activated duodenal mucosal PKC-δ and a gut-brain-liver neuronal pathway to reduce glucose production. Molecular and pharmacologic inhibition of duodenal mucosal PKC-δ negated the ability of duodenal OAG and lipids to reduce glucose production. In the duodenal mucosa, PKC-δ regulates glucose homeostasis. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

Histologia geral dos intestinos do Caiman crocodilus yacare (Daudin, 1802 (Crocodilia: Reptilia

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Sonia Maria Jin

1990-01-01

Full Text Available General histology of small intestine (duodenum and jejunum and the large intestine (colon and cloaca of C. c. yacare (Daudin, 1802 Crocodilia-Reptilia. A comparative description is made of the histology of the small and large intestine of C. c. yacare. In all segments mucosa, submucosa, muscularis and serosa tunics were observed. The duodenum as very long villi, wich are well-developed and attached together to form irregular transverse ridges, covered with simple columnar epithelium with marginal and goblet cells. In the jejunum, the villi are shorter and less frequent. The colon as few folds, covered with the same epithelium; the lamina própria contains straight tubular glands with absortive cells, goblet and Paneth cells. The cloaca is very complex, with three well-defined regions: coprodeum, urodeum and proctodeum. In the coprodeum, the wall is folded, less muscular and the thin mucosa is covered by an epithelium with a few basal cells and mucosal cells. The urodeum as an additional external muscular tunic, with striated muscle fibers and a stritifield cylindrical epithelium with goblet cells. The proctodeum includes the free part of the penis in the male and, laterally, the ducts of a pair of holocrine cloacal glands. Near the opening of the ducts, the epithelium changes to a squamous keratinized type.

Effect of Pithecellobium dulce (Roxb.) Benth. fruit extract on cysteamine induced duodenal ulcer in rats.

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Megala, Jayaraman; Geetha, Arumugam

2015-10-01

The edible fruits of Pithecellobium dulce (Roxb.) Benth. are traditionally used for various gastric complications in India. Here, we investigated the antiulcer activity of hydroalcoholic fruit extract of P. dulce (HAEPD) by applying cysteamine induced duodenal ulcer model in rats. Duodenal ulcer was induced in male albino Wistar rats by oral administration of cysteamine @ 420 mg/kg body wt. as a single dose. The rats were pre-administered orally with HAEPD @ 200 mg/kg body wt. for 30 days prior to ulcer induction. Rats pre-administered with ranitidine @ 30 mg/kg body wt. served as reference drug control. Ulcer score, thiobarbituric acid reactive substances (TBARS), glycoproteins, superoxide dismutase, catalase and glutathione peroxidase and reduced glutathione levels were measured in the duodenum. Rats pre-administered with the HAEPD showed significantly reduced ulcer score comparable to that of ranitidine pretreated rats. The co-administration of HAEPD lowered the TBARS level and also restored the levels of glycoproteins, enzymatic and non-enzymatic antioxidants. Histopathological observations confirmed the presence of inflammation, necrosis and hemorrhagic spots in the duodenum of ulcer control rats which were significantly reduced due to HAEPD treatment. No abnormal alterations were observed in normal rats treated with HAEPD at the dosage studied. The results demonstrated antioxidant and cytoprotective nature of P. dulce, and thereby its significant anti ulcer property.

A canine case of partial heterotaxia detected by radiography and ultrasound

International Nuclear Information System (INIS)

Kayanuma, H.; Suganuma, T.; Shida, T.; Sato, S.

2000-01-01

With radiography and ultrasound, reversed positioning of the fundus ventriculi and pylorus, a duodenum running on the left side, transposition of the kidneys, and normal thoracic organs were found in a 5-month-old miniature dachshund that presented with anorexia and weight loss. The case was diagnosed as partial heterotaxia. Gross observation revealed partial heterotaxia, polysplenia, abnormal lobulation of the liver, and absence of the greater omentum. These findings were consistent with those observed in asplenia-polysplenia syndrome in humans

Familiær adenomatøs polypose

DEFF Research Database (Denmark)

Bülow, Steffen

2013-01-01

Familial adenomatous polyposis (FAP) is an autosomally dominant disease characterized by early development of up to thousands of colorectal adenomas and colorectal carcinoma in untreated patients. Extra-colonic manifestations include duodenal adenomatosis and desmoid development. Due...... to identification of gene carriers by DNA analysis or endoscopy the prognosis is good after early colectomy, but life-long surveillance of the rectum and the duodenum is necessary. The Danish Polyposis Register coordinates prophylactic examination and treatment in the families, and serves as basis for research....

[Videocapsule endoscopy as a useful tool to diagnose primary intestinal lymphangiectasia].

Science.gov (United States)

Vignes, S; Bellanger, J

2007-03-01

Primary intestinal lymphangiectasia (Waldmann's disease) lead to a protein-losing enteropathy due to lymph leak into intestinal tract. A 28-year-old woman presented a bilateral lower limb lymphedema. Laboratory examination showing lymphopenia, hypoalbuminemia, hypogammaglobulinemia suggested the diagnosis of primary intestinal lymphangiectasia. Gastroscopy was normal and second duodenum biopsies were negative. Videocapsule endoscopy gave evidence of intestinal lymphangiectasia of the small bowel. Videocapsule endoscopy may be proposed to confirm intestinal lymphangiectasia and to precise their localization when gastroscopy is not conclusive.

Primary intestinal lymphangiectasia: twenty years of experience at a Mexican tertiary care hospital

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D. Valdovinos-Oregón

2014-01-01

Conclusions: Intestinal lymphangiectasia should be suspected when there is a clinical picture of chronic diarrhea and protein-losing enteropathy accompanied with edema at any level, as well as hypoalbuminemia, hypocalcemia, lymphopenia, hypogammaglobulinemia, and hypocholesterolemia, which are the main biochemical findings of this pathology. All children presenting with intestinal lymphangiectasia should undergo an upper gastrointestinal series with bowel transit time and endoscopy with biopsies taken at the level of the duodenum. Treatment includes diet and the periodic administration of albumin and gamma globulin.

Duodenal diverticula demonstrated by barium examination

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Christiansen, T.; Thommesen, P.

An investigation for biliary tract calculi and food-stimulated gastro-oesophageal reflux was carried out in 37 patients with duodenal diverticula demonstrated by barium examination. Sixty per cent of the diverticula were located in the descending part of the duodenum. Biliary tract calculi were demonstrated in 38 per cent and food-stimulated gastro-oesophageal reflux in 81 per cent of the patients. The detection of a duodenal diverticulum should result in a supplementary investigation for gallstones and gastrooesophageal reflux and its sequelae.

Rapid duodenal and jejunal intubation

International Nuclear Information System (INIS)

Nolan, D.J.

1979-01-01

A size 12 French radiopaque catheter, 135 cm long, suitable for rapid duodenal and jejunal intubation, is described. Its size and flexibility enable it to be passed with ease through the nose, stomach and duodenum. A guide wire is used to act as a stiffener as the catheter is passed through the stomach. The catheter is suitable for infusing barium directly into the small intestine and for performing hypotonic duodenography. The technique for duodenal and jejunal intubation is discussed. (author)

Transport of plutonium across isolated segments of the intestine of neonatal swine

International Nuclear Information System (INIS)

Sullivan, M.F.; Gorham, L.S.

1980-01-01

Absorption of 239 Pu was measured in neonatal swine gavaged with either 239 Pu(IV) or 239 Pu(VI) niitrate 1 day after birth. When they were killed, 1 or 3 wk later, retention of the Pu(VI) was about 50% greater than retention of Pu(IV). Studies with isolated intestinal segments indicated no appreciable difference in 238 Pu transport by the duodenum, midgut or terminal ileum, and a substantial decrease in absorption between 2 and 19 days after birth