Sample records for pylorus

  1. [Treatment of complications of pylorus preserving stomach resection]. (United States)

    Lubianskiĭ, V G; Leont'ev, S V; Kuznetsov, G L


    Causes of unsatisfactory outcomes of pylorus preserving stomach resection are analyzed, method of prophylaxis and surgical correction is proposed. Pylorus preserving stomach resection was performed in 207 patients with chronic gastric ulcer. 2 groups of patients were compared: 166 patients who have undergone pylorus preserving stomach resection by Maky--Gorobashko (group 1); 41 patients operated according to an original method of suprapyloric stomach resection with preserving of distal Latarget nerves on serous-muscular flap formed from lesser curvature of the stomach (group 2). Of 122 examined patients of group 1 excellent and good long-term results according to Visick's criteria were achieved in 101 (82.79%), satisfactory--in 12 (9.84%), unsatisfactory--in 9 (7.37%). Bad stump evacuation due to a stable spasm of the denervated pylorus and hypokinesia of the stump were the main causes of unsatisfactory results. In group 2-39 of 41 patients were examined in long-term period. Excellent and good results were achieved in 38 patients, satisfactory--in 1. There were no unsatisfactory results.


    Institute of Scientific and Technical Information of China (English)

    赵玉沛; 蔡力行; 钟守先; 朱预


    Sixty-five patients with neoplasm(62 cases) or pancreatitis(3 cases)were treated with preserving pylorus pancreatoduodenectomy(PPPD) from 1984 to 1991.One postoperative death occurred.Follow-up studies were performed in 35 patients who had been treated by PPPD or the standard Whipple's proceduere;they were questioned carefully concerning clinical symptoms.Further studies were performed in 20 patients with or without pylorus preservation(10 patients,respectively).Nutritional status and gastrointestinal digestive and absorptive functions were evaluated by determination of serum components,gastric analysis,barium emptying time ,D-xylose absorption test,14CO2 breath test ,PABA,and other methods.The results demonstrated malnutrition and postgastrectomy syndromes in some patients after the standared Whipple's procedure,but not in those with PPPD,The quality of life was better in the latter.Pylorus preservation may be the main reason for this above difference.Delayed gastric emptying in the early postoperative period was a complication in some patients(21%) treated by PPPD,We recommend PPPD for pancreatoduodenectomy.

  3. Double Pylorus After a Peptic Ulcer in the Gastric Antrum: A Case Report

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    Song, Jang hyeon; Shin, Sang Soo; Heo, Young Hoe [Chonnam National University Medical School, Gwangju (Korea, Republic of); Kim, Jin Woong; Jeong, Yong Yeon; Heo, Suk Hee; Kang, Heoung Keun [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)


    Double pylorus is an accessory channel between the gastric antrum and duodenal bulb with a normal pyloric canal. It is understood that the etiology of double pylorus is a congenital anomaly or an acquired complication after the occurrence of peptic ulcer disease. We report the CT findings with CT gastrography of double pylorus as a complication after a previous peptic ulcer in the gastric antrum

  4. Concomitant Pancreas Divisum and Double Pylorus: A Case Report

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    Gurhan Sisman


    Full Text Available Double pylorus (DP is a rare condition that is usually discovered incidentally through an upper endoscopy (UE examination. While acquired DP, which is the most common type, often develops as a complication of peptic ulcer disease (PUD, congenital DP can be isolated associated with other congenital abnormalities such as heterotopic pancreatic tissue or gastric duplication [1, 2]. This article presents the first case of DP associated with pancreas divisum (PD. A twenty two-year-old woman was admitted to our hospital because of mild epigastric pain. Her medical history was unremarkable. The laboratory tests that were requested on admission were normal except for amylase 920 U/L (reference range: 60-180 U/L.The patient denied having had any history of PUD or of having used nonsteroidal anti-inflammatory drugs (NSAIDs. A UE examination revealed two pyloric openings into the duodenal bulb. However, there was no evidence of PUD on the UE. The presence of Helicobacter pylori was not observed in the histologic examination of the gastric antrum tissue. Magnetic resonance cholangiopancreatogram (MRCP imaging showed PD (Figure 1 A-B. The patient was treated symptomatically, and she recovered. When the UE and MRCP were repeated for control on the sixth month of the treatment, they demonstrated the same findings as the initial UE and MRCP.

  5. Pylorus-preserving versus pylorus-resecting pancreaticoduodenectomy for periampullary and pancreatic carcinoma: a meta-analysis.

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    Chong Yang

    Full Text Available BACKGROUND: The aim of this meta-analysis was to compare the long-term survival, mortality, morbidity and the operation-related events in patients with periampullary and pancreatic carcinoma undergoing pylorus-preserving pancreaticoduodenectomy (PPPD and pylorus-resecting pancreaticoduodenectomy (PRPD. METHOD: A systematic search of literature databases (Cochrane Library, PubMed, EMBASE and Web of Science was performed to identify studies. Outcome measures comparing PPPD versus PRPD for periampullary and pancreatic carcinoma were long-term survival, mortality, morbidity (overall morbidity, delayed gastric emptying [DGE], pancreatic fistula, wound infection, postoperative bleeding, biliary leakage, ascites and gastroenterostomy leakage and operation related events (hospital stays, operating time, intraoperative blood loss and red blood cell transfusions. RESULTS: Eight randomized controlled trials (RCTs including 622 patients were identified and included in the analysis. Among these patients, it revealed no difference in long-term survival between the PPPD and PRPD groups (HR = 0.23, p = 0.11. There was a lower rate of DGE (RR = 2.35, p = 0.04, 95% CI, 1.06-5.21 with PRPD. Mortality, overall morbidity, pancreatic fistula, wound infection, postoperative bleeding, biliary leakage, ascites and gastroenterostomy leakage were not significantly different between the groups. PPPDs were performed more quickly than PRPDs (WMD = 53.25 minutes, p = 0.01, 95% CI, 12.53-93.97; and there was less estimated intraoperative blood loss (WMD = 365.21 ml, p = 0.006, 95% CI, 102.71-627.71 and fewer red blood cell transfusions (WMD = 0.29 U, p = 0.003, 95% CI, 0.10-0.48 in patients undergoing PPPD. The hospital stays showed no significant difference. CONCLUSIONS: PPPD had advantages over PRPD in operating time, intraoperative blood loss and red blood cell transfusions, but had a significantly higher rate of DGE for periampullary


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    Sanjay Jain*, Rakesh Barik, Nidhi Yadav and Shivpal Singh


    Full Text Available Tribulus terrestris L. (TT; Zygophyllaceae is employed in the folk medicine against sexual impotence, oedemas, abdominal distention and cardiovascular diseases. Gastroprotective (i.e. antiulcer and anti-secretory potential of methanolic extract of TT fruits was evaluated in pylorus-ligated rat model of Wistar rat. The methanolic extract of TT was tested orally at the doses of 150, 300 & 600 mg/kg, on gastric ulcerations experimentally induced by pylorus ligation. Preliminary phytochemical screening of the methanol extract of TT showed the presence of alkaloids, carbohydrates, cardiac glycosides, flavonoids, saponins, tannins and proteins. The methanolic extract at the doses of 300 & 600 mg/kg produced more significant inhibition when gastric ulcerations were induced by pylorus ligation respectively. The methanol extract of the fruits of Tribulus terrestris L. possess gastroprotective i.e. antiulcer and anti-secretory effect.

  7. The effect of pylorus removal on delayed gastric emptying after pancreaticoduodenectomy: a meta-analysis of 2,599 patients.

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    Wenming Wu

    Full Text Available BACKGROUND: Delayed gastric emptying is a serious complication of pancreaticoduodenectomy. The effect of pylorus removal on delayed gastric emptying has not been well evaluated. STUDY DESIGN: We searched five databases (PubMed, EMBASE and the Cochrane Central Register of Controlled Trials, Scopus and Web of Science up to July 2014. The meta-regression analysis was performed to evaluate any factors accountable for the heterogeneity. Publication bias was assessed by Egger's test, and corrected by Duval's trim and fill method. Subgroup analyses were conducted for different surgical techniques of pyloric removal. Other intraoperative and postoperative parameters were compared between two groups. RESULTS: We included 27 studies involving 2,599 patients, with a moderate-high heterogeneity for primary outcome (I(2 = 63%. Meta-regression analysis showed that four variables primarily contributed to the heterogeneity, namely nasogastric tube intubation time, solid food start time, preoperative diabetes percentage and the number of patients in pylorus-preserving group. After excluding four studies, the remaining twenty-three studies showed reduced heterogeneity (I(2 = 51%. Then we used Duval's trim and fill method to correct publication bias. The corrected MH odds ratio was 0.78 (95% CI: 0.52-1.17. A subgroup analysis showed that pylorus removal tends to reduce delayed gastric emptying incidence for subtotal stomach-preserving pancreaticoduodenectomy or pylorus-resecting pancreaticoduodenectomy, compared with pylorus-preserving group. However, standard Whipple procedure failed to show any significant reduction of DGE compared with pylorus-removal group. No significant differences were observed in terms of length of hospital stay, infection and pancreatic fistula; however, pylorus removal resulted in longer operation time, more blood loss and higher mortality. CONCLUSION: The pylorus removal does not significantly reduce the overall incidence of delayed

  8. Determination of the antiulcer properties of sodium cromoglycate in pylorus-ligated albino rats

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    Srivastava Vivek


    Full Text Available Objectives : To study the ulcer protective property of sodium cromoglycate in pylorus-ligated rats and the biochemical role in ulcer protection by various biochemical tests. Materials and Methods : The ulcer protective effect of sodium cromoglycate was studied using a Pyloric Ligation Model using Wistar albino rats. The antiulcer effect of sodium cromoglycate 40 mg/kg b.w., i.p., was compared with the reference drug ranitidine 27 mg/kg b.w., i.p. The ulcer index was calculated and other biochemical parameters like free acidity, total acidity, pH, mucin, pepsin and volume of gastric juice were determined. Results : Pylorus ligation showed a significant (P < 0.01 reduction in gastric volume, free acidity, total acidity and ulcer index as compared to the control. Conclusion : Sodium cromoglycate has activity equipotent to ranitidine.

  9. Comparative study of proton pump inhibitors on dexamethasone plus pylorus ligation induced ulcer model in rats

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    Thippeswamy A. H. M.


    Full Text Available The present study was designed to compare ulcer protective effect of proton pump inhibitors viz. omeprazole, rabeprazole and lansoprazole against dexamethasone plus pylorus ligation induced ulcer model. Dexamethasone (5 mg/kg was used as an ulcerogen. Dexamethasone suspended in 1% CMC in water was given orally to all the rats 15 min after the pylorus ligation. Omeprazole (20 mg/kg, rabeprazole (20 mg/kg, and lansoprazole (20 mg/kg were administered by oral route 30 min prior to ligation was used for ulcer protective studies, gastric secretion and mucosal studies. Effects of proton pump inhibitors were determined by the evaluation of various biochemical parameters such as ulcer index, free and total acidity, gastric pH, mucin, pepsin and total proteins. Oral administration of proton pump inhibitors showed significant reduction in gastric acid secretion and ulcer protective activity against dexamethasone plus pylorus ligation induced ulcer model. The % protection of omeprazole, rabeprazole and lansoprazole was 84.04, 89.36 and 79.78, respectively. Rabeprazole significantly inhibited the acid-pepsin secretion and increased the gastric mucin secretion. The observations made in the present study suggest that rabeprazole is the most effective gastric antisecretory and ulcer healing agent as compared to omeprazole and lansoprazole.

  10. Gastroduodenal ulcer treated by pylorus and pyloric vagus-preser-ving gastrectomy

    Institute of Scientific and Technical Information of China (English)


    AIM To evaluate the curative effect of pylorus and pyloric vagus-preserving gastrectomy (PPVPG) on peptic ulcer.METHODS Treating 132 cases of GU and DU with PPVPG, and comparative studies made with 24 cases treated with Billroth Ⅰ (BⅠ) and 20 cases with Billroth Ⅱ (BⅡ); advantages and shortcomings evaluated.RESULTS Not a single death after PPVPG. No recurrence of the disorder in the subsequent follow-up for an average of 6.5 years. Curative effect (visik Ⅰ & Ⅱ) 97.7%. Acidity reduction similar to that found in BⅠ and BⅡ, but 97.7% of the BⅠ and all BⅡ cases having more than second degree intestinal fluid reflux, in contrast to 7.1% in PPVPG cases. Dumping syndrome occurred in the BⅠ and BⅡ cases, none in PPVPG cases. With regard to gastric emptying, food digestion, absorption, body weight and life quality, PPVPG proved to be superior to Billroth procedure.CONCLUSION PPVPG has the advantages of conventional Billroth gastrectomy in reducing acid, removing ulcer focus, and at the same time preserves the pylorus and pyloric vagus for maintaining the normal gastric physiological function. Dumping syndrome, intestinal fluid reflux and other complications of conventional gastrectomy may be avoided.

  11. Organization of vagal afferents in pylorus: mechanoreceptors arrayed for high sensitivity and fine spatial resolution? (United States)

    Powley, Terry L; Hudson, Cherie N; McAdams, Jennifer L; Baronowsky, Elizabeth A; Martin, Felecia N; Mason, Jacqueline K; Phillips, Robert J


    The pylorus is innervated by vagal mechanoreceptors that project to gastrointestinal smooth muscle, but the distributions and specializations of vagal endings in the sphincter have not been fully characterized. To evaluate their organization, the neural tracer dextran biotin was injected into the nodose ganglia of rats. Following tracer transport, animals were perfused, and their pylori and antra were prepared as whole mounts. Specimens were processed to permanently label the tracer, and subsets were counterstained with Cuprolinic blue or immunostained for c-Kit. Intramuscular arrays (IMAs) in the circular muscle comprised the principal vagal afferent innervation of the sphincter. These pyloric ring IMAs were densely distributed and evidenced a variety of structural specializations. Morphometric comparisons between the arbors innervating the pylorus and a corresponding sample of IMAs in the adjacent antral circular muscle highlighted that sphincter IMAs branched profusely, forming more than twice as many branches as did antral IMAs (means of 405 vs. 165, respectively), and condensed their numerous neurites into compact receptive fields (∼48% of the area of antral IMAs) deep in the circular muscle (∼6μm above the submucosa). Separate arbors of IMAs in the sphincter interdigitated and overlapped to form a 360° band of mechanoreceptors encircling the pyloric canal. The annulus of vagal IMA arbors, putative stretch receptors tightly intercalated in the sphincter ring and situated near the lumen of the pyloric canal, creates an architecture with the potential to generate gut reflexes on the basis of pyloric sensory maps of high sensitivity and fine spatial resolution.

  12. Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation. (United States)

    Traverso, L W; Longmire, W P


    We have previously reported our efforts to minimize postgastrectomy symptoms in two patients with benign disease who underwent resection of the head of the pancreas and the duodenum. In these cases the pylorus and first portion of the duodenum were preserved during pancreaticoduodenectomy. Our experience has now been extended to encompass 18 patients, eight of whom were available for comprehensive evaluation an average of six months postoperation. These studies have attempted to differentiate malabsorption of pancreatic insufficiency from possible gastrointestinal dysfunction of the new alimentary connection. Pancreatic insufficiency was evaluated by a 72-hour stool collection and radioactive trioctanoate (RATO) test. Gastrointestinal absorption was evaluated by D-xylose excretion and the Schilling test, as well as serum vitamin. A, vitamin B-12, carotene, folate, iron, and total iron binding capacity. Gastrointestinal secretion and motility were assessed by using pyloric fluoroscopy, gastric barium emptying, the Hunt test, and gastric acid analysis. Finally, a questionnaire regarding clinical symptoms of postgastrectomy syndromes and malabsorption was answered. Although every patient exhibited marked pancreatic insufficiency by laboratory tests, 88% described normal formed bowel movements, and weight loss was claimed by only 25%. Other test findings were generally normal. While the follow-up period has been limited to three years, the current data demonstrate that gastrointestinal function subsequent to preservation of the pylorus has not thus far predisposed to postgastrectomy syndromes or marginal ulcers. All of the patients required intensive pancreatic enzyme replacement. PMID:7416828

  13. Protective effect of ginger oil on aspirin and pylorus ligation-induced gastric ulcer model in rats

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    Khushtar M


    Full Text Available The present investigation was performed in aspirin and pylorus ligation-induced ulcer model in Wistar rats, in which ability of ginger oil to provide gastric protection was studied at two different doses, 0.5 and 1 g/kg po. Gastric protection was evaluated by measuring the ulcer index, serum λ- GTP levels, total acidity of gastric juice and gastric wall mucus thickness. The results obtained in the present study indicated that ginger oil has a protective action against gastric ulcers induced by aspirin plus pylorus ligation in Wistar rats.

  14. Pylorus-preserving pancreatoduodenectomy : Influence of a Billroth I versus a Billroth II type of reconstruction on gastric emptying

    NARCIS (Netherlands)

    Goei, TH; Henegouwen, MIV; Slooff, MJH; van Gulik, TM; Gouma, DJ; Eddes, EH


    Background/Aim: Delayed gastric emptying (DGE) is a frequent problem after pylorus-preserving pancreatoduodenectomy. Important risk factors are the presence of intra-abdominal complications. Searching for other causes, this study evaluates the influence of the type of reconstruction after a pancreat

  15. The ameliorative effect of fisetin, a bioflavonoid, on ethanol-induced and pylorus ligation-induced gastric ulcer in rats

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    Amit D Kandhare


    Full Text Available Fisetin, a tetrahydroxy flavone, exhibits many biological activities such as antioxidant, antibacterial and anti-inflammatory. The aim of present study was to unravel the therapeutic potential of fisetin at a dose of 10, 20, 30 mg/kg, per oral (p.o., in ethanol-induced gastric ulcer and pylorus ligation-induced gastric ulcer. Omeprazole (20 mg/kg was used as a standard drug. In ethanol-induced ulcer, after the pretreatment period of 1 hr gastric ulcer was induced with absolute ethanol at a dose of 8 ml/kg (p.o., where as in pylorus ligation-induced gastric ulcer; after the pretreatment period of 1 hr ulcer was induced by tight ligation of pylorus portion of stomach. In the pylorus ligation-induced ulcer model there was a significant reduction in the ulcer area as well as the total volume, free acidity and total acidity and increase in the pH of gastric content along with the mucous production were found. There was a significant decrease in ulcer area and significant increase in the mucosal production in the ethanol-induced gastric ulcer model. Fisetin significantly lowered the level of lipid peroxidase, neutrophil infiltration along with gastric mucosal nitrite in both models of the gastric ulcer. The present findings elucidate the therapeutic value of fisetin in the prevention of experimental gastric ulcer by virtue of its antioxidant mechanism.

  16. Protective Effect of Ginger oil on Aspirin and Pylorus Ligation-Induced Gastric Ulcer model in Rats

    National Research Council Canada - National Science Library

    Khushtar, M; Kumar, V; Javed, K; Bhandari, Uma


    The present investigation was performed in aspirin and pylorus ligation-induced ulcer model in Wistar rats, in which ability of ginger oil to provide gastric protection was studied at two different doses, 0.5 and 1 g/kg po...

  17. Surgical anatomy of the innervation of pylorus in human and Suncus murinus, in relation to surgical technique for pylorus-preserving pancreaticoduodenectomy (United States)

    Yi, Shuang-Qin; Ru, Fei; Ohta, Tetsuo; Terayama, Hayato; Naito, Munekazu; Hayashi, Shogo; Buhe, Sichen; Yi, Nozomi; Miyaki, Takayoshi; Tanaka, Shigenori; Itoh, Masahiro


    AIM: To clarify the innervation of the antro-pyloric region in humans from a clinico-anatomical perspective. METHODS: The stomach, duodenum and surrounding structures were dissected in 10 cadavers, and immersed in a 10mg/L solution of alizarin red S in ethanol to stain the peripheral nerves. The distribution details were studied to confirm innervations in the above areas using a binocular microscope. Similarly, innervations in 10 Suncus murinus were examined using the method of whole-mount immunohistochemistry. RESULTS: The innervation of the pyloric region in humans involved three routes: One arose from the anterior hepatic plexus via the route of the suprapyloric/supraduodenal branch of the right gastric artery; the second arose from the anterior and posterior gastric divisions, and the third originated from the posterior-lower region of the pyloric region, which passed via the infrapyloric artery or retroduodenal branches and was related to the gastroduodenal artery and right gastroepiploic artery. For Suncus murinus, results similar to those in humans were observed. CONCLUSION: There are three routes of innervation of the pyloric region in humans, wherein the route of the right gastric artery is most important for preserving pyloric region innervation. Function will be preserved by more than 80% by preserving the artery in pylorus-preserving pancreaticoduodenectomy (PPPD). However, the route of the infrapyloric artery should not be disregarded. This route is related to several arteries (the right gastroepiploic and gastroduodenal arteries), and the preserving of these arteries is advantageous for preserving pyloric innervation in PPPD. Concurrently, the nerves of Latarjat also play an important role in maintaining innervation of the antro-pyloric region in PPPD. This is why pyloric function is not damaged in some patients when the right gastric artery is dissected or damaged in PPPD. PMID:16610023

  18. Different effects of cytoprotective drugs on ethanol- and aspirin-induced gastric mucosal injury in pylorus-ligated rats

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    Takeuchi, K.; Nishiwaki, H.; Niida, H.; Okabe, S. (Kyoto Pharmaceutical Univ. (Japan))


    In anesthetized rats oral administration (2 ml) of both ethanol (50% in 150 mM HCl) and aspirin (80 mM in 150 mM HCl) produced bandlike lesions in the stomach, while more generalized lesions occurred in the pylorus-ligated stomach when the irritant was given intragastrically through the fistula prepared in the rumen and the mucosal folds were removed by stomach distension. The bandlike lesions induced in the intact stomach by both irritants were significantly and dose-dependently prevented by 16,16-dimethyl PGE2 (dmPGE2: 3 and 10 micrograms/kg, subcutaneously), cysteamine (30 and 100 mg/kg, subcutaneously) or timoprazole (10 and 30 mg/kg, per os) at the doses which significantly inhibited gastric motility. In the pylorus-ligated stomach, however, neither of these agents showed any protection against the generalized lesions induced by ethanol, but such lesions caused by aspirin were significantly prevented only by dmPGE2. These agents also showed similar effects against the reduction of transmucosal PD in the pylorus-ligated stomach exposed to ethanol and aspirin. These results suggest that (1) the formation of bandlike lesions caused by ethanol and aspirin depends on the presence of mucosal folds and may be prevented by the agents that inhibit gastric motility, (2) the pathogenesis of the lesions induced by aspirin and ethanol may be different in the pylorus-ligated stomach, and (3) dmPGE2 has a unique protective ability that is not shared by usual cytoprotective agents.

  19. Morbid obesity and subsequent pancreatic cancer: pylorus-preserving pancreatoduodenectomy after laparoscopic sleeve gastrectomy. (United States)

    Küper, Markus A; Königsrainer, Ingmar; Schmidt, Diethard; Kramer, K Michael; Granderath, Frank A; Schneider, Joachim; Löb, Stefan; Zieker, Derek; Hartmann, Jörg T; Zdichavsky, Marty; Königsrainer, Alfred; Brücher, Björn L D M


    Morbid obesity is a recognized risk factor for gastrointestinal cancer. Little is known about pancreatic cancer developing after gastric bypass surgery or about surgery for this type of tumor following bariatric surgery. This report describes a case of pancreatic head cancer identified 3 months after laparoscopic sleeve gastrectomy for morbid obesity. During routine follow-up, mild abdominal pain and elevated pancreatic enzymes prompted computed tomography, which revealed mild edematous pancreatitis. Hyperbilirubinemia developed, and magnetic resonance imaging showed a pancreatic head tumor. CA19-9 was elevated. After a pylorus-preserving pancreatic head resection, the postoperative course was uneventful. The patient received adjuvant chemotherapy. Unfortunately, at the time of writing (9 months postoperatively), a local recurrence and hepatic metastases were diagnosed. Patients treated with bariatric surgery who develop new symptoms or report constant mild symptoms should be evaluated using endoscopy and radiomorphological imaging. Interdisciplinary obesity treatment can then offer significant benefits for the patient, particularly in the case of pancreatic cancer, which is still difficult to diagnose. In addition, there is a need for epidemiological studies of patients who undergo bariatric surgery and subsequently develop cancer.

  20. Pylorus-preserving whipple pancreaticoduodenectomy : CT findings of immediate postoperative complications

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    Kim, Keon Woo; Kim, Tae Hun [Kyungpook National Univ., Taegu (Korea, Republic of). School of Medicine


    The purpose of this paper is to determine the CT findings of immediately postoperative complications including anastomotic leakage, and to evaluate the usefulness of CT scan in the assessment of early postoperative complications of pylorus preserving whipple pancreaticoduodenectomy (PPPD). During the early postoperative period, fluid accumulated in the abdominal cavity of ten of 23 patients who had undergone PPPD. In all cases, the time interval between the first follow up CT scan and surgery was no more than two weeks. At each leakage site, we compared CT findings with those of conventional fluoroscopic studies: upper gastrointestinal studies with oral water-soluble contrast materials, a contrast injection study via drainage catheters in place in the stomach, the site of choledochojejunostomy during surgery and pancreaticojejunostomy, and nine cases of sinogram via percutaneous drainage catheters. We also evaluated CT findings of the locations, amounts, and margin of the fluid collections. If conventional fluoroscopic studies showed no evidence of anastomotic leakage, as was the case with six patients, the leakage site was determined on the basis of clinical and laboratory data. In four of the six, this was found to be the site of pancreaticojejunostomy, and in the other two, an abscess without anastomotic leakage. In some cases of suspected complications arising after PPPD, and including anastomotic leakage and abdominal abscess, leakage is not revealed by conventional fluoroscopic studies; in such cases, CT scanning may help detect the complications and determine the site of anastomotic leakage. (author). 10 refs., 2 figs.

  1. Histological and Histomorphometric studies of ethanol-injured pylorus and duodenum of Wistar rats pre-treated with Moringa oliefera extract

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    Olayemi Kafilat Olaibi


    Full Text Available Background: This study investigated the effects of pre-treatment with Moringa oleifera extract on the histomorphology and histomorphometry of the pylorus and duodenum of rats following ethanol-induced gastrointestinal injury. Methods: Following extract and ethanol treatment, pylorus and duodenum of the rats were processed for histological procedures, and tissue quantification of total antioxidant capacity, to access the protective abilities of the extract. Results: We showed that Moringa oleifera extract significantly reduces (p<0.05 total lesion area of the secretory portion of stomach following ethanol induced damage. Also the extract, to a great extent preserved the histological integrity of the pylorus and duodenum, and also significantly improved (p<0.05 the % of glandular mucosa of the pylorus that was intact and the ratio of villi height to crypt depth following ethanol damage. There was significant difference in pyloric and duodenal concentration of total antioxidant capacity between ethanol injured rats compared to control and extract treated groups. Conclusion: The present study confirms the antiulcer properties of Moringa oleifera extract, and demonstrates that the extract preserves the histological integrity and dimensions of the various layers of pylorus and duodenum of Wistar rats, thereby preventing a decrease gastrointestinal surface area following ethanol induced injury.

  2. Identification of the pylorus from the intraluminal pH profile. Validation of the method by comparing it with transpyloric potential difference and pressure profile

    DEFF Research Database (Denmark)

    Rosenkilde-Gram, B; Højgaard, L; Kraglund, K;


    In contrast to the steady low intragastric pH, the pH in the proximal duodenum shows wide, rapid, and frequent fluctuations. This change in pH pattern may be used to localize the pylorus and thereby ensure reproducible measurements of duodenal pH at a known and reproducible distance from...... the pylorus. To validate this method of localizing the pylorus, simultaneous measurements were performed of the transpyloric pH and potential difference (PD) profile and of the pH and pressure profile in 10 normal subjects. pH-metry and PD-metry localized the pylorus within the same 1.5 cm in 82% of 104 5-min...... periods, and pH-metry and manometry localized the pylorus within the same 5 cm in 72% of 77 10-min periods. This agreement and accuracy seem satisfactory for most studies of intraluminal pH in the duodenum and make reliable long-term ambulatory recording of duodenal pH possible without serial...

  3. [Synchronous Double Cancer Involving Gastric Cancer Resembling a Submucosal Tumor with Stenosis in the Pylorus and Ascending Colon Cancer - A Case Report]. (United States)

    Miyauchi, Tatsuomi; Miyaki, Akira; Ida, Arika; Kishibe, Saki; Yamaguchi, Kentaro; Shiozawa, Shunichi; Usui, Takebumi; Kuhara, Kotaro; Kono, Teppei; Naritaka, Yoshihiko


    An 82-year-old woman presented to our hospital with a complaint of frequent vomiting. She was admitted for intensive examination and treatment. Abdominal computed tomography revealed that her stomach was severely expanded, and the wall of the ascending colon was thickened throughout its circumference. Upper gastrointestinal endoscopy uncovered severe stenosis in the pylorus and an elevated lesion resembling a submucosal tumor on the posterior wall of the pylorus. Biopsies of the lesion revealed that it was of Group 1. On colonoscopy, type 2 cancer was found in the ascending colon throughout the circumference, and the biopsies revealed that it was of Group 5. Upper gastrointestinal endoscopy was repeated, and the same result was obtained. The possibility of malignancy could not be excluded; therefore, distal gastrectomy and right colectomy were performed. In terms of histopathology, both resected specimens displayed poorly differentiated adenocarcinoma; however, immunohistochemical studies revealed differences in staining at the two sites. The case was diagnosed as synchronous double cancer involving gastric cancer resembling a submucosal tumor with stenosis in the pylorus and ascending colon cancer. Gastric cancer resembling a submucosal tumor is usually difficult to diagnose on biopsy. If the endoscopic findings reveal an elevated lesion resembling a submucosal tumor with stenosis, then the possibility of carcinoma should be considered, and the most suitable treatment should be selected.

  4. R-alpha-methylhistamine-induced inhibition of gastric acid secretion in pylorus-ligated rats via central histamine H3 receptors. (United States)

    Barocelli, E; Ballabeni, V; Chiavarini, M; Impicciatore, M


    1. The effect of central H3 histamine receptor activation on gastric acid and pepsin production has been investigated in pylorus-ligated rats. 2. Intracerebroventricular injections (i.c.v.) of the selective H3 agonist, R-alpha-methylhistamine (0.5-50 nmol per rat) caused a dose-dependent inhibition of gastric acid secretion while intravenous administration (5-500 nmol per rat) was completely ineffective. 3. I.c.v. microinjections of mepyramine, tiotidine and thioperamide (51 nmol per rat), selective antagonists at H1-, H2- and H3-sites respectively, failed to modify the acid secretory response to pylorus ligation. 4. The antisecretory effect of R-alpha-methylhistamine (5 nmol per rat, i.c.v.) was selectively prevented by the H3-blocker, thioperamide (51 nmol per rat, i.c.v.), mepyramine and tiotidine pretreatment being completely inactive. 5. Unlike acid secretion, pepsin production was not significantly affected by all the tested compounds. 6. These findings provide the first pharmacological evidence that the activation of central H3 histamine receptors exerts a negative control in the regulation of gastric acid secretion in conscious pylorus-ligated rats.

  5. R-alpha-methylhistamine-induced inhibition of gastric acid secretion in pylorus-ligated rats via central histamine H3 receptors.


    Barocelli, E; Ballabeni, V.; Chiavarini, M.; Impicciatore, M


    1. The effect of central H3 histamine receptor activation on gastric acid and pepsin production has been investigated in pylorus-ligated rats. 2. Intracerebroventricular injections (i.c.v.) of the selective H3 agonist, R-alpha-methylhistamine (0.5-50 nmol per rat) caused a dose-dependent inhibition of gastric acid secretion while intravenous administration (5-500 nmol per rat) was completely ineffective. 3. I.c.v. microinjections of mepyramine, tiotidine and thioperamide (51 nmol per rat), se...

  6. Influence of fasting period, ligation time, sex, age and bodyweight on the gastric secretory response of pylorus-ligated Wistar rats. (United States)

    Schiantarelli, P; Toson, G; Guelfi, M; Murmann, W


    A study on variables influencing the gastric secretory response of pylorus-ligated Wistar rat, shows that: 1. 24 h is a sufficient fasting period for satisfactory emptying of the stomach, periods of up to 48 h yielding no advantage; 2. between 2 and 4 h is the most appropriate pyloric ligation time because in this range there are no variations in volume of gastric secretion, concentration and output of acid per unit of ligation time; 3. sex has no influence on any of the parameters; 4. animals should be age-selected because only above a given age threshold the gastric secretory response per unit of bodyweight is constant.

  7. Double pylorus: case report and review of the literature Duplo Piloro: Estudo de caso e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Adriana Vaz Safatle-Ribeiro


    Full Text Available Double pylorus is an unusual condition in which a double communication between the gastric antrum and the duodenal bulb occurs. It may be congenital, or it may be acquired complication of peptic ulcer disease. We present a case of double pylorus in a gentleman with epigastric pain and previous history of peptic ulcer disease. The relationship between Helicobacter pylori and this disease was assessed. A review of the literature, the role of associated diseases and the role of H. pylori are discussed.Duplo piloro é condição rara em que se forma dupla comunicação entre o antro gástrico e o bulbo duodenal. Pode ser congênito ou adquirido como complicação de doença cloridropéptica. Apresentamos caso de duplo piloro adquirido em paciente masculino com epigastralgia e história prévia de úlcera péptica. A pesquisa do Helicobacter pylori foi positiva em amostras de tecido gástrico. Foi realizada revisão da literatura e discutido o papel de doenças associadas e do Helicobacter pylori na etiopatogenia desta afecção.

  8. Delayed gastric emptying is associated with pylorus-preserving but not classical Whipple pancreaticoduodenectomy: A review of the literature and critical reappraisal of the implicated pathomechanism

    Institute of Scientific and Technical Information of China (English)

    Kosmas I Paraskevas; Costas Avgerinos; Costas Manes; Dimitris Lytras; Christos Dervenis


    Pylorus-preserving pancreaticoduodenectomy (PPPD)is nowadays considered the treatment of choice for periampullary tumors, namely carcinoma of the head,neck, or uncinate process of the pancreas, the ampulla of Vater, distal common bile duct or carcinoma of the peri-Vaterian duodenum. Delayed gastric emptying (DGE)comprises one of the most troublesome complications of this procedure. A search of the literature using Pubmed/Medline was performed to identify clinical trials examining the incidence rate of DGE following standard Whipple pancreaticoduodenectomy (PD) vs PPPD. Additionally we performed a thorough in-depth analysis of the implicated pathomechanism underlying the occurrence of DGE after PPPD. In contrast to early studies, the majority of recently performed clinical trials demonstrated no significant association between the occurrence of DGE with either PD or PPPD. PD and PPPD procedures are equally effective operations regarding the postoperative occurrence of DGE. Further randomized trials are required to investigate the efficacy of a recently reported (but not yet tested in largescale studies) modification, that is, PPPD with antecolic duodenojejunostomy.(C) 2006 The WJG Press. All rights reserved.

  9. Recurrent Cholangitis by Biliary Stasis Due to Non-Obstructive Afferent Loop Syndrome After Pylorus-Preserving Pancreatoduodenectomy: Report of a Case (United States)

    Sanada, Yukihiro; Yamada, Naoya; Taguchi, Masanobu; Morishima, Kazue; Kasahara, Naoya; Kaneda, Yuji; Miki, Atsushi; Ishiguro, Yasunao; Kurogochi, Akira; Endo, Kazuhiro; Koizumi, Masaru; Sasanuma, Hideki; Fujiwara, Takehito; Sakuma, Yasunaru; Shimizu, Atsushi; Hyodo, Masanobu; Sata, Naohiro; Yasuda, Yoshikazu


    We report a 71-year-old man who had undergone pylorus-preserving pancreatoduodenectomy (PPPD) using PPPD-IV reconstruction for cholangiocarcinoma. For 6 years thereafter, he had suffered recurrent cholangitis, and also a right liver abscess (S5/8), which required percutaneous drainage at 9 years after PPPD. At 16 years after PPPD, he had been admitted to the other hospital because of acute purulent cholangitis. Although medical treatment resolved the cholangitis, the patient was referred to our hospital because of dilatation of the intrahepatic biliary duct (B2). Peroral double-balloon enteroscopy revealed that the diameter of the hepaticojejunostomy anastomosis was 12 mm, and cholangiography detected intrahepatic stones. Lithotripsy was performed using a basket catheter. At 1 year after lithotripsy procedure, the patient is doing well. Hepatobiliary scintigraphy at 60 minutes after intravenous injection demonstrated that deposit of the tracer still remained in the upper afferent loop jejunum. Therefore, we considered that the recurrent cholangitis, liver abscess, and intrahepatic lithiasis have been caused by biliary stasis due to nonobstructive afferent loop syndrome. Biliary retention due to nonobstructive afferent loop syndrome may cause recurrent cholangitis or liver abscess after hepaticojejunostomy, and double-balloon enteroscopy and hepatobiliary scintigraphy are useful for the diagnosis of nonobstructive afferent loop syndrome. PMID:25058778

  10. Comparison of five methods for Helicobacter pylorus detection%幽门螺旋杆菌5种检测方法比较

    Institute of Scientific and Technical Information of China (English)

    何周桃; 谢贤和; 韦红; 蓝程


    目的 通过对5种幽门螺旋杆菌(Hp)检测方法的比较,寻求敏感性及特异性高、快速简便的Hp检测方法,促进Hp感染的早期诊断及治疗.方法 对最近1个月内未使用过抗生素、质子泵抑制荆、H2受体阻滞剂等可能影响Hp检测结果的95例患者同步完成快速尿素酶试验(RUT)、细菌培养、13C-尿素呼气试验(13C-UBT)、血清学(幽门螺杆菌抗体Hp IgG)检查、Hp病理组织学检测等检查,以细菌培养、病理组织学检测中任何1项阳性为Hp感染阳性为诊断标准,比较RUT、细菌培养、13C-UBT、Hp IgG检查、Hp病理组织学检测5种检测方法检出的敏感度及特异度.结果 敏感度以RUT最高(95.7%),其次为病理组织学(87.5%)、细菌培养(82.9%)、13C-UBT(78.1%),最低为Hp IgG(43.9%).特异度由高及低依次为细菌培养(96.3%)、13C-UBT(91.4%)、病理组织学(89.7%)、Hp IgG(70.4%)、RUT(65.7%).RUT检测、13C-UBT、病理组织学检测、细菌培养的敏感度与Hp IgG检潮的敏感度比较差异有统计学意义(P<0.01),而RUT、病理组织学、细菌培养、13C-UBT检测的敏感度4者间差异无统计学意义(P>0.05).RUT检测的特异度与13C-UBT检测、病理组织学检测、细菌培养的特异度比较差异有统计学意义(P<0.01),13C-UBT检测的特异度与Hp IgG检测的特异度相比差异有统计学意义(P<0.01),而病理组织学、细菌培养、13C-UBT检测的特异度组间差异无统计学意义(P>0.05).结论 13C-UBT检测的敏感度及特异度均较高,更能反映HP感染的变化状况,可作为临床诊断Hp的首选方法.%Objective With the comparison of five methods for Helicobacter pylorus(Hp) detection, trying to seek high, fast and simple ways in testing the sensitivity and specificity, thus to improve the early diagnosis and treatment.Methods The comparison was made with 95 patients who within one month had never applied antibiotics,proton pump inhibitors,H2-receptor blockers

  11. Tubo gástrico con conservación anatómica y funcional del píloro Gastric tube with anatomical and functional conservation of the pylorus

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    Albio Ferrá Betancourt


    result obtained in patients who underwent subtotal esophagectomy and replacement of the organ by tubulised stomach without applying gastric drainage (pyroloplasty. METHODS. 16 patients treated with this procedure from January 2002 to September 2005 were analyzed. The studied variables were the surgical technique used, the postoperative complications and the presence of symptoms. RESULTS. The resection by McKeown's technique was performed in 50 % of the cases, whereas the transhiatal access was carried out in 43.8 % and Ivor Lewis' technique in 6.2 %. Seven patients (43.8 % suffered complications, mainly due to esophagogastric cervical fistula (6 cases. The last of them presented atelactasia and bilateral bronchopneumonia that caused his death. At the six months of follow-up, there were neither symptoms of alkaline reflux nor of difficulty to evacuate the stomach. CONCLUSIONS. The presence of gastric retention or duodenogastric reflux was not proved in this study. However, it is recommendable to conduct a randomized study to compare the results obtained in patients that underwent a procedure of gastric drainage with those whose physiology and anatomy of the denervated pylorus are intact

  12. Alterações morfométricas da musculatura dos músculos longitudinal e circular de ratos submetidos à criação de piloros no intestino delgado Morfometric alterations of the longitudinal and circular muscle layers in rats who underwent pylorus construction in the small bowel

    Directory of Open Access Journals (Sweden)

    Cícero de Lima Rena


    Full Text Available OBJETIVO: Realizar um estudo morfométrico comparativo da musculatura longitudinal e circular do intestino delgado de ratos submetidos à construção cirúrgica de um e de dois piloros no intestino delgado utilizando-se da técnica de criação de piloros proposta por Rena et al. MÉTODO: Foram utilizados 52 ratos Wistar machos divididos em três grupos. O Grupo A, destacado como controle, composto de 10 animas, cada um forneceu 20mm de segmento de intestino para o estudo. Os animais do Grupo B, composto de 32 animais, foram submetidos à construção de dois piloros, um a 100mm e outro a 150mm da válvula ileocecal e os animais do grupo C, composto de 10 animais, foram submetidos à construção de um piloro a 100mm da mesma. A eutanásia ocorreu no décimo dia. A morfometria das camadas musculares longitudinal e circular acima e abaixo dos piloros foi estudada com utilização do microscópico modelo "Axiostar plus" conectado à câmera "Axioncam Version 5.05.10" com objetiva X5 / 0,12 no o programa "AxioVision". RESULTADOS: As alças apresentaram aumento da espessura da camada muscular acima e abaixo do ponto da operação. O estudo morfométrico comparativo das camadas musculares longitudinal e circular mostrou aumento significativo em comparação ao controle, não demonstrando significância entre os grupos B e C. CONCLUSÃO: Os resultados deste estudo revelaram importante aumento de espessura das camadas musculares, porém, menos acentuados que aqueles descritos na literatura quando foram realizados em animais submetidos à estenose fixa. Esses dados indicam que a construção operatória de piloros pela técnica utilizada promove alterações musculares de menor monta, possivelmente, pela função valvular do piloro.BACKGROUND AND PURPOSE: To undertake a morphometric comparative study of the longitudinal and circular layers of the small bowel muscularis propria in rats, whom underwent surgical construction of one and two pylorus

  13. 大黄黄连泻心汤、理中丸对水浸应激型、幽门结扎型胃溃疡寒、热证模型大鼠血清COR含量的影响%The Influence of Dahuang Huanglian Xiexin Decoction and Lizhong Pill on COR Contents in Serum on Gastric Ulcer Induced by Bondage Water Immersion Stress or Pylorus Deligation Combined with Cold or Heat Syndrome Model Rats

    Institute of Scientific and Technical Information of China (English)

    李冀; 李胜志; 柴剑波; 毕珺辉; 胡晓阳


    目的:探讨水浸应激型、幽门结扎型胃溃疡中医寒、热证模型的形成机制及寒、热方剂对胃溃疡寒、热证模型的基本作用机理并进一步探讨方证相应的客观规律.方法:采用寒、热因素结合束缚水浸、幽门结扎法应激法分别建立大鼠胃溃疡寒、热证动物模型,采用酶联免疫法检测各实验组受试大鼠血清COR的含量.结果:水浸应激型、幽门结扎型胃溃疡模型中除单寒组、寒假组外各模型组大鼠血清COR的含量与空白对照组比较均明显升高(P <0.05或P<0.01),以热因素表达明显,血清COR的含量可作为溃疡热证的微观指征.寒性方剂大黄黄连泻心汤可显著降低热性模型大鼠血清COR的含量(P<0.05或P<0.01);理中丸对其血清COR的含量影响不显著(P>0.05).结论:通过“方证相应”理论验证了“病证结合”的胃溃疡寒、热模型复制成功,寒性方剂大黄黄连泻心汤对热性溃疡的治疗作用,可通过抑制大鼠血清皮质醇的分泌而实现.%Objective: To explore the forming mechanism of gastric ulcer model induced by bondage water immersion stress or pylorus deligation combined with cold or heat syndrome. And to observe the basic mechanism of action of cold or heat formula on gastric ulcer model combined with cold or heat syndrome and the objective regularity of "formula - syndrome corresponding". Methods; Adopting cold or heat factors combined with bondage water immersion stress or pylorus deligation methods to establish gastric ulcer model combined with cold and heat syndrome. Using euzymelinked immunosorbent assay to detect the contents of COR in serum. Results:Compared with the blank group, except the cold syndrome group and the fake cold syndrome group, the contents of COR in serum increased remarkably in each model group, (P <0. 05 or P <0. 01) . The heat factors expressed obviously among the model groups, and the contents of COR could be regarded as the

  14. 保留十二指肠的胰头切除与保留幽门的胰十二指肠切除治疗胰头肿块型胰腺炎的Meta分析%A meta-analysis on surgical treatments for chronic pancreatitis: duodenum-preserving pancreatic head resection versus pylorus-preserving pancreaticoduodenectomy

    Institute of Scientific and Technical Information of China (English)

    汪超; 黄强; 林先盛; 刘臣海; 杨骥


    Objective To compare the safety and effectiveness of duodenum-preserving pancreatic head resection (DPPHR) with pylorus-preserving pancreaticoduodenectomy (PPPD) in the treatment of chronic pancreatitis with a pancreatic head mass.Methods Medline,Biosis,Cochrane Library,Science Citation Index Database,CBM Database,Wan Fang and CNKI were searched systematically.The bias risk of the included trials was assessed according to the assessing tools as suggested by the Cochrane Handbook.Review Manage 5.2 was used to perform the statistical analysis.Results 7 RCTs with 226 patients were included in the meta-analysis which showed that there were no significant differences between PPPD and DPPHR in overall postoperative morbidity,postoperative hospital stay,complete pain relief,pancreatic fistula,exocrine insufficiency,symptom score at 5 to 7-year follow-up,and quality of life score at 14 to 15-year follow-up (P > 0.05).While DPPHR had significant superiorities in operation time,blood replacement,delayed gastric emptying,occupational rehabilitation after the operations,weight gain,quality of life score at 1 to 2-year follow-up,symptom score at 5 to 7-year follow-up,and physical functioning score at 14 to 15-year follow-up.Conclusions DPPHR is more favourable than PPPD in reducing the use of blood replacement,shortening operation time,delayed gastric emptying,occupational rehabilitation after the operations,weight gain,physical functioning,and in improving quality of life of patients.%目的 探讨保留十二指肠的胰头切除术(DPPHR)与保留幽门的胰十二指肠切除术(PPPD)治疗胰头肿块型胰腺炎的安全性和有效性.方法 系统检索Medline、Biosis、The Cochrane Library、Science Citation Index Database、中国生物医学文献数据库、中国期刊全文数据库、万方数据库、维普中文科技期刊数据库.选取相关临床随机对照试验,参考Cochrane Handbook的偏倚风险评估工具评估偏倚风险.应用Review Manager

  15. Surgical anatomy of the innervation of pylorus in human and Suncus murinus, in relation to surgical technique for pylorus- preserving pancreaticoduodenectomy

    Institute of Scientific and Technical Information of China (English)

    Shuang-Qin Yi; Shigenori Tanaka; Masahiro Itoh; Fei Ru; Tetsuo Ohta; Hayato Terayama; Munekazu Naito; Shogo Hayashi; Sichen Buhe; Nozomi Yi; Takayoshi Miyaki


    AIM: To clarify the innervation of the antro-pyloric region in humans from a dinico-anatomical perspective.METHODS: The stomach, duodenum and surrounding structures were dissected in 10 cadavers, and immersed in a 10mg/L solution of alizarin red S in ethanol to stain the peripheral nerves. The distribution details were studied to confirm innervations in the above areas using a binocular microscope. Similarly, innervations in 10Suncus murinus were examined using the method of whole-mount im munohistochemistry.RESULTS: The innervation of the pyloric region in humans involved three routes: One arose from the anterior hepatic plexus via the route of the suprapyloric/supraduodenal branch of the right gastric artery; the second arose from the anterior and posterior gastric divisions, and the third originated from the posteriorlower region of the pyloric region, which passed via the infrapyloric artery or retroduodenal branches and was related to the gastroduodenal artery and right gastroepiploic artery. For Suncus murinus, results similar to those in humans were observed.CONCLUSION: There are three routes of innervation of the pyloric region in humans, wherein the route of the right gastric artery is most important for preserving pyloric region innervation. Function will be preserved by more than 80% by preserving the artery in pyloruspreserving pancreaticoduodenectomy (PPPD). However,the route of the infrapyloric artery should not be disregarded. This route is related to several arteries (the right gastroepiploic and gastroduodenal arteries),and the preserving of these arteries is advantageous for preserving pyloric innervation in PPPD. Concurrently,the nerves of Latarjet also play an important role in maintaining innervation of the antro-pyloric region in PPPD. This is why pyloric function is not damaged in some patients when the right gastric artery is dissected or damaged in PPPD.

  16. Fluoxetine and infantile hypertrophic pylorus stenosis : a signal from a birth defects drug exposure surveillance study

    NARCIS (Netherlands)

    Bakker, M.K.; de Walle, H.E.K.; Wilffert, B.; de Jong-van den Berg, L.T.W.


    Purpose We report an association found in a surveillance study which systematically evaluated combinations of specific birth defects and drugs used in the first trimester of pregnancy. Method The database of a population-based birth defects registry (birth years 1997-2007) was systematically screene

  17. Impact of the reconstruction method on delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy

    DEFF Research Database (Denmark)

    Tamandl, Dietmar; Sahora, Klaus; Prucker, Johannes


    criteria on postoperative day (POD) 10. A paracetamol absorption test was also administered with a liquid meal, and serial plasma levels of intestinal peptides were measured. RESULTS: Overall, 64 patients were amenable for analysis: 36 in the antecolic group and 28 in the retrocolic group. The incidences......–6) days; p = 0.353], or morbidity (52.9 vs. 50.0 %; p = 0.777). The median length of nasogastric tube decompression was similar in the two groups [4 (3–7) vs. 3 (3–5) days; p = 0.600]. Levels of paracetamol and glucagon-like peptide-1 were markedly decreased in patients with DGE. CONCLUSIONS: Antecolic...

  18. [Complications in morbid obesity treatment--pylorus obstruction caused by a deflated intragastric balloon]. (United States)

    Constantin, V; Socea, B; Moculescu, C; Sireţeanu, G; Ciofoaia, V; Popa, F


    An aggressive array of new treatments and improvements of existing approaches for addressing morbid obesity were developed during the last two decades in response to the recognition that a new pandemic affects humanity, i.e. obesity. Initially used as a temporizing solution for other specific interventions used for obesity treatment, the endoscopic placement of an intragastric balloons has currently became in certain cases a complete therapeutic solution. Multiple studies emphasize the efficiency of this new therapeutic method, in some cases resulting in a 45 kg weight loss at the end of the monitoring period. The intragastric balloon, after endoscopic placement can be kept into position for an average period of 4-6 months. After this period, balloon extraction is recommended because of the complications that can occur with prolonged intragastric placement. This paper presents a case of pyloric obstruction by an intragastric balloon kept for 14 months. In this case, the initial approach was endoscopic, but the surgical approach offered the definitive therapeutic solution.

  19. Preoperative segmental embolization of the proper hepatic artery prior to pylorus-preserving pancreaticoduodenectomy: A case report

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    Masanobu Taguchi


    Conclusion: Preoperative segmental embolization of the hepatic artery before PPPD for a patient with a replaced left hepatic artery encouraged the growth of collateral blood supply, allowing radical resection including the vessels and obviated the need for arterial reconstruction.


    Directory of Open Access Journals (Sweden)

    K.R. Tandel* and B.K. Shah


    Full Text Available Objectives: To assess the effect of unripe dried banana powder in experimentally induced gastric ulcers and effect on gastric acid secretion. To evaluate the antiulcerogenic effect of plantain banana of Gujarat as a part of evaluation of impact of biological variables on this activity. Materials and methods: Total of 24 albino rats of either sex weighing between 150-250 gm were randomly divided into 4 groups. Each group has 6 no. of rats. The first group received placebo (distilled water, the second, third & forth group received 0.5gm/kg, 1gm/kg and 2mg/kg of banana powder respectively. Banana powder was given as suspension at fixed time (3 times in a day for two days and animals were kept for fasting for another 48hrs. On 5th day, the animals were sacrificed after 7 hrs and stomach were removed for examination and gastric juice samples were collected to analyze volume and acidity.Results: Orally administered banana powder in the dose of 2gm/kg caused a statistically significant decrease in aspirin with pyloric ligation induced ulcers in rats without significantly decrease in secretary activity.Conclusion: It can be concluded from these results that vegetable plantain banana has antiulcerogenic and mucosal protective actions, but it has no antisecretory activity.

  1. Role of calcium stores and membrane voltage in the generation of slow wave action potentials in guinea-pig gastric pylorus. (United States)

    van Helden, D F; Imtiaz, M S; Nurgaliyeva, K; von der Weid, P; Dosen, P J


    1. Intracellular recordings made in single bundle strips of a visceral smooth muscle revealed rhythmic spontaneous membrane depolarizations termed slow waves (SWs). These exhibited 'pacemaker' and 'regenerative' components composed of summations of more elementary events termed spontaneous transient depolarizations (STDs). 2. STDs and SWs persisted in the presence of tetrodotoxin, nifedipine and ryanodine, and upon brief exposure to Ca2+-free Cd2+-containing solutions; they were enhanced by ACh and blocked by BAPTA AM, cyclopiazonic acid and caffeine. 3. SWs were also inhibited in heparin-loaded strips. SWs were observed over a wide range of membrane potentials (e.g. -80 to -45 mV) with increased frequencies at more depolarized potentials. 4. Regular spontaneous SW activity in this preparation began after 1-3 h superfusion of the tissue with physiological saline following the dissection procedure. Membrane depolarization applied before the onset of this activity induced bursts of STD-like events (termed the 'initial' response) which, when larger than threshold levels initiated regenerative responses. The combined initial-regenerative waveform was termed the SW-like action potential. 5. Voltage-induced responses exhibited large variable latencies (typical range 0.3-4 s), refractory periods of approximately 11 s and a pharmacology that was indistinguishable from those of STDs and spontaneous SWs. 6. The data indicate that SWs arise through more elementary inositol 1,4,5-trisphosphate (IP3) receptor-induced Ca2+ release events which rhythmically synchronize to trigger regenerative Ca2+ release and induce inward current across the plasmalemma. The finding that action potentials, which were indistinguishable from SWs, could be evoked by depolarization suggests that membrane potential modulates IP3 production. Voltage feedback on intracellular IP3-sensitive Ca2+ release is likely to have a major influence on the generation and propagation of SWs.

  2. Gastroprotective Effect of Freeze Dried Stripped Snakehead Fish (Channa striata Bloch.) Aqueous Extract against Aspirin Induced Ulcerogenesis in Pylorus Ligated Rats. (United States)

    Ali Khan, Mohammed Safwan; Mat Jais, Abdul Manan; Hussain, Javeed; Siddiqua, Faiza; Gopala Reddy, A; Shivakumar, P; Madhuri, D


    Channa striata (Bloch.) is a fresh water fish belonging to the family Channidae. The stripped snakehead fish possesses wide range of medicinal properties. In view of traditional use of C. striata for wound healing, the present study was undertaken to investigate the beneficial effects of orally administered freeze dried aqueous extract of Channa striata (AECS) in experimentally induced gastric ulcers in Wistar rats. Aspirin induced ulcerogenesis in pyloric ligation model was used for the assessment of antiulcer activity and Ranitidine (50 mg/kg) was employed as the standard drug. The various gastric parameters like volume of gastric juice, pH, free and total acidities, ulcer index, and levels of antioxidant enzymes like catalase, superoxide dismutase, and lipid peroxidation marker malondialdehyde were determined. AECS at concentrations of 40% and 50% w/v significantly decreased the volume of gastric juice and increased the levels of catalase while considerable decrease in free and total acidities and increase in superoxide dismutase were observed with the treatment of standard drug and AECS (50% w/v). All the test doses of AECS markedly decreased ulcer index and malondialdehyde compared to the standard drug whereas AECS 30% w/v did not alter volume of gastric juice, pH, free and total acidities, catalase, and superoxide dismutase. From these findings, it can be concluded that AECS is devoid of acid neutralizing effects at lower doses and possesses antisecretory and antiulcer activities and this could be related to its antioxidant mechanism.


    Institute of Scientific and Technical Information of China (English)




  4. Acquired double pylorus:A case report

    Institute of Scientific and Technical Information of China (English)

    Qing-Yu Chen; Yan Chen; Liang; Jing Wang; Qin Du; Jian-Ting Cai; Jia-Min Chen


    Double pylorus is one of the rare anomalies of the gastrointestinal tract, it can be congenital or acquired. In this case we report a case of double pylorus because of chronic peptic ulcer. Upper GI endoscopy revealed gastroduodenal fistula located on the lesser curve of the antrum, the patient's symptoms were improved rapidly by intensive antiulcer treatment.

  5. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... or within various body organs such as the liver or kidneys. top of page What are some ... is performed to evaluate the: appendix stomach/ pylorus liver gallbladder spleen pancreas intestines kidneys bladder testicles ovaries ...

  6. the roles of gastric acid and nitric oxide

    African Journals Online (AJOL)

    Dr Olaleye

    well as mucosal blood flow via increased NO mechanism. INTRODUCTION1 ... transection was made at the junction of the pylorus with the duodenum where a pyloric ..... Fujishita, T., Furutani, K and Okabe, S. (2003):. Pharmacological control ...

  7. Oral vaccination with attenuated Salmonella choleraesuis C500 ...

    African Journals Online (AJOL)


    Several H. pylori virulence factors have been identified, .... twice in sterile 0.9% NaCl, and the pylorus, liver, lung, duodenum and spleen from mice .... duodenal ulcer risk. Cancer Res. ... developing adenocarcinoma of stomach. Cancer Res.


    Directory of Open Access Journals (Sweden)

    Darshan Shah


    Full Text Available The gastroprotective effect of some extracts of the ripe fresh fruits of Cordia dichotoma were investigated in aspirin induced gastric ulcer model and pylorus ligation model in rats. The water and alcoholic extract showed antiulcer activity. The water extract has been found to be more effective than alcoholic extract compared to standard ranitidine in case of aspirin induced gastric ulcer model (p<0.001 as well as in pylorus ligation model.

  9. Antiulcerogenic effect of Justicia prostrata Gamble. (United States)

    Sanmugapriya, E; Shanmugasundaram, P; Venkataraman, S


    Antiulcerogenic effect of the alcoholic (ALJP) and aqueous (AQJP) extracts of the whole plant of Justicia prostrata was studied in aspirin+pylorus ligated rat models and analysed for gastric volume, ulcer index, free and total acidity. Biochemical parameters like total proteins, total hexoses, hexosamine, fucose and sialic acid were also estimated. Both extracts (ALJP and AQJP) significantly reduced both the gastric volume and the acidity of gastric juice. It also significantly promoted gastric mucus secretion by increasing total carbohydrates and decreasing the protein concentration in aspirin+ pylorus ligated rats. The results suggest that both the extracts (ALJP and AQJP) possess antiulcer activity, whereas AQJP is more effective when compared with ALJP in aspirin+pylorus ligated rat models. The results were compared with the standard drug Rantidine, a H2 receptor antagonist.

  10. Effects of San Qi on Gastric Secretion and Protective Factors of Gastric Mucosa in the Rat with Precancerous Lesion of Stomach

    Institute of Scientific and Technical Information of China (English)

    石雪迎; 赵凤志; 戴欣; 董秀云; 方杰; 杨会敏


    @@ In the model rat with precancerous lesion of stomach induced by the combined method of insertion of a spring into the pylorus and high salt hot paste, effects of San Qi (三七 Radix Notoginseng) on gastric secretion and protective factors of stomach were investigated.

  11. Two Cases of Type Va Extrahepatic Bile Duct Duplication With Distal Klatskin Tumor Surgically Treated with Whipple Procedure and Hepaticojejunostomy. (United States)

    Hammad, Tariq A; Alastal, Yaseen; Khan, Muhammad Ali; Hammad, Mohammad; Alaradi, Osama; Nigam, Ankesh; Sodeman, Thomas C; Nawras, Ali


    We describe the diagnostic and therapeutic challenges of a type Va extrahepatic bile duct duplication coexistent with distally located hilar cholangiocarcinoma (Klatskin tumor). We present 2 cases that were diagnosed preoperatively and treated with a modified surgical technique of a combined pylorus-preserving Whipple procedure and hepaticojejunostomy.

  12. Watermelon-stomach og sklerodermi

    DEFF Research Database (Denmark)

    Diederichsen, Axel Cosmus Pyndt; Rasmussen, Jens Møller


    We report here a 72-year-old man with severe, persistent, iron deficiency anaemia. Upper gastrointestinal endoscopy revealed red stripes radiating to the pylorus, characteristic of watermelon stomach (gastric antral vascular ectasia). The patient was found to have scleroderma with calcinosis, scl...

  13. Adult Pancreatic Hemangioma: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Gerhard S. Mundinger


    Full Text Available We report an adult pancreatic hemangioma diagnosed on pathological specimen review following pylorus preserving pancreaticoduodenectomy for a symptomatic cystic mass in the head of the pancreas. Eight cases of adult pancreatic hemangioma have been reported in literature since 1939. Presenting symptoms, radiographic diagnosis, pathologic characteristics, and treatment of adult pancreatic hemagiomas are discussed following review of all published cases.

  14. Amang et al., Afr J Tradit Complement Altern Med. (2014) 11(1):165 ...

    African Journals Online (AJOL)


    HCl/ethanol, absolute ethanol, cold/restraint stress rats, and pylorus legated rats pre-treated with indomethacin. ... Phytochemical analysis ... extract by oral route, 1 h before they were given the necrotizing solution. ... lesion formation and mucus production (lesion indices expressed as the sum of the lengths of the lesions for ...

  15. Inhibitory neural pathway regulating gastric emptying in rats. (United States)

    Ishiguchi, T; Nishioka, S; Takahashi, T


    The relaxation of the pylorus is one of the most important factors for promoting gastric emptying. However, the role of inhibitory neurotransmitters in the regulation of pyloric relaxation and gastric emptying remains unclear. In this study, we investigated the effects of NO biosynthesis inhibitor, N(G)-nitro-L-arginine methyl ester (L-NAME), and calcium dependent potassium channel blocker, apamin, on vagal stimulation-induced pyloric relaxation and gastric emptying in rats. Sodium nitroprusside (SNP), adenosine 5'-triphosphate (ATP), vasoactive intestinal polypeptide (VIP) and pituitary adenylate cyclase-activating peptide (PACAP) caused pyloric relaxations in a dose dependent manner in vivo. Apamin (120 microg/kg) significantly reduced ATP and PACAP-induced pyloric relaxations without affecting SNP- or VIP-induced relaxations. Vagal stimulation (10 V, 1 ms, 1-20 Hz)-induced pyloric relaxation was significantly inhibited by L-NAME (10 mg/kg). The combined administration of L-NAME and apamin almost completely abolished vagal stimulation-induced pyloric relaxation. L-NAME and apamin significantly increased spontaneous contractions in the antrum, pylorus and duodenum. Increased motility index by L-NAME and apamin was significantly higher in the pylorus and duodenum, compared to that of antrum. L-NAME and apamin significantly delayed liquid gastric emptying. These results suggest that besides NO, probably ATP and PACAP, act as inhibitory neurotransmitters in the rat pylorus and regulate gastric emptying.

  16. Management of trichobezoar: case report and literature review.

    NARCIS (Netherlands)

    Gorter, R.R.; Kneepkens, C.M.; Mattens, E.C.; Aronson, D.C.; Heij, H.A.


    Trichobezoars (hair ball) are usually located in the stomach, but may extend through the pylorus into the duodenum and small bowel (Rapunzel syndrome). They are almost always associated with trichotillomania and trichophagia or other psychiatric disorders. In the literature several treatment options

  17. Management of trichobezoar: case report and literature review

    NARCIS (Netherlands)

    Gorter, R.R.; Kneepkens, C.M.F.; Mattens, E.C.J.L.; Aronson, D.C.; Heij, H.A.


    Trichobezoars (hair ball) are usually located in the stomach, but may extend through the pylorus into the duodenum and small bowel (Rapunzel syndrome). They are almost always associated with trichotillomania and trichophagia or other psychiatric disorders. In the literature several treatment options

  18. Anatomy of the Digestive System of Radix sp. (Bassomatophora: Lymnaeidae from Lake Taal, Batangas

    Directory of Open Access Journals (Sweden)

    Aileen Joyce Cukingnan


    Full Text Available The digestive anatomy of Radix sp. from Taal Lake, Batangas, Philippines, was studied. The major differences with the other known lymnaeids previously described from the Philippines are found in the radular formula, presence of intestinal caecum, the orientation of the pylorus and the intestine, and the number of loops made by the intestine around the stomach and the digestive gland.

  19. Retrograde pylorogastric intussusception – Case report and review

    Directory of Open Access Journals (Sweden)

    Efrat Avinadav


    Full Text Available A case of gastric outlet obstruction in an infant due to retrograde intussusception of the pylorus into the stomach is presented. This anomaly is extremely rare, with almost no reports in the literature. The patient underwent formal Heineke-Mikulicz pyloroplasty with an uneventful recovery and resumed full enteral feeding.

  20. Peculiarities of surgical treatment of acute form of congenital hypertrophic pyloric stenosis

    Directory of Open Access Journals (Sweden)

    Олег Владимирович Спахи


    Full Text Available Aim of research: to study an efficiency of the double pyloromyotomy at congenital pyloric stenosis in children and its impact on regress of hypertrophy of pylorus in postoperative period. Material and methods of research: there was carried out an analysis of 157 patients with an acute form of congenital hypertrophic pyloric stenosis (CHPS that characterizes with a sudden beginning of disease, predominance of “fountain” vomiting over regurgitation, fast growth of homeostasis dysfunctions and decrease of the body weight. All children were separated in 2 groups statistically homogenous on sex, age and prescription of disease.  The first group of examination (children who underwent the double pyloromyotomy included 65 boys. The second (control group included 92 male children who underwent the standard pyloromyotomy according to Frede-Weber-Ramstedt.  The ultrasound examination of pylorus in dynamics with detection of its volume was carried out in both groups.Results. The results of intraoperative assessment of the state of injured pylorus indicate an existence of two macroscopic variants of it: “rigid pyloric olive” that was registered in 82 % of children of the first group and the “soft pyloric olive” – in 79% of patients of the control group. “Rigid olive” characterized with hard “cartilaginoid” consistency of fusiform thickened pylorus of the whitish color. “Soft olive” had the dense elastic consistency and the pink-pale color.   The regress of “pyloric olive” in all children took place on average during 67,92,2 (Mm days. But in children of the second group medium terms of involution of hypertrophy of pylorus were 75,74,1 (Mm days. In patients who underwent the double pyloromyotomy these terms were reliably (р0,05 lower and varied within 41,71,5 (Mm days.Conclusions. Involution of hypertrophy of pyloric end after the surgical treatment of CHPS occurs gradually and depends on adequacy of regeneration of the

  1. Effect of Lonicerae Flos extracts on reflux esophagitis with antioxidant activity

    Institute of Scientific and Technical Information of China (English)

    Sae-Kwang Ku; Bu-Il Seo; Ji-Ha Park; Gyu-Yeol Park; Young-Bae Seo; Jae-Soo Kim; Hyeung-Sik Lee; Seong-Soo Roh


    AIM: To observe the effects of traditional antiinflammatory medicine Lonicerae Flos (LF) on rat reflux esophagitis (RE) induced by pylorus and forestomach ligation compared with the well-known proton antioxidant, α-tocopherol. METHODS: Rat s were pret reated wi th three different dosages of LF (500, 250 and 125 mg/kg) orally, once a day for 14 d before pylorus and forestomach ligation. Nine hours after pylorus and forestomach ligation, changes to the stomach and esophagus lesion areas, gastric volumes, acid and pepsin outputs, antioxidant effects, esophageal lipid peroxidation, superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), myeloperoxidase and glutathione (GSH) levels, and collagen contents (marker of flexibility) were observed on the esophageal and fundic histopathology. The results were compared with an α-tocopherol (once orally, 1 h before operation, 30 mg/kg) treated group in which the effects on RE were already confirmed. RESULTS: Pylorus and forestomach ligations caused marked increases of gross esophageal and gastric mucosa lesion areas, which corresponded with histopathological changes. In addition, increases of esophageal lipid peroxidation, decreases of SOD, CAT, and GSH-free radical scavengers, increases of collagen were observed. However, these pylorus and forestomach ligation induced RE were dose-dependently inhibited by treatment of 500, 250 and 125 mg/kg of LF extract, mediated by antioxidant effects. RE at 250 mg/kg showed similar effects α-tocopherol. CONCLUSION: The results suggest that antioxidant effects of LF could attenuate the severity of RE and prevent the esophageal mucosal damage, and validate its therapeutic use in esophageal reflux disease.

  2. Immunohistochemical study on gastrointestinal endocrine cells of four reptiles

    Institute of Scientific and Technical Information of China (English)

    Xu-Gen Huang; Xiao-Bing Wu


    AIM: To darify the types, regional distributions and distribution densities as well as morphological features of gastrointestinal (GI) endocrine cells in various parts of the gastrointestinal track (GIT) of four reptiles, Gekko japonicus, Eumeces chinensis, Sphenomorphus indicus and Eumeces elegans.METHODS: Paraffin-embedded sections (5 μm) of seven parts (cardia, fundus, pylorus, duodenum, jejunum, ileum,rectum) of GIT dissected from the four reptiles were prepared. GI endocrine cells were revealed by using immunohistochemical techniques of streptavidin-peroxidase (S-P) method. Seven types of antisera against 5-hydroxytryptamine (5-HT), somatostatin (SS), gastrin (GAS),glucagon (GLU), substance P (SP), insulin and pancreatic polypeptide were identified and then GI endocrine cells were photomicrographed and counted.RESULTS: The GI endocrine system of four reptiles was a complex structure containing many endocrine cell types similar in morphology to those found in higher vertebrates.Five types of GI endocrine cells, namely 5-HT, SS, GAS,SP and GLU immunoreactive (IR) cells were identified in the GIT of G. japonicus, E. chinensis and S. indicus, while in the GIT of E. elegans only the former three types of endocrine cells were observed. No PP- and INS- IR cells were found in all four reptiles. 5-HT-IR cells, which were most commonly found in the pylorus or duodenum, distributed throughout the whole GIT of four reptiles. However, their distribution patterns varied from each other. SS-IR cells,which were mainly found in the stomach especially in the pylorus and/or fundus, were demonstrated in the whole GIT of E. chinensis, only showed restricted distribution in the other three species. GAS-IR cells, with a much restricted distribution, were mainly demonstrated in the pylorus and/or the proximal small intestine of four reptiles. GLU-IR cells exhibited a limited and species-dependent variant distribution in the GIT of four reptiles. SP-IR cells were found throughout the

  3. Tyramine and β-phenylethylamine, from fermented food products, as agonists for the human trace amine-associated receptor 1 (hTAAR1) in the stomach. (United States)

    Ohta, Hiroto; Takebe, Youhei; Murakami, Yuka; Takahama, Yusei; Morimura, Shigeru


    The aromatic amines tyramine and β-phenylethylamine are abundant in fermented foods. Recently, a family of human trace amine-associated receptors (hTAARs) was discovered that responds to these compounds. This study examined the expression of hTAAR genes in five human organs. Among them, the stomach expressed hTAAR1 and hTAAR9. Interestingly, more hTAAR1 was expressed in the pylorus than in the other stomach regions. The CRE-SEAP reporter assay revealed that only hTAAR1 functioned as a Gs-coupled receptor in response to tyramine and β-phenylethylamine stimulation. The β-phenylethylamine-mediated hTAAR1 activity could be potentiated using 3-isobutyl-1-methylxanthine. These data suggest that tyramine and β-phenylethylamine in fermented foods act at hTAAR1 as agonists in the pylorus of stomach.

  4. [Use of spasmolytic agent otilonium bromide (spasmomen) in digestive endoscopy: a prospective study in 63 patients]. (United States)

    Gómez, N A; León, C J; Gutiérrez, J


    Otilonium bromide is a calcium antagonist with a direct myolytic effect, that is indicated in spastic conditions and functional dyskinesias of the gastroenteric apparatus (irritable bowel syndrome) and as a premedication for gastrointestinal endoscopic procedures. The present study assessed otilonium bromide 40 mg PO the night before and 40 mg PO the morning in 49 upper and 14 lower flexible endoscopies in 63 patients, to determine the presence or absence of peristalsis and relaxation of the pylorus. No side effects were observed due to the medication. In 46 (93.8%) upper endoscopies marked relaxation of the gastrointestinal tract and also pylorus relaxation were observed. In 13 (92.8%) lower endoscopies, marked relaxation of the colonic tract was also seen. All patients tolerated well the endoscopies. Otilonium bromide was useful as premedication in order to enable upper and lower endoscopic explorations, because of its spasmolytic effect.

  5. Gastric Adenocarcinoma Presenting with Gastric Outlet Obstruction in a Child

    Directory of Open Access Journals (Sweden)

    Abdulrahman Al-Hussaini


    Full Text Available Gastric carcinoma is extremely rare in children representing only 0.05% of all gastrointestinal malignancies. Here, we report the first pediatric case of gastric cancer presenting with gastric outlet obstruction. Upper endoscopy revealed a markedly thickened antral mucosa occluding the pylorus and a clean base ulcer 1.5 cm × 2 cm at the lesser curvature of the stomach. The narrowed antrum and pylorus underwent balloon dilation, and biopsy from the antrum showed evidence of Helicobacter pylori gastritis. The biopsy taken from the edge of the gastric ulcer demonstrated signet-ring-cell type infiltrate consistent with gastric adenocarcinoma. At laparotomy, there were metastases to the liver, head of pancreas, and mesenteric lymph nodes. Therefore, the gastric carcinoma was deemed unresectable. The patient died few months after initiation of chemotherapy due to advanced malignancy. In conclusion, this case report underscores the possibility of gastric adenocarcinoma occurring in children and presenting with gastric outlet obstruction.

  6. Symptomatic Morgagni′s hernia in an elderly patient

    Directory of Open Access Journals (Sweden)

    Rai Santosh


    Full Text Available Hernia of Morgagni occurs through an anterior defect in the diaphragm. Symptoms of these hernias are attributable to the herniated viscera. In our case, there was partial obstruction due to herniation of the distal stomach and pylorus into the right hemithorax that was reduced surgically through a right thoracolapaorotomy. Of special emphasis are the various modalities used to diagnose this condition in our case.

  7. Immunoglobulin G4-related disease with recurrent obstructive jaundice

    Directory of Open Access Journals (Sweden)

    Yu-Hsiang Chiu


    Full Text Available A 51-year-old man was referred to our clinic for recurrent obstructive jaundice and underwent pylorus-preserving pancreaticoduodenectomy for a suspected malignancy. The pathology showed immunoglobulin G4 positive plasma cell infiltrated at the pancreas and the gallbladder. We discuss the cost-effectiveness of serum immunoglobulin G4 level prior to arranging for a pancreaticoduodenectomy, which would reduce the possibility of surgical complications as well as costs.

  8. Synthesis and antiulcer activity of 2-[5-substituted-1--benzo(d) imidazol-2-yl sulfinyl]methyl-3-substituted quinazoline-4-(3) ones

    Indian Academy of Sciences (India)

    Avinash Patil; Swastika Ganguly; Sanjay Surana


    2-[5-substituted-1--benzo(d)imidazol-2-yl sulfinyl]methyl-3-substituted quinazoline-4-(3)-one derivatives were synthesized and tested for antiulcer activity against pylorus ligation-induced, aspirin induced and ethanol induced ulcer in rat model. All the synthesized compounds were characterized by using IR, MS and 1H NMR spectral and elemental analysis. The compounds were scramed for their antiulcer activity: compounds 5k and 5n showed higher activity than omeprazole used as standard.

  9. Regeneration of the vagus nerve after highly selective vagotomy, an autoradiographic study in the ferret stomach .


    Al Muhtaseb, M. H. [محمد هاشم المحتسب; Abu-Khalaf, M.


    This study investigates the regeneration of the vagal nerve fibres after highly selective vagotomy in the ferret stomach by using the autoradiographic technique. Autoradiographic examination of the body of the stomach in the acute experimental animals has failed to show any labelled nerve fibres after highly selective vagotomy while the pylorus has shown many labelled nerve fibres . These observations indicate that the highly selective vagotomy has been performed properly and adequately. ...

  10. A case of peribiliary cysts accompanying bile duct carcinoma

    Institute of Scientific and Technical Information of China (English)

    Fumihiko Miura; Tadahiro Takada; Hodaka Amano; Masahiro Yoshida; Takahiro Isaka; Naoyuki Toyota; Keita Wada; Kenji Takagi; Kenichiro Karo


    A rare case of peribiliary cysts accompaying bile duct carcinoma is presented. A 54-year-old man was diagnosed as having lower bile duct carcinoma and peribiliary cysts by diagnostic imaging. He underwent pylorus preserving pancreatoduodenectomy. As for the peribiliary cysts, a course of observation was taken.Over surgery due to misdiagnosis of patients with biliary malignancy accompanied by peribiliary cysts should be avoided.

  11. A Case of Stenotic Change from Gastric Candidiasis Managed with Temporary Stent Insertion


    Joo, Moon Kyung; Park, Jong-Jae; Lee, Beom Jae; Kim, Ji Hoon; Yeon, Jong Eun; Kim, Jae Seon; Byun, Kwan Soo; Bak, Young-Tae


    Invasive gastric Candida infection in patient with co-morbidity can cause stenotic change if it is developed at anatomically narrowing portion, such as distal antrum, pylorus, or duodenal bulb. However, proper management of benign stenosis by diffuse gastric Candidasis is still under controversy and palliative bypass surgery has several shortcomings because high risk operative group may be included in this case. Palliative placement of self-expandable metallic stent has been settled as a stan...

  12. Endoscopic excision of a prolapsing malignant polyp which caused intermittent gastric outlet obstruction

    Institute of Scientific and Technical Information of China (English)

    Huqh J Freeman


    A 69-year-old male with chronic lymphocytic leukemia presented with iron deficiency anemia and post-prandial abdominal fullness. Endoscopy showed a large polyp on a stalk, protruding through the pylorus into the duodenum causing intermittent gastric outlet obstruction. While prolapsing gastric antral polyps are usually benign and hyperplastic, inflammatory or regenerative in type, excisional snare polypectomy here led to complete resolution of his symptoms, but showed a malignant polyp.

  13. Effect of lycopene against gastroesophageal reflux disease in experimental animals


    Giri, Arvind Kumar; Rawat, Jitendra Kumar; Singh, Manjari; Gautam, Swetlana; Kaithwas, Gaurav


    Background Lycopene is a robust antioxidant with significant antiulcer activity. Henceforth, the present study was ventured to elucidate the effect of lycopene on experimental esophagitis. Methods Groups of rats were subjected to forestomach and pylorus ligation with subsequent treatment with lycopene (50 and 100 mg/kg, po) and pantoprazole (30 mg/kg, po). Results Treatment with lycopene evidenced sententious physiological protection when scrutinized for pH, acidity (total and free), volume o...

  14. Anti-ulcer effects of Lycium barbarum polysaccharide in rats

    Institute of Scientific and Technical Information of China (English)

    YE Rui-dong; YANG Qian-zi; XIAO Wei; LIU Fang-e; CHEN Jian-kang


    Objective: To investigate the effects of Lycium barbarum polysaccharide (LBP) on experimental gastric ulcers in rats. Methods: The ulcers were induced by water-immersion restraint stress, acetic acid and pylorus-ligation in rats. In each model, animals were divided randomly into 4 groups and administrated with LBP of 100 mg/kg and 300 mg/kg, ranitidine 100 mg/kg (as a reference standard) and saline respectively. Mucosal lesions were scored as ulcer index. In the pylorus-ligation model, we also compared the gastric juice volume, total acidity, acid output and pepsin activity among groups. Results: Oral administration of LBP inhibited the formation of the acute gastric lesions induced by physical stress such as water-immersion restraint (P<0.05), and accelerated the healing of chronic gastric ulcer model induced by acetic acid (P<0.05 to P<0.01). In the pylorus-ligated rats, significant decrease was also seen in ulcer index (P<0.05 to P<0.01), total acidity (P<0.05), acid output (P<0.05 to P<0.01). LBP 300 mg/kg even showed marked reduction of the volume (P<0.05) and pepsin activity (P<0.05) in the gastric juice. These effects were in a dose-dependent manner. Conclusion: LBP has protective effects on treating gastric ulcer and this action may relate to the reduction of acid output and pepsin activity in the gastric juice.

  15. Effect of centrally administered oxytocin on gastric and duodenal ulcers in rats%脑室注射催产素对大鼠胃和十二指肠溃疡的作用

    Institute of Scientific and Technical Information of China (English)

    Mohammed ASAD; Deepak Gopal; Kallasam KOUMARAVELOU; Benny K ABRAHAM; Sadashivam VASU; Subramanian RAMASWAMY


    AIM: To investigate the effect of centrally administered oxytocin and its receptor antagonist, atosiban, on gasuic acid secretion and on experimentally induced gastric and duodenal ulcers. METHODS: The acute gastric ulcer models, such as pylorus ligation, indomethacin-induced and ethanol-induced gastric ulcers were used. Chronic gastric ulcers were induced by acetic acid and duodenal ulcers by cysteamine HC1. RESULTS: In pylorus ligated rats, oxytocin ( 10 μg/kg, icv) showed signifi cant antisecretory and antiulcer activity (P<0.01 ). However, it aggravated the ethanol-induced gastric ulcers and did not show any effect on indomethacin-induced gas tric ulcers. Oxytocin increased gastric ulcer healing in acetic acid-induced chronic gastric ulcers. The effect of oxytocin was reversed by atosiban (10 μg/kg, icy), a selective oxytocin receptor antagonist. Atosiban when given alone increased gastric acid secretion and ulcer index in pylorus-ligated rats and also aggravated acetic acid-induced chronic gastric ulcers. It seems the antiul cer activity of oxytocin was due to its anti-secretory ef fect. CONCLUSION: Centrally administered oxytocin possesses gastric anti-secretory and anti-ulcer activity and oxytocin antagonist, atosiban, is pro-ulcerogenic in rats.

  16. Single port laparoscopic assisted pyloromyotomy: our experience

    Directory of Open Access Journals (Sweden)

    Appignani Antonino


    Full Text Available Background Ramstedt pyloromyotomy is the procedure of choice for infantile hypertrophic pyloric stenosis; however, the best way to approach the pylorus is debated. Recent literature reports many comparisons between various open and laparoscopic approaches. The purpose of this experience is to show a new approach to infantile hypertrophic pyloric stenosis: single-port, laparoscopic-assisted pyloromyotomy. Methods: 31 infants underwent single-port laparoscopic-assisted pyloromyotomy. The approach to the abdominal cavity is performed through a right circumbilical incision, and then a 12-mm trocar is inserted. After the pneumoperitoneum is established, an operative telescope is introduced. Once the telescope is inserted, the pylorus is easily located, and then grasped and exteriorized via the umbilical incision. At this point, conventional Ramstedt pyloromyotomy is performed. Once the pylorus is reintroduced in the abdomen, a new pneumoperitoneum is created to control mucosal integrity and hemostasis. Results. In all 31 cases operated on, an adequate pyloromyotomy was performed in a good ranging time without any intra- or post-operative complications, achieving also excellent cosmetic results. Conclusions The feasibility of single-port laparoscopic assisted pyloromyotomy obtained in this small sample suggests that this procedure could be an excellent alternative to open or laparoscopic pyloromyotomy as long as it acts as intermediary between the two techniques.

  17. Fluoroscopy-guided gastric peroral endoscopic pyloromyotomy (G-POEM): a more reliable and efficient method for treatment of refractory gastroparesis. (United States)

    Xue, H B; Fan, H Z; Meng, X M; Cristofaro, S; Mekaroonkamol, P; Dacha, S; Li, L Y; Fu, X L; Zhan, S H; Cai, Q


    Prior studies show promising results of the gastric peroral endoscopic pyloromyotomy (G-POEM) procedure for treatment of refractory gastroparesis. One major technical challenge involved in this procedure is identifying the pyloric muscular ring (PMR). The aim of this study is to establish a reliable method for identification of the PMR during G-POEM. Fluoroscopy-guided G-POEM was performed by placing an endoclip at the 9 to 11'o clock position at the pylorus for identification of PMR. Conventional G-POEM was performed by observation of blue colored mucosa at the pylorus area as an indirect marker for PMR. The degree of the PMR identification was graded into well identified, identified, and not identified based on the appearance of the PMR. Procedure times were accurately documented. Gastroparesis cardinal symptoms index and gastric emptying scintigraphy were evaluated before and after the procedure. Fourteen patients were studied, seven underwent fluoroscopy-guided G-POEM, and seven patients underwent conventional G-POEM. All procedures achieved technical success and no adverse events occurred. In the seven patients who underwent fluoroscopy-guided G-POEM, the PMR was well identified in four patients and identified in three patients. In the seven patients who underwent conventional G-POEM, the PMR was identified in four patients and not identified in three patients. The average time to complete the fluoroscopy-guided G-POEM was significantly shorter than that of the conventional G-POEM. Fluoroscopy-guided G-POEM by placement of an endoclip at the pylorus was a reliable and safe method to direct the orientation of the submucosal tunnel, to facilitate the location of the PMR, and to shorten the procedure time.

  18. Antiulcer Activity of Methanol Extract of Erythrina indica Lam. Leaves in Experimental Animals

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    S Sakat Sachin


    Full Text Available Gastric ulcer is one of the most prevalent gastrointestinal disorders, which affects approximately 5-10% of people during their life. In recent years, abundant work has been carried out on herbal medicine to clarify their potential efficacy in gastric ulcer prevention or management. Here, present study was carried out to investigate antiulcer activity of methanol extract of Erythrina indica (family: Febaceae leaves in pylorus ligated and indomethacin induced ulceration in the albino rats. Preliminary methanol extract of E. indica was subjected to the acute oral toxicity study according to the OECD guideline no. 423. Based on which, three dose levels i.e. 125, 250 and 500mg/kg were selected for the further study. In pylorus ligation induced ulcer model, various parameters were studied viz. gastric volume, pH, total acidity free acidity, and ulcer index. Ulcer index and percentage inhibition of ulceration was determined for indomethacin induced ulcer model. Ranitidine at 100mg/kg was used as the standard drug. Pretreatment of methanol extract of E. indica leaves showed significant (P< 0.01 decrease in the gastric volume, total acidity and free acidity. However, pH of the gastric juice was significantly (P< 0.05 increased only at higher dose, 500mg/kg. It showed also significant (P< 0.01 decrease in number of ulcers and ulcer score index in pylorus ligation and indomethacin induced ulceration models. The methanol extract of E. indica leaves possess significant antiulcer properties in a dose dependent manner. In conclusion the antiulcer properties of the extract may be attributed to the polyphenolic compounds that are present in it.

  19. Gastroprotective activity of α-terpineol in two experimental models of gastric ulcer in rats

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    JS Batista


    Full Text Available Background and the purpose of the study: Several plant essential oils, as well as terpenes present in essential oils, have shown gastroprotective activity. The aim of the present work was to evaluate the gastroprotective activity of α-terpineol, a monoterpene alcohol which is present in essential oils of various plants. Methods: The gastroprotective activity of α-terpineol was evaluated in rats by assessing the changes in ethanol and indomethacin-induced gastric ulcer scores and on gastric secretory volume and total acidity in pylorus-ligated rats. Alpha-terpineol was administrated orally at the doses of 10, 30, and 50 mg/kg one hour before administration of the ulcer inducing agents by the pylorus ligation procedure. The involvement of endogenous prostaglandins in the protective effect of α-terpineol in ethanol-induced gastric lesions test was assessed by administration of indomethacin (10 mg/kg, s.c. 30 min before oral administration of α-terpineol at the dose of 50 mg/kg. Results: α-terpineol presented gastroprotective activity against ethanol-induced ulcers at the doses of 10, 30, and 50 mg/kg. Epoxy-carvone at the dose of 10 mg/kg did not present gastroprotective activity against ulcer induced by indomethacin, but at the doses of 30 and 50 mg/kg it attenuated the gastric damages induced by this agent significantly. Pretreatment with indomethacin did not prevent the gastroprotective effect of α-terpineol on ethanol-induced ulcers. Alpha-terpineol also did not affect the gastric secretion in pylorus-ligated rats. Major conclusion: The results suggest that α-terpineol presents gastroprotective action which does not involve either an increase in the synthesis of endogenous prostaglandin or a decrease in the gastric acid secretion.

  20. Synchronous Epithelioid Stromal Tumour and Lipoma in the Stomach

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    Nabeel Al-Brahim


    Full Text Available An 82-year-old man presented with upper gastrointestinal bleeding. A polypoid lesion of the distal stomach with focal ulceration was seen at endoscopy. This was treated by a partial gastrectomy. The resected stomach contained two separate tumours near the pylorus: a gastrointestinal stromal tumour (GIST and an adjacent lipoma. The literature includes case reports of synchronously occurring GIST and adenocarcinoma, GIST and mucosa-associated lymphoid tissue lymphoma and GIST and carcinoid tumour. Herein is the first case report of two distinct mesenchymal tumors coexisting in the stomach.

  1. How I Do It: Per-Oral Pyloromyotomy (POP). (United States)

    Allemang, Matthew T; Strong, Andrew T; Haskins, Ivy N; Rodriguez, John; Ponsky, Jeffrey L; Kroh, Matthew


    Several surgical treatments exist for treatment of gastroparesis, including gastric electrical stimulation, pyloroplasty, and gastrectomy. Division of the pylorus by means of endoscopy, Per-Oral Pyloromyotomy (POP), is a newer, endoluminal therapy that may offer a less invasive, interventional treatment option. We describe and present a video of our step by step technique for POP using a lesser curvature approach. The following are technical steps to complete the POP procedure from the lesser curve approach. In our experience, these methods provide promising initial results with low operative risks, although long-term outcomes remain to be determined.

  2. The use of double-balloon enteroscopy in retrieving mucosal biopsies from the entire human gastrointestinal tract

    DEFF Research Database (Denmark)

    Rhee, Nicolai Alexander; Vilmann, Peter; Hassan, Hazem


    OBJECTIVE: The aim of this explorative study was to evaluate double-balloon enteroscopy (DBE) as a new tool for collecting mucosal biopsies from well-defined parts of the entire small and large bowel in patients with type 2 diabetes and in matched healthy subjects. MATERIAL AND METHODS: Twelve su...... possibility to access hitherto unexplored human anatomy and physiology....... subjects with type 2 diabetes and 12 body mass index and age-matched healthy subjects underwent anterograde and retrograde DBE under nurse-administered propofol sedation on two separate days. We attempted to collect two mucosal biopsies from every 30 cm from pylorus to rectum. RESULTS: A mean of 21 biopsy...

  3. Effect of Monotherapy and Combination Therapy of Pantoprazole and Aprepitant in Gastric Esophageal Reflux Disease in Albino Rats


    Kamleshwar Shukla; Prince Raj; Arun Kumar(University of Delhi, Delhi, India); Mukesh Kumar; Gaurav Kaithwas


    The present study was undertaken to elucidate the effect of pantoprazole and aprepitant on experimental esophagitis in albino rats. Groups of rats, fasted overnight, received normal saline (3 mL/kg, sham control) or toxic control (3 mL/kg) or pantoprazole (30 mg/kg) or aprepitant (10 mg/kg), or their combinations and were subjected to pylorus and forestomach ligation. Animals were sacrificed after 8 h and evaluated for the gastric pH, volume of gastric juices, total acidity, esophagitis index...

  4. The Structure of Stomach and Intestine of Triturus karelinii(Strauch, 1870) and Mertensiella luschani (Steindachner, 1891) (Amphibia: Urodela) - Histological and Histometical Study



    In this study, the stomach and small intestine structures of M. luschani and T. karelinii were evaluated in terms of histologically and histometrically.Thestomach and small intestine tissues of M. luschani and T. karelinii have similar characteristics.Mucosa consists of lamina propria/submucosa, tunica muscularis and tunica serosa layers. Histometrical results shows that M. luschani’s fundus (t=0,003; p<0,05) and pylorus (t=0,000; p<0,05) epithelial thickness and mean lumen area (t=0,00...

  5. Role of putative neurotransmitters in the central gastric antisecretory effect of prostaglandin E2 in rats.


    Puurunen, J.


    The role of putative neurotransmitters of the central nervous system in the central gastric antisecretory effect of prostaglandin E2 (PGE2) was investigated in pylorus-ligated rats. Pretreatment of the rats with an intracerebroventricular (i.c.v.) injection of 6-hydroxydopamine (6-OHDA) prevented the antisecretory effect of the i.c.v. administration of PGE2, whereas pretreatment with 5,6-dihydroxytryptamine (5,6-DHT) plus p-chlorophenylalanine (PCPA) had no effect. I.c.v.-administered phentol...

  6. Subnuclear globules in simple mucinous glands of the gastrointestinal tract

    DEFF Research Database (Denmark)

    Holck, Susanne; Ingeholm, P.


    Pyloric and duodenal Brunner glands may be the site of a peculiar cytoplasmic change characterized by clear vacuoles or glassy eosinophilic globules, occupying a subnuclear position with displacement of the nuclei towards the lumenal surface. To our knowledge this previously documented,5,6 althou...... rarely described cellular phenomenon has not previously been recorded in extrapyloric/duodenal sites. During a 5-year period, we have noticed 3 such cases involving the simple gastrointestinal mucinous glands, 2 of which occurring in sites outsides the pylorus and duodenum....

  7. Immunohistochemical study on localization of serotonin immunoreactive cells in the gastrointestinal tract of the European catfish (Silurus glanis, L.). (United States)

    Köprücü, S; Yaman, M


    In this study, it was aimed to identify the distribution of serotonin immunoreactive cells within the gastrointestinal tract (GIT) of European catfish (Silurus glanis). For this purpose, the tissue samples were taken from the stomach (cardia, fundus and pylorus region) and intestine (anterior, middle and posterior region). They were examined by applying the avidin-biotin-immunoperoxidase method. The serotonin containing immunoreactive cells are presented in all regions of the GIT. It was determined to be localized generally in different distribution within the stomachs and intestines of S. glanis. It was found that the most intensive regions of immunoreactive cells were the cardia stomach and posterior of intestine.

  8. Distal gastrectomy in pancreaticoduodenectomy is associated with accelerated gastric emptying, enhanced postprandial release of GLP-1, and improved insulin sensitivity

    DEFF Research Database (Denmark)

    Harmuth, Stefan; Wewalka, Marlene; Holst, Jens Juul


    OBJECTIVE: This study aims to investigate the relationship between gastric emptying, postprandial GLP-1 and insulin sensitivity after pancreaticoduodenectomy (PD). BACKGROUND: Abnormal glucose regulation is highly prevalent in patients with pancreatic neoplasm and resolves in some after PD......, the cause of which is unclear. The procedure is carried out with pylorus preservation (PPPD) or with distal gastrectomy (Whipple procedure). Accelerated gastric emptying and ensuing enhanced release of glucagon-like peptide-1 (GLP-1) conceivably play a role in glucose metabolism after PD. It was the purpose...

  9. Laparoscopic Pancreaticoduodenectomy for the Management of Localized Crohn's Disease of the Duodenum. (United States)

    Xingjun, Guo; Feng, Zhu; Min, Wang; Renyi, Qin


    Crohn's disease of the duodenum is an uncommon condition. Our case was an extremely rare manifestation of Crohn's disease, who presented with obstruction of the pylorus and the first and the second parts of the duodenum. Because of the severity of the obstruction, he underwent laparoscopic pancreaticoduodenectomy. Postoperative pancreatic leakage and bowel fistula were not observed, and there was no morbidity during the follow-up period. There was also no disturbance in digestive function, postoperatively. This is the first case employing laparoscopic pancreaticoduodenectomy to cure benign lesions leading to duodenal obstruction. Minimally invasive laparoscopic pancreaticoduodenectomy technology shows a very big advantage in treating this rare benign Crohn's disease.

  10. Function-preserving gastrectomy for gastric cancer in Japan (United States)

    Nomura, Eiji; Okajima, Kunio


    Surgery used to be the only therapy for gastric cancer, and since its ability to cure gastric cancer was the focus of attention, less attention was paid to function-preserving surgery in gastric cancer, though it was studied for gastroduodenal ulcer. Maki et al developed pylorus-preserving gastrectomy for gastric ulcer in 1967. At the same time, the definition of early gastric cancer (EGC) was being considered, histopathological investigations of EGC were carried out, and the validity of modified surgery was sustained. After the development of H2-blockers, the number of operations for gastroduodenal ulcers decreased, and the number of EGC patients increased simultaneously. As a result, the indications for pylorus-preserving gastrectomy for EGC in the middle third of the stomach extended, and various alterations were added. Since then, many kinds of function-preserving gastrectomies have been performed and studied in other fields of gastric cancer, and proximal gastrectomy, jejunal pouch interposition, segmental gastrectomy, and local resection have been performed. On the other hand, from the overall perspective, it can be said that endoscopic resection, which was launched at almost the same time, is the ultimate function-preserving surgery under the current circumstances. The current function-preserving gastrectomies that are often performed and studied are pylorus-preserving gastrectomy and proximal gastrectomy. The reasons for this are that these procedures that can be performed with systemic lymph node dissection, and they include three important elements: (1) reduction of the extent of gastrectomy; (2) preservation of the pylorus; and (3) preservation of the vagal nerve. In addition, these operations are more likely to be performed with a laparoscopic approach as minimally invasive surgery. Of the above-mentioned three elements, reduction of the extent of gastrectomy is the most important in our view. Therefore, we should try to reduce the extent of gastrectomy

  11. A giant trichobezoar causing rapunzel syndrome in a 12-year-old female

    Directory of Open Access Journals (Sweden)

    Nadeem Ul Nazeer Kawoosa


    Full Text Available Bezoar is a tightly packed collection of undigested material that is unable to exit the stomach. Most bezoars are of indigestible organic matter such as hair-trichobezoars; or vegetable and fruit-phytobezoars; or a combination of both. Trichobezoars commonly occur in patients with psychiatric disturbances who chew and swallow their own hair. In very rare cases, the Rapunzel syndrome hair extends through the pylorus into the small bowel causing symptom and sign of partial or complete gastric outlet obstruction. A case report of trichobezoar in the stomach causing Rapunzel syndrome in a 12-year-old female is reported.

  12. 血行性腎カンジダ症による急性腎不全を合併した胃幽門部癌の1例



    A 67-year-old man was referred to our hospital because of high-grade fever and acute renal failure on January 11, 1996. Gastroduodenal fiberscopy performed 17 days before admission revealed advanced gastric cancer in the pylorus. Intravenous hyper- alimentation was started on December 27, 1995. Because of the fever, the patient had been treated with 5mg/day of indomethacin and 2g/day of cefazolin since January 1, 1996. Serum creatinine was elevated to 8.2mg/dl. To rule out acute interstitial ...

  13. Bouveret syndrome: gallstone ileus of the duodenum. (United States)

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


    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.

  14. Expression of Cocaine and Amphetamine Regulated Transcript (CART) in the Porcine Intramural Neurons of Stomach in the Course of Experimentally Induced Diabetes Mellitus. (United States)

    Bulc, Michał; Gonkowski, Sławomir; Całka, Jarosław


    In the present study, the effect of streptozotocin-induced diabetes on the cocaine- and amphetamine-regulated transcript-like immunoreactive (CART-LI) enteric nervous structures was investigated within the porcine stomach. To induce diabetes, the pigs were administered intravenously streptozotocin at a dose of 150 mg/kg of body weight. A significant decrease of the number of CART-LI perikarya was observed in the myenteric plexus of the gastric antrum, corpus, and pylorus in the experimental group. In contrast, submucous plexus was devoid of CART-positive neuronal cells both in control and experimental animals. In the control group, the highest densities of CART-LI nerve fibers were observed in the circular muscle layer of antrum and slightly less nerve fibers were present in the muscle layer of corpus and pylorus. In turn, submucous layer of all studied stomach regions revealed relatively smaller number of CART-positive nerve fibers. Diabetes caused statistically significant decrease in the expression of CART-LI nerve fibers only in the antrum circular muscle layer. Also, no changes in the CART-like immunoreactivity in the intraganglionic nerve fibers were observed. The obtained results suggest that acute hyperglycemia produced significant reduction of the CART expression in enteric perikarya throughout entire stomach as well as decrease of density the CART-LI fibers in circular muscle layer of the antrum. Additionally, we suggest that CART might be involved in the regulation of stomach function especially in the gastric motility.

  15. Influence of renovascular hypertension on the distribution of vasoactive intestinal peptide in the stomach and heart of rats. (United States)

    Kasacka, Irena; Piotrowska, Żaneta; Janiuk, Izabela


    Arterial hypertension is associated with serious dysfunction of the cardiovascular system and digestive system. Given the relevant role of vasoactive intestinal peptide (VIP) in the regulation of digestion process, control of blood pressure and heart rate as well as cardio- and gastro-protective character of the peptide, it appeared worthwhile to undertake the research aimed at immunohistochemical identification and evaluation of VIP-positive structures in the pylorus and heart of hypertensive rats. Up to now, this issue has not been investigated. The experimental model of hypertension in rats according to Goldblatt (two-kidney one clip model of hypertension) was used in the study. The experimental material (pylorus and heart) was collected in the sixth week of the study. VIP-containing structures were evaluated using immunohistochemical and morphometric methods. The analysis of the results showed a significant increase in the number of immunoreactive VIP structures and in the intensity of immunohistochemical staining in the stomach and in the heart of hypertensive rats. Our findings indicate that VIP is an important regulator of cardiovascular and digestive system in physiological and pathological conditions. However, to better understand the exact role of VIP in hypertension further studies need to be carried out.

  16. Adult hypertrophic pyloric stenosis due to peptic ulcer disease: a rare presentation

    Directory of Open Access Journals (Sweden)

    Shameer Deen


    Full Text Available Primary adult hypertrophic stenosis is uncommon with an uncertain etiopathogenesis and associated gastric outlet obstruction mimics gastric carcinoma. We present a case of AHPS as sequel of peptic ulcer disease in a 72 year old male. With the advent of proton pump inhibitors as a mainstay of medical therapy, complication into gastric outlet obstruction is a rare disease today. Upper GI endoscopy revealed a distended stomach, residual food and a hyperemic bulky pylorus not accommodating the endoscope. Barium meal follow-through revealed a dilated stomach and minimal barium passing through the pylorus. Histological analysis revealed mild dysplasia at the focus with dense inflammatory infiltrates composed of lymphocytes and eosinophils in the lamina propria. No evidence of malignancy was noted, favouring chronic gastritis. The condition mimics other forms of proliferative disorders like carcinoma, gastrointestinal stromal tumors. We present the clinical findings, imaging analysis and discuss etiopathogenesis and management. [Int J Res Med Sci 2016; 4(5.000: 1730-1732

  17. Rocket " Eruca sativa": A salad herb with potential gastric anti-ulcer activity

    Institute of Scientific and Technical Information of China (English)

    Saleh Alqasoumi; Mohammed Al-Sohaibani; Tawfeq Al-Howiriny; Mohammed Al-Yahya; Syed Rafatullah


    AIM: To validate gastric anti-ulcer properties of Rocket " Eruca sativa" on experimentally-induced gastric secretion and ulceration in albino rats.METHODS: Gastric acid secretion studies were undertaken using pylorus-ligated rats. Gastric lesions in the rats were induced by noxious chemicals including ethanol, strong alkalis, indomethacin and hypothermic restraint stress. The levels of gastric wall mucus (GWM), nonprotein sulfhydryls (NP-SH) and malondialdehyde (MDA) were also measured in the glandular stomach of rats following ethanol administration. The gastric tissue was also examined histologically. The extract was used in two doses (250and 500 mg/kg body weight) in all experiments.RESULTS: In pylorus-ligated Shay rats, the ethanolic extract of Rocket " Eruca sativa L." (EER) significantly and dose-dependently reduced the basal gastric acid secretion, titratable acidity and ruminal ulceration.Rocket extract significantly attenuated gastric ulceration induced by necrotizing agents (80% ethanol,0.2 mol/L NaOH, 25% NaCl), indomethacin and hypothermic restraint stress. The anti-ulcer effect was further confirmed histologically. On the other hand,the extract significantly replenished GWM and NP.SH levels, as well as the MDA level significantly reduced by extract pretreatment.

  18. Using a modification of the Clavien-Dindo system accounting for readmissions and multiple interventions: defining quality for pancreaticoduodenectomy. (United States)

    Baker, Marshall S; Sherman, Karen L; Stocker, Susan J; Hayman, Amanda V; Bentrem, David J; Prinz, Richard A; Talamonti, Mark S


    The Clavien-Dindo system (CD) does not change the grade assigned a complication when multiple readmissions or interventions are required to manage a complication. We apply a modification of CD accounting for readmissions and interventions to pancreaticoduodenectomy (PD). PDs done between 1999 and 2009 were reviewed. CD grade IIIa complications requiring more than one intervention and II and IIIa complications requiring significantly prolonged lengths of stay including all 90-day readmissions were classified severe-adverse-postoperative-outcomes (SAPO). CD IIIb, IV, and V complications were also classified SAPOs. All other complications were considered minor-adverse-postoperative-outcomes (MAPO). Four-hundred forty three of 490 PD patients (90.4%) had either no complication or a complication of low to moderate CD grade (I, II, IIIa). When reclassified by the new metric, 92 patient-outcomes (19%) were upgraded from CD II or IIIa to SAPO. One-hundred thirty nine patients (28.4%) had a SAPO. Multivariable regression identified age >75 years, pylorus preservation and operative blood loss >1,500 ml as predictors of SAPO. Age was not associated with poor outcome using the unmodified CD system. Established systems may under-grade the severity of some complications following PD. We define a procedure-specific modification of CD accounting for readmissions and multiple interventions. Using this modification, advanced age, pylorus preservation, and significant blood loss are associated with poor outcome. © 2014 Wiley Periodicals, Inc.

  19. High-resolution analysis of the duodenal interdigestive phase III in humans. (United States)

    Castedal, M; Abrahamsson, H


    To study the spatial organization of the propagating pressure waves of duodenal phase III, we performed fasting antroduodenal high-resolution manometry with a 16-channel catheter in 12 healthy subjects. The phase III pressure waves diverged in an anterograde and retrograde direction from the start site of each pressure wave. The pressure waves maintained this configuration as the activity front moved distally in the duodenum. The start site of the pressure waves moved gradually to a point approximately 12 cm (median) distal to the pylorus and remained at this point for about 40% of the phase III time before moving further distally. The length of retrograde pressure wave propagation increased to 6 cm (median) as the pressure wave origin moved aborally to a point 10-14 cm distal to the pylorus, and then decreased when the origin of pressure waves reached the distal end of the duodenum. Bidirectional pressure waves dominated in both retrograde and anterograde activity fronts. Three pressure-wave mechanisms behind the duodenal phase IV were observed. Isolated pyloric pressure waves were absent during late duodenal phase III retroperistalsis. Thus, a number of new features of the duodenal phase III-related motility were observed using high-temporospatial resolution recordings.

  20. Lectin histochemistry of gastrointestinal glycoconjugates in the greater horseshoe bat, Rhinolophus ferrumequinum (Schreber, 1774). (United States)

    Scillitani, Giovanni; Zizza, Sara; Liquori, Giuseppa Esterina; Ferri, Domenico


    Mucins in the gastrointestinal tract of Rhinolophus ferrumequinum were investigated by histochemistry and lectin histochemistry to evaluate morphofunctional variations of different regions and their possible physiological and evolutionary implications. Histochemical methods included periodic acid-Schiff (PAS), Alcian blue (AB) at pH 2.5 and 1.0 and high-iron-diamine AB pH 2.5. Binding of lectins Con A, DBA, WGA, LTA, LFA, PNA and SBA; LFA, PNA and SBA with prior sialidase treatment; and paradoxical Con A were evaluated. The oesophagus lacked glands. The stomach was divided into a short cardias, a wide fundus and a brief pylorus. The surface muciparous cells secreted sulpho- and sialomucins with N-acetylgalactosamine (GalNAc) residues, N-acetyllactosamine and (beta1,4 N-acetylglucosamine)(n) chains. Towards the pylorus, N-acetylgalactosamine residues disappeared and acidity decreased. Cardiac glands, neck cells in the fundic glands, pyloric and duodenal Brunner's glands all shared neutral, stable class-III mucins, mainly with N-acetylgalactosamine sequences. The intestine was divided into a duodenum, a jejuno-ileum and a short rectum. The goblet cells produced sulpho- and sialomucins with sialylated N-acetylgalactosamine sequences, (beta1,4 N-acetylglucosamine)(n) and N-acetyllactosamine, whose sialylation increased towards the rectum. The main features of the mucins are probably associated with the requirements of fast absorption and food passage and in protection against mechanical and pathogenic injuries.

  1. Gastroprotective Effect of the Ethanolic Extract and Fractions obtained from Syngonanthus bisulcatus Rul.

    Directory of Open Access Journals (Sweden)

    Leônia Maria Batista


    Full Text Available Syngonanthus bisulcatus Rul., popularly known in Brazil as “sempre-vivas chapadeira”, is a plant of the family Eriocaulaceae, it is found in the states of Minas Gerais and Bahia. In this work, the ethanolic extract (EtOHE, flavonoid-rich (FRF, and flavonoid-deficient (FDF fractions obtained from scapes of S. bisulcatus were investigated for gastroprotection in both rats and mice. The activity was evaluated in models for induced gastric ulcer (absolute ethanol, stress, non-steroidal anti-inflammatory drugs, and pylorus ligation. The participation of mucus and prostaglandin E 2 were also investigated. Sb-EtOHE (50, 100, and 250 mg/kg, p.o., Sb-FRF (100 mg/kg, p.o., and Sb-FDF (100 mg/kg, p.o. significantly reduced gastric injuries in all models. Sb- FRF altered gastric juice parameters after pylorus ligation. Sb-FRF and Sb-FDF (100 mg/kg each, p.o. significantly increased the amount of adherent mucus in the gastric mucosa. Sb-FRF maintained the mucosal levels of prostaglandin after the administration of indomethacin. The results indicate that Sb-EtOHE, Sb-FRF and Sb-FDF have significant gastroprotective activity. The observed gastroprotective effects of S.bisulcatus probably involve the participation of both mucus and prostaglandins, integral parts of the gastrointestinal mucosa’s cytoprotective mechanisms against aggressive factors.

  2. Torus hyperplasia of the pyloric antrum. (United States)

    Kim, Chi-Hun; Han, Hye Seung; Lee, Sun-Young; Kim, Byung Kook; Sung, In-Kyung; Seong, Moo Kyung; Lee, Kyung Yung


    Primary or idiopathic hypertrophy of the pyloric muscle in adult, so called torus hyperplasia, is an infrequent but an established entity. It is caused by a circular muscle hypertrophy affecting the lesser curvature near the pylorus. Since most of the lesions are difficult to differentiate from tumor, distal gastrectomy is usually preformed to rule out most causes of pyloric lesions including neoplastic ones through a pathological study. A 56-yr-old man with a family history of gastric cancer presented with abdominal discomfort of 1 month duration. Upper gastrointestinal endoscopy showed a 1.0 cm sized irregular submucosal lesion proximal to the pylorus to the distal antrum on the lesser curvature. On colonoscopy examination, a 1.5 cm sized protruding mass was noticed on the appendiceal orifice. Gastrectomy and cecectomy were done, and histological section revealed marked hypertrophy of the distal circular pyloric musculature and an appendiceal mucocele. To the best of our knowledge, this is the first case of torus hyperplasia with appendiceal mucocele which is found incidentally.

  3. Immunocytochemical Identification and Localization of Diffuse Neuroendocrine System (DNES) Cells in Gastrointestinal Tract of Channel Catfish (Ictalurus punctatus)

    Institute of Scientific and Technical Information of China (English)

    HE Min; WANG Kai-yu; ZHANG Yu


    To detect distribution and relative frequency of diffuse neuroendocrine system (DNES) cells in the gastrointestinal tract of channel catfish (Ictalurus punctatus), the intestinal tract of channel catfish was divided into seven portions from proximal to distal: the enlarged area after oesophagus, cardia, fundus, pylorus, and anterior, middle, and posterior intestine. Immunohistochemical method using the strept avidin-biotin-complex (SABC) was employed. All antisera between seven portions of the channel catfish were compared statistically using statistical package for the social science (SPSS). Five types of DNES cells were determined: neuropeptide Y-immunoreactive (NPY-IR) cells were demonstrated in both anterior and middle intestine; serotonin (5-HT) immunoreactive cells were detected throughout the whole gastrointestinal tract; vasoactive intestinal peptide (VIP) positive cells were at the highest frequency in pylorus; glucagon-immunoreactive (GLU-IR) cells were moderate in number in the fundus and anterior, middle intestine, and no immunoreactivity was determined in the other portions; somatostatin (SOM) positive cells were more abundant in the anterior and middle intestine. The regional distribution and relative frequency of immunoreactive cells in the channel catfish, Ictalurus punctatus, are essentially similar to those of other fish. However, some characteristics are observed in this species, which further proved that the diversity of the physiological function of DNES cells was based on their morphology.

  4. Gastroprotective effect ofAcacia nilotica young seedless pod extract:Role of polyphenolic constituents

    Institute of Scientific and Technical Information of China (English)

    Vijay Kumar Bansal; Rajesh Kumar Goel


    ABSTRACT Objective:To systematically evaluate antiulcer potential ofAcacia nilotica in different ulcer models in rats.Methods:Different extracts [ethanolic,50% hydroethanolic(50:50),70% hydroethanolic(70:30) and aqueous] of young seedless pods were examined in pylorus ligation induced gastric ulcers in rats.Various parameters like, volume of gastric acid secretion, pH, free acidity, total acidity, ulcer index , mucin content and antioxidant studies were determined and were compared between extract treated, standard and vehicle control following ulcer induction. The most active extract was also evaluated in swimming stress induced andNSAID induced gastric ulceration.Results:Among different extracts of young seedless pods only hydroethanolic extracts showed significant antiulcer activity in pyloric ligation induced ulceration.Even more the70% hydroethanolic extract showed better protection as compared to50% hydroethanolic extract.Further70% hydroethanolic extract also showed significant mucoprotection in swimming stress induced and nonsteroidal antiinflammatory drugs induced gastric ulceration.Conclusions:The results of present study concluded that the hydroethanolic extract of young seedless pods of Acacia nilotica has antiulcer activity in pylorus ligation, swimming stress andNSAID induced rat ulcer models.The extract containing more amount of phenolic components show high antiulcer activity, indicating the phenolic component of the extract to be responsible for the activity of the extracts.

  5. Inhibiting renin angiotensin system in rate limiting step by aliskiren as a new approach for preventing indomethacin induced gastric ulcers. (United States)

    Halici, Zekai; Polat, Beyzagul; Cadirci, Elif; Topcu, Atilla; Karakus, Emre; Kose, Duygu; Albayrak, Abdulmecit; Bayir, Yasin


    Previously blocking the renin angiotensin system (RAAS) has been effective in the prevention of gastric damage. Therefore, the aim of this study was to investigate the effects of aliskiren, and thus, direct renin blockage, in indomethacin-induced gastric damage model. Effects of aliskiren were evaluated in indomethacin-induced gastric damage model on Albino Wistar rats. Effects of famotidine has been investigated as standard antiulcer agent. Stereological analyses for ulcer area determination, biochemical analyses for oxidative status determination and molecular analyses for tissue cytokine and cyclooxygenase determination were performed on stomach tissues. In addition, to clarify antiulcer effect mechanism of aliskiren pylorus ligation-induced gastric acid secretion model was applied on rats. Aliskiren was able to inhibit indomethacin-induced ulcer formation. It also inhibited renin, and thus, decreased over-produced Angiotensin-II during ulcer formation. Aliskiren improved the oxidative status and cytokine profile of the stomach, which was most probably impaired by increased Angiotensin II concentration. Aliskiren also increased gastroprotective prostaglandin E2 concentration. Finally, aliskiren did not change the gastric acidity in pylorus ligation model. Aliskiren exerted its protective effects on stomach tissue by decreasing inflammatory cytokines and oxidative stress as a result of inhibiting the RAAS, at a rate-limiting step, as well as its end product, angiotensin II. Aliskiren also significantly increased protective factors such as PGE2, but not affect aggressive factors such as gastric acidity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Gastroprotective and Antiulcer Effects of Celastrus paniculatus Seed Oil Against Several Gastric Ulcer Models in Rats. (United States)

    Palle, Suresh; Kanakalatha, A; Kavitha, Ch N


    Peptic ulcer is a recurrent chronic illness and has become almost a hallmark of the so-called civilized life. In folk medicine, the Celastrus paniculatus plant has been used for the prevention and treatment of various diseases and gastrointestinal disturbances, including dyspepsia and stomach ulcers. The aim of this study is to evaluate the gastroprotective and antiulcer effects of Celastrus paniculatus seed oil (CPO) against several gastric ulcer models in rats. The gastroprotective and antiulcer effects of CPO were evaluated using pylorus-ligated ulcer ethanol- and indomethacin-induced ulcers using rantidine (40 mg/kg per os [PO]) as standard. Gastrointestinal motility was determined by gastric emptying time and gastrointestinal transit ratio. The results of the pharmacological studies of CPO (200 mg/kg, 400 mg/kg) demonstrated effective gastroprotection against ethanol- and indomethacin-induced ulcer models. In pylorus-ligated rats, the seed oil showed gastroprotective activity by decreasing total gastric juice volume and gastric acidity while increasing the gastric pH. The gastroprotection against ethanol and indomethacin is partially attributed to effective inhibition of proinflammatory cytokines, TNF-α and IL-6, and increase in the levels of IL-10. Treatment with CPO in ethanol-induced ulcer rats significantly (p gastric emptying but had no effect on gastrointestinal transit. The present findings indicate that CPO has potent gastroprotective effects and support the folkloric usage of the seed oil to treat various gastrointestinal disturbances.

  7. Effect of Brazilian green propolis on experimental gastric ulcers in rats. (United States)

    de Barros, Muriel Primon; Sousa, João Paulo Barreto; Bastos, Jairo Kenupp; de Andrade, Sérgio Faloni


    Propolis is a resinous hive product collected by honeybees from plants. The propolis produced in Southeastern of Brazil is known as green propolis because of its color. Modern herbalists recommend its use because it displays antibacterial, antifungal, antiviral, hepatoprotective, anti-inflammatory, immunomodulatory and anti-ulcer properties. The anti-ulcer activity of green propolis hydroalcoholic crude extract was evaluated by using models of acute gastric lesions induced by ethanol, indomethacin and stress in rats. Moreover, the effects of extract on gastric content volume, pH and total acidity, using pylorus ligated model were evaluated. Animals pretreated with propolis hydroalcoholic crude extract (50, 250 and 500 mg/kg) showed a significant reduction in lesion index, total affected area and percentage of lesion in comparison with control group (ppropolis extract, at a higher dose (500 mg/kg), displayed a significant protection by reducing (ppropolis extract (250 and 500 mg/kg). Regarding the pylorus ligated model it was observed that green propolis extract (250 and 500 mg/kg) displayed an anti-secretory activity, which lead to a reduction in the gastric juice volume, total acidity and pH. These findings indicate that Brazilian green propolis displays good anti-ulcer activity, corroborating the folk use of propolis preparations, and contributing for its pharmacological validation.

  8. Laparoscopic total pancreatectomy (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing


    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  9. Tibetan herbal formula Padma Digestin modulates gastrointestinal motility in vitro

    Institute of Scientific and Technical Information of China (English)

    Bruno; M; Balsiger; Magali; Krayer; Andreas; Rickenbacher; Beatrice; Flogerzi; Cecile; Vennos; Juergen; M; Gschossmann


    AIM:To examine the effects of Padma Digestin on the smooth muscle motility of different gastrointestinal segments in vitro . METHODS:The effects of the ethanolic extract of Padma Digestin (at 8.16 mg/mL or 81.6mg/mL) on the contractility and susceptibility to acetylcholine (ACh) of muscle strips from the cardia, antrum, pylorus, duodenum, jejunum, ileum and colon of male Wistar rats were analyzed.RESULTS:Compared with the control treatment, the Padma Digestin extract had a procontractile effect on the antral smooth muscle strips. Padma Digestin decreased ACh sensitivity in cardia muscle strips and increased it in those from the antrum and pylorus. In the intestinal segments, spontaneous contractility was inhibited in both the duodenal and jejunal strips, whereas reactivity to ACh was inhibited in the jejunal strips only. In the colonic samples, Padma Digestin inhibited spontaneous and ACh-stimulated contractility at a low dose but seems to have increasing effects at a high dose. CONCLUSION:Padma Digestin extract has regionspecific effects on the contractility and excitability of gastrointestinal smooth muscle. Our results support the traditional use of Padma Digestin for maldigestion and functional gastrointestinal disorders.

  10. Gastroprotective effects of thymol on acute and chronic ulcers in rats: The role of prostaglandins, ATP-sensitive K(+) channels, and gastric mucus secretion. (United States)

    Ribeiro, Ana Roseli S; Diniz, Polyana B F; Pinheiro, Malone S; Albuquerque-Júnior, Ricardo L C; Thomazzi, Sara M


    Thymol, a monoterpene phenol derivative of cymene, is found in abundance in the essential oils of Thymus, Origanum, and Lippia species. The present study investigated the gastroprotective actions of thymol (10, 30, and 100 mg/kg, p.o.) in the acute (ethanol- and nonsteroidal anti-inflammatory drug-induced ulcers) and chronic (acetic acid-induced ulcers) ulcer models in rats. Some of the mechanisms underlying to the gastroprotective effect of thymol were investigated in the ethanol-induced ulcer model. Gastric secretion parameters (volume, pH, and total acidity) were also evaluated by the pylorus ligature model, and the mucus in the gastric content was determined. The anti-Helicobacter pylori activity of thymol was performed using the agar-well diffusion method. Thymol (10, 30, and 100 mg/kg) produced dose dependent reduction (P ulcer model. The gastroprotective response caused by thymol (30 mg/kg) was significantly attenuated (P ulcer index (P ulcer models, respectively. In the model pylorus ligature, the treatment with thymol failed to significantly change the gastric secretion parameters. However, after treatment with thymol (30 and 100 mg/kg), there was a significant increase (P ulcer models through mechanisms that involve increased in the amount of mucus, prostaglandins, and ATP-sensitive K(+) channels.

  11. Upper gastrointestinal burns by peroxyacetic acid in children: a review of seven cases

    Institute of Scientific and Technical Information of China (English)

    Zhibin Niu; Keren Zhang; Weilin Wang


    Objective: To study the clinical features of upper gastrointestinal burns by peroxyacetic acid (PA) in children and improve its treatment and outcome. Methods: The clinical materials of 7 cases with upper gastrointestinal burns by PA including clinical presentation, treatment and outcomes were reviewed. Results: There were six boys and one girl. The concentration of the swallowed PA was from 10% to 20% and the amount was 3-10 ml. The mainly burns were located in esophagus in one case, stomach in three cases, both esophagus and stomach in three cases. The gastrostomy and operation of dilating esophagus were performed in the cases with esophageal stricture. The pyloroplasty or gastroduodenostomy was performed in the cases with pyloric obstruction. All the cases were followed up for 12-18 months, dysfunction of esophagus or(and) cardia as well as stiffness and hypodynamia of the stomach was showed in most of the patients. Conclusion: The degree of upper gastrointestinal burns by PA varied according to different concentrations of PA which was swallowed. Correct emergent measures in the acute stage of the bums was very important, gastric tube should be inserted and go through esophagus and pylorus and must be retained for 5-8 weeks to prevent the stricture of esophagus and pylorus, otherwise the tube could act as a passage of nutriment. Prophylaxis of upper gastrointestinal burns by PA is very important because the treatment of the burns is difficulty and the outcomes are not always satisfactory.

  12. Does antecolic reconstruction decrease delayed gastric emptying after pancreatoduodenectomy?

    Institute of Scientific and Technical Information of China (English)

    Nadia Peparini; Piero Chirletti


    Delayed gastric emptying (DGE) is a frequent complication after pylorus-preserving pancreatoduodenectomy (PpPD).Kawai and colleagues proposed pylorus-resecting pancreatoduodenectomy (PrPD) with antecolic gastrojejunal anastomosis to obviate DGE occurring after PpPD.Here we debate the reported differences in the prevalence of DGE in antecolic and retrocolic gastro/duodeno-jejunostomies after PrPD and PpPD,respectively.We conduded that the route of the gastro/duodeno-jejunal anastomosis with respect to the transverse colon;i.e.,antecolic route or retrocolic route,is not responsible for the differences in prevalence of DGE after pancreatoduodenectomy (PD) and that the impact of the reconstructive method on DGE is related mostly to the angulation or torsion of the gastro/duodeno-jejunostomy.We report a prevalence of 8.9% grade A DGE and 1.1%grade C DGE in a series of 89 subtotal stomach-preserving PDs with Roux-en Y retrocolic reconstruction with anastomosis of the isolated Roux limb to the stomach and single Roux limb to both the pancreatic stump and hepatic duct.Retrocolic anastomosis of the isolated first jejunal loop to the gastric remnant allows outflow of the gastric contents by gravity through a "straight route".

  13. Gastric Wall Thickness and the Choice of Linear Staples in Laparoscopic Sleeve Gastrectomy: Challenging Conventional Concepts. (United States)

    Abu-Ghanem, Yasmin; Meydan, Chanan; Segev, Lior; Rubin, Moshe; Blumenfeld, Orit; Spivak, Hadar


    Little evidence is available on the choice of linear staple reloads in laparoscopic sleeve gastrectomy (LSG). Previous literature recommends matching closed staple height (CSH) to tissue-thickness (TT) to avoid ischemia. Our objective was to examine feasibility and safety of "tight" hemostatic (CSH/TT <1) stapling and map the entire gastric wall TT in LSG patients. Prospectively collected outcomes on 202 consecutive patients who underwent LSG with tight order of staples (Ethicon Endosurgery) in this order: pre-pylorus-black (CSH = 2.3 mm), antrum-green (CSH = 2.0 mm), antrum/body-blue (CSH = 1.5 mm), and white (CSH = 1.0 mm) on the body and fundus. Measurements of entire gastric wall TT were made on the first 100 patients' gastric specimens with an electronic-dogmatic indicator. Study included 147 females and 55 males with a mean age of 41.5 ± 11.9 years and body mass index of 41.5 ± 3.8 kg/m(2). Gastric wall measurements revealed mean CSH/TT ratio <1, decreasing from 0.7 ± 0.1 at pre-pylorus to 0.5 ± 0.1 at the fundus. There were 3.1% mechanical failures, mainly (68%) at pre-pylorus-black reloads. Post-operative bleeding occurred in 5 (2.5%) patients. There were no leaks or clinical evidence of sleeve ischemia. Stepwise regression analysis revealed that body mass index (P < 0.001), hypertension (P < 0.01), and male gender (P < 0.001) were associated with increased gastric TT. Our study suggests that reloads with CSH/TT <1 in LSG including staples with CSH of 1 mm on body and fundus are safe. The results challenge the concept that tight stapling cause's ischemia. Since tight reloads are designed to improve hemostasis, their application could have clinical benefit.

  14. Evaluation of anti-ulcer activity of the leaf extract of Osyris quadripartita Decne. (Santalaceae) in rats (United States)

    Abebaw, Mastewal; Mishra, Bharat; Gelayee, Dessalegn Asmelashe


    Osyris quadripartita (OQ) Salzm. ex Decne. has been used to treat peptic ulcer disease in Ethiopian folk medicine, but its efficacy has not been validated. The present study was therefore carried out to evaluate the anti-ulcer activity of 80% methanol leaf extract of OQ in rats. The effect of OQ extract on gastric ulcer in rats in pylorus ligation-induced and ethanol-induced models was studied using single dosing (100, 200, 400 mg/kg) and repeated dosing (200 mg/kg for 10 and 20 days) approaches. Ranitidine (50 mg/kg) and sucralfate (100 mg/kg) were used as the standard drugs. Depending on the model, outcome measures were volume and pH of gastric fluid, total acidity, ulcer score, percent inhibition of ulcer score, ulcer index as well as percent inhibition of ulcer index. Data were analyzed using one-way analysis of variance followed by Tukey’s post hoc test, and P<0.05 was considered as statistically significant. OQ significantly (P<0.001) reduced gastric ulcer index by 55.82% and 62.11%, respectively, in pylorus ligation-induced and ethanol-induced ulcer models at the 400 mg/kg dose, which is comparable to the standard drugs. Ten and 20 days pre-treatment with OQ200 exhibited significant (P<0.001) ulcer inhibition by 66.48% and 68.36% (pylorus ligation-induced model) as well as 71.48% and 85.35% (ethanol-induced model), respectively. OQ possesses both dose-dependent and time-dependent anti-ulcer effect in the two models. The oral median lethal dose (LD50) is estimated to be higher than 2000 mg/kg for the crude hydroalcoholic extract, and secondary metabolites such as flavonoids, tannins, and saponins were present. The findings of this study confirmed that OQ has anti-ulcer pharmacologic activity due to one or more of the secondary metabolites present in it. Therefore, this study validates its anti-ulcer use in Ethiopian folk medicine. Further investigations on isolation of specific phytochemicals and elucidating mechanisms of action are needed. PMID:28144167

  15. Morgagni hernia presenting as gastric outlet obstruction in an elderly male. (United States)

    Kumar, A; Bhandari, R S


    Morgagni hernia is the rarest of all congenital diaphragmatic hernias, first described in 1769. It is rarely symptomatic and found on routine radiological examinations for other conditions. Gastric outlet obstruction in adults with Morgagni Hernia is exceedingly rare. An 80-year-old man was taken to the operating room with a diagnosis of Morgagni hernia with gastric outlet obstruction. An upper midline laparotomy was performed, and the incarcerated pylorus and antrum of the stomach reduced with primary closure of the defect. Postoperative period was uneventful, and the patient was discharged on the sixth postoperative day. Morgagni hernia is exceedingly rare in adults and may present with gastric outlet obstruction in the emergency room. This clinical entity should be kept in mind while evaluating the patient, and early surgical intervention should be initiated.

  16. Multiple endocrine neoplasia type 1 with upper gastrointestinal hemorrhage and perforation: a case report and review. (United States)

    Lu, Ying-Ying; Zhu, Feng; Jing, Da-Dao; Wu, Xie-Ning; Lu, Lun-Gen; Zhou, Gen-Quan; Wang, Xing-Peng


    Multiple endocrine neoplasia type 1 (MEN1) is a rare hereditary syndrome known to predispose subjects to endocrine neoplasms in a variety of tissues such as the parathyroid glands, pituitary gland, pancreas and gastrointestinal tract. We herein report a patient with a past history of pituitary adenoma, presenting with symptoms of chronic diarrhea for nearly one year and a sudden upper gastrointestinal hemorrhage as well as perforation without signs. Nodules in the duodenum and in the uncinate process and tail of pancreas and enlargement of the parathyroid glands were detected on preoperative imaging. Gastroscopy revealed significant ulceration and esophageal reflux diseases. The patient underwent subtotal parathyroidectomy and autotransplantation, pylorus-preserving pancreaticoduodenectomy and pancreatic tail resection and recovered well. The results observed in our patient suggest that perforation and bleeding of intestine might be symptoms of Zollinger-Ellison Syndrome in patients with MEN1.

  17. Gastrin release: Antrum microdialysis reveals a complex neural control

    DEFF Research Database (Denmark)

    Ericsson, P; Håkanson, R; Rehfeld, Jens F.


    in serum regardless of the prandial state. The rats were conscious during microdialysis except when subjected to electrical vagal stimulation. Acid blockade (omeprazole treatment of freely fed rats for 4 days), or bilateral sectioning of the abdominal vagal trunks (fasted, 3 days post-op.), raised...... the gastrin concentration in blood as well as microdialysate. The high gastrin concentration following omeprazole treatment was not affected by vagotomy. Vagal excitation stimulated the G cells: electrical vagal stimulation and pylorus ligation (fasted rats) raised the gastrin concentration transiently...... that vagotomy suppresses an inhibitory as well as a stimulating effect on the G cells. While local infusion of atropine was without effect, infusion of the neuronal blocker tetrodotoxin (TTX) (which had no effect on basal gastrin) virtually abolished the food-evoked gastrin response and lowered the high...

  18. A case of gastric adenocarcinoma in a Shih Tzu dog: successful treatment of early gastric cancer. (United States)

    Lee, Hee-Chun; Kim, Ji-Hyun; Jee, Cho-Hee; Lee, Jae-Hoon; Moon, Jong-Hyun; Kim, Na-Hyun; Sur, Jung-Hyang; Cho, Kyu-Woan; Kang, Byeong-Teck; Ha, Jeongim; Jung, Dong-In


    A 9-year-old castrated male Shih Tzu dog was referred to us, because of chronic vomiting. The patient's hematological, radiographic, ultrasonographic, endoscopic and histological examinations were evaluated for diagnosis. Hematologic analysis indicated moderate anemia and azotemia. Based on the imaging studies, an oval-shaped mass was identified in the gastric pylorus area. A proliferative mass was found on endoscopic examination, and we performed biopsy using grasping forceps. The histopathological findings of the biopsy specimens indicated hypertrophic gastritis, and Y-U pyloroplasty was performed. However, histopathological examination of the surgically resected mass revealed tubular adenocarcinoma of the stomach. Then, carboplatin chemotherapy was performed 4 times for 13 weeks. Clinical signs, such as vomiting, were resolved gradually after surgery and chemotherapy, and the patient's condition was managed favorably until recently (30 months after surgery). This case report describes clinical features, imaging studies, endoscopic characteristics and histopathological and immunohistochemical features of gastric tubular adenocarcinoma as early gastric cancer in a dog.

  19. Evaluation of Antiulcer and Antioxidant Activity of Barleria gibsoni Dalz. Leaves (United States)

    Tamboli, Firoj A.; More, Harinath N.


    Background: Peptic ulcer is a digestive disorder most commonly found in clinical practice. Given the many side effects of modern medicine, the initial acquisition of fewer side effects, and medication of indigenous drugs, it should be considered as a better alternative for the treatment of peptic ulcer. Objective: To assess antiulcer and antioxidant activity of ethanol extract of Barleria gibsoni (EBG) Dalz. leaves in ulcer-induced rats and in vitro antioxidants method, respectively. Materials and Methods: Ethanol EBG was screened for antiulcer activity in pylorus ligation-induced ulcer models in Wistar rats. In vitro antioxidant activity of the extracts was tested using 2,2-diphenyl-1-picrylhydrazyl (DPPH), nitric oxide (NO) radical scavenging activity. Total phenol and flavonoid content in the extracts were determined spectrophotometrically. Results: Oral administration of ethanol extract of leaves at doses of 250, 500 mg/kg p.o. reduced significant gastric lesions induced by pylorus ligation-induced ulcer as compared to standard omeprazole (20 mg/kg p.o.). The IC50 values were found to be 150 μg/mL in leaves extract. The ethanol extracts showed good antioxidant capacity in DPPH radical scavenging assay and NO radical scavenging activity when compared to standard. The total phenolic content using Folin–Ciocalteu reagent estimated in 1 mg of leaves extracts was 368 μg and 481 μg with gallic acid equivalent and also the total flavonoid content found to be 240 and 410 μg, respectively, with quercetin equivalence. Conclusion: These findings suggest that the leaves of B. gibsoni possessed antiulcer potential and antioxidant compared to standard. This is the first ever report of antiulcer and antioxidant activities in B. gibsoni (Acanthaceae). SUMMARY In vivo antiulcer and in vitro antioxidant activity of Barleria gibsoni was evaluated.Soxhelt extraction was carried out and extracts were subjected to qualitative phytochemical analysis. Extract obtained by

  20. Histology of the Larval Neodiprion abietis (Hymenoptera: Diprionidae Digestive Tract

    Directory of Open Access Journals (Sweden)

    Christopher J. Lucarotti


    Full Text Available The alimentary canal of Neodiprion abietis larvae is a straight tube divided into foregut, midgut, and hindgut. Posterior to the mouth, the foregut is further divided into the pharynx, esophagus (crop, and proventriculus, all of which are lined with cuticle. A pair of muscular, chitin-lined pouches branch off the anterior foregut and lie lateral to the alimentary canal. Gastric caeca are located at the anterior end of the midgut, where the peritrophic membrane is formed and was observed throughout the midgut. A single layer of midgut columnar epithelial cells abuts on the basal lamina at one end with microvilli extending into the gut lumen at the other. Nidi of regenerative cells were observed between columnar epithelial cells at the basal lamina. Malpighian tubules are attached to the posterior end of the midgut. The hindgut consists of the pylorus, a muscular ileum connecting to a bulbous rectum, which then opens to the anus.

  1. [Functional state of the gastro-duodenal area in gastro-esophageal reflux disease]. (United States)

    Vakhrushev, Ia M; Potapova, L O


    The complex study of stomach and duodenal function was performed in 150 patients with GERD. It was revealed that 84,3% of patients had increased stomach acid-production. In GERD exacerbation we found the disturbance of gastric mucosa decreasing protective properties of esophageal, stomach and duodenal mucosa. The patients had increased intragastral and intraduodenal pressure leading to decreasing of closing function of pylorus. Due to dynamic gastroscintigraphy the slowing of stomach evacuation was revealed in 69,2% patients, the acceleration - in 7,7% patients. The prevalence of bradyperistalsis was found in elecrogastromyography. The role of hormones (gastrin, insulin, cortisol, thyrotrophin, thyroxin) in disorders of gastro-duodenal complex function was shown. The complex investigation of gastro-duodenal complex function opens the pathophysiologic base of GERD and these data may be used in the choice of adequate therapy.

  2. Effect of Monotherapy and Combination Therapy of Pantoprazole and Aprepitant in Gastric Esophageal Reflux Disease in Albino Rats (United States)

    Shukla, Kamleshwar; Raj, Prince; Kumar, Arun; Kumar, Mukesh; Kaithwas, Gaurav


    The present study was undertaken to elucidate the effect of pantoprazole and aprepitant on experimental esophagitis in albino rats. Groups of rats, fasted overnight, received normal saline (3 mL/kg, sham control) or toxic control (3 mL/kg) or pantoprazole (30 mg/kg) or aprepitant (10 mg/kg), or their combinations and were subjected to pylorus and forestomach ligation. Animals were sacrificed after 8 h and evaluated for the gastric pH, volume of gastric juices, total acidity, esophagitis index, and free acidity. Esophageal tissues were further subjected to estimations of TBARS, GSH, catalase, and SOD. Treatment with pantoprazole and aprepitant significantly inhibited the gastric secretion, total acidity, and esophagitis index. The treatment also helped to restore the altered levels oxidative stress parameters to normal. PMID:24790551

  3. Effect of Monotherapy and Combination Therapy of Pantoprazole and Aprepitant in Gastric Esophageal Reflux Disease in Albino Rats

    Directory of Open Access Journals (Sweden)

    Kamleshwar Shukla


    Full Text Available The present study was undertaken to elucidate the effect of pantoprazole and aprepitant on experimental esophagitis in albino rats. Groups of rats, fasted overnight, received normal saline (3 mL/kg, sham control or toxic control (3 mL/kg or pantoprazole (30 mg/kg or aprepitant (10 mg/kg, or their combinations and were subjected to pylorus and forestomach ligation. Animals were sacrificed after 8 h and evaluated for the gastric pH, volume of gastric juices, total acidity, esophagitis index, and free acidity. Esophageal tissues were further subjected to estimations of TBARS, GSH, catalase, and SOD. Treatment with pantoprazole and aprepitant significantly inhibited the gastric secretion, total acidity, and esophagitis index. The treatment also helped to restore the altered levels oxidative stress parameters to normal.

  4. Assessment of the antiulcer potential of Moringa oleifera root-bark extract in rats. (United States)

    Choudhary, Manoj Kumar; Bodakhe, Surendra H; Gupta, Sanjay Kumar


    In the present study, an ethanolic root-bark extract of Moringa oleifera (MO) was examined for its antiulcer potential in albino Wistar rats using two experimental models: ethanol-induced and pylorus ligation-induced gastric ulceration. The extract was orally administered at three different doses (150, 350, and 500 mg/kg) for 15 consecutive days. The antiulcer effects in rats treated with different doses of the extract and omeprazole (30 mg/kg, p.o.) were determined and compared statistically with the antiulcer effects in the control rats treated with saline (NaCl, 0.9%). The MO at doses of 350 and 500 mg/kg decreased the ulcer index significantly as compared to the control group (p Moringa oleifera can be used as source for an antiulcer drug.

  5. [Pharmacological effects of the combination of a spasmolytic (otilonium) with a benzodiazepine (diazepam)]. (United States)

    Coruzzi, G; Adami, M; Poli, E; Signorini, G; Bertaccini, G


    The pharmacological effects of an association represented by a myolitic agent (otilonium bromide) and a benzodiazepine (diazepam) were investigated on different in vitro preparations and on one in vivo test. In the isolated preparations both drugs administered alone showed a remarkable inhibitory effect on the motility of different areas of the digestive system both spontaneous and evoked by different stimulatory agents. Association of the two compounds gave rise to additive effects or actually to a potentiating effect according to the different tissues and animal species. Negative interference was never observed. The same was true also in the in vivo preparation ("in situ" rat pylorus). The significance and the importance of these observations are discussed also in the light of the relevant clinical implications.

  6. Gastrin release: Antrum microdialysis reveals a complex neural control

    DEFF Research Database (Denmark)

    Ericsson, P; Håkanson, R; Rehfeld, Jens F.;


    in serum regardless of the prandial state. The rats were conscious during microdialysis except when subjected to electrical vagal stimulation. Acid blockade (omeprazole treatment of freely fed rats for 4 days), or bilateral sectioning of the abdominal vagal trunks (fasted, 3 days post-op.), raised...... the gastrin concentration in blood as well as microdialysate. The high gastrin concentration following omeprazole treatment was not affected by vagotomy. Vagal excitation stimulated the G cells: electrical vagal stimulation and pylorus ligation (fasted rats) raised the gastrin concentration transiently...... microdialysate gastrin concentration in omeprazole-treated rats by 65%. We conclude that activated gastrin release, unlike basal gastrin release, is highly dependent on a neural input: 1) Vagal excitation has a transient stimulating effect on the G cells. The transient nature of the response suggests...

  7. Endoscopic diagnosis in Ascaris lumbricoides case with pyloric obstruction. (United States)

    Peker, Kemal; Kılıç, Kemal


    Ascaris lumbricoides is the largest and most prevalent helminth seen in the human body. Ascariasis having high morbidity and mortality causes a unique type of intestinal obstruction with specific problems. This is probably due to reduced intestinal absorption and luminal obstruction, which can lead to anorexia and blockage of the absorbing surface. It affects humans especially in developing countries. This essay presented a 78-year-old female case had severe abdominal pain, nausea and constipation for seven days and the pylorus was obstructed by A. lumbricoides and diagnosis was obtained by endoscopy. During endoscopy in the treatment, the ascariasis that could be removed was. Afterwards, 100 mg mebendazole was given for 3 days once in two months.The purpose of the presentation of this case is that it is seen in advanced ages and it sets us thinking of stomach tumor due to its obstruction and anemia clinic.

  8. Gastric dilatation and volvulus in a brachycephalic dog with hiatal hernia. (United States)

    Aslanian, M E; Sharp, C R; Garneau, M S


    A brachycephalic dog was presented with an acute onset of retching and abdominal discomfort. The dog had a chronic history of stertor and exercise intolerance suggestive of brachycephalic airway obstructive syndrome. Radiographs were consistent with a Type II hiatal hernia. The dog was referred and within hours of admission became acutely painful and developed tympanic abdominal distension. A right lateral abdominal radiograph confirmed gastric dilatation and volvulus with herniation of the pylorus through the hiatus. An emergency exploratory coeliotomy was performed, during which the stomach was derotated, and an incisional gastropexy, herniorrhaphy and splenectomy were performed. A staphylectomy was performed immediately following the exploratory coeliotomy. The dog recovered uneventfully. Gastric dilatation and volvulus is a potentially life-threatening complication that can occur in dogs with Type II hiatal hernia and should be considered a surgical emergency.

  9. Ruminal, Intestinal, and Total Digestibilities of Nutrients in Cows Fed Diets High in Fat and Undegradable Protein

    DEFF Research Database (Denmark)

    Palmquist, D.L.; Weisbjerg, Martin Riis; Hvelplund, Torben


    To study relationships of high undegradable intake protein and dietary fat on intestinal AA supply, the ruminal, intestinal, and total digestibilities of diets with or without added fat (5% of DM) and animal protein (blood meal: hydrolyzed feather meal, 1:1; 8% of DM) were examined with four cows...... in a 2×2 factorial design in a 4×4 Latin square experiment. Ruminal degradabilities were 14.9 and 18.6%, and intestinal digestibilities were 98.9 and 68.3%, respectively, for CP in blood meal and feather meal. Treatment effects on ruminal digestibilities were small. Protein supplementation increased...... total N intake by 29%, duodenal AA N flow by 39%, and AA N absorbed by 37%; absorption of Leu and Lys increased 60 and 33%, and absorption of ne and Met increased 11 and 7%, respectively. Measured duodenal AA N flow (Cr2O3 marker) was 33% higher in cows cannulated adjacent to the pylorus compared...

  10. Pregnancy as a risk factor for undertreatment after bariatric surgery. (United States)

    Jacquemyn, Yves; Meesters, Johanna


    A pregnant woman presented at the emergency department with severe nausea and vomiting at 20 weeks of gestational age; she was known with gastric banding. Advanced imaging studies were avoided of fear to harm the fetus. The patient continued to vomit and at 23 weeks intrauterine fetal death was noted. The symptoms did not resolve after delivery and CT scan demonstrated slippage of the gastric band over the pylorus resulting in a high digestive obstruction as the cause of hyperemesis and finally resulting necrosis of the vasa brevia. The gastric band was laparoscopically removed along with the necrotic tissue. Avoidance of radiological and endoscopic investigations of fear to harm the pregnancy resulted in complications and possibly in fetal death.

  11. Gastric serosal tear due to congenital pyloric atresia: A rare anomaly, a rare complication

    Directory of Open Access Journals (Sweden)

    Mithat Gunaydin


    Full Text Available Congenital pyloric atresia (CPA is a very rare malformation with unknown aetiology. It has has numerous complications including gastric perforation, aspiration pneumonia. Gastric perforations in newborns occur by three mechanisms: trauma, ischaemia, or spontaneous. Here, we report a newborn with CPA presenting with gastric serosal tearing without full-cut gastric perforation. The diagnosis was confirmed with the help of plain abdominal radiograph, ultrasound, contrast-study, and at operation. Treatment of CPA is surgery irrespective of the type of atresia. We performed serosa repair and then the solid, cord-like atretic pylorus was excised with accompanying gastroduodenostomy. Our patient had an uneventful course and was discharged at the end of the second postoperative week.

  12. Effects of nuclei ambiguus and dorsal motor nuclei of vagus on gastric H+ and HCO3- secretion in rats

    Institute of Scientific and Technical Information of China (English)

    Xue-Ying Zhang; Hong-Bin Ai; Xi-Yun Cui


    AIM: To determine the effects of electrical stimulation of nucleus ambiguus (NA) and dorsal motor nuclei of vagus (DMV) on gastric acid and bicarbonate secretion in rats.METHODS: NA and DMV in rats were electrically stimulated. Pylorus ligation or esophagus perfusion was used to collect the gastric secretion. The titratable H+ quantum, H+ concentration, HCO3- secretion quantum were measured.RESULTS: Electrical stimulation of NA had no effects on the volume of gastric juice, titratable acidity and acid concentration, but elicited a pronounced increase in the total bicarbonate. However, electrical stimulation of DMV significantly increased the titratable acidity, the volume of gastric juice and the acid concentration. Similarly,electrical stimulation of either NA or DMV decreased the respiratory frequency and sinus bradycardia.CONCLUSION: NA in rats can not control the secretion of gastric acid but the secretion of bicarbonate in gastric juice, while DMV controls the secretion of gastric acid.

  13. A case of stenotic change from gastric candidiasis managed with temporary stent insertion. (United States)

    Joo, Moon Kyung; Park, Jong-Jae; Lee, Beom Jae; Kim, Ji Hoon; Yeon, Jong Eun; Kim, Jae Seon; Byun, Kwan Soo; Bak, Young-Tae


    Invasive gastric Candida infection in patient with co-morbidity can cause stenotic change if it is developed at anatomically narrowing portion, such as distal antrum, pylorus, or duodenal bulb. However, proper management of benign stenosis by diffuse gastric Candidasis is still under controversy and palliative bypass surgery has several shortcomings because high risk operative group may be included in this case. Palliative placement of self-expandable metallic stent has been settled as a standard management of malignant gastric pyloric obstruction and it is expected to be applied in benign stenotic lesions due to its gradual dilation effect. We described a case of stenosis by diffuse gastric Candidasis at anastomosis of subtotal gastrectomy, which was managed by temporary placement of self-expandable metallic stent.

  14. Postoperative recurrence of an IPMN of the pancreas with a fistula to the stomach. (United States)

    Uesato, Masaya; Nabeya, Yoshihiro; Miyazaki, Shinichi; Aoki, Taito; Akai, Takashi; Shuto, Kiyohiko; Tanizawa, Tohru; Miyazaki, Masaru; Matsubara, Hisahiro


    We report on a case of a 74 year old man who was diagnosed with a recurrence of non-invasive carcinoma of intraductal papillary mucinous neoplasm (non-invasive IPMN) by postoperative gastroscopy (GS). A pylorus preserving pancreatico duodenectomy for IPMN in the pancreatic head was performed. A histopathological study revealed non-invasive adenocarcinoma. At first, the local recurrence of the tumor around the superior mesenteric artery circumference was diagnosed and disappeared with gemcitabine. Later, the GS showed the elevated lesion with mucin hypersecretion in the remnant stomach. The lesion had a central dip and a fistula common to the pancreas was confirmed on fisterography. We diagnosed a recurrence of IPMN and administered chemotherapy again. However, he died of his original illness. There are no reports of postoperative recurrence of IPMN checked by GS. It should be remembered that the elevated lesion of the remnant stomach is considered as one of the recurrent patterns of IPMN.

  15. Gene expression profiling of gastric mucosa in mice lacking CCK and gastrin receptors

    DEFF Research Database (Denmark)

    Zhao, Chun-Mei; Kodama, Yosuke; Flatberg, Arnar


    acid secretion was impaired and the ECL cell signaling pathway was inhibited in CCK2 receptor KO mice but not in CCK1 receptor KO mice. However, in CCK1+2 receptor double KO mice the acid secretion in response to pylorus ligation-induced vagal stimulation and the ECL cell pathway were partially...... hydroxylase probably in trefoil peptide2-immunoreactive cells. In conclusion, mice lacking CCK receptors exhibited a functional shift from the gastrin-CCK pathways to the neuronal pathway in control of the ECL cells and eventually the acid secretion. Taking the present data together with previous findings, we......The stomach produces acid, which may play an important role in the regulation of bone homeostasis. The aim of this study was to reveal signaling pathways in the gastric mucosa that involve the acid secretion and possibly the bone metabolism in CCK1 and/or CCK2 receptor knockout (KO) mice. Gastric...

  16. A rare presentation of clinically intractable hypertension: Pancreatic paraganglioma

    Directory of Open Access Journals (Sweden)

    Chao-Ming Tseng


    Full Text Available Paraganglioma is a rare extra-adrenal pheochromocytoma which originates from chromaffin cells within the ganglia of the sympathetic trunk and of the celiac, renal, suprarenal, and hypogastric plexuses. Pancreatic paragangliomas are rarer still. And even then, paragangliomas are mostly reported to be nonfunctional. We report a case of a 64-year-old woman with underlying disease of hypertension who presented with biliary colic. Contrast-enhanced computer tomography showed an enhancing mass in the uncinate process of the pancreas. Pylorus-sparing Whipple procedure was performed for complete tumor excision. Hypertensive crisis developed after Whipple, which improved after continuous intravenous nicardipine infusion. Pathology revealed a paraganglioma. A 24-h catecholamine urine test showed increased norepinephrine and vanillylmandelic acid level. Functional paraganglioma was diagnosed.

  17. Anti-gastric ulcer effect of Kaempferia parviflora. (United States)

    Rujjanawate, C; Kanjanapothi, D; Amornlerdpison, D; Pojanagaroon, S


    Kaempferia parviflora is a Zingiberaceous plant, which has been reputed for its beneficial medicinal effects. The present study was undertaken to evaluate the Kaempferia parviflora ethanolic extract (KPE) for its anti-gastric ulcer activity by experimental models. Oral administration of the KPE at 30, 60 and 120 mg/kg significantly inhibited gastric ulcer formation induced by indomethacin, HCl/EtOH and water immersion restraint-stress in rats. In pylorus-ligated rats, pretreatment with the KPE had no effect on gastric volume, pH and acidity output. In ethanol-induced ulcerated rats, gastric wall mucus was significantly preserved by the KPE pretreatment at doses of 60 and 120 but not at 30 mg/kg. The findings indicate that the ethanolic extract of Kaempferia parviflora possesses gastroprotective potential which is related partly to preservation of gastric mucus secretion and unrelated to the inhibition of gastric acid secretion.

  18. Immunoreactivity to cocaine- and amphetamine-regulated transcript in the enteric nervous system of the pig and wild boar stomach. (United States)

    Zacharko-Siembida, A; Arciszewski, M B


    Cocaine- and amphetamine-regulated transcript (CART) is a recently discovered peptide inducing strong anxiogenic-like effect. CART distribution and its role(s) at periphery are not well understood. Immunohistochemisty was utilized to investigate the distribution patterns of CART in the stomach of the pig and wild boar. Double immunohistochemisty was applied to elucidate whether CART-immunoreactive (IR) neuronal elements coexpress galanin, substance P (SP) and neuropeptide Y (NPY). In the pig stomach, different proportions of CART-IR myenteric neurons were found in the antrum (42.3 ± 3.5%), corpus (18.0 ± 1.9%) and pylorus (33.2 ± 3.0%). CART-IR myeneric neurons were also found in the antrum, corpus and pylorus of the wild boar stomach (41.7 ± 3.2, 36.0 ± 2.2 and 35.8 ± 3.5%; respectively). In both species, none of gastric submucous neurons were CART-IR; however, CART-IR nerve fibres encircled submucous perikarya. In all portions of the pig and wild boar stomach, CART-IR nerve fibres were frequently found in the smooth muscle layer as well as in the lamina muscularis mucosae. In all regions of the pig and wild boar stomach, the expression of galanin and SP was found in CART-IR myenteric neurons and smooth muscle-supplying nerve fibres. CART/NPY coexpression was not found in the porcine stomach; however, in different regions of the wild boar stomach, subpopulations of CART-IR/NPY-IR myenteric neurons were noted. In conclusion, in this study, the existence and distribution patterns of CART in discrete regions of the pig and wild boar stomach were described in details. Colocalization studies revealed that in both animal species, a functional cooperation of CART with several neuropeptides is likely.

  19. Study of Total Alkaloids from Rhizoma Coptis Chinensis on Experimental Gastric Ulcers

    Institute of Scientific and Technical Information of China (English)


    Objective: To study the effects of total alkaloids (TA) extracted from Rhizoma Coptis Chinensis on experimental gastric ulcer models. Methods: Four kinds of experimental ulcer models were established respectively by water-immersion stress, intragastric ethanol, acetic acid erosion, and pylorus ligation. The anti-ulcer effects of TA were evaluated, and compared with that of berberine (Ber) and cimetidine(Cim). Results: TA showed significant inhibitory effects on ulcerative formation induced by water-immersion stress, intragastric ethanol, and pylorus l igation in dose-dependent manner, and showed therapeutic effect on acetic acid erosion-inducing ulcer, in comparison with the control group. The anti-ulcer activity of Ber was less than TA containing equal content of Ber. TA significantly reduced the free acidity, total acidity and total acid output, but didn't affect the gastric juice volume, gastric pepsin activity, adherent mucus quantity of stomach wall and free mucus dissolving in gastric juice. The suppressive activities of TA on gastric acid secretion didn't occur when it was administered into dodecadactylon at a dose of 360 mg/kg wt. Moreover,when compared with Cim, the inhibitory effect of TA on gastric acid secretion isn't proportional to the inhibitory effects on the formation of the 4 kinds of experimental ulcers. Conclusion: TA is a potent candidate in therapeutic drugs for treating gastric ulcer. Its anti-ulcer effective components and mechanism is not only related to Ber and inhibition of gastric acid, but also to other ingredients of TA and mechanism so far unknown.

  20. Height, weight, and body mass index associations with gastric cancer subsites. (United States)

    Camargo, M Constanza; Freedman, Neal D; Hollenbeck, Albert R; Abnet, Christian C; Rabkin, Charles S


    Although excess body weight has been associated with cancers of the gastric cardia, relationships with gastric cancer at other anatomic subsites are not well defined. Furthermore, subsite-specific associations with attained height have not been fully assessed. In 1995-1996, 483,700 Whites enrolling in the multi-state NIH-AARP Diet and Health Study self-reported height and weight. Gastric cancers occurring through 31 December 2006 were ascertained from regional population-based registries. We used Cox regression models to estimate cancer hazard ratios (HRs) for sex-specific tertiles of height and weight and for body mass index (BMI) categories of the World Health Organization. One thousand incident cancers (48 % localized to the cardia, 4 % fundus, 6 % corpus, 3 % greater curvature, 6 % lesser curvature, 10 % antrum, 2 % pylorus, 5 % overlapping lesion, and 16 % unspecified) occurred an average of 5.4 years after enrollment. After controlling for effects of age, sex, education, and smoking, we found an inverse association between height and total noncardia cancers (i.e., fundus, corpus, greater and lesser curvatures, antrum, and pylorus), with HRs vs. tertile 1 of 0.65 and 0.71 for tertiles 2 and 3, respectively (p trend = 0.016). Trends were consistent for individual noncardia subsites. In contrast, although weight and BMI were each associated with risk of cardia cancer, neither was associated with total noncardia cancer nor individual subsites. Noncardia gastric cancer is associated with short stature but not with high body weight or obesity. The excess risk for shorter adults would be consistent with the known association of chronic H. pylori infection with growth retardation during childhood.

  1. Production of ghrelin by the stomach of patients with gastric cancer. (United States)

    Kizaki, Junya; Aoyagi, Keishiro; Sato, Takahiro; Kojima, Masayasu; Shirouzu, Kazuo


    Poor nutrition and weight loss are important factors contributing to poor quality of life (QOL) after gastrectomy in patients with gastric cancer. Ghrelin is a hormone produced by the stomach that, plays a role in appetite increase and fat storage. The present study aims to clarify the location of ghrelin mRNA in the stomach, changes in blood ghrelin concentrations after gastrectomy and whether or not they are associated with the reconstruction method in patients with gastric cancer. We collected seven normal mucosa samples from different parts of six totally resected stomachs with gastric cancer. We extracted RNA from the normal mucosa, synthesized cDNA from total RNA (1 μg), and then quantified ghrelin mRNA using quantitative real-time polymerase chain reaction (Q-PCR). Ghrelin blood concentrations were measured using enzyme-linked immunosorbent assay (ELISA) kits in 74 patients with gastric cancer (total gastrectomy (TG), n=23; distal gastrectomy (DG), n=30; proximal gastrectomy (PG), n=11; pylorus preserving gastrectomy (PPG), n=10). In order, the ghrelin gene was expressed most frequently in the gastric body, followed by the fornix, cardia, antrum and pylorus ring. Blood ghrelin concentrations after surgery similarly changed in all groups. The average blood ghrelin concentrations were significantly higher in the DG and PPG groups than in the TG group on postoperative days (POD) 1, 7, 30, 90 and 180. However, blood ghrelin concentrations did not significantly differ between the DG and TG groups on POD 270 and 360. Cells that produce ghrelin are supposed to be located mostly in the fundic gland of the stomach. We speculate that the production of ghrelin from other organs increases from around nine months after total gastrectomy. Therefore, evaluating the nutritional status and the weight of patients at nine months after total gastrectomy is important to help these patients improve their QOL.

  2. [Participation of parasympathetic part of nervous system in realization of bioflavonoids action on gastric secretion in rats]. (United States)

    Vovkun, T V; Yanchuk, P I; Shtanova, L Y; Veselskyy, S P; Shalamay, A S


    In this study we investigated the effects of corvitin--modified form of flavonoid quercetin on the stomach secretory function and physiological mechanisms involved in the maintenance of such effects in rat's pylorus-ligated model. In animals which corvitin was injected at a dose of 5 mg/kg, regardless of the route of administration--in the stomach or duodenum, did not observe any changes in the volume of gastric juice or general production of hydrochloric acid, compared with the control data. Dose of 40 mg/kg caused an increase in the volume of gastric juice and hydrochloric acid output as when administered in the stomach and in the duodenum. We also found that after the application of a large dose of corvitin (intragastrically) in the blood of experimental animals showed reduction in glucose levels, which was not detected when using the drug in a dose of 5 mg/kg. Nonspecific antagonist of M-cholinergic receptors--atropine almost completely blocked the enhancement of gastric secretion, which was caused by the introduction into the stomach of corvitin in large dose. From the present data, it is reasonable to conclude that intragastric administration of a large dose of corvitin to pylorus-ligated rats induces hypoglycemic reaction of blood, which may causes an increase in vagus nerve activity with subsequent stimulation of gastric secretion. The increase in gastric juice volume and gastric acid output induced by corvitin was completely inhibited by atropine. These results suggested that the increase in gastric secretion induced by intragastrically administered corvitin could be mediated by the parasympathetic nervous system.

  3. Hydroethanolic extract of Baccharis trimera promotes gastroprotection and healing of acute and chronic gastric ulcers induced by ethanol and acetic acid. (United States)

    Dos Reis Lívero, Francislaine Aparecida; da Silva, Luisa Mota; Ferreira, Daniele Maria; Galuppo, Larissa Favaretto; Borato, Debora Gasparin; Prando, Thiago Bruno Lima; Lourenço, Emerson Luiz Botelho; Strapasson, Regiane Lauriano Batista; Stefanello, Maria Élida Alves; Werner, Maria Fernanda de Paula; Acco, Alexandra


    Ethanol is a psychoactive substance highly consumed around the world whose health problems include gastric lesions. Baccharis trimera is used in folk medicine for the treatment of gastrointestinal disorders. However, few studies have evaluated its biological and toxic effects. To validate the popular use of B. trimera and elucidate its possible antiulcerogenic and cytotoxic mechanisms, a hydroethanolic extract of B. trimera (HEBT) was evaluated in models of gastric lesions. Rats and mice were used to evaluate the protective and antiulcerogenic effects of HEBT on gastric lesions induced by ethanol, acetic acid, and chronic ethanol consumption. The effects of HEBT were also evaluated in a pylorus ligature model and on gastrointestinal motility. The LD50 of HEBT in mice was additionally estimated. HEBT was analyzed by nuclear magnetic resonance, and a high-performance liquid chromatography fingerprint analysis was performed. Oral HEBT administration significantly reduced the lesion area and the oxidative stress induced by acute and chronic ethanol consumption. However, HEBT did not protect against gastric wall mucus depletion and did not alter gastric secretory volume, pH, or total acidity in the pylorus ligature model. Histologically, HEBT accelerated the healing of chronic gastric ulcers in rats, reflected by contractions of the ulcer base. Flavonoids and caffeoylquinic acids were detected in HEBT, which likely contributed to the therapeutic efficacy of HEBT, preventing or reversing ethanol- and acetic acid-induced ulcers, respectively. HEBT antiulcerogenic activity may be partially attributable to the inhibition of free radical generation and subsequent prevention of lipid peroxidation. Our results indicate that HEBT has both gastroprotective and curative activity in animal models, with no toxicity.

  4. Clinical significance of pyloric aperture in the aetiology of peptic ulcer disease: a prospective study. (United States)

    Saha, Sisir Kumar


    Despite so much contributions reported in the literature, the aetiology of the duodenal ulcer remains an enigmatic subject to the medical profession. Findings of Helicobacter pylori seem to have overshadowed the real issue, in that, how a small area of the duodenal mucosa could be inflicted with the acid-pepsin injury has not been questioned? One hundred and sixty-eight consecutive patients, presented with epigastric pain were included in the endoscopic study. The aim of the study was to find out the prevalence and its clinical importance on the sizes of the pyloric aperture in the aetiology of peptic ulcer disease. Demographic data on the sizes of the pyloric aperture were divided into two groups, in that, those up to 3 mm in diameter were included in one and those over the size of 3 mm in another. Among the 168 cases, the gastric ulcer was found in 12 and duodenal ulcer in 27 patients. The sex ratio of men to women was 1.4:1 found in the former and 8:1 in the latter. Among other findings, a knuckle of duodenal mucoa was noticed prolapsing through the large pyloric aperture. It could be postulated that a knuckle of the mucosa that keeps peeping through the pylorus acts as a mucosal plug in empty stomach, like a cork in the acid bottle. The main physiological function is to protect the mucosa from being damaged by the acid-pepsin injury or by the reflux of bile, but the tip of the plug seems to be subjected to such injury. Furthermore, the surface epithelial cells could also be subjected to ischaemic change while prolapsing through the pylorus. This may lead to reduced production of the mucosal gel and bicarbonate secretion, thus exposing the damaged mucosa to acid bath. This supports the concept, how a small area of the stomach or duodenum could be inflicted with ulceration.

  5. Pancreatoduodenectomía con preservación de píloro: Experiencia de 5 casos HSJD

    Directory of Open Access Journals (Sweden)

    Alejandra Elizondo- Marín


    Full Text Available La pancreatoduodenectomía fue introducida por Kaush en 1912 y popularizada por Whipple en 1935. Su uso se ha incrementado en los últimos años y ha probado ser una opción en algunos pacientes bien seleccionados con cáncer periampular y de la cabeza del páncreas. La preservación del antro y del píloro es el resultado del esfuerzo para reducir las complicaciones asociadas con el procedimiento tradicional, reconstruyendo el tracto gastrointestinal en una forma más fisiológica. Su uso en pacientes con cáncer de la cabeza del páncreas es controversial. El propósito de este estudio es revisar en forma retrospectiva la evolución de 5 pacientes con cáncer de páncreas y periampular, a los que se les hizo una pancreatoduodenectomía con preservación de píloro en nuestro servicio en el primer cuatrimestre de 2003.Pancreatoduodenectomy was first introduced by Kaush in 1912 and popularized by Whipple in 1935. This procedure has gained increased utilization in recent years and it has proven to be an appropiate option in selected patients with periampullary and pancreatic cancer. The preservation of the antrum and the pylorus is the result of an effort to reduce complications associated with the standard procedure, restoring the alimentary tract in a more physiological way. Whether it should be used in patients with pancreatic cancer is still controversial. The purpose of this study is to retrospectively review 5 patients with pancreatic or periampullary cancer who underwent a pylorus preserving pancreatoduodenectomy in our institution during the first 4 months of 2003.

  6. Early pyloric stenosis: a case control study. (United States)

    Demian, Marie; Nguyen, Son; Emil, Sherif


    Pyloric stenosis (PS) is rare in the first 2 weeks of life, often leading to delays in diagnosis and treatment. We conducted a case control study to delineate the characteristics of patients with early PS (EPS). In addition, we tested the hypothesis that patients with EPS present with a smaller pylorus than older patients. A database of all patients presenting with PS to a children's hospital over a 5-year period (2002-2006) was obtained. Each patient admitted during the first 2 weeks of life (subject) was matched to a patient admitted after 4 weeks of age (control), with the same gender, electrolyte status, and treating surgeon. A single pediatric radiologist, blinded to patient age, reviewed all available ultrasounds retrospectively. Demographic, clinical, diagnostic, therapeutic, and outcome data were compared. During the study period, 278 pyloromyotomies were performed for PS. Sixteen patients (5.8%) presented with EPS between 2 and 14 days of life. EPS patients had a higher prevalence of positive family history (31 vs. 0%, P = 0.043), and breast milk feeding (75 vs. 31%, P = 0.045). Sonographic measurements showed a pylorus that was of significantly less length (17.1 +/- 0.6 vs. 20.5 +/- 0.9 mm, P = 0.006) and muscle thickness (3.5 +/- 0.2 vs. 4.9 +/- 0.2 mm, P < 0.001) in patients with EPS. Hospital stay was significantly longer for EPS patients (4.3 +/- 0.9 vs. 2.0 +/- 0.1 days, P = 0.19). Babies presenting with EPS are more likely to be breast fed and to have a positive family history. EPS is associated with a longer hospital stay. Use of sonographic diagnostic measurements specific to this age group may prevent delays in diagnosis and treatment, and improve outcomes.


    Institute of Scientific and Technical Information of China (English)

    黄徐根; 吴孝兵


    . SS positive cells were detected only in stomach. GAS positive cells showed a restricted distribution and were only demonstrated in the pylorus and duodenum. In the DT of E. elegans the region with the highest degree of cell type heterogeneity was pylorus and all types of endocrine cell along the DT showed peak density in the pylorus as well. Conclusion Some common features of the distribution of different types of GI endocrine cells are found between E. elegans and other reptiles. This common trait may reflect the similarity in digestive physiology of various vertebrates. On the other hand, some species-dependent unique distribution features of endocrine cells in DT were also detected in E. elegans.

  8. Effect of cholecystokinin and secretin on contractile activity of isolated gastric muscle strips in guinea pigs

    Institute of Scientific and Technical Information of China (English)

    Wei Li; Tian Zhen Zheng; Song Yi Qu


    AIM To study the effect of cholecystokininoctapeptide (CCK-8) and secretin on contractile activity of isolated gastric muscle strips in guinea pigs.METHODS Each isolated gastric muscle strip was suspended in a tissue chamber containing5 mL Krebs solution constantly warmed by water jacked at 37℃ and supplied with a mixed gas of 95% O2 and 5% CO2. After incubating for 1 h under 1 g tension, varied concentrations of CCK-8 and secretin were added respectively in the tissue chamber and the contractile response was measured isometrically on ink-writing recorders.circular and longitudinal muscular tension at rest (fundus LM 19.7%±2.1%, P<0.01; fundus CM 16.7%±2.2%, P<0.01; gastric body LM 16.8% ± 2.3%, P<0.01; body CM 12.7% ± 2.6%,P<0.01; antrum LM 12.3%±1.3%, P<0.01;antrum CM 16.7%±4.5%, P<0.01; pylous CM frequencies of body LM, both LM and CM of antrum and pylorus CM (5.1/min ± 0.2/min to 5.6/min ± 0.2/min, 5.9/min ± 0.2/min to 6.6/min ±0.1/min, 5.4/min ± 0.3/min to 6.3/min ± 0.4/min, 1.3/min ± 0.2/min to 2.3/min ± 0.3/min,amplitude of antral circular muscle (58.6%±pylorus CM (145.0% ± 23.8%, P<0.01), but decrease the mean contractile amplitude of gastric body and antral LM ( - 10.3% ± 3.3%, -10.5% ±4.6%, respectively, P<0.05). All the CCK-8 effects were not blocked by atropine or indomethacin. Secretin had no effect on gastric smooth muscle activity.CONCLUSION CCK-8 possessed both excitatory and inhibitory action on contractile activity of different regions of stomach in guinea pigs. Its action was not mediated via cholinergic M receptor and endogenous prostaglandin receptor.

  9. Correlation of Somatic Dysfunction With Gastrointestinal Endoscopic Findings: An Observational Study. (United States)

    Snider, Karen T; Schneider, Robert P; Snider, Eric J; Danto, Jay B; Lehnardt, Charles W; Ngo, Christopher S; Johnson, Jane C; Sheneman, Timothy A


    Gastrointestinal (GI) endoscopy provides a novel means of correlating visceral abnormalities with somatic dysfunction. To assess the correlation of palpatory findings of somatic dysfunction with GI abnormalities determined by endoscopy and to identify which types of somatic dysfunction were most commonly correlated with GI abnormalities. In this observational, cross-sectional study, participants who were scheduled to receive an esophagogastroduodenoscopy (EGD), colonoscopy, or both were examined by 2 osteopathic physicians immediately prior to endoscopy for the presence of vertebral tenderness, asymmetry, restricted range of motion, and tissue texture abnormalities (TART findings); tenderness of anterior Chapman reflex points; and tenderness of visceral sphincters. Each type of somatic dysfunction and the somatic dysfunction burden (sum of findings) were compared with the type of endoscopic procedure and abnormal endoscopic findings. Sixty-six adults participated: 43 received an EGD, 40 received a colonoscopy, and 17 received both. The incidence of vertebral TART findings ranged from 70% at T12 to 98% at the sacrum. Participants who received only EGD had a higher somatic dysfunction burden than those who received only colonoscopy and those who received both procedures (P=.002). The incidence of abnormal endoscopic findings ranged from 98% in the stomach to 0% at the ileocecal valve. Statistically significant positive associations were found between specific vertebral TART findings and abnormalities of the esophagus, gastroesophageal junction, pylorus, ascending colon, and sigmoid colon; specific Chapman reflex point tenderness and abnormalities of the esophagus, gastroesophageal junction, pylorus, ascending colon, descending colon, sigmoid colon, and rectum; and specific visceral sphincter tenderness and abnormalities of the duodenum, ascending colon, and sigmoid colon. The current study found numerous associations between somatic dysfunction and abnormal

  10. Lansoprazole prevents experimental gastric injury induced by non-steroidal anti-inflammatory drugs through a reduction of mucosal oxidative damage

    Institute of Scientific and Technical Information of China (English)

    Corrado Blandizzi; Matteo Fornai; Rocchina Colucci; Gianfranco Natale; Valter Lubrano; Cristina Vassalle; Luca Antonioli; Gloria Lazzeri; Mario Del Tacca


    AIM: This study investigated the mechanisms of protection afforded by the proton pump inhibitor lansoprazole against gastric injury induced by different non-steroidal antiinflammatory drugs (NSAIDs) in rats.METHODS: Male Sprague-Dawley rats were orally treated with indomethacin (100 μmol/kg), diclofenac (60 μmol/kg),piroxicam (150 μmol/kg) or ketoprofen (150 μmol/kg).Thirty minutes before NSAIDs, animals were orally treated with lansoprazole 18 or 90 μmol/kg. Four hours after the end of treatments, the following parameters were assessed: gastric mucosal PGE2, malondialdehyde (MDA), myeloperoxidase (MPO) or non-proteic sulfhydryl compounds (GSH) levels; reverse transcription-polymerase chain reaction (RT-PCR) of mucosal COX-2 mRNA; gastric acid secretion in pylorus-ligated animals; in vitro effects of lansoprazole (1-300 μmol/L) on the oxidation of low density lipoproteins (LDLs) induced by copper sulphate.RESULTS: All NSAIDs elicited mucosal necrotic lesions which were associated with neutrophil infiltration and reduction of PGE2 levels. Increments of MPO and MDA contents, as well as a decrease in GSH levels were detected in the gastric mucosa of indomethacin- or piroxicam-treated animals. Indomethacin enhanced mucosal cyclooxygenase-2 expression, while not affecting cyclooxygenase-1. At the oral dose of 18 μmol/kg lansoprazole partly counteracted diclofenac-induced mucosal damage, whereas at 90 μmol/kg it markedly prevented injuries evoked by all test NSAIDs. Lansoprazole at 90 μmol/kg reversed also the effects of NSAIDs on MPO, MDA and GSH mucosal contents, without interfering with the decrease in PGE2 levels or indomethacin-induced cyclooxygenase-2 expression. However, both lansoprazole doses markedly inhibited acid secretion in pylorus-ligated rats. Lansoprazole concentration-dependently reduced the oxidation of LDLs in vitro.CONCLUSION: These results suggest that, besides the inhibition of acid secretion, lansoprazole protection against NSAID

  11. Effect of two-channel gastric electrical stimulation with trains of pulses on gastric motility

    Institute of Scientific and Technical Information of China (English)

    Bin Yang; Xiao-Hua Hou; Geng-Qing Song; Jin-Song Liu; Jiande DZ Chen


    AIM: To investigate the effect of two-channel gastric electrical stimulation (GES) with trains of pulses on gastric emptying and slow waves. METHODS: Seven dogs implanted with four pairs of electrodes and equipped with a duodenal cannula were involved in this study. Two experiments were performed. The first experiment included a series of sessions in the fasting state with trains of short or long pulses, each lasted 10 min. A 5-min recording without pacing was made between two sessions. The second experiment was performed in three sessions (control, single-channel GES, and two-channel GES). The stimulus was applied via the 1st pair of electrodes for single-channel GES (GES via one pair of electrodes located at 14 cm above the pylorus), and simultaneously via the 1st and 3rd channels for two-channel GES (GES via two pairs of electrodes located at 6 and 14 cm above the pylorus). Gastric liquid emptying was collected every 15 min via the cannula for 90 min. RESULTS: GES with trains of pulses at a pulse width of 4 ms or higher was able to entrain gastric slow waves. Two-channel GES was about 50% more efficient than single-channel GES in entraining gastric slow waves. Two channel but not single-channel GES with trains of pulses was capable of accelerating gastric emptying in healthy dogs. Compared with the control session, two-channel GES significantly increased gastric emptying of liquids at 15 min (79.0% ± 6.4% vs 61.3% ± 6.1%, P < 0.01), 30 min (83.2% ± 6.3 % vs 68.2% ± 6.9%, P < 0.01),60 min (86.9% ± 5.5 % vs 74.1% ± 5.9%, P < 0.01),and 90 min (91.0% ± 3.4% vs 76.5% ± 5.9%, P < 0.01).CONCLUSION: Two-channel GES with trains of pulses accelerates gastric emptying in healthy dogs and may have a therapeutic potential for the treatment of gastric motility disorders.

  12. Robot-assisted pancreatoduodenectomy with preservation of the vascular supply for autologous islet cell isolation and transplantation: a case report

    Directory of Open Access Journals (Sweden)

    Giulianotti Piero


    Full Text Available Abstract Introduction For patients with chronic pancreatitis presenting with medically intractable abdominal pain, surgical intervention may be the only treatment option. However, extensive pancreatic resections are typically performed open and are associated with a substantial amount of postoperative pain, wound complications and long recovery time. Minimally invasive surgery offers an avenue to improve results; however, current limitations of laparoscopic surgery render its application in the setting of chronic pancreatitis technically demanding. Additionally, pancreatic resections are associated with a high incidence of diabetes. Transplantation of islets isolated from the resected pancreas portion offers a way to prevent post-surgical diabetes; however, preservation of the vascular supply during pancreatic resection, which determines islet cell viability, is technically difficult using current laparoscopic approaches. With recent advances in the surgical field, robotic surgery now provides a means to overcome these obstacles to achieve the end goals of pain relief and preserved endocrine function. We present the first report of a novel, minimally invasive robotic approach for resection of the pancreatic head that preserves vascular supply and enables the isolation of a high yield of viable islets for transplantation. Case presentation A 35-year old Caucasian woman presented with intractable chronic abdominal pain secondary to chronic pancreatitis, with a stricture of her main pancreatic duct at the level of the ampulla of Vater and distal dilatation. She was offered a robotic-assisted pylorus-preserving pancreatoduodenectomy and subsequent islet transplantation, to both provide pain relief and preserve insulin-secretory reserves. Conclusion We present a novel, minimally invasive robotic approach for resection of the pancreatic head with complete preservation of the vascular supply, minimal warm ischemia time (less than three minutes and

  13. Analysis of risk factors for postoperative pancreatic fistula following pancreaticoduodenectomy. (United States)

    Liu, Qi-Yu; Zhang, Wen-Zhi; Xia, Hong-Tian; Leng, Jian-Jun; Wan, Tao; Liang, Bin; Yang, Tao; Dong, Jia-Hong


    To explore the morbidity and risk factors of postoperative pancreatic fistula (POPF) following pancreaticoduodenectomy. The data from 196 consecutive patients who underwent pancreaticoduodenectomy, performed by different surgeons, in the General Hospital of the People's Liberation Army between January 1(st), 2013 and December 31(st), 2013 were retrospectively collected for analysis. The diagnoses of POPF and clinically relevant (CR)-POPF following pancreaticoduodenectomy were judged strictly by the International Study Group on Pancreatic Fistula Definition. Univariate analysis was performed to analyze the following factors: patient age, sex, body mass index (BMI), hypertension, diabetes mellitus, serum CA19-9 level, history of jaundice, serum albumin level, blood loss volume, pancreatic duct diameter, pylorus preserving pancreaticoduodenectomy, pancreatic drainage and pancreaticojejunostomy. Multivariate logistic regression analysis was used to determine the main independent risk factors for POPF. POPF occurred in 126 (64.3%) of the patients, and the incidence of CR-POPF was 32.7% (64/196). Patient characteristics of age, sex, BMI, hypertension, diabetes mellitus, serum CA19-9 level, history of jaundice, serum albumin level, blood loss volume, pylorus preserving pancreaticoduodenectomy and pancreaticojejunostomy showed no statistical difference related to the morbidity of POPF or CR-POPF. Pancreatic duct diameter was found to be significantly correlated with POPF rates by univariate analysis and multivariate regression analysis, with a pancreatic duct diameter ≤ 3 mm being an independent risk factor for POPF (OR = 0.291; P = 0.000) and CR-POPF (OR = 0.399; P = 0.004). The CR-POPF rate was higher in patients without external pancreatic stenting, which was found to be an independent risk factor for CR-POPF (OR = 0.394; P = 0.012). Among the entire patient series, there were three postoperative deaths, giving a total mortality rate of 1.5% (3/196), and the mortality

  14. Antiulcer effect of the methanolic extract of Tamarindus indica seeds in different experimental models

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    Pankaj Kalra


    Full Text Available Background: Peptic ulcer is a global health problem of the gastrointestinal tract characterized by mucosal damage secondary to pepsin and gastric acid secretion which occurs due to due to an imbalance between offensive and defensive factors. Objective: The present study was carried out with methanolic extract of the seed coat of Tamarindus indica Linn. to evaluate its antiulcer potential on ibuprofen, alcohol and pyloric ligation induced gastric lesions. Materials and Methods: Doses of 100 mg/kg & 200 mg/kg of methanolic extract wre administered orally to rats of different groups. Ranitidine at a dose of 50 mg/kg was used as a standard drug for these gastric ulcer models. The gastric content was collected and the volume was measured. The ulceration index was determined by examining the inner lining of each stomach. Furthermore, the effect was assessed by free acidity, pepsin activity, total carbohydrate (TC, protein content (PK. Result: The result showed that the methanolic extract of seed coats of Tamarindus indica significantly reduce the total volume of gastric juice, free and total acidity of gastric secretion (P < 0.01 in pylorus ligation induced ulcer model as is comparable with the standard drug ranitidine. There was also a significant reduction in ulcer index (P < 0.01 as compared to control group. Conclusion: The methanolic extracts of seed coat of Tamarindus indica can be used as a new source of antiulcer agent in animals.

  15. Exceptionally rare cause of a total stomach resection

    Institute of Scientific and Technical Information of China (English)

    Jadwiga Snarska; Krzysztof Jacyna; Jacek Janiszewski; Danuta Shafie; Katarzyna Iwanowicz; Anna Zurada


    The first-ever case of a 54-year-old woman who overdosed on non-steroidal anti-inflammatory drugs in an attempt at suicide.Before that incident,she had not been treated for coexisting diseases such as rheumatoid arthritis or depression.At the time of admission to the General Surgery Department,the patient reported pains in the epigastric region with accompanying nausea and vomiting with mucous content as well as the inability to ingest food orally.Despite parenteral and enteral feeding,the patient exhibited a drop in body mass.The histopathologic examination of a sample taken from the stomach during gastroscopy showed some non-specific necrotic and inflammatory masses with granulation.Intraoperatively,a very small,infiltrated stomach with an initial section of duodenum was identified.A total stomach resection together with the reconstruction of digestive tract continuity was performed using the Roux-Y method.Histopathologic examination of the stomach revealed a deep,chronic and exacerbated inflammatory condition with an extensive ulceration over the entire length of the stomach,reaching up to the pylorus.Additionally,numerous lymphatic glands with inflammatory reaction changes were observed.

  16. B型超声波诊断先天性肥厚性幽门狭窄%Diagnosis of Congenital Hypertrophic Pyloric Stenosis by Real Time Sonography

    Institute of Scientific and Technical Information of China (English)

    陈博渊; 韩湘珍; 唐伟椿; 孙建芳; 孟晓敏


    本文报道B超诊断先天性肥厚性幽门狭窄的方法,其影像特点为:胃内容呈涡流和滞留现象,肥厚幽门为椭园形暗区,大小为≥19×13mm,幽门壁厚5mm.作者认为B超优于钡餐X线检查,可以作为新生儿吐奶的筛选检查方法.%Real time sonography was performed for identification of congenital hypertrophic pyloric stenosis(CHPS)in 21 patients(19 males and 2 females)from June 1985 to July 1987.Their diagnosis was proved at operation in all cases.50-100 ml of sugar water was fed during sonographic examination.The characteristic image of CHPS includes:1.gastric reflux from the antrum backward and the possible simultaneous clinical vomiting;2.stasis of gastric content lasting over 30 minutes;3.hypertrophic pyloric mass which can be seen and measured about 19×13 mm;4.a thin thread-like shaddow passing through the center of the pylorus demonstrating its hypertrophied muscular wall which can be seen and measured around 5 mm in thickness.It is also discussed in this article that real time sonography can be utilized to differentiate stomach volvulus,pyloric web,pyloric spasm,and other functional vomiting.

  17. 2D DIGE Does Not Reveal all: A Scotopic Report Suggests Differential Expression of a Single “Calponin Family Member” Protein for Tetany of Sphincters! (United States)

    Chaudhury, Arun


    Using 2D differential gel electrophoresis (DIGE) and mass spectrometry (MS), a recent report by Rattan and Ali (2015) compared proteome expression between tonically contracted sphincteric smooth muscles of the internal anal sphincter (IAS), in comparison to the adjacent rectum [rectal smooth muscles (RSM)] that contracts in a phasic fashion. The study showed the differential expression of a single 23 kDa protein SM22, which was 1.87 fold, overexpressed in RSM in comparison to IAS. Earlier studies have shown differences in expression of different proteins like Rho-associated protein kinase II, myosin light chain kinase, myosin phosphatase, and protein kinase C between IAS and RSM. The currently employed methods, despite its high-throughput potential, failed to identify these well-characterized differences between phasic and tonic muscles. This calls into question the fidelity and validatory potential of the otherwise powerful technology of 2D DIGE/MS. These discrepancies, when redressed in future studies, will evolve this recent report as an important baseline study of “sphincter proteome.” Proteomics techniques are currently underutilized in examining pathophysiology of hypertensive/hypotensive disorders involving gastrointestinal sphincters, including achalasia, gastroesophageal reflux disease (GERD), spastic pylorus, seen during diabetes or chronic chemotherapy, intestinal pseudo-obstruction, and recto-anal incontinence. Global proteome mapping may provide instant snapshot of the complete repertoire of differential proteins, thus expediting to identify the molecular pathology of gastrointestinal motility disorders currently labeled “idiopathic” and facilitating practice of precision medicine. PMID:26151053

  18. Gastroprotective effect of Benincasa hispida fruit extract

    Directory of Open Access Journals (Sweden)

    Rachchh Manish


    Full Text Available Objectives: The antiulcer activity of Benincasa hispida (Thunb. Cogn. fruit was evaluated in rats against ethanol-induced gastric mucosal damage, pylorus ligated (PL gastric ulcers, and cold restraint-stress (CRS-induced gastric ulcer models. Methods: Petroleum ether and methanol extracts were administrated orally at the dose of 300 mg/kg, and omeprazole (reference standard at the dose of 20 mg/kg. Ulcer index was common parameter studied in all the models. Further, vascular permeability was evaluated in ethanol model, and effect on lipid peroxidation, viz. melondialdehyde (MDA content, superoxide dismutase (SOD, and catalase (CAT levels were studied in CRS model. Results: Both the extracts produced significant reduction in ulcer index (P < 0.05 in all the models and the results were comparable with that of omeprazole-treated group. Further, significant reduction in vascular permeability (P < 0.05 was observed. In CRS model, MDA content was significantly reduced along with increase in CAT levels as compared to control group. Conclusions: Petroleum ether and methanol extracts of B. hispida possess significant antiulcer as well as antioxidant property.

  19. Gross anatomy of the intestine and its mesentery in the nutria (Myocastor coypus). (United States)

    Pérez, W; Lima, M; Bielli, A


    The intestines and mesentery of the nutria (Myocastor coypus) have not been fully described. In the present study 30 adult nutrias were studied using gross dissection. The small intestine was divided into the duodenum, jejunum and ileum as usual. The duodenum started at the pylorus with a cranial portion, which dilated forming a duodenal ampulla. The ileum was located within the concavity of the caecum and attached to the coiled caecum by means of the iliocaecal fold. The ascending colon had two ansae, one proximal and one distal. The proximal ansa was fixed to the caecum by the caecocolic fold. The base of the caecum and a short proximal part of the ascending colon belonging to the proximal ansa were attached to the mesoduodenum descendens. The distal ansa of the ascending colon had a proximal part which was sacculated and a distal part which was smooth. The two parts of the distal ansa of the ascending colon were parallel and joined by a flexure of variable localisation. The smooth part of the distal ansa of the ascending colon was attached to the initial portion of the descending colon by a peritoneal fold. The short transverse colon was directly attached to the mesoduodenum and greater omentum. In conclusion, we have described the anatomy of the intestines of the nutria and its mesentery in detail, and provided a nomenclature list adapted to the Nomina Anatomica Veterinaria.

  20. Diffuse Peritonitis due to Perforated Gastric Ectopic Pancreas

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    Nobutada Fukino


    Full Text Available Ectopic pancreas is frequently found in the gastrointestinal tract. Lesions comprise well-developed and normally organized pancreatic tissue outside the pancreas, without anatomic or vascular connections with the true pancreas. Most patients with ectopic pancreas are asymptomatic or exhibit nonspecific symptoms. A 68-year-old Japanese woman had been experiencing intermittent pain in the right upper abdomen. Suddenly, the abdominal pain changed to intense pain in the right flank of the abdomen 2 days later. On initial medical examination, the abdomen exhibited rebound tenderness and distension. The results of laboratory tests revealed increased inflammatory reaction. Abdominal computed tomography showed free air and ascites on the surface of the liver and elevated levels of adipose tissue around the antrum and pylorus of the stomach. Perforation of the upper gastrointestinal tract was diagnosed and we performed urgent surgery. The site of perforation, whose size was 25 mm, was the lesser curvature of the antrum of the stomach. Since it was not possible to perform omentopexy, we performed extensive gastric resection. The reconstruction was a Billroth II operation. Microscopic analysis revealed pancreatic tissue within the ulceration, showing islets of Langerhans, acini, and ducts; the lesion was diagnosed as type I using Heinrich’s criteria. The postoperative course was uneventful. The patient was discharged on day 13 and remains clinically healthy. Gastric perforation due to ectopic pancreas has been reported in 2 cases, including our patient, and is extremely rare. Once gastric perforation has been diagnosed, the presence of ectopic pancreas might be considered.


    Directory of Open Access Journals (Sweden)

    Ch. Kalyan


    Full Text Available Pancreatic cancer has a lower incidence than many other types of cancer, but is the fourth most common cause of death from cancer, among men and women, being responsible for 6% of all cancer - related deaths. The global annual incidence rate for pancreas cancer is about 8/100,000 persons. Pancreatic cancer disease is notoriously difficult to diagnose in its early stages. Study was carried out in the Department of General Surgery, Government General Hospital, Guntur from October 2010 to 2012, in which 16 cases with a diagnosis of carcinoma pancreas. They were investigated with routine blood investigations. They were treated accordingly with Pylorus preserving pancreaticodenectomy (PPPD or palliative bypass or with non - operative palliative measures. Carcinoma pancreas is an aggressive disease with male preponderance with peak incidence in 5th and 6th decade. Important risk factors are Smoking and alcohol consumption. Nearly 75% of the cases presented in the late stage of the disease. Resection of the tumour had better survival. The limitations of our study are small number of patients and short follow - up

  2. Zinc acexamate inhibits gastric acid and pepsinogen secretion in the rat. (United States)

    Bulbena, O; Esplugues, J V; Escolar, G; Gil, L; Navarro, C; Esplugues, J


    Pretreatment with zinc acexamate (25-100 mg kg-1 i.p.) inhibited acid and pepsinogen secretion in the pylorus-ligated rat. Zinc acexamate (5-50 mg kg-1 p.o.) also inhibited the increases in acid secretion induced by carbachol (10 micrograms kg-1) and 2-deoxy-D-glucose (200 mg kg-1) in the perfused stomach of the anaesthetized rat. A delayed antisecretory effect was observed with this drug on histamine induced responses. High concentrations of zinc acexamate (10(-5) - 10(-2) M) did not modify the in-vitro activity of pepsin. Administration of zinc acexamate resulted in an increase in the presence of pepsinogen at the mucosal level. A morphological examination of the gastric mucosa confirmed an accumulation of zymogen-containing granules in the gastric chief cells of zinc acexamate-treated rats (50 mg kg-1 p.o.). These results indicate that zinc acexamate decreases acid and pepsinogen secretion in-vivo, and this may explain its antiulcer activity.

  3. Zinc compounds, a new treatment in peptic ulcer. (United States)

    Escolar, G; Bulbena, O


    Effects of zinc in gastric ulcer have been reviewed through investigations carried out on zinc acexamate (ZAC). ZAC is an organic compound that has been shown to possess an experimental antiulcer effect and a wide therapeutic index, making it a useful drug in the treatment of peptic ulcer disease. ZAC protects from ulceration in several experimental models such as pylorus occlusion, reserpine-induced ulcer, necrotizing agents, PAF-induced ulcer and cold-restraint stress. ZAC first reduces the gastric acid output by inhibiting the mast cell degranulation, an action likely to be mediated through a membrane stabilizing action. Secondly, it enhances the mucosal protection factors by increasing mucus secretion, inhibiting the H+ retrodiffusion and improving microcirculation. ZAC is also effective in acetic acid-induced chronic ulcer, restoring the continuity of the damaged mucosa. Several clinical trials have shown the usefulness of ZAC in acute and maintenance treatment of both gastric and duodenal ulcers. Endoscopic studies showed that ZAC reduced the inflammatory processes (gastritis and duodenitis) associated with ulcer healing. This reduction was statistically significant and not observed with other comparative treatments (H2-antagonists). The observed side-effects were minimal and affected less than 2% of treated patients. The pharmacological profile, clinical effectiveness and good tolerance of ZAC suggest this compound as an interesting option in the treatment of peptic disease.

  4. Pharmacology of JB-9315, a new selective histamine H2-receptor antagonist. (United States)

    Palacios, B; Montero, M J; Sevilla, M A; San Román, L


    1. The histamine H2-receptor antagonistic activity and antisecretory and antiulcer effects of JB-9315 were studied in comparison with the standard H2 blocker ranitidine. 2. In vitro, JB-9315 is a competitive antagonist of histamine H2 receptors in the isolated, spontaneously beating guinea-pig right atrium, with a pA2 value of 7.30 relative to a value of 7.36 for ranitidine. JB-9315 was specific for the histamine H2 receptor because, at high concentration, it did not affect histamine- or acetylcholine-induced contractions in guinea-pig isolated ileum or rat isolated duodenum, respectively. 3. JB-9315 dose dependently inhibited histamine-, pentagastrin- or carbachol-stimulated acid secretion and basal secretion in the perfused stomach preparation of the anesthetized rat. In the pylorus-ligated rat after intraperitoneal administration, total acid output over 4 h was inhibited by JB-9315 with an ID50 of 32.8 mg/kg, confirming its H2-receptor antagonist properties. 4. JB-9315 showed antiulcer activity against cold stress plus indomethacin-induced lesions with an ID50 of 6.8 mg/kg. 5. JB-9315, 50 and 100 mg/kg, inhibited macroscopic gastric hemorrhagic lesions induced by ethanol. In contrast, ranitidine (50 mg/kg) failed to reduce these lesions. 6. These results indicate that JB-9315 is a new antiulcer drug that exerts a cytoprotective effect in addition to its gastric antisecretory activity.

  5. JB-9322, a new selective histamine H2-receptor antagonist with potent gastric mucosal protective properties. (United States)

    Palacios, B; Montero, M J; Sevilla, M A; Román, L S


    1. JB-9322 is a selective histamine H2-receptor antagonist with gastric antisecretory activity and mucosal protective properties. 2. The affinity of JB-9322 for the guinea-pig atria histamine H2-receptor was approximately 2 times greater than that of ranitidine. 3. In vivo, the ID50 value for the inhibition of gastric acid secretion in pylorus-ligated rats was 5.28 mg kg-1 intraperitoneally. JB-9322 also dose-dependently inhibited gastric juice volume and pepsin secretion. In gastric lumen-perfused rats, intravenous injection of JB-9322 dose-dependently reduced histamine-, pentagastrin- and carbachol-stimulated gastric acid secretion. 4. JB-9322 showed antiulcer activity against aspirin and indomethacin-induced gastric lesions and was more potent than ranitidine. 5. JB-9322 effectively inhibited macroscopic gastric haemorrhagic lesions induced by ethanol. Intraperitoneal injection was effective in preventing the lesions as well as oral treatment. The oral ID50 value for these lesions was 1.33 mg kg-1. By contrast, ranitidine (50 mg kg-1) failed to reduce these lesions. In addition, the protective effect of JB-9322 was independent of prostaglandin synthesis. 6. These results indicate that JB-9322 is a new antiulcer drug that exerts a potent cytoprotective effect in addition to its gastric antisecretory activity.

  6. Analysis of the Distribution of Mucins in Adult Human Gastric Mucosa and Its Functional Significance (United States)


    Introduction Mucins are complex composition of carbohydrates seen in the epithelial cells lining the gastrointestinal tract (GIT). Normal distribution of such mucins in different part of the GIT and its alteration in various inflammatory, benign and malignant lesions of GIT has aroused interest in the field of histochemistry. Aim By applying variety of histochemical techniques an attempt has been made to draw a map of mucin secretion by the different epithelial cell types in different parts of the stomach. Materials and Methods Fifty samples were taken each from different parts of the stomach like fundus, body and pylorus, from dissected fresh specimens (total of 150 specimens). Tissue samples were subjected for routine process and studied for histological and different histochemical staining. Results Mucin pattern in adult predominantly secretes neutral mucosubstances. Surface epithelium shows predominant neutral mucin while cardiac and gastric glands with foveolar cells show moderate amount. Sialomucin is present in a few cells of the surface epithelium, foveolar cells and in most of the mucous neck cells. Small amount of sialomucin and sulphomucin are found in surface epithelial foveolar cells while traces of sulphomucin are found in deep foveolar cells. Mucous neck cells secrete both sulphomucin and sialomucin. Conclusion Normal gastric mucosa adjacent to gastric ulcers and malignant tumours of stomach secretes mucins which differ histochemically and biochemically from that of normal. Early recognition of such changes could be useful in recognizing the different type of carcinomas and their prognosis. PMID:27042436

  7. Histomorphology of the Alimentary tract of adult, Odoiporus longicollis (oliv. (Coleoptera: Curculionidae

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    B. Prasad


    Full Text Available The banana pseudostem borer Odoiporus longicollis (Oliv. is the most serious pest of banana plantation in Manipur. The present study on the anatomy and histomorphology of alimentary tract of adult weevil is one of the striking scientific aspects as the stage has to propagate the pests race. The digestive tract is tubular and coiled structure having 39-42mm in length measuring almost double the length of the body (measuring 18-22mm long. The tract is divisible into Stomodaeum or foregut measuring 9-11 mm. in length, Mesenteron or Midgut is 20-22 mm in length and Proctodaeum or Hindgut measuring 10-11mm in length. These parts are well demarcated by the presence of distinct grooves. Stomodaeum has pharynx, oesophagus, crop and stomodaeum valve having the histological layers like lumen,inner intimal layer, outer intimal, epithelium, basement membrane, musculatures; Mesenteron possees anterior voluminous, middle tubular and posterior with regenerative crypts with histological layers of lumen, peritrophic membrane, epithelium, basement membrane and the last proctodaeum has pylorus, Ilium, Colon and rectum with histological layers namely lumen, intima, epithelium, basement membrane and muscularis repectively.

  8. Animal study for airway inflammation triggered by gastroesophageal reflux

    Institute of Scientific and Technical Information of China (English)

    LAI Yun-gang; WANG Zhong-gao; JI Feng; WU Ji-min; CHEN Xiu; LI Zhen; DONG Shu-kui


    Background Gastroesophageal reflux disease with extra-esophageal symptoms, especially those with respiratory istress was attracting more and more attention. The related mechanisms were still in controversy. The purpose of the work was to explore airway inflammation triggered by gastroesophageal reflux.Methods Sixteen Sprague-Dawley rats were used as study group and 9 as control. In the study group, a plastic extender with a trumpet-shaped distal end was inserted into the lower esophagus to dilate the cardia, the pylorus was ligated. One ml of 0.1 mol/L hydrochloric acid was injected into the stomach, While a simple laparotomy was performed for control animals. All animals from two groups were sacrificed 24 hours after operation. Then tracheotomy was carried and the bronchoalveolar lavage fluid was collected in all animals. Cells in the fluid were counted and levels of intedeukin (IL)-5, -6, -8 in it were measured.Results Compared with control group, the study group presented a neutrophil pattem of airway inflammation and an elevated concentration of IL-5, -6, -8 with no significant difference regarding eosinophil count.Conclusion The gastroesophageal reflux-triggered airway inflammation is characterized by a neutrophilic airway inflammation which differed from that caused by asthma, and enhanced levels of IL-5, -6 and -8, which are similar to that caused by asthma.

  9. Gastroprotective Effect of Xylopia langsdorffiana A. St.-Hil. & Tul. (Annonaceae: Involvement of Endogenous Sulfhydryls Compounds and Nitric Oxide

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    Camila de Albuquerque Montenegro


    Full Text Available Xylopia langsdorffiana A. St.-Hil. & Tul., belonging to the Annonaceae family, popularly known as "pimenteira-da-terra" was selected for study on the basis of chemotaxonomic criteria because various chemical compounds (among these the diterpenes with pharmacological activities have been isolated. We investigated the acute toxicity of the ethanolic extract (EtOHE and hexane phase (HexPh obtained from the leaves of X. langsdorffiana (XL and its ability to prevent gastric mucosa ulceration in animal models. The results suggest that XL-EtOHE has low toxicity to mice treated with a single dose of 2000 mg/kg (p.o. and the inhibition the formation of gastric lesions induced by ethanol, restraint-hypothermic stress and NSAIDs. In the pylorus ligature model, XL-EtOHE (500 mg/kg and XL-HexPh (250 mg/kg showed gastric protection with both oral (p.o. and intraduodenal (i.d. administration, yet without altering the gastric juice parameters (pH, [H +], and volume. XL-HexPh (250 mg/kg did not increase mucus production, and both EtOHE and HexPh induced gastroprotection with a certain dependency on sulfhydryls groups and nitric oxide.

  10. Intravenous theophylline poisoning and multiple-dose charcoal in an animal model. (United States)

    Kulig, K W; Bar-Or, D; Rumack, B H


    Large overdoses of IV theophylline (50 to 100 mg/kg) were administered to five canines on two separate occasions. On day one, with no charcoal administered, theophylline levels were serially obtained between ten minutes and 12 hours after infusion and the animals were recovered from anesthesia. Three days later the same dose of theophylline was administered, but then 50 g activated charcoal was placed through a nasogastric tube into the duodenum every hour for eight doses. In all five animals tested, activated charcoal significantly decreased the area under the serum concentration-time curve, decreased the half-life of elimination, and increased the clearance of theophylline. This effect on pharmacokinetics was not seen when the nasogastric tube was put into the stomach instead of the small bowel because the charcoal administered did not pass beyond the pylorus. In a separate experiment in which bile theophylline concentrations were measured, it was demonstrated that enhanced elimination was not from interruption of enterohepatic circulation of theophylline. This suggests that the demonstrated physiologic mechanism is that of gastrointestinal dialysis.

  11. Development of techniques for gastrojejunal bypass surgery in obese mice. (United States)

    Lan, Zhu; Zassoko, Roman; Liu, Weihua; Garcia, Bertha; Sun, Hongtao; Wang, Rennian; Wang, Hao


    We have previously described a duodenojejunal bypass (DJB) surgical model in healthy C57BL/6 mice. However, our pilot study showed that the same surgical technique caused a high mortality rate in obese mice. In this study, to significantly improve animal survival rate following bariatric surgery and thereby providing a stable surgical model for the study of glucose homeostasis in obese mice, we have used modified techniques and developed the end-to-side gastrojejunal bypass (GJB) surgery in obese C57BL/6 with impaired glucose tolerance. The modification consisted of using the distal part of the jejunum for biliopancreatic diversion including: 1) ligation of the distal stomach at the level of the pylorus; 2) connection the jejunum to the anterior wall of stomach in an end-to-side fashion; and 3) diverting the biliopancreatic secretions through the blind limb into the distal jejunum through an end-to-side anastomosis. We found that by modifying the proximal end-to-end duodenojejunal anastomosis, described in our original model, to an end-to-side gastrojejunal anastomosis in these obese mice, we were able to significantly improve the postoperative mortality in this study. We have also demonstrated that performing the GJB surgery in obese mice resulted in significant weight loss, normalized blood glucose levels, and prevented acute pancreatitis. This newly developed GJB surgery in the obese mice offers a unique advantage to study the mechanisms of gastrointestinal surgery as treatment for type 2 diabetes.

  12. Bromophenacyl bromide, a phospholipase A2 inhibitor attenuates chemically induced gastroduodenal ulcers in rats

    Institute of Scientific and Technical Information of China (English)

    Mohammad Tariq; Ibrahim Elfaki; Haseeb Ahmad Khan; Mohammad Arshaduddin; Samia Sobki; Meshal Al Moutaery


    AIM: To study the effect of bromophenacyl bromide (BPB), a phospholipase A2 inhibitor on gastric secretion and to protect chemically induced gastric and duodenal ulcers in rats.METHODS: Acid secretion studies were undertaken in pylorus-ligated rats with BPB treatment (0, 5, 15 and 45 mg/kg). Gastric and duodenal lesions in the rats were induced by ethanol and cysteamine respectively. The levels of gastric wall mucus, nonprotein sulfhydryls (NPSH) and myeloperoxidase (MPO) were also measured in the glandular stomach of rats following ethanol induced gastric lesions.RESULTS: BPB produced a dose-dependent inhibition of gastric acid secretion and acidity in rats. Pretreatment with BPB significantly attenuated the formation of ethanol induced gastric lesion. BPB also protected intestinal mucosa against cysteamine-induced duodenal ulcers.The antiulcer activity of BPB was associated with significant inhibition of ethanol-induced depletion of gastric wall mucus, NP-SH and MPO. These findings pointed towards the mediation of sulfhydryls in BPB induced gastrointestinal cytoprotection.CONCLUSION: BPB possesses significant antiulcer and cytoprotective activity against experimentally induced gastroduodenal lesions.

  13. 2D DIGE Does Not Reveal all: A Scotopic Report Suggests Differential Expression of a Single "Calponin Family Member" Protein for Tetany of Sphincters! (United States)

    Chaudhury, Arun


    Using 2D differential gel electrophoresis (DIGE) and mass spectrometry (MS), a recent report by Rattan and Ali (2015) compared proteome expression between tonically contracted sphincteric smooth muscles of the internal anal sphincter (IAS), in comparison to the adjacent rectum [rectal smooth muscles (RSM)] that contracts in a phasic fashion. The study showed the differential expression of a single 23 kDa protein SM22, which was 1.87 fold, overexpressed in RSM in comparison to IAS. Earlier studies have shown differences in expression of different proteins like Rho-associated protein kinase II, myosin light chain kinase, myosin phosphatase, and protein kinase C between IAS and RSM. The currently employed methods, despite its high-throughput potential, failed to identify these well-characterized differences between phasic and tonic muscles. This calls into question the fidelity and validatory potential of the otherwise powerful technology of 2D DIGE/MS. These discrepancies, when redressed in future studies, will evolve this recent report as an important baseline study of "sphincter proteome." Proteomics techniques are currently underutilized in examining pathophysiology of hypertensive/hypotensive disorders involving gastrointestinal sphincters, including achalasia, gastroesophageal reflux disease (GERD), spastic pylorus, seen during diabetes or chronic chemotherapy, intestinal pseudo-obstruction, and recto-anal incontinence. Global proteome mapping may provide instant snapshot of the complete repertoire of differential proteins, thus expediting to identify the molecular pathology of gastrointestinal motility disorders currently labeled "idiopathic" and facilitating practice of precision medicine.

  14. Two synchronous somatostatinomas of the duodenum and pancreatic head in one patient

    Institute of Scientific and Technical Information of China (English)

    Radoje B (C)olovi(c); Slavko V Mati(c); Marjan T Micev; Nikica M Grubor; Henry Dushan Atkinson; Stojan M Latin(c)i(c)


    Somatostatinomas are extremely rare neuroendocrine tumors of the gastrointestinal tract, first described in the pancreas in 1977 and in the duodenum in 1979. They may be functional and cause somatostatinoma or inhibitory syndrome, but more frequently are non-functioning pancreatic endocrine tumors that produce somatostatin alone. They are usually single, malignant, large lesions, frequently associated with metastases, and generally with poor prognosis. We present the unique case of a 57-year-old woman with two synchronous non-functioning somatostatinomas, one solid duodenal lesion and one cystic lesion within the head of the pancreas, that were successfully resected with a pylorus-preserving Whipple's procedure. No secondaries were found in the liver, or in any of the removed regional lymph nodes. The patient had an uneventful recovery, and remains well and symptom-free at 18 mo postoperatively. This is an extremely rare case of a patient with two synchronous somatostatinomas of the duodenum and the pancreas. The condition is discussed with reference to the literature.

  15. [A case of gastric metastasis and carcinomatous peritonitis of breast cancer with improved QOL by stent implantation and gemcitabine]. (United States)

    Mukaibashi, Tomoe; Kojima, Izumi; Yamanaka, Ayumi; Nishiyama, Sachiko; Yamanaka, Takashi; Nakayama, Hirotaka; Matsuura, Hitoshi; Matsuzu, Kenichi; Inaba, Masaaki; Yoshida, Akira; Shimizu, Satoru


    A 73-year-old woman had undergone mastectomy for left breast cancer. One year later, bone metastasis was detected. After 7 years, the patient experienced epigastric discomfort, and gastrointestinal endoscopy showed stenosis of the pylorus and enlarged gastric folds. Stomach cancer was suspected at first, but gastric metastasis of breast cancer was diagnosed on the basis of endoscopic reexamination and computed tomography(CT)images. The patient could not drink water, and therefore, gastrointestinal stenting was performed, which facilitated ingestion to some extent. However, at the same time, an elevated serum carcinoembryonic antigen(CEA)level and jaundice were observed. Therefore, biliary tract stenosis due to carcinomatous peritonitis was diagnosed. We attempted to treat the jaundice with endoscopic retrograde cholangiopancreatography( ERCP)or percutaneous transhepatic cholangiography(PTCD), but the treatment was not successful, and an increase in ascites was noted. Accordingly, gemcitabine was administered as systemic therapy. As a result, ascites decreased and jaundice improved. Patients with gastric metastasis of breast cancer have poor quality of life(QOL)because of difficulties in ingestion or vomiting, and poor prognoses, because of frequent concurrent carcinomatous peritonitis. We experienced a case of gastric metastasis and carcinomatous peritonitis, and were able to improve the patient's QOL by gastrointestinal stenting and gemcitabine administration.

  16. Prophylactic and curative effects of Bacopa monniera in gastric ulcer models. (United States)

    Sairam, K; Rao, C V; Babu, M D; Goel, R K


    Bacopa monniera Wettst. (BM, syn. Herpestis monniera L; Scrophulariaceae), is an Ayurvedic drug used as a rasayana. Its fresh juice was earlier reported to have significant antiulcerogenic activity. In continuation, methanolic extract of BM (BME) standardized to bacoside-A content (percentage-38.0 +/- 0.9), when given in the dose of 10-50 mg/kg, twice daily for 5 days, showed dose-dependent anti-ulcerogenic on various gastric ulcer models induced by ethanol, aspirin, 2 h cold restraint stress and 4 h pylorus ligation. BME in the dose of 20 mg/kg, given for 10 days, twice daily showed healing effects against 50% acetic acid-induced gastric ulcers. Further work was done to investigate the possible mechanisms of its action by studying its effect on various mucosal offensive acid-pepsin secretion and defensive factors like mucin secretion, mucosal cell shedding, cell proliferation and antioxidant activity in rats. BME 20 mg/kg showed no effect on acid-pepsin secretion, increased mucin secretion, while it decreased cell shedding with no effect on cell proliferation. BME showed significant antioxidant effect per se and in stressed animals. Thus, the gastric prophylactic and curative effects of BME may be due to its predominant effect on mucosal defensive factors.

  17. A case of methicillin-resistant Staphylococcus aureus infection following bile duct stenting

    Institute of Scientific and Technical Information of China (English)

    Markus K Diener; Alexis Ulrich; Theresia Weber; Moritz N Wente; Markus W Büchler; Helmut Friess


    AIM: To present a case of methicillin-resistant Staphylococcus aureus (MRSA) infection following bile duct stenting in a patient with malignant biliary obstruction.METHODS: A 78-year-old male patient was admitted to a community hospital with progredient painless jaundice lasting over two weeks, weight loss and sweating at night.Whether a stent should be implanted pre-operatively in jaundiced patients or whether these patients should directly undergo surgical resection, was discussed.RESULTS: ERC and a biopsy from the papilla of Vater revealed an adenocarcinoma. In addition, a 7-Ch plastic stent was placed into the common bile duct. Persistent abdominal pain, increasing jaundice, weakness and indigestion led to the transfer of the patient to our hospital.A pylorus-preserving pancreatoduodenectomy wasperformed. Intraoperatively, bile leaked out of the transected choledochus andthe stent was found to be dislocated in the duodenum. A smear of the bile revealed an infection with MRSA, leading to post-operative isolation of the patient.CONCLUSION:As biliary stents can cause severe infection of the bile, the need for pre-operative placement of biliary stents should be carefully evaluated in each individual case.

  18. Protective Effect of Liriodendrin Isolated from Kalopanax pictus against Gastric Injury. (United States)

    Sohn, Yoon Ah; Hwang, Seon A; Lee, Sun Yi; Hwang, In Young; Kim, Sun Whoe; Kim, So Yeon; Moon, Aree; Lee, Yong Soo; Kim, Young Ho; Kang, Keum Jee; Jeong, Choon Sik


    In this study, we investigated the inhibitory activities on gastritis and gastric ulcer using liriodendrin which is a constituent isolated from Kalopanax pictus. To elucidate its abilities to prevent gastric injury, we measured the quantity of prostaglandin E2 (PGE2) as the protective factor, and we assessed inhibition of activities related to excessive gastric acid be notorious for aggressive factor and inhibition of Helicobacter pylori (H. pylori) colonization known as a cause of chronic gastritis, gastric ulcer, and gastric cancer. Liriodendrin exhibited higher PGE2 level than rebamipide used as a positive control group at the dose of 500 μM. It was also exhibited acid-neutralizing capacity (10.3%) and H(+)/K(+)-ATPase inhibition of 42.6% (500 μM). In pylorus-ligated rats, liriodendrin showed lower volume of gastric juice (4.38 ± 2.14 ml), slightly higher pH (1.53 ± 0.41), and smaller total acid output (0.47 ± 0.3 mEq/4 hrs) than the control group. Furthermore liriodendrin inhibited colonization of H. pylori effectively. In vivo test, liriodendrin significantly inhibited both of HCl/EtOH-induced gastritis (46.9 %) and indomethacin-induced gastric ulcer (46.1%). From these results, we suggest that liriodendrin could be utilized for the treatment and/or protection of gastritis and gastric ulcer.

  19. Fluid mechanical consequences of pendular activity, segmentation and pyloric outflow in the proximal duodenum of the rat and the guinea pig. (United States)

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


    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.

  20. A case of postoperative recurrent cholangitis after pancreaticoduodenectomy successfully treated by tract conversion surgery. (United States)

    Shiihara, Masahiro; Miura, Osamu; Konishi, Kozo; Takeo, Sachiko; Kakimoto, Tadatoshi; Hidaka, Gen; Shibui, Yuichi; Minamisono, Yoshikazu; Toda, Tomohiro; Uemura, Shuichiro; Yamamoto, Masakazu


    A 69-year-old man, who had undergone pylorus-preserving pancreaticoduodenectomy (PD) (Imanaga procedure) for duodenum papilla cancer 13 years prior, had a history of repeated hospitalization due to cholangitis since the third year after surgery and liver abscess at the 10th year after surgery. Gastrointestinal series indicated no stenosis after the cholangiojejunostomy. However, reflux of contrast media into the bile duct and persistence of food residues were observed. We considered the cholangitis to be caused by reflux and persistence of food residues into the bile duct. So, we performed the tract conversion surgery, Imanaga procedure to Child method. The postoperative course was good even after re-initiating dietary intake. He was discharged on the 19th day after surgery. He has not experienced recurrent cholangitis for 18 months. For patients with post-PD recurrent cholangitis caused by reflux of food residues like ours, surgical treatment should be considered because tract conversion may be an effective solution. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

  1. A case of postoperative recurrent cholangitis after pancreaticoduodenectomy successfully treated by tract conversion surgery (United States)

    Shiihara, Masahiro; Miura, Osamu; Konishi, Kozo; Takeo, Sachiko; Kakimoto, Tadatoshi; Hidaka, Gen; Shibui, Yuichi; Minamisono, Yoshikazu; Toda, Tomohiro; Uemura, Shuichiro; Yamamoto, Masakazu


    A 69-year-old man, who had undergone pylorus-preserving pancreaticoduodenectomy (PD) (Imanaga procedure) for duodenum papilla cancer 13 years prior, had a history of repeated hospitalization due to cholangitis since the third year after surgery and liver abscess at the 10th year after surgery. Gastrointestinal series indicated no stenosis after the cholangiojejunostomy. However, reflux of contrast media into the bile duct and persistence of food residues were observed. We considered the cholangitis to be caused by reflux and persistence of food residues into the bile duct. So, we performed the tract conversion surgery, Imanaga procedure to Child method. The postoperative course was good even after re-initiating dietary intake. He was discharged on the 19th day after surgery. He has not experienced recurrent cholangitis for 18 months. For patients with post-PD recurrent cholangitis caused by reflux of food residues like ours, surgical treatment should be considered because tract conversion may be an effective solution. PMID:27402542

  2. Effect of Perilla frutescens Fixed Oil on Experimental Esophagitis in Albino Wistar Rats

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    Ekta Arya


    Full Text Available The present study was undertaken to elucidate the effect of Perilla frutescens fixed oil on experimental esophagitis in albino rats. A group of rats (n=6, treated with control vehicle (0.9% NaCl in double distilled water, 3 mL/kg, i.p. and Perilla frutescens fixed oil (100% (1, 2, and 3 mL/kg, i.p., or pantoprazole (30 mg/kg, i.p., were subjected to pylorus and forestomach ligation. Animals were sacrificed after 6 h and evaluated for the gastric pH, volume of gastric juices, total acidity, esophagitis index and free acidity. Esophageal tissues were further subjected to estimations of TBARS, GSH, catalase, and SOD. Treatment with fixed oil significantly inhibited the gastric secretion, total acidity, and esophagitis index. The oil also helped to restore the altered levels of oxidative stress parameters to normal. The present study also makes evident the in vitro antihistaminic and anticholinergic activity of alpha linolenic acid (ALA (18 : 3, n−3 on isolated rat ileum preparation. The lipoxygenase inhibitory, histamine antagonistic, antisecretory (anticholinergic, and antioxidant activity of the oil was attributed for its efficacy in reflux esophagitis.

  3. Comparative antidiarrheal and antiulcer effect of the aqueous and ethanolic stem bark extracts of Tinospora cordifolia in rats

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    Mohanjit Kaur


    Full Text Available Tinospora cordifolia is indigenous to the tropical areas of India, Myanmar and Sri Lanka. The use of plant as remedy for diarrhea and ulcer is well-documented in Ayurvedic system of medicine. However, pharmacological evidence does not exist to substantiate its therapeutic efficacy for the same. The aim was to investigate the antidiarrheal and antiulcer activity of ethanolic and aqueous extracts of T. cordifolia in rats. The antidiarrheal activity of T. cordifolia extracts was evaluated by castor oil and magnesium sulfate-induced diarrhea using parameters such as onset of diarrhea, number of wet stools, total number of stool and weight of total number of stools. The antiulcer activity of extracts was investigated using ethanol and pylorus ligation-induced ulcer. Furthermore, tissue antioxidant parameters such as reduced glutathione, catalase activity and lipid peroxidation level were also investigated. Tinospora cordifolia extracts were more efficacious in reducing number of total stools in both the models of diarrhea and showed a dose-dependent antidiarrheal effect. The antiulcer activity of the extracts was confirmed by a reduction in ulcer index along with the decrease in gastric volume, total acidity, and an increase in pH of gastric content in both the models. The obtained results have established a pharmacological evidence for the folkloric use of the T. cordifolia as antidiarrhoeal and antiulcer agent.

  4. Antiulcer activity of methanolic extract and fractions of Picralima nitida seeds(Apocynacaea) in rats

    Institute of Scientific and Technical Information of China (English)

    Okonta Jegbefume Mathew; Adibe Maxwell Ogochukwu; Ubaka Chukwuemeka Michael


    Objective: To investigated the antisecrectory activities of the methanol extract, chloroform fraction and methanol fraction of Picralima nitida seeds. Methods: The methanol extract of Picralima nitida seeds was fractionated into chloroform fraction and methanol fraction. They were evaluated for antiulcer activity and gastric emptying time in rats using aspirin-pylorus-ligation model. Results: Oral administration of the methanol extract, chloroform fraction and methanol fraction at 1 000 mg/kg reduced gastric ulcer by 56.4%, 40.0% and 56.3%, respectively; and the fractions of the extract significantly (P<0.05) reduced gastric emptying time when compared to the control. Gastric acidity was significantly decreased when compared with saline group, 40.25 mEq/L in methanol extract, 50.0 mEq/L in chloroform fraction 51.25 mEq/L in methanol fration but had no significant effect on the gastric secretion volume. Conclusions: These findings showed that methanol extract, chloroform fraction and methanol fraction of the seeds of Picralima possessed potent antiulcer properties and some antisecretory properties.

  5. Acute duodenal Crohn's disease successfully managed with low-speed elemental diet infusion via nasogastric tube: A case report

    Institute of Scientific and Technical Information of China (English)

    Takayuki Yamamoto; Maki Nakahigashi; Satoru Umegae; Tatsushi Kitagawa; Koichi Matsumoto


    Duodenal Crohn's disease is rare, and patients without obstruction are treated medically. We herein report one case whose duodenal Crohn's disease was successfully managed with low-speed elemental diet infusion through a nasogastric tube. A 28-year-old female developed acute duodenal Crohn's disease. Upper GI radiologic and endoscopic examinations showed a stricture in the duodenal bulb. Using the duodenal biopsy specimens,mucosal cytokine levels were measured; interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α levels were remarkably elevated. For initial 2 wk, powdered mesalazine was orally given but it was not effective. For the next 2 wk, she was treated with low-speed elemental diet therapy using a commercially available ElentalTM,which was infused continuously through a nasogastric tube using an infusion pump. The tip of the nasogastric tube was placed at an immediate oral side of the pylorus.The infusion speed was 10 mL/h (usual speed, 100 mL/h).After the 2-wk treatment, her symptoms were very much improved, and endoscopically, the duodenal stricture and inflammation improved. The duodenal mucosal cytokine levels remarkably decreased compared with those before the treatment. Although our experience was limited, lowspeed elemental diet infusion through a nasogastric tube may be a useful treatment for acute duodenal Crohn's disease.

  6. Gastric volvulus in children: the twists and turns of an unusual entity

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    Oh, Sarah K.; Han, Bokyung K.; Levin, Terry L.; Blitman, Netta M. [Children' s Hospital at Montefiore Medical Center, Department of Radiology, Bronx, NY (United States); Murphy, Robyn [Morristown Memorial Hospital, Department of Radiology, Morristown, NJ (United States); Ramos, Carmen [Children' s Hospital at Montefiore Medical Center, Department of Pediatric Surgery, Bronx, NY (United States)


    Gastric volvulus in children is uncommon, and characteristic radiographic findings might not be recognized. To present the spectrum of clinical and imaging findings, correlate the type of gastric volvulus with clinical outcome, and identify imaging findings to aid in early diagnosis. Medical records and imaging findings of ten children with gastric volvulus were reviewed. Imaging included abdominal radiographs, upper gastrointestinal (UGI) series, and CT. The diagnosis (organoaxial, mesenteroaxial or mixed type) was made on the UGI series (n = 9) and CT (n = 1), and confirmed surgically in seven children. Patients were classified based on presentation: four acute, four chronic, and two neonatal. All of the acute group (three mesenteroaxial and one mixed type) had abnormal radiographic findings: three spherical gastric distension, four paucity of distal gas, three elevated left hemidiaphragm, one overlapping pylorus and gastric fundus, one unusual nasogastric tube course, and one situs inversus. All underwent emergent surgery. Three had diaphragmatic abnormalities. One had heterotaxy. Patients in the chronic group (three organoaxial, one mesenteroaxial) had long-standing symptoms. Most had associated neurologic abnormalities. In the neonatal group, organoaxial volvulus was found incidentally on the UGI series. A spectrum of findings in gastric volvulus exists. Mesenteroaxial volvulus has greater morbidity and mortality. Radiographic findings of spherical gastric dilatation, paucity of distal gas and diaphragmatic elevation are suggestive of acute volvulus, particularly in patients with predisposing factors. (orig.)

  7. Aqueous suspension of anise "Pimpinella anisum" protects rats against chemically induced gastric ulcers

    Institute of Scientific and Technical Information of China (English)

    Ibrahim A Al Mofleh; Abdulqader A Alhaider; Jaber S Mossa; Mohammed O Al-Soohaibani; Syed Rafatullah


    AIM:To substantiate the claims of Unani and Arabian traditional medicine practitioners on the gastroprotective potential effect of a popular spice anise,"Pimpinella anisum L." on experimentally-induced gastric ulceration and secretion in rats.METHODS:Acute gastric ulceration in rats was produced by various noxious chemicals including 80% ethanol,0.2 mol/L NaOH,25% NaCl and indomethacin.Anti-secretory studies were undertaken using pylorusligated Shay rat technique.Levels of gastric non-protein sulfhydryls(NP-SH)and wall mucus were estimated and gastric tissue was also examined histologically.Anise aqueous suspension was used in two doses(250 and 500 mg/kg body weight)in all experiments.RESULTS:Anise significantly inhibited gastric mucosal damage induced by necrotizing agents and indomethacin.The anti-ulcer effect was further confirmed histologically.In pylorus-ligated Shay rats,anise suspension significantly reduced the basal gastric acid secretion,acidity and completely inhibited the rumenal ulceration.On the other hand,the suspension significantly replenished ethanol-induced depleted levels of gastric mucosal NP-SH and gastric wall mucus concentration.CONCLUSION:Anise aqueous suspension possesses significant cytoprotective and anti-ulcer activities against experimentally-induced gastric lesions.The anti-ulcer effect of anise is possibly prostaglandin-mediated and/or through its anti-secretory and antioxidative properties.

  8. Structural classifications in the digestive tract of short mackerel, Rastrelliger brachysoma (Bleeker, 1865 from Upper Gulf of Thailand

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    Sinlapachai Senarat


    Full Text Available This study was the first attempt on the classification of the gross anatomy with histological structures of the digestive tract in the Rastrelliger brachysoma. Based on gross anatomical analysis, the digestive tract (65.68±7.06 cm, n = 25 is distinctly composed of four parts; oesophagus, stomach, pyloric caeca and intestine, respectively. Base on the histological analysis of the digestive tract, it is composed of four layers: mucosa, submucosa, muscularis and serosa. The epithelial lining of anterior oesophagus was shown to be a simple squamous epithelium whereas posterior oesophagus, stomach and intestine were simple columnar epithelium. The surface of this epithelium positively stained with both Periodic Acid Schiff (PAS and alcian blue (AB. The posterior oesophagus exclusively showed high longitudinal fold with numerous gastric glands in the mucosal layer, which is similar to the stomach structure (cariac and pylorus. Numerous pyloric caeca about 220-225 pieces, were detected between the stomach and intestine regions. Finally, the intestinal coefficient (IC was 3.69±0.47 cm. The anterior intestine presented either various longitudinal folds or various goblet cells. The short longitudinal folds of posterior intestine were in the higher number of goblet cell than the previous part.

  9. Diagnostic and treatment modalities for autoimmune pancreatitis. (United States)

    Rao, Atul S; Palazzo, Francesco; Chung, Joanne; Hager, Eric; Abdollahi, Hamid; Yeo, Charles J


    Since the recognition of autoimmune pancreatitis (AIP) as a clinical entity, many advances have been made in defining clinical, radiologic, histologic, and laboratory parameters to assist in a complete definition of the disease. Despite all these efforts, a preoperative diagnosis still remains a clinical challenge but is of paramount importance, as these cases have been reported to be steroid-responsive; therefore, early treatment may obviate the need for surgical resection. Although the utilization of recently proposed guidelines by the Japanese Pancreas Society and an Italian study group may further assist the clinician and prompt the initiation of steroid treatment, the response to therapy should be observed within 2 to 4 weeks and reflected in progressive resolution of the presenting radiologic and laboratory abnormalities. Should these fail to demonstrate improvement, the diagnosis of AIP should undergo re-evaluation, and consideration for surgical exploration should be made, as the patient may be harboring a malignancy. Surgical resection in the form of pylorus-preserving pancreaticoduodenectomy remains the optimal solution in the attempt to clarify the diagnosis and offer treatment with low complication rates.

  10. Successful treatment with a combination of endoscopic injection and irrigation with coca cola for gastric bezoar-induced gastric outlet obstruction. (United States)

    Lin, Chen-Sheng; Tung, Chun-Fang; Peng, Yen-Chun; Chow, Wei-Keung; Chang, Chi-Sen; Hu, Wei-Hsiung


    We report a case of gastric bezoar-induced gastric outlet obstruction that was successfully treated with a combination of endoscopic injection and irrigation with Coca Cola. A 73-year-old diabetic woman had a history of perforated peptic ulcer and had received pyloroplasty more than 20 years previously. She had been ingesting Pho Pu Zi (Cordia dichotoma Forst. f.) as an appetizer for 1 month. She presented with epigastric pain, nausea, and vomiting. Upper gastrointestinal endoscopy, performed at a local hospital, showed 2 gastric bezoars in the stomach, and 1 of them impacted at the pylorus. She was referred to our emergency department for removal of the gastric bezoars that were suspected to be causing gastric outlet obstruction. All attempts at endoscopic removal using a polypectomy snare, biopsy forceps and Dormia basket failed. We then injected Coca Cola directly into the bezoar mass, followed by irrigation with Coca Cola. Follow-up endoscopy was performed the next day, which revealed that the gastric bezoars had dissolved spontaneously.

  11. The impact of asthma on the gastrointestinal tract (GIT

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    Warren Antonio Vieira


    Full Text Available Warren Antonio Vieira, Etheresia PretoriusDepartment of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South AfricaAbstract: The gastrointestinal tract (GIT of vertebrates is composed of several distinct ­compartments and glands as well as an extensive mucosal surface. Its primary function is that of chemical and physical digestion of food and the absorption of nutrients; however, due to its continual antigen exposure, the GIT also has an important defensive immunological function. The GIT’s immunological participation is facilitated by the mucosa-associated lymphoid tissues, thought to share the mucosal immunological system with the respiratory mucosa-associated lymphoid tissues. As a result of this shared mucosal immunity, it has been hypothesized that bronchial asthma may be able to affect the body’s GIT in the same pathophysiological manner as the airways and lungs. Here we discuss the link between bronchial asthma and ­pathophysiological features in the GIT – including leukocyte influx, goblet cell alterations, fibrosis, and epithelial and villous atrophy.Keywords: fundus, pylorus, common mucosal system, asthma, gastrointestinal tract

  12. Autoimmune pancreatitis associated with a large pancreatic pseudocyst

    Institute of Scientific and Technical Information of China (English)

    Thilo Welsch; J(o)rg Kleeff; Irene Esposito; Markus W Büchler; Helmut Friess


    Pancreatic cystic lesions comprise various entities with different histopathological characteristics and their differential diagnosis is often a challenge for clinicians.Autoimmune pancreatitis (ATP) is usually not considered in the differential diagnosis of cystic lesions, but often mimics the morphological aspects of pancreatic neoplasm. We report the case of a 64-year-old male patient with a cystic pancreatic head lesion (diameter 5 cm) and stenosis of the distal bile duct requiring repeated stentlng. Because of the clinical presentation together with moderate elevation of serum CA19-9 and massive elevation of cyst fluid CA19-9 (122.695 U/L; normal range: <37.0 U/L), the patient underwent explorative laparotomy and pylorus preserving partial pancreaticoduodenectomy.Histology revealed surprisingly ATP with an inflammatory pseudocyst. Tn conclusion, cyst fluid analysis of tumor markers and cyst fluid cytology lack high accuracy to clearly differentiate cystic pancreatic lesions. Although ATP is rarely associated with pseudocysts, the disease has to be considered in the differential diagnosis of cystic pancreatic lesions. Early examination of serum IgG,IgG4 and auto-antibodies might save these patients from unnecessary endoscopical and surgical procedures.

  13. Total laparoscopic gastrocystoplasty: experimental technique in a porcine model

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    Frederico R. Romero


    Full Text Available OBJECTIVE: Describe a unique simplified experimental technique for total laparoscopic gastrocystoplasty in a porcine model. MATERIAL AND METHODS: We performed laparoscopic gastrocystoplasty on 10 animals. The gastroepiploic arch was identified and carefully mobilized from its origin at the pylorus to the beginning of the previously demarcated gastric wedge. The gastric segment was resected with sharp dissection. Both gastric suturing and gastrovesical anastomosis were performed with absorbable running sutures. The complete procedure and stages of gastric dissection, gastric closure, and gastrovesical anastomosis were separately timed for each laparoscopic gastrocystoplasty. The end-result of the gastric suturing and the bladder augmentation were evaluated by fluoroscopy or endoscopy. RESULTS: Mean total operative time was 5.2 (range 3.5 - 8 hours: 84.5 (range 62 - 110 minutes for the gastric dissection, 56 (range 28 - 80 minutes for the gastric suturing, and 170.6 (range 70 to 200 minutes for the gastrovesical anastomosis. A cystogram showed a small leakage from the vesical anastomosis in the first two cases. No extravasation from gastric closure was observed in the postoperative gastrogram. CONCLUSIONS: Total laparoscopic gastrocystoplasty is a feasible but complex procedure that currently has limited clinical application. With the increasing use of laparoscopy in reconstructive surgery of the lower urinary tract, gastrocystoplasty may become an attractive option because of its potential advantages over techniques using small and large bowel segments.

  14. Effect of denervation of the myenteric plexus on gastroduodenal motility in turkeys. (United States)

    Chaplin, S B; Duke, G E


    The effect of denervation of portions of the myenteric plexus on initiation and coordination of gastric and duodenal contractions was examined in domestic turkeys. Three areas of the muscular stomach (MS), the isthmus between the glandular stomach (GS) and MS, and the pylorus were denervated by application of 1% benzalkonium chloride. Motor activity of the gastroduodenal organs was monitored for 1 h every other day for 13 days using strain gauge transducers implanted at selected sites. Denervation of the isthmus reduced the frequency of MS and duodenal contractions by 50% and abolished GS contractions. Pyloric denervation did not affect the frequency of GS or MS contractions but abolished duodenal contractions. These results suggest that 1) a driving pacemaker for the gastroduodenal cycle is located in the isthmus, and 2) the myenteric plexus is essential for conduction from the pacemaker to the GS and to the duodenum. Denervation of the medial commissure of the myenteric plexus of the MS significantly impaired the function of the ventral half of the MS. It caused atrophy of the underlying medial thick muscle and significantly decreased contraction amplitude. Denervation at this site also caused an enlargement and impaction of the adjacent caudal thin muscle with food and a significant decrease in contraction amplitude. In contrast, denervation of the lateral commissure enlarged the underlying lateral thick muscle and significantly increased its contraction amplitude. Denervation of the cranial thin muscle delayed contractions of that muscle, causing an asynchronization of thin muscle pair.(ABSTRACT TRUNCATED AT 250 WORDS)


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    N. Hamdulay*, Z. Attaurrahaman , V. Shende and M. Lawar


    Full Text Available Trichosanthes dioica Roxb (family: Cucurbitaceae, commonly known as “Sespadula” in English and “Parwal” in Hindi and is widely grown throughout India. The leaves of this plant have also been used in traditional system of medicine for overcoming problems like constipation, fever, skin infection, wound healing and also in gastric ulcer. In the present study Aqueous extract of leaves of Trichosanthes dioica Roxb was evaluated for its antiulcer activity against; 1 Aspirin plus pylorus ligation model and, 2 Ethanol/HCl-induced ulcer in wistar rats. Ranitidine (100 mg/kg was used as the standard drug. Different groups of rats (n=6 in each group were given two doses (250 and 500 mg/kg of T.dioica extract. Phytochemical analysis of the extract was also done. Phytochemical results revealed presence of tannins, saponins, triterpenoids, flavanoids. Thus only T.dioica extract (500 mg/kg significantly (p<0.001 reduced the ulcer index in all the models used. The extract also significantly (p<0.001 increased the pH of gastric acid while at the same time reduced the volume of gastric juice, free and total acidities. Also it showed significant (p<0.05 reduction in pepsin activity. In conclusion, the present study provides preliminary data on antiulcer potential of Trichosanthes dioica leaves and supports the traditional use of the plant for the treatment of gastric ulcer.

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

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    Egashira Yutaro


    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.

  17. Inflammatory responses in the muscle coat of stomach and small bowel in the postoperative ileus model of guinea pig. (United States)

    Choi, Hong Kyu; Lee, Young Ju; Lee, Young Ho; Park, Jong Pil; Min, Kevin; Park, Hyojin


    Small intestinal function returns first after surgery, and then the function of the stomach returns to normal after postoperative ileus (POI). The aim of this study was to investigate inflammatory responses in the muscle coat of stomach and small intestine in guinea pig POI model. The distance of charcoal migration from pylorus to the distal intestine was measured. Hematoxylin and eosin (H&E) and immunohistochemical stain for calprotectin were done from the histologic sections of stomach, jejunum and ileum obtained at 3 and 6 hour after operation. Data were compared between sham operation and POI groups. The distance of charcoal migration was significantly reduced in the 3 and 6 hour POI groups compared with sham operated groups (pstomach of 3 hour POI groups compared with jejunum and ileum of POI groups or sham operated groups (pstomach of 3 hour POI groups compared with jejunum and ileum of POI groups or sham operated groups (pstomach. Postoperative ileus induced by cecal manipulation significantly increased the degree of inflammation and calprotectin positive cells in the muscle coat of stomach as a remote organ. The relevance of degree of inflammation and the recovery time of ileus should be pursued in the future research.

  18. Semipurified Ethyl Acetate Partition of Methanolic Extract of Melastoma malabathricum Leaves Exerts Gastroprotective Activity Partly via Its Antioxidant-Antisecretory-Anti-Inflammatory Action and Synergistic Action of Several Flavonoid-Based Compounds (United States)

    Ismail Suhaimy, Noor Wahida; Noor Azmi, Ahmad Khusairi; Mohtarrudin, Norhafizah; Cheema, Manraj Singh


    Recent study has demonstrated the gastroprotective activity of crude methanolic extract of M. malabathricum leaves. The present study evaluated the gastroprotective potential of semipurified extracts (partitions): petroleum ether, ethyl acetate (EAMM), and aqueous obtained from the methanolic extract followed by the elucidation of the gastroprotective mechanisms of the most effective partition. Using the ethanol-induced gastric ulcer assay, all partitions exerted significant gastroprotection, with EAMM being the most effective partition. EAMM significantly (i) reduced the volume and acidity (free and total) while increasing the pH of gastric juice and enhanced the gastric wall mucus secretion when assessed using the pylorus ligation assay, (ii) increased the enzymatic and nonenzymatic antioxidant activity of the stomach tissue, (iii) lost its gastroprotective activity following pretreatment with N-omega-nitro-L-arginine methyl ester (L-NAME; NO blocker) or carbenoxolone (CBXN; NP-SH blocker), (iv) exerted antioxidant activity against various in vitro oxidation assays, and (v) showed moderate in vitro anti-inflammatory activity via the LOX-modulated pathway. In conclusion, EAMM exerts a remarkable NO/NP-SH-dependent gastroprotective effect that is attributed to its antisecretory and antioxidant activities, ability to stimulate the gastric mucus production and endogenous antioxidant system, and synergistic action of several gastroprotective-induced flavonoids. PMID:28168011

  19. Structure and Function of the Gastrointestinal Tract of the Green Turtle (Chelonia mydas) Hatchling

    Institute of Scientific and Technical Information of China (English)

    Hualing CHEN; Mingbin YE; Yuyan LU; Jinxia DUAN; Pipeng LI; Hexiang GU


    The gastrointestinal tracts of four Chelonia mydas hatchlings were examined at the anatomical, histological and ultrastructural level. Our results show that the gastrointestinal tract (GI) is composed by esophagus, stomach, small intestine (SI) and large intestine (LI), and histologically of mucosa, submucosa, muscularis externa (ME) and serosa. The esophagus is marked by conical papillae lined by keratinized stratified squamous epithelium, whereas the remaining GI by simple columnar epithelium; esophageal diverticulum is absent. The stomach covered with mucous granule cells, contains cardia, fundic regions and pylorus, which are separately characterized by cardiac glands, fundic glands and pyloric glands, and have the thickest submucosa and ME of the GI. The ME of the esophagus mainly consist of one layer of circular smooth muscle whereas the rest of GI of two layers, inner circular muscle and outer longitudinal muscle. The SI is slightly longer than the LI and the GI is approximately 5.11 times of the carapace length. The SI is lined with longitudinal zigzag folds and characterized by absorptive cells with longer and denser microvilli, whereas the LI by transversal folds, goblet cells and lymphoid nodules. Only intestinal glands appear in duodenum. Endocrine cells are observed in all sections of the GI and accounted for the largest proportion in duodenum. The results demonstrate a perfect combination of the structure and function of the GI and reveal that the digestion and absorption primarily occurs in the foregut. C. mydas hatchling may prefer carnivorous diet.

  20. Desmodium gangeticum: a potent anti-ulcer agent. (United States)

    Dharmani, Poonam; Mishra, Pushpesh Kumar; Maurya, Rakesh; Chauhan, Vinay Singh; Palit, Gautam


    The present study was designed to investigate anti-ulcerogenic property of ethanolic extract of Desmodium gangeticum (DG) against cold restraint (CRU, 2 hr cold restraint stress), aspirin (ASP, 150 mg/kg orally), alcohol (AL, absolute alcohol 1 ml/200gm) and pyloric ligation (PL, 4 hr pylorus ligation) induced gastric ulcer models in Sprague Dawley rats, and histamine (HST, 0.25 mg/kg) induced duodenal ulcer in guinea pigs. We found that DG at a dose of 200mg/kg, (orally), markedly decreased the incidence of ulcers in all the above models. DG showed significant protection against CRU (68.37%), AL (88.87%), ASP (38.2%), PL (40.63%) and HST (63.15%) induced ulcer models, whereas standard drug omeprazole (OMZ) showed protection index of 83.86, 56.35, 70.31 and 84.21%, respectively in CRU, ASP, PL and HST models. Sucralfate as standard drug showed 92.64% protection in AL model. DG significantly reduced acid secretion 41.61%, whereas OMZ produced 43.13% reduction. Treatment with DG showed increase in mucin secretion by 56.17%, whereas OMZ showed 12.45% increase. Anti-ulcer effect of DG may be due to its cytoprotective effect along with antisecretory activity and could act as a potent therapeutic agent against peptic ulcer disease.

  1. Effects of cisapride on ulcer formation and gastric secretion in rats: comparison with ranitidine and omeprazol. (United States)

    Alarcón de la Lastra, C; Martin, M J; La Casa, M; López, A; Motilva, V


    1. The antiulcerogenic effects of cisapride, a potent benzamide-stimulating gastrointestinal motility agent, were studied on cold-resistant and pylorus-ligated gastric ulcers. Acidity, composition of gastric secretion, and quantitative and qualitative changes on mucus glycoprotein content were also determined. These effects were compared with those of ranitidine (50 mg/kg) and omeprazol (10 mg/kg). 2. Oral cisapride (10-100 mg/kg) dose-relatedly and significantly (P < 0.01, P < 0.05) decreased the severity of the lesions induced by cold-resistant stress. In stressed rats, cisapride increased the amount of mucus secretion and markedly enhanced the glycoprotein content. Morphometric evaluation of mucus secretion revealed a significant increase in both the PAS area (neutral glycoproteins) and Alcian blue area (sulfated glycoproteins). 3. In 4 h pyloric-ligated animals, cisapride (10-100 mg/kg) showed a significant reduction in the number and severity of ulcers (P < 0.01) and histamine concentration (P < 0.01, P < 0.001). In addition, at the highest doses (50-100 mg/kg), cisapride produced a significant decreases in acidity; however, it did not alter the gastric volume secretion or pepsin concentrations. 4. These results suggest that cisapride shows antiulcerogenic effects which could possibly be explained through antisecretory and cytoprotective mechanisms involving an enhancement of cuality and production of gastric mucus.

  2. Gastric cancer following bariatric surgery: a review. (United States)

    Orlando, Giulio; Pilone, Vincenzo; Vitiello, Antonio; Gervasi, Rita; Lerose, Maria A; Silecchia, Gianfranco; Puzziello, Alessandro


    Bariatric procedures can induce a massive weight loss that lasts for >15 years after surgery; in addition, they achieve important metabolic effects including diabetes resolution in the majority of morbidly obese patients. However, some bariatric interventions may cause gastroesophageal reflux disease and other serious complications. The aim of our study is to evaluate the risk of cancer after bariatric surgery. We conducted a review of the literature about the cases of gastric cancer arising after any bariatric procedure, including a case of adenocarcinoma incidentally discovered by the authors 6 months after laparoscopic adjustable gastric banding. Globally, 17 case reports describing 18 patients were retrieved, including the case study by the authors. The diagnosis of tumor was at a mean of 8.6 years after bariatric surgery, 9.3 years after RYGB, and 8.1 years after restrictive procedures. The adenocarcinoma represented most cases (15 patients, 83%). In the patients with RYGB, the adenocarcinoma was localized in the excluded stomach in 5 patients (83%) and in the pouch in 1 patient (17%). After a restrictive procedure, the cancer was localized in the pouch in 5 patients (62.5%), in the pylorus in 2 patients (25%), and in lesser curvature only in 1 patient (12.5%). There is a lack of evidence about a connection between the late occurrence of gastric adenocarcinoma and the bariatric surgery. For this reason, although the preoperative upper endoscopy is still mandatory, there is no need for a regular endoscopic evaluation of patients after surgery.

  3. A case of feline gastrointestinal eosinophilic sclerosing fibroplasia associated with phycomycetes. (United States)

    Grau-Roma, L; Galindo-Cardiel, I; Isidoro-Ayza, M; Fernandez, M; Majó, N


    Feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) is a recently described inflammatory condition of domestic cats with unknown aetiology. A proportion of cases of FGESF are associated with bacteria, but antibiotic treatment is ineffective. It has been hypothesized that genetically predisposed cats may develop FGESF in response to the introduction of bacteria or other antigens into the intestinal wall. A 9- month-old male Persian cat presented with a history of marked acute haematemesis. A mass (10 cm diameter) was detected within the pylorus and proximal duodenum and this was not surgically accessible. On necropsy examination the duodenal wall was seen to be markedly thickened with extensive mucosal ulceration. Microscopically, there were haphazardly oriented trabecular bands of dense eosinophilic collagen, separated by wide, clear areas containing variable numbers of fibroblasts, eosinophils, mast cells, neutrophils, macrophages, lymphocytes and plasma cells. Numerous pleomorphic, non-parallel walled, sparsely septate hyphae, characteristic of phycomycetes, were present within the collagen matrix. Colonies of gram-positive and gram-negative rods were also present within the lesion. This is the first description of FGESF with intralesional fungi.


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    Full Text Available Gastric outlet obstruction is defined as a clinical and patho - physiological consequence of any disease process that produces a mechanical impediment to gastric emptying which may be extrinsic or intrinsic. Gastric outlet obstruction can be a diagnostic and treatment dilemma. Endoscopy of upper gastrointestinal tract has been a sensitive and specific investigation to study the status of gastric outlet - the pylorus and has enabled early detection of lesions of both stomach a nd duodenum. We undertook a prospective clinical study regarding incidence, etiology, investigation and management of cases of Gastric outlet obstruction in adults in a period of three years. In our study the m ost common cause of GOO is Carcinoma stomach a ntral region 46.6% , duodenal ulcer 33.3% , corrosive acid ingestion sequel 8.3%, peri ampullary carcinoma 6.6%, Ca pancreas 3.3%% , cholangio Carcinoma 1.6%. Males are more commonly involved in a ratio of M: F=3:1. Surgical procedures done varied from defini tive resections to palliative bypass or feeding jejunostomy for enteral feeding

  5. Total pancreatectomy combined with partial pancreas autotransplantation for recurrent pancreatic cancer: a case report. (United States)

    Kobayashi, T; Sato, Y; Hirukawa, H; Soeno, M; Shimoda, T; Matsuoka, H; Kobayashi, Y; Tada, T; Hatakeyama, K


    We describe a patient presenting with a resectable carcinoma of the remnant pancreas at 3 years after undergoing a pylorus-preserving pancreaticoduodenectomy for invasive ductal carcinoma of the pancreatic head. We also performed a distal pancreas autotransplantation using a part of the resected pancreas to preserve endocrine function. Final histologic findings showed the second tumor to be an invasive ductal carcinoma consisting of a well-differentiated tubular adenocarcinoma with similar histopathologic findings as the first tumor. There were no microscopic lymph node metastases and no evidence of microvascular invasion (pStage IA [pT1, pN0, M0] and R0 according to the International Union Against Cancer TNM classification). The patient was discharged at 20 days after surgery without any trouble and followed by adjuvant chemotherapy with S-1. The carbohydrate antigen 19-9 value was again normalized after the second surgery. Twenty months after the second operation, the patient is alive without cancer recurrence. The pancreas graft is functioning with a blood glucose of 108 mg/dL, HbA1C of 6.2%, and serum C-peptide of 1.4 ng/mL.

  6. Sonographic Layers in Infantile Hypertrophic Pyloric Stenosis seen on High Resolution Sonography

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    Kim, Dae Soon; Yoo, Shi Joo; Yoo, Yong Ho; Kim, In Koo; Kim, Kyung Mo; Choe, Ghee Young [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)


    Sonography is a conclusive method in the diagnosis of infantile hypertrophic pyloric stenosis(IHPS). However, previous reports incompletely described the sonographic layers. This study was performed to define the layers seen on high resolution sonography. We performed high resolution sonography with 10-5 MHz linear transducer in 8 patients with IHPS. The layers seen on sonography were correlated with histopathologic findings by obtaining thin section of thickened gastric wall during surgery. All cases showed typical sonographic findings that were previously described. The thickened pyloric wall consisted of 5 sonographic layers : extremely echogenic mucosal interface, hypoechoic mucosa, hyperechoic submucosa, mixed echogenic circular muscle layer, and hypoechoic longitudinal muscle layer. On longitudinal scan of pylorus,circular muscle fiber directions were identified as alternating bands of hyper-and hypoechogenicity with the appearance of zebra skin. Clear delineation of the layers of gastric wall and the muscle fiber directions of hypertrophied circular muscle in IHPS showed by high resolution sonography. Our results are contradictory to the previous reports that defined the sonolucent double tracks as collapsed lumen and the echogenic lines as mucosa. We believe that the multiple hypoechogenic bands seen in longitudinal scan represent the folded mucosal layers and that the echogenic lines are from the mucosal interface

  7. Cholecystokinin hyperresponsiveness in functional dyspepsia

    Institute of Scientific and Technical Information of China (English)

    ASB Chua; PWN Keeling


    Functional dyspepsia (FD) is a common disorder of yet uncertain etiology. Dyspeptic symptoms are usually meal related and suggest an association to gastrointestinal (GI) sensorimotor dysfunction. Cholecystokinin (CCK) is an established brain-gut peptide that plays an important regulatory role in gastrointestinal function. It inhibits gastric motility and emptying via a capsaicin sensitive vagal pathway. The effects on emptying are via its action on the proximal stomach and pylorus. CCK is also involved in the regulation of food intake. It is released in the gut in response to a meal and acts via vagal afferents to induce satiety. Furthermore CCK has also been shown to be involved in the pathogenesis of panic disorder, anxiety and pain. Other neurotransmitters such as serotonin and noradrenaline may be implicated with CCK in the coordination of GI activity. In addition,intravenous administration of CCK has been observed to reproduce the symptoms in FD and this effect can be blocked both by atropine and Ioxiglumide (CCK-A antagonist). It is possible that an altered response to CCK may be responsible for the commonly observed gastric sensorimotor dysfunction, which may then be associated with the genesis of dyspeptic symptoms.

  8. Visceral response to acute retrograde gastric electrical stimulation in healthy human

    Institute of Scientific and Technical Information of China (English)

    Shu-Kun Yao; Mei-Yun Ke; Zhi-Feng Wang; Da-Bo Xu; Yan-Li Zhang


    AIM: To investigate the visceral response to acute retrograde gastric electrical stimulation (RGES) in healthy humans and to derive optimal parameters for treatment of patients with obesity.METHODS: RGES with a series of effective parameters were performed via a bipolar mucosal electrode implanted along the great curvature 5 cm above pylorus of stomach in 12 healthy human subjects. Symptoms associated with dyspepsia and other discomfort were observed and graded during RGES at different settings, including long pulse and pulse train. Gastric myoelectrical activity at baseline and during different settings of stimulation was recorded by a multi-channel electrogastrography.RESULTS: The gastric slow wave was entrained in all the subjects at the pacing parameter of 9 cpm in frequency, 500 ms in pulse width, and 5 mA in amplitude.The frequently appeared symptoms during stimulation were satiety, bloating, discomfort, pain, sting, and nausea. The total symptom score for each subject significantly increased as the amplitude or pulse width was adjusted to a higher scale in both long pulse and pulse train. There was a wide diversity of visceral responses to RGES among individuals.CONCLUSION: Acute RGES can result in a series of symptoms associated with dyspepsia, which is beneficial to the treatment of obesity. Optimal parameter should be determined according to the individual sensitivity to electrical stimulation.

  9. Autoimmune pancreatitis characterized by predominant CD8+ T lymphocyte infiltration

    Institute of Scientific and Technical Information of China (English)

    She-Yu Li; Xiang-Yang Huang; Yong-Tao Chen; Yi Liu; Sha Zhao


    Autoimmune pancreatitis (AIP) is a rare form of pancreatitis characterized by prominent lymphocyte infiltration and pancreatic fibrosis resulting in organ dysfunction.The pathogenesis and pathology of AIP remain unknown. A 64-year-old Chinese man presented with symptoms and signs of bile duct obstruction diffuse enlargement of the head of pancreas, elevated IgG levels, and negative autoimmune antibody responses. A pylorus-preserving pancreatoduodenectomy was performed and a pancreatic tumor was suspected. However,periductal lymphoplasmacytic infiltration and fibrosis were found in the head of pancreas and nearby organs instead of tumor cells. Four months after surgery, the patient was readmitted because of reoccurrence of severe jaundice and sustained abdominal distension. Prednisone 30 mg/d was administered orally as an AIP was suspected. One and a half months later, the symptoms of the patient disappeared, and globulin, aminotransferase and bilirubin levels decreased significantly. Over a 9-mo follow-up period, the dose of prednisone was gradually decreased to 10 mg/d and the patient remained in good condition. We further demonstrated dominant CD3+/CD8+ populations, CD20+ cells and a few CD4+ cells in the pancreatic parenchyma, duodenum and gallbladder wall by immunohistochemical assay. This AIP case presented with significant CD8+ T lymphocyte infiltration in the pancreas and extra-pancreatic lesions, indicating that this cell population may be more important in mediating AIP pathogenesis than previously known and that AIP might be a poorly defined autoimmune disease with heterogeneous pathogenesis.

  10. Analysis of the proteases activity in 13 organs of the doll fish (Andrias davidianus) digestive system%中国大鲵消化系统13种器官的蛋白水解酶种类和活性分析

    Institute of Scientific and Technical Information of China (English)

    乔志刚; 辛泽华; 李吉学; 沈国民; 徐存拴


    Protease activity in 13 doll fish, Andrias davidianus, digestive organs: tongue, esophagus, cardia, stomach,pylorus, duodenum, jejunum, ileum, rectum, cloacal chamber, liver, pancreas, gall bladder were analysed with gelatine polyacrylamide gel-electrophoresis (G-PAGE). Compared to rats and rhesus monkeys (Macaca mullatta tcheliensis ),protease activity in the Andrias davidianus digestive system was more varied and stronger. The activity of acid proteases>that of the neutral proteases>that of the alkaline proteases. The kinds and activities of neutral and alkaline proteases in the Andrias davidianus digestive system wereare very different, while the kinds of acid proteases in them were very simi-lar, but their activities are different. Analysing the activities of proteases in these organs shows that protease activity in the duodenum > that in rectum > that in stomach > that in pancreas > that in liver. Experimental results suggest that the function of the rectum and liver in Andrias daviclianus may be as important as that of the duodenum and pancreas in food degradation.

  11. Healing mechanisms of the hydroalcoholic extract and ethyl acetate fraction of green tea (Camellia sinensis (L.) Kuntze) on chronic gastric ulcers. (United States)

    Borato, Débora Gasparin; Scoparo, Camila Toledo; Maria-Ferreira, Daniele; da Silva, Luísa Mota; de Souza, Lauro Mera; Iacomini, Marcello; Werner, Maria Fernanda de Paula; Baggio, Cristiane Hatsuko


    Green tea is an infusion of unfermented leaves of Camellia sinensis (L.) Kuntze (Theaceae), traditionally used for the treatment of obesity, hypercholesterolemia, and gastric complaints. This study evaluated the mechanisms involved in the gastric ulcer healing of the hydroalcoholic extract from green tea (GEt), its ethyl acetate fraction, (GEAc) and epigallocatechin gallate (EGCG) using the model of acetic acid-induced gastric ulcer in rats. The chronic gastric ulcer was induced by application of 80 % acetic acid on serosal mucosa of rats. After 7 days of oral treatment with GEt and GEAc, the ulcer area, mucin content, inflammatory parameters (MPO and NAG), and antioxidant system (GSH and LOOH levels, SOD and GST activities) were evaluated. In vitro, the scavenging activity of GEt and GEAc were also measured. The antisecretory action was studied on the pylorus ligature method in rats. Oral treatment with GEt and GEAc reduced significantly the gastric ulcer area induced by acetic acid. The gastric ulcer healing was accompanied by increasing of mucin content, restoration of GSH levels and SOD activity, and reduction of MPO and LOOH levels. In addition, GEt and GEAc reduced the DPPH free radicals in vitro. Furthermore, the oral treatment of animals with GEt and GEAc did not alter the gastric acid secretion or cause signs of toxicity. Collectively, these results showed that GEt had a pronounced antiulcer effect, possibly through maintenance of mucin content and reduction of inflammation and oxidative stress. In addition, the compounds present in its ethyl acetate fraction could be responsible for the extract activity.

  12. Is gastric sham feeding really sham feeding? (United States)

    Sclafani, A; Nissenbaum, J W


    Rats were fitted with gastric cannulas, food deprived, and allowed to drink a sugar solution that drained out of the opened cannula; i.e., the rats sham-fed. Although this procedure is thought to prevent absorption of ingested food, it was found that the sham feeding of a 32% glucose or sucrose solution significantly elevated blood glucose levels. The addition of acarbose, a drug that inhibits the digestion of sucrose, to the 32% sucrose solution blocked the blood glucose rise, as did closing the pylorus with an inflatable pyloric cuff. Neither the drug nor the cuff, however, reduced the amount of sucrose solution consumed. These findings indicate that gastric sham feeding does not necessarily prevent the digestion and absorption of food, although absorption is not essential for the appearance of a vigorous sham-feeding response. Nevertheless the possibility that neural or hormonal feedback from the stomach contributes to the sham-feeding response cannot be excluded, and until this issue is resolved the results of gastric sham-feeding studies should be interpreted with caution.

  13. Successful Gastric Volvulus Reduction and Gastropexy Using a Dual Endoscope Technique

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    Laith H. Jamil


    Full Text Available Gastric volvulus is a life threatening condition characterized by an abnormal rotation of the stomach around an axis. Although the first line treatment of this disorder is surgical, we report here a case of gastric volvulus that was endoscopically managed using a novel strategy. An 83-year-old female with a history of pancreatic cancer status postpylorus-preserving Whipple procedure presented with a cecal volvulus requiring right hemicolectomy. Postoperative imaging included a CT scan and upper GI series that showed a gastric volvulus with the antrum located above the diaphragm. An upper endoscopy was advanced through the pylorus into the duodenum and left in this position to keep the stomach under the diaphragm. A second pediatric endoscope was advanced alongside and used to complete percutaneous endoscopic gastrostomy (PEG placement for anterior gastropexy. The patient’s volvulus resolved and there were no complications. From our review of the literature, the dual endoscopic technique employed here has not been previously described. Patients who are poor surgical candidates or those who do not require emergent surgery can possibly benefit the most from similar minimally invasive endoscopic procedures as described here.

  14. Pyloric obstruction secondary to epicardial pacemaker implantation: a case report. (United States)

    Bedoya Nader, G; Kellihan, H B; Bjorling, D E; McAnulty, J


    A 10-year old Lhasa Apso dog was presented for an acute history of exercise intolerance and hind limb weakness. High grade second degree atrioventricular block with an atrial rate of 200 beats per minute, ventricular rate of 40 beats per minute and an intermittent ventricular escape rhythm, was diagnosed on electrocardiograph. A transdiaphragmatic, unipolar, epicardial pacemaker was implanted without immediate surgical complications. Severe vomiting was noted 12 h post-operatively. Abdominal ultrasound and a barium study supported a diagnosis of pyloric outflow obstruction and exploratory abdominal surgery was performed. The pyloric outflow tract appeared normal and no other causes of an outflow obstruction were identified. The epicardial generator was repositioned from the right to the left abdominal wall. Pyloric cell pacing was presumed to be the cause for the pyloric obstruction and severe vomiting, and this was thought to be due to close proximity of the pacemaker generator to the pylorus situated in the right abdominal wall. Repositioning of the pulse generator to the left abdominal wall resulted in resolution of vomiting. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Essential oil of Croton zehntneri and its major constituent anethole display gastroprotective effect by increasing the surface mucous layer. (United States)

    Coelho-de-Souza, Andrelina N; Lahlou, Saad; Barreto, João E F; Yum, Maria E M; Oliveira, Ariclécio C; Oliveira, Hermógenes D; Celedônio, Nathalia R; Feitosa, Roney G F; Duarte, Gloria P; Santos, Cláudia F; de Albuquerque, Aline A C; Leal-Cardoso, José H


    Croton zehntneri, a plant native to northeastern Brazil, is widely used in folk medicine to treat gastrointestinal problems and has rich essential oil content. The effects of the essential oil of Croton zehntneri (EOCZ) and its main constituent anethole on several models of gastric lesions were studied in mice and rats. Oral treatment with EOCZ and anethole, both at doses of 30-300 mg/kg, caused similar and dose-dependent gastroprotection against ethanol- and indomethacin-induced gastric damage, but did not change cold-restraint stress-induced ulcers in rats. Furthermore, EOCZ and anethole (both at 30 and 300 mg/kg) similarly and significantly increased the mucus production by the gastric mucosa, measured by Alcian blue binding, in ethanol-induced ulcer model. However, at the same doses, neither EOCZ nor anethole promoted significant alteration in gastric production of non-protein sulfhydryl groups. In pylorus-ligated model, neither EOCZ nor anethole (both at 30 and 300 mg/kg) had a significant effect on the volume of gastric juice, pH, or total acidity. The results of this study show for the first time that EOCZ possesses a gastroprotective potential, an effect mostly attributed to the action of anethole. This activity is related predominantly to the ability of EOCZ and anethole to enhance the production of gastric wall mucus, an important gastroprotective factor. Furthermore, they suggest that EOCZ has potential therapeutic application for the treatment of gastric ulcers.

  16. Endoscopic retrieval of gastric trichophytobezoar (United States)

    Zhao, Jiu-ling; Zhao, Wei-chuan; Wang, Yu-shui


    Abstract Rationale: Trichophytobezoars, which are composed of hair and plant fibers, are usually located in the stomach. They are often associated with trichophagia and trichotillomania. The most commonly reported methods of trichophytobezoar treatment are open surgery and laparoscopic retrieval; there are few reports of endoscopic removal of trichophytobezoars. Patient concerns and Diagnoses: Twelve-year-old girl presented with a 3-day history of increasing upper abdominal pain, anorexia, and postprandial emesis. She had a 3-year history of pulling out and eating her own hair. Endoscopic examination showed a large intragastric trichophytobezoar measuring 10.5 cm × 3.5 cm in size, with extension of a few hairs through the pylorus. Interventions and Outcomes: The trichophytobezoar was packed with hair fibers and contained a hard core of mixed hair and vegetable fibers. After the core was cut, the trichophytobezoar was fragmented into pieces with the alternating use of a polypectomy snare and argon plasma coagulation. A small amount of hair and nondigestible food fibers was removed with grasping forceps during the initial procedure. The remaining hairball was loosened with biopsy forceps and was injected with sodium bicarbonate solution. The trichophytobezoar was removed completely at repeat endoscopy 5 days later. After 6 months of psychological intervention, the patient had no recurrence of trichophagia or trichophytobezoar. Lessons: Endoscopy with sodium bicarbonate injection is an effective and minimally invasive method of retrieving a gastric trichophytobezoar. PMID:28099364


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    K Prabhu


    Full Text Available The genus, Viburnum Linn., belonging to the family, Adoxaceae (formerly positioned under the family - Caprifoliaceae, has been surveyed to cover about 200 species, in the world, and about 17 of them in India, especially, at an altitude from 800 – 2500 ft, habitat such as Himalaya and Nilgiri hills. The stem parts of these species claim to contain an appreciable quantity of therapeutically valuable phenolic compounds like anthocyanins, phenolic acids, flavones, flavonols and biflavone, and their glycosides. Based on the above facts on records, the present study has been under taken. With an objective of screening the antiulcer potentials 75% v/v aqueous ethanolic stem extracts of some three species of this genus, namely: V.punctatum, V.coriaceum and V.erubescens by aspirin plus pylorus ligation model in rats, using Ranitidine 50 mg/ kg b.w (p.o as the positive reference drug. From the findings of ulcer score, histo-pathological features and the status of biochemical parameters of gastric contents, it is concluded that extract of V.coriaceum at a dose level of 500 mg/kg.b.w possessed a significant antiulcer activity (p<0.01, p<0.001. However, the magnitude of antiulcer potential among the species was not far different. This study can be a referential tool for isolation of active constituents which are responsible for the above biological activity and to conduct an advanced scientific investigation on these species in that regard.

  18. Inhomogeneities in the propagation of the slow wave in the stomach. (United States)

    Lammers, W J


    The propagation of the slow wave in the stomach and its role in inducing sweeping peristaltic contractions toward the pylorus, essential for a proper digestion and emptying, have been studied for many years. Irregularities in the timing or in the pattern of propagation of the slow wave have been known to induce various gastric malfunctions and, recently, several types of gastric dysrhythmias have been described which could lead to gastric contraction abnormalities. In this study, Du et al. have analyzed the disturbances caused by a simple transmural incision in a human stomach, performed to obtain a biopsy of the muscle, on the propagation pattern of the slow wave. In addition, they show that such an incision may by itself also induce new types of gastric dysrhythmias. These results are important in demonstrating that the function of the stomach can easily be disturbed by such procedures. This mini-review describes several ways in which inhomogeneities in propagation may affect the conduction pattern of the slow wave, including the genesis of several dysrhythmias, and what is currently known about their impact on gastric contraction and digestion.

  19. The anatomy of the gastrointestinal tract of the African lungfish, Protopterus annectens. (United States)

    Icardo, José M; Wong, Wai P; Colvee, Elvira; Loong, Ai M; Ip, Yuen K


    The gastrointestinal tract of the African lungfish Protopterus annectens is a composite, which includes the gut, the spleen, and the pancreas. The gut is formed by a short oesophagus, a longitudinal stomach, a pyloric valve, a spiraling intestine, and a cloaca. Coiling of the intestine begins dorsally below the pylorus, winding down to form six complete turns before ending into the cloaca. A reticular tissue of undisclosed nature accompanies the winding of the intestinal mucosa. The spleen is located along the right side of the stomach, overlapping the cranial end of the pancreas. The pancreas occupies the shallow area, which indicates on the gut dorsal side the beginning of the intestine coiling. In addition, up to 25 lymphatic-like nodes accompany the inner border of the spiral valve. The mesenteric artery forms a long axis for the intestine. All the components of the gastrointestinal tract are attached to each other by connective sheaths, and are wrapped by connective tissue, and by the serosa externally. We believe that several previous observations have been misinterpreted and that the anatomy of the lungfish gut is more similar among all the three lungfish genera than previously thought. Curiously, the gross anatomical organization is not modified during aestivation. We hypothesize that the absence of function is accompanied by structural modifications of the epithelium, and are currently investigating this possibility.

  20. Gross anatomy of the ringed seal (Pusa hispida) gastro-intestinal tract. (United States)

    Smodlaka, H; Henry, R W


    The gross anatomical structure of the ringed seal (Pusa hispida) gastrointestinal tract is poorly described and often veterinary anatomical terminology is not used. Although the basic abdominal visceral pattern corresponded to domestic carnivores, significant differences were noted. The stomach was an elongated sharply bent tube (u-shaped) with the pylorus and fundus juxtaposed. The elongated jejunum measured up to 15.6 times body length and had 37 jejunal arteries from the cranial mesenteric artery. The pancreas was asymmetrical with a small right lobe and a large left lobe. The unusually short greater omentum negated formation of deep and superficial leaves. The most remarkable difference was the separation of the liver parenchyma into three physically separate masses, held together by hepatic ducts, veins and arteries. The topography and position of the liver was dependent on the amount of blood in the hepatic sinus (distended hepatic veins and hepatic portion of vena cava). Thus, as the hepatic sinus filled, the lateral liver masses separate from the central mass by moving caudolaterally. This was facilitated by modified coronary and triangular ligaments which did not attach directly to the liver, but instead to the hepatic sinus. These anatomical adaptations are apparently advantageous to ringed seal's survival in a deep marine environment. © 2013 Blackwell Verlag GmbH.

  1. Effects and mechanisms of L-glutamate microinjected into nucleus ambiguus on gastric motility in rats

    Institute of Scientific and Technical Information of China (English)

    SUN Hong-zhao; ZHAO Shu-zhen; CUI Xi-yun; AI Hong-bin


    Background L-glutamate (L-GLU) is a major neurotransmitter in the nucleus ambiguus (NA), which can modulate respiration, arterial pressure, heart rate, etc. This study investigated the effects and mechanisms of L-GLU microinjected into NA on gastric motility in rats.Methods A latex balloon connected with a pressure transducer was inserted into the pylorus through the forestomach for continuous recording of the gastric motility. The total amplitude, total duration, and motility index of gastric contraction waves within 5 minutes before microinjection and after microinjection were measured.Results L-GLU (5 nmol, 10 nmol and 20 nmol in 50 nl normal saline (PS) respectively) microinjected into the right NA significantly inhibited gastric motility, while microinjection of physiological saline at the same position and the same volume did not change the gastric motility. The inhibitory effect was blocked by D-2-amino-5-phophonovalerate (D-AP5, 5 nmol, in 50 nl PS), the specific N-methyl-D-aspartic acid (NMDA) receptor antagonist, but was not influenced by 6-cyaon-7-nitroquinoxaline-2,3-(1H,4H)-dione (CNQX) (5 nmol, in 50 nl PS), the non-NMDA ionotropic receptor antagonist. Bilateral subdiaphragmatic vagotomy abolished the inhibitory effect by microinjection of L-GLU into NA. Conclusions Microinjection of L-GLU into NA inhibits the gastric motility through specific NMDA receptor activity, not non-NMDA receptor activity, and the efferent pathway is the vagal nerves.

  2. [Gastroprotective and antisecretory effect of a phytochemical made from matico leaves (Piper aduncum)]. (United States)

    Arroyo, Jorge; Bonilla, Pablo; Moreno-Exebio, Luis; Ronceros, Gerardo; Tomás, Gloria; Huamán, Juana; Raez, Ernesto; Quino, Mariano; Rodriguez-Calzado, Javier


    To determine the gastroprotective and antisecretory effect of ethanol extract from matico leaves (Piper aduncum) in animal models. To evaluate the gastroprotective effect, 220 mice of the Balb C57 strain were used. They were randomized in 22 groups of ten animals each, in which the formation of gastric ulcers was induced with indomethacin. Gastroprotection was determined by evaluating three aspects: inflammation, number of hemorrhagic shocks and number of ulcers. To evaluate the antisecretory effect, 64 white male Holtzman rats were used, which were randomized in eight groups of eight animals, one control and seven groups of treatment with one extract dose level and two phytochemical dose levels. Antisecretion was obtained through the pylorus ligation. Regarding gastroprotection, dichloromethane, chloroform, hexane and methanol extracts decreased inflammation to over 66% (p<0,05). The ethanolic extract shows 100% activity in reducing the number of hemorrhagic bands (p<0,05). The chloroform extract shows antiulcer activity at 75% (p<0,05). In terms of antisecretion, the phytochemical in capsules containing the ethanolic extract achieved 72% reduction of the gastric secretion volume (p<0,01) and 104,3% (p<0,01) PH increase. In experimental conditions, ethanolic extracts, their fractions and phytochemicals have a gastroprotective effect in mice and antisecretory effect in rats.

  3. Endoscopic Aspects of Gastric Syphilis

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    Mariana Souza Varella Frazão


    Full Text Available Introduction. Considered as a rare event, gastric syphilis (GS is reported as an organic form of involvement. Low incidence of GS emphasizes the importance of histopathological analysis. Objective. We aim to characterize GS endoscopic aspects in an immunocompetent patient. Case Report. A 23-year-old man presented with epigastric pain associated with nausea, anorexia, generalized malaise and 11 kg weight loss that started 1 month prior to his clinical consultation. Physical examination was normal except for mild abdominal tenderness in epigastrium. Endoscopy observed diminished gastric expandability and diffuse mucosal lesions, from cardia to pylorus. Gastric mucosa was thickened, friable, with nodular aspect, and associated with ulcers lesions. Gastric biopsies were performed, and histopathological analysis resulted in dense inflammatory infiltration rich in plasmocytes. Syphilis serologies were positive for VDRL and Treponema pallidum reagents. Immunohistochemical tests were positive for Treponema pallidum and CD138. The patient was treated with penicillin, leading to resolution of his clinical complaints and endoscopic findings. Conclusion. Diagnosis suspicion of GS is important in view of its nonspecific presentation. Patients with gastric symptoms that mimic neoplastic disease should be investigated thoroughly based on the fact that clinical, endoscopic, and histological findings can easily be mistaken for lymphoma or plastic linitis.

  4. Pancreatic Resections for Advanced M1-Pancreatic Carcinoma: The Value of Synchronous Metastasectomy

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    S. K. Seelig


    Materials and Methods. From January 1, 2004 to December, 2007 a total of 20 patients with pancreatic malignancies were retrospectively evaluated who underwent pancreatic surgery with synchronous resection of hepatic, adjacent organ, or peritoneal metastases for proven UICC stage IV periampullary cancer of the pancreas. Perioperative as well as clinicopathological parameters were evaluated. Results. There were 20 patients (9 men, 11 women; mean age 58 years identified. The primary tumor was located in the pancreatic head (n=9, 45%, in pancreatic tail (n=9, 45%, and in the papilla Vateri (n=2, 10%. Metastases were located in the liver (n=14, 70%, peritoneum (n=5, 25%, and omentum majus (n=2, 10%. Lymphnode metastases were present in 16 patients (80%. All patients received resection of their tumors together with metastasectomy. Pylorus preserving duodenopancreatectomy was performed in 8 patients, distal pancreatectomy in 8, duodenopancreatectomy in 2, and total pancreatectomy in 2. Morbidity was 45% and there was no perioperative mortality. Median postoperative survival was 10.7 months (2.6–37.7 months which was not significantly different from a matched-pair group of patients who underwent pancreatic resection for UICC adenocarcinoma of the pancreas (median survival 15.6 months; P=.1. Conclusion. Pancreatic resection for M1 periampullary cancer of the pancreas can be performed safely in well-selected patients. However, indication for surgery has to be made on an individual basis.

  5. Middle-Preserving Pancreatectomy: An Interesting Procedure for Pancreas-Sparing Resection

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    Cosimo Sperti


    Full Text Available Context Total pancreatectomy is the treatment of choice for multicentric diseases involving the head and the body-tail of the pancreas. Middle-preserving pancreatectomy is a recently reported alternative procedure when the pancreatic body is spared from disease. We report on the successful preservation of the pancreatic body in a patient harboring a multicentric intraductal papillary mucinous neoplasia (IPMN. Case report A multicentric IPMN was diagnosed in a 59-year-old man. A standard pylorus preserving pancreaticoduodenectomy was performed, followed by a spleen-preserving distal pancreatectomy. The splenic vessels were carefully preserved. The residual 5 cm of the pancreatic body were anastomosed to the jejunum after verifying that the resection line on both sides was negative at frozen section examination. The postoperative course was complicated by transient peritoneal bleeding managed with angiographic embolization of the splenic artery. A borderline mixed type IPMN of the head and chronic pancreatitis of the tail were found at pathological examination. Eleven months after surgery, the patient is well and disease free; glycemic control is achieved by diet. Conclusion A middle-preserving pancreatectomy can be performed safely for multicentric IPMNs involving the head and the body-tail of the gland. It can prevent problems with the glycemic control that usually follows total pancreatectomy.

  6. Intraductal papillary mucinous neoplasm (IPMN) of the gastric-type with focal nodular growth of the arborizing papillae: a case of high-grade transformation of the gastric-type IPMN. (United States)

    Ban, Shinichi; Naitoh, Yoshihisa; Ogawa, Fumihiro; Shimizu, Yoshihiko; Shimizu, Michio; Yasumoto, Akihiro; Koyama, Isamu


    We present a case of intraductal papillary mucinous neoplasm (IPMN) of the pancreas, demonstrating a process of high-grade transformation of the gastric-type IPMN. An 83-year-old Japanese woman underwent pylorus-preserving pancreatoduodenectomy for removal of a multicystic mass of the pancreas head, which had been followed up for 7 years. The removed tumor was a low-grade gastric-type IPMN spreading in the branch ducts, focally forming an intraluminal nodular lesion. The nodular lesion was comprised of arborizing papillotubular proliferation of cuboidal to columnar epithelia with high-grade atypia, and was characterized by diffuse MUC1 expression and a gastric mucin phenotype (focal MUC5AC and MUC6 expressions). Therefore, the nodular lesion was consistent with the pancreatobiliary-type IPMN, and the present case suggests that the low-grade gastric-type IPMN may progress to a focal intraductal carcinoma over the years, and the pancreatobiliary-type IPMN may be one of the forms of such high-grade transformation of the gastric-type IPMN. One of the cystic lesions was an oligocystic-type serous cystic neoplasm (serous cystadenoma), which might be an incidental concomitance or have a common basis.

  7. Small Undifferentiated Pancreatic Adenocarcinoma which Mimics IPMN at Imaging

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    Mirko D’Onofrio


    Full Text Available Context To present the case of an unusual presentation at imaging of a very small solid undifferentiated pancreatic adenocarcinoma which mimics a side-branch intraductal papillary mucinous neoplasm. Case report The patient came to our hospital for a revaluation of a cystic pancreatic lesion. Ultrasound (US and contrast-enhanced ultrasound (CEUS examinations were carried out. A small cystic lesion of about 1.5 cm in diameter was seen in the posterior aspect of the pancreatic uncinate process A very small, solid, vascularized nodule was detected at CEUS within the lesion. Consequently, the patient underwent CT and MRI. MRI confirmed the presence of an intralesional nodule and communication with the main pancreatic duct was demonstrated, suggesting the diagnosis of intraductal papillary mucinous neoplasm with solid intralesional tissue. A pylorus preserving pancreaticoduodenectomy was carried out. An undifferentiated adenocarcinoma having a notable peripheral inflammatory reaction and dilated branch duct was finally diagnosed. Conclusion To our knowledge, we present for the first time, the case of a very small solid undifferentiated pancreatic adenocarcinoma of the uncinate process which mimicked a side-branch intraductal papillary mucinous neoplasm at imaging. The cystic appearance may be an epiphenomenon of a solid lesion and this possibility has to be considered when one encounters incidental cystic lesions at imaging.

  8. Peptic Ulcer at the End of the 20th Century: Biological and Psychological Risk Factors

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    Susan Levenstein


    Full Text Available The prevailing concept of peptic ulcer etiology has swung over entirely in just a few years from the psychological to the infectious, yet the rich literature documenting an association between psychosocial factors and ulcer is not invalidated by the discovery of Helicobacter pylori. Physical and psychological stressors interact to induce ulcers in animal models, concrete life difficulties and subjective distress predict the development of ulcers in prospective cohorts, shared catastrophes such as war and earthquakes lead to surges in hospitalizations for complicated ulcers, and stress or anxiety can worsen ulcer course. Many known ulcer risk factors, including smoking, nonsteroidal anti-inflammatory drug use, heavy drinking, loss of sleep and skipping breakfast, can increase under stress; the association of low socioeconomic status with ulcer is also accounted for in part by psychosocial factors. Among possible physiological mechanisms, stress may induce gastric hypersecretion, reduce acid buffering in the stomach and the duodenum, impair gastroduodenal blood flow, and affect healing or inflammation through psychoneuroimmunological mechanisms. Psychosocial factors seem to be particularly prominent among idiopathic or complicated ulcers, but they are probably operative in run of the mill H pylori disease as well, either through additive effects or by facilitating the spread of the organism across the pylorus, while gastrointestinal damage by nonsteroidal anti-inflammatory drugs can also be potentiated by stress. Although the clinical importance of peptic ulcer is fading along with the millenium, due to secular trends and new therapies, it remains worthy of study as a splendid example of the biopsychosocial model.

  9. Synthesis and PASS-assisted in silico approach of some novel 2-substituted benzimidazole bearing a pyrimidine-2, 4, 6(trione system as mucomembranous protector

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    Bijo Mathew


    Full Text Available Purpose: The present paper demonstrates the utility of PASS computer-aided program and makes a clear comparison of predicted and observed pharmacological properties of some novel 5-[(2E-1-(1H-benzimidazol-2-yl-3-substituted phenylprop-2-en-1-ylidene] pyrimidine-2, 4, 6 (1H, 3H, 5H-triones (5a-f. Materials and Methods: The synthesis of the titled derivatives were achieved by the reaction between 2E-1-(1H-benzimidazol-2-yl-3-phenylprop-2-en-1-ones (4a-f and barbituric acid in the presence of catalytic amount of acetic acid medium. All the final structures were assigned on the basis of IR, 1 HNMR and mass spectra analysis. All the newly synthesized compounds were screened for their antiulcer activity in the pylorus-ligated rats. Results: Compounds 5b, 5e and 5c showed a percentage protection of (69.58, 69.56 and 67.17 at a dose of 50 mg/kg b.w. when compared to standard omeprazole (77.37%, 2 mg/kg b.w.. Conclusion: Scanning of stomach specimens using electron microscope revealed that the mice treated with standard and synthetic derivatives had no injury observed in stomach mucosa, which is identical to that of the control animal.

  10. Malignant carcinoid tumor of the pancreas

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    Čolović Radoje B.


    Full Text Available Carcinoid tumors arise from argentaffine cells or from a primitive stem cells which may differentiate into anyone of a variety of adult endocrine-secreting cells. Carcinoid tumor of the pancreas is a very rare tumor with less than 50 cases reported in world literature. In literature it is denoted "pancreatic serotoninoma" or "serotonin-producing pancreatic tumor". Due to its rarity the tumor is an unusual cause of carcinoid syndrome. As the carcinoid tumor of the pancreas does not always causes carcinoid syndrome its absence does not necessarily exclude the existence of the tumor. The tumor is frequently malignant. Over 50% of patients have metastases at the time of surgery. This is the reason why radical surgery is not possible in a number of patients. Excisional surgery offers the best chance for recovery or long term survival. We report on a 57-year-old woman with carcinoid syndrome caused by malignant carcinoid tumor of the head of the pancreas without liver or other distant metastases; it was successfully excised with pylorus preserving cephalic duo-denopancreatectomy (after Longmire-Traverso and radical lymphadenectomy. The diagnosis was established on the basis of histologic and immunohistochemical findings. The patient is symptom free for more than eight months.

  11. Evaluation of Anti-ulcer Activity of Echinops Persicus on Experimental Gastric Ulcer Models in Rats

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    Ahmad Farajzadeh-Sheikh


    Full Text Available Extract of Echinops persicus is traditionally used for a long time in Iran for treatment of cough and constipation. This extract is produced by activity of bug (Situphilus spp. on the plant. We documented its anti-tussive effect in rats in our previous study.The aim of this study was to assess the anti-ulcer effect of Echinops persicus in an animal model. In this study we evaluated anti-ulcer effect of Echinops persicus by Shay's method in rats. In 3 groups of rats, pylorus was ligatured under anesthesia. The rats were euthanized after 19 hours later and number and level of ulcer in stomach was measured. In group 2 the extract was orally administered 45 minutes before pyloric ligature, and in group 3, it was administered intraperitoneally 20 minutes before pyloric ligature. The number of ulcers in stomach was significantly low in group 2 (P = 0.01 and 3 (P = 0.037 in comparison with group 1. The level of ulcer was significantly decreased in group 2 (P = 0.047 with comparison to group 1. We conclude that, Echinops extract can exhibit potentially cytoprotective and anti-ulcer activity.

  12. Minute ampullary carcinoid tumor with lymph node metastases: a case report and review of literature

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    Sakano Shigeru


    Full Text Available Abstract Background Carcinoid tumors are usually considered to have a low degree of malignancy and show slow progression. One of the factors indicating the malignancy of these tumors is their size, and small ampullary carcinoid tumors have been sometimes treated by endoscopic resection. Case presentation We report a case of a 63-year-old woman with a minute ampullary carcinoid tumor that was 7 mm in diameter, but was associated with 2 peripancreatic lymph node metastases. Mild elevation of liver enzymes was found at her regular medical check-up. Computed tomography (CT revealed a markedly dilated common bile duct (CBD and two enlarged peripancreatic lymph nodes. Endoscopy showed that the ampulla was slightly enlarged by a submucosal tumor. The biopsy specimen revealed tumor cells that showed monotonous proliferation suggestive of a carcinoid tumor. She underwent a pylorus-preserving whipple resection with lymph node dissection. The resected lesion was a small submucosal tumor (7 mm in diameter at the ampulla, with metastasis to 2 peripancreatic lymph nodes, and it was diagnosed as a malignant carcinoid tumor. Conclusion Recently there have been some reports of endoscopic ampullectomy for small carcinoid tumors. However, this case suggests that attention should be paid to the possibility of lymph node metastases as well as that of regional infiltration of the tumor even for minute ampullary carcinoid tumors to provide the best chance for cure.

  13. Evaluation of bile reflux in HIDA images based on fluid mechanics. (United States)

    Lo, Rong-Chin; Huang, Wen-Lin; Fan, Yu-Ming


    We propose a new method to help physicians assess, using a hepatobiliary iminodiacetic acid scan image, whether or not there is bile reflux into the stomach. The degree of bile reflux is an important index for clinical diagnosis of stomach diseases. The proposed method applies image-processing technology combined with a hydrodynamic model to determine the extent of bile reflux or whether the duodenum is also folded above the stomach. This condition in 2D dynamic images suggests that bile refluxes into the stomach, when endoscopy shows no bile reflux. In this study, we used optical flow to analyze images from Tc99m-diisopropyl iminodiacetic acid cholescintigraphy (Tc99m-DISIDA) to ascertain the direction and velocity of bile passing through the pylorus. In clinical diagnoses, single photon emission computed tomography (SPECT) is the main clinical tool for evaluating functional images of hepatobiliary metabolism. Computed tomography (CT) shows anatomical images of the external contours of the stomach, liver, and biliary extent. By exploiting the functional fusion of the two kinds of medical image, physicians can obtain a more accurate diagnosis. We accordingly reconstructed 3D images from SPECT and CT to help physicians choose which cross sections to fuse with software and to help them more accurately diagnose the extent and quantity of bile reflux.

  14. Protective effects of neohesperidin and poncirin isolated from the fruits of Poncirus trifoliata on potential gastric disease. (United States)

    Lee, Je-Hyuk; Lee, Seung-Ho; Kim, Yeong Shik; Jeong, Choon Sik


    The effects of Poncirus trifoliata (P. trifoliata) (Ponciri Fructus, PF) extract and its constituents such as neohesperidin and poncirin on gastritis in rats and human gastric cancer cells were investigated. The PF 70% ethanol extracts (1 g) showed approximately 11.38% of acid-neutralizing capacities and cytotoxicity (IC50=85.39 microg/mL) against human AGS gastric cancer cells. In addition, neohesperidin exhibited antioxidant activity (IC50=22.31 microg/mL) in the 1,1-diphenyl-2-picryldydrazyl (DPPH) radical-scavenging assay. Neohesperidin (50 mg/kg) and poncirin (100 mg/kg) significantly inhibited 55.0% and 60.0% of HCl/ethanol-induced gastric lesions, respectively, and increased the mucus content. In pylorus ligated rats, neohesperidin (50 mg/kg) significantly decreased the volume of gastric secretion and gastric acid output, and increased the pH. From these results, it could be suggested that neohesperidin and poncirin isolated from PF may be useful for the treatment and/or protection of gastritis.

  15. Pancreatic Perivascular Epithelioid Cell Tumour Presenting with Upper Gastrointestinal Bleeding

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    Christos Petrides


    Full Text Available PEComa is a family of rare mesenchymal tumours which can occur in any part of the human body. Primary PEComas of the pancreas are extremely rare tumours with uncertain malignant potential. A 17-year-old female was admitted to the hospital due to melena. She required several transfusions. CT scan demonstrated a mass at the head of the pancreas measuring 4.2 cm in maximum diameter. An endoscopic ultrasound showed an ulcerating malignant looking mass infiltrating 50% of the wall of the second part of the duodenum in the region of the ampulla. Multiple biopsies taken showed extensive ulceration with granulation tissue formation and underlying large macrophages without being able to establish a definite diagnosis. We proceeded with pylorus-preserving pancreaticoduodenectomy. The postoperative course of the patient was unremarkable, and she was discharged on the 8th postoperative day. Histology examination of the specimen showed a PEComa of pancreas. Eighteen months after resection the patient is disease free. To the best of our knowledge this is the first time we describe a case of a pancreatic PEComa presenting with massive gastrointestinal bleeding.

  16. Ultrasonographic anatomy of bearded dragons (Pogona vitticeps). (United States)

    Bucy, Daniel S; Guzman, David Sanchez-Migallon; Zwingenberger, Allison L


    To determine which organs can be reliably visualized ultrasonographically in bearded dragons (Pogona vitticeps), describe their normal ultrasonographic appearance, and describe an ultrasonographic technique for use with this species. Cross-sectional study. 14 healthy bearded dragons (6 females and 8 males). Bearded dragons were manually restrained in dorsal and sternal recumbency, and coelomic organs were evaluated by use of linear 7- to 15-MHz and microconvex 5- to 8-MHz transducers. Visibility, size, echogenicity, and ultrasound transducer position were assessed for each organ. Coelomic ultrasonography with both microconvex and linear ultrasound transducers allowed for visualization of the heart, pleural surface of the lungs, liver, caudal vena cava, aorta, ventral abdominal vein, gallbladder, fat bodies, gastric fundus, cecum, colon, cloaca, kidneys, and testes or ovaries in all animals. The pylorus was visualized in 12 of 14 animals. The small intestinal loops were visualized in 12 of 14 animals with the linear transducer, but could not be reliably identified with the microconvex transducer. The hemipenes were visualized in 7 of 8 males. The adrenal glands and spleen were not identified in any animal. Anechoic free coelomic fluid was present in 11 of 14 animals. Heart width, heart length, ventricular wall thickness, gastric fundus wall thickness, and height of the caudal poles of the kidneys were positively associated with body weight. Testis width was negatively associated with body weight in males. Results indicated coelomic ultrasonography is a potentially valuable imaging modality for assessment of most organs in bearded dragons and can be performed in unsedated animals.

  17. Copaifera langsdorffii: evaluation of potential gastroprotective of extract and isolated compounds obtained from leaves

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    Marivane Lemos


    Full Text Available AbstractGastric ulcer is a prevalent gastrointestinal disease, and the drugs currently used in the treatment produce several adverse effects. In this context, the search for new therapeutic antiulcer agents is essential, and medicinal plants have great potential. Here, we investigated the gastroprotective properties of Copaifera langsdorffii Desf., Fabaceae, hydroalcoholic extract obtained from leaves and its isolated compounds. The phytochemistry studies and the compounds isolations were performed using chromatographic and spectroscopic methodologies. The hydroalcoholic extract was evaluated using ethanol/HCl, non-steroidal anti-inflammatory drug, stress-induced-ulcer and chronic ulcer-model. The effects on gastric content volume, pH, total acidity and mucus stomach production were evaluated in the pylorus ligated-model. The C. langsdorffii extract obtained from leaves (50, 250 or 500 mg/kg reduced the injured area compared to control group in all experiments. The extract showed a significant decrease in the total gastric juice acidity and an increase in mucus production (500 mg/kg when compared to vehicle. Among isolated compounds (30 mg/kg α-humulene, β-caryophyllene and caryophyllene oxide showed greater gastroprotective activity in the ethanol/HCl induced ulcer model. The data herein obtained shown that C. langsdorffii leaves extract and isolated compounds from it, presented gastroprotective properties in different animal models of gastric ulcer. These effects may be associated with the ability of the extract to decrease gastric secretion and increase the mucus production.

  18. Semipurified Ethyl Acetate Partition of Methanolic Extract of Melastoma malabathricum Leaves Exerts Gastroprotective Activity Partly via Its Antioxidant-Antisecretory-Anti-Inflammatory Action and Synergistic Action of Several Flavonoid-Based Compounds

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    Noor Wahida Ismail Suhaimy


    Full Text Available Recent study has demonstrated the gastroprotective activity of crude methanolic extract of M. malabathricum leaves. The present study evaluated the gastroprotective potential of semipurified extracts (partitions: petroleum ether, ethyl acetate (EAMM, and aqueous obtained from the methanolic extract followed by the elucidation of the gastroprotective mechanisms of the most effective partition. Using the ethanol-induced gastric ulcer assay, all partitions exerted significant gastroprotection, with EAMM being the most effective partition. EAMM significantly (i reduced the volume and acidity (free and total while increasing the pH of gastric juice and enhanced the gastric wall mucus secretion when assessed using the pylorus ligation assay, (ii increased the enzymatic and nonenzymatic antioxidant activity of the stomach tissue, (iii lost its gastroprotective activity following pretreatment with N-omega-nitro-L-arginine methyl ester (L-NAME; NO blocker or carbenoxolone (CBXN; NP-SH blocker, (iv exerted antioxidant activity against various in vitro oxidation assays, and (v showed moderate in vitro anti-inflammatory activity via the LOX-modulated pathway. In conclusion, EAMM exerts a remarkable NO/NP-SH-dependent gastroprotective effect that is attributed to its antisecretory and antioxidant activities, ability to stimulate the gastric mucus production and endogenous antioxidant system, and synergistic action of several gastroprotective-induced flavonoids.

  19. Semipurified Ethyl Acetate Partition of Methanolic Extract of Melastoma malabathricum Leaves Exerts Gastroprotective Activity Partly via Its Antioxidant-Antisecretory-Anti-Inflammatory Action and Synergistic Action of Several Flavonoid-Based Compounds. (United States)

    Ismail Suhaimy, Noor Wahida; Noor Azmi, Ahmad Khusairi; Mohtarrudin, Norhafizah; Omar, Maizatul Hasyima; Tohid, Siti Farah Md; Cheema, Manraj Singh; Teh, Lay Kek; Salleh, Mohd Zaki; Zakaria, Zainul Amiruddin


    Recent study has demonstrated the gastroprotective activity of crude methanolic extract of M. malabathricum leaves. The present study evaluated the gastroprotective potential of semipurified extracts (partitions): petroleum ether, ethyl acetate (EAMM), and aqueous obtained from the methanolic extract followed by the elucidation of the gastroprotective mechanisms of the most effective partition. Using the ethanol-induced gastric ulcer assay, all partitions exerted significant gastroprotection, with EAMM being the most effective partition. EAMM significantly (i) reduced the volume and acidity (free and total) while increasing the pH of gastric juice and enhanced the gastric wall mucus secretion when assessed using the pylorus ligation assay, (ii) increased the enzymatic and nonenzymatic antioxidant activity of the stomach tissue, (iii) lost its gastroprotective activity following pretreatment with N-omega-nitro-L-arginine methyl ester (L-NAME; NO blocker) or carbenoxolone (CBXN; NP-SH blocker), (iv) exerted antioxidant activity against various in vitro oxidation assays, and (v) showed moderate in vitro anti-inflammatory activity via the LOX-modulated pathway. In conclusion, EAMM exerts a remarkable NO/NP-SH-dependent gastroprotective effect that is attributed to its antisecretory and antioxidant activities, ability to stimulate the gastric mucus production and endogenous antioxidant system, and synergistic action of several gastroprotective-induced flavonoids.

  20. Laparoscopic Pyloromyotomy: A Modified Simple Technique

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    Mohammed Omer Anwar


    Full Text Available Background: A modified laparoscopic pyloromyotomy (LP technique may provide an alternative to treating infantile hypertrophic pyloric stenosis (IHPS by improving operative timing with reduction of postoperative complication rates, compared with a three-port trocar system.Methods: Thirty-three infants were treated with IHPS at a single-centre between January 2002 and December 2011. The local surgical incision to the pylorus was performed according to Ramstedt’s pyloromyotomy; but with a two-port trocar system (umbilical and right lower abdominal crease ports, following a controlled stab wound into the epigastric region and a 3mm incision to allow introduction of ophthalmic knife. With the aid of atraumatic forceps and camera guidance, the ophthalmic knife was used to carefully incise the seromuscular layer, which allows improved manual tactile sensation compared to ergonomic laparoscopic spreaders. A Benson pyloric spreader was then used to further separate the pyloric muscle layer to complete the procedure.Results: In all 33 infants treated, LP was safely performed with no evidence of duodenal or mucosal perforation with complete pyloromyotomy achieved in each case. The postoperative course was rather uneventful apart from an umbilical wound infection.Conclusion: This modified approach is simple, safe and allows improved operative timing, whilst increasing surgeon’s confidence by tactile sensation.

  1. Periampullar y carcinoma presenting as duodenojejunal intussusception:a diagnostic and therapeutic dilemma

    Institute of Scientific and Technical Information of China (English)

    Mansoor Ahmed Madanur; Viswanath Reddy Mula; Dave Patel; Arunachalam Rathinaswamy; Ahmed Ali Madanur


    BACKGROUND: An intussusception is the invagination of one segment of the intestine into another. It is more common in children, but a rare clinical entity in adults, where the condition is almost always caused by tumors. METHODS: A 51-year-old female presented with symptoms of gastric outlet obstruction associated with signiifcant weight loss, but no jaundice. Routine hematological and biochemical investigation, including tumor markers, were normal. Abdominal ultrasound revealed duodenojejunal intussusception, and subsequent CT of the abdomen conifrmed it. RESULTS: She underwent a laparotomy, which conifrmed duodenojejunal intussusception. On reducing the intussusception and performing a duodenotomy, a periampullary mass was conifrmed. Hence, she underwent a pylorus-preserving pancreaticoduodenectomy. Histology conifrmed periampullary adenocarcinoma. CONCLUSIONS: Adult intussusceptions are mostly caused by tumors. Contrast CT is the investigation of choice, although ultrasound can be used. One should have a low threshold for suspecting malignancy, obtain frozen section histology, and seek appropriate help at an early stage.

  2. 保留幽门的胰十二指肠切除术10例临床分析

    Institute of Scientific and Technical Information of China (English)

    王仁启; 刘晓宇; 张齐峰; 胡黎明


    @@ 1943年Watson率先将保留幽门的胰十二指肠切除术(Pylorus-preserving Pancreatico-duodenectomy,PPPD)应用于治疗壶腹部周围癌,但当时并未引起重视,随后1978年Traverso和Longmire[1]对慢性钙化性胰腺炎合并胰头部囊肿和浸润胰头的十二指肠水平部肿瘤患者成功实施了PPPD 术式,才逐渐受到众多学者的重视.目前PPPD术式已成为治疗慢性胰腺炎和壶腹部周围癌的首选术式,2006年1月-2009年11月我院采用PPPD治疗壶腹周围癌10例,取得满意效果,现报告如下.


    Institute of Scientific and Technical Information of China (English)

    黄徐根; 吴孝兵


    Objective To clarify the types, regional distributional and distributional density as well as morphological features of gastrointestinal (GI) endocrine cells in the digestive tract (DT) of a reptilian, Sphenomorphus indicus. Methods Using the immunohistochemical streptavidin-peroxidase (S-P)method. Results Five types of endocrine cells, namely 5-hydroxytryptamine (5-HT), somatostatin(SS), gastrin (GAS), substance P (SP) and glucagon (GLU) immunoreactive (IR) cells, were identified in the DT of S. indicus . 5-HT-IR cells, which were most commonly found in the pylorus, distributed throughout the DT at various densities. SS-IR cells were only found in the stomach, GAS-IR only in pylorus and duodenum, GLU-IR only in ileum and rectum, and SP-IR only in the rectum. The endocrine cells were round, oval, fusiform cuneiform, conical or irregular in shape. Most were found in the gastric glands of the stomach and in the epithelium of oesophagus and intestine. Conclusion The regional distribution and relative frequency of IR cells inS. indicus are similar to those of other Reptilia. However,some characteristic differences are observed in this species.%目的阐明爬行动物蝘蜓消化管各段内分泌细胞的类型、局部分布、分布密度和形态学特征.方法应用免疫组织化学技术中链霉卵白素-过氧化物酶(S-P)法.结果在蝘蜓消化管内鉴别出5种内分泌细胞,即:5-羟色胺(5-hydroxytryptamine,5-HT)、生长抑素(somatostatin,SS)、胃泌素(gastrin,GAS)、高血糖素(glucagon,GLU)、P-物质(substance P,SP)免疫活性(immnoreactive,IR)细胞.5-羟色胺免疫活性细胞是消化管中最主要的内分泌细胞类型,以不同密度分布于消化管各段,其中胃幽门部位分布密度最高.生长抑素免疫活性细胞在消化管内仅局限分布于胃部.胃泌素免疫活性细胞仅见于幽门和十二指肠部位.高血糖素免疫活性细胞仅分布于回肠和直肠.P-物质免疫活性细胞仅出现在直肠

  4. Morphology of the digestive tract and liver of Plecoglossus altivelis%香鱼消化道及肝脏的形态结构特征

    Institute of Scientific and Technical Information of China (English)

    卢明明; 李海燕; 竺俊全; 李明云


    The morphological characteristics of the digestive tract and liver in Plecoglossus altivelis were observed by paraffin section and photomicrography techniques. The digestive tract includes the orol-pharyngeal cavity, esophagus, stomach and intestine. The orol-pharyngeal cavity is big, long and narrow; in the front of its bottom wall there are a pair of mucous plait; on the edge of the two jaws there are broad flat pectinate jaw teeth; there are teeth on the palate bone and hyoid bone, but no teeth on the vomer. Tongue is formed by the projecting part of basihyoid covered by mucosa. Tongue mucosa epithelium is stratified squamous epithelium, and contains many goblet cells and taste buds. The esophagus, stomach and intestines all consist of mucous membrane layer, submucosa, muscularis and outer membrane. The mucosa of esophagus is stratified squamous epithelium with developed goblet cells. V-shaped stomach comprises cardia, body of stomach and pylorus. Stomach mucosa epithelium is simple columnar epithelium. There are gastric glands in the lamina propria of cardia and body of stomach. Intestine is short and consists of foregut, midgut and hindgut. The mucous epithelium of intestinal wall is simple columnar epithelium and the free surface of it contains a dense array of microvilli. Lots of goblet cells are distributed in the intestinal epithelium. Conjunctive sites of intestines and pylorus contain 350 — 400 pyloric caecums whose histological structure is the same as intestines. The liver is singular and coated by the serosa. The shape of hepatocyte is irregular and the boundaries of hepatic lobules are inconspicuous.%采用解剖及石蜡切片显微技术观察了香鱼消化道及肝脏的组织学结构.香鱼消化道由口咽腔、食道、胃及肠构成.口咽腔大且狭长,其底壁前部有一对粘膜褶,两颌边缘着生宽扁梳状齿,腭骨及舌骨具齿,犁骨无齿;舌由基舌骨突出部分覆盖粘膜构成,舌粘膜上皮为复层扁平上

  5. Evidence of gastric ulcer healing activity of Maytenus robusta Reissek: In vitro and in vivo studies. (United States)

    da Silva, Luisa Mota; Boeing, Thaise; Somensi, Lincon Bordignon; Cury, Benhur Judah; Steimbach, Viviane Miranda Bispo; Silveria, Alessandro Conrado de Oliveira; Niero, Rivaldo; Cechinel Filho, Valdir; Santin, José Roberto; de Andrade, Sérgio Faloni


    Maytenus robusta Reissek (Celastraceae) is traditionally used in Brazilian folk medicine to treat gastric ulcer, as a substitute for M. ilicifolia, which is almost extinct. The gastroprotective properties of M. robusta were demonstrated previously using only preventive approaches, such as acute gastric ulcer models. However, the healing effect of M. robusta in gastric ulcers remains unclear. The current study was carried out to investigate the healing effectiveness of M. robusta hydroalcoholic extract (HEMR) from aerial parts in the acetic acid-induced chronic ulcer model and to determine its effect on cell proliferation, scavenging free radicals, and inflammatory and oxidative damage. To evaluate the healing properties of HEMR in vivo, chronic gastric ulcer was induced in rats by 80% acid acetic. Next, different groups of animals (n=6) were treated orally with vehicle (water plus 1% tween, 1 ml/kg), omeprazole (20mg/kg), or HEMR (1-10mg/kg), twice daily for 7 days. At the end of the treatment, the total ulcer area (mm(2)) was measured and a sample of gastric tissue was taken for histological and histochemical analysis. Evaluation of GSH and LOOH levels, GST, SOD, CAT and MPO activity was also performed at the site of the lesion. In parallel, radical scavenging activity, cytoprotective effect, and cell proliferation activity in fibroblasts (L929 cells) were determined by in vitro trials. The antisecretory properties were evaluated using the pylorus ligature model in rats, and the anti-Helicobacter pylori activity was determined in vitro. Acute toxicity was evaluated by relative organ weight and biochemical parameters in serum. The prokinetic properties were also evaluated in mice. Oral administration of HEMR (10mg/kg) reduced the gastric ulcer area by 53%, compared to the vehicle group (120.0 ± 8.3mm(2)), the regeneration of gastric mucosa was evidenced in histological analysis. Moreover, HEMR treatment increased gastric mucin content and reduced oxidative stress

  6. Antiulcer mechanisms of Vernonia condensata Baker: A medicinal plant used in the treatment of gastritis and gastric ulcer. (United States)

    Boeing, Thaise; da Silva, Luisa Mota; Somensi, Lincon Bordignon; Cury, Benhur Judah; Michels Costa, Ana Paula; Petreanu, Marcel; Niero, Rivaldo; de Andrade, Sérgio Faloni


    The leaves from Vernonia condensata Baker are broadly used in folk medicine for the treatment of gastric ulcers and dyspepsia. The Brazilian Public Health System (SUS) describes this species as having the potential to serve as a new herbal product with therapeutic benefits. The purpose of the study was to evaluate the gastroprotective activity and gastric healing properties of a crude ethanolic extract from leaves of V. condensata (CEEV) in different animal models. In order to assess the gastroprotective potential of CEEV, ulcer models were established using ethanol and indomethacin. The gastric healing effect was then evaluated in the acetic acid-induced ulcer model, where the tissue was used to assess oxidative levels (reduced glutathione and lipid hydroperoxide levels, as well as superoxide dismutase and catalase activity), inflammatory [myeloperoxidase (MPO)] parameters, and mucin content. Furthermore, the ligature pylorus model, with and without secretagogue stimuli, was employed to investigate the mechanism of action of CEEV. In addition, H(+)K(+)-ATPase activity, MPO activity, and antioxidant activity through the DPPH assay were examined through in vitro trials. Phytochemical analyses were also performed. The ethanol/HCl-induced gastric ulcer method was employed to verify the gastroprotective effect of the main compound in CEEV. CEEV (30 and 300mg/kg, p.o) exhibited gastroprotective activity and prevented both gastric lesions induced by ethanol or indomethacin in rats. The gastric healing effect of CEEV (300mg/kg, p.o. taken twice a day for a duration of seven days) was confirmed by examining the macroscopic and microscopic appearance of chronic gastric ulcers induced by acetic acid in rats. The restorative effect of CEEV was accompanied by a significant increase in mucin content (PAS staining) and by a reduction in oxidative stress and inflammatory parameters at the site of the ulcer. Moreover, CEEV (300mg/kg), administered via an intraduodenal route

  7. Anti-Ulcer Activity of Tuber Extracts of Solanum tuberosum (Solanaceae in Rats

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    Ahmad Mohd Fasih


    Full Text Available Solanum tuberosum (Solanaceae is a plant species widespread throughout India and world. S. tuberosum contains starch, sugar (glucose, sucrose and fructose, cellulose (10-20%, crude fibre, pectin substances (0.7-1.5% of dry weight, hemicelluloses (1%, fat (1.1% and vitamin C. The proteins of S. tuberosum tuber comprised of about 60-70% globulin and 20-40% glutelin with no albumin. For external use, the grated raw S. tuberosum is applied locally in cases of arthritis, itching, neuralgia and mild burns. Therefore, the present study was aimed to assess the potential of S. tuberosum for the treatment of ulcers. Ranitidine is used as a standard referenceto evaluate anti-ulcer activity in models such as pylorus ligation model and stress-induced ulcers by cold water immersion. When alcoholic extract of tubers of S. tuberosum (AETST and aqueous extract of tubers of S. tuberosum (AQETST were subjected for LD50 study at the dose level of 2,000 mg/kg body weight. Preliminary phytochemical investigations revealed the presence of tannins, carbohydrates, sterols, flavonoids, glycosides, alkaloids and triterpenes in both the extracts. The dose was selected as low (100 mg/kg, medium (200 mg/kg and high (400 mg/kg, and the doses of both the extracts significantly reduced the ulcer (P < 0.05*, 0.01** and 0.001***. The present study revealed that both the AETST and AQETST possessed anti-ulcer activity. Phytochemical constituents such as tannins, flavonoids and triterpenes have already been reported for their anti-ulcer activity. These phytochemical constituents were present in both the extracts and, hence, responsible for the observed activity.

  8. Factors Influencing Readmission After Pancreaticoduodenectomy: Is there a List of Bad and Very Bad?

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    Generoso Uomo


    advanced age, body mass index, cardiovascular/ pulmonary comorbidities, diabetes, steroid use, Whipple type (standard vs. pylorus preserving pancreaticoduodenectomy, preoperative endobiliary stenting, and vascular reconstruction.

  9. Solid-pseudopapillary tumor of the pancreas: Clinical experience and literature review

    Institute of Scientific and Technical Information of China (English)

    Hsueh-Lien Huang; Shou-Chuan Shih; Wen-Hsiung Chang; Tsang-En Wang; Ming-Jen Chen; Yu-Jan Chan


    AIM: To evaluate the clinical presentations of solidpseudopapillary tumor of the pancreas (SPT) and examine the diagnosis, treatment, low grade malignant potential of this rare disease.METHODS: We retrospectively reviewed a series of seven patients with SPT managed in our hospital between July 1990 and October 2003. Six females and one male with mean age of 31 years (range 13 to 50 years) were diagnosed with SPT at our institution.RESULTS: Clinical presentation included a palpable abdominal mass in two patients and vague abdominal discomfort in another two. Two patients were asymptomatic;their tumors were found incidentally on abdominal sonographic examination for other reasons. The final patient was admitted with hemoperitoneum secondary to tumor rupture. The mean diameter of the tumors in the seven patients was 10.5 cm (range 5 to 20 cm). The lesions were located in the body and tail in five cases and in the head of the pancreas in two. Surgical procedures included distal pancreatectomy (3), distal pancreatectomy with splenectomy (2), pancreaticoduodenectomy (1) and a pylorus-preserving Whipple procedure (1). There were gross adhesions or histological evidence of infiltration to the adjacent pancreas and/or splenic capsule in four cases. None of the patients received adjuvant therapy.The mean follow up was 7 years (range 0.5 to 14 years).One patient developed multiple liver metastases after 14 years of follow up.CONCLUSION: SPT is a rare tumor that behaves less aggressively than other pancreatic tumor. However, in cases with local invasion, long-term follow up is advisable.


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


    The ring-tailed lemur (Lemur catta) is primarily distributed in south and southwestern Madagascar. It is classified as an endangered species by the International Union for Conservation of Nature. Various abdominal diseases, such as hepatic lipidosis, intestinal ulcers, cystitis, urinary tract obstruction, and neoplasia (e.g., colonic adenocarcinoma and cholangiocarcinoma), have been reported in this species. The aim of this study was to describe the normal radiographic and ultrasonographic abdominal anatomy in captive ring-tailed lemurs to provide guidance for clinical use. Radiography of the abdomen and ultrasonography of the liver, spleen, kidneys, and urinary bladder were performed in 13 and 9 healthy captive ring-tailed lemurs, respectively, during their annual health examinations. Normal radiographic and ultrasonographic reference ranges for abdominal organs were established and ratios were calculated. The majority (12/13) of animals had seven lumbar vertebrae. The sacrum had mainly (12/13) three segments. Abdominal serosal detail was excellent in all animals, and hypaxial muscles were conspicuous in the majority (11/13) of animals. The spleen was frequently (12/13) seen on the ventrodorsal (VD) view and rarely (3/13) on the right lateral (RL) view. The liver was less prominent and well contained within the ribcage. The pylorus was mostly (11/13) located to the right of the midline. The right and left kidneys were visible on the RL and VD views, with the right kidney positioned more cranial and dorsal to the left kidney. On ultrasonography, the kidneys appeared ovoid on transverse and longitudinal views. The medulla was hypoechoic to the renal cortex. The renal cortex was frequently (8/9) isoechoic and rarely (1/9) hyperechoic to the splenic parenchyma. The liver parenchyma was hypoechoic (5/5) to the renal cortex. Knowledge of the normal radiographic and ultrasonographic abdominal anatomy of ring-tailed lemurs may be useful in the diagnosis of diseases and in

  11. Gastroprotective effect of an aqueous suspension of black cumin Nigella sativa on necrotizing agents-induced gastric injury in experimental animals

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    Al Mofleh Ibrahim


    Full Text Available Background/Aim: Previous studies on "Black seed" or "Black Cumin" Nigella sativa (NS have reported a large number of pharmacological activities including its anti-ulcer potential. These studies employed either fixed oil, volatile oil components or different solvent extracts. In folkloric practices, NS seeds are taken as such, in the form of coarse dry powder or the powdered seeds are mixed with water. This study examines the effect of NS aqueous suspension on experimentally induced gastric ulcers and basal gastric secretion in rats to rationalize its use by herbal and Unani medicine practitioners. Materials and Methods: The study was conducted at the Medicinal, Aromatic and Poisonous Plants Research Center, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Acute gastric ulceration was produced by various noxious chemicals (80% ethanol, 0.2 M NaOH, 25% NaCl and indomethacin in Wistar albino rats. Anti-secretory studies were undertaken in a separate group of rats. Gastric wall mucus contents and non-protein sulfhydryl concentration were estimated, and gastric tissue was examined histopathologically. Results: An aqueous suspension of Black seed significantly prevented gastric ulcer formation induced by necrotizing agents. It also significantly ameliorated the ulcer severity and basal gastric acid secretion in pylorus-ligated Shay rats. Moreover, the suspension significantly replenished the ethanol-induced depleted gastric wall mucus content levels and gastric mucosal non-protein sulfhydryl concentration. The anti-ulcer effect was further confirmed histopathologically. Conclusion: These findings validate the use of Black seed in gastropathies induced by necrotizing agents. The anti-ulcer effect of NS is possibly prostaglandin-mediated and/or through its antioxidant and anti-secretory activities.

  12. Evaluation of density and distribution of CART-immunoreactive structures in gastrointestinal tract of hypertensive rats. (United States)

    Kasacka, Irena; Piotrowska, Zaneta


    The prevalence of CART (cocaine- and amphetamine-regulated transcript) throughout the organism, multiplicity of functions fulfilled by that peptide, and the collected evidence confirming CART contribution to blood pressure regulation prompted us to undertake the research aiming to identify, localize, and assess changes in CART-immunopositive structures of the gastrointestinal tract (GI tract) of rats with renovascular hypertension. The two-kidney one-clip model of arterial hypertension was used to evaluate the location and density of CART-containing structures in the stomach (cardia, fundus, and pylorus), duodenum, jejunum, ileum, and colon of hypertensive rats. The study was carried out on the GI tract of 20 rats. Ten rats were subjected to the renal artery clipping procedure and after a 6-week period each of them developed stable hypertension. An immunohistochemical localization of CART was performed on paraffin GI tract sections from all the study animals. CART was detected in the extensive population of neurons, particularly within the myenteric plexuses all along the GI tract, and also in neuroendocrine cells, being especially numerous in the stomach and a few in the small intestine. The hypertension significantly increased the density of CART-positive structures in the rat GI tract. The differences between the hypertensive rats and the control animals concerned not only the density of CART-immunoreactive structures but also the staining intensity. As this study provides novel findings, we are planning further molecular examinations to better understand the impact of hypertension on the functioning and activity of CART in the GI tract.

  13. Protective effects of nedocromil sodium and sodium cromoglycate on gastroduodenal ulcers: a comparative study in rats. (United States)

    Tariq, Mohammad; Moutaery, Meshal Al; Elfaki, Ibrahim; Arshaduddin, Mohammad; Khan, Haseeb Ahmad


    Stabilization of mast cells plays a key mechanism to protect gastrointestinal tract from injury. This study presents a comparative evaluation of mast cell stabilizers nedocromil sodium (NDS) and sodium cromoglycate (SCG) in experimental gastric and duodenal ulcers in rats. Wistar rats of either sex were used in this study. Both NDS and SCG, in the doses of 10, 30 and 100 mg/kg were given intraperitoneally for gastric secretion studies and by gavage for antiulcer studies. Acid secretion studies were undertaken in pylorus-ligated rats. Gastric lesions were induced by water immersion restraint stress (WIRS), indomethacin and ethanol whereas duodenal ulcers were produced by cysteamine. The level of glutathione (GSH) and gastric wall mucus were measured in glandular stomach of rats following ethanol-induced gastric lesions. SCG was more effective than NDS in preventing WIRS- and indomethacin-induced gastric lesions whereas reverse was true in ethanol- and cysteamine-induced ulcers. All the 3 doses of SCG offered almost equal protection against WIRS-induced gastric lesions whereas only medium and high dose of NDS provided significant protection in this model of ulcer. NDS significantly inhibited cysteamine-induced duodenal ulcers whereas SCG failed to do so. Pretreatment with NDS or SCG significantly and dose-dependently protected gastric mucosa against ethanol-induced injury, while the former drug appeared to be more effective. The cytoprotective effects of these two drugs were accompanied by the attenuation of ethanol-induced depletion of gastric wall mucus and GSH. The differential effects of NDS and SCG against various gastric lesions rationalize the possible benefits of a combined therapy (NDS+SCG) for the treatment of complex gastroduodenal ulcers.

  14. 中西医结合治疗消化性溃疡58例疗效观察

    Institute of Scientific and Technical Information of China (English)



    消化性溃疡属中医的“胃脘痛”、“呕吐”、“吐酸”等范畴,主要症状特征有反复发作的中上腹疼痛,呈周期性,严重者可有吐血、便血、穿孔、幽门梗阻、癌变等并发症;现代医学可以使胃酸分泌减少,抑制胃酸而缓解疼痛,促进溃疡愈合,用抗生素杀灭幽门螺杆菌,加强胃黏膜–碳酸氢盐屏障;祖国医学可以加固胃黏膜屏障,改善黏膜血流等作用;引气止痛;中西结合用药,达到标本兼治的临床效果。%peptic ulcer in traditional Chinese medicine " stomach ache ", " vomit ", " spit acid " category, the main symptom of recurrent abdominal pain, periodic, serious person can hematemesis, hematochezia, perforation, obstruction of the pylorus, cancer; modern medicine can make gastric acid secretion reduce, inhibition of gastric acid and relieve pain, promote healing of the ulcer, with antibiotics to kill Helicobacter pylori, gastric mucosa, strengthen bicarbonate barrier; the motherland medicine can reinforce the gastric mucosal barrier, improve mucosal blood flow; air entraining pain; combination of traditional Chinese and Western medicine, to integrate the clinical effect.

  15. Antiulcerogenic activity of Carica papaya seed in rats. (United States)

    Pinto, Lorraine Aparecida; Cordeiro, Kátia Wolff; Carrasco, Viviane; Carollo, Carlos Alexandre; Cardoso, Cláudia Andréa Lima; Argadoña, Eliana Janet Sanjinez; Freitas, Karine de Cássia


    The purpose of the present study was to evaluate the gastroprotective and healing effects of the methanolic extract of the seed of the papaya Carica papaya L. (MECP) in rats. Models of acute gastric ulcer induction by ethanol and indomethacin and of chronic ulcer by acetic acid were used. The gastric juice and mucus parameters were evaluated using the pylorus ligation model, and the involvement of sulfhydryl compounds (GSH) and nitric oxide in the gastroprotective effect was analyzed using the ethanol model. The toxicity was assessed through toxicity tests. No signs of toxicity were observed when the rats received a single dose of 2000 mg/kg of extract. The MECP in doses of 125, 250, and 500 mg/kg significantly reduced the gastric lesion with 56, 76, and 82 % inhibition, respectively, and a dose of 30 mg/kg lansoprazole showed 79 % inhibition in the ethanol model. MECP (125, 250, 500 mg/kg) and cimetidine (200 mg/kg) reduced the gastric lesion in the indomethacin model, with 62, 67, 81, and 85 % inhibition, respectively. The MECP (500 mg/kg) and cimetidine (200 mg/kg) treatments showed a reduction in ulcerative symptoms induced by acetic acid by 84 and 73 %, respectively. The antiulcerogenic activity seems to involve GSH because the inhibition dropped from 72 to 13 % in the presence of a GSH inhibitor. Moreover, the MECP showed systemic action, increasing the mucus production and decreasing gastric acidity. Treatments with MECP induce gastroprotection without signs of toxicity. This effect seems to involve sulfhydryl compounds, increased mucus, and reduced gastric acidity.

  16. Gastroprotective effects of extracts and guttiferone A isolated from Garcinia achachairu Rusby (Clusiaceae) against experimentally induced gastric lesions in mice. (United States)

    Niero, Rivaldo; Dal Molin, Marlova Manhabosco; Silva, Suellen; Damian, Natália Santos; Maia, Láis Orlof; Delle Monache, Franco; Cechinel Filho, Valdir; de Andrade, Sérgio Faloni


    This study was undertaken to evaluate the gastroprotective properties of seed, leaf, and branch methanolic extracts and guttiferone A obtained from Garcinia achachairu (Clusiaceae). Mice were used in all the models, and treatments were administered orally only in pylorus-ligated model of the extracts, and drugs were administered intraduodenally. Treatment with different extracts (500 mg/kg) significantly reduced the ulcerative lesions in the ethanol/HCl-induced model; however, the seed extract was most active. When tested in different doses (50, 250, or 500 mg/kg), the seed extract of G. achaicharu showed a dose-dependent effect with a percentage of inhibition of gastric lesions of 41, 49, and 85 %, respectively. The seed extract also significantly reduced the ulcerative lesions in the indomethacin/bethanechol-induced ulcer. In this model, the percentage of inhibition of ulcer was 24, 58, and 90 %, respectively. Regarding the model of gastric secretion, a reduction of gastric juice volume and total acidity was observed, as well as an increase in gastric pH. Considering that the seed extract was the most active, it was subjected to silica gel column chromatography, leading to the isolation of guttiferone A. The isolated compound and omeprazole were evaluated in the HCl/ethanol-induced ulcer model. In this assay, both compounds at a dose of 30 mg/kg reduced the ulcerative lesions by about 75 %. These results demonstrate, for the first time, that extracts obtained from G. achachairu and guttiferone A produce gastroprotective effects, corroborating ethnomedicinal use of this plant.

  17. In vitro and in vivo anti-Helicobacter pylori activities of FEMY-R7 composed of fucoidan and evening primrose extract. (United States)

    Cai, Jingmei; Kim, Tae-Su; Jang, Ja Young; Kim, Jihyun; Shin, Kyungha; Lee, Sung-Pyo; Choi, Ehn-Kyoung; Kim, Sa-Hyun; Park, Min; Kim, Jong Bae; Kim, Yun-Bae


    Effects of FEMY-R7, composed of fucoidan and evening primrose extract, on the bacterial growth and intragastric infection of Helicobacter pylori as well as gastric secretion were investigated in comparison with a proton-pump inhibitor pantoprazole. For in vitro anti-bacterial activity test, H. pylori (1×10(8) CFU/mL) was incubated with a serially-diluted FEMY-R7 for 3 days. As a result, FEMY-R7 fully inhibited the bacterial growth at 100 µg/mL, which was determined to be a minimal inhibitory concentration. In addition, 6-hour incubation with H. pylori, FEMY-R7 inhibited urease activity in a concentration-dependent manner, showing a median inhibitory concentration of 1,500 µg/mL. In vivo elimination study, male C57BL/6 mice were infected with the bacteria by intragastric inoculation (5×10(9) CFU/mouse) 3 times at 2-day intervals, and simultaneously, orally treated twice a day with 10, 30 or 100 mg/kg FEMY-R7 for 7 days. In Campylobcter-like organism-detection test and bacterial identification, FEMY-R7 exerted a high bacteria-eliminating capacity at 30-100 mg/kg, comparably to 30 mg/kg pantoprazole. In contrast to a strong antacid activity of pantoprazole in a pylorus-ligation study, FEMY-R7 did not significantly affect gastric pH, free HCl, and total acidity, although it significantly decreased fluid volume at a low dose (10 mg/kg). The results indicate that FEMY-R7 eliminate H. pylori from gastric mucosa by directly killing the bacteria and preventing their adhesion and invasion, rather than by inhibiting gastric secretion or mucosal damage.

  18. 影像学观察精神分裂症住院患者的胃功能改变%Image observation to functional change of the stomach and intestine in the hospitalized patients of schizophrenia

    Institute of Scientific and Technical Information of China (English)



    Objective To observe the abnormal function change of the stomach and intestine in the hospitalized patients of schizophrenia by X - ray imagine. Method 120 cases of schizophrenia patients who have teen treated in hospital for 3-6 months from 2008 to 2010 were used by barium meal examination. The stomach liquid, shape type, stomach tension, pylorus spasm, stomach movement and evacuation function of patients were analyzed. Result The abnormal function change including stomach tension lessen, stomach movement lack, and the stomach evacuation delay were existed in most schizophrenic patients. Conclusion The schizophrenic hospitalized patients have abnormal function of the stomach and intestine, it may caused by their lonely taking phenothiazine medicines.%目的 采用X线数字胃肠机观察精神分裂症患者住院期间胃肠功能的变化.方法 对我院2008年~2010年120例住院三月至半年的精神分裂症患者进行传统钡餐检查,对胃潴留液量、形态类型、胃紧张度、幽门一时性痉挛,胃蠕动和排空功能等进行分析总结.结果 精神分裂症患者存在胃紧张力降低,胃蠕动乏力,胃排空延缓等功能下降的比例较大.结论 精神分裂症患者住院期间存在胃肠功能异常改变,原因可能与长期服用吩噻嗪类药物有关.

  19. A case report of an ampullary tumor presenting with spontaneous perforation of an aberrant bile duct and treated with total laparoscopic pancreaticoduodenectomy

    Directory of Open Access Journals (Sweden)

    Kaplan Mehmet


    Full Text Available Abstract Background This case report discusses a patient who presented with bile peritonitis due to spontaneous perforation of an aberrant bile duct that originated in the triangular ligament of the liver. It was associated with an ampullary tumor and treated with total laparoscopic pancreaticoduodenectomy (TLPD. Case report A 58-year-old male patient was admitted to the emergency department of Medical Park Gaziantep Hospital in September 2009 with acute abdominal findings. He underwent an urgent laparoscopy, and, interestingly, bile peritonitis due to the rupture of an aberrant bile duct in the triangular ligament was noted. After laparoscopic treatment of the acute conditions, the follow-up examinations of the patient showed the finding of obstructive jaundice. Endoscopic retrograde cholangio-pancreatography revealed a 1-cm polypoid mass located at the ampulla of Vater (duodenal papilla with possible extension to the ampullary sphincter. A stent was inserted for temporary biliary drainage, and subsequent endoscopic biopsy showed the pathological finding of adenocarcinoma. After waiting for a 1-month period for the peritonitis to heal, the patient underwent pylorus-preserving TLPD and was discharged without any major complications on postoperative day 7. Conclusion In patients with bile peritonitis, it should be considered that the localization of the perforation may be in an aberrant bile duct localized at the triangular ligament and the etiology may be associated with an obstructing periampullary tumor. Laparoscopic pancreaticoduodenectomy is a feasible operative procedure in carefully selected patients. This technique can achieve adequate margins and follows oncological principles. Randomized comparative studies are needed to establish the superiority of minimally invasive surgery over traditional open surgery.

  20. Antiulcer and in vitro antioxidant activities of Jasminum grandiflorum L. (United States)

    Umamaheswari, M; Asokkumar, K; Rathidevi, R; Sivashanmugam, A T; Subhadradevi, V; Ravi, T K


    The study was aimed at evaluating the antiulcer and antioxidant activities of 70% ethanolic axtract of leaves of Jasminum grandiflorum L. (JGLE). The leaves of Jasminum grandiflorum L. (Family: Oleaceae) is used in folk medicine for treating ulcerative stomatitis, skin diseases, ulcers, wounds, corns - a hard or soft hyperkeratosis of the sole of the human foot secondary to friction and pressure (Stedman's Medical Dictionary, 28th ed. Lippincott Williams & Wilkins, Philadelphia. p. 443), etc., Antiulcerogenic activity of JGLE (100 and 200 mg/kg, b.w., orally) was evaluated employing aspirin + pylorus ligation (APL) and alcohol (AL) induced acute gastric ulcer models and ulcer-healing activity using acetic acid-induced (AC) chronic ulcer model in rats. Both the antisecretory and cytoprotection hypothesis were evaluated. The antioxidant activity of JGLE has been assayed by using in vitro methods like 2,2-diphenyl-1-picrylhydrazylhydrate (DPPH) assay, reductive ability, superoxide anion scavenging activity, nitric oxide scavenging activity and total phenolic content, in order to explain the role of antioxidant principles in the antiulcerogenic activity of the extract. There was a significant (P<0.01) dose-dependent decrease in the ulcerative lesion index produced by all the three models in rats as compared to the standard drug famotidine (20 mg/kg, b.w. orally). The reduction in gastric fluid volume, total acidity and an increase in the pH of the gastric fluid in APL rats proved the antisecretory activity of JGLE. Additionally, JGLE completely healed the ulcer within 20 days of treatment in AC model as evidenced by histopathological studies. Like antiulcer activity, the free radical scavenging activities of JGLE depends on concentration and increased with increasing amount of the extract. These results suggest that leaves of Jasminum grandiflorum possess potential antiulcer activity, which may be attributed to its antioxidant mechanism of action.

  1. Effects of the selective I1 imidazoline receptor agonist, moxonidine, on gastric secretion and gastric mucosal injury in rats. (United States)

    Glavin, G B; Smyth, D D


    1. Previous reports of the effects of alpha 2-adrenoceptor stimulation on gastric secretion are inconsistent because it was not clear whether the compounds were activating alpha 2-adrenoceptors and/or newly described imidazoline receptors. In the present experiments, the effects of moxonidine, an I1-imidazoline receptor agonist and antihypertensive agent, on gastric secretion and on experimental gastric mucosal injury were examined. 2. Moxonidine (0.01, 0.1 and 1.0 mg kg-1, i.p.) potently inhibited basal (non-stimulated) gastric acid secretion in conscious rats with an ED50 of 0.04 mg kg-1. Two hours following administration of the highest dose of moxonidine (1.0 mg kg-1), gastric acid output was completely suppressed. Moxonidine also significantly increased intragastric pH, at the two highest doses. 3. The alpha 2-adrenoceptor agonist, clonidine (0.01, 0.1 and 1.0 mg kg-1, i.p.) decreased basal acid secretion at the lowest dose (37%) and at the highest dose (46%), while the intermediate dose did not affect gastric acid output. 4. In an ethanol-induced model of gastric mucosal injury, moxonidine decreased the length of lesions at the lowest and highest doses (0.01 and 1.0 mg kg-1) as well as the number of the lesions, at the highest dose (1.0 mg kg-1). 5. In pylorus-ligated rats, moxonidine significantly decreased acid secretion (all doses), total secretory volume (1.0 mg kg-1) as well as pepsin output (1.0 mg kg-1). 6. In comparison to clonidine, moxonidine appears to be a more potent anti-secretory and gastric-protective compound.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7773534

  2. Gastroprotective activity of alkaloid extract and 2-phenylquinoline obtained from the bark of Galipea longiflora Krause (Rutaceae). (United States)

    Zanatta, Francielle; Gandolfi, Renan Becker; Lemos, Marivane; Ticona, Juan Carlos; Gimenez, Alberto; Clasen, Bruna Kurz; Cechinel Filho, Valdir; de Andrade, Sérgio Faloni


    As part of our continuing search for bioactive natural products from plants, the present study was carried out in order to evaluate the gastroprotective properties of alkaloid extract and 2-phenylquinoline obtained from the bark of Galipea longiflora (Rutaceae). Anti-ulcer assays were performed using the following protocols in mice: nonsteroidal anti-inflammatory drug (NSAID)/bethanecol-induced ulcer, ethanol/HCl-induced ulcer, and stress-induced ulcer. The effects of the extract on gastric content volume, pH and total acidity were also evaluated, using the pylorus ligated model. Treatment using doses of 50, 125 and 250 mg/kg of G. longiflora alkaloid extract and positive controls (omeprazol or cimetidine) significantly diminished the lesion index, total lesion area, and percentage of lesion, in comparison with the negative control groups in all the models evaluated. Regarding the model of gastric secretion, a reduction in volume of gastric juice and total acidity was observed, as well as an increase in gastric pH. The main alkaloid of the plant, 2-phenylquinoline, was also evaluated in the ethanol-induced ulcer model. The results showed that at a dose of 50 mg/kg, it significantly inhibited ulcerative lesions. However, this effect was less than that of the alkaloid extract. All these results taken together show that G. longiflora displays gastroprotective activity, as evidenced by its significant inhibition of the formation of ulcers induced by different models. There are indications that mechanisms involved in anti-ulcer activity are related to a decrease in gastric secretion and an increase in gastric mucus content. Also, there is evidence of involvement of NO in the gastroprotector mechanisms. These effects may be attributed, at least in part, to the presence of some alkaloids, particularly 2-phenylquinoline.

  3. Acid reflux directly causes sleep disturbances in rat with chronic esophagitis.

    Directory of Open Access Journals (Sweden)

    Kenichi Nakahara

    Full Text Available BACKGROUND & AIMS: Gastroesophageal reflux disease (GERD is strongly associated with sleep disturbances. Proton pump inhibitor (PPI therapy improves subjective but not objective sleep parameters in patients with GERD. This study aimed to investigate the association between GERD and sleep, and the effect of PPI on sleep by using a rat model of chronic acid reflux esophagitis. METHODS: Acid reflux esophagitis was induced by ligating the transitional region between the forestomach and the glandular portion and then wrapping the duodenum near the pylorus. Rats underwent surgery for implantation of electrodes for electroencephalogram and electromyogram recordings, and they were transferred to a soundproof recording chamber. Polygraphic recordings were scored by using 10-s epochs for wake, rapid eye movement sleep, and non-rapid eye movement (NREM sleep. To examine the role of acid reflux, rats were subcutaneously administered a PPI, omeprazole, at a dose of 20 mg/kg once daily. RESULTS: Rats with reflux esophagitis presented with several erosions, ulcers, and mucosal thickening with basal hyperplasia and marked inflammatory infiltration. The reflux esophagitis group showed a 34.0% increase in wake (232.2±11.4 min and 173.3±7.4 min in the reflux esophagitis and control groups, respectively; p<0.01 accompanied by a reduction in NREM sleep during light period, an increase in sleep fragmentation, and more frequent stage transitions. The use of omeprazole significantly improved sleep disturbances caused by reflux esophagitis, and this effect was not observed when the PPI was withdrawn. CONCLUSIONS: Acid reflux directly causes sleep disturbances in rats with chronic esophagitis.

  4. Management of postoperative arterial hemorrhage after pancreato-biliary surgery according to the site of bleeding: re-laparotomy or interventional radiology. (United States)

    Miura, Fumihiko; Asano, Takehide; Amano, Hodaka; Yoshida, Masahiro; Toyota, Naoyuki; Wada, Keita; Kato, Kenichiro; Yamazaki, Eriko; Kadowaki, Susumu; Shibuya, Makoto; Maeno, Sawako; Furui, Shigeru; Takeshita, Koji; Kotake, Yutaka; Takada, Tadahiro


    Intra-abdominal arterial hemorrhage is still one of the most serious complications after pancreato-biliary surgery. We retrospectively analyzed our experiences with 15 patients in order to establish a therapeutic strategy for postoperative arterial hemorrhage following pancreato-biliary surgery. Between August 1981 and November 2007, 15 patients developed massive intra-abdominal arterial bleeding after pancreato-biliary surgery. The initial surgery of these 15 patients were pylorus-preserving pancreatoduodenectomy (PPPD) (7 patients), hemihepatectomy and caudate lobectomy with extrahepatic bile duct resection or PPPD (4 patients), Whipple's pancreatoduodenectomy (PD) (3 patients), and total pancreatectomy (1 patient). Twelve patients were managed by transcatheter arterial embolization and three patients underwent re-laparotomy. Patients were divided into two groups according to the site of bleeding: SMA group, superior mesenteric artery (4 patients); HA group, stump of gastroduodenal artery, right hepatic artery, common hepatic artery, or proper hepatic artery (11 patients). In the SMA group, re-laparotomy and coil embolization for pseudoaneurysm were performed in three and one patients, respectively, but none of the patients survived. In the HA group, all 11 patients were managed by transcatheter arterial embolization. None of four patients who had major hepatectomy with extrahepatic bile duct resection survived. Six of seven patients (85.7%) who had pancreatectomy survived, although hepatic infarction occurred in four. Management of postoperative arterial hemorrhage after pancreato-biliary surgery should be done according to the site of bleeding and the initial operative procedure. Careful consideration is required for indication of interventional radiology for bleeding from SMA after pancreatectomy and hepatic artery after major hepatectomy with bilioenteric anastomosis.

  5. Observation of Shenque (CV8) Pasting with Rhubarb Capsule Powder Mixed Alcohol in Pattents with Abdominal Distension in the Mechanical Ventilation%大黄胶囊粉外敷神阙穴治疗机械通气患者腹胀临床观察

    Institute of Scientific and Technical Information of China (English)

    胡喜燕; 黄丽霞; 王磊


    目的 观察大黄胶囊粉外敷神阙穴治疗机械通气患者腹胀的临床疗效.方法 患者60例随机分为观察组及对照组,两组均使用抗生素、解痉、化痰、胃肠减压等常规治疗,观察组加用大黄粉调和酒精外敷神阙穴,治疗72h后评定疗效.结果 观察组患者腹胀及肠鸣音的改善及胃幽门十二指肠压力的降低均优于于对照组:结论 大黄胶囊外敷神阙穴能有效减轻机械通气患者的腹胀.%Objective: To observe the abdominal distension in the mechanical ventilation patients treated with pasting the Shenque(CV8) with rhubarb capsule powder mixed alcohol. Methods: 60 cases of abdominal distension patients were randomly divided into trial group (n=30) and control group (ra=30). Both groups were treat with antibiotics, spasmolysis, eliminating phlegm, gastrointestinal tract decompression and mechanical ventilation. The trial group was added with rhubarb capsule powder mixed alcohol paste the Shenque (CV8). Results: Compare with the control group, the abdominal distention and the bowel sound were better than those of the control group. The pressure of the pylorus and the duodenum was lower than that of the control group. Conclusion: The treatment of pasting the Shenque (CV8) with rhubarb capsule mixed alcohol can reduce the abdominal distension.

  6. Gastric obstruction secondary to metastatic breast cancer: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Hussain Tasadooq


    Full Text Available Abstract Introduction Gastrointestinal tract soft tissues metastasis is a well-known occurrence with invasive lobular breast cancer subtypes. Gastric involvement is more common, with reports of both diffuse and localized involvements. Usually, a gastric localized involvement presents as wall thickening with an appearance similar to that of a gastrointestinal stromal tumour; rarely does a localized metastatic deposit grow aggressively to present as a large tumour causing obstructive symptoms. Our case highlights one such unusual presentation in a patient presenting with non-specific gastrointestinal symptoms. To the best of our knowledge, there have been no previous reports on a similar presentation occurring from a localized metastasis. Case presentation A 65-year-old Caucasian woman awaiting an outpatient oral gastroduodenoscopy for symptoms of intermittent vomiting, epigastric pains and weight loss of six weeks’ duration presented acutely with symptoms of haematemesis and abdominal distension. An initial contrast-enhanced computed tomography scan showed a grossly dilated stomach with a locally advanced stenosing tumour mass at the pylorus. Our patient had a history of left mastectomy and axillary clearance followed by adjuvant endocrine therapy for an oestrogen receptor- and progesterone receptor-positive, grade 2, invasive lobular breast cancer. The oral gastroduodenoscopy confirmed the computed tomography findings; biopsies of the pyloric mass on immunohistochemistry stains were strongly positive for pancytokeratin and gross cystic disease fluid proteins, consistent with an invasive lobular breast cancer metastasis. She received a palliative gastrojejunal bypass and her adjuvant endocrine treatment was switched over to exemestane. Conclusion Our case highlights the aggressive behaviour of a localized gastric metastasis that is unusual and unexpected. Gastrointestinal symptomatology can be non-specific and, at times, non-diagnostic on

  7. Non-Hodgkin lymphoma as a cause of obstructive jaundice with simultaneous extrahepatic portal vein obstruction: A case report

    Institute of Scientific and Technical Information of China (English)

    Masao Hashimoto; Nobutaka Umekita; Kazumasa Noda


    Non-Hodgkin lymphoma is a rare cause of biliary obstruction. To the best of our knowledge, non-Hodgkin lymphoma in the peripancreatic region causing obstructive jaundice with simultaneous portal vein (PV) invasion has not yet been reported. We present a 50-year-old patient with obstructive jaundice whose extrahepatic portal vein was obstructed by the invasion of a peripancreatic non-Hodgkin lymphoma. The patient denied any other symptoms such as recurrent fever, night sweat and loss of body weight. Computed tomography (CT) revealed a 10cm mass in the retroperitoneal space behind the head of the pancreas causing obstruction of the distal bile duct and the PV. A pylorus-preserving pancreaticoduodenectomy combined with a PV resection was performed. The PV was reconstructed using an autologous right internal jugular vein graft. The resected specimen showed endoluminal invasion of both the bile duct and the PV. Histological examination showed the mass consisting of diffuse sheets of large malignant lymphoid cells. These cells were positive for CD20 and CD79a, partially positive for CD10, and negative for CD3, CD4, CD5, CD8 and CD30. The pathologic diagnosis was diffuse large B-cell type non-Hodgkin lymphoma and the patient was transferred to the Department of Hematology and Oncology for chemotherapy. He received four cycles of combined chemotherapy including cyclophosphamide, doxorubicin, vincristine and prednisone plus rituximab, and three cycles of intrathecal chemoprophylaxis including methotorexate, cytosine arbinoside and prednisone. The patient is alive with no evidence of the disease for 7 mo after operation and will receive additional courses of chemotherapy.

  8. The role of pancreaticoduodenectomy in the treatment of severe chronic pancreatitis. (United States)

    Vickers, S M; Chan, C; Heslin, M J; Bartolucci, A; Aldrete, J S


    Chronic pancreatitis remains a debilitating disease with few definitive options for treatment. The purpose of this study was to evaluate the benefit of pancreaticoduodenectomy in the treatment of chronic pancreatitis. The results were evaluated by standard descriptive statistics. In a retrospective study, we reviewed the patients at a single institution undergoing pancreaticoduodenectomy between 1994 and 1997 for complications of chronic pancreatitis. Patients were evaluated for preoperative indication for surgery and perioperative morbidity and mortality, as well as long-term results. Thirty-two patients underwent pancreaticoduodenectomy for chronic pancreatitis; 56 per cent (18) underwent pylorus-preserving and 44 per cent (14) underwent classic pancreaticoduodenectomy. The mean age of these patients was 56+/-14.7 years (range, 23-79). All patients underwent preoperative CT scan and endoscopic retrograde cholangiopancreatography. The preoperative indication for surgery in 81 per cent (26) of these patients was intractable pain in the setting of a nondilated pancreatic duct. The other 19 per cent were treated for biliary/pancreatic duct stricture and pancreatic head fibrosis (mass suspicious of malignancy). Fifty-three per cent of the patients had a history of previous abdominal surgery. There were no perioperative deaths. The mean postoperative stay was 12.2+/-7.4 days. The postoperative morbidity rate was 31 per cent (10), consisting of 25 per cent with delayed gastric emptying, 3 per cent with pneumonia, and 3 per cent with wound infections. There was no occurrence of pancreatic fistulas. With a mean follow-up of 40 months (range, 10-52 months), 85 per cent reported a significant improvement in pain with 71 per cent being pain free and not requiring narcotics. Twenty per cent developed new-onset diabetes. The overall event survival rate at 5 years was 97 per cent. Thus, in a selected group of patients with severe chronic pancreatitis, resection of the head of

  9. Proximal gastric vagotomy: effects of two operative techniques on clinical and gastric secretory results. (United States)

    Hallenbeck, G A; Gleysteen, J J; Aldrete, J S; Slaughter, R L


    PGV performed in 39 patients by separating the lesser omentum from the stomach beginning 6 or 7 cm proximal to the pylorus and skeletonizing the distal 1 to 2 cm of esophagus was followed by 15.4% of proven and 10.2 of suspected recurrent ulcers. Insulin tests were done during the first 3 months postoperatively on 31 of the patients, including the 6 with proven and the 4 with suspected recurrent ulcers. The peak acid output to insulin minus tha basal acid output (PAOI-BAO) was less than 5 mEq/hr in 16 cases (52%) and from 5 to 25 mEq/hr in the remaining 15 cases. In 6 patients with proven recurrent ulcer, PAOI-BAO averaged 21.9 mEq/hr (range, 11.3 to 41.8); in the 4 patients with suspected recurrence, 9.5 (range, 4.4 to 11.8).The operative technique was changed in one respect; the distal 5 to 7.5 cm of the esophagus was skeletonized. In 14 patients, the mean PAOI-BAO +/- S.E. within 3 months of PGV was 1985 +/- 0.7 mEq/hr, and 13 of 14 values were less than 5 mEq/hr. One patient developed recurrent ulcer and required re-operation; this patient's value for PAO-BAO was 1.8 mEq/hr. The results show quantitatively that great differences in the completeness of PGV result from differences in the periesophageal dissection and emphasize its importance if optimal results are to be obtained and, especially, if the efficacy of the operation is to be judged. PMID:1015889

  10. Protective effects of Ginkgo biloba extract on the ethanol-induced gastric ulcer in rats

    Institute of Scientific and Technical Information of China (English)

    Sheng-Hsuan Chen; Yu-Chih Liang; Jane CJ Chao; Li-Hsueh Tsai; Chun-Chao Chang; Chia-Chi Wang; Shiann Pan


    AIM: To evaluate the preventive effect of Ginkgo bilobaextract (GbE) on ethanol-induced gastric mucosal injuries in rats.METHODS: Female Wistar albino rats were used for the studies. We randomly divided the rats for each study into five subgroups: normal control, experimental control, and three experimental groups. The gastric ulcers were induced by instilling 1 mL 50% ethanol into the stomach. We gaveGbE 8.75, 17.5, 26.25 mg/kg intravenously to the experimental groups respectively 30 min prior to the ulcerative challenge. We removed the stomachs 45 min later. The gastric ulcers,gastric mucus and the content of non-protein sulfhydryl groups (NP-SH), malondialdehyde (MDA), c-Jun kinase (JNK) activity in gastric mucosa were evaluated. The amount of gastric juice and its acidity were also measured. RESULTS: The findings of our study are as follows: (1)GbE pretreatment was found to provide a dose-dependent protection against the ethanol-induced gastric ulcers in rats; (2) the GbE pretreatment afforded a dose-dependent inhibition of ethanol-induced depletion of stomach wall mucus, NP-SH oontents and increase in the lipid peroxidation (increase MDA) in gastric tissue; (3) gastric ulcer induced by ethanolproduced an increase in JNK activity in gastric mucosawhich also significantly inhibited by pretreatment with GbE;and (4) GbE alone had no inhibitory effect on gastric secretionin pylorus-ligated rats.CONCLUSION: The finding of this study showed that GbE significantly inhibited the ethanol-induced gastric lesions in rats. We suggest that the preventive effect of GbE may be mediated through: (1) inhibition of lipid peroxidation;(2) preservation of gastric mucus and NP-SH; and (3)blockade of cell apoptosis.

  11. Characterization of gastric cancer models from different cell lines orthotopically constructed using improved implantation techniques

    Institute of Scientific and Technical Information of China (English)

    Yan Li; Bo Li; Chun-Ping Xiang; Yu Zhang; Yuan-Yuan Li; Xiao-Ling Wu


    AIM: To develop orthotopic gastric cancer mouse models from different cell lines and characterize the tumor features to assist further in preclinical trials and clinical treatment strategies. METHODS: Human gastric cancer SGC-7901 and BGC- 823 cell suspensions were injected subcutaneously into nude mice to develop solid tumors, and tumor tissue pieces were then implanted under the serous coat of the stomach. An autopsy was performed on all animals of the SGC-7901 and BGC-823 models to observe the primary tumor growth and metastases using pathological and immunohistochemical methods. RESULTS: Both models showed large tumors in situ resulting in pressure and infiltration of the adjacent organs. The gastric cavity became smaller, along with stenosis of the cardia or pylorus. There were biological and statistical differences between the two models. The metastasis rate in involved organs (lymph nodes, kidney, spleen, testis) was significantly higher in the BGC-823 model compared to the SGC-7901 model (P < 0.05 or P < 0.01). The median survival of the BGC-823 model was shorter than that of SGC-7901 (23 d vs 84 d, P < 0.05). Histopathologically, the primary tumor and metastatic lesions of the two models showed obvious atypia and mucus in the cytoplasm. Compared with the SGC-7901 model, BGC-823 appeared more poorly differentiated (absence of adenoid structure), had a smaller volume, and richer capillary structure. Immunohistochemical staining revealed cytokeratin 20 and epithelial membrane antigen expression was positive in the SGC-7901 tumors, while negative in BGC-823 ones. CONCLUSION: Models using the SGC-7901 and BGC-823 cell lines were established which could function in gastric cancer research on carcinogenesis mechanism and drug discovery. The two models showed different tumor behavior and the latter was more malignant than the former.

  12. Professor Ludwik Rydygier father and legend of Polish surgery. (United States)

    Bielecki, K


    Ludwik Rydygier is undoubtedly the father of Polish gastrointestinal surgery. He performed two pioneering stomach operations: on 16 November 1880, first in Poland and second in the world after Jules Pean, the surgical removal of the pylorus in a 64-year-old patient suffering from stomach cancer; the operation took about four hours, unfortunately the patient died 12 hours later, and on 21 November 1881 he performed the world's first pylorectomy due to gastric ulcer, applying his own method of pylorectomy followed by the restoration by end-to-end anastomosis of the duodenal stump with the stomach stump; the patient survived the operation and recovered. Three years later, Rydygier introduced a new method of surgical treatment of peptic ulcer disease by means of gastroenterostomy. This review was designed to commemorate the outstanding achievements of Professor Rydygier, who worked at two universities: at the Jagiellonian University in Cracow, and at the Lemberg (Lviv) University. He was one of the founders of the Association of Polish Surgeons and an organizer of the first Meeting of Polish Surgeons in 1889. He was the author of over 200 published papers and several text-books on surgical infections, surgical techniques, orthopaedics and traumatology, urology, neurosurgery, and gynaecology. Professor Ludwik Rydygier possessed comprehensive knowledge of surgery and other medical disciplines, he was a courageous surgeon and skilled operator, being at the same time an extremely gifted organizer. His promotion to the rank of General of Polish Army crowned his credits for country's defence. At the anniversary of 90 years after his death, Polish surgeons pay the tribute to their mentor.

  13. Hydrolysis of phytic acid by intrinsic plant and supplemented microbial phytase (Aspergillus niger) in the stomach and small intestine of minipigs fitted with re-entrant cannulas. 3. Hydrolysis of phytic acid (IP6) and occurrence of hydrolysis products (IP5, IP4, IP3 and IP2). (United States)

    Rapp, C; Lantzsch, H J; Drochner, W


    Hydrolysis of phytate in the stomach and the small intestine as influenced by intrinsic plant (wheat) and supplemented microbial phytase (Aspergillus niger) were investigated with six minipigs (40-50 kg initial body weight) fitted with re-entrant cannulas in the duodenum, 30 cm posterior to the pylorus (animals 1, 4, 5 and 6) and ileocecal re-entrant cannulas, 5 cm prior the ileocecal junction (animals 1, 2 and 3), respectively. Dietary treatments were as follows: (1) diet 1, a corn-based diet [43 U phytase/kg dry matter (DM)]; (2) diet 2, diet 1 supplemented with microbial phytase (818 U/kg DM); and (3) diet 3, a wheat-based diet (1192 U/kg DM). At 07 30 h and 19 30 h, each animal was fed 350 g diet mixed with 1050 ml de-ionized water. Digesta were collected continuously and completely during a 12-h period after feeding. Mean hydrolysis rates of IP6 in the stomach as measured at the proximal duodenum of animals 1, 4, 5 and 6 were 9.0, 77.2 and 66.2% for diet 1, 2 and 3, respectively. Microbial phytase was much more effective in phytate hydrolysis than wheat phytase. Mean IP6 hydrolysis rates of the respective diets in the stomach and small intestine as measured at the distal ileum of animals 1, 2 and 3 were 19.0, 62.6 and 64.6% and were lower than treatment means of the stomach only. Differences existed between experimental animals with respect to their ability to hydrolyse IP6 in the stomach independent of the presence and source of dietary phytase. Considerable amounts of hydrolysis products occurred in both the duodenal and ileal digesta when diets 2 and 3 were fed; however, only traces were determined after ingestion of diet 1. Independent of dietary treatment, four IP5 isomers were detected, but in different amounts.

  14. Rare causes of gastric outlet obstruction in children. (United States)

    Feng, Jiexiong; Gu, Weizhong; Li, Minju; Yuan, Jiyan; Weng, Yizhen; Wei, Minfa; Zhou, Xuefeng


    Gastric outlet obstruction (GOO) presenting beyond the newborn period is a relatively rare condition, when infantile hypertrophic pyloric stenosis (IHPS) is excluded. This report describes the clinical features, evaluation and management of 18 patients with GOO which was not caused by IHPS. The sex, age, and main presenting features were recorded on admission. Hemoglobin estimation, serum chemistry and blood gas analysis were also assessed in these patients. The diagnosis was confirmed with gastrointestinal barium, B ultrasound, gastroscopy, or at surgery. Some of them underwent gastroscopy with biopsy sampling for rapid urease test or histologic examination with Giemsa stains for Helicobacter pylori. Thirteen patients had peptic ulcer disease, of which six were successfully treated with medications. While the other seven needed operative management which included Heineke-Mikulicz pyloroplasty, gastroduodenostomy or gastrojejunostomy, respectively. All the patients who had Heineke-Mikulicz pyloroplasty or gastrojejunostomy developed bile reflux gastritis that could be alleviated with omeprazol. None of the patients developed dumping syndrome, failing to thrive, or anemia. Three children with antral diaphragm recovered without any complications by diaphragm excision with Heineke-Mikulicz pyloroplasty. The pylorus was compressed by fibrotic band in one 30-month boy, and he recovered uneventfully with Heineke-Mikulicz pyloroplasty during 10-year follow-up. Gastric outlet obstruction secondary to ingestion of sulfuric acid was noted in one patient, and he was successfully treated with gastroduodenostomy. Our data suggests that the satisfactory results could be expected in children with GOO with different therapeutic modalities based on the specific cause and degree of obstruction.

  15. Postprandial inhibition of gastric ghrelin secretion by long-chain fatty acid through GPR120 in isolated gastric ghrelin cells and mice. (United States)

    Lu, Xinping; Zhao, Xilin; Feng, Jianying; Liou, Alice P; Anthony, Shari; Pechhold, Susanne; Sun, Yuxiang; Lu, Huiyan; Wank, Stephen


    Ghrelin is a gastric peptide hormone that controls appetite and energy homeostasis. Plasma ghrelin levels rise before a meal and fall quickly thereafter. Elucidation of the regulation of ghrelin secretion has been hampered by the difficulty of directly interrogating ghrelin cells diffusely scattered within the complex gastric mucosa. Therefore, we generated transgenic mice with ghrelin cell expression of green fluorescent protein (GFP) to enable characterization of ghrelin secretion in a pure population of isolated gastric ghrelin-expressing GFP (Ghr-GFP) cells. Using quantitative RT-PCR and immunofluorescence staining, we detected a high level of expression of the long-chain fatty acid (LCFA) receptor GPR120, while the other LCFA receptor, GPR40, was undetectable. In short-term-cultured pure Ghr-GFP cells, the LCFAs docosadienoic acid, linolenic acid, and palmitoleic acid significantly suppressed ghrelin secretion. The physiological mechanism of LCFA inhibition on ghrelin secretion was studied in mice. Serum ghrelin levels were transiently suppressed after gastric gavage of LCFA-rich lipid in mice with pylorus ligation, indicating that the ghrelin cell may directly sense increased gastric LCFA derived from ingested intraluminal lipids. Meal-induced increase in gastric mucosal LCFA was assessed by measuring the transcripts of markers for tissue uptake of LCFA, lipoprotein lipase (LPL), fatty acid translocase (CD36), glycosylphosphatidylinositol-anchored HDL-binding protein 1, and nuclear fatty acid receptor peroxisome proliferator-activated receptor-γ. Quantitative RT-PCR studies indicate significantly increased mRNA levels of lipoprotein lipase, glycosylphosphatidylinositol-anchored HDL-binding protein 1, and peroxisome proliferator-activated receptor-γ in postprandial gastric mucosa. These results suggest that meal-related increases in gastric mucosal LCFA interact with GPR120 on ghrelin cells to inhibit ghrelin secretion.

  16. Clinicopathology of Early Gastric Carcinoma: An Update for Pathologists and Gastroenterologists (United States)

    Huang, Qin; Zou, Xiaoping


    Background The WHO defines early gastric carcinoma (EGC) as invasive carcinoma up to the submucosal layer, regardless of nodal metastasis. The recent study results indicate that EGC varies in location, histology, nodal metastasis, and prognosis. Summary The heterogeneity in EGC may be related to various types of epithelial stem cells. The most important stem cells include Lgr5+ cells at the base of a gastric unit in the antrum-pylorus-cardia, Mist1+ cells at the isthmus/Troy+ cells at the base in the corpus-fundus, and Sox2+ cells at the base in almost all regions. Dysregulation of these cells along with environmental factors transform stem cells in different regions into malignancy in genetically susceptible populations. Key Message The 2 most vulnerable regions for EGC have been found along the lesser curvature: the cardia in elderly patients and antrum-angularis in mid-aged and elderly patients. Most hereditary early-onset gastric carcinomas are concentrated in the corpus-fundus of young women. By histology, the most common EGC type is tubular adenocarcinoma in many growth patterns, starting in the neck of a gastric unit. Worse prognosis has been found in early papillary, compared to tubular, adenocarcinoma, related to deeper penetration, more lymphovascular invasion, and more liver and nodal metastases. Contrary to the common belief, intramucosal signet ring cell carcinoma demonstrates low risk of nodal metastasis, comparable to early intestinal-type EGC. Practical Implications The overall risk for nodal metastasis in EGC is low but significant. It is urgent to organize multicenter studies on risk of nodal metastasis in EGC in order to establish more reliable clinical practice guidelines to treat EGC patients. PMID:28611977

  17. [Compared efficacies of somes antispasmodic drugs on the digestive tract and the bladder of the anesthetized dog (author's transl)]. (United States)

    Dureng, G; Boero, C; Meunier, A; Labrid, C


    The antispasmodic activity of tiemonium, mebeverine, pitofenone + fenpiverinium association and N-butyl scopolammonium was compared in the anesthetized dog. Strain gauges were fixed on the gastric antro-fundic border, on the pylorus, on the descending duodenum and on the terminal colon. Pressure transducers were connected with water filled small balloons inserted into the gall bladder and the bladder. Five minutes after the intra-venous injection of the drugs, contraction of the smooth musculature was induced by 3 intra-venous injections of BaCl2 (1 at 3 minutes intervals. The results were expressed as ED50 values ( 2. Tiemonium was the most potent of the 4 antispasmodic drugs. Its ED50 values were very similar for the different organs, ranging from 0.13 +/- 0.022 for the duodenum to 0.31 +/- 0.03 for the bladder. Mebeverine and pitofenone + fenpiverinium association were equipotent but for colon contraction, where mebeverine was more active (ED50 = 0.68 +/- 0.06). Other ED50 relatives to these 2 compounds were ranging from 0.40 +/- 0.02 (duodenum) to 1.32 +/- 0.14 (gall bladder). N-butyl scopolammonium was found to be the weakest antispasmodic drug on this model. Its activity was very weak on colon (ED50 = 5.21 +/- 0.037), gall bladder (ED50 = 5.40 +/- 0.074) and bladder (ED50 = 5.02 +/- 0.059). 3. The strong antispasmodic activity demonstrated on this model with tiemonium seems to be due to its potent inhibition of membrane Ca++ ions, added to its moderate anticholinergic activity.

  18. Long-Term Outcomes and Prognostic Factors in Periampullary Carcinoma. (United States)

    Sunil, Bhanu Jayanand; Seshadri, Ramakrishnan A; Gouthaman, S; Ranganathan, Rama


    The aim of the study was to analyze the long-term survival and the various prognostic factors that influence overall survival in patients undergoing pancreaticoduodenectomy (PD) with non-pancreatic periampullary carcinomas. A retrospective analysis of consecutive patients diagnosed with non-pancreatic periampullary carcinomas who underwent PD at a tertiary cancer center was performed. Univariate analysis of various prognostic factors influencing the disease-free survival (DFS) was performed using log-rank test. Factors identified to be significant in univariate analysis were included in the multivariate analysis, which was performed using the Cox proportional hazard model. The survival estimates were calculated by life-table method. Statistical significance was considered when p value was <0.05. The SPSS v16.0.1 software was used for statistical analysis. Between 1995 and 2010, 78 patients underwent PD with or without (Whipple's operation) pylorus preservation for non-pancreatic periampullary adenocarcinomas. Of these, eight patients received adjuvant chemotherapy. The most common subsite was ampulla (60 patients), followed by the second part duodenum (11 patients), and distal common bile duct (7 patients). The median duration of follow-up of all patients in this study was 50 months. The recurrence rate was 39.7 %. The 5-year disease-free survival and overall survival was 57 %. Patients without nodal metastasis had a non-significant trend towards better 5-year disease-free survival when compared to those with nodal metastasis (64 vs 45 %, p = 0.11). On multivariate analysis, it was found that male gender (p = 0.05) and presence of lymphovascular invasion (p = 0.04) predicted a significantly poor 5-year disease-free survival. Periampullary carcinomas have a favorable prognosis after surgery. Male gender and presence of lymphovascular invasion are independent prognostic factors in patients diagnosed with non-pancreatic periampullary carcinomas who underwent

  19. 胰腺神经内分泌肿瘤的手术治疗%Surgical management of pancreatic neuroendocrine neoplasms

    Institute of Scientific and Technical Information of China (English)

    吴峻立; 苗毅


    Pancreatic neuroendocrine neoplasms (pNENs) can be divided into functional and non-functional.Insulinomas,gastrinomas,glucagonomas and VIPomas are the common types of pNENs.Radical resection is the only way for curing pNENs or for a long-time survival of patients.The basic surgical procedures for pNENs are consist of local resection (tumor enucleation) or anatomical resection [pancreatoduodenectomy (standard or pylorus-preserving pancreatoduodenectomy),distal pancreatectomy (combined with splenectomy or spleen-preserving pancreatectomy) and middle segmental pancreatectomy].Liver is the most common site for metastases.Surgical resection is the method of choice for liver metastases.Radiofrequency ablation,transcatheter arterial chemoembolization and liver transplantation could be the adjunctive therapies.%胰腺神经内分泌肿瘤(pNENs)分为功能性与无功能性两大类,常见类型包括胰岛素瘤、胃泌素瘤、胰高血糖素瘤、血管活性肠肽瘤等,根治性手术切除是pNENs患者治愈和长期生存的唯一方法.基本手术方式包括局部切除和规则切除两类,前者为肿瘤局部切除(剜除)术,后者包括胰十二指肠切除术(标准或保留幽门)、胰体尾切除术(联合脾脏切除或保留脾脏)及中段胰腺切除术等.肝脏是最常见远处转移部位,手术切除是肝转移瘤首选治疗方法,RFA、TACE以及肝移植可以作为辅助治疗手段.

  20. D-002 (beeswax alcohols: Concurrent joint health benefits and gastroprotection

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    Vivian Molina


    Full Text Available Nonsteroidal antiinflammatory drugs include the traditional drugs and more selective COX-2 inhibitors. Traditional nonsteroidal antiinflammatory drug use is hampered by their gastrotoxicity, while COX-2-inhibitors increase the cardiovascular risk. The search of safer substances for managing inflammatory conditions is updated, a challenge wherein dual COX/5-LOX inhibitors have a place. This review summarizes the benefits of D-002, a mixture of higher aliphatic beeswax alcohols, on joint health and gastric mucosa. D-002 elicits gastroprotection through a multiple mechanism that involves the increased secretion and improved quality of the gastric mucus, the reduction of hydroxyl radical, lipid peroxidation, protein oxidation, neutrophil infiltration and the increase of antioxidant enzymes on the gastric mucosa. Consistently, D-002 inhibits NSAIDs, ethanol, pylorus-ligation and acetic acid-induced gastric ulceration in rats, and has reduced gastrointestinal symptoms in clinical studies. Early results found that D-002 was effective in the cotton pellet-induced granuloma and carrageenan-induced pleurisy model in rats, lowering pleural leukotriene B4 levels without causing gastrointestinal ulceration. However, D-002 effects on inflammation received little attention for years. Recent data have shown that D-002 inhibited both COX and 5-LOX activities with a greater affinity for 5-LOX and could act as a dual COX/5-LOX inhibitor. This mechanism might explain efficacy in experimental inflammatory and osteoarthritic models as well as clinical efficacy in osteoarthritic patients while supporting the lack of D-002 gastrotoxicity, but not the gastroprotective effects, which appear to be due to multiple mechanisms. In summary oral D-002 intake could help manage inflammatory conditions that impair joint health, while offering gastroprotection.

  1. Surgical management of chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Stavros Gourgiotis; Stylianos Germanos; Marco Pericoli Ridolifni


    BACKGROUND:Treatment of chronic pancreatitis (CP) is a challenging condition for surgeons. During the last decades, increasing knowledge about pathophysiology of CP, improved results of major pancreatic resections, and integration of sophisticated diagnostic methods in clinical practice have resulted in signiifcant changes in surgery for CP. DATA SOURCES:To detail the indications for CP surgery, the surgical procedures, and outcome, a Pubmed database search was performed. The abstracts of searched articles about surgical management of CP were reviewed. The articles could be identiifed and further scrutinized. Further references were extracted by cross-referencing. RESULTS: Main indications of CP for surgery are intractable pain, suspicion of malignancy, and involvement of adjacent organs. The goal of surgical treatment is to improve the quality of life of patients. The surgical approach to CP should be individualized according to pancreatic anatomy, pain characteristics, baseline exocrine and endocrine function, and medical co-morbidity. The approach usually involves pancreatic duct drainage and resection including longitudinal pancreatojejunostomy, pancreatoduodenectomy (Whipple's procedure), pylorus-preserving pancreatoduodenectomy, distal pancreatectomy, total pancreatectomy, duodenum-preserving pancreatic head resection (Beger's procedure), and local resection of the pancreatic head with longitudinal pancreatojejunostomy (Frey's procedure). Non-pancreatic and endoscopic management of pain has also been advocated. CONCLUSIONS:Surgical procedures provide long-term pain relief, a good postoperative quality of life with preservation of endocrine and exocrine pancreatic function, and are associated with low early and late mortality and morbidity. In addition to available results from randomized controlled trials, new studies are needed to determine which procedure is the most effective for the management of patients with CP.

  2. Protective Effect of Two Extracts of Cydonia oblonga Miller (Quince) Fruits on Gastric Ulcer Induced by Indomethacin in Rats. (United States)

    Parvan, Morteza; Sajjadi, Sayed-Ebrahim; Minaiyan, Mohsen


    In various studies, Cydonia oblonga Miller (quince) has been reported to have many properties such as antioxidant and anti-ulcerative effects. This study has aimed to investigate the protective effects of quince aqueous extract (QAE) and quince hydroalcoholic extract (QHE) on gastric ulcer caused by indomethacin and the relevant macroscopic, histopathology, and biochemical factors in rats. Ten groups of male Wistar rats, six in each, were used in this study. These groups included: normal (distilled water), control (distilled water + indomethacin), reference (ranitidine or sucralfate + indomethacin), and test groups (QAE or QHE + indomethacin) treated with three increasing doses (200, 500, and 800 mg/kg). Extracts and drugs were given orally to rats 1 h before injecting the indomethacin (25 mg/kg, intraperitoneally). Six hours later, the abdomen of rats was exposed, its pylorus was legated, gastric acid content was extracted, and its pH and the amount of pepsin secreted were measured by Anson method. Then, histopathology indices, ulcer area, ulcer index, and myeloperoxidase (MPO) activity were measured in gastric mucus. Both extracts of quince were effective to reduce the acidity of stomach and pepsin activity. Compared to control group, the average of enzyme activity of MPO was significantly declined in all treated groups. Control group had the highest level of gastric ulcer indices including severity, area, and index while the evaluated parameters had decreased in all extract treated groups although it seems that QAE was somewhat more effective. Protective effect of QAE and QHE on gastric ulcer was done by undermining offensive factors including decreasing the secretion of gastric acid and pepsin activity and by strengthening the protective factors of gastric mucus including antioxidant capacity.

  3. Protective effect of two extracts of Cydonia oblonga miller (Quince fruits on gastric ulcer induced by indomethacin in rats

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    Morteza Parvan


    Full Text Available Background: In various studies, Cydonia oblonga Miller (quince has been reported to have many properties such as antioxidant and anti-ulcerative effects. This study has aimed to investigate the protective effects of quince aqueous extract (QAE and quince hydroalcoholic extract (QHE on gastric ulcer caused by indomethacin and the relevant macroscopic, histopathology, and biochemical factors in rats. Methods: Ten groups of male Wistar rats, six in each, were used in this study. These groups included: normal (distilled water, control (distilled water + indomethacin, reference (ranitidine or sucralfate + indomethacin, and test groups (QAE or QHE + indomethacin treated with three increasing doses (200, 500, and 800 mg/kg. Extracts and drugs were given orally to rats 1 h before injecting the indomethacin (25 mg/kg, intraperitoneally. Six hours later, the abdomen of rats was exposed, its pylorus was legated, gastric acid content was extracted, and its pH and the amount of pepsin secreted were measured by Anson method. Then, histopathology indices, ulcer area, ulcer index, and myeloperoxidase (MPO activity were measured in gastric mucus. Results: Both extracts of quince were effective to reduce the acidity of stomach and pepsin activity. Compared to control group, the average of enzyme activity of MPO was significantly declined in all treated groups. Control group had the highest level of gastric ulcer indices including severity, area, and index while the evaluated parameters had decreased in all extract treated groups although it seems that QAE was somewhat more effective. Conclusions: Protective effect of QAE and QHE on gastric ulcer was done by undermining offensive factors including decreasing the secretion of gastric acid and pepsin activity and by strengthening the protective factors of gastric mucus including antioxidant capacity.

  4. The histochemical assessment of sulpho-, sialo-, and neutral-mucosubstances in fetal gastric mucosa

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    Lokadolalu Chandracharya Prasanna


    Full Text Available Background: Mucins are complex composition of carbohydrates and may be present as a mixture of different types. Normal distribution of mucin and its alteration in various inflammatory, benign and malignant lesions of gastrointestinal tract has aroused interest in the field of histochemistry. The main purpose of present work is to study the staining pattern and distribution of cells in different parts of fetal gastric mucosa and to correlate the nature of gastric mucins and its functional significance. Methods: A total of 25 fetus stomach specimens (total 75 samples one sample each from different parts of the stomach like fundus, body and pylorus, from fresh specimens. The samples were washed in normal saline, fixed in 2% calcium acetate in 10% formalin. These tissues were routinely processed and paraffin blocks were prepared. 6 and #61549; sections of these blocks were taken for histological and different histochemical staining. Results: Fetal fundic part of stomach shows increased neutral mucin in surface epithelium and foveolar cells. With combined AB pH 2.5 - PAS technique increased neutral mucin and small amount of acid mucins are observed. With AB pH 1, surface epithelium and deep glands show negative staining. Moderate alcinophilia is observed in deep foveolar cells and glandular cells. AB pH 2.5 shows alcinophilia in surface epithelium, foveolar cells and mucous neck cells indicating presence of sialomucin. Fetal pyloric part of stomach shows increased acid and neutral mucins. With pH 2.5 - PAS staining, purple staining is observed in surface epithelium, deep foveolar and pyloric glands. Conclusion: All types of mucosubstances - neutral, sialo and sulpho-mucins, are secreted in relatively increased amounts by the surface epithelium and the glands of the stomach of the human fetus and neonate. Sulphomucin is seen mainly in the cells of the surface epithelium. [Int J Res Med Sci 2015; 3(1.000: 235-238

  5. Mechanism of antiulcerogenic activity of semi-synthetic crotonin obtained from Croton cajucara Benth.

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    Ana Beatriz A. Almeida


    Full Text Available The bark of Croton cajucara Benth. is used in Brazilian folk medicine to treat gastrointestinal disorders. Transdehydrocrotonin (DHC isolated from the bark of Croton cajucara has antiulcerogenic activity25. The presence of similar activity in semi-synthetic crotonin obtained from dehydrocrotonin from Croton cajucara was observed in gastric ulcer-induced models (HCl/ethanol, ethanol, indomethacin, stress and pylorus ligature. The aim of the present study was to assess the mechanisms involved in the antiulcerogenic activity of semi-synthetic crotonin. We investigated the effects of semi-synthetic crotonin on the response to histamine of right atria isolated from guinea pigs and on the response to carbachol of stomach fundus strips from rats. Semi-synthetic crotonin (3, 10 or 30 mM induced a shift to the right in the concentrationresponse curves to carbachol in the isolated rat stomach at the pD2 level (pD2: 5.42±0.05, 5.76±0.061, 5.77±0.076, 6.48±0.012, respectively, without any alteration in the maximum response. Semi-synthetic crotonin also induced a shift to the right in the concentration-response curves to histamine in guinea pig right atria, pD2 (5.54±0.06, 6.01±0.06, 5.89±0.06, 5.92±0.03 and (% maximum response (80±6.18, 118±6.18, 114±6.18, 122±1.4, respectively. Thus, the protective effect of semi-synthetic crotonin on induced gastric lesions could be due to antagonism of histaminergic and cholinergic effects on gastric secretion.

  6. Acid-gastric antisecretory effect of the ethanolic extract from Arctium lappa L. root: role of H(+), K(+)-ATPase, Ca(2+) influx and the cholinergic pathway. (United States)

    da Silva, Luisa Mota; Burci, Ligia de Moura; Crestani, Sandra; de Souza, Priscila; da Silva, Rita de Cássia Melo Vilhena de Andrade Fonseca; Dartora, Nessana; de Souza, Lauro Mera; Cipriani, Thales Ricardo; da Silva-Santos, José Eduardo; André, Eunice; Werner, Maria Fernanda de Paula


    Arctium lappa L., popularly known as burdock, is a medicinal plant used worldwide. The antiulcer and gastric-acid antisecretory effects of ethanolic extract from roots of Arctium lappa (EET) were already demonstrated. However, the mechanism by which the extract reduces the gastric acid secretion remains unclear. Therefore, this study was designed to evaluate the antisecretory mode of action of EET. The effects of EET on H(+), K(+)-ATPase activity were verified in vitro, whereas the effects of the extract on cholinergic-, histaminergic- or gastrinergic-acid gastric stimulation were assessed in vivo on stimulated pylorus ligated rats. Moreover, ex vivo contractility studies on gastric muscle strips from rats were also employed. The incubation with EET (1000 µg/ml) partially inhibited H(+), K(+)-ATPase activity, and the intraduodenal administration of EET (10 mg/kg) decreased the volume and acidity of gastric secretion stimulated by bethanechol, histamine, and pentagastrin. EET (100-1000 µg/ml) did not alter the gastric relaxation induced by histamine but decreased acetylcholine-induced contraction in gastric fundus strips. Interestingly, EET also reduced the increase in the gastric muscle tone induced by 40 mM KCl depolarizing solution, as well as the maximum contractile responses evoked by CaCl2 in Ca(2+)-free depolarizing solution, without impairing the effect of acetylcholine on fundus strips maintained in Ca(2+) -free nutritive solution. Our results reinforce the gastric antisecretory properties of preparations obtained from Arctium lappa, and indicate that the mechanisms involved in EET antisecretory effects include a moderate reduction of the H(+), K(+)-ATPase activity associated with inhibitory effects on calcium influx and of cholinergic pathways in the stomach muscle.

  7. D-002 (beeswax alcohols): concurrent joint health benefits and gastroprotection. (United States)

    Molina, Vivian; Mas, R; Carbajal, D


    Nonsteroidal antiinflammatory drugs include the traditional drugs and more selective COX-2 inhibitors. Traditional nonsteroidal antiinflammatory drug use is hampered by their gastrotoxicity, while COX-2-inhibitors increase the cardiovascular risk. The search of safer substances for managing inflammatory conditions is updated, a challenge wherein dual COX/5-LOX inhibitors have a place. This review summarizes the benefits of D-002, a mixture of higher aliphatic beeswax alcohols, on joint health and gastric mucosa. D-002 elicits gastroprotection through a multiple mechanism that involves the increased secretion and improved quality of the gastric mucus, the reduction of hydroxyl radical, lipid peroxidation, protein oxidation, neutrophil infiltration and the increase of antioxidant enzymes on the gastric mucosa. Consistently, D-002 inhibits NSAIDs, ethanol, pylorus-ligation and acetic acid-induced gastric ulceration in rats, and has reduced gastrointestinal symptoms in clinical studies. Early results found that D-002 was effective in the cotton pellet-induced granuloma and carrageenan-induced pleurisy model in rats, lowering pleural leukotriene B4 levels without causing gastrointestinal ulceration. However, D-002 effects on inflammation received little attention for years. Recent data have shown that D-002 inhibited both COX and 5-LOX activities with a greater affinity for 5-LOX and could act as a dual COX/5-LOX inhibitor. This mechanism might explain efficacy in experimental inflammatory and osteoarthritic models as well as clinical efficacy in osteoarthritic patients while supporting the lack of D-002 gastrotoxicity, but not the gastroprotective effects, which appear to be due to multiple mechanisms. In summary oral D-002 intake could help manage inflammatory conditions that impair joint health, while offering gastroprotection.


    Directory of Open Access Journals (Sweden)

    Mohammed Aneesur Rahman


    Full Text Available BACKGROUND Interest in human development is very widespread largely because of the curiosity about our beginnings and desire to improve the quality of life. Understanding of the processes involved in the formation of various organs and systems has unrevealed most cryptic secrets of the nature. Human development begins at fertilisation when a male gamete or sperm unites with a female gamete or oocyte to form a single cell, a zygote. With the formation of zygote (single-celled stage, foetal development begins. The aim of the study is to- 1 Study the morphometric parameters of foetal stomach at various gestational ages. 2 Compare these observations with the previous studies. MATERIALS AND METHODS Present work was the cross-sectional study carried out in the Department of Anatomy in collaboration with the Department of Obstetrics and Gynaecology at SRTRGMC and Hospital, Ambajogai Dist., Beed, Maharashtra. For this, approval of Institutional Ethical Committee was taken. 30 aborted human foetuses of different age groups ranging from 12 to 36 weeks of fertilisation were taken from the Department of OB-GYN. Foetuses were preserved by using 10% formalin. Age of foetuses were determined by crown-rump length and history given by mother. Foetuses were dissected after preservation for 15 days and morphometric studies were done on stomach. RESULTS Various quantitative parameters like weight of foetus, crown-rump length, total length of stomach, weight of stomach, length of greater curvature, lesser curvature, width of cardia and width of pylorus were used. For the purpose of study and comparison with other researchers, the foetuses were divided into 3 groups. Morphometric changes were observed in different groups and compared with previous studies. CONCLUSION With the increase in the body weight, crown-rump length and gestational age of the foetus, there is gradual increase on various parameters of stomach.

  9. The location of obstruction predicts stent occlusion in malignant gastric outlet obstruction (United States)

    Grunwald, Douglas; Cohen, Jonah; Bartley, Anthony; Sheridan, Jennifer; Chuttani, Ram; Sawhney, Mandeep S.; Pleskow, Douglas K.; Berzin, Tyler M.; Mizrahi, Meir


    Background: Gastric outlet obstruction (GOO) can occur with locally invasive or metastatic cancer involving the upper gastrointestinal tract at the pylorus or the duodenum. Endoscopic management with self-expanding metal stents (SEMSs) is often the preferred palliative approach. Stent occlusion is a common reason for failure and reintervention. We set out to determine whether the location of the malignant obstruction is associated with the angulation of the stent and can predict stent occlusion. Methods: We performed a retrospective review of consecutive patients who underwent successful duodenal stenting with SEMS for malignant GOO between 2006 and 2015 at a large advanced endoscopy referral center. We determined the location of obstruction, the stent angle, and the rate of technical and clinical success of stent placement. We then identified cases of subsequent stent occlusion confirmed by endoscopic evaluation. Results: A total of 100 consecutive patients were included in the study; 91 of these patients had enough data to evaluate SEMS occlusion. A total of 21 patients (23%) developed stent occlusion with a median time of 39 days. The risk of occlusion sequentially increased as the obstruction occurred more distally from the antrum to the third or fourth portion of the duodenum (p = 0.006). This relationship was maintained after controlling for stent angle (p = 0.05). Conclusions: A distal location of malignant GOO was strongly predictive of stent occlusion, independent of stent angle. This may be due to longer and more complex distal obstructions, along with foreshortening of the stent during placement and tumor infiltration. If replicated, these results will have implications for endoscopic practice and future device development. PMID:27803736

  10. Effects of broth culture filtrate protein of VacA+ Helicobacter pylori on the proliferation and apoptosis of gastric epithelial cells. (United States)

    Zhao, Yu-qing; Guo, Tao; Qian, Jia-ming


    Infection with Helicobacter pylori (H. pylori) may lead to chronic inflammation of the stomach epithelium, mucosal atrophy, imbalance of proliferation and apoptosis of epithelial cells; resulting in chronic gastritis, peptic ulcer, gastric cancer, and many other clinical outcomes. Why and how H. pylorus leads to gastric cancer is not clear yet. Through in vitro experiments, this study evaluated the effects of broth culture filtrate protein (BCF-P) from the supernatant of liquid culture media of H. pylori on proliferation and apoptosis of immortalized human gastric epithelial cell lines (GES-1) and gastric cancer cell lines (AGS). For the study, GES-1 and AGS cell lines mix with BCF-P and epidermal growth factor (EGF). MTT assay and flow cytometry (FCM) determined the levels of proliferation and apoptosis. Detected expression levels of cyclooxygenase-2 (COX-2) and Fas mRNA by reverse transcription (RT)-PCR. Also did analysis of the effects of BCF-P on epidermal growth factor receptor (EGFR) tyrosine kinase activity of GES-1 and AGS cells by non-radioactive enzyme-linked assay. The Student's t test and one-way analysis of variance (ANOVA) were used for statistical analysis. BCF-P inhibited proliferation of GES-1 and AGS cells in a concentration-dependent manner. The inhibition rates are respectively 68.7% in AGS and 61.4% in GES-1. With the same dose and time for inhibiting the proliferation, BCF-P failed to induce apoptosis of GES-1 and AGS cells. Effects of BCF-P reduced the expression of Fas mRNA of GES-1 and AGS cells (P cells (P cells. BCF-P inhibited the proliferation of AGS and GES-1 cells in vitro, unrelated to apoptosis. Effects of BCF-P on gastric epithelial cells in vitro are not equivalent to that of EGF.

  11. Gastric Outlet Obstruction Palliation: A Novel Stent-Based Solution

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    Natasha M. Rueth


    Full Text Available Gastric outlet obstruction (GOO after esophagectomy is a morbid outcome and significantly hinders quality of life for end-stage esophageal cancer patients. In the pre-stent era, palliation consisted of chemotherapy, radiation, tumor ablation, or stricture dilation. In the current era, palliative stenting has emerged as an additional tool; however, migration and tumor ingrowth are ongoing challenges. To mitigate these challenges, we developed a novel, hybrid, stent-based approach for the palliative management of GOO. We present a patient with esophageal cancer diagnosed with recurrent, metastatic disease 1 year after esophagectomy. She developed dehydration and intractable emesis, which significantly interfered with her quality of life. For palliation, we dilated the stenosis and proceeded with our stent-based solution. Using a combined endoscopic and fluoroscopic approach, we placed a 12-mm silicone salivary bypass tube across the pylorus, where it kinked slightly because of local tumor biology. To bridge this defect and ensure luminal patency, we placed a nitinol tracheobronchial stent through the silicone stent. Clinically, the patient had immediate relief from her pre-operative symptoms and was discharged home on a liquid diet. In conclusion, GOO and malignant dysphagia after esophagectomy are significant challenges for patients with end-stage disease. Palliative stenting is a viable option, but migration and tumor ingrowth are common complications. The hybrid approach presented here provides a unique solution to these potential pitfalls. The flared silicone tube minimized the chance of migration and impaired tumor ingrowth. The nitinol stent aided with patency and overcame the challenges of the soft tube. This novel strategy achieved palliation, describing another endoscopic option in the treatment of malignant GOO.

  12. Challenges in pancreatic adenocarcinoma surgery - National survey and current practice guidelines (United States)

    Dhayat, Sameer A.; Mirgorod, Philip; Lenschow, Christina; Senninger, Norbert


    Background Pancreatic ductal adenocarcinoma (PDAC) remains one of the most deadly cancers in Europe and the USA. There is consensus that radical tumor surgery is the only viable option for any long-term survival in patients with PDAC. So far, limited data are available regarding the routine surgical management of patients with advanced PDAC in the light of surgical guidelines. Methods A national survey on perioperative management of patients with PDAC and currently applied criteria on their tumor resectability in German university and community hospitals was carried out. Results With a response rate of 81.6% (231/283) a total of 95 (41.1%) participating departments practicing pancreatic surgery in Germany are certified as competence and reference centers for surgical diseases of the pancreas in 2016. More than 95% of them indicate to carry out structured and interdisciplinary therapies along with an interdisciplinary pre- and postoperative tumor board. The majority of survey respondents prefer the pylorus-preserving partial pancreatoduodenectomy (93.1%) with standard lymphadenectomy for cancer of the pancreatic head. Intraoperative histological evaluation of the resection margins is used regularly by 99% of the survey respondents. 98.7% of survey respondents carry out partial or complete vein resection, 126 respondents (54.5%) would resect tumor adjacent arteries, and 102 respondents (44.2%) would perform metastasectomy if complete PDAC resection (R0) is possible. Conclusion Evidence-based and standardized pancreatic surgery is practiced by a large number of hospitals in Germany. However, a significant number of survey respondents support an extended radical tumor resection in patients with advanced PDAC even when not indicated by current clinical guidelines. PMID:28267771

  13. Evaluation of Gastroprotective Potential of the Ethanol Extract From Murdannia loriformis in rats

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    Phraepakaporn Kunnaja


    Full Text Available Summary. Murdannia loriformis (ML has been used in traditional medicine for the treatment of various diseases. The objective of this study was to examine gastroprotective activity of ethanol extract of ML. For the gastroprotective study, rats received ML extract (100-400 mg/kg via oral route before induction of gastric ulcer using three different inducer models; EtOH/HCl, indomethacin, and restraint water immersion stress. ML extract significantly inhibited gastric ulcer formation induced by EtOH/HCl (p<0.001, indomethacin (p<0.01 and stress (p<0.001. Like misoprostol, ML extract, increased the amount of mucus content in gastric wall mucus assay (p<0.001. Moreover, the extract was equivalent to cimetidine for reducing gastric acid secretion in pylorus ligation model (p<0.05. Therefore, all of these results indicated that ML extract possessed an effective gastroprotective effect via promoting mucus production and inhibiting gastric acid secretion.Industrial relevance. In recent years, Thai government has had a policy for medicinal plant research and development in order to support the alternative health care. M. loriformis has long been used to treat a broad spectrum of disorders. The ethanol extract of this plant has already been proved to possess anti-inflammatory, analgesic, and antipyretic activities in rats without ulcerogenic effect. This research aims to investigate the gastroprotective activity of the ethanol extract of ML. The results from this study might give useful information in supporting one of its folklore uses.Keywords. Murdannia loriformis; ethanol extract; gastroprotective activity; gastric ulcer; rat models

  14. [A prospective randomized study of the usefulness of weighted versus unweighted feeding tubes. A comparison of the transpyloric passage capacity, duration time and the signs of intolerance for enteral nutrition]. (United States)

    Jiménez, C; González-Huix, F; Auger, E; Bou, R; Pons, N; Vila, N; Figa, M; Acero, D


    Weighted feeding tubes for parenteral nutrition were designed to facilitate duodenal intubation and to reduce the risk of aspiration into the bronchi. The goal of the study was to compare the effectiveness of two types of tubes, weighted and unweighted, with regard to their ability to pass the pylorus in 24 hours' time, the time they remained, their involuntary detubation percentages, and the appearance of signs of digestive intolerance during enteral nutrition. Only patients who preserved some level of consciousness were included. Thirty-eight were fitted with weighted tubes, and 32 with unweighted tubes. Twenty-four feeding tubes reached the duodenum during the first day. The average time the tubes remained after insertion was 10.2 +/- 1.1 (range of 1-51) days. In 20 patients, the tube left the body unnoticed, and 15 displayed signs of intolerance to enteral nutrition, though it had to be suspended in the case of only 5. Weighted feeding tubes showed greater effectiveness in their duodenal intubation rate (47% versus 19%, p = 0.0058), the time they remained in the body (12.2 +/- 1.7 versus 7.9 +/- 1.1 days; p = 0.037) and their percentage of involuntary detubation (6 weighted tubes and 14 unweighted tubes, p = 0.009). There were no differences between the two tube types with regard to the appearance of signs of digestive intolerance. The weighted tubes that reached the duodenum (n = 18) were those which remained for the longest periods; 73% of them remained for over 8 days.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Excess intraoperative fluid volume administration is associated with pancreatic fistula after pancreaticoduodenectomy: A retrospective multicenter study. (United States)

    Han, In Woong; Kim, Hongbeom; Heo, JinSeok; Oh, Min Gu; Choi, Yoo Shin; Lee, Seung Eun; Lim, Chang-Sup


    Recent studies on perioperative fluid administration in patients undergoing pancreaticoduodenectomy (PD) have suggested that increased fluid loads are associated with worse perioperative outcomes. The purpose of this study was to investigate the relationship between intraoperative fluid (IOF) administration and postoperative pancreatic fistula (POPF), and to determine additional risk factors affecting pancreatic fistula in patients undergoing PD.From 2005 to 2014, a total of 182 patients with various periampullary diseases after PD were reviewed retrospectively at Dongguk University Ilsan Hospital, Chung-Ang University Hospital, and Dongnam Institute of Radiological and Medical Sciences. Patients were assigned to high or low IOF groups based on more or less fluid administration for supplementation of estimated blood loss and maintenance volume (12.5 mL/kg/h) than planned, respectively. The associations between IOF administration, pancreatic fistula development, and perioperative outcomes were evaluated.A total of 98 patients were assigned to the high-IOF group, and 84 to the low-IOF group. Risk factors for pancreatic fistula after univariate analysis were assignment to the high-IOF group, higher preoperative serum hemoglobin level, ampullary or bile duct cancer, pylorus preserving PD, small pancreatic duct, duct-to-mucosa pancreatojejunostomy, use of a stent, and mesh application to pancreatojejunal anastomosis. Among these, assignment to the high-IOF group (hazard ratio [HR] = 5.501, 95% CI 1.624-18.632, P = .006) and a small (fistula after multivariate analysis. However, long-term survival rate did not differ according to IOF group or duct size.Excessive IOF volume administration is associated with an increased incidence of pancreatic fistula after pancreaticoduodenectomy.

  16. Critical appraisal of the International Study Group of Pancreatic Surgery (ISGPS) consensus definition of postoperative hemorrhage after pancreatoduodenectomy. (United States)

    Welsch, Thilo; Eisele, Hanna; Zschäbitz, Stefanie; Hinz, Ulf; Büchler, Markus W; Wente, Moritz N


    Postpancreatectomy hemorrhage (PPH) is one of the most serious complications after pancreatoduodenectomy (PD). This study analyzed and validated the International Study Group of Pancreatic Surgery (ISGPS) definition of PPH and aimed to identify risk factors for early (<24 h) and late PPH. Patients who underwent PD for pancreatic head tumors between 2001 and 2008 were included and complications were prospectively recorded. Factors associated with PPH were assessed by uni- and multivariate analysis. Complete datasets were available for 796 patients. Classic and pylorus-preserving PD was performed in 13.8% and 86.2% of the patients, respectively. According to the ISGPS definition, PPH occurred in 29.1% of the cases (232 of 796 patients): 4.8% grade A, 15.2% grade B, and 9.2% grade C. The definition is based largely on surrogate markers (e.g., transfusion requirement) that are affected by other critical illnesses and more than 97% of patients with mild PPH had no clinical signs of bleeding. The need for postoperative intensive care as well as the incidence of pancreatic fistula, relaparotomy, and mortality rates significantly increased from grades A to C. Thirty-seven patients (4.6%) required interventional (endoscopy or angiography) and/or relaparotomy for PPH. Relaparotomy for PPH was performed in 3.1% of all patients. Independent risk factors for early PPH were preoperative anemia (hemoglobin, <11 mg/dl) and multivisceral resection while advanced age, chronic renal insufficiency, increased blood loss, and long operation time were associated with late PPH. The ISGPS definition of PPH is feasible and applicable but produces a high rate of false positive mild PPH cases. The different grades still significantly correlate with relevant outcome variables, thus the definition discriminates postoperative courses, but a minor modification of the definition of mild PPH is suggested. The new results further demonstrate the need to optimize preoperative anemia and chronic renal

  17. Anti-ulcerogenic mechanisms of the sesquiterpene lactone onopordopicrin-enriched fraction from Arctium lappa L. (Asteraceae): role of somatostatin, gastrin, and endogenous sulfhydryls and nitric oxide. (United States)

    de Almeida, Ana Beatriz Albino; Luiz-Ferreira, Anderson; Cola, Maíra; Di Pietro Magri, Luciana; Batista, Leonia Maria; de Paiva, Joseilson Alves; Trigo, José Roberto; Souza-Brito, Alba R M


    Arctium lappa L. has been used in folk medicine as a diuretic, depurative, and digestive stimulant and in dermatological conditions. The mechanisms involved in the anti-ulcerogenic activity of the sesquiterpene onopordopicrin (ONP)-enriched fraction (termed the ONP fraction), obtained from A. lappa leaves, were studied. The gastroprotective mechanism of the ONP fraction was evaluated in experimental in vivo models in rodents, mimicking this disease in humans. ONP fraction (50 mg/kg, p.o.) significantly inhibited the mucosal injury induced by ethanol/HCl solution (75%), indomethacin/bethanecol (68.9%), and stress (58.3%). When the ONP fraction was investigated in pylorus ligature, it did not induce alteration in the gastric volume but did modify the pH and total acid concentration of gastric juice. ONP fraction significantly increased serum somatostatin levels (82.1±4.1 vs. control group 12.7±4 pmol/L) and decreased serum gastrin levels (62.6±6.04 vs. control group 361.5±8.2 μU/mL). Mucus production was not significantly altered by the ONP fraction. Gastroprotection by the ONP fraction was completely inhibited by N-ethylmaleimide treatment and did not modify the effect in the animals pretreated with l-N(G)-nitroarginine methyl ester. These results suggest an antisecretory mechanism involved with the antiulcerogenic effect of the ONP fraction. However, only endogenous sulfhydryls play an important role in gastroprotection of the ONP fraction.

  18. Gastroprotective effect of alpha-pinene and its correlation with antiulcerogenic activity of essential oils obtained from Hyptis species

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    Marcelo de Almeida Pinheiro


    Full Text Available Background: Alpha-pinene (α-pinene is a monoterpene commonly found in essential oils with gastroprotective activity obtained from diverse medicinal plants, including Hyptis species. The genus Hyptis (lamiaceae consists of almost 400 species widespread in tropical and temperate regions of America. In the north and northeastern Brazil, some Hyptis species are used in traditional medicine to treat gastrointestinal disturbances. Objective: The present study has investigated the gastoprotective effect of purified α-pinene in experimental gastric ulcer induced by ethanol and indomethacin in mice. Materials and Methods: Gastric ulcers were induced in male Swiss mice (20-30 g by oral administration of absolute ethanol or indomethacin 45 min after oral pretreatment with vehicle, standard control drugs or α-pinene (10, 30, and 100 mg/kg. One hour after the ulcerative challenges, the stomach were removed, and gastric lesions areas measured. The effects of α-pinene on the gastric juice acidity were determined by pylorus ligation model. The gastrointestinal motility and mucus depletion were determined by measuring the gastric levels of phenol red and alcian blue, respectively. Hematoxylin and eosin stained sections of gastric mucosa of the experimental groups were used for histology analysis. Results: α-pinene pretreatment inhibited ethanol-induced gastric lesions, reduced volume and acidity of the gastric juice and increased gastric wall mucus (P < 0.05. Furthermore, we showed an interesting correlation between concentration of α-pinene and gastroprotective effect of Hyptis species (P Pearson = 0.98. Conclusion: Our data showed that the α-pinene exhibited significant antiulcerogenic activity and a great correlation between concentration of α-pinene and gastroprotective effect of Hyptis species was also observed.

  19. The Progress in Clinical and Basic Research of the Effect ofAcupuncture in Treating Disorders of Gastrointestinal Motility

    Institute of Scientific and Technical Information of China (English)


    Though the function of “spleen” in TCM refers to a lot of systems, it is mainly related to digestive system, reflecting changes of physiology and pathology of gastrointestinal tract. The deficiency of Spleen Qi is correlated to the disorders of gastrointestinal motility.(19) In recent years the research has been developed in adjustment of Spleen and Stomach function and the improvement of gastrointestinal motility by acupuncturing mainly Zusanli, which formed a theoretic base for acupuncture therapy of disorders of gastrointestinal motility.Effect of Acupuncture on Gastric Peristalsis  Observation by gastroendoscopy and B-ultrasonography showed that, acupuncture at Zusanli could decrease gastric tension and resolve spasm of cardia, gastric body and pylorus, and improve delayed opening of pylorus, so as to make gastric hyperperistalsis tend to go placid and normalize retarding. It is demonstrated that acupuncture at Zusanli could adjust the function of gastric peristalsis bi-directionally.(20,21) In healthy volunteers after acupuncture at Zusanli the frequency and the amplititude of gastric peristalsis both increased. In patients whose pylorus ring could not open during the operation of gastroscopy, acupuncture at Zusanli could relax and open it. Acupuncture at Neiguan could produce either opening or closing the bi-directional effect of pylorus.(22) In patients with disorders of gastrointestinal motility it was observed that the amplititude and frequency of constriction of sphincter pylori increased and the strength and frequency of stomach improved after acupuncture at Zusanli according to the measurement of gastroscopic manometry.(23) Acupuncture may accelerate or reduce the speed of gastric evacuation.(24,25) In addition, acupuncture can increase the volume of gastric antrum. Observed by B-ultrasonography, acupuncture Zusanli, Shangjuxu (ST37), Chongyang (ST42) and Neiting (ST44) in the lower extremity section of the Yangming meridian of the foot could

  20. Effect of carbachol on intestinal mucosal blood flow, activity of Na+-K+-ATPase, expression of aquaporin-1, and intestinal absorption rate during enteral resuscitation of burn shock in rats. (United States)

    Bao, Chengmei; Hu, Sen; Zhou, Guoyong; Tian, Yijun; Wu, Yan; Sheng, Zhiyong


    We investigated the effect of carbachol (CAR, a cholinergic agent) on intestinal mucosal blood flow (IMBF), activity of Na-K-ATPase, expression of aquaporin (AQP)-1, and intestinal absorption rate during enteral resuscitation of a 35%TBSA scald in rats with a glucose electrolyte solution (GES). One hundred male Wistar rats were randomly divided into five groups: sham scald (N group); scald without fluid resuscitation (S group); scald resuscitated with enteral GES alone (GES group); scald resuscitated with enteral CAR alone (CAR group); and scald resuscitated with enteral CAR plus GES (GES/CAR group). The rats were inflicted 35%TBSA third degree of scald injury on the back with boiling water (100 degrees C, 15 seconds) in all groups, except the sham scald group. A catheter was inserted into the proximal duodenum (5 cm distal to pylorus) and distal ileum (5 cm proximal to cecum), of each rats through laparotomy, thus a segment of intestine was virtually isolated to form a loop for inlet and outlet of introduced fluid. In N, GES, and GES/CAR groups, fluids were introduced 30 minutes after scald injury. The speed of fluid infusion was 4 ml/kg/1%TBSA for 4 hours. CAR (60 microg/kg) was injected into the intestinal lumen at 30-minute after injury in CAR and GES/CAR groups. At 2 and 4 hours after scald, intestinal absorption rate of water and Na, and IMBF were determined, respectively. Then, animals were killed, and specimens of intestinal tissue were obtained for the determination of the activity of Na-K-ATPase, hematoxylin-eosin coloring, and expression of AQP-1. The intestinal absorption rate was reduced markedly in GES group compared with sham scald group at 2 and 4 hours after scald, and absorption rate of small intestine in GES/CAR was significantly higher than that in GES group (P absorption rate of water and Na by improving IMBF, ATPase activity, and AQP-1 expression in gut mucosa during resuscitation with enteral GES of burn shock in rats.

  1. Physicochemical properties and nutritional quality of raw cereals for newly weaned piglets. (United States)

    White, G A; Doucet, F J; Hill, S E; Wiseman, J


    The digestibility of the starch component of raw cereals in newly weaned piglets is highly variable. Reasons for this must be elucidated if the most suitable cereals are to be used. A novel approach was employed, which consisted of assessing the physicochemical properties (rapid visco analysis, water absorption and solubility indices, particle size distribution and in vitro amylolytic digestion) of eight raw cereals contained within piglet diets and subsequently relating this in vitro data to the biological responses of weaned piglets. Trial 1 examined soft and hard wheat, trial 2 - soft wheat, barley, rye and triticale, and trial 3 - soft wheat, naked oats, whole oats and maize. The initial observation was that in vitro testing prior to animal trials is recommended in nutritional evaluation since it indicated fundamental differences between raw cereals, such as for example the levels of endogenous amylase in wheat. Starch and nitrogen digestibility differed between cereals (apparent digestibility coefficients at the 0.5 site of the small intestine ranged from 0.10 to 0.69 for starch and from 0.17 to 0.68 for nitrogen). There is also a probable relationship between the coefficients of ileal apparent starch digestibility, at approximately halfway from the gastric pylorus to the ileocaecal valve, and the presence of endogenous amylase (mean values of 0.53 and 0.62 in trials 2 and 3, respectively, for the higher amylase wheat; 0.38 for the low-amylase wheat used in trial 1). This additional variable (i.e. the unforeseen presence of endogenous amylase) in wheat made it more difficult to draw a firm conclusion about the nutritional suitability of the different cereals. All raw-cereal diets caused atrophy of the villi during the initial week following weaning, but the soft wheat was associated with the highest comparative villi height and might therefore be considered the best of all raw cereals in minimising the post-weaning growth check. For wheat, this might also

  2. Role of an indole-thiazolidine molecule PPAR pan-agonist and COX inhibitor on inflammation and microcirculatory damage in acute gastric lesions.

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    José Roberto Santin

    Full Text Available The present study aimed to show the in vivo mechanisms of action of an indole-thiazolidine molecule peroxisome-proliferator activated receptor pan-agonist (PPAR pan and cyclooxygenase (COX inhibitor, LYSO-7, in an ethanol/HCl-induced (Et/HCl gastric lesion model. Swiss male mice were treated with vehicle, LYSO-7 or Bezafibrate (p.o. 1 hour before oral administration of Et/HCl (60%/0.03M. In another set of assays, animals were injected i.p. with an anti-granulocyte antibody, GW9962 or L-NG-nitroarginine methyl ester (L-NAME before treatment. One hour after Et/HCl administration, neutrophils were quantified in the blood and bone marrow and the gastric microcirculatory network was studied in situ. The gastric tissue was used to quantify the percentage of damaged area, as well as myeloperoxidase (MPO, inducible nitric oxide synthase (iNOS, endothelial nitric oxide synthase (eNOS protein and PPARγ protein and gene expression. Acid secretion was evaluated by the pylorus ligation model. LYSO-7 or Bezafibrate treatment reduced the necrotic area. LYSO-7 treatment enhanced PPARγ gene and protein expression in the stomach, and impaired local neutrophil influx and stasis of the microcirculatory network caused by Et/HCl administration. The effect seemed to be due to PPARγ agonist activity, as the LYSO-7 effect was abolished in GW9962 pre-treated mice. The reversal of microcirculatory stasis, but not neutrophil influx, was mediated by nitric oxide (NO, as L-NAME pre-treatment abolished the LYSO-7-mediated reestablishment of microcirculatory blood flow. This effect may depend on enhanced eNOS protein expression in injured gastric tissue. The pH and concentration of H(+ in the stomach were not modified by LYSO-7 treatment. In addition, LYSO-7 may induce less toxicity, as 28 days of oral treatment did not induce weight loss, as detected in pioglitazone treated mice. Thus, we show that LYSO-7 may be an effective treatment for gastric lesions by controlling

  3. Protective effect of anacardic acids from cashew (Anacardium occidentale) on ethanol-induced gastric damage in mice. (United States)

    Morais, Talita C; Pinto, Natália B; Carvalho, Karine Maria M B; Rios, Jeison B; Ricardo, Nagila Maria P S; Trevisan, Maria Teresa S; Rao, Vietla S; Santos, Flávia A


    Cashew nut-shell liquid and the contained anacardic acids (AAs) have been shown to possess antioxidant, lipoxygenase inhibitory, anti-Helicobacter pylori and antitumor properties. Despite these known effects, hitherto there were no published reports on their likely gastroprotective effects. The present study was designed to verify whether AAs afford gastroprotection against the ethanol-induced gastric damage and to examine the underlying mechanism(s). Gastric damage was induced by intragastric administration of 0.2mL of ethanol (96%). Mice in groups were pretreated orally with AAs (10, 30 and 100mg/kg), misoprostol (50 microg/kg), or vehicle (2% Tween 80 in saline, 10mL/kg), 45min before ethanol administration. They were sacrificed 30min later, the stomachs excised, and the mucosal lesion area (mm(2)) measured by planimetry. Gastroprotection was assessed in relation to inhibition of gastric lesion area. To study the gastroprotective mechanism(s), its relations to capsaicin-sensitive fibers, endogenous prostaglandins, nitric oxide and ATP-sensitive potassium channels were analysed. Treatments effects on ethanol-associated oxidative stress markers GSH, MDA, catalase, SOD, and total nitrate/nitrite levels as an index of NO were measured in gastric tissue. Besides, the effects of AAs on gastric secretory volume and total acidity were analysed in 4-h pylorus-ligated rat. AAs afforded a dose-related gastroprotection against the ethanol damage and further prevented the ethanol-induced changes in the levels of GSH, MDA, catalase, SOD and nitrate/nitrite. However, they failed to modify the gastric secretion or the total acidity. It was observed that the gastroprotection by AAs was greatly reduced in animals pretreated with capsazepine, indomethacin, l-NAME or glibenclamide. These results suggest that AAs afford gastroprotection principally through an antioxidant mechanism. Other complementary mechanisms include the activation of capsaicin-sensitive gastric afferents

  4. Low eradication rate of Helicobacter pylori with triple 7-14 days and quadriple therapy in Turkey

    Institute of Scientific and Technical Information of China (English)

    Yuksel Gumurdulu; Sedat Boyacioglu; Ender Serin; Birol Ozer; Fazilet Kayaselcuk; Kursat Ozsahin; Arif Mansur Cosar; Mlurat Gursoy; Gurden Gur; Ugur Yilmaz


    AIM: The eradication rate of Helicobacter pylori(H pylorl)shows variation among countries and regimens of treatment.We aimed to study the eradication rates of different regimens in our region and some factors affecting the rate of eradication.METHODS: One hundred and sixty- four H pylori positive patients (68 males, 96 females; mean age: 48±12 years)with duodenal or gastric ulcer without a smoking history were included in the study. The patients were divided into three groups according to the treatment regimens. Omeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1 g were given twice daily for 1 week (Group I) and 2 weeks (Group II).Patients in Group III Received bismuth subsitrate 300 mg,tetracyline 500 mg and metronidazole 500 mg four times daily in addition to Omeprazole 20 mg twice daily. Two biopsies each before and after treatment were obtained from antrum and corpus, and histopathologically evaluated.Eradication was assumed to be successful if no H pylorus was detected from four biopsy specimens taken after treatment. The effects of factors like age, sex, H pylori density on antrum and corpus before treatment, the total H pylori density, and the inflammation scores on the rate of H pylori eradication were evaluated.RESULTS: The overall eradication rate was 42%. The rates in groups II and III were statistically higher than that in group I (P<0.05). The rates of eradication were 24.5%,40.7% and 61.5% in groups I, II and III, respectively. The eradication rate was negatively related to either corpus H pylori density or total H pylori density (P<0.05). The median age was older in the group in which the eradication failed in comparison to that with successful eradication (55 yr vs 39 yr, P<0.001). No correlation between sex and H pylori eradication was found.CONCLUSION: Our rates of eradication were significantly lower when compared to those reported in literature. We believe that advanced age and high H pylori density are negative predictive factors for

  5. 胃肠超声造影在临床诊断的应用%Gastric Ultrasound Imaging in Clinical Diagnosis

    Institute of Scientific and Technical Information of China (English)



    目的:探讨胃肠超声造影在诊断胃肠疾病方面的应用价值。方法348例受检者空腹口服超声助显剂,使胃内形成中等回声界面,超声依次检查食道下段、贲门胃底、胃体(大弯及小弯侧)、胃角部胃窦部、幽门、十二指肠球部。结果超声造影可以清晰显示胃壁各层回声,胃的蠕动快慢、及胃内病变的部位、形态、大小、累及深度、腹腔大血管周围淋巴结等情况。结论口服助显剂胃肠超声造影检查方便、价廉、无创,是对胃镜和 X 线钡餐检查的有效补充方法,适合应用于对胃肠疾病的筛查。%Objective To evaluate the gastrointestinal contrast-enhanced ultrasound in the diagnosis of gastrointestinal diseases. Methods 348 cases of oral ultrasonic significantly aid subjects on an empty stomach, the stomach formation of medium interface of the echo,ultrasonic inspection in turn lower segment of the esophagus and cardia gastric bottom, the body (large bending and little side),stomach Angle distal stomach,pylorus and duodenal bulb. Results Contrast-enhanced ultrasound can clearly show the hole in the stomach wal layers echo, how peristalsis of the stomach and the stomach in the lesion area, shape, size, involving the depth, abdominal lymph nodes around the great vessels,and so on and so forth. Conclusion Oral dose of gastrointestinal contrast-enhanced ultrasound examination is convenient, inexpensive,noninvasive,is the effective complement to gastroscope and X-ray barium meal examination method, suitable for application in screening for gastrointestinal diseases.

  6. Tricobezoar gástrico: relato de caso e revisão da literatura

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    César Tadeu Spadella


    Full Text Available Bezoar é a impactação de material estranho no interior do trato digestivo, originado a partir da ingestão de diversas substâncias, incluindo cabelos ou pêlos, fibras vegetais e outros. No presente estudo relata-se caso de um volumoso tricobezoar gástrico observado em uma adolescente de 16 anos, com queixa de dor e tumoração palpável na região epigástrica, diagnosticado através da endoscopia digestiva alta. Dada às proporções do bezoar, a paciente foi submetida à gastrotomia anterior com retirada de uma massa sólida de cabelos, com 1200 g, a qual moldava todo o estômago, desde o fundo até o piloro. Uma grande úlcera de pressão também foi detectada em região antral, cujas biópsias revelaram- se negativas para neoplasia. Após a alta, sem intercorrências, a paciente foi encaminhada ao Serviço de Neuropsiquiatria para o tratamento da tricofagia e prevenção da recorrência, objetivo final, ao nosso ver, de todo o tratamento.Bezoar is an impaction of swallowed foreign material into the digestive tract. It is formed from several substances included hairs of humans or animals, vegetable matters and others. At present study the authors report a case of a voluminous gastric trichobezoar observed in a 16-yr-old adolescent with abdominal pain and palpated mass in the epigastrium. Trichobezoar was diagnosed throughout fiberoptic gastroscopy and laparotomy was indicated due to exaggerated size of the mass. Anterior gastrotomy was performed and a solid mass of hairs weighting 1200 g was removed. The removed mass occupied the whole stomach from fundus to pylorus. A big pression ulcer was also detected in the antrum. Biopsies of this ulcer showed to be negatives for neoplasy. There were no complications in postoperative recovery. After discharge the patient was referred to the Neuropsychiatric Service for treatment of trichophagia and prevention of recurrence, in our point of view, the main purpose of all treatment.


    Directory of Open Access Journals (Sweden)



    Full Text Available From the standpoint of pathology, the term pyloric stenosis is usually inaccurate at least in adult patients, since the site of obstruction is rarely situated at the pylorus itself but is more often placed immediately proximal to the sphincter where the diagnosis of carcinoma is most probable or more dista lly in the duodenal bulb where the cause is almost invariably a duodenal ulcer. This study has been taken up to review the changes in presentation of gastric outlet obstruction in view of changing trends in the aetiology analysing the occurrence of benign and malignant causes, signs and symptoms, investigatory modalities, management and their results. The present study is an observational study a total of 50 cases were studied with Cicatrised duodenal ulcer and carcinoma pyloric antrum being the major cause s. Clinical profile, investigations and treatment outcomes were analysed. The majority of patients had malignant gastric outlet obstruction with 32[64%] patients presenting with Gastric cancer and 18[36%] patients presenting with cicatrised duodenal ulcer. In this study most patients were in the fifth and seventh decades of life. Men outnumbered women by 3: 1. The clinical presentation is not different from those in other studies with non - bilious vomiting being common to all the patients with dehydration. V isible gastric peristalsis and succussion splash were more prominent in Cicatrised Duodenal Ulcer. All cases were subjected to serum electrolyte estimation. Out of them 20 cases [40%] showed electrolyte imbalance barium meal, ultrasound abdomen pelvis and CT scan abdomen being the other investigating tools. Blood group ‘O’ was common in cicatrized duodenal ulcer patients [77.7%] followed by blood group ‘A’ [11.1%]. Upper GI endoscopy was done in all cases [100%]. 32[64%] cases had pyloric antral Carcinoma i n which 23 cases had fungating growth and the rest 9 had ulcerative growth and 18[36%] had cicatrized duodenal ulcer. 100

  8. Effects of broth culture filtrate protein of VacA+ Helicobacter pylori on the proliferation and apoptosis of gastric epithelial cells

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yu-qing; GUO Tao; QIAN Jia-ming


    Background Infection with Helicobacterpylori (H.pylori) may lead to chronic inflammation of the stomach epithelium,mucosal atrophy,imbalance of proliferation and apoptosis of epithelial cells; resulting in chronic gastritis,peptic ulcer,gastric cancer,and many other clinical outcomes.Why and how H.pylorus leads to gastric cancer is not clear yet.Through in vitro experiments,this study evaluated the effects of broth culture filtrate protein (BCF-P) from the supernatant of liquid culture media of H.pylori on proliferation and apoptosis of immortalized human gastric epithelial cell lines (GES-1) and gastric cancer cell lines (AGS).Methods For the study,GES-1 and AGS cell lines mix with BCF-P and epidermal growth factor (EGF).MTT assay and flow cytometry (FCM) determined the levels of proliferation and apoptosis.Detected expression levels of cyclooxygenase-2 (COX-2) and Fas mRNA by reverse transcription (RT)-PCR.Also did analysis of the effects of BCF-P on epidermal growth factor receptor (EGFR) tyrosine kinase activity of GES-1 and AGS cells by non-radioactive enzyme-linked assay.The Student's t test and one-way analysis of variance (ANOVA) were used for statistical analysis.Results BCF-P inhibited proliferation of GES-1 and AGS cells in a concentration-dependent manner.The inhibition rates are respectively 68.7% in AGS and 61.4% in GES-1.With the same dose and time for inhibiting the proliferation,BCF-P failed to induce apoptosis of GES-1 and AGS cells.Effects of BCF-P reduced the expression of Fas mRNA of GES-1 and AGS cells (P <0.05).This is consistent with the effects of EGF.BCF-P reduced the expression of COX-2mRNA of AGS cells (P <0.05).This is opposite to the effects of EGF (P <0.05).Effects of BCF-P improved more than three times the EGFR tyrosine kinase activity of GES-1 and AGS cells.Conclusions BCF-P inhibited the proliferation of AGS and GES-1 cells in vitro,unrelated to apoptosis.Effects of BCF-P on gastric epithelial cells in vitro are not

  9. Clinical efficacy and quail ty of life of pvlorus-preserving gastrectomy for early gastric cancer: a Meta-analysis%保留幽门胃部分切除术治疗早期胃癌临床效果及生活质量系统评价

    Institute of Scientific and Technical Information of China (English)

    梁冀望; 宋永喜; 孙景旭; 徐惠绵; 王振宁


    目的 系统评价保留幽门胃部分切除术(PPG)治疗早期胃癌的临床效果及生活质量.方法 计算机检索1995年1月至2010年12月PubMed、Wiley Online Library、中国生物医学数据库(CBM)、CNKI、VIP及万方数据库关于PPG和传统远端胃切除术(CDG)治疗早期胃癌的随机对照试验.RevMan 5.0进行Meta分析.结果 纳入2个随机对照试验和11个临床对照试验,共1011例病人.PPG和CDG相比,术后能减少倾倒综合征、残胃炎的发生,病人营养状况和体重恢复较好;但总并发症、胆结石、反流性食管炎无显著差别.结论 现有研究表明,早期胃癌行PPG后生活质量较好.由于纳入研究方法学质量低、数量少,期待更多高质量试验提供高质量证据.%Objective To assess the clinical efficacy and postoperative quality of life of pylorus-preserving gastrectomy (PPG) for early gastric cancer. Methods Literature search was performed in PubMed, Wiley Online Library, Chinese Biomedical Database(CBM), CNK1, VIP and Wanfang to identify clinical randomized controlled trails on PPG and conventional distal gastrectomy (CDG) for early gastric cancer published between January 1995 and November 2010. RevMan 5.0 software was used for statistical analysis. Results A total of 13 studies involving 1011 patients were included. Meta-analysis showed that compared with PPG group, early dumping syndrome, gastritis were more common in CDG group. Nutritional status and the average relative body weight in PPG group were better than those in CDG group significantly. However, there were no .significant differences between the two groups in complications, gallstones and reflux esophagitis. Conclusion PPG is safe and effective for the treatment of patients with early gastric cancer, which may have a better postoperative quality of life. Due to the poor quality and small sample size of included trials, more well-designed randomized controlled trials should be performed.

  10. Intraductal papillary mucinous carcinoma of the pancreas associated with pancreas divisum: a case report and review of the literature. (United States)

    Nishi, Takeshi; Kawabata, Yasunari; Ishikawa, Noriyoshi; Araki, Asuka; Yano, Seiji; Maruyama, Riruke; Tajima, Yoshitsugu


    Pancreas divisum, the most common congenital anomaly of the pancreas, is caused by failure of the fusion of the ventral and dorsal pancreatic duct systems during embryological development. Although various pancreatic tumors can occur in patients with pancreas divisum, intraductal papillary mucinous neoplasm is rare. A 77-year-old woman was referred to our hospital because she was incidentally found to have a cystic tumor in her pancreas at a regular health checkup. Contrast-enhanced abdominal computed tomography images demonstrated a cystic tumor in the head of the pancreas measuring 40 mm in diameter with slightly enhancing mural nodules within the cyst. Endoscopic retrograde pancreatography via the major duodenal papilla revealed a cystic tumor and a slightly dilated main pancreatic duct with an abrupt interruption at the head of the pancreas. The orifice of the major duodenal papilla was remarkably dilated and filled with an abundant extrusion of mucin, and the diagnosis based on pancreatic juice cytology was "highly suspicious for adenocarcinoma". Magnetic resonance cholangiopancreatography depicted a normal, non-dilated dorsal pancreatic duct throughout the pancreas. The patient underwent a pylorus-preserving pancreaticoduodenectomy under the diagnosis of intraductal papillary mucinous neoplasm with suspicion of malignancy arising in the ventral part of the pancreas divisum. A pancreatography via the major and minor duodenal papillae on the surgical specimen revealed that the ventral and dorsal pancreatic ducts were not connected, and the tumor originated in the ventral duct, i.e., the Wirsung's duct. Microscopically, the tumor was diagnosed as intraductal papillary mucinous carcinoma with microinvasion. In addition, marked fibrosis with acinar cell depletion was evident in the ventral pancreas, whereas no fibrotic change was noted in the dorsal pancreas. Invasive ductal carcinomas of the pancreas associated with pancreas divisum usually arise from the dorsal

  11. [Prevention, diagnosis and treatment of perioperative complications of bariatric and metabolic surgery]. (United States)

    Wu, Haifu; Zhong, Ming; Zhou, Di; Shi, Chenye; Jiao, Heng; Wu, Wei; Chang, Xinxia; Cang, Jing; Bian, Hua


    treatment should be performed when necessary. Marginal ulcer after gastric bypass is a kind of peptic ulcer occurring close to small intestine mucosa in the junction point of stomach and jejunum. Ulcer will also occur in the vestige stomach after laparoscopic sleeve gastrectomy, and the occurrence site locates mostly in the gastric antrum incisal margin. Preoperative anti-HP (helicobacter pylorus) therapy and postoperative continuous administration of proton pump inhibitor (PPI) for six months is the main means to prevent and treat marginal ulcer. For patients on whom conservative treatment is invalid, endoscopic repair or surgical repair should be considered. Different surgical procedures will generate different related operative complications. Fully understanding and effectively dealing with the complications of various surgical procedures through multidisciplinary cooperation is a guarantee for successful operation.

  12. 胰腺良性肿瘤22例临床诊治分析%Clinical analysis of 22 cases of pancreatic benign tumor

    Institute of Scientific and Technical Information of China (English)

    陈守坤; 任泽强; 张蓬波


    目的 探讨胰腺良性肿瘤的诊治方法.方法 对我院手术治疗的22例胰腺良性肿瘤病例进行临床分析.结果 术前检查B超确诊率90.9%(20/22),薄层增强螺旋CT确诊率100%(2/2),通过普通CT、磁共振胰胆管成像(MRCP)检查对肿瘤与胆胰管关系作初步了解,结合术中探查情况3例行肿瘤摘除术,5例行胰十二指肠切除术或保留幽门的胰十二指肠切除术,1例行保留十二指肠的胰头切除术,4例行胰腺节段切除术,9例行胰尾切除术或加脾切.结论 B超是胰腺良性肿瘤主要的筛查手段,胰腺局部切除术和胰尾切除术是治疗胰腺良性肿瘤的重要手术方式.%Objective To investigate the diagnosis and treatment of benign tumor of the pancreas. Methods The clinical data of 22 cases of benign pancreas tumors,who was admitted to our hospital,was analyzed. Metods The clinical data of 22 cases of benign pancreas tumors, who was admitted to our hospital ,was analyzed. Results Preoperative BUS - positive 90. 9% ( 20/22 ), thin - enhanced spiral CT - positive 100% ( 2/2 ), combined with regular CT, MRCP examination we have a preliminary understanding the relationship of the tumor and the bile duct, under the intraoperative exploration 3 cases of tumor were local excision,5 cases of pancreaticoduodenectomy or pylorus - preserving pancreaticoduode-nectomy, a case of duodenum - preserving pancreatic head resection, 4 cases of pancreatic segments resection, 9 cases of pancreatic tail resection with or without spleen cut. Conclusion The main means of screening pancreatic benign tumor is BUS,local resection of the pancreas and pancreatic tail resection are the important surgery of benign tumor of the pancreas.

  13. Evaluation of roentgenologic study of the stomach

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Jung Ho; Choi, Byung So [Yonsei University College of Medicine, Seoul (Korea, Republic of)


    In order to achieve more correct diagnosis of gastric lesion, further progress in the technique of diagnosis is much desired. And so, in pursuing the more ideal study, about 7,500 cases of U. G. I. studies taken in Severance Hospital in the past 29 months from May 1969 to September 1971, have been reviewed to evaluate how the following factors will affect the demonstrability of gastric lesion in upper G. I. series. (1) Introduction of air into the stomach by nasogastric tube. (2) Kinds and concentration of barium. (3) Demonstrability according to the position of the patient. (4) Use of antispasmodics. The results may be briefly summarized as follows: 1. The intubation of nasogastric tube gives discomfort temporarily to the patient: however, it has an advantage that the amount of air required for ideal insufflation of the stomach can be controlled under the fluoroscopy. 2. About concentration and type of barium. a) Mikabarium in 90% seems to give the best result in filling study, mucosal relief study and double contrast study. b) Mikabarium in higher concentration adheres to the mucosa better, thus resulting in good double contrast: however, it tends to coagulate each other in the high concentration. c) Micropaque powder of 110% solution produces good double contrast, but it has the disadvantage of making air bubbles. d) When water is given prior to barium ingestion, the anterior wall of stomach is better demonstrated with mucosal relief study. e) To get better result in contrast study, the selection of barium is important as well as rapid and proper positioning of the patient and abdominal respiratory movement. 3. Demonstrability of the stomach lesion according to the position. a) The small lesion either in pylorus or in antrum can be best demonstrated by compression technique of double contrast method in supine position. b) The mucosal relief study in prone by adequate air insufflation was proper to demonstrate the lesion of anterior wall. c) In the lesion of the


    Institute of Scientific and Technical Information of China (English)



    Objective To explore the effect of methylene blue on blind placement of nasointestinal tubes in critical patients .Methods Methylene blue was transfused through nasointestinal tube in 54 critical pa‐tients , and whether or not methylene blue was discharged from nasointestinal tube was observed . If methylene blue was discharged from nasointestinal tube ,nasointestinal tubes would be placed again and methylene blue was transfused again . Those who showed no discharge of methylene blue after the two times of transfusion underwent X‐ray check‐ups .Re‐sults The success rate of nasointestinal tube crossing pylorus tested with methylene blue for the first time was 97 .50% ,and the success rate for the second time was 80% .Conclusion Locating the position of blind placement of nasointestinal tubes in critical patients is convenien and easy to manage .%目的:探讨亚甲蓝在危重患者盲插鼻肠管中的应用效果。方法将54例危重患者置入鼻肠管后,经鼻胃管注入亚甲蓝,观察鼻胃管内有无亚甲蓝流出,流出者,进行第二次置管,置管后再经鼻胃管注入亚甲蓝。将两次置管后鼻胃管无亚甲蓝流出者行腹部X片检查。结果第一次置管后亚甲蓝验证鼻肠管过幽门的成功率为97.50%;第二次为80%。结论亚甲蓝定位床旁盲插鼻肠管位置的方法简便易行,观察便利及时,值得临床推广应用。

  15. A comparative study of two-dimensional and three-dimensional ultrasonography in evaluation of gastric affections in dogs

    Directory of Open Access Journals (Sweden)

    Madan Pal


    Full Text Available Aim: The objective of the study was to obtain and compare the two-dimensional (2D and three-dimensional (3D ultrasonographic images of pathological conditions of the stomach in dogs in clinical cases. Materials and Methods: In our study, 12 clinical conditions of the stomach were recorded using ultrasonography. The ultrasound machine used for this study was 3D ultrasound machine (Nemio-XG: Toshiba, Japan having four-dimensional volumetric transducer. Results: Present study was done to compare 2D and 3D ultrasonographic images in different gastric affections in dogs. In case of uremic gastropathy due to inflammatory response, the wall of the stomach was 0.6 cm thick and hyperechoic and gastric folds were also hyperechoic indicative of gastritis. In second, third, and fourth case of gastritis the wall of the stomach was 0.7, 0.6, and 0.55 cm, respectively thick and hyperechoic. In fifth and sixth case of gastritis, inflammatory response due to ingestion of polythene and sand led to gastritis and ultrasonographically, the wall of the stomach was 0.6 cm and 0.7 cm thick, respectively, and hyperechoic. In case of gastric ulcer, ultrasonographically, there was a disruption of gastric mucosal layer. In cases of gastric dilatation, anechoic content indicating fluid was seen in stomach area and due to dilatation boundary of the stomach was not clear and the increase in the lumen of the stomach was observed. In case of foreign body, ultrasonographically the wall of the stomach was 0.55 cm thick and hyperechoic. In the middle of the stomach, multiple hyperechoic shadows of the foreign bodies i.e. leather and bunch of straw of grass were observed. In case of pyloric stenosis ultrasonographically, anechoic lumen of the pylorus surrounded by 0.5 cm hypoechoic thickened muscle. In some cases, 3D ultrasonography was not diagnostic i.e. gastric foreign bodies and gastric dilatation. These conditions were better visualized on the 2D sonogram. Conclusion: The

  16. 不同产地北寒水石炮制前后药效学研究%Comparative study on pharmacodynamic activity in vivo of North Calcitum from different origins before and after processing

    Institute of Scientific and Technical Information of China (English)

    陆景坤; 陈朝军; 周昊菲; 李燕


    目的:比较3种产地北寒水石炮制前后主成分变化及对小鼠的胃肠功能的影响.方法:配位滴定法测定主成分硫酸钙含量;观察灌服北寒水石炮制品、生品后对正常小鼠小肠推动率、钙的吸收率以及对结扎幽门小鼠胃液分泌的影响.结果:炮制使主成分含量增加;与空白组相比,炮制前后均能有效增加小鼠肠推动率;有两种产地炮制品组小鼠对钙的吸收率显著低于另一产地的生品和炮制品组;与模型组相比,有两种产地炮制品组结扎幽门小鼠的胃液pH值显著增加,总酸度、总排酸量显著降低,其他组有一定活性,但没有显著差异.结论:不同产地寒水石炮制前后对胃肠功能的影响有所不同.%Objective: To investigate the main composition and the effects of North Calcitum from different areas before and after processing on mice gastrointestinal function. Methods: The principal component (calcium sulfate) were detected by the coordination titrations. The mice were administered with the processed products and the unprocessed in order to observe the effects on the intestinal propulsion and the absorption rate and the gastric juice of pylorus-ligature mice. Results: The principal component of North Calcitum was significantly increased after processed. Compared with the control group, the processed products and the unprocessed could significantly enhance the intestinal propulsion rate of normal mice, while the absorption rate of the mice administered with the processed from two places were lower than the other processed group respectively. Compared with the model group, the acid-base scale of gastric juice of two processed from different areas groups raised remarkably, and the total acidity and the gastric acid secretory volume of both groups notably decreased. Meanwhile, others had restrainable trend to regulate gastric juice secretion and neither of them had the statistical value. Conclusion: The North

  17. Small amounts of tissue preserve pancreatic function (United States)

    Lu, Zipeng; Yin, Jie; Wei, Jishu; Dai, Cuncai; Wu, Junli; Gao, Wentao; Xu, Qing; Dai, Hao; Li, Qiang; Guo, Feng; Chen, Jianmin; Xi, Chunhua; Wu, Pengfei; Zhang, Kai; Jiang, Kuirong; Miao, Yi


    Abstract Middle-segment preserving pancreatectomy (MPP) is a novel procedure for treating multifocal lesions of the pancreas while preserving pancreatic function. However, long-term pancreatic function after this procedure remains unclear. The aims of this current study are to investigate short- and long-term outcomes, especially long-term pancreatic endocrine function, after MPP. From September 2011 to December 2015, 7 patients underwent MPP in our institution, and 5 cases with long-term outcomes were further analyzed in a retrospective manner. Percentage of tissue preservation was calculated using computed tomography volumetry. Serum insulin and C-peptide levels after oral glucose challenge were evaluated in 5 patients. Beta-cell secreting function including modified homeostasis model assessment of beta-cell function (HOMA2-beta), area under the curve (AUC) for C-peptide, and C-peptide index were evaluated and compared with those after pancreaticoduodenectomy (PD) and total pancreatectomy. Exocrine function was assessed based on questionnaires. Our case series included 3 women and 2 men, with median age of 50 (37–81) years. Four patients underwent pylorus-preserving PD together with distal pancreatectomy (DP), including 1 with spleen preserved. The remaining patient underwent Beger procedure and spleen-preserving DP. Median operation time and estimated intraoperative blood loss were 330 (250–615) min and 800 (400–5500) mL, respectively. Histological examination revealed 3 cases of metastatic lesion to the pancreas, 1 case of chronic pancreatitis, and 1 neuroendocrine tumor. Major postoperative complications included 3 cases of delayed gastric emptying and 2 cases of postoperative pancreatic fistula. Imaging studies showed that segments representing 18.2% to 39.5% of the pancreas with good blood supply had been preserved. With a median 35.0 months of follow-ups on pancreatic functions, only 1 patient developed new-onset diabetes mellitus of the 4

  18. Effects of Morinda citrifolia aqueous fruit extract and its biomarker scopoletin on reflux esophagitis and gastric ulcer in rats. (United States)

    Mahattanadul, Sirima; Ridtitid, Wibool; Nima, Sawpheeyah; Phdoongsombut, Narubodee; Ratanasuwon, Pranee; Kasiwong, Srirat


    The present study was carried out to evaluate the effect of dried mature unripe Morinda citrifolia L. (Rubiaceae) fruit, commonly known as "Noni", in an aqueous extract preparation (AFE) as used in Thai traditional medicine and its biomarker scopoletin on gastro-esophageal inflammatory models that are related to the claimed pharmacological properties of AFE and/or resembled the human esophagitis or gastric ulcer. The powder of dried mature unripe Noni fruit was boiled in water until it became a sticky paste and was then dried into a powder by lyophilization. The pharmacological activity of AFE and pure scopoletin at the same equivalent dose present in AFE was investigated in rat on gastro-esophageal inflammatory models (acid reflux esophagitis, acute gastritis induced by ethanol and serotonin, and chronic gastric ulcer induced by acetic acid); gastric biochemical parameters and gastrointestinal motility. AFE (0.63-2.50 g/kg) significantly prevented the formation of acid reflux esophagitis, reduced the formation of ethanol-induced acute gastric lesions, suppressed the development of gastric lesions in response to serotonin, and accelerated the healing of acetic acid-induced chronic gastric ulcer in rats with equal potency to those obtained by standard antisecretory agents (ranitidine and lansoprazole). AFE also significantly inhibited gastric acid secretion and pepsin activity in pylorus ligated rats. Additionally, AFE strongly increased the gastrointestinal transit of charcoal meal with a higher potency than cisapride. Pure scopoletin, when compared at the same equivalent dose containing in AFE, possessed similar antiulcer and antisecretory properties to that of AFE although it exerted a less prokinetic activity than AFE. The findings indicated that AFE as well as its biomarker: scopoletin may be beneficial as a potential preventive and therapeutic agent for gastro-esophageal inflammatory diseases, mainly through its antisecretory and prokinetic activities

  19. Protective effects of pentadecapeptide BPC 157 on gastric ulcer in rats

    Institute of Scientific and Technical Information of China (English)

    Xiao-Chang Xue; Yong-Jie Wu; Ming-Tang Gao; Wen-Guang Li; Ning Zhao; Zeng-Lu Wang; Chun-Jie Bao; Zhen Yan; Ying-Qi Zhang


    AIM: To investigate the protective effects of gastric pentadecapeptide BPC 157 on acute and chronic gastric ulcers in rats and to compare the results in therapy of human gastric ulcers by different administration methods.METHODS: Gastric pentadecapeptide BPC 157 was administered (initial single or continuous administration) into rats either intragastrically or intramuscularly before (induced acute gastric ulcer) or after (induced chronic gastric ulcer) the applications of inducing agents, and each animal was sacrificed to observe the protective effects of BPC 157 on gastric ulcers.RESULTS: Both intramuscular (im) and intragastric (ig) administration of BPC 157 could apparently reduce the ulcer area and accelerate the healing of induced ulcer in different models and the effect of im administered BPC 157 was better than that of ig. The rats treated with higher dosages (400 ng/kg, 800 ng/kg) of BPC 157 (im and ig) showed significantly less lesion (P<0.01 vs excipient or saline control), the inhibition ratio of ulcer formation varied between 45.7% and 65.6%, from all measurements except 400 ng/kg BPC 157 in pylorus ligation induced model (P<0.05),in which the inhibition rate was 54.2%. When im administered (800 ng/kg BPC 157) in three models, the inhibition ratio of ulcer formation was 65.5%, 65.6% and 59.9%, respectively, which was better than that of famotidine (its inhibition rate was 60.8%, 57.2% and 34.3%,respectively). Continuous application of BPC 157 (in chronic acetate induced gastric ulcer) could accelerate rebuilding of glandular epithelium and formation of granulation tissue (P<0.05 at 200 ng/kg and P<0.01 at 400 ng/kg and 800 ng/kg vs excipient or saline control).CONCLUSION: Both im and ig administered gastric pentadecapeptide BPC 157 can apparently ameliorate acute gastric ulcer in rats and antagonize the protracted effect of acetate challenge on chronic ulcer. The effect of im administration of BPC 157 is better than that of ig, and the effective

  20. Action of progesterone on contractile activity of isolated gastric strips in rats

    Institute of Scientific and Technical Information of China (English)

    Fang Wang; Tian-Zhen Zheng; Wei Li; Song-Yi Qu; Di-Ying He


    AIM: To study the effect of progesterone on contractile activity of isolated gastric strips in rats.METHODS: Wistar rats were sacrificed to remove whole stomach. Then, the stomach was opened and the mucosal layer was removed. Parellel to either the circular or the longitudial fibers, muscle strips were cut from fundus, body,antrum and pylorus. Each muscle strip was suspended in a tissue chamber containing 5 mL Krebs solution. Then the motility of gastric strips in tissue chambers was simultaneously recorded. The preparations were subjected to 1 g load tension and washed with 5 ml Krebs solution every 20 min. After 1 h equilibration, progesterone or antagonists were added in the tissue chamber separately. The antagonists were added 3 min before using progesterone (50 μmol. L-1).RESULTS: Progesterone decreased the resting tension of fundus and body longitudinal muscle (LM) (P<0.05). It inhibited the mean contractile amplitude of body and antrum LM and circular muscle (CM), and the motility index of pyloric CM (P<0.05). The inhibition of progesterone on the mean contractile amplitude could be partially blocked by phentolamine in LM of the stomach body (the mean contractile amplitude of body LM decreased from -7.5±5.5to -5.2±4.5 P<0.01), and by phentolamine or indomethacin in CM of body (The inhibition of progesterone on the mean contractile amplitude of body CM decreased from -5.6±3.0to -3.6±2.7 by phentolamine and from -5.6±3.0 to -3.5±2.5by indomethacin, P<0.01). Hexamethonium, propranolol and L-NNA (inhibitor of NO synthetase) didn′t affect the action of progesterone (P>0.05).CONCLUSION: The study suggested that progesterone can inhibit the contractile activity of isolated gastric strips in rats and the mechanism seems to be a direct one except that the action on gastric body is mediated through prostaglandin and adrenergic α receptor partly.

  1. Risk factors for postoperative pancreatic fistula: Analysis of 539 successive cases of pancreaticoduodenectomy. (United States)

    Hu, Bing-Yang; Wan, Tao; Zhang, Wen-Zhi; Dong, Jia-Hong


    To analyze the risk factors for pancreatic fistula after pancreaticoduodenectomy. We conducted a retrospective analysis of 539 successive cases of pancreaticoduodenectomy performed at our hospital from March 2012 to October 2015. Pancreatic fistula was diagnosed in strict accordance with the definition of pancreatic fistula from the International Study Group on Pancreatic Fistula. The risk factors for pancreatic fistula were analyzed by univariate analysis and multivariate logistic regression analysis. A total of 269 (49.9%) cases of pancreatic fistula occurred after pancreaticoduodenectomy, including 71 (13.17%) cases of grade A pancreatic fistula, 178 (33.02%) cases of grade B, and 20 (3.71%) cases of grade C. Univariate analysis showed no significant correlation between postoperative pancreatic fistula (POPF) and the following factors: age, hypertension, alcohol consumption, smoking, history of upper abdominal surgery, preoperative jaundice management, preoperative bilirubin, preoperative albumin, pancreatic duct drainage, intraoperative blood loss, operative time, intraoperative blood transfusion, Braun anastomosis, and pancreaticoduodenectomy (with or without pylorus preservation). Conversely, a significant correlation was observed between POPF and the following factors: gender (male vs female: 54.23% vs 42.35%, P = 0.008), diabetes (non-diabetic vs diabetic: 51.61% vs 39.19%, P = 0.047), body mass index (BMI) (≤ 25 vs > 25: 46.94% vs 57.82%, P = 0.024), blood glucose level (≤ 6.0 mmol/L vs > 6.0 mmol/L: 54.75% vs 41.14%, P = 0.002), pancreaticojejunal anastomosis technique (pancreatic duct-jejunum double-layer mucosa-to-mucosa pancreaticojejunal anastomosis vs pancreatic-jejunum single-layer mucosa-to-mucosa anastomosis: 57.54% vs 35.46%, P = 0.000), diameter of the pancreatic duct (≤ 3 mm vs > 3 mm: 57.81% vs 38.36%, P = 0.000), and pancreatic texture (soft vs hard: 56.72% vs 29.93%, P = 0.000). Multivariate logistic regression analysis showed that

  2. Transport of Zinc Oxide Nanoparticles in a Simulated Gastric Environment (United States)

    Mayfield, Ryan T.

    Recent years have seen a growing interest in the use of many types of nano sized materials in the consumer sector. Potential uses include encapsulation of nutrients, providing antimicrobial activity, altering texture, or changing bioavailability of nutrients. Engineered nanoparticles (ENP) possess properties that are different than larger particles made of the same constituents. Properties such as solubility, aggregation state, and toxicity can all be changed as a function of size. The gastric environment is an important area for study of engineered nanoparticles because of the varied physical, chemical, and enzymatic processes that are prevalent there. These all have the potential to alter those properties of ENP that make them different from their bulk counterparts. The Human Gastric Simulator (HGS) is an advanced in vitro model that can be used to study many facets of digestion. The HGS consists of a plastic lining that acts as the stomach cavity with two sets of U-shaped arms on belts that provide the physical forces needed to replicate peristalsis. Altering the position of the arms or changing the speed of the motor which powers them allows one to tightly hone and replicate varied digestive conditions. Gastric juice, consisting of salts, enzymes, and acid levels which replicate physiological conditions, is introduced to the cavity at a controllable rate. The release of digested food from the lumen of simulated stomach is controlled by a peristaltic pump. The goal of the HGS is to accurately and repeatedly simulate human digestion. This study focused on introducing foods spiked with zinc oxide ENP and bulk zinc oxide into the HGS and then monitoring how the concentration of each changed at two locations in the HGS over a two hour period. The two locations chosen were the highest point in the lumen of the stomach, which represented the fundus, and a point just beyond the equivalent of the pylorus, which represented the antrum of the stomach. These points were

  3. Recent advances in diagnosis and treatment of Bouveret's syndrome%Bouveret综合征诊治进展

    Institute of Scientific and Technical Information of China (English)

    陈琳光; 马静; 陈志男; 侯利民


    Gallstone ileus is a rare complication of cholelithiasis. Bouveret's syndrome is a special variant of gallstone ileus resulting in gastric outlet obstruction. It is caused by a persistently impacted gallstone passing in the proximal duodenum or pylorus through a cholecystoenteric fistula. It occurs most commonly in elderly female patients. The morbidity and mortality rates once remained at a high level because of the unspecific clinical manifestations, patient's advanced age, basic comorbidities and delayed diagnosis. Surgery still maintains a prominent position, even though non-operative procedures have an increasing role in treatment. Remove the stones, relieve obstruction followed by cholecystectomy and fistula repair as a 1- or 2-stage procedure is the main surgical strategy. For many years, controversies exist in the choice of surgical approach. Anyway, highlighting the awareness of this syndrome, early correct diagnosis and timely effective treatment is the key to improving prognosis.%胆石性肠梗阻是胆石症的少见并发症,Bouveret综合征是胆石性肠梗阻的特殊类型,即胆石通过胆肠瘘进入胃肠道,持续嵌顿于近端十二指肠或幽门部而引起胃流出道梗阻。本病多见于老年女性患者。由于临床表现缺乏特异性,加之患者高龄、合并基础疾病、存在延迟诊断,致使并发症与病死率一度维持在较高水平。尽管各种非手术治疗手段扮演着越来越重要的作用,手术仍在治疗中占据主导地位。取出结石、解除梗阻,一期或二期切除胆囊、修补瘘管是手术治疗主要策略。多年来争议的焦点集中在手术方式的选择上。总之,提高对本病的认识,早期正确的诊断和及时有效的治疗措施是改善预后的关键。

  4. Gastric electrical stimulation for treatment of clinically severe gastroparesis

    Directory of Open Access Journals (Sweden)

    Naga Venkatesh G Jayanthi


    Full Text Available Background: Severe, drug-resistant gastroparesis is a debilitating condition. Several, but not all, patients can get significant relief from nausea and vomiting by gastric electrical stimulation (GES. A trial of temporary, endoscopically delivered GES may be of predictive value to select patients for laparoscopic-implantation of a permanent GES device. Materials and Methods: We conducted a clinical audit of consecutive gastroparesis patients, who had been selected for GES, from May 2008 to January 2012. Delayed gastric emptying was diagnosed by scintigraphy of ≥50% global improvement in symptom-severity and well-being was a good response. Results: There were 71 patients (51 women, 72% with a median age of 42 years (range: 14-69. The aetiology of gastroparesis was idiopathic (43 patients, 61%, diabetes (15, 21%, or post-surgical (anti-reflux surgery, 6 patients; Roux-en-Y gastric bypass, 3; subtotal gastrectomy, 1; cardiomyotomy, 1; other gastric surgery, 2 (18%. At presentation, oral nutrition was supplemented by naso-jejunal tube feeding in 7 patients, surgical jejunostomy in 8, or parenterally in 1 (total 16 patients; 22%. Previous intervention included endoscopic injection of botulinum toxin (botox into the pylorus in 16 patients (22%, pyloroplasty in 2, distal gastrectomy in 1, and gastrojejunostomy in 1. It was decided to directly proceed with permanent GES in 4 patients. Of the remaining, 51 patients have currently completed a trial of temporary stimulation and 39 (77% had a good response and were selected for permanent GES, which has been completed in 35 patients. Outcome data are currently available for 31 patients (idiopathic, 21 patients; diabetes, 3; post-surgical, 7 with a median follow-up period of 10 months (1-28; 22 patients (71% had a good response to permanent GES, these included 14 (68% with idiopathic, 5 (71% with post-surgical, and remaining 3 with diabetic gastroparesis. Conclusions: Overall, 71% of well-selected patients

  5. 小儿幽门管溃疡36例%Pyloric Canal Ulcer in 36 Children

    Institute of Scientific and Technical Information of China (English)

    陈昌斌; 游洁玉; 陈志勇; 欧阳文献; 罗艳红; 赵红梅; 段柏萍


    chloride hyperlipidemia in 18 cases.The initial gastroscopy could get through the pylorus and pyloric canal ulcer was found in 9 cases,complicated by pyloric obstruction but the front - part of gastroscope could not get through the pylorus in 27 cases for which dilute barium meal examination showed pyloric canal ulcer in 6 cases and pyloric obstruction was not complete in 21 cases.Twenty -three cases(63.9% )were cured by conservative medical treatment and 13 caacs(36.1% )were cured by surgical treatment.Conclusions Vomiting is the first manifestation in children with pyloric canal ulcer,and gastroscopy and barium meal examination are the primary means to diagnose pyloric canal ulcer.Conservative medical treatment is the main treatment and acid suppression treatment should be appropriately extended in order to reduce recurrence because of specific anatomical location of pyloric canal ulcer, and a course of acid suppression therapy for 4 -6 weeks in children is necessary.Surgical treatment should be used in a small number of patients whose bleeding is difficult to be controled or whose multiple pyloric canal ulcer and pyloric obstruction can not be removed and completely by conservative treatment for 72 hours.Using balloon dilation or pneumatic dilation under gastroscopy to those of the conditional is desirable.

  6. Modified Mason's vertical banded gastroplasty. Radiological follow-up 322 patients with morbid obesity; Ruolo della radiologia nella valutazione dei pazienti affetti da obesita' patologica sottoposti a gastroplastica verticale secondo Mason modificata. Studio di 322 casi

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    Monteduro, F.; Cappello, I.; Pezzi, A.; Spagnol, A. [Bologna Univ., Bologna (Italy). Policlinico S. Orsola, Servizio Radiologia 2; Ghetti, A. [Bologna Univ., Bologna (Italy). Clinica Chirurgica 2


    Mason's vertical banded gastroplasty (VBG) is one of the most popular surgical techniques for the treatment of morbid obesity because it is effective and easy to perform and presents a low incidence of long-term complications. In this issue it is reported personal results in 322 Mason's VBG patients who were followed-up radiologically. 322 patients were submitted to modified Mason's VBG and underwent radiological follow-up, preferably with single contrast, to assess the shape and volume of the pouch and the presence of postoperative complications. The patients were 272 women and 50 men whose average weight was 124 kg (range: 78 to 218 kg). The women's average age was 37 years (range: 17 to 69) and the men's 36 (range: 19 to 64). It was performed a double contrast examination, adapting the dosage of effervescent powders to the gastric pouch capacity, only in particular cases where a more detailed study of pouch surface was required. The examinations were performed at 1 month and 12 months postoperatively to evaluate the pouch shape and volume, in order to correlate surgical results with weight loss. Premature or unscheduled examinations were necessary only in some cases due to suspected complications or unsatisfactory weight loss. It was observed that early postoperative complications such as pseudo pylorus edema (8 patients) and intragastric hemorrhage (1 patient), and late complications such as pseudo pylorus adherence to the gallbladder bed (1 patient), pseudo diverticular extroversion (1 patient), and axial enlargement (4 patients) of the pouch. The only two cases of staple-line dehiscence were both identified radiographically. In 305 patients with satisfactory weight loss no complications were observed with a pouch size of 45-70 mL (at 1 month) and 58-70 mL (at 12 months). Upper gastrointestinal radiological studies permit to detect both early and late postoperative complications in Mason's VBG patients. That also provide data on

  7. Does troncular vagotomy modify the proliferative gastric lesions induced in rats by duodenogastric reflux? A vagotomia troncular modifica as lesões proliferativas gástricas induzidas em ratos pelo refluxo duodenogástrico?

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    Paulo Antônio Rodrigues


    Full Text Available PURPOSE: to investigate if combining VT to DGR through the pylorus can modulate the biological behavior of PL induced by DGR and to verify if TV alone can induce morphologic lesions in the gastric mucosa. METHODS: 62 male Wistar rats were assigned to four groups: 1 - Control (CT gastrotomy; 2 - Troncular Vagotomy (TV plus gastrotomy; 3 - Duodenogastric reflux through the pylorus (R and 4 - Troncular vagotomy plus DGR (RTV. The animals were killed at the 54 week of the experiment. DGR was obtained by anastomosing a proximal jejunal loop to the anterior gastric wall. TV was performed through isolation and division of the vagal trunks. Gastrotomy consisted of 1 cm incision at the anterior gastric wall. PL were analyzed gross and histologically in the antral mucosa, at the gastrojejunal stoma and at the squamous portion of the gastric mucosa. RESULTS: Groups R and RTV developed exophytic lesions in the antral mucosa (R=90.9%; RTV=100% and at the gastrojejunal stoma (R=54.54%; RTV=63.63%. Histologically they consisted of proliferative benign lesions, without cellular atypias, diagnosed as adenomatous hyperplasia. Both groups exposed to DGR presented squamous hyperplasia at the squamous portion of the gastric mucosa (R= 54.5%; RTV= 45.4%. TV, alone, did not induce gross or histological alterations in the gastric mucosa. TV did note change the morphologic pattern of the proliferative lesions induced by DGR. CONCLUSIONS: DGR induces the development of PL in the pyloric mucosa and at the gastrojejunal stoma. TV does not change the morphologic pattern of the proliferative lesions induced by DGR. TV alone is not able to induce morphologic lesions in the gastric mucosa.OBJETIVO: investigar se a adição da VT ao RDG através do piloro, interfere no comportamento biológico das LP induzidas pelo RDG e observar se a VT isoladamente leva ao desenvolvimento de lesões morfológicas na mucosa gástrica. MÉTODOS: Foram utilizados 62 ratos Wistar machos, distribu

  8. Gastrointestinal Stromal Tumors of the Pancreas

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    Muhammad Wasif Saif


    Full Text Available Dear Sir, We read with great interest the case report published by Padhi et al. in the 2010 May issue of JOP. J Pancreas (Online titled “Extragastrointestinal Stromal Tumor Arising in the Pancreas: A Case Report with a Review of the Literature” [1]. Extragastrointestinal stromal tumors arising in the pancreas are extremely rare. Only nine cases have been reported in the literature up to today including the one by Padhi et al. [1, 2, 3, 4, 5, 6, 7, 8, 9]. We here report another case, probably to be the 10th in medical literature of a pancreatic gastrointestinal stromal tumor (GIST patient with an aggressive outcome. Our patient is a 31-year-old male in his usual state of health until February 2009 when he began to experience abdominal pain and fatigue accompanied by a 4.5 kg weight loss. There was no history of pancreatitis or abdominal trauma. He had a small episode of hematemesis for which he had blood work performed including complete blood count that revealed hemoglobin of 4.6 g/dL (reference range: 14.0-18.0 g/dL. He was admitted to the hospital where received 5 units of packed red blood cells and he was subsequently evaluated with upper endoscopy. Upon the procedure a friable area of mucosa was identified on the duodenum of which no biopsy could be taken. After this finding he had a CT scan which showed a 5.1x4.2x5.6 cm hypervascular mass in the pancreatic head compressing the common bile duct with minimal dilatation. The mass was further characterized by MRI, in which a 5.0x4.3 soft tissue mass was invading the pancreatic head and duodenum, obstructing the common bile duct without pancreatic duct obstruction. On admission, his total bilirubin was 7.3 mg/dL (reference range: 0-1.20 mg/dL, alkaline phosphatase was 686 U/L (reference range: 30-130 U/L, CA 19-9 was 11 U/mL (reference range: 0-37 U/mL, and CEA was 0.9 ng/mL (reference range: 0-3.0 ng/mL. The patient underwent a pylorus-preserving pancreatoduodenectomy and the pathology

  9. Solid pseudopapillary epithelial neoplasm--a rare but curable pancreatic tumour in young women. (United States)

    Frost, M; Krige, J E J; Bornman, P C; Panieri, E; Beningfield, S J; Wainwright, H


    Solid pseudopapillary epithelial neoplasms (SPENs) of the pancreas are rare but curable tumours that have a low-grade malignant potential and occur almost exclusively in young women, with an excellent prognosis after complete resection. This study examines the clinicopathological characteristics of these tumours and evaluates the role of surgery in relation to their size and location. We reviewed the pre-, intra- and postoperative data on 21 patients with SPENs who underwent resection during a 30-year period. Data including demographic information, presenting symptoms and signs, extent of operation, histology, tumour markers and postoperative complications were evaluated to establish the optimal surgical management. All 21 tumours occurred in women (mean age 24.6 years, range 13-51 years). Sixteen patients presented with nonspecific abdominal complaints and a palpable abdominal mass, in 1 patient the tumour was found during emergency laparotomy for a complicated ovarian cyst, 1 patient presented with severe abdominal pain and shock due to a ruptured tumour, and in 3 patients the tumour was detected incidentally during imaging. The correct pre-operative diagnosis of SPEN was made in 10 patients. Incorrect preoperative diagnoses included hydatid cyst (3 patients), mesenteric cyst (2), pancreatic cystadenoma (2), ovarian cysts (1), islet cell tumour of the pancreas (1), and cavernous haemangioma of the liver (1). The mean diameter of the tumours was 12.5 cm (range 8 - 20 cm), and they occurred in the head (8), neck (5), body (2), and tail (6) of the pancreas. All SPENs were resected. Five patients had a pylorus-preserving pancreaticoduodenectomy, 4 a central pancreatectomy with distal pancreaticogastrostomy, 8 a distal pancreatectomy, 3 a local resection and one a total pancreatectomy and portal vein graft. In 1 patient, 2 liver metastases were resected in addition to the pancreatic primary tumour. The patient who presented in shock with tumour rupture and bleeding

  10. Diagnosis and treatment of 50 patients with early gastric carcinomas%早期胃癌50例临床诊治的回顾性研究

    Institute of Scientific and Technical Information of China (English)

    郭庆森; 杜京丽; 师英强; 林雨冬


    Objective To evaluate the factors implicated in the diagnosis and treatment of early gastric caner.Methods Fifty Patients early gastric caner with diagnosed from March 2004 to May 2006,were investigated in the study retrospectively.Results All of the patients were diagnosed accurately by the gastroscopy,among which 2 had atrophic gastritis history for 6 or 10 years,respectively.Twenty-four masses were located in gastric pylorus,12 in gastic angular incisure,14 in gastric body.D2 radical mastectomy was performed in 41 cases,and D1 radical mastectomy in 9 cases.In 10 cases the diameter of tumors was <1 cm,17 cases 1 -2 cm,14 cases 2-3 cm,9 cases >3 cm.Lymph node involvements were observed in five cases ( 10% ).Follow data were available in 48 cases.Among them,3 died from local recurrence and metastasis at postoperative 10,12,19 months respectively. Conclusions Although endosopic mucosal resection or limited surgical resection is a reasonable treatment for some early gastric caner patients,D2 radical mastectomy is necessary for most early gastric caner patients.%目的 评价早期胃癌的诊断及治疗合理性.方法 回顾性分析2004年3月- 2008年5月南京军区福州总医院第一附属医院普外科收治的50例早期胃癌患者的临床资料.结果 全部病例均经胃镜检查诊断,其中2例分别有6、10年萎缩性胃窦炎病史;肿瘤位于胃窦幽门处24例,胃角12例,胃体14例;行D1根治术9例,D2根治术41例;肿瘤直径<1 cm 10例,1~2 cm 17例,2~3 cm 14例,>3 cm9例;淋巴结累及5例(10%),淋巴结阴性者45例.随访48例,术后随访至今,其中3例分别在术后10、12、19个月发生复发转移死亡,生存45例.另外2例失访.结论 尽管目前缩小的微创手术可用于治疗某些早期胃癌,但D2根治术标准的清扫术仍适用于多数早期胃癌的治疗.

  11. Gastroprotective effect of hydroalcoholic extract from barks of Persea major Kopp (Lauraceae in rats Efeito gastroprotetor do extrato hidroalcoólico da casca da Persea major Kopp (Lauraceae em ratos

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    Simone A. Cosmo


    Full Text Available Persea major Kopp (Lauraceae is used in folk medicine to treat skin wounds and gastric disorders. This study evaluates the potential of crude hydroalcoholic extract (EHA as gastroprotective and its acute toxicity. Swiss mice were treated with EHA by oral (p.o. and intraperitoneal (i.p. routes with doses of 0.125 to 10 g/kg and were observed until 14 days after the administration of the extract. The calculated LD50 of EHA after i.p. administration was 480 mg/kg in mice and the LD50 values of EHA by the oral route were calculated to be up to 10 g/kg in mice. Wistar rats were orally pretreated with EHA (30, 100, 300 and 1000 mg/kg before induction of gastric lesions by 70% ethanol (0.5 mL/animal, p.o., indomethacin (20 mg/kg, s.c. and hypothermic restraint stress (during 3 h at 4 ºC. The EHA protected the gastric mucosa against lesions induced by ethanol, but did not reduce the stress- and indomethacin-induced gastric lesions. When the EHA was injected into the duodenal lumen (i.d., the volume, pH and total acidity of the gastric secretion of rats with pylorus ligature was not altered with different doses of the extract. Results therefore suggest that the cytoprotective effect of this extract against the direct necrosing action of ethanol and its effect were not related with reduction of gastric acid secretion.Persea major Kopp (Lauraceae é utilizada na medicina tradicional para o tratamento de lesões cutâneas e distúrbios gástricos. O objetivo deste estudo é avaliar o potencial gastroprotetor e a toxicidade aguda do extrato bruto hidroalcóolico da Persea major Kopp (EHA. Camundongos Swiss foram tratados com EHA pelas vias oral (v.o. e intraperitoneal (i.p. com as doses de 0,125 a 10 g/kg e foram observados por 14 dias. A DL50 calculada após administração i.p. de EHA foi de 480 mg/kg e superior a 10 g/kg pela via oral, em camundongos. Ratos Wistar foram pré-tratados oralmente com EHA (30, 100,300 e 1000 mg/kg antes da indução de les

  12. Surgical strategies in the treatment of chronic pancreatitis (United States)

    Zhao, Xin; Cui, Naiqiang; Wang, Ximo; Cui, Yunfeng


    Abstract Background: 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. Methods: 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. Results: 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

  13. 小型猪正常胰腺MRI表现%MRI manifestations of normal pancreas in piglets

    Institute of Scientific and Technical Information of China (English)

    肖波; 张小明; 曾南林; 蒲宇; 唐伟; 周立绥; 左友波; 庞君豪


    目的 探讨小型猪正常胰腺的MRI表现及其解剖学基础.方法 对8头健康小型猪行MR扫描,观察胰腺的形态、大小及信号强度.然后开腹观察所有猪的胰腺形态、位置和毗邻,同时术中探查胆总管和胰管的开口.术后处死2头,完整取出胰腺供解剖研究.结果 小型猪正常胰腺分左、中、右三叶,在MRI上均能清晰显示.整个胰腺T1加权像信号强度高于肝、脾,T2加权像信号强度低于肝、脾.MR胰胆管水成像未见胰管显影,但胆总管能清晰辨认.解剖发现胆总管开口在胃幽门稍下方的十二指肠上部,而胰管开口于胰右叶对应十二指肠内壁乳头.结论 小型猪正常胰腺MR成像显示良好;解剖上小型猪胰腺形态和胰胆管汇入方式与人类有所不同.%Objective To observe the MRI findings of normal pancreas in piglets. Methods Eight healthy piglets underwent MR examination, and the morphology, size, signal intensity of pancreas were observed. After MR imaging, all piglets were abdominally incised to observe the anatomy of pancreas and pancreatic adjacent structures. The opening of both common bile duct and pancreatic duct were detected during operation. Two piglets were sacrificed after operation and the whole pancreases were dissected for anatomic research. Results The pancreas of piglets was composed of three parts: right lobe, median lobe and left lobe. All the lobes were displayed clearly on MRI. The signal intensity of pancreas was higher than that of liver and spleen on T1WI, whereas lower than that of liver and spleen on T2WI. On MRCP, pancreatic duct was not presented, whereas the common bile duct could be seen clearly. The opening of common bile duct located at superior part of duodenum (nearby the pylorus) and the opening of pancreatic duct situated at duodenal papilla corresponding to pancreatic right lobe. Conclusion MRI can show the pancreas of piglets very well. The morphology of pancreas and features of

  14. Acupuncture at heterotopic acupoints enhances jejunal motility in constipated and diarrheic rats (United States)

    Qin, Qing-Guang; Gao, Xin-Yan; Liu, Kun; Yu, Xiao-Chun; Li, Liang; Wang, Hai-Ping; Zhu, Bing


    AIM: To investigate the effect and mechanism of acupuncture at heterotopic acupoints on jejunal motility, particularly in pathological conditions. METHODS: Jejunal motility was assessed using a manometric balloon placed in the jejunum approximately 18-20 cm downstream from the pylorus and filled with approximately 0.1 mL warm water in anesthetized normal rats or rats with diarrhea or constipation. The heterotopic acupoints including LI11 (Quchi), ST37 (Shangjuxu), BL25 (Dachangshu), and the homotopic acupoint ST25 (Tianshu), and were stimulated for 60 s by rotating acupuncture needles right and left at a frequency of 2 Hz. To determine the type of afferent fibers mediating the regulation of jejunal motility by manual acupuncture, the ipsilateral sciatic A or C fibers of ST37 were inactivated by local application of the A-fiber selective demyelination agent cobra venom or the C fiber blocker capsaicin. Methoctramine, a selective M2 receptor antagonist, was injected intravenously to identify a specific role for M2 receptors in mediating the effect of acupuncture on jejunal motility. RESULTS: Acupuncture at heterotopic acupoints, such as LI11 and ST37, increased jejunal motility not only in normal rats, but also in rats with constipation or diarrhea. In normal rats, manual acupuncture at LI11 or ST37 enhanced jejunal pressure from 7.34 ± 0.19 cmH2O to 7.93 ± 0.20 cmH2O, an increase of 9.05% ± 0.82% (P acupuncture at LI11 or ST37 increased intrajejunal pressure from 8.17 ± 0.31 cmH2O to 9.86 ± 0.36 cmH2O, an increase of 20.69% ± 2.10% (P 0.05), respectively. In contrast, acupuncture ST25, a homotopic acupoint, decreased not only intrajejunal pressure, but also significantly decreased frequency in normal rats and rats with constipation or diarrhea. Following demyelination of Aδ fibers, acupuncture at ST37 again augmented intrajejunal pressure to 121.48% ± 3.06% of baseline. Following capsaicin application for 24 h, acupuncture at ipsilateral ST37 increased

  15. 胃镜下胃管代替鼻肠管在重症患者中应用%The application of feeding tube instead of naso-gastric tube under gastroscope in critical patients

    Institute of Scientific and Technical Information of China (English)

    焦宪法; 李伟丽; 牛杏果; 张科; 王小雯; 赵玉洁


    [ Objective ] To observe the safety and effectiveness of enteral feeding tube as nasogastric tube instead of common nasointestenal tube with the help of endoscopy in the critical patients. [Methods] 70 cases of critical patients who received enteral nutrition by postpyloric feeding tube, were divided into naso-gastric tube group and spiral naso-in-testinal tube group. Each group was consisted of 35 cases. In naso-gastric group, naso-gastric tube instead of naso-in-testinal tube, the feeding tubes were placed with endoscopy. With the guidance of endoscopy, the pincers grasped the end of the nasogastric tube, and sent it into the pylorus, as far as possible. [ Results ] The success rate of such method which placed the naso-pyloric feeding tube with the guidance of endoscopy was 100%. There were no complications during the procedure. The feeding tube displaced into the stomach in 2 cases during the enteral nutrition, reflux in 2 cases, aspiration pneumonia 2 cases, no blockage of all feeding tubes. [ Conclusion ] Naso-gastric tube instead of common naso-in-testinal tube ,which was placed beyond postpylorus as naso-postpyloric feeding tube, was safe and effective, not prone to blockage, less reflux during enteral nutrition.%目的 探讨在重症患者中胃镜辅助下以鼻胃管代替普通鼻肠管实施肠内营养的安全性和可靠性.方法 选择需要肠内营养重症患者70例,分为胃管代鼻肠管组和螺旋型鼻肠管组,每组35例.胃管代鼻肠管组在胃镜下用异物钳钳夹鼻胃管,推送胃镜和异物钳经过幽门,尽可能送胃管达幽门以远.螺旋型鼻肠管组鼻肠管远端未在小肠者,借助胃镜完成.结果 此种胃镜下胃管代鼻肠管方法营养管放置成功率为100%.放置期间均无并发症.在使用过程中有2例出现反流,胃镜检查发现1例营养管易位于胃腔,另1例位置正常.吸入性肺炎发生率为5.7%;肠内营养期间未发生堵管现象.肠内营养支持治疗后

  16. 美洲黑石斑鱼消化道的形态结构%The morphology of the digestive tract of Centropristis striata

    Institute of Scientific and Technical Information of China (English)

    李海燕; 竺俊全; 陈飞; 丁理法


    The morphological and histological structures of the digestive tract in Centropristis striata were observed by optical microscopes. The digestive tract includes the orol-pharyngeal cavity , esophagus , stomach and intestines. The orol-pharyngeal cavity is big;there are jaw teeth, palato-teeth and vomerine teeth; tongue consists of basihyoid covered by mucosa. The esophagus, stomach and intestines stratified into mucous membrane layer, submucosa, muscularis and outer membrane. Esophageal mucosa layer villi fell into columnar epithelium and squamous epithelium; the surface of the squamous epithelium was the goblet cell layer; there are esophagealgland in the submucosa of esophagus. V-shaped stomach comprises cardia, bady of stomach and pylorus ; stomach mucosa epithelium is simple columnar epithelium; gastric gland locates in the lamina propria of cardia and bady of stomach. Intestines are schilfig and Sshaped, which are consisted by foregut, midgut and hindgut; mucous membrane layer protuberates to the gut cavity and forms volume villi; epithelium is simple columnar epithelium; the epithelial free surface contains a dense array of microvilli which form striated border; epithelium contains goblet cells whose quantity decreases from front to back; the average ratio between the length of the intestine and the body length is 1. 6. Conjunctive sites of stomach and intestine contain 3 pairs multi-finger pyloric caecum whose histologic structure is the same as intestines'.%采用解剖和光镜技术观察了美洲黑石斑鱼消化道的形态及组织学结构.消化道由口咽腔、食道、胃、肠构成.口咽腔较大,具颌齿、腭齿及犁齿;舌由基舌骨突出部分覆盖粘膜构成.食道、胃及肠均由粘膜层、粘膜下层、肌层及外膜构成.食道粘膜层绒毛分柱状上皮区及扁平上皮区,扁平上皮区表面为杯状细胞层;食道粘膜下层中有食道腺.胃呈V形,由贲门部、胃体部及幽门部组成,胃壁粘膜层上

  17. Utilização do óleo de alho e da amoxilina, metronidazol e omeprazol no controle de Helicobacter spp. em cães Use of garlic oil and amoxicillin, metronidazole, and omeprazol in the control of Helicobacter spp. in dogs

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    M.C. Costa


    mucosa biopsies. Treatment with amoxicillin, metronidazole, and omeprazol resulted in eradication of Helicobacter spp. both in fundic and pyloric regions. The garlic oil treatment reduced glandular degeneration in the fundic region in two animals and in the pylorus region in two other animals, and it was inefficient in eradicating Helicobacter spp. in dogs as it only reduced the colonization in some of the treated animals.


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    macroscopic subtype was Borrmann type II with 24 (48%. Majority of the cases were well differentiated adenocarcinoma, which is 30 (60% cases of which females had higher percentage of poorly differentiated tumours, i.e. 6 (27.2% cases. CONCLUSION This study was undertaken to study the prevalence of gastric cancer as occurring in Adichunchanagiri Hospital, Mandya, which is a rural hospital with a large input of cases from Mandya and its surrounding districts. In this study, gastric cancer was more prevalent in males. Majority of the patients belonged to the lower socioeconomic strata and had association of risk factor. Blood Group A was the prevalent blood group. The disease was more prevalent in patients above age of 45 with the oldest being 78. Majority presented in the advanced stage of the disease, although there were few cases which presented in the early gastric carcinoma stage. The pylorus remained the most common site of affliction in contrast to western countries, which have showed a consistent shift towards proximal tumours. The major percentage of the tumours was well differentiated. The finding of this study are comparable to other similar studies in India and proximal tumours continue to be the major subtype in this part of the world and association of risk factor increase the likelihood of an individual developing gastric cancer.

  19. The Clinical Application of the Duodenum Closed Exclusion%十二指肠缝闭式旷置术临床应用研究

    Institute of Scientific and Technical Information of China (English)

    张钦增; 侯化丽; 张利标; 金鑫; 孙宗林


      目的:比较幽门旷置十二指肠憩室化各种术式,探讨十二指肠缝闭式旷置术的临床应用可能性及方法。方法:通过近12年32例十二指肠缝闭式旷置术患者的临床资料分析,对比其他手术方法,观察手术并发症、手术时间及术后恢复情况。结果:32例患者中2例出现胃瘫,经禁食、胃肠减压、肠内外营养等,分别与本次手术后第15天、21天恢复;1例切口感染,经换药痊愈;1例胃癌晚期患者出院后半年因恶性消耗衰竭而亡,其余患者恢复顺利,无近期与手术有关死亡病例。结论:十二指肠缝闭式旷置术术式简便、缝闭准确、并发症少、手术时间短、创伤小、更符合损伤控制原则,尤其适用于损伤严重、年老体弱及术中生命体征不平稳者。%Objective:To compare various duodenal diverticulization operation with pylorus exclusion,investigate the possibility of clinical application and method of the duodenum closed exclusion. Method:According to the clinical data of 32 cases with the duodenum closed exclusion during the past 4 years,to compare with others technique,observe the complication,operative time and postoperative recovery. Result:In the 32 cases,2 cases recovered in the postoperative fifteenth day and twenty-first day which occured gastroplegia. 1 case occurred postoperative infection and recovered after change dressings,1 case with advanced stage of gastric carcinoma died after half a year,because of cachexy. Others successfully recovered,and there was no dead case who was relevant to operation in the near future. Conclusion:The duodenum closed exclusion is convenient and accurate,the trauma is little and complication is few,the operative time is short,it is more coincident with the principle of damage control,especially applies to these cases who are aged and physically weak,injure severely and don’t have stable vital sign during operation.

  20. The value of high frequency ultrasound in diagnosis of foreign body in children's digestive tract%高频超声在儿童消化道异物诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    王晓曼; 贾立群


    目的 探讨高频超声在儿童消化道异物诊断中的应用价值.方法 回顾性分析我院9例经超声诊断并经胃镜或手术证实的消化道异物患儿(年龄9个月至11岁)的超声声像图特点,并与X线平片结果对照.结果 9例患儿超声均清晰显示异物具体位置及与周围脏器关系.2例异物嵌顿在幽门并造成幽门和(或)邻近器官损伤,小肠内磁铁异物造成闭襻梗阻1例,腹腔内鱼刺异物包裹1例,其余分别位于胃内3例,十二指肠1例,结肠1例,均未造成脏器损伤.所有异物的超声表现均为强回声,无声影.7例同时行平片检查,均仅显示异物位于上、中、下腹区域.结论 高频超声检查可以清晰显示异物的位置,与周围脏器的关系,弥补X平片的不足,有助于治疗方案的选择.%Objective To evaluate the value of high frequency ultrasound in diagnosis of foreign body in digestive tract. Methods The ultrasound features of 9 patients ( the ages ranging from 9 month to 11 years old ) with ingested foreign bodies were retrospectively analysed and were diagnosed by ultrasound. The results were confirmed by endoscopy or operation. The X-ray film findings were also compared.Results The location and relationship with surround organs of all the foreign bodies were clearly demonstrated by ultrasonography. The foreign body was stuck into pylorus and the adjacent organs were injured in 2 cases. The magnet in bowel led to obstruction in 1 case. A fishbone that was wrapped up was located in one abdomen lumen.Others were located in stomach ( 3 cases ), duodenum ( 1 case ) and colon( 1 case ),and the surrounding organs were not injured. All the foreign bodies in our group were hypoechogenic without shadow. In X-ray film, the un-radiolucent foreign body could be detected, but the relationship with surrounding organ could not be definitely identified. Conclusion The high frequency ultrasonography can definitely identified the location of foreign body

  1. Design and application of multifunctional stomach clamp

    Institute of Scientific and Technical Information of China (English)

    Yun Fu Lu; Pi Wu Li; Xir Xin Zhang


    AIM Pylorus and pyloric vagus preserving gastrectomy (PPVPG) is an efficient operation mode for treatinggastric and duodenal ulcers. For its better application and popularization, we have designed andmanufactured a special multifunctional stomach clamp.METHODS The clamp has been designed carefully in view of the different sizes of the patients' stomachsand the different starting points of Latarjer nerves so as to facilitate the execution of the present operationmode, which requires the preservation of the vagus innervated pyloric region so as to make the remnantstomach maintain its normal physiological function and the vagus branches clinging antral seromuscular flapkept in proper size so that avoiding too much remaining antral mucosa is removed to cause greater difficultyin operation. With this in view, we observed and measured the distance between the Latarjer nerves distribution and the pyloric rings of 42 patients' stomachs in the course of operations. We bent an aluminumstring 3 mm thick for each stomach according to the size of antral seromuecular flap and chose an optimalcurvature from the 42 sizes for manufacturing the clamp. The clamp is made of 3 Cr13 stainless steel,consisting of three parts, the curved head, the fastening ring and the handle. The curved head is shapedalmost exactly like the remained antral seromuscular flap. The ring at its tip when in place fastens the twosides of the clamp so that the tissue of the stomach between will be clutched by an even force. On one sideare three cuts for moving the ring upwards, each cut representing 1 mm for fastening and adjustments can bemade in view of the thickness or thinness of the tissue. The handles bend backward for fighting shy of thecuts so as to facilitate the operation.RESULTS With the stomach disassociated in the light of PPVPG procedures, the clamp may easily beapplied from the upper part of the Latarjer nerves. The following merits can be noted. ① The curving line ofthe flap can be precisely

  2. Gastroprotective effects of the essential oil of Hyptis crenata Pohl ex Benth. on gastric ulcer models. (United States)

    Diniz, Lúcio Ricardo Leite; Vieira, Charliene Freire Xavier; Santos, Edgleyson Chaves Dos; Lima, Glauber Cruz; Aragão, Kalynca Kayla Viana; Vasconcelos, Renata Prado; Araújo, Pâmella Cristina da Costa; Vasconcelos, Yuri de Abreu Gomes; Oliveira, Ariclécio Cunha de; Oliveira, Hermógenes David de; Portella, Viviane Gomes; Coelho-de-Souza, Andrelina Noronha


    Hyptis crenata Pohl ex Benth (Lamiaceae), popularly known as "hortelã-brava" or "hortelã do campo", is widely distributed in the northeast of Brazil. In Brazil, the leaves of this plant have been used in traditional medicine for the treatment of gastrointestinal disturbances, including gastric ulcers. In an attempt to experimentally validate this claimed antiulcerogenic activity, the gastroprotective effects of the essential oil extracted from the leaves of the Hyptis crenata Pohl ex Benth (EOHc) were evaluated in recognized gastric ulcer models in mice. EOHc was obtained by hydrodistillation and analyzed using gas chromatography-mass spectrometry (GC-MS). Swiss male mice (25-30g) were used for the studies. The gastric ulcers were induced by oral administration of absolute ethanol or indomethacin 45min after oral pretreatment with EOHc, vehicle and positive control drugs. One hour after the ulcerative challenges, the stomachs were removed and the area of the lesions was measured. The volume, pH and total acidity of the gastric secretions were determined using the pylorus ligature model. The gastrointestinal motility was measured using gastric emptying and intestinal transit. The ethanol-induced gastric mucus depletion and lipid peroxidation were also analyzed. Our findings are as follows: A significant inhibition of gastric lesions induced by absolute ethanol was observed in the mice pre-treated with EOHc, at a dose of 30 and 100 and 300mg/kg (5.56±1.51, 2.88±0.82 and 1.71±0.54mm(2), respectively) compared to control group (118.03±35.4mm(2)). Also, EOHc (300mg/kg) produced a gastroprotective effect against the gastric lesions induced by indomethacin (16.07±4.68mm(2)) compared to control group (38.64±6.1mm(2)). EOHc pretreatment produced a reduction in the ethanol-induced lipid peroxidation from 3.9±0.22 to 2.4±0.1μmol/mg tissue (EOHc-300mg/kg and control group, respectively). We also observed that EOHc pretreatment decreased the gastric emptying, but did

  3. Expression of heat shock protein 27 in the esophageal tissue of rats with reflux esophagitis

    Institute of Scientific and Technical Information of China (English)

    ZHENG Chao-xu; WANG Zhuo-qing; LIN Wei-bin; CHU Zhong-hua; CHEN Liu-hua; JI Zhuang-qi


    Background Little attention has been paid to the expression of heat shock protein 27 (HSP27) in patients with reflux esophagitis (RE), and few studies of the importance of HSP27 in esophagitis have been carried out in animal models.This study aimed to explore the expression of HSP27 in the esophageal tissue of rats with RE. Methods Eighty female Wistar rats were randomly divided into experimental groups A and B and control groups C and D (n=20 in each group). To establish RE, rats in the two experimental groups received pylorus and forestomach ligations,while rats in the control group received gastrostomy and gastric perforation repair. The rats in groups A and C were sacrificed 7 days after surgery, and the rats in groups B and D were sacrificed 14 days after surgery. In groups A and B,10 and 8 rats were diagnosed with RE by pathological examination, respectively (they were included in groups A' and B',respectively). The histopathological diagnosis of all the lower esophageal tissues in groups C and D was normal and 20normal specimens were randomly selected for groups C and D' with 10 specimens in each group. Macroscopic and microscopic esophagitis scores were assessed for the specimens in groups A' and B'. Lower esophageal tissues were collected from groups A', B', C, and D', and paraffin-embedded slices were made using part of the tissues. The expression of HSP27 in the tissues was detected using the two-step streptavidin-peroxidase immunohistochemical method. Some collected tissues were frozen, and expressions of HSP27 mRNA were detected using fluorescence quantitative polymerase chain reaction (FQ-PCR). Results Median macroscopic and microscopic esophagitis scores in groups A' (n=10) and B' (n=8) were 1.0 and 1.5,and 2.0 and 2.5, respectively. There were no significant differences in the macroscopic or microscopic esophagitis scores between the two groups (Z=-0.330, P=0.741; Z=-0.142, P=0.887, respectively). Immunohistochemical staining showed that HSP27 was

  4. 皇冠沙鳅消化道组织学观察%Histological Observation on Digestive Tract of Chromobotia Macracanthus

    Institute of Scientific and Technical Information of China (English)

    史晋绒; 杨琴; 王永明; 谢碧文


    采用解剖和光镜技术对皇冠沙鳅消化道的结构进行了详细观察.结果表明:皇冠沙鳅的消化道由口咽腔、食道、胃、肠及肛门5个部分组成,肠道系数为(0.53±0.02),为典型的肉食性鱼类.口咽腔及食道粘膜层上皮为复层扁平上皮,内含杯状细胞、粘液细胞,偶见味蕾分布;胃“U”形,粘膜层上皮为单层柱状上皮,无杯状细胞,贲门部及胃体部具丰富胃腺,幽门部稀少甚至消失,幽门部肌肉层发达.肠由前肠、中肠和后肠3个部分组成.前肠粘膜褶皱数最多,中肠粘膜褶皱最高,后肠杯状细胞最多且肌肉层最厚.皇冠沙鳅消化道的组织结构特点与其消化和吸收作用关系密切.%In order to investigate the relationship between histological structure of the digestive tract and the feeding habits of C .macracanthus ,morphology and histology of the digestive tract in C .macracanthus have been observed by vivisection and microscope technology . T he results are as follow s :the digestive tract of C . macracanthus is composed of buccopharyngeal cavity , oesophagus , stomach , intestine and anus .The relative gut length of these specific species is (0 .53 ± 0 .02) .There are a lot of goblet cells ,mu‐cous secretory cells and a few of taste buds in the stratified squamous epithelia of buccopharyngeal cavity and oesophagus .The stomach is “U” shaped and the mucosa epithelia is simple columner epithelium . There are no goblet cells in the mucosa epithelia ,but gestric glands in the cardiac and the fundic portion of stomach are abundant .The muscular coats of the pylorus portion is well‐developed .The intestine is com‐posed of cranial intestine ,mid intestine and retral intestine .With changes from cranial intestine to retral intestine ,the number of mucosal flods is reduced ,the number of goblet cells and the thickness of muscular coats are increased .Meanwhile ,the mucosal flods of

  5. clinical Applications of capsule Endoscopy%胶囊内镜的临床应用

    Institute of Scientific and Technical Information of China (English)

    言红健; 鲁素彩; 田自力; 王阳阳


      Objective To assess the value and summarize the expierence of clinical applications of capsule endoscopy. Methods From June 2008 to June 2011, 67 male and 52 female patients aged 21-83 years old were examined with capsule endoscopy in our hospital. The examinations were generally conducted from 8:00 to 11:00 AM and polyethylene glycol elect rolyte powder was used for bowel preparation. Results Less than 60 min were taken to pass throgh the pylorus in 104 cases, and more than 120 min in 14 cases. Intramuscular injection of metoclopramide was applied to facilitate movement of the capsule endoscopies in 12 cases, and flexible endoscope in 2 cases. After 1-3 days, the capsule endoscopies were usually excreted from the bowels. Small intestine examination was completed in 103 case (88.65%), while total colon examination in 3 cases (2.52%). The detection of jejun-ilealintestinal, gastroduodenal and colonic lesion were 33.05%, 33.61% and 2.54%respectively. There occurred a few complications, including a case of incarcerated pyriform sinus and a case of capsule retention. conclusion With its security, convenience, good-compliance and less complications, capsule endoscopy is highly significant for diagnosis of small intesinal lesions.%  目的总结和探讨胶囊内镜应用价值和体会.方法2008年6月至2011年6月河北大学附属医院胶囊内镜检查119例,男性67例,女性52例,年龄21~83岁,检查前服用聚乙二醇电解质散清洁肠道,吞服胶囊时间为8:00-11:00.结果胶囊通过幽门时间:120 min 14例,其中12例应用胃复安10 mg,肌肉注射,通过幽门,2例内镜协助胶囊通过幽门.胶囊排出时间:多为1~3 d.小肠检查完成103例(86.55%),全结肠检查完成3例(2.52%).小肠病变检出率为33.05%,胃十二指肠病变检出率为33.61%,结肠病变检出率为2.54%,总阳性率为69.49%.并发症:梨状窝胶囊嵌顿1例;胶囊滞留1例.结论胶囊内镜检查安全、方便、依从性好、并

  6. Efeito da administração de cogumelo tibetano, um consórcio microbiano, sobre a peristalse intestinal em ratos Effect of the administration of Tibetan mushroom, a microbial consortium, on the intestinal peristalsis in rats

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    Luiz G.V. Cardoso


    other groups treated with distilled water (1,5 mL/animal. After 15 days the animals were maintained in fast for 24h, and treated with suspension CT (1,5 mL/animal/v.o, distilled water (control, 1,5mL/animal/v.o, acetylcholine (1mg/kg/s.c and atropine (1mg/kg/i.m. After 30 min, the animals received a suspension of active coal 10% (0,1 mL/10g, v.o, after the euthanasia, excision of the portion of the pylorus to the beginning of the cecum, and determination of the distance traveled by the coal. The administration of the CT suspension increased the intestinal peristalsis in 68,7% and the other treatments presented the following percentages: atropine 20,2%, acetylcholine 78,7% and control 42,9% (p < 0,05, ANOVA followed by Tukey-Kramer test. Those results showed that the CT suspension stimulated the peristalsis in the animals, what suggests a positive effect in the digestion and alimentary absorption for the microbial consortium.


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    Suresh Kumar


    Full Text Available BACKGROUND Gastric Outlet Obstruction implies complete or incomplete obstruction of the distal stomach pylorus or proximal duodenum. (1 Gastric outlet obstruction poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. There is no sufficient data on this subject in our setting. Studies throughout the world shows drastic reduction in peptic ulcer disease (PUD after Proton Pump Inhibitor (PPI era. (1 This study was undertaken to highlight the etiology and treatment of Duodenal Ulcer (DU and its most important complication, gastric outlet obstruction in Tertiary Hospital in South India. This study was done in SRM Medical College Hospital and Research Centre, Chennai, where in for all Gastric Ulcer (GU and Duodenal Ulcer (DU patients, eradication of H. Pylori has become a standard treatment. Surgical treatment is required for complications of peptic ulcer disease. (1 The aim of the study are two: first to analyze sex and age distribution of GU and DU and second to study the various types of management. MATERIALS AND METHODS This study on PUD and Gastric Outlet Obstruction (GOO is based on a study of 50 cases that were admitted in SRM Medical College Hospital and Research Centre during the period of October 2014 to September 2015. The patients were evaluated by routine investigations like upper gastrointestinal endoscopy and ultrasonography of the abdomen. Barium meal and CECT abdomen in selected cases. All cases were taken up for curative/palliative surgery and operated depending upon the causes. All patients with a clinical diagnosis of gastric outlet obstruction were included after informed consent for the study, consecutively enrolled into the study. Statistical data analysis was done using SPSS computer software version 17.0. RESULTS In 37 cases, carcinoma of antrum with gastric outlet obstruction was found. Males are 25 (68% and females are 12 in numbers (32%. In 12 cases of chronic duodenal


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    Yeganathan Rajappan


    present in 80% to 86% of cases; 48.5% of the cases of perforated ulcer were in shock at the time of admission. The size of perforation is less than 5 mm in 13/81 cases. In only 9/81 cases the size was more than 10 mm, in 59/81 of cases the size was 5 to 10 mm. The site of perforation in 77 cases is on the anterior wall of first part of duodenum, 4 cases showed perforation at pylorus/Gastroduodenal junction. History of taking NSAID is an important aetiological factor in our study, persons having this history showed perforations of related larger size and higher incidence of death. In 96.3% of the cases, the operative procedure adopted is simple closure of the perforation with live omental patch. The longer the time interval between perforation of peptic ulcer and the operation, morbidity and mortality is high. Postoperative complications are seen more in cases with comorbid conditions like Diabetes Mellitus, Hypertension, Old age, Ischaemic heart disease. Average duration of stay in hospital after surgery in this study is 13.4 days. At MGM Hospital, Trichy in 81 cases of Peptic ulcer perforation studied from December 2014 to August 2015, the mortality rate is 13.5%. CONCLUSION Smoking, Alcohol intake, Stress and NSAID intake, Blood group has significant association with peptic ulcer perforation. Out of 81 patients studied, 11 deaths occurred and the mortality rate is 13.5%. Duration between onset of perforation and management is the most significant predictor for mortality. Associated comorbid conditions have significance in secondary outcomes, but does not show significant association to death.

  9. Ultramorphology of digestive tract of Anticarsia gemmatalis (Hübner, 1818 (Lepidoptera: Noctuidae at final larval development/ Ultramorfologia do trato digestivo de Anticarsia gemmatalis (Hübner, 1818 (Lepidoptera: Noctuidae no final do desenvolvimento larval

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    Luis Antônio Toledo


    Full Text Available The digestive tract of insects is an important natural, physical, and chemical defense barrier against pathogen invasion. Certain lepidopteran caterpillars are serious pests of agricultural crops and their biology has received much attention, but little is known about the larval noctuid gut. The morphological analysis of the digestive tract in Anticarsia gemmatalis under scanning electron microscopy (SEM is a good model for studies about its defense mechanism. The material was fixed (2,5% glutaraldehyde solution; 0.1M-phosphate buffer, pH 7.3, post-fixed (1% osmium tetroxide in the same buffer, dried at critical point, gold coated and analyzed in a SEM 515-Philips. A. gemmatalis digestive tract consists of a straight duct of varying length and diameter, subdivided in three main regions: the foregut formed by the oral cavity, pharynx, esophagus, and crop; the midgut that is the largest portion of the digestive tract without noticeable morphological differentiation along its length; and the hindgut that is morphologically differentiated in pylorus, ileum, colon, and rectum. Although the general morphology of the A. gemmatalis digestive tract is quite similar to the other Lepidoptera species, the anatomical array of the crop muscular layers is quite different comparing with the description for other larval insect.O trato digestivo dos insetos constitui uma importante barreira físico-química natural contra invasão de patógenos. Algumas larvas de lepidópteros são consideradas pragas agrícolas potenciais e sua biologia tem recebido muita atenção; no entanto, pouco se sabe sobre a morfologia do sistema digestivo. A análise morfológica do trato digestivo de Anticarsia gemmatalis em nível ultraestrutural é um método bastante eficaz para o estudo dos seus mecanismos de defesa. Os materiais foram fixados (solução de glutaraldeído 2,5%; 0.1M tampão fosfato, pH 7.3, pós-fixados (tetróxido de ósmio 1% no mesmo tampão, desidratados em

  10. Differential expression of Orexin A in gastrointestinal tract betw een yak and cattle%Orexin A在牦牛和黄牛消化道中的表达差异

    Institute of Scientific and Technical Information of China (English)

    丁艳平; 孟媛; 张晋平; 邵宝平


    通过分析促食欲素A(Orexin A)在牦牛和黄牛消化道不同部位的分布特征及表达差异,探讨Orexin A对牦牛能量代谢的调节作用.运用免疫组织化学SP法检测Orexin A在牦牛和黄牛胃肠道的表达,利用Image‐ProPlus 6.0软件对其表达强度进行半定量分析.结果表明, Orexin A在牦牛和黄牛的皱胃、幽门、贲门和十二指肠均有表达,但表达特征不同;牦牛胃和十二指肠中Orexin A阳性反应产物极显著地低于黄牛(P<0.01);牦牛胃肠道中Orexin A阳性反应产物的吸光度分布为:皱胃区>幽门区>贲门区>十二指肠区(P<0.01).推测牦牛通过胃肠道Orexin A的低表达,调节中枢及外周组织的激素水平,从而维持机体能量代谢水平,适应青藏高原的特殊环境.%To explore the regulation effect of Orexin A on energy metabolism of yak by analyzing the difference of distribution and expression in gastrointestinal tract between yak and cattle . Immunohistochemistry is used to localize the expression of Orexin A in the gastrointestinal tract of the yak ,Image‐ProPlus 6.0 software is used to semi‐quantitative analyse the intensity of expression of Orexin A . Results show that Orexin A is widely expressed in the abomasum ,pylorus and duodenum cardia in yak and cattle ,which have different expressional characteristics ;The mean absorbance of Orexin A positive reaction product in stomach tissue and duodenum of yak is significantly lower than that of cattle ( P<0.01);By comparing the mean absorbance of Orexin A positive reaction product in the yak , it is found that its expression from strong to weak successively is abomasums area , pyloric region , cardiac region , and then duodenum area (P<0.01) .It indicats that the lower expression of Orexin A could regulate the hormone levels in the central and peripheral tissues to maintain its energy balance to adapt to the extreme environment of the Tibetan

  11. Effect of traditional Chinese herbal preparation Cudong Tongbian capsule on gastrointestinal motility%促动通便胶囊影响胃肠道动力功能的效应

    Institute of Scientific and Technical Information of China (English)



    residual rate = (gastric methyl orange optical density/basic methyl orange absorbence)×100%.②Intestinal movement experiment was carried out with BMT as the standard control.Fifty SD rats were randomized into five groups, namely normal saline group (0.2 mL/20 g), CDTB high dose (10 g/kg) and low dose (5 g/kg) groups, and BMT high-dose (10 g/kg) and low-dose (5 g/kg) groups.CDTB capsule and BMT were dissolved in normal saline for gastric lavage at 0.2 mL/20 g twice a day for 3 consecutive days.Thirty minutes after the last administration, 100 g/L active carbon was used for gastric larvae at the dose of 0.2 mL/20 g.Thirty minutes later, the rats were killed and the mesentery was isolated with the intestines between the pylorus and ileocecal junction taken for examination.The carbon powder movement rate= distance between the pylorus and the farthest carbon powder / total distance between the pylorus and ileocecal junction×100%.③ BMT was used as the standard control in defecation experiment.The grouping and drug administration were similar to those in intestinal moving experiment.The fecal amount within 7 days and the first fecal time after drug administration were recorded, and the fecal wet weight and dry weight (dried at 65 ℃ for 12 hours) were used to calculate fecal water content, and higher water content was thought to facilitate defecation.④ Intestinal water absorbent experiment was performed with BMT and glycerol as the standard controls.After a fast for 24 hours, the rats were anaesthetized by intraperitoneal injection of urethane and the ileocecal junction was ligated, with the intestine above the ileocecal junction ligated into 5 segments where normal saline, glycerol in 0.2 mL normal saline,BMT (10 g/kg), and CDTB at high (10 g/kg) and low doses (5 g/kg) were injected respectively.The rats were killed 2 hours after closure of the incision and edema of each intestinal segment and the intestinal perimeter was observed or measured, with the wet weight and

  12. 经口内镜肌切开术治疗贲门失弛缓症的实验及临床经验初探%Animal experiment and clinical pilot study of peroral endoscopic myotomy for achalasia

    Institute of Scientific and Technical Information of China (English)

    龚伟; 智发朝; 刘思德; 谢露; 郭智慧; 叶秀杰; 周丹; 黄颖; 姜泊


    Objective The procedure of peroral endoscopic myotomy (POEM) was practiced in porcine esophagus-stomach model and the efficacy and safety of POEM for patients with achalasia were evaluated.Methods The ex-vivo esophagus-stomach was obtained and the pylorus was closed by hemostatic forceps.The entrance of the esophagus was fixed to foamed plastics.To perform POEM,a submucosal tunnel was created,after which the circular muscle layer was dissected and the mucosal entry was finally closed with clips.After successful animal experiment,we performed POEM on 4 patients with achalasia.Results POEM was completed in 5 porcine training models,in which 2 procedures were successful without any complication,2 were complicated with perforation in muscularis propria layer and 1 with rupture in mucosal layer.POEM was successfully performed in 4 patients with achalasia,with a mean operation time of 110min.The mean length of the submucosal tunnel was 10.5cm ( ranging 8-11 cm) and the mean length of myotomy of circular muscle layer was 7 cm (ranging 5-8 cm).The resting pressure of lower esophageal sphincter (LES) decreased from 52.4 mm Hg before POEM to 19.9 mm Hg.Massive bleeding occurred at the gastroesophageal junction in the first case and perforation occurred in mucosal layer during endoscopic hemostasis.All patients were followed up for 1-4 months,and the symptom of dysphasia was relieved significantly.Conclusion The ex-vivo esophagus-stomach model can be used as training model for procedure of POEM,enabling endoscopists with enough experience for its use in patients.POEM is an effective therapy for achalasia,while the long-term efficacy and managements for complications are still to be elucidated.%目的 利用猪食管-胃模型进行经口内镜肌切开术(POEM)实验,为临床开展POEM术积累经验并探讨POEM治疗贲门失弛缓症的安全性和有效性.方法 止血钳结扎离体猪的胃幽门出口,并将离体猪的食管口侧末端固定于带孔泡沫塑料,

  13. 胃癌17号染色体异倍体改变及TP53和拓扑异构酶Ⅱα蛋白过表达与病理诊断的相关性%Correlation between aneuploidy of chromosome 17,over-expression of TP53 and TOP Ⅱα,and the clinicopathoiogical features and diagnosis of gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    鲁海珍; 吴玉鹏; 罗巍; 韩亚玲; 蔡岩; 徐昕; 梁晶; 刘尚梅; 王明荣


    Objective The purpose of this study was to investigate the markers which can be used in auxiliary diagnosis of gastric adenocarcinoma (GAC),and their correlation with their clinicopathological features.Methods 122 surgical specimens including 99 gastric adenocarcinoma (GAC),18 adjacent mucosa and 5 distal normal mucosa were collected,and analyzed by in situ hybridization (FISH).The centromere probe cen17,specific for chromosome 17,which was reported to be frequently amplified in GAC,was selected for the FISH analysis.The clinicopathological features of the 99 GAC cases were reviewed,and the level of TP53 and TOP Ⅱα gene expression,located in chromosome 17,was detected using tissue microarray (TMA),compared with that of corresponding adjacent normal mucosa.Data were analyzed with SPSS 11.5 for Windows.Results The statistical results of FISH and TMA showed that 58.6% of cen17 in tumor tissues were aneuploid,and 45.5% of TP53 and 84.7% of TOP Ⅱα were over-expressed in GAC samples,significantly higher than those in non-tumor gastric mucosa (0,12.1% and 14.1%,respectively) (P =0.000).58 GAC tissues were aneuploid of cen 17,including 26 cases TP53-positive and 49 cases TOP Ⅱα-positive.The expression of TP53 in non-tumor gastric mucosa with dysplasia was significantly higher than that in the mucosa without dysplasia (P=0.009).Aneuploidy of cen17 was more frequent in grade 1 or 2 than in grade 3 GAC(P<0.05).Higher frequency of aneuploidy of cen17 was also observed in the gastric cardia than in pylorus (P<0.05),while no correlation was found between aneuploidy of cen17 and age,sex of patients,lymph node metastasis,and clinical stage of tumors.Over-expression of TP53 protein was associated with the size of tumors (P<0.05).In addition,a negative correlation was observed between over-expression of TOP Ⅱα and lymph node metastasis (LNM) as well as TNM classification (P<0.05).Conclusion Detection of aneuploidy of cen17 as well as over-expression of TP53 and


    Müller, Verena; Fikatas, Panagiotis; Gül, Safak; Noesser, Maximilian; Fuehrer, Kirs Ten; Sauer, Igor; Pratschke, Johann; Zorron, Ricardo


    Bariatric surgery is currently the most effective method to ameliorate co-morbidities as consequence of morbidly obese patients with BMI over 35 kg/m2. Endoscopic techniques have been developed to treat patients with mild obesity and ameliorate comorbidities, but endoscopic skills are needed, beside the costs of the devices. To report a new technique for internal gastric plication using an intragastric single port device in an experimental swine model. Twenty experiments using fresh pig cadaver stomachs in a laparoscopic trainer were performed. The procedure was performed as follow in ten pigs: 1) volume measure; 2) insufflation of the stomach with CO2; 3) extroversion of the stomach through the simulator and installation of the single port device (Gelpoint Applied Mini) through a gastrotomy close to the pylorus; 4) performance of four intragastric handsewn 4-point sutures with Prolene 2-0, from the gastric fundus to the antrum; 5) after the performance, the residual volume was measured. Sleeve gastrectomy was also performed in further ten pigs and pre- and post-procedure gastric volume were measured. The internal gastric plication technique was performed successfully in the ten swine experiments. The mean procedure time was 27±4 min. It produced a reduction of gastric volume of a mean of 51%, and sleeve gastrectomy, a mean of 90% in this swine model. The internal gastric plication technique using an intragastric single port device required few skills to perform, had low operative time and achieved good reduction (51%) of gastric volume in an in vitro experimental model. A cirurgia bariátrica é atualmente o método mais efetivo para melhorar as co-morbidades decorrentes da obesidade mórbida com IMC acima de 35 kg/m2. Técnicas endoscópicas foram desenvolvidas para tratar pacientes com obesidade leve e melhorar as comorbidades, mas habilidades endoscópicas são necessárias, além dos custos. Relatar uma nova técnica para a plicatura gástrica interna

  15. The diagnotic significance of the capsule endoscopy for intractable gastrointestinal hemorrhage in the elderly%胶囊内镜对老年人不明原因消化道出血的诊断价值

    Institute of Scientific and Technical Information of China (English)

    言红健; 鲁素彩; 田自力; 王阳阳


    no positive observation in them with gastroscope and colonoscopy. The examinations were generally conducted at the 1st or 2nd weeks after hemorrhage was stopped. Polyethylene glycol elect rolyte powder was used for bowel preparation, ranging in time from 8:00 to 11:00 AM. Results One petient could not swallow the capsule. Less than 60 min were taken to pass throgh the pylorus in 25 cases, and more than 120 min in 6 cases. Intramuscular injection of metoclopramide was applied to facilitate movement of the capsule endoscopies in 5 cases, and flexible endoscope in 1 cases. After 1-4 days, the capsule endoscopies were usually excreted from the bowels, small intestine examination was completed in 29 case (90.62%). The positive results were shown in 26 cases. Among them, 13 cases (50.00%) had small intestine erosion or ulcer, 6 cases (23.07%) had polyposis of small intestine, 5 cases (19.23%) had dysplasia of small intestine vessels including vessel exposure and anomalies, 2 cases (7.69%) had small intestinal tumor. The total positive rate of small intestine diseases was 81.25%, 5 cases was negative. Conclusion With its security, convenience, good-compliance and less complication for the elderly, capsule endoscopy is highly significant for diagnosis of small intesinal lesions so long as we learn its indictions and choose the best time for conduction.

  16. Risk factors of pancreatic leakage after pancreaticoduodenectomy

    Institute of Scientific and Technical Information of China (English)

    Yin-Mo Yang; Xiao-Dong Tian; Yan Zhuang; Wei-Min Wang; Yuan-Lian Wan; Yan-Ting Huang


    AIM: To analyze the risk factors for pancreatic leakage after pancreaticoduodenectomy (PD) and to evaluate whether duct-to-mucosa pancreaticojejunostomy could reduce the risk of pancreatic leakage.METHODS: Sixty-two patients who underwent PD at our hospital between January 2000 and November 2003 were reviewed retrospectively. The primary diseases of the patients included pancreas cancer, ampullary cancer, bile duct cancer, islet cell cancer, duodenal cancer, chronic pancreatitis, pancreatic cystadenoma, and gastric cancer.Standard PD was performed for 25 cases, PD with extended lymphadenectomy for 27 cases, pylorus-preserving PD for 10 cases. A duct-to-mucosa pancreaticojejunostomy was performed for patients with a hard pancreas and a dilated pancreatic duct, and a traditional end-to-end invagination pancreaticojejunostomy for patients with a soft pancreas and a non-dilated duct. Patients were divided into two groups according to the incidence of postoperative pancreaticojejunal anastomotic leakage: 10 cases with leakage and 52 cases without leakage. Seven preoperative and six intraoperative risk factors with the potential to affect the incidence of pancreatic leakage were analyzed with SPSS10.0 software. Logistic regression was then used to determine the effect of multiple factors on pancreatic leakage.RESULTS: Of the 62 patients, 10 (16.13%) were identified as having pancreatic leakage after operation. Other major postoperative complications included delayed gastric emptying (eight patients), abdominal bleeding (four patients), abdominal abscess (three patients) and wound infection (two patients). The overall surgical morbidity was 43.5% (27/62). The hospital mortality in this series was 4.84% (3/62), and the mortality associated with pancreatic fistula was 10% (1/10). Sixteen cases underwent duct-to-mucosa pancreaticojejunostomy and 1 case (1/16, 6.25%) devel-oped postoperative pancreatic leakage, 46 cases underwent invagination pancreaticojejunostomy and 9

  17. Variation and treatment of vessels in laparoscopic right hemicolectomy. (United States)

    Ye, Kai; Lin, Jianan; Sun, Yafeng; Wu, Yiyang; Xu, Jianhua; He, Songbing


    the middle colic vein (MCV) are relatively difficult. With the SMV and pancreas as anatomic landmarks, it is more feasible to locate the blood vessels in the neck of the pancreas. The middle colic artery (MCA) originates from the superior mesenteric artery (SMA), and the distance from the inferior border of the pancreas differs slightly in the literature, but is at the most 5 cm. Identification of the MCA trunk and branches, as well as the common origin of the MCA and RCA, is of great importance for the maintaining the blood supply during surgery for primary colon cancer. The MCV mainly drains into the SMV and GCT; however, if branching variation drains into the jejunal vein, inferior mesenteric vein, or splenic vein, the effect is serious when a vessel is torn. Isolation of the GCT is the step at which bleeding will likely occur in standard right resection and is a difficult stage of the surgery. The GCT has five origins including the right gastroepiploic vein (RGV), right colic vein (RCV), accessory right colic vein (ARCV), pancreaticduodenal vein (PDV), and MCV, which can have 2, 3, or 4 branches; therefore, familiarity with variants may be helpful to avoid bleeding. Approximately 5-10% of colon cancers at the hepatic flexure have No. 6 group lymph node metastasis, and laparoscopic radical extended right hemicolectomy requires thorough dissection of No. 6 group lymph nodes and the omental arcade 10 cm from the pylorus. The inferior arteriovenous vessels are a common source of bleeding, and the RGV can serve as a clue to finding the artery. The core area of laparoscopic radical extended right hemicolectomy includes the pancreatic neck, duodenum, and right gastroepiploic vessels. The difficulty lies with the standard treatment of the GCT. A medial-to-lateral approach is more in line with the principle of no-touch in tumor surgery and is applied from lower to upper, inside to outside, and left to right, for both the vessels and plane of dissection. Familiarity with

  18. Weight loss and morphometric study of intestinal mucosa in rats after massive intestinal resection: influence of a glutamine-enriched diet Perda de peso e estudo morfométrico da mucosa intestinal de ratos submetidos à ressecção subtotal de intestino delgado: influência do uso de dieta com glutamina

    Directory of Open Access Journals (Sweden)

    Sidney Resende Ribeiro


    Full Text Available Short-bowel syndrome is responsible for significant metabolic alterations that compromise nutritional status. Glutamine is considered an essential nutrient for enterocytes, so beneficial effects from supplementation of the diet with glutamine are hypothesized. PURPOSE: In this study, the effect of a diet enriched with glutamine was evaluated in rats undergoing extensive small bowel resection, with analysis of postoperative weight loss and intestinal morphometrics of villi height, crypt depth, and thickness of the duodenal and remnant jejunal mucosa. METHODS: Three groups of male Wistar rats were established receiving the following diets: with glutamine, without glutamine, and the standard diet of laboratory ration. All animals underwent an extensive small bowel resection, including the ileocecal valve, leaving a remnant jejunum of only 25 cm from the pylorus that was anastomosed lateral-laterally to the ascendant colon. The animals were weighed at the beginning and end of the experiment (20th postoperative day. Then they were killed and the remnant intestine was removed. Fragments of duodenal and jejunal mucosa were collected from the remnant intestine and submitted to histopathologic exam. The morphometric study of the intestinal mucosa was accomplished using a digital system (KS 300 connected to an optic microscope. Morphometrics included villi height, crypt depth, and the total thickness of intestinal mucosa. RESULTS: The weight loss comparison among the 3 groups showed no significant loss difference. The morphometric studies showed significantly taller duodenal villi in the glutamine group in comparison to the without glutamine group, but not different from the standard diet group. The measurements obtained comparing the 3 groups for villi height, crypt depth, and thickness of the remnant jejunum mucosa were greater in the glutamine-enriched diet group than for the without-glutamine diet group, though not significantly different from with

  19. 胰十二指肠切除术与保留十二指肠胰头次全切除术治疗胰头肿块型慢性胰腺炎的临床疗效%Clinical efficacy of pancreaticoduodenectomy and duodenum-preserving pancreatic head resection for the treatment of chronic pancreatitis with mass in the head of the pancreas

    Institute of Scientific and Technical Information of China (English)

    贺舜民; 李志强; 余枭; 余灿; 朱红伟; 汪东文; 宋军


    Objective To investigate the clinical efficacy of pancreaticoduodenectomy (PD) and duodenumpreserving pancreatic head resection (DPPHR,including Beger,Frey and Berne procedures)for the treatment of chronic pancreatitis (CP) with mass in the head of the pancreas.Methods The clinical data of 48 patients with CP who were admitted to the Armed Police Corps Hospital of Hunan province(13) and the Third Xiangya Hospital of Central South University (35) between January 2007 and December 2013 were retrospectively analyzed.The operation methods were selected according to clinical symptoms,imaging findings and intraoperative pathological examinations.Twenty-three patients receiving PD (Whipple procedure or pylorus-preserving PD) were allocated into PD group and 25 receiving DPPHR (Beger,Frey and Berne procedures) were allocated into DPPHR group.The operation time,volume of intraoperative blood loss,rate of postoperative pain relief,changes of pancreatic endocrine and exocrine function,complications,duration of hospital stay and hospital expenses in the 2 groups were analyzed.Patients were followed up by telephone interview and outpatient examination up to September 2014.Measurement data with normal distribution were presented as (x) ± s.Comparison between groups was analyzed using the t test.Count data were analyzed using chi-square test or Fisher exact probability.Results Of the 23 patients in the PD group,15 patients received Whipple procedure and 8 patients received pylorus preserving PD.Of 25 patients in the DPPHR group,8 patients received Beger procedure,13 patients received Frey procedure and 4 patients received Berne procedure.The operation time and volume of intraoperative blood loss were (5.5 ± 0.4) hours,(372 ± 174) mL in the PD group,and (4.2 ± 0.6) hours,(272 ± 114) mL in the DPPHR group,showing significant differences between the 2 groups (t =8.712,2.375,P < 0.05).Three patients had massive hemorrhage in the PD group and 2 patients receiving Beger


    Institute of Scientific and Technical Information of China (English)

    林旋; 林树根; 王全溪; 陈梅芳; 严美姣; 王寿昆


    实验采用改良甲苯胺蓝(MTB)、阿利新蓝-沙黄(AB/SO)、甲基绿-派洛宁(MG-P)、天青Ⅱ-伊红-瑞氏混合液和硫堇5种组化染色法,对尼罗罗非鱼(Nile tilapia)消化道组织中的肥大细胞(Mast cell,MC)组化性质进行研究.尼罗罗非鱼的食管、胃及小肠壁内均显示有肥大细胞,在食管和胃的切片标本上肥大细胞主要分布在黏膜固有层和胃腺体之间.在肠道中的肥大细胞主要分布在黏膜固有层和肠上皮下方,少量肥大细胞存在于黏膜下层结缔组织中.细胞呈圆形、椭圆形,也有长梭形的.而且肥大细胞有沿血管分布的特点.5种组化染色结果表明:AB/SO、MTB和MG-P显示的MC效果较好,尤其AB/SO染色效果最好,肥大细胞轮廓清楚,胞质颗粒较清晰;尼罗罗非鱼肥大细胞胞浆颗粒都呈红色,即肥大细胞胞浆主要含肝素,不含组胺.天青Ⅱ-伊红-瑞氏混合液染色效果也很好,但被染的肥大细胞较少;80%乙醇硫堇染色,在尼罗罗非鱼消化道各段组织中均未能鉴定出肥大细胞.尼罗罗非鱼消化道肥大细胞大多分布于浅层的黏膜或血管、腺体周围的结缔组织等易表露于环境抗原的位点.罗非鱼消化道黏膜层结缔组织中的肥大细胞与大多数脊椎动物的肥大细胞一样,具有沿血管分布的特性,说明硬骨鱼的肥大细胞如哺乳动物肥大细胞一样与血管有着密切的关系.%Five healthy nile tilapia (average weight 500g) were bought. After executing, the esophagus, stomachus (stomachus fundus, stomachus pylorus and stomachus cardiacus), small intestine (foregut, midgut and hindgut) were respectively fixed in the Carnoy solution (60% dehydrate alcohol, 30% chloroform and 10% glacial acetic acid), continuously embedded and sliced with 6μm. Toluidine blue staining (MTB), Alcian blue Safranin O staining (AB/SO),methyl green-Pyronine staining (MG-P), Azure II - Eosin - Wright mixture staining and Thionine