Indications for surgery of the upper gastrointestinal tract.
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Digestive System Surgical Procedures↗
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Results for “GASTROINTESTINAL TRACT”
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Prospective evaluation for upper gastrointestinal tract acute graft-versus-host disease after hematopoietic stem cell transplantation.
The incidence and clinical significance of upper gastrointestinal tract acute graft-versus-host disease (upper GI GVHD) were prospectively evaluated in 44 Japanese patients who underwent allogeneic (n = 26) or autologous (n = 18) stem cell transplantation. Endoscopic examination was routinely performed between days 20 and 50 post-transplant and when symptoms of upper GI and/or acute GVHD of other organs were present. The results were compared with the historical records of 49 allograft and 20 autograft recipients. The diagnosis of upper GI GVHD was confirmed by histologic findings of GVHD and persistent upper GI tract symptoms. The incidence of upper GI GVHD was 46% in the prospective allograft group, higher than in the retrospective group. Upper GI GVHD was not diagnosed in any autograft patients. Twelve of 19 patients with upper GI GVHD had skin GVHD, and two of the 12 had concurrent lower GI GVHD. Upper GI GVHD was successfully treated with steroids and did not progress to symptomatic lower GI GVHD. In addition, upper GI GVHD completely resolved without specific alteration in immunosuppressant therapy in six patients. No risk factors for upper GI GVHD could be identified. The presence of upper GI GVHD did not significantly affect early death rate, incidence of chronic GVHD, and overall survival. In conclusion, by the prospective evaluation of the upper GI tract by endoscopy we could accurately diagnose upper GI GVHD in half our allogeneic recipients. However, upper GI GVHD was successfully controlled with or without additional steroids in all cases and had little impact on transplant outcome.
Adolescent↗
Use of gut cyclic motor activity to evaluate a stimulant (narcotic) and inhibitor (anticholinergic) of gastrointestinal-tract activity in the unanesthetized dog.
The use of gut cyclic motor activity to evaluate both a stimulant and inhibitor of gastrointestinal contractile activity in the unanesthetized dog is described. In the interdigestive (fasted) state, there is a cyclic alternation of intense periods of contractions (burst) with quiescent periods (basal). Codeine phosphate, a narcotic agent, caused a dose-dependent increase in the number and duration of circular muscle contractions when administered in the basal phase. Hyoscine N-butyl-bromide, an anticholinergic drug, caused a dose-dependent reduction in both amplitude and frequency of burst-phase contractions. When a combination of codeine phosphate and hyoscine N-butylbromide was administered simultaneously in the basal or burst phase, the hyoscine N-butylbromide prevailed and had the dominant effect. This is a useful in vivo model to evaluate the effects of drugs on the gastrointestinal tract.
Animals↗
[Benign tumors in the upper gastrointestinal tract (author's transl)].
Information is given on 113 cases of solitary or multiple benign tumors of the upper gastrointestinal tract. The clinical symptoms and procedures of diagnosis of these rare tumors of esophagus, stomach, and small intestine are discussed. For therapy, surgical intervention is usually required because of malignant degeneration and complications like bleeding or perforation. Mortality was found to be 4.4%, so that the individual indication for operation should be considered.
Adult↗
[Kaposi sarcoma of the gastrointestinal tract in AIDS. Morphologic findings and differential diagnostic aspects].
At autopsies of 20 patients with AIDS, 7 cases with gastrointestinal involvement by Kaposi's sarcoma were observed. The lesions were found in nearly all parts of the digestive canal; although we observed a certain accumulation in the upper gastrointestinal tract. Macroscopically the spectrum of appearances extended from red macules in the mucosal plane to plaquelike indurations of the wall and polypoid, hemorrhagic mucosal nodules. A certain, stage-dependent correlation between the macroscopic presentation and the histologic findings was found. In consideration of differential diagnostic aspects the morphologic findings in different tumor-stages are presented.
Acquired Immunodeficiency Syndrome↗
[A case of recurrent bleeding from the upper part of the gastrointestinal tract in a patient with hypoproconvertinemia].
A case is described of recurrent bleeding from the upper part of the gastrointestinal tract in a female patient with previously unrecognized hypoproconvertinaemia. The patient was referred to hospital because of severe anaemia. Panendoscopy demonstrated bleeding aphthae in the stomach. After obtaining the result of clotting tests suspicion (later confirmed) appeared of hypoproconvertinaemia. Antihaemophilic plasma was given and a rapid regression of changes in the stomach and regression of anaemia were achieved.
Anemia↗
Smooth muscle tumours of the upper gastrointestinal tract.
The clinical and radiological features and endoscopic findings in 13 patients with smooth muscle tumours of the upper gastrointestinal tract are reviewed. The study emphasises the non-specific nature of the symptomatology and exemplifies a number of aspects of the radiological picture of these disorders. It also illustrates some of the problems that can arise in their investigation, by radiological and endoscopic methods, and gives some indication of the favourable prognosis that may obtain when complete surgical removal of the tumour is possible.
Adult↗
Three-dimensional surface model analysis in the gastrointestinal tract.
The biomechanical changes during functional loading and unloading of the human gastrointestinal (GI) tract are not fully understood. GI function is usually studied by introducing probes in the GI lumen. Computer modeling offers a promising alternative approach in this regard, with the additional ability to predict regional stresses and strains in inaccessible locations. The tension and stress distributions in the GI tract are related to distensibility (tension-strain relationship) and smooth muscle tone. More knowledge on the tension and stress on the GI tract are needed to improve diagnosis of patients with gastrointestinal disorders. A modeling framework that can be used to integrate the physiological, anatomical and medical knowledge of the GI system has recently been developed. The 3-D anatomical model was constructed from digital images using ultrasonography, computer tomography (CT) or magnetic resonance imaging (MRI). Different mathematical algorithms were developed for surface analysis based on thin-walled structure and the finite element method was applied for the mucosa-folded three layered esophageal model analysis. The tools may be useful for studying the geometry and biomechanical properties of these organs in health and disease. These studies will serve to test the structure-function hypothesis of geometrically complex organs.
Algorithms↗
Toxic effects of chronic fluoride ingestion on the upper gastrointestinal tract.
In a prospective case controlled study, we evaluated the adverse effects of long-term fluoride ingestion on the gastrointestinal tract. Ten patients with otosclerosis who were receiving sodium fluoride 30 mg/day for a period of 3-12 months, and 10 age- and sex-matched healthy volunteers were included. They were all evaluated clinically and subjected to a real time ultrasound examination, upper gastrointestinal endoscopy, and biopsies from the gastric antrum and duodenum. The biopsies were subjected to a rapid urease test as well as light and electron microscopic examinations. Ionic fluoride was estimated in the serum, urine, and drinking water using an ION 85 Ion Analyzer. Seven subjects (70%) ingesting fluoride had abdominal pain, vomiting, and nausea. Petechiae, erosions, and erythema were seen on endoscopy in all the subjects, but not in the controls. Histological examination of the gastric antral biopsy showed chronic atrophic gastritis in all the subjects but in only one (10%) healthy volunteer. Scanning electron microscopic examination showed "cracked-clay" appearance, scanty microvilli, surface abrasions, and desquamated epithelium in the subjects ingesting fluoride, but not in the controls. We conclude that long-term fluoride ingestion is associated with a high incidence of dyspeptic symptoms as well as histological and electron microscopic abnormalities.
Adolescent↗
The biology of photodynamic therapy in the gastrointestinal tract.
This article reviews current knowledge on the biology of photodynamic therapy on normal and diseased tissues in the gastrointestinal tract. There is little effect on connective tissue, so the mechanical integrity of the luminal gut is well preserved, even with full thickness damage. This makes photodynamic therapy suitable for treating small tumors, but strictures may occur after circumferential treatment of conditions like Barrett's esophagus unless a muscle-sparing photosensitizing agent is used. Animal studies show that the pancreas and surrounding tissues can tolerate photodynamic therapy, justifying pilot clinical trials on percutaneous, interstitial photodynamic therapy for localized, inoperable pancreatic cancers.
Animals↗
Dopamine antagonists in the upper gastrointestinal tract.
Certain dopamine antagonists have gained increasing clinical use because of their effect on the motility of the upper gastrointestinal tract. Dopamine, while acting through specific dopaminergic receptors, inhibits lower oesophageal sphincter pressure (LOSP) and gastroduodenal motility. When given with dopamine, the specific dopamine antagonists metoclopramide and domperidone counteract these effects. When given alone, these agents elicit an increased LOSP and stimulate gastroduodenal motility and gastric emptying. They have consequently proved to be of value in certain cases of gastroparesis, and in relieving nausea and vomiting. They also appear to be useful in the management of reflux oesophagitis.
Diabetic Neuropathies↗
Malignancies of upper gastrointestinal tract in Nigerians: early symptoms and prognosis.
A total of 237 patients with confirmed malignancies of the upper-gastrointestinal tract (UGIT) were studied. Of these, 143 (60.34%) were gastric cancers, 66 (27.85) were oesophageal malignancies and 28 (11.81%) were in the small intestine. Epigastric pain accompanied by vomiting after meals was the commonest first symptom in patients of gastric cancer whereas dysphagia formed the commonest first symptom in oesophageal cancer. However, no definite first symptom could be attributed to those with small intestinal tumors. As many as 134 patients (56.54%) had advanced malignancies at presentation itself. The usefullness of first symptoms in early diagnosis and prognosis is discussed.
Adolescent↗
Malignant tumours of the gastrointestinal tract in an area with an asbestos-cement plant.
Data on persons who died of cancer of the gastrointestinal tract in a Croatian coastal area with an asbestos-cement plant were analysed for the period 1970-1990. By poll method applied to the families of deceased subjects, additional data on occupation, lifestyle, educational level, length of resistance and cancer mortality among relatives were collected. The investigation showed that in the study area, but also in certain narrower locations within it (subarea settlements), some of the tumours studied occurred at higher rates than expected. Although not conclusive, these findings may indicate a role of environmental exposure to asbestos, particularly in the occurrence of peritoneal mesothelioma.
Age Factors↗
Carcinoid tumors of the gastrointestinal tract.
This study is based on a review of the records of 107 patients with primary carcinoids of the gastrointestinal tract diagnosed at the Memorial Hospital for Cancer and Allied Diseases during the 20 years from 1948 to 1968. The tumors were classified into two major groups according to their gross and pathologic presentation, and were correlated with clinical behavior and treatment. Carcinoids which were still intramural in location were usually asymptomatic, and yielded successfully to local excision (85% 5-year overall survival); carcinoids which had invaded into the serosa and/or beyond were usually symptomatic, and hd much poorer results (5% overall 5-year result), despite radical surgery with or without palliative radiotherapy and/or chemotherapy.
Adolescent↗
Large-cell anaplastic lymphoma of the gastrointestinal tract: an immuno- and genotypic study on archival material.
Primary large-cell anaplastic lymphomas (LCAL) presenting in the gastrointestinal tract are rare and sometimes difficult to distinguish from nonlymphoid tumors. Because recognition of these tumors as lymphoma has clinical and prognostic implications for the patient, the diagnostic contribution of genotyping by polymerase chain reaction (PCR) and of immunophenotyping was evaluated in 16 routinely processed samples of gastric and small-intestinal LCALs. Gene rearrangement analysis was done with primers for the immunoglobulin heavy (IgH) and T-cell receptor gamma(TCR gamma) chain. Nine of the 16 cases were assigned to T- or B-lymphoid lineage immunophenotypically. Twelve of the 16 samples had a predominant T- or B-cell clone by PCR. Combination of both methods resulted in lineage assignment of 14 cases (9 T-LCAL, 5 B-LCAL). Two LCAL samples were EBV positive by PCR, one also by immunophenotyping. High expression levels of p53 did not correlate with the presence of EBV or cell lineage. Thus, gene rearrangement studies on routinely processed biopsy specimens by PCR are practical and add to the diagnostic repertoire in cases of gastrointestinal large-cell tumors of immunophenotypically undefined lineage.
Adult↗
Influence of dietary peroxides, selenium and vitamin E on glutathione peroxidase of the gastrointestinal tract.
The influence of dietary peroxides, vitamin E and selenium on glutathione peroxidase (GSH-Px) activity in the gastrointestinal tract of the rat was investigated. Feeding 7% oxidized stripped corn oid (peroxide value 1,000) in a diet adequate in selenium and vitamin E increased the specific activity of GSH-Px in the stomach mucosa. Feeding oxidized oil produced an increase in the wet weight of the intestinal mucosa which was associated with a decrease in the specific activity of the enzyme. Total GSH-Px activity in the intestinal mucosa was unchanged or moderately increased. These changes were unaffected by the presence of vitamin E in the diet. Dietary peroxides had no effect on GSH-Px activity in the plasma or in the perirenal and paraepididymal adipose tissues. Subacute vitamin E deficiency had no consistent effect on the activity of the enzyme in several tissues examined. In rats fed a Se deficient diet glutathione peroxidase activity decreased markedly in most tissues but only slightly in the intestinal mucosa. The moderate decrease in the intestine may be explained by the accessibility of residual dietary Se to the mucosal cells. The role of Se in the detoxification of peroxides in foods and the response of gastrointestinal GSH-Px to dietary peroxides are discussed.
Adipose Tissue↗
Solitary and multiple adenomatous polyps of the gastrointestinal tract.
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Adenomatous Polyps↗
[Malignant tumors of the gastrointestinal tract].
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Digestive System Neoplasms↗
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