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At least 37 records · Page 2Linked to original sources
PubMed1994

Primary small-intestinal lymphomas in Taiwan: immunoproliferative small-intestinal disease and nonimmunoproliferative small-intestinal disease.

PURPOSE: The clinicopathologic findings in 45 adult Chinese patients with primary small-intestinal lymphoma (PSIL) are described and compared with those in Western countries and in underdeveloped nations. The efficacy of combination chemotherapy is also assessed. PATIENTS AND METHOD: Six patients had immunoproliferative small-intestinal disease (IPSID) indicated by the presence of alpha-heavy chain protein (alpha-CP) in body fluids or tumor tissues. Thirty-nine patients had non-IPSID, including one with postrenal transplant lymphoma. Thirty-three non-IPSID patients received a minimum of four cycles of combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP). RESULTS: All IPSID patients presented with the clinical and laboratory features of severe intestinal malabsorption, and all had diffuse lymphoplasmacytic infiltration in the mucosa of the small bowel. Lymphomas were localized mainly in the jejunum and mesenteric nodes. The histologic subtypes were diffuse large cell in two, immunoblastic in three, and diffuse mixed in one. All patients responded poorly to chemotherapy, with a median survival duration of 10.5 months. The common presenting symptoms of the 39 non-IPSID patients included abdominal pain (90%), weight loss (31%), abdominal mass (26%), obstruction (26%), and perforation (23%). Diffuse large-cell and immunoblastic lymphomas constituted 82% of cases. Four patients had stage IE, 19 stage II 1E, and 16 stage 112E disease according to the Musshoff's criteria; 22 had bulky tumors and 19 had multiple tumors. The tumors were completely resected in 14 patients. Of 33 patients treated with combination chemotherapy, 73% achieved a complete remission. With a median follow-up duration of 90 months, there have been four relapses, with only one at the primary tumor site. The overall 5-year survival and disease-free survival rates for non-IPSID patients who were treated with chemotherapy were 59% and 54%, respectively. CONCLUSION: Intensive chemotherapy produces long-term disease-free survival in locally advanced non-IPSID PSIL.

Adult↗
PubMed1999

[Apoptosis of small intestinal epithelial cells in small intestinal allograft rejection].

OBJECTIVE: To investigate apoptosis of epithelial cells during small intestinal allograft rejection in rats. METHODS: Heterotopic small intestinal transplantation was performed with inbred rat F344/N (RT1(l)) and inbred rat Wistar/A (RT1-A(k), RT1-E(d)). All recipients were divided into four groups: group I, nonoperative control (Wistar); group II, isograft control (Wistar-->Wistar); group III, allograft (F344-->Wistar); group IV, treatment control [F344-->Wistar + Cyclosporine A (6 mg x kg(-1) x d(-1))]. The grafts were harvested on day 3, 5, 7 after operation. All graft samples were subjected to histological examination and apoptotic cells of graft epithelial cells with terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). RESULTS: Histologically mild acute rejection occurred on day 3 after operation in group III, moderate acute rejection on day 5 after operation, severe acute rejection on day 7 after operation. But none of group II had the histological evidence of acute rejection and the histological evidence of group IV indicated that Cyclosporine A could effectively controlled small intestinal acute allograft rejection. The TUNEL showed that the number of apoptotic cells per crypt in group III was significantly higher than that of the other three control groups on day 3 and day 5 after operation (P < 0.01). The epithelial mucosa in group III completely sloughed on day 7 after operation. CONCLUSIONS: Apoptosis plays an important role in small intestinal allograft rejection. Detection of apoptotic cells with TUNEL could be a valuable tool for the diagnosis of small intestinal allograft rejection.

Animals↗
PubMed1995

[Diverticulosis of the small intestine].

Small bowel diverticulosis is a rare disease of gastrointestinal tract that occurs most frequently in older patients. Since this disease can be asymptomatic, for a long time, the diagnosis rarely is made in the preoperative period. In 40% of cases there are acute or chronic complications, most frequently diverticulitis either with or without perforation, bowel obstruction and massive haemorrhage clinically manifested as bleeding from the lower part of the gastrointestinal tract. Abdominal pain, pseudoobstructive and malabsorption syndrome, expressive weight loss, steatorrhea and anemia are common chronic complications. In these cases a surgical treatment is necessary. Resection of the affected part of the small bowel is usually performed with end-to-end anastomosis. The authors present 4 cases with diverticulosis of the small bowel, two cases of which were manifested by diverticulitis and one of them was perforated. Pseudoobstructive syndrome, malabsorption and expressive weight loss were presented in other two cases. All four cases were dominated by severe abdominal pain. The surgical treatment was based upon radical resection of the small bowel with end-to-end anastomosis. (Fig. 4, Ref. 28.)

Adolescent↗
PubMed1994

[Endoscopy of the small intestine].

Small bowel pathology has been a difficult problem for all the scientists related with the study of these diseases. Small bowel position; far from the oral cavity and rectum, makes it quite inaccessible to exploration. Although double-contras technique in radiology has improved the study of this part of the digestive tract, many of these lesions cannot be evaluated. During the last few years, endoscopy has developed a great deal and at present, equipments capable of exploring this segment are available, even though the technique needs to be improved making it less troublesome and uncomfortable to the patient. We present a study of 32 patients who underwent "push" jejunoscopy with a large sterilized colonoscope. The main indications were bleeding and diarrhea of unknown cause. Three patients had jejunitis; one had a lymphoma; the second had a bleeding polyp and the third patient had a multiple polyposis. Five patients with partial atrophy of intestinal villi were found to have a normal endoscopic appearance of the mucosa. This indicates the necessity of performing biopsy in all cases. The absence of complications accounts for the confidence and safety of the exploration.

Adolescent↗
PubMed2005

Effects of psychological stress on small intestinal motility and expression of cholecystokinin and vasoactive intestinal polypeptide in plasma and small intestine in mice.

AIM: To investigate the effects of psychological stress on small intestinal motility and expression of cholecystokinin (CCK) and vasoactive intestinal polypeptide (VIP) in plasma and small intestine, and to explore the relationship between small intestinal motor disorders and gastrointestinal hormones under psychological stress. METHODS: Thirty-six mice were randomly divided into psychological stress group and control group. A mouse model with psychological stress was established by housing the mice with a hungry cat in separate layers of a two-layer cage. A semi-solid colored marker (carbon-ink) was used for monitoring small intestinal transit. CCK and VIP levels in plasma and small intestine in mice were measured by radioimmunoassay (RIA). RESULTS: Small intestinal transit was inhibited (52.18+/-19.15% vs 70.19+/-17.79%, P<0.01) in mice after psychological stress, compared to the controls. Small intestinal CCK levels in psychological stress mice were significantly lower than those in the control group (0.75+/-0.53 microg/g vs 1.98+/-1.17 microg/g, P<0.01), whereas plasma CCK concentrations were not different between the groups. VIP levels in small intestine were significantly higher in psychological stress mice than those in the control group (8.45+/-1.09 microg/g vs 7.03+/-2.36 microg/g, P<0.01), while there was no significant difference in plasma VIP levels between the two groups. CONCLUSION: Psychological stress inhibits the small intestinal transit, probably by down-regulating CCK and up-regulating VIP expression in small intestine.

Animals↗
PubMed1985

Immunoproliferative small intestinal disease and primary small intestinal lymphoma. Relation to alpha chain protein.

Forty-three patients with immunoproliferative small intestinal disease and primary small intestinal lymphoma were studied prospectively. Eighteen patients in whom alpha-chain protein was detected in the serum had significantly more features of malabsorption, and disease was localized more commonly in the jejunum. In all of these patients, a diffuse lymphoplasmacytic infiltrate was found in the intestine; in three patients lymphoma was found only in mesenteric lymph nodes. Twenty-five patients with lymphoma in whom alpha-chain protein failed to be detected had significantly more features of intestinal obstruction, and disease was found more commonly in the ileum. Five of these patients had lymphoma associated with a diffuse mucosal infiltrate that was indistinguishable from the first group. In patients available for follow-up, no difference was found in cumulative survival over 30 months in the two groups, with approximately 40% mortality at 6 months.

Adolescent↗
PubMed2001

A phenotypic change of small intestinal epithelium to colonocytes in small intestinal adenomas and adenocarcinomas.

OBJECTIVE: Using a novel monoclonal antibody (mAb Das-1) that specifically reacts with colon epithelium, we examined if there is a phenotypic change of small intestinal enterocytes toward colonocytes in small intestinal neoplastic tissue. METHODS: Tissue sections of the small intestine consisting of adenomas (n = 20, five with histories of familial polyposis), adenocarcinomas (eight primary and one metastatic from colon). carcinoids (n = 2), and hyperplastic polyps (n = 3) were examined by a sensitive immunoperoxidase assay using mAb Das-1 (IgM isotype). Normal jejunal (n = 10) and colonic (n = 10) biopsy specimens were also included as additional controls. RESULTS: mAb Das-1 reacted with normal colonic epithelium but not with jejunal mucosa. However, mAb Das-1 reacted strongly with each of the five adenomas (100%) from patients with histories of familial polyposis, but only five of 15 (33%) of the adenomas from nonfamilial polyposis patients, and each of the eight (100%) adenocarcinomas of the small intestine (p < 0.001). The reactivity with the adenomas from nonfamilial polyposis patients was very focal, whereas in the adenomas with familial polyposis the reactivity was more extensive. Each of the eight carcinomas reacted strongly with mAb Das-1. Adjacent normal small intestinal mucosa did not react. Hyperplastic polyps and the carcinoids did not react with mAb Das-1. CONCLUSION: These data demonstrate a phenotypic change in small intestinal epithelium toward the colonic phenotype, particularly in familial polyposis and in adenocarcinomas. mAb Das-1 may be clinically useful in identifying small intestinal adenomas with "high risk" for malignancy, such as in familial polyposis.

Adenocarcinoma↗
PubMed1995

Clinicopathological features and management of immunoproliferative small intestinal disease and primary small intestinal lymphoma in Pakistan.

This study was performed to confirm the existence of immunoproliferative small intestinal disease (IPSID) in Pakistan. Clinicopathological features of 12 patients with histologically confirmed disease were analysed. Patients were mostly young males with median age of 24.6 years. Two thirds belonged to poor socioeconomic class. Main presenting features were chronic diarrhoea and weight loss. Eleven patients had radiologic evidence of malabsorption syndrome. Endoscopic findings of mucosal thickening, edema, and flattened villi were present in the majority. Patients had both secretory and non-secretory types of disease. Six patients presented with stage A disease. Four responded to antibiotics or steroids, although mucosal abnormalities persisted in three. Two stage A patients evolved into stage C disease, one was lost to follow-up, the other is alive with disease. Three patients presented with stage B disease. Two responded completely to chemotherapy, the third refused treatment and expired after 16 months. Three patients had stage C disease at diagnosis. They received aggressive combination chemotherapy and remain in complete remission with a median follow-up of 2.2 years. This is the first series of patients with IPSID reported from Pakistan. Clinicopathological features and therapeutic results are consistent with the experience elsewhere. Increased awareness may result in early diagnosis and better management.

Adult↗
PubMed1980

[New method of studying membrane hydrolysis and transport as well as metabolic processes in the small intestine in vitro (everted small intestinal sac with bilateral oxygenation)].

The effect of bilateral oxygenation (from mucosal and serosal surfaces) of the small intestinal preparation on glucose accumulation has been investigated. It has been demonstrated that such a type of oxygenation significantly (two fold) increases the absorption of glucose as compared to that under oxygenation only from musocal surface. This data sugested that oxygenation from serosal site of the small intestine had an important role in the transport of free glucose.

Animals↗
PubMed1979

Leiomyosarcomas of the small intestine.

Small bowel leiomyosarcomas are uncommon but potentially curable tumors often diagnosed at an advanced stage. Twenty such lesions were studied, and 19 of these produced symptoms and signs. Clinical findings included abdominal pain in 17 (85%), rectal bleeding in 8 (40%), anemia in 7 (35%), intraperitoneal perforation in 6 (30%), and abdominal mass in 4 (20%). Various abdominal x-ray examinations revealed nonspecific abnormalities (ileus, bowel obstruction, abdominal mass) in about half the cases in which they were obtained, but in only one instance was the correct diagnosis of small bowel tumor made preoperatively. Five of 12 patients undergoing resection in hope of cure survived five years. These tumors tend to metastasize by hematogenous dissemination, peritoneal implantation, local invasion, and, uncommonly, lymphogenous spread. Wide small bowel resection with adjacent mesentery is suggested for most lesions. Five year survival following resection approximates 50% in reported series.

Adult↗
PubMedDate not supplied

[Tumors of the small intestine].

Small bowel tumors (SBT) are rare neoplasms and represent less than 10% of all gastrointestinal tumors. The majority of them are benign and discovered at the time of autopsy. However of those who present symptoms the majority belong to the group of malignant tumors and require of treatment. The most common histological variety are the adenocarcinoma and the carcinoid tumors. Abdominal pain, intestinal obstruction or gastrointestinal bleeding are the most common clinical complaints. Endoscopy or contrast X-ray examination are the most common forms of diagnosis and surgery remain the best way of treatment chemotherapy or radiotherapy are used in combination with surgery according to the histological diagnosis, the survival depends to the final histological report. A review of the experience at the National Institute of Cancer in Mexico city was performed and 34 patients were found with the diagnosis of SBT of which the majority presented with abdominal pain, nausea, vomiting and abdominal distension. The most common histological diagnosis were the adenocarcinoma (52%) and the leiomyosarcoma (32%). Surgery was the most common form of treatment (73%) of which in 20% distant metastasis was diagnosed. Only nine are alive at the time of the report without recurrent disease with a mean follow up of 7 months. Our experience shows that SBT are rare neoplasms, the majority are diagnosed late but surgery remain the best way of treatment because it can offer the possibility of cure or adequate palliation with derivative procedures.

Adenocarcinoma↗
PubMed1994

Effects of heparin, venous strangulation obstruction of the small intestine, and reperfusion of the small intestine on plasma diamine oxidase activity in horses.

Diamine oxidase (DAO), an enzyme of small intestinal origin, is released from mucosal storage sites by IV administration of heparin, to yield the plasma postheparin DAO (PHD) curve. The PHD curve is diminished when mucosal surface area is lost, and baseline (without heparin) plasma DAO activity increases when mucosal storage sites are damaged. Plasma DAO activity was measured after 2 doses of heparin were administered IV in healthy, conscious horses. In anesthetized horses, the PHD curve was studied: during sham small intestinal surgery, and during venous strangulation obstruction (VSO) of the distal 50% of the small intestine. In a third group of anesthetized horses, baseline plasma DAO activity (without heparin) was measured during VSO of the distal 50% of the small intestine for 90 minutes, followed by reperfusion for 90 minutes. Postheparin plasma DAO curves in conscious horses were similar to those reported in other species. Horses with VSO had a similar PHD curve as did sham-operated controls at all times, except at 15 minutes, when plasma DAO activity was significantly (P < 0.05) greater in the VSO group. Horses with VSO and reperfusion had no change in baseline plasma DAO activity throughout the study. Peritoneal fluid DAO activity remained low throughout the study, but increased slightly in horses with VSO that received heparin, possibly because of DAO from extravasated blood in the peritoneal fluid. Results indicated that the plasma DAO response to IV administered heparin in horses is similar to that in other mammals, but, unlike other species, baseline and postheparin DAO activities did not change as expected after small intestinal vascular obstruction and mucosal injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Amine Oxidase (Copper-Containing)↗
PubMedDate not supplied

Recovery of the small intestine in coeliac disease on a gluten-free diet: changes in intestinal permeability, small bowel morphology and T-cell activity.

Intestinal permeability was assessed before and 1, 2, 4, 8 and 12 weeks after commencing a gluten-free diet (GFD) in eight coeliac subjects. Intestinal morphology was quantified in six coeliac subjects on a normal diet, six coeliac subjects on a GFD, and 21 normal subjects. T-cell activity was measured in the eight coeliac subjects by soluble interleukin-2 receptor (sIL-2R) concentration (normal less than 477 U/mL). Intestinal permeability was increased 10-fold with a geometric mean value of 0.72 on a normal diet, and decreased to 0.17 at 4 weeks (P = 0.04), to 0.07 at 8 weeks (P = 0.010), and to 0.20 at 12 weeks (P = 0.015) of a GFD. Two of the eight subjects showed a poor response to gluten withdrawal. Quantitative intestinal morphology showed no significant improvement after 3 to 6 months of a GFD. Mean +/- s.d. sIL-2R concentrations in the eight subjects were increased 5-fold higher than control values at 1400 +/- 530 U/mL on a normal diet and decreased to 750 +/- 200 U/mL after 12 weeks of a GFD (P = 0.004). We conclude that intestinal permeability improves rapidly in the majority of coeliac subjects after commencing a GFD, although some abnormal permeability and increased T-cell activity persists. This may be due to varying degrees of gluten ingestion resulting in continued immune activation.

Adult↗