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[Study of the influence of Staphylococcus aureus on gastrointestinal tract microbiocenosis in rats].

The authors studied the modifying effect of Staphylococcus aureus on the microbial composition of gastrointestinal tract microbiocenosis. The subjects were female rats in the condition of eubiosis or dysbiosis. The species and quantitative composition of the fecal microflora and the parietal mucin in different parts of the intestine were studied after an intragastral administration of St. aureus suspension. A single introduction of St. aureus into the gastrointestinal tract of rats led to the appearance of this microbe in the feces and parietal mucin in all the parts of the intestine regardless the initial condition of the intestinal microbiocenosis. The indigenous microflora, both in eubiotic and dysbiotic conditions, practically did not respond to an intragastral administration of staphylococcus, except a little decrease in the proportion of bifidobacteria. Meanwhile, there was a significant increase in the incidence of candid detection. The indigenous parietal microflora changed more substantially, which demonstrates a higher sensitivity of the parietal microbiocenosis to a short-time exposure to an exogenous microbial factor.

Animals↗

Monocarboxylate transporter 1 gene expression in the ovine gastrointestinal tract.

In this study, we investigated the tissue distribution and expression of monocarboxylate transporter 1 (MCT1) along the gastrointestinal tract of sheep. Western blot analysis suggested the presence of MCT1 as a 43-kDa protein in immunoblots of membranes from the various tissues examined. The results of Western blotting were further confirmed by immunohistochemical studies, which revealed intense immunoreactivity for the MCT1 protein in the forestomach (rumen, reticulum and omasum) and large intestine (caecum, proximal and distal colon). Moderate reactivity, however, was detected in the abomasum, while no immunoreactivity could be seen in any regions of the small intestine examined. Furthermore, MCT1 was expressed at the mRNA level as determined by reverse transcriptase polymerase chain reaction (RT-PCR), which showed a band of the expected size (300 bp) in all tissues examined. From these results we concluded that MCT1 protein is highly expressed and distributed in the stomach and large intestine of sheep suggesting that MCT1 may play a significant role in the transport of short chain fatty acids and their metabolites in the gastrointestinal tract of ruminants.

Animals↗

CT of the gastrointestinal tract: principles and interpretation.

The experience accumulated in daily abdominal CT scanning and CT evaluation of gastrointestinal lesions has generated helpful technical guidelines and some reliable principles of interpretation. These general principles are briefly discussed in this review, and the importance of performing a CT examination that is adequate for the detection and evaluation of gastrointestinal lesions is stressed. CT features useful in differentiating benign from malignant lesions, limitations and pitfalls in CT interpretation, overlap in the CT appearance, and classical CT features leading to specific diagnoses are described and illustrated. Although CT is established as one of the most important techniques for imaging the gastrointestinal tract, it should be used selectively and only in the context of appropriate clinical and conventional radiologic examination. CT should not be regarded as competing with, but as complementing, barium examination of the gastrointestinal tract.

Gastrointestinal Diseases↗

Plasma creatinine in neonates with atresia of the upper gastrointestinal tract.

The human fetus swallows a considerable amount of amniotic fluid which appears to be in balance with the urine output. Since amniotic fluid intake is considered to be compromised in fetuses with atresia of the upper gastrointestinal tract, glomerular function development in such infants may be delayed. Plasma creatinine level determined in 6 neonates with atresia of the upper gastrointestinal tract was similar to the level measured in neonates with lower obstruction, and both groups were within the range of values obtained during other studies in normal newborns. Glomerular functional development is probably not affected in neonates with atresia of the upper gastrointestinal tract.

Creatinine↗

The gastrointestinal tract in uremia.

Gastrointestinal mucosal abnormalities ranging from edema to ulceration occur in two thirds of patients dying of uremia. Early studies suggested that uremic patients on maintenance dialysis treatment were at increased risk of peptic ulceration but more recent data indicate that this is not so. Other gastrointestinal problems reported for uremic subjects on maintenance dialysis treatment include bleeding from telangiectatic lesions, constipation, mucosal deposition of amyloid and acute pancreatitis. Nausea and vomiting are common in the uremic patient but gastric emptying studies have yielded conflicting results. Patients undergoing renal transplantation are at increased risk of development of esophagitis, complicated peptic ulcer, intestinal ulceration, and perforation as well as acute pancreatitis.

Acute Kidney Injury↗

Preventing NSAID Toxicity to the Upper Gastrointestinal Tract.

Prevention of gastrointestinal toxicity begins with the selection of an appropriate analgesic or anti-inflammatory agent. For conditions without inflammation, such as some cases of osteoarthritis, an analgesic with no risk for gastrointestinal toxicity is appropriate. Risk factors for nonsteroidal anti-inflammatory drug (NSAID)-related complications include advanced age; history of ulcer disease or gastrointestinal bleeding; concomitant corticosteroid or anticoagulant use; use of high-dose or multiple NSAIDs; and certain chronic diseases, such as cardiovascular disease. If an NSAID must be used in a patient with risk factors, the patient should receive the lowest-risk NSAID and, in most cases, co-therapy to reduce the risk for NSAID-associated ulcers and their complications. The PGE1 prostaglandin analogue misoprostol is highly efficacious for the prevention of both gastric and duodenal ulcers and has also been shown to reduce the incidence of NSAID-induced ulcer complications. Side effects, such as diarrhea, may limit patient acceptance of the drug. Acid suppression with traditional ulcer-healing doses of H2-blockers significantly reduces rates of duodenal ulcer but is ineffective in reducing gastric ulceration. More potent acid inhibition with double-dose H2-blockers reduces rates of both gastric and duodenal ulcers. Proton-pump inhibitors, such as omeprazole, have been shown to prevent gastric and duodenal ulcers with an efficacy equal to that of misoprostol. They also reduce NSAID-related dyspepsia. Specific cyclooxygenase-2 (COX-2) inhibitors are associated with a markedly reduced rate of endoscopic ulcers. Very high-risk patients who receive these agents may still require co-therapy to prevent complications or reduce dyspepsia. This protocol may be changed by the results of long-term gastrointestinal outcome studies now underway.

Journal Article↗

Small-bowel complications of major gastrointestinal tract surgery.

OBJECTIVE: Gastrointestinal complications of major abdominal surgery often require radiologic assessment. The purpose of this article is to review the expected imaging findings and complications after commonly performed gastric and pancreatic surgery. CONCLUSION: It is important to understand the postsurgical anatomy to avoid misinterpreting an expected postoperative finding as a complication. Postoperative complications can be categorized as being related to adhesions, anastomosis, an enteric connection, and abnormal bowel position.

Abdomen, Acute↗

Treatment of HIV-related cytomegalovirus disease of the gastrointestinal tract with foscarnet.

Gastrointestinal cytomegalovirus (CMV) disease occurs in a significant proportion of patients with AIDS. A series of 66 AIDS patients with first-episode gastrointestinal CMV disease diagnosed on the basis of clinical and histopathologic findings were treated with foscarnet as first-line therapy at our institution between January 1987 and January 1991. Primary sites of infection were the colon (28 patients) and the esophagus (22 patients). Foscarnet was administered as a continuous infusion of 200 mg/kg (prior to 1988) or as an intermittent infusion of 60 mg/kg t.i.d. or 90 mg/kg b.i.d., with saline hyperhydration accompanying each infusion. Patients were treated initially for 2 weeks, with an additional 1-2 weeks of treatment being given in those not having a complete response during initial treatment; maintenance therapy was given only in cases of concurrent CMV retinitis. Complete response to foscarnet therapy (resolution of symptoms and endoscopic findings) was observed in 17 esophagitis patients (77%) within 3 weeks, with only 4 patients relapsing (at 1-7 months) and none developing colitis or retinitis. Complete response was observed in 16 colitis patients (57%) within 3 weeks, with relapse occurring in 5. Asymptomatic hypocalcemia occurred in 19.7% of patients and penile ulceration occurred in 6.1%; increases in serum creatinine were observed in five patients (7.6%), but did not require discontinuation of treatment. These findings indicate that foscarnet is an effective first-line treatment for gastrointestinal CMV infection. They also suggest that maintenance therapy with foscarnet may not be required in all patients.

Acquired Immunodeficiency Syndrome↗

Outpatient dilation of anastomotic strictures of the upper gastrointestinal tract.

Anastomotic upper gastrointestinal strictures in 32 patients were dilated on an outpatient basis. Strictures had developed following resection-anastomosis of the esophagus in 27, total esophagectomy in two and total/partial gastrectomy in three patients. Patients with benign anastomotic strictures (group A; n = 21) presented within 6 (median 2) months of surgery while those with recurrent tumors at the site of anastomosis (group B; n = 11) presented 7 (median 14) months later. Dilation using Savary-Gilliard (n = 24), through the scope balloon (n = 2) and Eder Puestow (n = 1) dilators or a combination of these (n = 1) was possible in 20 (95%) patients in group A and 8 (73%) patients in group B. All the 28 patients had relief of dysphagia. Median duration of response after first dilation was 4.2 and 1.2 months in groups A and B respectively. Nature of previous surgery, length of the remaining stomach and recurrence of tumor at anastomosis appeared to affect the technique and outcome of dilation. Savary-Gilliard dilators can be used in a majority of patients except those with short stomachs where through the scope balloon dilators may be preferred.

Deglutition Disorders↗

The value of serum zinc, copper, ceruloplasmin levels in patients with gastrointestinal tract cancers.

BACKGROUND/AIMS: Gastrointestinal cancers are frequent diseases of particular importance for surgeons with regard to their management and follow-up. Neoplastic diseases activate antioxidant defense systems. As a result, concentrations of redoxal enzymes and their co-factor elements appear to change. The levels of zinc (Zn), copper (Cu) and ceruloplasmin have been found to be critical parameters. In addition, it seems to be important to consider the Cu/Zn ratio in such cases. In this study, changes in the levels of Cu, Zn and ceruloplasmin in patients with gastrointestinal system cancers was evaluated, and the proportion of Cu to Zn (Cu/Zn) is discussed. METHODS: In this clinical trial, levels of Cu and Zn were defined with calorimetric methods and ceruloplasmin levels were measured with immunohistochemical methods in a control group of 20 healthy individuals and in 25 patients who underwent surgery for gastrointestinal system cancer. The blood samples were taken preoperatively in gastrointestinal system cancer patients. RESULTS: This study has shown that while the decrease in Zn levels and the increase in ceruloplasmin levels in patients with gastrointestinal system cancers were found to be significant (p<0. 001, p=0. 014) when compared to the control group, the increase in the level of Cu was also found to be significant (p=0. 019). In the patient group, the correlations between serum Cu and serum ceruloplasmin proved to be significant (r=991, p<0. 001). The Cu/Zn ratio, when compared with Zn, ceruloplasmin and Cu, showed significant results (r= 0. 562, r= 0. 500, r=0. 506, p<0. 001). CONCLUSIONS: This study shows that serum Cu, Zn and ceruloplasmin levels show changes in gastrointestinal system cancers, but further research is needed to demonstrate the importance and significance of these parameters and their relation with other contributing neoplastic factors.

Adult↗

Microemulsions for improved peptide absorption from the gastrointestinal tract.

Results on gastrointestinal absorption of three peptides, insulin, cyclosporin from microemulsions, obtained from studies in our laboratories during the past years have been summarized. The routes of administration were period, intralumenal or rectal. The experiments were carried out in dogs, rabbits and rats. An absorption model for peptides using microemulsions as delivery systems is presented.

Administration, Oral↗

Tissue and cell specific methylation, repair and synthesis of DNA in the upper gastrointestinal tract of Wistar rats treated with single doses of N-methyl-N'-nitro-N-nitrosoguanidine.

Several potential cancer risk factors have been monitored concurrently in the upper gastrointestinal tract of young adult male Wistar rats given single (i.g.) doses of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) which readily induces forestomach tumours under these conditions. Radioimmunoassay was used to determine the formation of O6-methyl-2'-deoxyguanosine (O6-MedG) in DNA after MNNG doses of 1, 5, 25 or 50 mg/kg and was found to be highest in the pylorus, with progressively lower levels in the corpus, forestomach, duodenum, oesophagus and jejunum. Immunohistochemical procedures showed that cells with nuclei containing O6-MedG were heterogeneously distributed in these tissues. O6-Alkylguanine-DNA alkyltransferase activity in untreated animals was highest in the mucosae of the corpus, lower and relatively similar in that of the pylorus, duodenum and jejunum and lowest in the tissues of oesophagus and forestomach. Estimates of DNA synthesis and cell proliferation indicated a 5-fold increase in the DNA labelling index in the forestomach whereas perturbations of DNA synthetic activity in the other tissues of the upper gastrointestinal tract were much less marked. As a result of these changes, cells with nuclei that contained O6-MedG and were also undergoing DNA synthesis (determined by sequential immunohistochemical analysis and autoradiography) were found most commonly in the forestomach and to a lesser extent in the pylorus. This distribution of replicating damaged cells corresponds with the relative tumour yields in these upper gastrointestinal tract tissues and such cells are the probable targets in this single dose carcinogenesis regime. Thus, whilst the highest concentration of O6-MedG did not correlate tumour incidence, the overall risk for tumour induction did correlate with a significant level of DNA damage, a lower capacity for DNA repair and a marked increase in DNA synthesis over the constitutive level in the target cells. Carcinogenic risk in this system is therefore more readily determined by studying several risk factors simultaneously.

Animals↗

Bombesin receptor subtype-3 is expressed by the enteric nervous system and by interstitial cells of Cajal in the rat gastrointestinal tract.

Bombesin receptor subtype-3 (BRS-3), a G-protein-coupled orphan receptor, shares 47% and 55% homology with other known mammalian bombesin receptors. Despite the molecular characterization of BRS-3, its function remains unclear as a consequence of its low affinity for bombesin and the absence of an identified natural ligand. Although the other mammalian bombesin receptors are widely distributed in the gut and central nervous system, expression of BRS-3 in the gastrointestinal tract has not been previously described. We report the expression of BRS-3 mRNA and protein in the tunica muscularis of the rat gastrointestinal tract. The mRNA expression pattern was studied by reverse transcription followed by quantitative polymerase chain reaction. To identify the cellular sites of expression of BRS-3, we performed immunocytochemistry by using a N-terminus-specific affinity-purified antiserum. BRS-3 was found to be widely expressed in the rat gastrointestinal tract at both the mRNA and protein levels. BRS-3-like immunoreactivity (BRS-3-LI) was localized in neurons of the myenteric and submucosal ganglia, being primarily concentrated near the neuronal plasma membrane, and in fibers distributed in the longitudinal and circular muscle layers. In addition, BRS-3-LI was observed in the cell bodies and processes of c-kit+ interstitial cells of Cajal. These data have functional applications for the effects mediated by the activation of BRS-3 on gut motility through distinct neuronal and non-neuronal pathways.

Animals↗

The stapled gastrointestinal tract anastomosis: incidence of postoperative complications compared with the sutured anastomosis.

Performance of gastrointestinal anastomosis by means of surgical stapling devices has achieved popularity in the last decade even though no detailed study has been reported comparing complications following the stapled anastomosis with those following hand sutured procedures performed by the same surgeons. We have reviewed 812 operative procedures on the gastrointestinal tract performed in one hospital over a four year period. Stapled anastomoses were performed in 472 with 13 (2.8%) complications related to the anastomosis; in 296 sutured anastomoses there were nine (3.0%) related complications. Comparison did not disclose any significant difference in the number of complications in these two groups. In 44 instances wherein the anastomosis contained both staples and sutures, there were no related complications. Further analysis of the patients in each group disclosed that stapling procedures were utilized in a much higher percentage of those operations which were performed under emergency conditions or in the presence of intra-abdominal sepsis, intestinal obstruction, and carcinomatosis. If the technical details of surgical stapling are mastered, this technique appears to be as safe as suturing in the performance of anastomoses in the gastrointestinal tract.

Colectomy↗

Calcium Channel Blockers and the Gastrointestinal Tract.

Calcium ions play an important role in the normal functioning of the gastrointestinal system. The calcium channel blockers appear to affect all the organs of the gastrointestinal tract and may have therapeutic efficacy on esophageal spasm, irritable bowel syndrome, mesenteric vascular insufficiency, dyskinesis of the Sphincter of Oddi, and insulinoma. Adverse effects are limited predominantly to constipation and some aggravation of ethanol-induced ulcer disease. In addition, the drugs continue to serve as important biologic probes for understanding the normal and abnormal functioning of the gastrointestinal tract.

Journal Article↗