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PubMed1981

[Complete correction in cases of malrotation (author's transl)].

The features of malrotation of the intestine, include the incomplete fixation of the mesentery which may lead to torsion in association with abnormal positioning of the cranial mesenteric vessels. There are also abnormal strangulated peritoneal bands extending from the large bowel across the duodenum. These anomalies can either lead to duodenal obstruction or to volvulus. The operative procedure described by Ladd has the advantage that it is brief but requires relatively frequent repeat laparotomies. Complete correction with the attempted construction of normal anatomy has the disadvantage that it is a difficult and time-consuming procedure, but the incidence of repeat laparotomy is significantly lower. It is therefore suggested that "at risk" children may be preferably treated by the Ladd procedure and this should always be used if there are anaesthetic problems.

Child↗

PubMed2005

A nonthiazolidinedione peroxisome proliferator-activated receptor gamma agonist reverses endothelial dysfunction in diabetic (db/db-/-) mice.

We have previously reported that endothelium-dependent relaxation to acetylcholine is impaired in small mesenteric arteries from spontaneously diabetic (db/db) mice. The objective of the present study was to examine the effects of treatment of the db/db and the insulin-resistant ob/ob mice with the PPARgamma agonist 2-(2-(4-phenoxy-2-propylphenoxy)ethyl)indole-5-acetic acid (COOH). In the db/db model, an 8-week treatment with COOH (30 mg/kg/day) reduced plasma glucose from 48.0 +/- 2.5 (untreated) to 12.6 +/- 1.1 mM. In contrast, plasma glucose was not elevated in untreated ob/ob mice. Relaxation of small mesenteric arteries mediated by acetylcholine was impaired in the untreated db/db diabetic mice (51.7 +/- 7.4% maximal relaxation, n = 6) but not in the ob/ob mice (70.8 +/- 8.6% maximal relaxation, n = 3). This impairment was reversed with COOH treatment (86.9 +/- 0.4% maximal relaxation, n = 5). Malondialdehyde was elevated in plasma from diabetic db/db mice (13.9 +/- 1.1 versus 12.0 +/- 0.7 micromol/ml); however, when normalized to total cholesterol, no significant differences in the ratio of lipid peroxidation in plasma were identified. Western blot analysis and quantitative polymerase chain reaction for eNOS was performed on the isolated mesenteric vessels and revealed no differences in the relative levels of eNOS expression in diabetic and control animals; in addition, treatment with COOH had no significant effect on eNOS levels in either group. In summary, endothelial dysfunction and hyperglycemia were completely normalized in COOH-treated db/db mice. In contrast, nonhyperglycemic ob/ob mice exhibited normal vasodilatory responses to acetylcholine and, consequently, COOH treatment had no effect on endothelial function.

Acetates↗

PubMed1977

Norepinephrine-synthesizing enzymes in brain, adrenals and peripheral sympathetic nerves of spontaneously hypertensive rats.

Dopamine-beta-hydroxylase (DBH) activity in serum, DBH and tyrosine hydroxylase (TH) activities in mesenteric vessels, and DBH and TH activities in locus coeruleus and hypothalamus of brain did not differ significantly between spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKR) at 16 weeks of age when hypertension of SHR was fixed. In contrast, DBH and TH activities in vas deferens and adrenal glands were significantly higher in SHR than in WKR. These changes in SHR at 16 weeks of age after establishment of hypertension are directly opposite those reported previously in SHR at 3 weeks of age before the onset of hypertension.

Adrenal Glands↗

PubMed1991

[Antithrombotic effects of molsidomine alone and in combination with other antithrombotic agents in a thrombosis model of the microcirculation of the rat].

The antithrombotic effect of Molsidomin and other different antithrombotic agents have been investigated alone and in combinations in a thrombosis model in rats in which mesenteric vessels with a diameter of 20-30 microns were injured by defined argon laser lesions. In this animal thrombosis model all agents showed a significant and dose-dependent antithrombotic effect. A strong additive effect was observed when Molsidomin was infused together with Cicaprost. A similar additive effect was observed after administration Molsidomin together with heparins. The combination of a minimal effective dose of Molsidomin with Aprosulate also had a significant additive effect. After application of Molsidomin together with a TXA2 receptor antagonists a slight additive antithrombotic effect was observed.

Animals↗

PubMed1999

Role of AT2 receptors in angiotensin II-stimulated contraction of small mesenteric arteries in young SHR.

This study assesses the receptor subtype (AT1 and AT2) through which angiotensin II (Ang II) mediates contraction in small arteries of young and adult spontaneously hypertensive rats (SHR). Segments of third-order mesenteric arteries ( approximately 200 microm in lumen diameter) were mounted in a pressurized system. Systolic blood pressure and media:lumen ratio of small arteries were significantly greater (P<0.001) in young SHR and adult SHR than in age-matched Wistar-Kyoto rats (WKY). Ang II-induced contractile effects were significantly increased (P<0.05) in young SHR compared with age-matched WKY. AT1 blockade with losartan, and combined AT1 and AT2 blockade with losartan and PD123319, abolished Ang II-stimulated contraction in young and adult rats. AT2 blockade (PD123319) significantly reduced (P<0.01) Ang II-elicited contraction in young SHR but had no effect in WKY or adult SHR, indicating that AT2 receptors may contribute to Ang II-induced contraction in young SHR. To determine the Ang receptor status in rat mesenteric vessels, AT1 and AT2 receptor mRNA expression was determined by reverse transcription-polymerase chain reaction. AT1 and AT2 receptor protein expression were detected by Western blot analysis. AT1 receptor mRNA was equally expressed in age-matched rats, but expression was significantly lower in young rats compared with adult rats. AT2 receptor mRNA was weakly expressed in WKY and adult SHR. In vessels from young SHR, AT2 receptor mRNA expression was significantly increased compared with the other groups. AT1 receptor protein was equally expressed in adult rats of both strains but was undetectable in young rats. AT2 receptor protein was only detectable in young rats, with the magnitude of expression greater in SHR than WKY. In conclusion, Ang II-stimulated contractile responses are augmented in vessels from young SHR. These effects are reduced by selective AT2 blockade and abolished by AT1 blockade, indicating that both Ang receptor subtypes are involved in contraction in young SHR. In WKY and adult SHR, losartan, but not PD123319, inhibited Ang II-induced contraction, indicating the exclusive involvement of AT1 receptors. Thus, in SHR, in the phase of developing hypertension, enhanced Ang II-stimulated vascular contraction may be associated with changes in Ang II receptor status, as evidenced pharmacologically and by increased vascular AT2 receptor mRNA and protein expression.

Aging↗

PubMed1994

Modulation of lymphatic spontaneous contractions by EDRF.

Mesenteric lymph vessels exhibit spontaneous contractions that are critical in lymph fluid propulsion. We hypothesized that endothelium-derived relaxing factor (EDRF), recently identified as being released by lymph vessels, regulates contractile activity in mesenteric lymph vessels. Porcine mesenteric lymph vessel rings in vitro were administered either prostaglandin F2 alpha (PGF2 alpha; 10(-6) M), which increases contractile activity, NG-monomethyl-L-arginine (L-NMMA; 10(-4) M), which blocks EDRF production, or PGF2 alpha + L-NMMA, while paired control vessel rings remained in Krebs buffer alone. Vessel segments stimulated with PGF2 alpha exhibited repetitive contractions with more regular rhythm and uniform morphology than control segments and significantly greater frequency, amplitude, and trough and active tensions. Inhibition of EDRF production significantly enhanced the frequency (3.9 +/- 0.5 vs 2.1 +/- 0.4 min-1) and amplitude (555 +/- 42 vs 378 +/- 62 mg) of basal spontaneous contractions compared to controls and appeared to elicit more uniform contractions with respect to rhythm and morphology. PGF2 alpha-stimulated vessels pretreated with L-NMMA demonstrated uniform contractions with significant increases in contraction frequency (6.3 +/- 0.7 vs 2.4 vs 0.9 min-1), amplitude (846 +/- 120 vs 495 +/- 99 mg), trough tension (738 +/- 146 vs -6 +/- 32 mg), and active tension (1584 +/- 192 vs 489 +/- 111 mg) compared to controls (P < 0.05 for each). The effects of L-NMMA on unstimulated vessels were reversed by the addition of L-arginine but not by D-arginine (10(-4) M for each).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1988

An improved pressure-sensitive capsule for endoscopic measurement of esophageal variceal pressure.

A new small noninvasive pressure-sensitive capsule for the endoscopic measurement of esophageal varix pressure was evaluated and compared to an initial Yale-designed capsule to test the hypothesis that the diameter of the capsule measuring surface is a limiting factor for the accuracy and variability of capsule pressure measurements. Capsule pressures obtained with each capsule, using rabbit mesenteric vessels comparable in size to human esophageal varices, were correlated with direct intraluminal pressure measurements. There was an excellent correlation between capsule pressure measurements obtained with the small capsule and intraluminal pressure (r2 = 0.97) which was significantly greater than the correlation obtained when the initial capsule was studied (r2 = 0.89, P less than 0.01). The variability of capsule pressure measurements obtained with the small capsule was less than that observed when measurements were obtained with the initial capsule (P less than 0.01). Therefore, this new small capsule should provide the most accurate and reproducible noninvasive measurements of variceal pressure.

Animals↗

PubMed1976

Occlusive mesenteric infarction. A retrospective study of 83 cases.

Acute mesenteric infarction was diagnosed clinically or post mortem in 83 patients over a 10 years period in 4 surgical departments. The present study is concerned with 56 of these patients who suffered occlusive disease of the mesenteric vessels and on whom sufficient data were available. Of these 17, patients had presented at least one symptom of chronic intestinal ischemia before the fatal exacerbation. Of 42 patients treated surgically 14 had operations with curative intend and 3 patients, all with venous thrombosis, survived after small bowel resection. Only 19 percent of the patients who underwent surgery were treated within 24 hours after onset of symptoms. Early diagnosis promptly followed by surgery might save some patients. A radical improvement of survival rate can however no be expected for the acute cases. More attention should be paid to the syndrome of abdominal angina, as elective arterial reconstruction in patients with chronic intestinal ischemia carries a low mortality and renders satisfactory results.

Acute Disease↗

PubMed1973

The cellular pathology of experimental hypertension. 7. Structure and permeability of the mesenteric vasculature in angiotensin-induced hypertension.

Acute hypertension was produced in rats by the infusion of angiotensin amide for 2 to 4 hours. These animals were injected intravenously prior to sacrifice with either colloidal carbon or iron dextran particles. The mesenteric vessels from hypertensive and control animals were processed for electron microscopy. Ultrastructural alterations are found in dilated segments of small arteries. Initially there is severe contraction of medial smooth muscle cells and the formation of processes of smooth muscle cytoplasm. This is followed by lysis of cell processes and bodies, and passage of plasma and colloidal iron into the media. Subsequently, carbon, platelets, fibrin and cellular debris are seen within these foci of medial necrosis. These changes appear as a sequence whose severity reflects the duration of the angiotensin infusion and degree of elevation of the systolic pressure. The morphologic alterations are discussed in relation to the generalized increase in vascular permeability that is associated with the hypertensive state.

Angiotensin II↗

PubMed1981

Mesenteric angiopathy, intestinal gangrene, and midgut carcinoids.

Twenty-six cases of carcinoid-related mesenteric angiopathy and intestinal infarction (three from our institution and 23 previously reported cases) were reviewed. Twenty patients presented with acute abdominal findings, including peritonitis (13 cases), intestinal obstruction (five cases), and bleeding per rectum (two cases). Fifteen patients (75%) experienced antecedent symptoms of abdominal pain and/or diarrhea, averaging 2.5 years in duration. Twelve patients (46%) exhibited symptoms of carcinoid syndrome. Mesenteric angiography in three cases demonstrated encasement and segmental branch narrowing or occlusion of major mesenteric vessels. Eleven patients underwent resection and primary bowel anastomosis with an early survival rate of 91%. Four additional patients who underwent lesser surgical procedures and five patients who did not undergo operation all died. Elastic vascular sclerosis (EVS) was identified in 19 of 22 cases with available histologic material (86%). These changes were observed in proximity to as well as distant to the primary tumor. In general, the severity of EVS did not correlate with the likelihood of gut ischemia. Although not the sole cause of intestinal gangrene in patients with midgut carcinoids, EVS may contribute significantly to the evolution of these ischemic changes.

Adult↗

PubMed1989

The surgical treatment of adenocarcinoma of the duodenum distal to the ampulla of Vater.

The case analysis of five patients with post-ampullary adenocarcinoma of the duodenum showed this to be a tumor which favors local extension into surrounding organs, instead of lymphatic or hepatic metastasis. This justifies and aggressive resectional approach to treatment, pancreaticoduodenectomy being the basic operation to be applied. Proximity to the superior mesenteric vessels involving them in four out of five of our tumors, is the major anatomic limiting factor. Leaving vascular control for the end of the excision and perfusing them to maintain viability of the gut until a comfortable vascular anastomosis can be constructed, should solve the problem. Misdiagnosis proved to be a prominent source of error, causing delays and inappropriate therapy. The Cancer Registry of Puerto Rico has documented an incidence of carcinoma of the duodenum similar to that of the ampulla of Vater. This fact demands the same care in the conduct of diagnostic procedures of the distal duodenum as is customary in the visualization of the ampulla.

Adenocarcinoma↗

PubMed1983

Effect of beta adrenoreceptor blocking drugs on the responses of isolated rat mesenteric arteries.

The effect of several beta-blockers on the vasoactive effect of several substances was studied on the perfused isolated rat mesenteric vessels. The agonists were tested while the beta-blocker was infused; the effects were compared in the same experiment with those observed in a control period in which the agonists were injected without simultaneous infusion of beta-blocker. l-propranolol, infused at three different doses, did not modify the vascular effect of either angiotensin II (AII) or vasopressin (VP). On the other hand, the constrictor effect of epinephrine (E) and norepinephrine (NE) was significantly reduced. Timolol, but not sotalol, showed the same results. d-propranolol produced the same effect as l-propranolol. A high dose of l-propranolol did not protect alpha adrenoceptors of blockade induced by phentolamine.

Adrenergic beta-Agonists↗

PubMed1996

Comparison of vascular nitric oxide production and systemic hemodynamics in cirrhosis versus prehepatic portal hypertension in rats.

Nitric oxide (NO) is postulated to play a role in the pathogenesis of arterial vasodilation in chronic portal hypertension. This present study investigates the relationship between systemic hemodynamics and the vascular production of NO, as estimated by measuring cyclic guanosine monophosphate (cGMP) in aortic tissue in two models of chronic portal hypertension in the rat: the partial portal vein ligation (PVL) model and CCl4-induced cirrhosis. NOS was also examined by Western blotting in aortic and mesenteric vessels. Sham-operated rats and rats given phenobarbital were used as controls. PVL rats and rats with cirrhosis and ascites showed a typical pattern of a hyperdynamic circulatory state, when compared with their respective controls: mean arterial pressure; PVL: 113 +/- 2 versus 124 +/- 2, P < .01 and cirrhotics: 103 +/- 5 versus 130 +/- 4 mm Hg, P < .01. Cardiac index; PVL: 32 +/- 2 versus 26 +/- 1, P < .01 and cirrhotics: 51 +/- 3 versus 30 +/- 1 mL . min-1 . 100 gm-1, P < .0001. Systemic vascular resistance; PVL: 3.7 +/- 0.1 versus 4.9 +/- 0.2, P < .01 and cirrhotics: 2.1 +/- 0.2 versus 4.4 +/- 0.2 mm Hg . min-1 100 g-1, P < .0001. Aortic cGMP was markedly increased in cirrhotic rats with ascites (728 +/- 83 fmol/ mg protein) as compared with phenobarbital-treated controls (244 +/- 31 fmol/mg, P < .001). This increase was abolished by chronic administration of N(omega)-nitro-L-arginine methyl ester. By contrast, PVL rats had an aortic cGMP concentration similar to sham-operated controls (282 +/- 16 fmol/mg vs. 274 +/- 33 fmol/mg, P = not significant) and significantly lower than that found in cirrhotic rats with ascites. Expression of cirrhotic aortic endothelial nitric oxide synthase (eNOS) was increased but PVL aortic eNOS did not differ from that of controls, whereas the mesenteric eNOS was increased in both PVL and cirrhotic rats as compared with the controls. These results suggest that vascular NO production is higher in cirrhotic rats than in PVL rats. This increased production may contribute to the more marked abnormalities in systemic hemodynamics seen in experimental cirrhosis as compared with PVL.

Animals↗

PubMed2005

Abdominal CT findings may suggest coeliac disease.

BACKGROUND: Coeliac disease is the most common gastrointestinal immunological disorder in the western countries. Many adult patients present non-specific symptoms and signs of malabsorption such as chronic diarrhoea, anaemia, weight loss and abdominal distention. In non-specific and doubtful conditions, computed tomography is often the first medical examination performed. In a clinical practice, a critical review of computed tomography signs is therefore mandatory. AIMS: To evaluate the abdominal computed tomography findings, which are useful to suggest the presence of coeliac disease in adult patients. PATIENTS AND METHODS: The computed tomography studies of 28 coeliac patients were reviewed, looking for any intestinal and extraintestinal abnormality. The computed tomography findings evaluated were: abnormalities of intestinal fold pattern, bowel dilatation, fluid and air excess, duodenal abnormalities, intestinal intussusception, bowel wall thickening, lymphadenopathy, ascites, intestinal stenosis, mesenteric vascular changes. The abdominal computed tomography of a group of 30 normal subjects was also analysed. RESULTS: Intestinal fold pattern abnormalities were seen in 23/28 patients. Intestinal dilatation was seen in 21/28. Fluid excess in 18/28 and lymphadenopathy was seen in 12/28 patients; engorgement of mesenteric vessels in 7/28. Bowel wall thickening was observed in 6/28 patients and transient intussusception was observed in 6/28 patients. Increased air content within the bowel in 4/28 and ascites in 2/28 patients. Bowel dilatation together with fluid excess was observed in 18/28 patients. None of the above mentioned abnormalities abnormalities were seen in normal subjects. CONCLUSIONS: Data of the present study show that several abdominal computed tomography findings may be seen in coeliac adult patients; these findings should be taken into consideration with a high in level of suspicion by radiologists, to avoid diagnostic delay and unnecessary diagnostic and therapeutic procedures.

Adult↗

PubMed1983

Experimental ischemic colitis in dogs.

Experimental ischemic colitis was produced in 42 dogs by either ligation (ligation group, n=18) or temporary occlusion of the mesenteric vessels (temporary occlusion group, n=24) and changes in the local blood flow in the bowel were measured by the hydrogen clearance method. Tissue damage similar to damage seen in patients with ischemic colitis were produced in both of these groups. There was a close correlation between the severity of the ischemia and the ensuing tissue damages. In the ligation group, the tissue damages ranging from erosions or minute ulcerations to diffuse ulcerations occurred when the local blood flow was measured at 30 minutes after the ligation and was below 50 per cent of the basal flow. In the temporary occlusion group, the tissue damages were observed when the local blood flow was below 40 per cent of the basal flow and the occlusion was maintained for over two hours.

Animals↗

PubMed1997

CT findings at lupus mesenteric vasculitis.

PURPOSE: To describe the spectrum of early CT findings of lupus mesenteric vasculitis (LMV) and to assess the utility of CT in the management of this uncommon entity. METHODS: Abdominal CT was performed within 1-4 days (average 2.2 days) of the onset of severe abdominal pain and tenderness in 15 women with systemic lupus erythematosus. Prompt high-dose i.v. corticosteroid was administered in 11 patients after the CT diagnosis of LMV was made. CT was performed after abdominal symptoms subsided. RESULTS: Eleven cases revealed CT features suggestive of LMV including conspicuous prominence of mesenteric vessels with palisade pattern or comb-like appearance (CT comb sign) supplying focal or diffuse dilated bowel loops (n = 11), ascites with slightly increased peritoneal enhancement (n = 11), small bowel wall thickening (n = 10) with double halo or target sign (n = 8). Follow-up CT before high-dose steroid therapy revealed complete or marked resolution of the abnormal CT findings. CONCLUSION: CT is helpful for confirming the diagnosis of LMV, especially the comb sign which may be an early sign. Bowel ischemia due to LMV is less ominous than previously expected, and the abnormal CT findings were reversible when early diagnosis and prompt i.v. steroid therapy could be achieved.

Abdominal Pain↗

PubMed1990

Endothelium-dependent and BRL 34915-induced vasodilatation in rat isolated perfused mesenteric arteries: role of G-proteins, K+ and calcium channels.

1. In the isolated perfused, noradrenaline (NA)-constricted mesenteric arteries of the rat, acetylcholine (0.003-1 nmol), histamine (0.01-10 nmol) and the calcium ionophore A23187 (0.01-1 nmol), caused endothelium-dependent vasodilatation while the vasodilatation by the K+ channel activator BRL 34915 (0.1-1 nmol) was independent of endothelium. 2. The guanylate cyclase inhibitor, methylene blue at 10 microM did not inhibit the action of any of the vasodilators but at 50 microM reduced the vasodilator effect of acetylcholine (ACh), histamine and A23187. 3. Infusion of ouabain or perfusion with K(+)-free or excess K+ (50 mM) Krebs solution reduced the vasodilator effect of ACh, histamine and A23187, suggesting the action of these agents involves, at least in part, activation of Na+/K(+)-ATPase. The vasodilator effect of BRL 34915 was not affected by ouabain, but abolished during perfusion with Krebs solution containing excess K+ or depleted of K+. 4. Five structurally distinct K+ channel blockers (apamin, crude scorpion venom, procaine, quinidine and tetraethylammonium) attenuated the vasodilator effect of ACh, histamine and A23187. The K+ channel blockers, except apamin and crude scorpion venom, also inhibited the vasodilatation produced by BRL 34915. 5. The vasodilator effect of ACh, histamine or A23187 was not altered in mesenteric vessels of pertussis toxin-treated rats, suggesting that the K+ channels associated with the endothelium-dependent vasodilator effect of these agents are either not coupled to G-proteins or are coupled to G-proteins that are insensitive to pertussis toxin. 6. The calcium channel blockers, diltiazem (0.1 or 1 microM), nifedipine (0.01 or 0.1 microM) or nitrendipine (1 nM) attenuated the vasodilatation produced by ACh, histamine, A23187 and also that by BRL 34915. 7. We conclude that endothelium-dependent vasodilatation induced by ACh, histamine and A23187 is mediated via activation of membrane K+ channels and Na+/K+-ATPase. The K+ channels involved in the vasodilator action of these agents are not coupled to pertussis toxin-sensitive G-proteins and appear to be regulated by Ca2 +.

Acetylcholine↗

PubMed2004

Isolated small bowel transplantation from a living-related donor at the Catholic University of Korea--a case report of rejection -free course-.

The bowel transplantation team at the Catholic Medical Center, Korea, on April 9 2004, accomplished a case of isolated small bowel transplantation (SBT) in a 57 year-old female with short bowel syndrome. The primary surgery was a jejunocolostomy due to mesenteric vein thrombosis, while maintaining 30 cm of the jejunum and colon distal to the splenic flexure. Her renal function was partially unbalanced. During more than 2 years of home TPN, the superior vena cava (VC) and subclavian veins had become occluded, but the inferior VC line remained. SBT was planned due to the repeated life-threatening infections of the last central line. One hundred and fifty centimeter of the distal ileum of the 27 year-old living-related donor, the patient's daughter, was harvested. The graft mesenteric artery and vein were anastomosed to the recipient's inferior mesenteric vessels. A proximal end-to-end jejuno-ileostomy and a distal end-to-side ileo-colostomy of the graft were made, creating a Bishop-Koop enterostomy for graft surveillance. A tube jejunostomy, via a gastrostomy, was established for early feeding and simultaneous gastric drainage. Induction with Daclizumab and immunosuppression consisted of tacrolimus and methylprednisolone, given intravenously, and then mycophenolate mofetil (MMF), enterally from day 3. The patient was discharged on day 42. A CMV infection on day 83 was successfully treated with 3 weeks of gancyclovir therapy. She has been nutritionally independent, with complete oral feeding, and free of rejection until day 170 after the transplantation.

Female↗