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[The current state of endoscopic polypectomy of the large intestine].

The current state of endoscopic polypectomy of the large intestine is analysed. The indications for this treatment and the main complications arising (haemorrhages, perforations, colonic rupture) are evaluated with details of possible treatment and/or prevention. The connections with histology and surgery are also discussed. Finally, the treatment and follow-up of cancerised rectocolonic polyps are discussed in detail.

Arginine Vasopressin↗

[Effect of the distribution of hay and cereals on the cellulolytic activity in the large intestine of the pony].

The cellulolytic activity in the large intestine of the pony varies according to the form and the composition of the feed. This activity was measured on two caecal and ventral colon-cannulated ponies receiving the following 4 diets during four successive 6-week periods: --6 kg of hay, --4 kg of hay + 1 kg of oats, --6 kg of ground, pelleted hay. --5 kg of a ground, pelleted blend of 80 p. 100 hay and 20 p. 100 oats. Adding oats to a hay feed increased the cellulolytical activity in the caecum and the colon, whereas grinding and pelleting hay alone or hay enriched with oats diminished that activity in the caecum without modifying it in the colon (table 1). The volatile fatty acid production shown in table 2 does not always vary in the same way as cellulolytic activity; this might be due to some variations in the values of the digestive contents in the two compartments.

Animal Feed↗

[The differential diagnosis of a tumor of the large intestine and ovaries].

Symptomatic of the affection of the large intestine are gastrointestinal discomfort presenting with disturbances in the intestinal passage, tendency toward persistent constipation, anemia of obscure genesis of longstanding, local pain, habitual or spasmodic, severe tenderness on the tumour. The main complaints in the affection of the ovaries include abrupt enlargement of abdomen in size, with the pain symptom being mild; in case it occurs, it has no clear-cut position; no complaints of the intestinal discomfort, the tumour is not tender, no anemia.

Adult↗

[A method for forming a large-intestine reservoir for the urine].

Eighteen patients with cancer of the urinary bladder underwent cystectomy with formation of a large intestinal reservoir for urine. The terminal large intestinal portion, 15-20 cm, the cecum, the ascending colon, and the hepatic angle of the colon were excluded to produce a reservoir from the intestinal tube. Appendectomy was performed. The continuity of the intestinal tube was restored via ileotransversostomy. The ureters were retroperitoneally grafted into the cecum by using antireflux and antistricture techniques. The ileocecal valve was clinico-anatomically examined. A device restraining urine was formed on an individual basis in relation to the function of Bauhin's valve. Cutaneous urinostoma ("dry") was formed epicutaneously in the right iliac region below the umbilicus. Three patients died in the postoperative period. Complete urine keeping was observed in 14 of 15 patients. The maximal capacity of the reservoir is 500 ml, the pressure is 30-40 cm H2O. Homeostasis and intestinal function were found to be normal.

Adult↗

[Diagnostic and therapeutic endoscopy in acute obstruction of the large intestine].

A total of 100 patients with a clinical picture of acute large-intestinal obstruction have been examined to whom 157 endoscopic highly effective diagnostic and therapeutic interventions were performed. The data obtained were used to determine the sequence of actions by a specialist in endoscopy during the treatment of large intestinal obstruction.

Acute Disease↗

Electrophysiological principles of motility disturbances in the small and large intestines--review of the literature and personal experience.

Motility disturbances of the small and large intestines are based on changes in the smooth-muscle potential, whereby the number of amplitudes and configuration of slow waves and of spike potentials as well as pattern, speed of propagation, and duration of the MMC are of crucial importance. Whereas the electromechanical principles of intestinal motility are sufficiently known, changes in the electromechanical activity in clinically manifest motility disturbances have as yet not been given due regard. Only recently, electromechanical measurements in the upper gastrointestinal tract and colon were performed in several gastrointestinal diseases of internal medicine. In the small intestine, changes in slow waves, spike potentials, and the MMC could be disclosed which are typical for hyperthyrosis, hypothyrosis, irritable bowel syndrome, bacterial diarrhea, primary and secondary intestinal pseudo-obstruction, short-bowel syndrome, postoperative bowel atonia, mechanical bowel obstruction, vagotomy, and diabetic enteropathy with disturbed gastric emptying. Regarding the colon, a disturbance in the electromechanical characteristics was found in irritable bowel syndrome, bacterial overgrowth in the small bowel, chronic constipation, and idiopathic intestinal pseudo-obstruction, which is probably identical with the clinical picture of adynamic ileus. Based on a thorough examination of the literature and on own results from electromechanical measurements in children, electromechanical disturbances have been narrowly defined.

Colon↗

Glycolipids of rat large intestine. Characterization of a novel blood group B-active tetraglycosylceramide absent from small intestine.

A novel blood group B-active tetraglycosylceramide has been isolated from rat large intestine. It is probably present only in the epithelial cells. Although the compound was not obtained pure, the structure was conclusively established by mass spectrometry, proton NMR spectroscopy and degradative studies to be Galp alpha 1 leads to 3Galp(2 comes from 1 alpha Fucp)beta 1 leads to 4Glcp beta 1 leads to 1Cer. The ceramide was composed of mainly trihydroxy long-chain base (18:0) and non-hydroxy fatty acids (16:0-24:0). The glycolipid was absent from small intestine.

Animals↗

Kinetics of hexose uptake by the small and large intestine of the chicken.

The kinetic parameters of hexose uptake by the small and large intestine of the chicken have been determined in vitro. Rates of initial influx of alpha-methyl-D-glucoside and L-glucose were measured in everted sleeves of the duodenum, jejunum, ileum, proximal cecum, and rectum. Results show the following. 1) Maximal transport capacity values for alpha-methyl-D-glucoside show that the jejunum is the segment that is best suited for Na(+)-mediated uptake. 2) The calculated apparent Michaelis constant values were (in mmol/l) 11.6 for duodenum, 7.8 for jejunum, 3.5 for ileum, 2.4 for proximal cecum, and 7.1 for rectum. This suggests that, with the exception of the rectum, the affinity of the carrier for alpha-methyl-D-glucoside progressively increases in the distal direction. 3) Diffusion constant values indicate that influx of hexoses by a passive mechanism in the duodenum and proximal cecum is significantly higher than in the other segments. 4) The sum of passive and mediated mechanisms confers to the duodenum and jejunum a high capacity to absorb hexoses. The ileum, proximal cecum, and rectum have a quantitatively minor role, albeit significant, in completing the absorptive function.

Animals↗

[Possible combination of eosinophilic infiltration of the stomach, small and large intestines with psoriasis].

The combination of the eosinophilic infiltration of the stomach, small and large intestine with psoriasis is described. Diarrhea and syndrome of the disturbed absorption in eosinophilic gastroenteritis coincided with exacerbation of the skin disease. Clinical regression of both conditions with disappearance of peripheral eosinophilia occurred simultaneously. Participation of T-cell immunity and IgE is suggested as a pathogenetic mechanism of eosinophilic gastroenteritis and psoriasis.

Eosinophilia↗

[Large intestinal epithelium and short-chain fatty acids. Expected, unexpected, unexplained findings].

Short-chain fatty acids (SCFA) are present in hindgut contents in high concentrations. SCFA are generated and also absorbed rapidly in the large intestine. Absorption results from diffusion of the undissociated and lipid soluble form or in exchange for bicarbonate. The controversial concepts concerning the extent of diffusion or the exchange for bicarbonate are partly due to contradictory findings and unequal mechanisms in different species and in different segments of the large intestine as well as in the different methods used. An almost neutral pH microclimate at the luminal surface is of importance for absorption of SCFA. The apical membranes of the epithelial cells in caecum and in proximal colon of guinea pigs are an substantial barrier for the diffusion of SCFA. After withdrawal of butyrate for only one hour from the perfusion or incubation solutions a massive apoptosis had been observed during the in situ perfusion of segments of guinea pig large intestine and also in in vitro studies with isolated epithelia in Ussing-chambers. In vitro apoptotic bodies and cells are emitted at the epithelial surface. However, in vivo induced by butyrate deprivation resident macrophages were tightly clustered below the surface epithelium. Aided by cytoplasmatic projections these macrophages phagocytose and transport apoptotic material from the epithelial intercellular spaces into their bodies. Obviously macrophages can be overloaded by this massive apoptosis, and some of the undigested apoptotic fragments are emitted into the lamina propria. Formation of a colitis ulcerosa may originate from these released undigested apoptotic bodies. Furthermore hints indicate aetiological interrelations between deprivation of butyrate and colon cancer. Butyrate-paradox denotes the contrarian effects on apoptosis and cell proliferation after addition or deprivation of butyrate in cultures of large intestinal tumour-cell-lines in comparison with the healthy, intact epithelium.

Animals↗

[A study on the development of the nitrergic neurons in the large intestine of human fetus].

By using histochemical methed of NADPH-diaphorse, the development of the nitrergic neurons in the large intestine of human fetus were studied. The results showed: At the fifth month of gestation, weak positive reaction of nitric oxide synthase (NOS) appeared in part of the round cells of intermuscular ganglia. The round cells differentiated into the nitrergic nerve cells. At the sixth month, the bodies of nitrergic neurons were obviously enlarged, the processes of which were lengthened. The nitrergic nerve fibers were seen in the muscle layer, the submucosa and the base of the intestinal gland. The growth and development of nitrergic neurons reached its peak at the seventh month. The number of intermuscular ganglionic cells was increased. The density of nitrergic nerve fibers was increased in the inner circular muscle layer, and have bead-like structures. At the eighth to tenth month, the staining intensity of nitrergic neurons was increased. The myenteric plexus was densely distributed with nitrergic nerve cell bodies, whereas the submucosa and the inner circular muscle layers contained only a few neurons. The nitrergic nerve fibers were observed in all layer of large intestine, the density of the distribution of nitrergic nerve fibers was by far the highest in the inner circular muscle layer, less in the submucosa and outer longitudinal muscle layer, and only a few were found in the mucous layer. To our knowledge, it is the first time that the development of nitrergic neurons in the large intestine of human fetus was demonstrated.

Enteric Nervous System↗