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Results for “GASTROINTESTINAL TRACT”

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PubMed1982

Malignant lymphomas primarily involving the gastrointestinal tract.

Primary gastrointestinal lymphoma (PGIL) develops mostly on the basis of lymphoplasmocellular infiltration following an alteration of gastric or intestinal mucosa; its evolution is enhanced by a simultaneous defect of cell-mediated immunity. The paper deals with clinical, biochemical and immunological findings observed in 22 patients with PGIL during a course of 10 years. Some illustrative patient summaries are reported in a more detailed description. In histological terms, the cases were classified according to the Kiel classification. There seems to be an unfavourable prognosis of the disease, the average survival being about 10 months and cytostatic treatment is not tolerated well. The particular features of PGIL important for the diagnosis and treatment are pointed out.

Adolescent↗

PubMed1998

[Factors involved in the regeneration of the gastrointestinal tract].

The gastrointestinal mucosal regeneration is a complex process that includes cell migration and proliferation. A wide variety of factors are presumably be involved in the reestablishment of the functional and structural integrity of the mucosa, and different experimental models have been applied to elucidate these factors. Accumulating evidences indicate the importance of soluble factors (e.g. growth factors, cytokines, trefoil peptides) and matrix components in the mucosal healing. Though the interactions of these factors remain to be fully elucidated, the identification of physiologically relevant factors that stimulate mucosal repair and a through description of the mechanisms of action may lead to the development of specific strategy for the promotion of the mucosal healing by exploiting natural mechanisms of regeneration.

Cell Division↗

PubMed1989

[Non-adrenergic, non-cholinergic inhibitory innervation to the gastrointestinal tract].

The smooth muscles of the gastrointestinal tract and blood vessels are innervated by non-adrenergic, non-cholinergic (NANC) inhibitory neurons. The transmitter(s) in relation to NANC inhibitory neurons remains unknown, but there are two main working hypotheses, the purinergic and VIPergic nerve hypotheses, at present. Although there is a large amount of data supporting the purinergic hypothesis, definitive evidence is still lacking. VIP seems to be regarded as a likely candidate for the neurotransmitters of some NANC inhibitory neurons. However, the data presented are still incomplete. For the purinergic hypothesis, the discrepancies seem to be greater in the stomach and oesophagus and those for the VIPergic hypothesis, in the guinea pig taenia coli. Moreover, there are many examples of the co-existence of peptides or of peptides and synthesizing enzymes of amines or acetylcholine in the gastrointestinal tract. Therefore, it is possible that NANC inhibitory neurons liberate more than one active inhibitory substance and/or there are different types of NANC inhibitory neurons in the gastrointestinal tract. Much more evidence seem to be needed before the neurotransmitter(s) of NANC inhibitory neurons in the gastrointestinal tract and blood vessels can be identified.

Adenosine Triphosphate↗

PubMed2004

[Acute complications of diabetes and the gastrointestinal tract].

Acute metabolic decompensation of diabetes, hypoglycemia and gastrointestinal tract disease are often connected. Hyperglycemic crisis can be induced by an infectious disease of the gastrointestinal tract, ulcerative disease, gall bladder disease, pancreas disease, and gastrointestinal tract tumours. It can result from diabetic visceral neuropathy manifested especially by impaired patency of the gastrointestinal tract. Metabolic decompensation of diabetes is often accompanied by gastrointestinal symptoms and abnormal laboratory findings. Some of them (especially abdominal pain and increased levels of amylases in serum) can evoke diagnostic and therapeutic hesitation. Insufficient nutrition as a result of gastrointestinal tract disease or adverse reaction to drugs used for its treatment can induce both metabolic decompensation and hypoglycemia.

Acute Disease↗

PubMed2003

Gastrointestinal tract cancer screening using fecal carcinoembryonic antigen.

There is a great need to detect gastrointestinal tract cancer at an early stage. It is well known that most carcinoma tissues of the gastrointestinal tract contain carcinoembryonic antigen (CEA). Stools are a rich source of cells derived from the gastrointestinal tract. We analyzed total fecal CEA in 60 gastrointestinal tract cancer patients, 20 benign gastrointestinal tract disorder patients, and 240 normal controls, using a simple, reliable method. We compared the sensitivity and specificity of fecal CEA with those of serum CEA and fecal occult blood test (FOBT). The level of fecal CEA in gastrointestinal tract cancer was much higher than controls (44.1 +/- 70.1 ng/mg stool vs 3.7 +/- 3.5 ng/mg stool, p < 0.001) and was not increased in benign gastrointestinal disorders (4.5 +/- 8.2 ng/mg stool). Fecal CEA level was > 10 ng/mg stool in 22 of 32 samples (69%)from stomach cancer patients and 24 of 28 samples (86%)from colorectal cancer patients. The sensitivity of serum CEA (> 5 ng/ml) was 19% in stomach cancer and 39% in colorectal cancer, whereas the sensitivity of FOBT was 13% in stomach cancer and 21% in colorectal cancer. The specificity of fecal CEA was 90% in benign gastrointestinal tract disorders and 93% in normal controls. This specificity was similar to those of serum CEA and FOBT. In conclusion, fecal CEA measurement is superior to serum CEA or FOBT for detection of gastrointestinal tract cancer. Fecal CEA may become the screening test of choice for gastrointestinal tract cancer.

Adult↗

PubMed1996

Endoscopic features of metastatic tumors in the upper gastrointestinal tract.

BACKGROUND AND STUDY AIMS: Metastatic tumors in the upper gastrointestinal tract are rare. The tumors that most frequently metastasize to the upper gastrointestinal tract are reported to be melanoma, lung cancer, and breast cancer. We describe here our experience in relation to the clinical manifestations and endoscopic findings of metastatic tumors in the upper gastrointestinal tract. PATIENTS AND METHODS: Excluding leukemia, lymphoma, and direct tumor invasion, eight cases of metastatic tumor in the upper gastrointestinal tract from five identified primaries were observed over a period of eight years. The histological nature of the lesions was verified by endoscopic biopsy. RESULTS: The primary tumors in the eight cases were lung cancer (two cases), renal transitional-cell carcinoma (two cases), colonic cancer (two cases), melanoma (one case) and testicular embryonal cell carcinoma (one case). Acute upper gastrointestinal bleeding and anemia were the most common features of the clinical presentation, and the stomach and duodenum were the organs most often involved. Endoscopically, submucosal tumors and polypoid masses, with either erosion or ulceration, were the usual morphological findings. CONCLUSIONS: Panendoscopy with histological examination is a way of identifying metastatic tumors to the upper gastrointestinal tract when patients have a known primary cancer and symptoms relating to the upper gastrointestinal tract. However, there is no specific information allowing the origin of a lesion to be predicted.

Adult↗

PubMed2005

Expression of cellulose and curli fimbriae by Escherichia coli isolated from the gastrointestinal tract.

Escherichia coli colonizes the gastrointestinal tract of humans; however, little is known about the features of commensal strains. This study investigated whether expression of the biofilm extracellular matrix components cellulose and curli fimbriae is found among commensal isolates. Fifty-two E. coli strains were isolated from faecal samples and, as a control, 24 strains from urinary tract infections were also used. Faecal isolates were characterized by serotyping and phylogenetically grouped by PCR. The genotype was determined by PFGE and the presence of virulence factors was assessed. Co-expression of cellulose and curli fimbriae at 28 degrees C and 37 degrees C was typical for faecal isolates, while urinary tract infection strains typically expressed the extracellular matrix components at 28 degrees C only. Knockout studies in a representative faecal isolate revealed that the response regulator CsgD regulated cellulose and curli fimbriae, as found previously in Salmonella enterica. In contrast to S. enterica, at 37 degrees C pellicle formation occurred in the absence of cellulose and curli fimbriae. The gastrointestinal tract represents a source of biofilm-forming bacteria, which can spread to susceptible sites.

Adolescent↗

PubMed1997

A correlative study of histology and imprint cytology in the diagnosis of gastrointestinal tract malignancies.

Endoscopic mucosal biopsies from 323 patients (201 from upper gastrointestinal tract and 122 from lower gastrointestinal tract) were studied to correlate the diagnostic efficacy of histology and imprint cytology in the diagnosis of malignant lesions of gastrointestinal tract. Of these 71 were from normal controls, 113 from benign lesions and 131 from malignant lesions. Histology showed no false positive reports but it was false negative in 6 cases (3 in oesophagus, 1 in stomach and 2 from colon). Imprint was false positive in 3 cases (2 oesophagus, 1 colon) and false negative in 2 cases (both oesophagus). The overall diagnostic accuracy of histology and imprint cytology in oesophagus, stomach and lower gastrointestinal tract was 95%, 98%, 98% and 95%, 100%, 98% respectively. When combined, the diagnostic accuracy increased to 98%, 100% and 100% in oesophagus, stomach and lower gastrointestinal tract respectively. The sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy for histology and cytology irrespective of the site was 96%, 100%, 100%, 94%, 97% and 98.5%, 97%, 98%, 98%, 98% respectively. Thus imprint cytology can act as an adjunct to bioptic histology to increase the diagnostic efficacy and save the time but definitely it cannot replace it as chances of false positives are high.

Biopsy↗

PubMed1990

Haemangiomas of the gastrointestinal tract in children.

Haemangiomas of the gastrointestinal tract are unusual vascular anomalies either in children or in adults. There is a significant difficulty in their diagnosis because of this rarity. However, when they are present, haemangiomas of the gastrointestinal tract may be a source of acute or chronic blood loss and anaemia. The case histories of two children with severe gastrointestinal bleeding due to cavernous haemangioma of the duodenum and caecum are presented in this report. Progressive haemorrhage from the gastrointestinal tract was the indication for operative intervention in both children. Each child underwent complete resections of the haemangiomas and is well and symptom-free one year after the surgical treatment. The purpose of this paper is to draw attention to this uncommon benign condition which has a relatively high mortality due to the delays in diagnosis and inadequate treatment.

Cecal Neoplasms↗

PubMed2006

The value of reoperative procedures after unusual reconstructions in the gastrointestinal tract associated with substantial morbidity.

Reconstructive procedures of the gastrointestinal tract after resection or for bypass surgery are well established and almost completely standardized but still may cause significant morbidity. Deviations from standard reconstructive procedures have pitfalls, especially when complex reconstructions are required, and may lead to substantial morbidity. Scientific evidence for the indication to reoperate as well as the best methods to be applied is lacking and surgical experience indispensable. We report on 10 reoperative cases between 1999 and 2003 after uncommon reconstructive procedures in the gastrointestinal tract associated with substantial morbidity. In five cases (five of seven), operative correction of uncommon reconstructions in the upper gastrointestinal tract after gastrectomy, completion gastrectomy, or distal gastric resection could completely alleviate the complaints including reflux esophagitis, whereas incomplete relief of symptoms was achieved in the remaining two cases (two of seven). Corrective procedures used end-to-side esophagojejunostomy or end-to-side gastrojejunostomy with a retrocolic isoperistaltic jejunal Roux-en-Y loop and end-to-side jejunojejunostomy approximately 40 cm distal to the proximal anastomosis for biliary and exocrine pancreatic drainage. After biliodigestive anastomosis, problematic cholangitis could be completely alleviated in three cases (three of three) using end-to-side hepaticojejunostomy with a retrocolic isoperistaltic jejunal Roux-en-Y loop and end-to-side jejunojejunostomy 40 cm distal to the hepaticojejunostomy for reconstruction of the continuity of the gastrointestinal tract. Compliance with well-established standard reconstructive procedures is of elementary importance in the gastrointestinal tract. Operative correction of uncommon reconstructions associated with morbidity is usually indicated.

Aged↗

PubMed1979

Disseminated endocrine cells of the gastrointestinal tract and their possible influence on gastrointestinal disease.

The role of the disseminated endocrine cells of the gastrointestinal tract is reviewed. Some of these cells are scarce or absent in pernicious anemia, ulcerative colitis and Sheehan's syndrome, but are increased in number in peptic ulceration, chronic gastritis and celiac disease. A subgroup of the diffuse endocrine cells with both endocrine and exocrine functions, the so-called amphicrine cells, suggests that these cells originate from the entoderm. A study of the diffuse endocrine cells in the chronic intestinal diseases of the developing countries is suggested.

Appendiceal Neoplasms↗

PubMed2005

What is dysplasia in the gastrointestinal tract?

Dysplasia in the gastrointestinal tract is considered both a carcinoma precursor and a marker of high cancer risk for the site at which it is found. Dysplasia is defined as unequivocally neoplastic epithelium, yet the specific criteria for making that determination are imperfectly defined. The current criteria actually include a mix of architectural and cytologic features, all of which occur in different intensities in different epithelia that are given the same diagnosis. Gastrointestinal dysplasias are divided into 2 grades, but there are problem areas in diagnosis at the lower end where low-grade dysplasias overlap with regenerating epithelia and in the middle where low- and high-grade dysplasias overlap. The diagnosis of dysplasia is too subjective with less than optimal reproducibility to be as useful a marker as needed. Pathologists need a dysplasia stain or a whole set of new markers of high cancer risk, presumably molecular and/or genetic, that are not dependent on pathologists' diagnoses of dysplasia and their inherent subjectivity.

Gastrointestinal Diseases↗

PubMed1993

Gastrointestinal tract duplications: clinical, pathologic, etiologic, and radiologic considerations.

Gastrointestinal tract duplications are uncommon congenital abnormalities. By definition, they are located in or adjacent to the wall of part of the gastrointestinal tract, have smooth muscle in their walls, and are lined by alimentary tract mucosa. The lining mucosa is not necessarily that of the adjacent segment of the gastrointestinal tract. The only clinically important ectopic tissues are gastric mucosa and pancreatic tissue. Although ectopic gastric mucosa is found in duplications at all levels of the gastrointestinal tract, it is most prevalent (43%) in esophageal duplications. Peptic ulcer within this ectopic tissue can account for unusual, often misleading symptoms. Ectopic pancreatic tissue is most common (37%) in gastric duplications and is associated with pancreatitis and elevated amylase levels. Detection of associated vertebral anomalies is a helpful clue in the radiographic diagnosis of duplications. Barium studies usually reveal an intraluminal, intramural, or extrinsic mass, and ultrasonography (US) demonstrates its cystic nature. When US findings are inconclusive, computed tomography can be used to show the true nature, location, and extent of the lesion, as well as associated vertebral anomalies and possible other duplications. Technetium-99m pertechnetate scintigraphy provides definitive evidence of a duplication when it contains ectopic gastric mucosa and is particularly useful for suspected esophageal, duodenal, and small bowel lesions.

Child↗

PubMed2004

Impact of commensal microbiota on murine gastrointestinal tract gene ontologies.

The gastrointestinal tract (GIT) of eukaryotes is colonized by a vast number of bacteria, where the commensal microbiota play an important role in defining the healthy gut. To investigate the influence of commensal bacteria on multiple regions of the host GIT transcriptome, the gene expression profiles of the corpus, jejunum, descending colon, and rectum of conventional (n = 3) and germ-free mice (n = 3) were examined using the Affymetrix Mu74Av2 GeneChip. Differentially regulated genes were identified using the global error assessment model, and a novel method of Gene Ontology (GO) clustering was used to identify significantly modulated biological functions. The microbiota modify the greatest number of genes in the jejunum (267 genes with an alpha < 0.001) and the fewest in the rectum (137 genes with an alpha < 0.001). Clustering genes by GO biological process and molecular function annotations revealed that, despite the large number of differentially regulated genes, the residential microbiota most significantly modified genes involved in such biological processes as immune function and water transport all along the length of the mouse GIT. Additionally, region-specific communication between the host and microbiota were identified in the corpus and jejunum, where tissue kallikrein and apoptosis regulator activities were modulated, respectively. These findings identify important interactions between the microbiota and the mouse gut tissue transcriptome and, furthermore, suggest that interactions between the microbial population and host GIT are implicated in the coordination of region-specific functions.

Animals↗

PubMed1992

Bleeding angiodysplasia of the gastrointestinal tract.

Bleeding angiodysplasia of the gastrointestinal tract poses frustrating challenges to clinicians because these minute vascular lesions are difficult to diagnose pre-operatively and to locate intra-operatively. During the past 12 years, 24 patients were treated for histopathologically confirmed bleeding angiodysplasia of the gastrointestinal tract. Pre-operative investigations and intra-operative localization followed a fixed protocol for patients with gastrointestinal bleeding of obscure origin. The median follow-up of these 24 patients was 51 months and the results of treatment for 22 patients were excellent. Two patients had recurrent bleeding but investigations failed to determine the bleeding source.

Adult↗

PubMed1999

Autonomic dysfunction and the gastrointestinal tract.

Autonomic neuropathy of the gastrointestinal tract may represent a primary disorder, but much more often it is secondary due to systemic disorders like diabetes mellitus. This review gives an overview about the common clinical manifestations and the principles and limitations in diagnostic work-up of autonomic dysfunction of the gastrointestinal tract. Diagnostic evaluation usually includes a combination of screening tests for autonomic neuropathy and specialized diagnostic procedures for the detection of sequela of autonomic neuropathy in gastrointestinal motility.

Autonomic Nervous System Diseases↗

PubMed1987

The transfer of serum IgG1 antibody into the gastrointestinal tract in newborn calves.

Transfer of functional blood IgG1 to the gastrointestinal tract was measured in neonatal calves. Radiolabelled immunoglobulin G1 (IgG1) anti-DNP antibody was administered to 2 day old calves by intravenous injection. The serum clearance rate was measured and was compared to the rate of protein-bound 125I excretion in the feces over a 10 day period to determine the importance of transfer to the gastrointestinal tract as a mechanism of serum IgG1 clearance. The amount of protein-bound and DNP-binding 125I present in the gastrointestinal tract of 10 day old calves at necropsy was also measured. Fecal excretion of protein-bound 125I accounted for 32% of the serum 125I-IgG1 clearance. Protein-bound 125I was present in the gastrointestinal tract at necropsy in amounts estimated to account for 68% of the total 125I-IgG1 clearance, and retained 65% of the DNP-binding ability of the original antibody. The discrepancy between the fecal excretion (32% of total IgG1 clearance) and the GI clearance estimated from protein-bound 125I in the gut (68% of total IgG1 clearance) is explained in part by IgG1 proteolysis occurring after transfer to the gastrointestinal tract but before fecal excretion. These results indicate that transfer to the calf gastrointestinal tract accounts for most IgG1 clearance in young calves, and that the intestinal antibody retains antigen binding function and may contribute to intestinal immunity.

Animals↗

PubMed1990

Mineralocorticoid receptor gene expression in the gastrointestinal tract: distribution and ontogeny.

The gastrointestinal tract is a well characterized target tissue for aldosterone, where it regulates electrolyte transport, particularly in the descending colon. Previous studies have demonstrated the presence of aldosterone receptors in gastrointestinal tissues. We have used specific cRNA probes for the rat mineralocorticoid receptor to explore both the distribution and ontogeny of mineralocorticoid receptor gene expression in the gastrointestinal tract. Mineralocorticoid receptor gene expression is found throughout the small and large intestine, but is absent from the stomach. The highest levels are observed in the distal colon, and significant expression is found in the duodenum; in both tissues levels of expression are higher than those in kidney. In both the developing duodenum and colon, mineralocorticoid receptor gene expression precedes the development of the full physiological response to aldosterone. These findings emphasise the colon as an important target tissue for aldosterone, and raise the question of potential roles for aldosterone in the duodenum.

Animals↗