PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Duodenum”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources

Effects of calcium salts of fatty acids and protein source on ruminal fermentation and nutrient flow to duodenum of cows.

Four Holstein cows fitted with ruminal and duodenal cannulas were used in a 4 x 4 Latin square to investigate the effects of calcium salts of long-chain fatty acids (fat) and source of protein (fish meal or soybean meal) on ruminal fermentation, flow of nutrients to the small intestine, and animal performance. Cows were fed for ad libitum intake a diet of 30% alfalfa haylage, 20% corn silage, and 50% concentrate on a DM basis. Treatments, arranged in a 2 x 2 (fat x protein) factorial, were 1) soybean meal, no fat; 2) soybean meal, fat; 3) fish meal, no fat; and 4) fish meal, fat. Intake of DM was not affected by fat or protein source, but feeding fat decreased the amount of OM truly digested in the rumen. Starch intake was decreased, but flow of starch to the duodenum was not altered by feeding fat. Nonammonia N and microbial N flows to the duodenum were not affected by treatment comparisons. However, efficiency of microbial growth was increased by feeding fat, but not by source of protein. Passage of amino acids to the duodenum was not affected by source of protein, probably because fish meal contributed only 17% of the total dietary CP, and microbial N constituted about 50% of the NAN passing to the duodenum; this had an equalizing effect on the pattern and quantity of amino acids that passed to the duodenum. Feeding fat or different sources of protein did not alter milk production. Milk fat percentage was increased, and protein percentage was decreased when fat was fed, but yields of milk fat and protein were not different.

Amino Acids↗

Developmental induction and villus-crypt distribution of retinol esterifying enzyme activities in chick duodenum.

Retinol absorbed and generated from dietary beta-carotene can be esterified by retinol esterifying enzyme(s) in intestinal absorptive cells. In this study, we observed the developmental changes and villus-crypt distribution of the activities of two retinol esterifying enzymes (lecithin-retinol acyltransferase (LRAT); and acyl-CoA-retinol acyltransferase (ARAT) in chick duodenum) to seek the possibility that these enzymes play distinct roles in retinol absorption and metabolism. Intestinal LRAT activity was barely expressed in embryonic stages until 2-3 d before hatching, when its activity becomes detectable; thereafter it abruptly increased to the maximal level at the third day of the posthatch period. In contrast, ARAT activity was present in the duodenum at the earliest stage examined, the 15th day of embryogenesis, and was elevated to the maximal level 3-4 d after hatching. An assay of LRAT and ARAT activities along the villus-crypt axis of the duodenum by a cryostat sectioning technique revealed that between the day of hatching and 1 d posthatch, an abrupt induction of LRAT activity occurred only in the villus region of the duodenum, where a coordinated induction of cellular retinol-binding protein, type II (CRBPII), was observed. In contrast, the rise in ARAT activity observed around the hatching period occurred at the broader portions of the villi including the area of villus-crypt junction. These observations in the developmental changes and distribution of LRAT and ARAT activities suggest that LRAT activity but not ARAT activity is closely related to the induction of CRBPII in the duodenum of developing chicks.

Acyltransferases↗

Inhibition of human liver and duodenum sulfotransferases by drugs and dietary chemicals: a review of the literature.

Sulfotransferase catalyzes the transfer of sulfate, donated by 3'-phosphoadenosine-5'-phosphosulfate, to an acceptor substrate that may be a hydroxy group or an amine group. Man is exposed daily to drugs and dietary chemicals that can inhibit sulfotransferase activity. The aim of this study was to review the literature concerning the inhibition of sulfotransferases by drugs and dietary chemicals in the human liver and duodenum. The IC50 value of mefenamic acid for human liver phenol sulfotransferase (SULT 1A1) was 0.02 microM and for human liver catechol sulfotransferase (SULT1A3) 76 microM with a SULT 1A3/SULT1A1 ratio for the IC50 of 3,800. Mefenamic acid is therefore a potent and selective inhibitor of human liver SULT1A1. The IC50 values of mefenamic acid for the sulfation rates of (-)-salbutamol and (-)-apomorphine were 4 orders of magnitude greater in the human duodenum than in the liver. Salicylic acid inhibited the sulfation of (-)-apomorphine in human liver with an IC50 of 54 gM but did not inhibit the sulfation of (-)-apomorphine in human duodenum. Quercetin, a flavonoid present in edible fruit, vegetable and wine, was a potent inhibitor of human liver SULT1A1 and estrogen sulfotransferase (EST) activities and the sulfation of resveratrol. Quercetin inhibited the sulfation of dopamine, (-)-salbutamol, minoxidil and paracetamol and the IC50 values were 1 - 2 orders of magnitude greater in human duodenum than in the liver. In conclusion, mefenamic acid, salicylic acid and quercetin inhibit SULT1A1 whereas SULT1A3 is relatively resistant to the inhibition by these compounds. Under particular circumstances, human duodenum sulfotransferase is more resistant than liver sulfotransferase to the inhibition by mefenamic acid, salicylic acid and quercetin.

Anti-Inflammatory Agents, Non-Steroidal↗

Practical guidelines for the preservation of the pancreaticoduodenal arteries during duodenum-preserving resection of the head of the pancreas: clinical experience and a study using resected specimens from pancreaticoduodenectomy.

BACKGROUND/AIMS: The purpose of this study was to create a practical guideline for vascular preservation during duodenum-preserving resection of the head of the pancreas. METHODOLOGY: We examined the anatomy of pancreaticoduodenal arteries by specimen angiography and dissection using 12 pancreaticoduodenectomy specimens. We also reviewed our experiences with duodenum-preserving resection of the head of the pancreas. RESULTS: In the specimens, the posterior pancreaticoduodenal artery and its duodenal branches were easily separated from the posterior surface of the pancreas, and its papillary branch was identified in two-thirds of the cases. It was difficult to dissect the anterior superior pancreaticoduodenal arteries from the pancreas because they were partially buried in the pancreatic parenchyma. The anterior inferior pancreaticoduodenal artery located in the posterior and inferior surface of the pancreas could be safely dissected in two-thirds of the cases. Duodenum-preserving resection of the head of the pancreas was performed in 7 patients. In every case, the anterior superior pancreaticoduodenal artery was sacrificed and the anterior inferior pancreaticoduodenal artery was preserved. In 3 cases, the entire posterior pancreaticoduodenal artery was preserved and in 4 cases a short segment of the posterior pancreaticoduodenal artery was removed accidentally. The pancreatic head was totally removed and the intrapancreatic common bile duct was preserved. There were 3 postoperative complications, pancreatic leakage, intraabdominal fluid collection and bile duct stricture. They improved with conservative management. CONCLUSIONS: To safely perform duodenum-preserving resection of the head of the pancreas, preservation of the whole posterior pancreaticoduodenal artery and anterior inferior pancreaticoduodenal artery is recommended because they can be safely dissected from the pancreas, and the posterior pancreaticoduodenal artery provides the major blood supply to the papilla and distal bile duct. However, removal of a short segment of posterior pancreaticoduodenal artery does not preclude a good blood supply to the duodenum because of bidirectional blood flow.

Adult↗

Effects of 13-nle-motilin on the electrical and mechanical activity of the isolated perfused canine stomach and duodenum.

Synthetic 13-norleucine-motilin (13-nle-motilin), structural and biological analogue of the naturally-occurring duodenal polypeptide, motilin, is known to stimulate antral and duodenal motor activity in vitro, but delays gastric emptying in man. In this study the direct actions of the synthetic polypeptide on myoelectrical activity and intraluminal pressure have been studied in the isolated vascular-perfused canine stomach and duodenum. 13-nle-motilin increased intraluminal pressure in the pylorus and duodenum, and dose-response analysis showed the duodenum to be twice as sensitive as the pylorus to the polypeptide. Pressure changes in the antrum were small and not dose-related, but, whereas the basic electrical rhythm in the duodenum was not altered, slow wave frequency, rhythm, and propagation in the antrum were disturbed. Electronic analysis of the duodenal spike increase which accompanied pressure rises demonstrated correlations between increases in spikes, intraluminal pressure, and dose. These results show that the direct effect of the polypeptide on adjacent organs may explain the combination of increased motor activity with delayed gastric emptying as a consequence of disturbance in the co-ordination between antrum, pylorus, and duodenum.

Animals↗

Preservation of arterial arcades during duodenum-preserving total pancreatic head resection for intraductal papillary tumor.

Duodenum-preserving pancreatic head resection with preservation of the bile duct or without, has been performed in cases of benign or low-grade malignancies, such as intraductal papillary tumors, of the head of the pancreas. However, the selection of the patients, the area of resection in the head of the pancreas, and the operative procedures for the preservation of the pancreaticoduodenal vessels has not been realized among surgeons to apply duodenum-preserving pancreatic head resection as a radical treatment of intraductal papillary tumors. In our experience, duodenum-preserving pancreatic head resection can be applied in the majority of the patients with the branch type of intraductal papillary tumors, and it is necessary to resect completely the head of the pancreas to avoid tumor remnant and pancreatic fistula from the remaining pancreatic rim. Therefore, we modified it to include a total resection of the pancreatic head and the preservation of both anterior and posterior arterial arcades, due to the multiformity of the location of the tumor, the variation of the branch duct in the head of the pancreas, the closure of the minor papilla in some patients, and the unbalanced development of the arterial arcades of the pancreaticoduodenal region. We performed a duodenum-preserving total pancreatic head resection with preservation of the bile duct and the both anterior- and posterior-arterial arcades for 6 patients with the normal gland involving intraductal papillary tumors. The blood flow in this organ was based on the blood supply from both preserved arterial arcades, and the duodenum had retained good color, and the postoperative results were satisfactory.

Carcinoma, Pancreatic Ductal↗

[Protective effect of ranitidine in the stomach and duodenum against piroxicam. An endoscopy controlled double-blind study].

Protective Effects of Ranitidine in Stomach and Duodenum against Piroxicam / An endoscopically controlled double-blind study In a randomized parallel double-blind study the gastroduodenal effects of 20 mg piroxicam (CAS 36322-90-4) daily in the presence and absence of 300 mg ranitidine nocte was evaluated in 28 healthy volunteers undergoing upper gastrointestinal endoscopy. Drugs were taken over a period of 14 days. Endoscopic controls were performed at entry, and repeated after 7 and 14 days of treatment. A damaging score according to Lanza et al. was used. At entry, both groups displayed comparable mucosal damages in the stomach (0.9 +/- 0.1) and in the duodenum (0.4 +/- 0.2). After 14 days the mean lesion score increased in the piroxicam/placebo group to 6.3 +/- 1.6 in the stomach and to 4.0 +/- 1.4 in the duodenum. The corresponding values in the piroxicam/ranitidine group were 3.4 +/- 1.0 (stomach) and 0.4 +/- 0.2 (duodenum). This protection afforded by ranitidine was significant when compared with placebo (p < 0.05). Our data suggest that 300 mg ranitidine at night markedly protect the stomach and the duodenum against piroxicam.

Adult↗

[Diagnosis and treatment policy in trauma of duodenum].

Experience of treatment of 70 patients aged from 17 to 71 years with trauma of duodenum (TD) was analyzed. Majority of them was men -- 57 (81.4%). Open TD were seen in 61.4% cases, closed -- in 38.6%. There were no pathognomonic symptoms. X-ray examination of abdominal cavity is the important procedure permitted to suspect TD. Diagnostic algorithm in abdominal trauma for exclusion of TD before surgery was developed. Yellow-green imbibition, mass of air vesicles in retro-abdominal space, hematomas in duodenal zone were the indications for revision of duodenum during surgery. Hematoma of duodenal wall was indication for it revision for exclusion of penetrating wound. In 55 (77.1%) patients with wounds penetrating into duodenum (or disruption of duodenum) suture of defects was performed. "Exclusion" of duodenum was performed in 20 (28.6%) patients when there was threat of sutures insufficiency. Lethal outcome was seen in 20 (28.6%) patients including 13 (18.6%) cases during first day due to combined injuries and massive blood loss. Developed algorithm and treatment policy permitted to improve results of this severe variant of abdominal trauma.

Adolescent↗

[Changes of somatostatin (SS) in stomach and duodenum of rats after +Gz exposure].

OBJECTIVE: To study effects of +Gz exposure on the change of somatostatin (SS) in stomach and duodenum of rats. METHOD: Forty male Wistar rats were randomly divided into +1 Gz control group, +5 Gz x 5 min group, +10 Gz x 5 min group and repeated exposure [(+5 Gz x 2 min) + (+10 Gz x 2 min) + (+5 Gz x 2 min)] group. After +Gz exposure, the rats in each group were anesthesized by aether, and gastric and duodenal mucosa were taken immediately. Levels of SS were assayed using radioimmunoassay (RIA) methods. RESULTS: Gastric and duodenal mucosa of the control group and +5 Gz group were intact and smooth. Under naked eye and light microscope, scattered hemorrhagic spoto, small ulcers, submucosal hyperemia, and erosion of mucosa were found in gastric antrum and duodenum in +10 Gz group rats. Diffuse hyperemia, erosion and small ulcers were found in mucosa of gastric fundus, gastric antrum and duodenum of repeated exposure group. Exposure to +Gz can increase somatostatin content in gastric antrum and duodenum (P<0.01). CONCLUSION: Increase of SS content may play an important role in the prevention of pathogenesis of stomach and duodenum after +G exposure.

Acceleration↗

[Spontaneous rupture of duodenum: case report and review].

Although rare, injuries of the duodenum increased in frequency during the past ten years. Careful attention must be paid to them, especially in blunt trauma of the abdomen and lower thoracic regions. Often they occur along with lesions of other related structures in polytraumatized patients. X-rays are the most important mean used in diagnosis. Early diagnosis and surgical treatment are conditio sine qua non for successful results. Complete intraoperative inspection of the duodenum, careful suture of the perforation and a correct placement of drainage are essential for the prevention of postoperative complications. If the duodenal wall had lost its vitality, a gastrojejunal or duodenojejunal anastomosis or gastrostomy are performed; the duodenum is decompressed and drainage of the peritoneal cavity is established. In cases of associated injury of the pancreas or choledochus, the drainage of the extrahepatic bile duct is recommended. The Authors report a case of spontaneous rupture of duodenum in which all of the above mentioned procedures were used; they stress that only suspicion of a duodenum's rupture indicates an immediate laparotomy.

Diagnosis, Differential↗

[Residual stomach, duodenum, and continual jejunal interposition after subtotal gastrectomy].

OBJECTIVE: To investigate the clinical effect of residual stomach, duodenum, and continual jejunal interposition on the patients of gastric cancer after subtotal gastrectomy. METHODS: Fifty-four patients with gastric cancer after subtotal gastrectomy were randomly divided into 2 groups: Group A (n = 26, receiving digestive tract reconstruction by manual end-to-side anastomosis of residual stomach and jejunum, end-to-side anastomosis of residual duodenum and jejunum, and side-to-side anastomosis of jejunum and jejunum, then the jejunum proximal to the stomach-jejunum anastomosis and the jejunum distal to the duodenum-jejunum anastomosis were ligated so as to form an integral continual jejunal interposition; and Group B (n = 28, receiving Bilroth digestive tract reconstruction. The operation time, body weight, prognosis nutrition index (PNI), and Visick score 3 and 6 months after the operation were observed. RESULTS: All patients recovered quickly and no complicating anastomosis leakage and obstruction was found. It took 53 +/- 9 minutes to finish the reconstruction in Group A, significantly shorter than that in Group B (57 +/- 6 minutes, t = -2.145, P = 0.037). The body weight and PNI of both groups decreased significantly 3 months after the operation in comparison with those before the operation (both P < 0.05). The body weight and PNI of Group A returned to the levels before operation. Although the body weight and PNI of Group B recovered to some extent 6 months after operation, they remained significantly lower than those before operation both P < 0.05). The Visick score 6 months after operation of Group A was superior to that of Group B (t = 2.1 P < 0.05). CONCLUSION: Residual stomach, duodenum, and continual jejunal interposition after subtotal gastrectomy helps overcome the difficulty in the procedure of digestive tract reconstruction and restore the physiological passage through duodenum, thus avoiding reflux and improving patients' quality of life.

Adult↗

[Fixation anomaly of the duodenum. Apropos of 4 cases].

"Z"--shaped duodenum and "roller - coaster" duodenum are synonyms for malfixation of the duodenum. This rare malformation has been described recently. We report 4 cases (ages 3 months-9 years) with: --intermittent abdominal pain; --bilious vomiting; --failure to thrive. Radiologic examination of the upper gastrointestinal tract revealed a malformation of the distal duodenum (D2-D3) which presented a "Z" or "M" form and under fluoroscopy, this portion was very mobile, causing intermittent obstruction when it became kinked. All attempts of medical management have failed. At surgery, all the bands were cut, giving the duodenum a normal shape. The symptoms disappeared after surgery. Follow-up between 4 months and 3 years showed the patients were completely asymptomatic.

Child↗

[Comparison of drug effects on the isolated rat colon and duodenum].

Adrenaline and isoproterenol elicited nearly maximal relaxation of the colon even in small doses, whereas increase in the doses caused greater relaxation in the duodenum. In the colon, these drugs prevented, to a great extent the contraction induced by acetylcholine (ACh) and serotonin but in the duodenum were totally ineffective. Dibenamine and propranolol reduced adrenaline- and isoproterenol-induced relaxation in the duodenum, though propranolol decreased the relaxation caused by isoproterenol. Atropine prevented ACh-induced contraction in both the colon and duodenum in the same way. After 2-bromolysergic acid diethylamide, duodenal contraction caused by ACh or serotonin decreased by over 70%; however, the contraction of the colon was not significantly inhibited. Methysergide had similar effects, but to a lesser degree. In calcium-free bathing fluid without addition of Na2EDTA, ACh and prostaglandin E1 elicited contraction in the colon, but not in the duodenum.

Acetylcholine↗

[Effect of serotonin on the myoelectrical activity of the body of the stomach, the pyloric sphincter and duodenum].

8-10 mg/kg serotonin augmented the AP amplitude in the duodenum and reduced it in the stomach and pyloric sphincter in rabbits, the burst frequency in the duodenum smooth muscles being much higher than in the latters. The amount of APs in each burst increased after serotonin administration in the duodenum and decreased in the stomach and pyloric sphincter, the activating effect of serotonin on the duodenum smooth muscles preceding its inhibitory effect on the latter's smooth muscles. The higher sensitivity to serotonin seems to be due to a higher concentration of endogenous serotonin in the duodenum tissue.

Action Potentials↗

Healing of incisional wounds in stomach and duodenum. The influence of aging.

An evaluation was made of the effects of increasing age on the mechanical properties and the collagen content of healing wounds in stomach and duodenum of rats. Wounds were made in the non-glandular (rumen) and the glandular oxyntic part (corpus)of the stomach and in the duodenum of rats that were 26 months old. The wounds were tested 7 and 20 days after the operation. The results of these tests were compared with those made on a group of young rats (3-4 months old) that were subjected similar wounds. Aging increased the stiffness and decreased the extensibility of tissue taken from intact stomach (rumen and corpus) and from wounded rumen. No differences in the stiffness and extensibility of the tissue from the duodenum wounds could be demonstrated. Except for a higher breaking strength in samples of rumen from old animals after 20 days of healing, no differences in mechanical strength measurements (breaking strength and breaking energy) from intact and wounded tissue could be demonstrated in the old and young animals. The collagen content of intact as well as wounded stomach tissues appeared related to age. No differences in the collagen content in the tissue from the duodenal wounds wee found. The dimensions of the biochemically active zone around the incision remained essentially unchanged in the duodenum and stomach and it was of the same width as that found for young animals. This indicates that aging has no adverse influence on wound healing in the stomach and the duodenum of rats.

Aging↗

Resection for cure of carcinoma of the colon directly invading the duodenum or pancreatic head.

BACKGROUND: Approximately 10 percent of carcinomas of the colon and rectum adhere to adjacent organs or structures, which rarely include the duodenum or pancreas. STUDY DESIGN: To confirm the importance of aggressive operative management in patients with locally advanced carcinoma of the colon invading the duodenum or pancreatic head, we reviewed the medical records of 12 patients who underwent an extended resection for a right-sided carcinoma of the colon involving the duodenum or the pancreatic head, or both. RESULTS: All patients underwent an extended right hemicolectomy, including en bloc pancreaticoduodenectomy (seven patients) or lateral duodenectomy (five patients). The mean operative blood loss was 627 mL, and there were no postoperative deaths. Malignant invasion of the duodenum or pancreas was confirmed in all 12 patients, but only three (25 percent) had lymph node metastases. The median survival period for all 12 patients was 32 months. However, the median survival period for the eight patients still alive without recurrent or metastatic disease was 42 months. CONCLUSIONS: In patients with locally advanced carcinoma of the colon involving the duodenum or pancreatic head long-term survival can be achieved by en bloc resection.

Adenocarcinoma↗

The suspensory muscle of the duodenum and its nerve supply.

The gross anatomy, microscopic structure and nerve supply of the suspensory muscle of the duodenum and Hilfsmuskel have been studied in cadavers of 88 adults, 5 children, 1 infant and 6 neonates. The suspensory muscle of the duodenum, consisting of plain muscle fibres, arose from the connective tissue around the stems of the coeliac and superior mementeric arteries. It was inserted into the third and fourth parts of the duodenum in 53%, and into the duodeno-jejunal flexure in addition in 40%. It was innervated by non-myelinated fibres arising from the coeliac and superior mesenteric plexuses. Although both the longitudinal and circular muscle coats of the duodenum extended into the suspensory muscle, it was not supplied by Auerbach's plexus. The Halfsmuskel, which is a slip of the diaphragm is attached above to the margin of the oesophageal hiatus and below to the connective tissue in the region of the stem of the coeliac artery, sometimes extending to the stem of the superior mesenteric artery. The Hilfmuskel and the suspensory muscle of the duodenum are separate entities.

Adult↗

A new method of duodenum-preserving subtotal resection of the head of the pancreas based on the surgical anatomy.

BACKGROUND/AIMS: Duodenum-preserving resection of the head of the pancreas has been performed for benign and, sometimes, malignant diseases of the pancreas. We propose a new procedure of duodenum-preserving subtotal pancreatectomy of the pancreas according to the precise anatomy of the pancreatoduodenal region, especially of the pancreaticoduodenal arteries which provide blood to the duodenum. MATERIAL AND METHODS: After a complete Kocher's maneuver is performed, the pancreas is cut above the portal vein and removed from the third portion of the duodenum, followed by the removal of the posterior surface of the pancreas head from a connective tissue membrane. The main pancreatic duct is identified at its junction with the terminal portion of the bile duct from the posterior surface of the head of the pancreas and is cut at the junction. The pancreas is cut in the line of the ASPD. This line is almost the same as the left side of the common bile duct. The ASPD and the common bile duct should be preserved in this procedure. RESULTS: The reason for leaving part of the pancreas between the duodenum and the anterior superior pancreaticoduodenal artery and the common bile duct is that the artery toward the papilla of Vater runs along the right side of the common bile duct and would be difficult to be preserved with the removal of this part of the pancreas. The most important technique of this procedure is in keeping the connective tissue membrane of the posterior surface of the pancreas intact so as to preserve pancreaticoduodenal arteries and veins, because all the pancreaticoduodenal arteries and veins are situated on this membrane. Complete Kocher's maneuver should cause no problem in this procedure. CONCLUSIONS: Benign lesions as well as low-grade malignancy of the head of the pancreas may possibly be the indication of this procedure.

Adenocarcinoma, Mucinous↗