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PubMed2001

Gastrointestinal tract resuscitation in critically ill patients.

Particular research interest is currently focusing on the resuscitation of the gastrointestinal tract, because the gut is regarded to be both the "canary of the body", i.e. a sentinel organ during situations of compromised oxygen or substrate supply, as well as the "motor of multiple organ failure". Several therapeutic strategies have recently been proposed for the resuscitation of this organ system, aimed primarily at the augmentation of blood flow and oxygenation but also integrating nutritional or metabolic support and antioxidant administration.

Antioxidants↗
PubMed1985

Effects of chemical sympathectomy on dopamine and noradrenaline content of the dog gastrointestinal tract.

The content of dopamine and noradrenaline in the mucosa-submucosa and muscular layers of different gastrointestinal areas of the dog, and its modification by 6-hydroxydopamine or pargyline plus 6-hydroxydopamine was studied by means of high pressure liquid chromatography with electrochemical detection. The amounts of dopamine and noradrenaline show a cephalocaudal increase but their physiological levels were rather low when compared with those reported in other tissues. This finding was consistent with the sparse noradrenergic innervation classically described for the gut with histochemical methodologies. On the basis that noradrenergic neurones are considered more susceptible to 6-hydroxydopamine than dopaminergic neurones, a difference abolished by previous treatment with pargyline, our findings did not suggest the existence of dopaminergic neurones in the gastrointestinal tract of the dog. In the muscular layer of the duodenum, jejunum and ileum it was observed that catecholamine depletion by both treatments was smaller than that obtained in the mucosa-submucosa. Due to the resistance to both kinds of chemical sympathectomy exhibited by the dopamine content, the existence of dopamine-containing enterochromaffin cells is proposed in the mucosa-submucosa of different portions of the stomach and small intestine.

Animals↗
PubMed2006

Pharmacological characterization of 5-hydroxytryptamine-induced contraction in the chicken gastrointestinal tract.

5-Hydroxytryptamine (5-HT) receptor subtypes involved in 5-HT-induced contraction of the chicken gastrointestinal tract were characterized pharmacologically using subtype-selective agonists and antagonists. The proventriculus (area of stomach adjacent to the oesophagus) and ileum are examined. 5-HT applied cumulatively caused sustained contraction of the proventriculus that was not decreased by tetrodotoxin, atropine or l-nitro-arginine methylester (l-NAME). alpha-Methyl-5-HT showed the same potency as that of 5-HT, indicating the involvement of the 5-HT(2) receptor. (+/-)-1-(2,5-dimethoxy-4-iodophenyl)-2-amino-propane (DOI), 5-methoxytryptamine and 1-(3-chlorophenyl)piperazine hydrochloride (mCPP) were potent, and 2-methyl-5-HT, 5-carboxamidotryptamine, BW723C86 and 6-chloro-2-(1-piperazinyl)pyrazine hydrochloride (MK212) were moderate, but (+/-)-8-hydroxy-2-dipropylaminotetralin hydrobromide (8-OH-DPAT), [endo-N-8-methyl-8-azabicyclo-(3,2,1)oct-3-yl]-2,3-dihydro-(1-methyl)ethyl-2-oxo-1H-benzimidazol-1-carboxamide (BIMU-8) and cisapride were weak agonists. Correlation of pEC(50) values of these agonists with documented pEC(50) values for 5-HT(2C) receptor was higher than 5-HT(2A) and 5-HT(2B). Cinanserin, ketanserin, methiothepin, methysergide, mianserin, (8-[5-(2,4-dimethoxy-5-(4-trifluoromethylphenylsulphonamido)phenyl-5-oxopentyl)-1,3,8-triazaspiro[4,5]decane-2,4-dione hydrochloride (RS102221), N-(1-methyl-1H-indolyl-5-yl)-N'-(3-methyl-5-isothiazolyl)urea (SB204741), spiperone and N-desmethylclozapine concentration-dependently inhibited the contractile responses to 5-HT. Correlation of pK(b)/pA(2) of antagonists with documented pK(i) for 5-HT(2C) receptor was highest among 5-HT(2) receptor subtypes. In the methysergide- and ketanserin-treated proventriculus, 5-HT, 2-methyl-5-HT and cisapride did not enhance the electrical field stimulation (5 Hz)-induced cholinergic contractions. 5-HT applied non-cumulatively caused transient contraction of ileum, and the responses were partly decreased by atropine or tetrodotoxin. 5-Methoxytryptamine, alpha-methyl-5-HT, 5-carboxamidotryptamine, L692,247 and DOI were potent agonists. However, 2-methyl-5-HT, cisapride, BW723C86, 8-OH-DPAT and 5-nonyloxytryptamine, mCPP and MK212 were less effective. Ketanserin and methysergide decreased the 5-HT-induced ileal contraction, but neither GR113808 nor SB269970 inhibited the responses. In conclusion, 5-HT causes contraction of the proventriculus via 5-HT(2C)-like receptors present on smooth muscle. 5-HT also causes contraction of the ileum, but the underlying mechanisms are complex, involving neural and smooth muscle components, and both 5-HT(1)- and 5-HT(2)-like receptors. Neural 5-HT receptors similar to 5-HT(3)/5-HT(4) receptors were not found in the chicken proventriculus and ileum.

Anesthetics, Local↗
PubMed1992

Immunoreactivity of transforming growth factor alpha in the normal adult gastrointestinal tract.

The immunolocalisation of transforming growth factor alpha (TGF alpha) in the normal human oesophagus and the gastrointestinal tract was elucidated using two different antibodies - Ab2, a monoclonal antibody reacting with part of the human TGF alpha molecule, and 26T a rabbit affinity purified polyclonal antibody raised against part of the rat TGF alpha peptide. There have been conflicting reports on the distribution of this growth factor in the gut. The results clearly showed that this peptide regulatory factor is confined to the luminal surface and foveolae in the stomach, restricted to the villous epithelium in the small intestine, and in the colon was seen in the upper one third of the crypt. This pattern indicates that the distribution of this peptide regulatory factor is within the differentiated compartment and indicates a role in differentiation besides its well known proliferative effects.

Adult↗
PubMed1992

[The localization and functional status of serotonin-producing structures in the gastrointestinal tract of chum salmon fry].

The data obtained shows that serotoninergic structures of the juvenile Siberian salmon gastrointestinal tract involve individual goblet cells of the mucose epithelium, serotoninergic cells as the components of the stomach cardiac glands, fibre-like structures in subepithelial and muscular layers related, probably, to a neural plexus. The serotoninergic structures decrease in their number towards the distal portion of the tract.

Animals↗
PubMed2006

Leiomyoma of the gastrointestinal tract with intracytoplasmic inclusion bodies. Report of three cases.

We report three cases of leiomyoma of the gastrointestinal tract with intracytoplasmic inclusion bodies similar to those characteristic of inclusion body fibromatosis (IBF). The first two cases represent leiomyoma of the stomach: one in a 70-year-old female and the other in a 72-year-old female. In both instances inclusion bodies were present in a large amount. In the third case the leiomyoma was located in the esophagus of a 63-year-old male and inclusion bodies in this case were rare. In all three cases an immunohistochemical analysis showed positivity of the tumor cells for muscle specific actin HHF35 (MSA), alpha-smooth muscle actin (SMA), h-caldesmon and desmin. The first case showed some inclusion bodies with positivity for cytokeratin CAM 5.2 and focal weak positivity for cytokeratin 18. In the second case the inclusion bodies were positive at the periphery with antibodies directed against MSA and SMA. In the third case the inclusion bodies were immunohistochemically entirely negative. Ultrastructurally, the inclusion bodies in the first case were composed of aggregated filaments, some with entrapped cytoplasmic organels and others with finely granular dense cores.

Actins↗
PubMed1988

Diarrhea associated with sand in the gastrointestinal tract of horses.

Four horses with diarrhea had radiographic evidence of large quantities of sand in the gastrointestinal tract. Initially, none of the horses had sufficient fecal sand quantity to suggest sand enteropathy. Diarrhea resolved in all horses within 2 days of oral administration of psyllium hydrophilic mucilloid. Historically, all 4 horses had lost weight or had difficulty maintaining weight. After treatment was administered, the horses either gained weight or were easier to maintain in good condition.

Administration, Oral↗
PubMed1987

[Regulatory neuropeptides in the nerves and endocrine cells of the gastrointestinal tract].

Already at the beginning of this century a dualism of neural and endocrine regulation of the gastrointestinal tract was apparent. This dualism first characterized by I. P. Pavlov on the one side and W. M. Bayliss and E. H. Starling on the other has persisted in the present days. It is only recently that we begin to realize that neural and endocrine regulations represent no antipodes but a continuum. Neural, endocrine and paracrine transmission of chemical messengers form an integrated signal. This view is supperted by many peptides present both in nerves and endocrine cells and by neural regulation of endocrine hormone release. These interelationships are illustrated by experiments concerning the enkephalins, neurotensin and CCK. Concurrent with the evolution from bacteria to mammals the chemical messengers in the higher animals act in a complex organisation including neural, endocrine and paracrine mechanisms.

Animals↗
PubMed1983

[Findings in the upper gastrointestinal tract in Crohn disease].

The features, frequency and clinical significance of Crohn's lesions in the upper gastrointestinal tract have been investigated. In 11 out of 28 randomly selected patients, lesions which may be caused by Crohn's disease were found on panendoscopy. These were serpiginous ulcerations in the pars II of the duodenum, as well as aphthous-like lesions and polypoid mucosal folds in the esophagus, antrum and duodenum. In 2 cases each of polypoid folds and aphthous-like lesions, the diagnosis was corroborated by histological finding of a granulomatous inflammation. The lesions suspected to be caused by Crohn's disease were found especially in younger patients and were accompanied by upper abdominal symptoms, but showed no correlation with the clinical activity of the disease.

Adolescent↗
PubMed1982

Carcinoid tumor of the gastrointestinal tract with metastases to the brain.

A 56-year-old women with carcinoid tumor of the gastrointestinal tract, which was metastatic to the mesenteric lymph nodes, was seen four months after bowel resection with new neurologic findings. Results of an initial examination suggested infection with mycobacteria, or fungi, but the condition of the patient deteriorated, and she died after antituberculous and antifungal therapy was begun. She never suffered from carcinoid syndrome, and 5-hydroxyindoleacetic acid and 5-hydroxytryptamine were not detected in blood samples. A postmortem examination disclosed widespread metastases of carcinoid tumor, including invasion of the cerebral hemispheres. In this article, CNS metastasis of carcinoid tumors is discussed as well as the possibility that drug interactions may have contributed to some of the patient's neurologic findings.

Brain↗
PubMed1993

[Use of surgical staplers in the lower gastrointestinal tract].

Practicability and indication for continuity preserving surgery increase by the use of staplers in the lower gastrointestinal tract. The mean rate of complications for the deep colorectal and colo-anal anastomosis decreased. Locoregional relapses occur as often as with other techniques, when the criteria of radicality have been observed. Stenoses are prevalently due to complications of extraperitoneal anastomoses. In higher large bowel sections, only a few surgeons favor the use of staplers, as the risk for the patient increases without offering particular advantages. The double stapling technique in deep anterior resection is possible for small tumors and a large pelvis. For colonic pouches linear staplers are completed by circular staplers for the subsequent pouchanal anastomosis. Studies are running, actually, regarding indication of the colonic pouch.

Anastomosis, Surgical↗
PubMed1998

[Treatment with stents in the upper gastrointestinal tract].

A wide range of therapeutic methods for treatment of malignant and benign stenoses of the upper gastrointestinal tract is at one's disposal with esophageal mechanical dilatation, laser therapy, insertion of plastic tubes and stent implantation. It has become routine to insert flexible metal stents in the treatment of esophageal carcinoma and tracheoesophageal fistula. Case reports exist describing the use of flexible metal stents in complicated benign esophageal stenoses of stomach and duodenum. Until January 1997 we implanted 18 stents (7 Z-stents[Wilson and Cook], 4 covered and 4 uncovered Ultraflex stents [Boston Scientific], 3 Endocoil stents [Instent]) in 15 patients. We treated patients with esophageal carcinoma, recurrent stenoses after gastrectomy and tracheoesophageal fistula. They were followed by questionnaires. Four days after stent implantation 50% of the patients were able to consume normal solid food, the other half semisolids. The main problem was the stent migration (28%). The decisive factors for stent migration were the quality of surface of the stent and its position in the gastroesophageal junction. The stents which were dislocated in the stomach could easily be extracted endoscopically. The endoscopic extraction of a dislocated Z-stent in the small bowel was impossible. The high rate of stent dislocation (20-30%) in distal stent position (gastroesophageal junction) is not to be tolerated with respect to the purchase price.

Adult↗