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PubMed1984

Arterial embolization for massive upper gastrointestinal tract bleeding in poor surgical candidates.

Therapeutic vascular occlusion was used in 32 patients to control massive upper gastrointestinal tract bleeding. All patients were poor surgical candidates and received an average of 12 U of red cells before embolization. Control of bleeding (for greater than 24 h) was attained in 23 of 32 patients (72%). Six of these 23 patients (26%) subsequently died within a 6-mo follow-up period, 5 due to underlying diseases, and only 1 due to rebleeding. Nine patients were not controlled initially with embolization, although 6 had marked reduction in bleeding. Eight of these 9 patients died (89%), 6 from hemorrhage or emergent gastric surgery, and 2 from underlying diseases. All patients with Mallory-Weiss tears (5) and with hemobilia (3) were successfully treated with embolization. Serious complications included gastric infarction in 2 patients with prior compromise of gastric arterial supply. Embolization offers an efficacious alternative to emergent surgery for control of massive upper gastrointestinal arterial hemorrhage in the poor risk surgical candidate.

Adolescent↗
PubMed1998

Immunohistochemical study of endocrine cells in the gastrointestinal tract of the Philippine carabao (Bubalus bubalis).

The distribution and frequency of occurrence of endocrine cells in the gastrointestinal tract of the Philippine carabao (Bubalus bubalis) were studied by immunohistochemistry. Fourteen types of immunoreactive (IR) endocrine cells were revealed. Among the cell types, only chromogranin, serotonin, and bovine pancreatic polypeptide (BPP) were present in the entire gut, while the others showed restricted distribution: somatostatin, gastrin, and cholecystokinin in the abomasum and small intestine; methionine-enkephalin-Arg6-Gly7-Leu8, motilin, neurotensin, secretin, gastric inhibitory peptide, and substance P in the small intestine; peptide tyrosine tyrosine (PYY) in the large intestine; and glucagon in the whole intestinal tract. Most of the cell types showed peak density in the pyloric, duodenal, or rectal region. The highest cell type heterogeneity was observed in the duodenum. The distribution profile of the gut endocrine cells in the carabao is closely related to that in the Holstein cattle. Important findings include the occurrence of BPP-IR cells in the entire gut and the high frequency of PYY-IR cells in the large intestine.

Abomasum↗
PubMed2002

Pituitary adenylate cyclase activating peptide (PACAP) immunoreactivity and mRNA expression in the duck gastrointestinal tract.

The presence and distribution of pituitary adenylate cyclase activating peptide (PACAP) immunoreactivity were studied in the duck gastrointestinal tract using immunohistochemistry and radioimmunoassays. Expression and distribution of PACAP mRNA were also studied using reverse transcriptase polymerase chain reaction (RT-PCR) and hybridization techniques. In addition, a partial coding sequence (cds) of the duck growth hormone-releasing hormone (GRF)/PACAP gene was identified. The presence of both PACAP-38 and PACAP-27 was demonstrated, the former being the predominant form. PACAP immunoreactivity was found in neurons and fibers of the enteric nervous system (ENS), in endocrine cells and in the gut associated lymphoid tissue (GALT). Double immunostaining showed that PACAP is almost completely colocalized with vasoactive intestinal peptide (VIP) in the ENS. Moreover, PACAP was also found in nitric oxide synthase (NOS)-containing neurons and nerve fibers. Radioimmunoassay (RIA) performed on denervated gut showed that more than one-half of the duodenal PACAP is extrinsic in origin. RT-PCR, Northern blot analysis and in situ hybridization confirmed the immunohistochemical data. The findings of the present study suggest that, in birds, PACAP may have multiple roles in regulating gastrointestinal functions.

Animals↗
PubMed1980

Are circulating CEA immune complexes a prognostic marker in patients with carcinoma of the gastrointestinal tract?

CEA immune complexes and free CEA were determined to 363 patients with histologically confirmed adenocarcinoma of the gastrointestinal tract before surgery and in a post-operative follow-up. Circulating CEA immune complexes (CEA-IC) could be detected preoperatively in 89 patients. Incidence of CEA-IC increased with increasing tumour extension; 72/89 patients with CEA-IC showed already metastatic disease progression, 40/89 had nonresectable tumours. Patients with preoperative CEA-IC had a poorer prognosis than patients without CEA-IC but with high levels of free CEA, or CEA-negative patients. The appearance of CEA-IC with consecutive increases in the postoperative follow-up indicated disease recurrence. In 32/55 relapse cases, circulating CEA-IC were detected postoperatively, all 32 cases developing metastatic spread of disease.

Adenocarcinoma↗
PubMed1994

The partition and fate of soluble and digesta particulate associated oxfendazole and its metabolites in the gastrointestinal tract of sheep.

The disposition of oxfendazole (OFZ) containing a trace of [14C]OFZ was examined in the gastrointestinal tract and bloodstream of sheep fitted with rumen and abomasal cannulae. Within 2 h of intraruminal (IR) administration, OFZ and its metabolites were almost completely associated with rumen particulate digesta. The proportion of metabolites in digesta fluid increased with their passage from the rumen into the abomasum. To determine the fate of 14C-labelled metabolites after distribution throughout rumen digesta, the rumen particulate and fluid digesta phases from a donor sheep were separated and each transferred to the rumen of an untreated recipient sheep. The 14C-labelled metabolites which derived from the donor rumen fluid quickly associated with recipient rumen particulate material. The metabolites were then progressively desorbed, as were metabolites which were transferred already associated with rumen particulate digesta. Desorption occurred faster in the abomasum than in the rumen. There was no difference in uptake kinetics between administration routes, indicating rapid equilibrium. Consequently the disposition of [14C] OFZ and its metabolites in the bloodstream was similar in each group. It is suggested that the progressive desorption of particulate associated metabolites is a principal determinant of the duration of OFZ availability.

Abomasum↗
PubMed2004

Multifocal granular cell tumors of the gastrointestinal tract: Immunohistochemical findings compared with those of solitary tumors.

Granular cell tumors (GCT) are infrequently found in the gastrointestinal tract (GIT), and only four previous reports have described lesions occurring simultaneously in different sites. The present case of 11 GCT, located in the esophagus, stomach, colon and pericolic adipose tissue, occurred in a 50-year-old Japanese woman. All GCT appeared histologically benign and there was no sign of recurrence at 3 years after surgery. Immunohistochemical analysis and comparison between this case of multifocal GCT and six cases of solitary benign GCT of the GIT, which were taken from the files of the Department of Pathology at Kitasato University (1986-2000), demonstrated the follow-ing: (1) all diffusely expressed S-100, DCC and bcl-2, and (2) median labeling indices for Ki-67, cyclin D1, p53 (Pab1801), and p21WAF1/CIP1 of 4%, 24%, 1% and 28%, respectively, for the multifocal tumors, and 3.5%, 23%, 1% and 29%, respectively, for the solitary lesions, with no significant difference between the two groups. Thus, the expression of cyclin D1 and p21WAF1/CIP1 may be involved in the tumorigenesis of both types of GCT. The present case emphasizes the need to evaluate the entire GIT when a single GCT is identified. Multifocal lesions should be treated conservatively by local excision because, as with the solitary tumors, they exhibit a benign biological behavior, consistent with their low Ki-67 immunoreactivity.

Biomarkers, Tumor↗
PubMed1981

The absorption and secretion of calcium in the gastrointestinal tract of germ-free and conventional chicks.

1. The uptake transport and secretion of calcium into the gastrointestinal tract of germ-free (GF) and conventional (CV) chicks was determined by a variety of in vivo and in vitro techniques using 45Ca as a marker following a standard fast-fed regimen. 2. Following an oral dose of Ca in conscious chicks, the transit time of digesta in the GF birds was appreciably faster than in the CV controls. 3. Although the proportion of the Ca dose absorbed was similar in both groups of chicks, the accumulation of Ca in the intestinal wall was much greater in CV birds. Distribution of the labelled Ca in plasma and bone was similar in both groups. 4. Following intravenous CA injection in conscious chicks in Ca secretion into the intestinal lumen was similar in both groups, but the amount appearing in the gut wall was appreciably greater in CV chicks. 5. There were regional differences in the ability of the gut to absorb Ca. There was a tendency for Ca uptake to be greater in the GF chicks but only in the proximal ileum did this approach significance. 6. When the Ca was confined to an intestinal loop the uptake/g tissue was similar in the proximal ileum of both groups but significantly greater in the distal ileum of the GF group. Uptake/10 mm gut was similar in both groups at both the proximal and the distal size. 7. It is suggested that the absence of a microbial load does not affect the ability of the enterocyte to absorb Ca but the subsequent removal of the absorbed load from the intestinal wall is appreciably slower in the CV group.

Animals↗
PubMed1996

Gastrointestinal tract complications of nonsteroidal anti-inflammatory drug treatment in rheumatoid arthritis. A prospective observational cohort study.

BACKGROUND: Gastrointestinal tract (GI) complications associated with nonsteroidal anti-inflammatory drug (NSAID) use are the most common serious adverse drug reactions in the United States. Nonsteroidal anti-inflammatory drugs cause both minor GI side effects such as abdominal pain and vomiting and serious GI events such as ulcers and bleeding. This study evaluates the event rates for all NSAID-induced GI complications in patients with rheumatoid arthritis, describes the time course of these events, and evaluates the role of prophylactic therapy with antacids and H2 receptor antagonists. METHODS: We studied 1921 patients with rheumatoid arthritis from 8 ARAMIS (Arthritis, Rheumatism, and Aging Medical Information System) centers. Patients were selected for the study if they were treated with NSAIDs and had at least 2.5 years of observation available. Information on GI complications attributed to NSAIDs was obtained from validated patient self-reports collected every 6 months and supplemented by review of hospital records for all hospitalizations. RESULTS: Approximately 15% of the 1921 patients reported an NSAID-induced GI side effect during the 2.5 year observation period. Forty-two patients had a serious GI complication requiring hospitalization; 34 of these 42 patients did not have a preceding GI side effect. Patients who were taking antacids and H2 receptor antagonists did not have a significantly lower risk for serious GI complications than did those not taking such medications. Asymptomatic patients taking these medications had a significantly higher risk for GI complications compared with those who did not take these medications (standardized odds ratio, 2.14;95% confidence interval, 1.06-4.32). CONCLUSIONS: A large majority of patients with serious GI complications do not have preceding mild side effects. Prophylactic treatment with antacids and H2 receptor antagonists is of questionable value and may increase the risk for subsequent serious GI complications.

Aged↗
PubMed2005

Expression of galanin receptor messenger RNAs in different regions of the rat gastrointestinal tract.

Galanin effects are mediated by three G-protein-coupled receptors: galanin receptor 1 (GalR1), GalR2 and GalR3. We quantified mRNA levels of GalR1, GalR2 and GalR3 in the rat stomach, small and large intestine using real-time RT-PCR. All three GalR mRNAs were detected throughout the gut at different levels. GalR1 and GalR2 mRNA levels were higher in the large than in the small intestine. GalR2 mRNA was most abundant in the stomach. GalR3 mRNA levels were generally quite low. The differential regional distribution of GalRs suggests that the complex effects of galanin in the gut are the result of activating multiple receptor subtypes, whose density, subtype and signaling vary along the gastrointestinal tract.

Animals↗
PubMed2004

Protease-activated receptors: protease signaling in the gastrointestinal tract.

Serine proteases from the circulation, inflammatory cells, digestive glands and microorganisms can signal to cells by cleaving protease-activated receptors (PARs), a family of four G-protein-coupled receptors. Proteases cleave PARs at specific sites to expose tethered ligand domains that bind to and activate the cleaved receptors. Despite this irreversible mechanism of activation, PAR signaling is tightly regulated to prevent the uncontrolled stimulation of cells. Although PARs are found in all organ systems, protease signaling is of particular interest in the gastrointestinal tract, where proteases regulate neurotransmission, secretion, motility, epithelial permeability and intestinal inflammation, and can thus contribute to disease.

Animals↗
PubMedDate not supplied

Ascitic fluid analysis in the differentiation of spontaneous bacterial peritonitis from gastrointestinal tract perforation into ascitic fluid.

A review of patients with bacterial peritonitis and ascites revealed six patients with gastrointestinal tract perforation into their ascitic fluid and 33 episodes of spontaneous bacterial peritonitis in 32 patients. Signs and symptoms were not helpful in differentiating the two groups; however, ascitic fluid analysis was found to be useful. All patients with perforation peritonitis fulfilled at least two of the following criteria: ascitic fluid total protein greater than 1 gm per dl, glucose less than 50 mg per dl and lactate dehydrogenase greater than 225 mU per ml. In only two episodes of spontaneous bacterial peritonitis were two of the criteria fulfilled.

Ascitic Fluid↗
PubMed1980

Pathologic interactions between prosthetic aortic grafts and the gastrointestinal tract. Clinical problems and a new experimental approach.

Twenty-one patients presented with pathologic interactions between the gastrointestinal tract and aortic grafts. Seventeen patients were managed by excision of the graft and axillobifemoral bypass. Six patients died. four deaths were due to disruption of the proximal aortic stump after initial therapy that appeared successful. An experimental model of a seromuscular jejunal patch is presented that may be beneficial for closure of the proximal aortic stump.

Animals↗
PubMed2001

Questions regarding future research on aspirin and the gastrointestinal tract.

Despite great proven and potential benefits, aspirin also has adverse side effects on all parts of the gastrointestinal tract including ulceration, bleeding, perforation, and stenosis. Because of widespread and growing use, there is a need to understand and, if possible, prevent the adverse effects of aspirin while maintaining its benefits. This article is part of a report from a consensus meeting in 1999 on nonsteroidal anti-inflammatory drugs, and examines possible mechanisms of each of the risks of normal and low-dose aspirin use including areas of uncertainty. Based on these issues, we recommend studies that would further clarify the actions of aspirin. We also examine various strategies that might be used to prevent or mitigate adverse effects. Finally, we propose future research prospects in the search for a safer aspirin.

Animals↗
PubMed1990

Cow milk feeding in infancy: further observations on blood loss from the gastrointestinal tract.

Because feeding of cow milk causes normal infants to lose increased amounts of occult blood from the gastrointestinal tract, we conducted a prospective trial to measure intestinal blood loss quantitatively and to monitor iron nutritional status. Fifty-two infants entered the trial at 168 days of age and were assigned at random to receive either cow milk or a milk-based formula. Initially, 31 infants had been breast-fed and 21 had been fed formulas. With the feeding of cow milk, the proportion of guaiac-positive stools increased from 3.0% at baseline to 30.3% during the first 28 days of the trial (p less than 0.01), whereas the proportion of positive stools remained low (5.0%) with the feeding of formula. The proportion of guaiac-positive stools among cow milk-fed infants declined later, but for the entire trial it remained significantly (p less than 0.01) elevated. Stool hemoglobin concentration increased markedly with the introduction of cow milk, rising from a mean (+/- SD) of 622 +/- 527 micrograms/gm dry stool at baseline to 3598 +/- 10,479 micrograms/gm dry stool during the first 28 days of ingestion of cow milk. Among infants fed formula, stool hemoglobin did not increase and was significantly (p less than 0.01) less than in the cow milk group. Among infants fed cow milk, the increase in hemoglobin concentration tended to be greater for those who had initially been fed human milk than for those who had initially been fed formulas. Iron nutritional status was not significantly different between the two feeding groups. However, one infant became iron deficient after 4 weeks of ingesting cow milk. We conclude that cow milk feeding leads to increased intestinal tract blood loss in a large proportion of normal infants and that the amount of iron lost is nutritionally important.

Animals↗
PubMed2002

[Acute necrotizing injuries of the upper gastrointestinal tract].

Because of the rich vascular supply and the density of the intramural vascular network in the upper gastrointestinal tract, acute necrotizing injuries at this site are exceptional. However, low-flow states secondary to certain severe systemic diseases can cause ischemic mucosal damage that finally leads to acute local necrosis. Two cases of acute necrotizing lesions in the esophagus and stomach are presented, together with their endoscopic and pathologic characteristics. The pathogenic, clinical and follow-up features of these injuries are also discussed.

Aged↗
PubMed1997

Effects of adrenalectomy on serotonin-, somatostatin-, and gastrin-immunoreactive cells in rat gastrointestinal tract.

The effects of bilateral adrenalectomy on the serotonin-, somatostatin-, and gastrin-immunoreactive cells in the rat gastrointestinal tract were studied four weeks after surgery. Body weight was reduced and the small intestine shorter in adrenalectomized animals compared with controls, while no changes were found in the histology of the mucosa. In the adrenalectomized animals the number of serotonin-immunoreactive cells was increased in the cecum and large intestine, while the somatostatin-immunoreactive cells were decreased in number in the antrum and increased in the corpus, cecum, and large intestine. The gastrin-immunoreactive cells in the antrum were not affected in number, but their nuclear size was enlarged, possibly indicating increased cellular activity.

Adrenal Glands↗