Science.gov

Sample records for human duodenal mucosa

  1. Autoradiographic localization of a gluten peptide during organ culture of human duodenal mucosa

    SciTech Connect

    Fluge, G.; Aksnes, L.

    1983-01-01

    An 125I-labeled subfraction of Frazer's fraction III (molecular weight, 8,000) was added to the culture medium during organ culture of duodenal biopsies from two patients with celiac disease in exacerbation. The isotope-labeled gluten peptide was localized by autoradiography after 6, 12, and 24 h of culture. At 6 h, labeling was located mainly in the basal layers of the biopsies. The tissue was well preserved. After 12 h in culture, the labeling had spread to the lamina propria and the crypts. A few grains were located over enterocytes and desquamated cells. Moderate histological signs of toxicity were observed. After 24 h, there was marked toxic deterioration, comparable to that seen after culture with alpha-gliadin. Labeling had spread throughout the entire section. There seemed to be no specificity of the binding, for the entire section was affected. Culture with the identical gluten fraction, in the radionegative state, produced histological deterioration comparable to that seen after exposure to the isotope-labeled peptide. Gluten peptides are presented to the target cells in a unique way during organ culture, different from in vivo conditions. This may influence the results when the organ culture method is used to investigate the pathogenesis of celiac disease.

  2. Luminal chemosensing in the duodenal mucosa

    PubMed Central

    Akiba, Yasutada; Kaunitz, Jonathan D

    2010-01-01

    The upper gastrointestinal (GI) mucosa is exposed to endogenous and exogenous chemicals, including gastric acid, CO2 and nutrients. Mucosal chemical sensors are necessary to exert physiological responses such as secretion, digestion, absorption, and motility. We propose the mucosal chemosensing system by which luminal chemicals are sensed to trigger mucosal defense mechanisms via mucosal acid sensors and taste receptors. Luminal acid/CO2 is sensed via ecto- and cytosolic carbonic anhydrases and ion transporters in the epithelial cells and via acid sensors on the afferent nerves in the duodenum and esophagus. Gastric acid sensing is differentially mediated via endocrine cell acid sensors and afferent nerves. Furthermore, a luminal L-glutamate signal is mediated via epithelial L-glutamate receptors, including metabotropic glutamate receptors and taste receptor 1 family heterodimers, with activation of afferent nerves and cyclooxygenase, whereas luminal Ca2+ is differently sensed via calcium-sensing receptor in the duodenum. These luminal chemosensors help activate mucosal defense mechanisms in order to maintain the mucosal integrity and physiological responses of the upper GI tract. Stimulation of luminal chemosensing in the upper GI mucosa may prevent mucosal injury, affect nutrient metabolism, and modulate sensory nerve activity. PMID:20518751

  3. Dopamine receptors in human gastrointestinal mucosa

    SciTech Connect

    Hernandez, D.E.; Mason, G.A.; Walker, C.H.; Valenzuela, J.E.

    1987-12-21

    Dopamine is a putative enteric neurotransmitter that has been implicated in exocrine secretory and motility functions of the gastrointestinal tract of several mammalian species including man. This study was designed to determine the presence of dopamine binding sites in human gastric and duodenal mucosa and to describe certain biochemical characteristics of these enteric receptor sites. The binding assay was performed in triplicate with tissue homogenates obtained from healthy volunteers of both sexes using /sup 3/H-dopamine as a ligand. The extent of nonspecific binding was determined in the presence of a 100-fold excess of unlabeled dopamine. Scatchard analysis performed with increasing concentrations of /sup 3/H-dopamine (20-500 nM) revealed a single class of saturable dopamine binding sites in gastric and duodenal mucosa. The results of this report demonstrate the presence of specific dopamine receptors in human gastric and duodenal mucosa. These biochemical data suggest that molecular abnormalities of these receptor sites may be operative in the pathogenesis of important gastrointestinal disorders. 33 references, 2 figures.

  4. Vascular changes in duodenal mucosa in shigellosis and cholera.

    PubMed

    Koshi, Rachel; Chandy, George; Mathan, Minnie; Mathan, V I

    2003-07-01

    Vascular endothelial cells are highly specialized cells with numerous sensory and modulator functions. Our previous studies show extensive microvascular changes in rectal mucosal vasculature of patients with acute infective diarrhea (Mathan and Mathan 1985a, Gut 26:710-717). We looked for changes in the duodenal mucosal vasculature in two naturally occurring diarrheal infections: shigellosis and cholera. Duodenal mucosal biopsies from 14 patients with shigellosis, 12 patients with cholera, and 10 healthy volunteers were examined under the electron microscope. There were extensive microvascular changes in the duodenum in shigellosis and cholera. Congestion and dilatation of capillaries and venules, stagnation of blood, thinning of the endothelial lining, and platelet clumping were commonly seen in both conditions. Endothelial damage was also common to both conditions but was mild to moderate in cholera and severe in shigellosis with frank hemorrhage, frequent formation of stress fibers, widening of intercellular spaces, cytoplasmic blebbing, cell fragmentation, and intravascular thrombosis. Erythrocyte aggregates, platelet aggregates, and leucocyte plugging lead to capillary obstruction. The arterioles were severely constricted. These changes in the endothelial lining of the microvasculature could contribute to the pathogenesis of the disease resulting in peripheral vascular insufficiency, inadequate oxygen delivery to intestine, and organ dysfunction. The factors influencing these changes, their implications, and possible therapeutic interventions are discussed. PMID:12794915

  5. CD4? T cell cytokine gene and protein expression in duodenal mucosa of dogs with inflammatory bowel disease.

    PubMed

    Ohta, Hiroshi; Takada, Kanae; Sunden, Yuji; Tamura, Yu; Osuga, Tatsuyuki; Lim, Sue Yee; Murakami, Masahiro; Sasaki, Noboru; Wickramasekara Rajapakshage, Bandula Kumara; Nakamura, Kensuke; Yamasaki, Masahiro; Takiguchi, Mitsuyoshi

    2014-03-01

    Inflammatory bowel disease (IBD) is a common cause of chronic gastrointestinal signs in dogs. In humans, T helper cells have important roles in the pathogenesis of IBD. In contrast, no specific involvement of a distinct T cell subset has been described in canine IBD. The present study evaluated the gene and protein expression of cytokines of T cell subsets in duodenal mucosa from dogs with IBD. Relative quantification of interleukin (IL)-17A, interferon (IFN)-?, IL-4 and IL-10 mRNA transcription was performed using duodenal mucosa from 27 IBD dogs and 8 controls. Duodenal mucosal IL-17A, IFN-? and IL-10 protein levels were determined by ELISA in 15 IBD dogs and 8 controls. There was no significant difference in each cytokines mRNA transcription level between groups. There was no significant difference in IL-17A, IFN-? and IL-10 protein expression levels between groups. Thus, there is no clear evidence for the involvement of distinct Th cytokine in the pathogenesis of canine IBD. PMID:24270804

  6. Duodenal Mucosa-Associated Lymphoid Tissue Lymphomas: Two Cases and the Evaluation of Endoscopic Ultrasonography

    PubMed Central

    Kim, Su Jin; Choi, Choel Woong; Ha, Jong Kun; Hong, Young Mi; Park, Jin Hyun; Park, Soo Bum; Kang, Dae Hwan

    2013-01-01

    Mucosa-associated lymphoid tissue lymphoma mainly arises in the stomach, with fewer than 30% arising in the small intestine. We describe here two cases of primary duodenal mucosa-associated lymphoid tissue lymphoma which were evaluated by endoscopic ultrasonography. A 52-year-old man underwent endoscopy due to abdominal pain, which demonstrated a depressed lesion on duodenal bulb. Endoscopic ultrasonographic finding was hypoechoic lesion invading the submucosa. The other case was a previously healthy 51-year-old man. Endoscopy showed a whitish granular lesion on duodenum third portion. Endoscopic ultrasonography image was similar to the first case, whereas abdominal computed tomography revealed enlargement of multiple lymph nodes. The first case was treated with eradication of Helicobacter pylori, after which the mucosal change and endoscopic ultrasound finding were normalized in 7 months. The second case was treated with cyclophosphamide, vincristine, prednisolone, and rituximab every 3 weeks. After 6 courses of chemotherapy, the patient achieved complete remission. PMID:24143321

  7. Ultrastructural aspects of duodenal mucosa repair during treatment of peptic disease.

    PubMed

    Zoli, G; Bonvicini, F; Ercoli, C; Gasbarrini, G; Laschi, R

    1984-01-01

    We applied scanning electron microscopy (SEM) to the study of duodenal ulcer healing during treatment with an H2-receptor antagonist (ranitidine). We also evaluated the changes in the duodenal mucosa close to the lesion, which appeared endoscopically and histologically normal. Endoscopic biopsies were taken from 8 patients both on the edge of the ulcer and in the upper duodenum, before and after 1, 2, 3, 4 and 8 weeks of treatment. Endoscopy revealed a decrease of the ulcer crater after the first week and a complete healing after three weeks of therapy. The ulcer edge presented a subtotal mucosal atrophy, cellular exfoliation (dome-shaped cells) and changes in microvilli (bridging, branching, blebs). In the first week of treatment, reepithelization was observed: however, cellular exfoliation and changes in microvilli persisted at least up to the end of the first month of treatment. Short and stumped villi began to reappear after one month. The mucosa farthest from the lesion showed the same alterations but to a lesser extent. The changes tended to decrease after treatment. Two months after the end of treatment the duodenal mucosa was endoscopically and histologically normal, while SEM showed altered microvilli. SEM allowed us to investigate the morphogenesis of mucosal repair and to identify minimal cellular alterations which could represent the morphological basis of the disease and its possible recurrence. PMID:6099683

  8. Changes in lipid composition and desaturase activities of duodenal mucosa induced by dietary fat.

    PubMed

    Girn, M D; Mataix, F J; Surez, M D

    1990-06-28

    In the present work we have studied the effects of feeding either olive or sunflower oil on lipid composition and desaturase activities of duodenal mucosa microsomes. Duodenal microsomes prepared from dogs fed the sunflower oil diet showed higher percentages of saturated, of linoleic and of n - 3 polyunsaturated fatty acids as well as lower levels of oleic, dihomo-gamma-linolenic and arachidonic acids in phosphatidylcholine and phosphatidylethanolamine than those prepared from animals fed the olive oil diet. In sphingomyelin, the dietary supplementation did not produce significant differences between the two groups. The cholesterol/phospholipid molar ratio was higher in the sunflower oil group than in the olive oil group. The in vitro delta 9-desaturase activity was higher in microsomes from the olive oil dogs. The delta 6-desaturase activity was similar in microsomes from the two groups and lower than that found for delta 9-desaturase activity. Desaturase activities were higher in duodenal microsomes than those previously found for liver microsomes. PMID:2369586

  9. Lower Bifidobacteria counts in both duodenal mucosa-associated and fecal microbiota in irritable bowel syndrome patients

    PubMed Central

    Kerckhoffs, Angle PM; Samsom, Melvin; van der Rest, Michel E; de Vogel, Joris; Knol, Jan; Ben-Amor, Kaouther; Akkermans, Louis MA

    2009-01-01

    AIM: To determine the composition of both fecal and duodenal mucosa-associated microbiota in irritable bowel syndrome (IBS) patients and healthy subjects using molecular-based techniques. METHODS: Fecal and duodenal mucosa brush samples were obtained from 41 IBS patients and 26 healthy subjects. Fecal samples were analyzed for the composition of the total microbiota using fluorescent in situ hybridization (FISH) and both fecal and duodenal brush samples were analyzed for the composition of bifidobacteria using real-time polymerase chain reaction. RESULTS: The FISH analysis of fecal samples revealed a 2-fold decrease in the level of bifidobacteria (4.2 1.3 vs 8.3 1.9, P < 0.01) in IBS patients compared to healthy subjects, whereas no major differences in other bacterial groups were observed. At the species level, Bifidobacterium catenulatum levels were significantly lower (6 0.6 vs 19 2.5, P < 0.001) in the IBS patients in both fecal and duodenal brush samples than in healthy subjects. CONCLUSION: Decreased bifidobacteria levels in both fecal and duodenal brush samples of IBS patients compared to healthy subjects indicate a role for microbiotic composition in IBS pathophysiology. PMID:19533811

  10. The effect of chronic alcohol abuse on gastric and duodenal mucosa.

    PubMed

    Bienia, Anna; Sodolski, Wojciech; Luchowska, Elzbieta

    2002-01-01

    Alcohol consumed in small quantities is not dangerous for health but if it is drunk in big amounts it has a negative effect on somatic and psychical health. A number of studies have been published on the harmful effect of ethanol on the nervous system, circulation, endocrine and immune systems. Ethyl alcohol can directly damage the mucosa of the alimentary tract. The studies conducted and published so far have estimated acute ethanol damage of gastric mucosa in experimental animals. The views found in literature on the effect of continuous consumption of ethanol on the stomach are differentiated. The purpose of the paper was to provide a morphological and functional analysis of stomach and duodendum in patients who continuously abuse alcohol. Besides, at attempt was made to find the answer to the question whether the changes observed in gastric mucosa point to any connection with the period of alcohol abuse. The study referred to 79 persons: 61 male aged 17-65 who had been chronically drinking alcohol for the period of 5-37 years and 18 persons aged 17-59 (9 male and 9 female) who had never drunk alcohol or who had drunk it only rarely and in small were divided into three groups differing with the period of addiction (I--5-10 years; II--10-20 years; III--over 20 years). Hydrochloric acid secretion in gastric juice was marked and gastroscopy was performed in all the examined patients. Gastroscopy estimated the appearance of the gastric and duodenal mucosa, while biopsy specimens were taken for histological examination from the pyloric area, the body of the stomach and the duodendal bulb. Hydrochloric acid secretion was determined using the Kay's aspiration method. Pentagastrin was used to stimulate gastric secretion. Within the group of 79 patients, gastric mucosa inflammation was observed in all patients chronically drinking alcohol and in 72% patients who were the control. Both groups differed considerably with the degree of progression of the inflammatory process, which was estimated with histological examination. Atrophic gastritis was observed only in patients addicted to alcohol. The appearance of atrophic changes pointed to a close relation with the period of addiction. 13 out of 14 people with this type of inflammation had been drinking alcohol for at least 10 years. The studies did not show any relation existing between the percentage of cases with atrophic inflammation and the kind of drinks or the content of ethanol in them. Examinations concerning the secretory function of the stomach showed lower values of hydrochloric acid secretion, both in basic conditions and after pentagastrin stimulation, in patients addicted to alcohol as compared to the control. The results prove that continuous abuse of alcohol predisposes to atrophic inflammation of the gastric mucosa, and the appearance of this type of inflammatory changes is related to the duration of addiction. The longer the addiction, the lower the secretion of hydrochloric acid is. PMID:12898897

  11. Photodynamic therapy of pancreatic cancer and elastic scattering spectroscopy of the duodenal mucosa for the detection of pancreaticobiliary malignancy

    NASA Astrophysics Data System (ADS)

    Huggett, M. T.; Baddeley, R. N. B.; Sandanayake, N. S.; Webster, G. J. M.; Bown, S. G.; Lovat, L. B.; Gillams, A.; Pogue, B. W.; Hasan, T.; Pereira, S. P.

    2011-02-01

    The diagnosis and treatment of pancreaticobiliary malignancy is of major interest to our group. Building on prior work, we undertook a phase I study of verteporfin photodynamic therapy in patients with locally advanced, unresectable, pancreatic cancer. We also initiated an optical diagnostic study using elastic scattering spectroscopy (ESS) of the normal-appearing periampullary duodenal mucosa in vivo to investigate the hypothesis of a field effect in pancreaticobiliary malignancy. In a phase I dose escalation study, patients were treated with interstitial verteporfin PDT via a single fibre, to determine its general safety profile and the optimum treatment parameters needed to achieve effective and safe necrosis of tumour, With increasing light doses, there was a linear increase in the extent of tumour necrosis around the fibre, without serious adverse events. Follow-on studies using multiple fibres are planned. In 30 patients with benign or malignant pancreaticobiliary disease undergoing clinically-indicated endoscopy, ESS spectra were collected from the normal-appearing duodenum and antrum and a diagnostic algorithm generated by principle component and linear discriminant analysis. Pooled data from duodenal sites distal to the ampulla gave a sensitivity of 86% and a specificity of 72% (82% AUC) for the detection of malignancy, whereas those from the periampullary region had a sensitivity of 77% and a specificity of 61% (72% AUC); antral measurements were not able to discriminate with such accuracy. These early results suggest that ESS of the duodenal mucosa could represent a novel minimally invasive diagnostic test for pancreaticobiliary malignancy.

  12. Modelling and determination of metabolic pools by stable carbon isotopes in the avian duodenal mucosa and albumen.

    PubMed

    Ducatti, C; Sartori, M M P; Denadai, J C; Costa, V E; Pelcia, V C; Macari, M

    2016-02-01

    Stable isotope analyses have helped in assessing dietary switches if the diet undergoes metabolic alteration (isotopic exchange). However, when considering the effects over time of switching from one diet to another, one can assess how quickly the new diet is incorporated into tissues via the isotopic renewal or incorporation rate, or turnover. Turnover is obtained using exponential curves that fit the original data, allowing the determination of practical order parameters such as the half-life (T) and the turnover constant (k). Researchers have found that metabolic incorporation can be fractionated. The resulting fractions, called metabolic pools, are identified using the linearization of the isotopic exchange model and its linear fit. This fractionation methodology is still not well defined. The objective of this study was to assess the behaviour of the metabolic renewal rate (turnover) in fractionated form, explain the theory, and apply it to data from the avian duodenal mucosa and albumen. We concluded that the duodenal mucosa has one metabolic pool, with a half-life of 1.23days, and that the albumen has two metabolic pools, with half-lives of 1.89 and 6.32days. PMID:25958857

  13. Genome Sequencing of Serinicoccus chungangensis Strain CD08_5 Isolated from Duodenal Mucosa of a Celiac Disease Patient.

    PubMed

    Chander, Atul Munish; Kaur, Gurwinder; Nair, Ramesan Girish; Dhawan, Devinder Kumar; Kochhar, Rakesh; Mayilraj, Shanmugam; Bhadada, Sanjay Kumar

    2016-01-01

    For the first time, we report here the 3.5-Mb genome of Serinicoccus chungangensis strain CD08_5, isolated from duodenal mucosa from a celiac disease (CD) patient. The specific annotations obtained revealed genes associated with virulence, disease, and defense, which predict its probable role in the pathogenesis of CD. PMID:26966212

  14. Genome Sequencing of Serinicoccus chungangensis Strain CD08_5 Isolated from Duodenal Mucosa of a Celiac Disease Patient

    PubMed Central

    Chander, Atul Munish; Kaur, Gurwinder; Nair, Ramesan Girish; Kochhar, Rakesh; Mayilraj, Shanmugam

    2016-01-01

    For the first time, we report here the 3.5-Mb genome of Serinicoccus chungangensis strain CD08_5, isolated from duodenal mucosa from a celiac disease (CD) patient. The specific annotations obtained revealed genes associated with virulence, disease, and defense, which predict its probable role in the pathogenesis of CD. PMID:26966212

  15. Gastrin- and somatostatin-immunoreactive cells of the antral mucosa in patients with duodenal or gastric ulcers. An immunocytochemical study.

    PubMed

    Hacker, G W; Bernatzky, G; Graf, A H; Hlbling, N; Stilianu, L; Payreder, M H; Miller, K; Thurner, J; Adam, H

    1990-12-01

    Gastrin- and somatostatin-immunoreactive cells in biopsies taken from the prepyloric portion of the antrum from 15 patients with duodenal ulcer, 16 patients with gastric ulcer, and a control group of 19 patients without histopathological alterations of the antral mucosa were studied using peroxidase anti-peroxidase and immunogold-silver staining methods in combination with morphometry. Numerical densities and sizes (immunoreactive areas) of the cells demonstrated were measured and compared between all three groups. Gastrin- and somatostatin-immunoreactive cells were located most frequently in the lower midzone of the gastric crypts. None of the parameters measured showed a correlation with age or sex. The group with duodenal ulcer tended to exhibit gastrin- and somatostatin-cell-hyperplasia whereas the size of both cell types remained unchanged. In comparison with the control group, the numerical density of gastrin-immunoreactive cells was significantly increased in gastric ulcer patients, whereas the numerical density of somatostatin-immunoreactive cells was decreased in this group. Immunoreactive areas of both cell types were significantly increased in patients with gastric ulcer. PMID:1982175

  16. Quantification of chemokine and chemokine receptor gene expression in duodenal mucosa of dogs with inflammatory bowel disease.

    PubMed

    Maeda, Shingo; Ohno, Koichi; Nakamura, Kenji; Uchida, Kazuyuki; Nakashima, Ko; Fukushima, Kenjiro; Tsukamoto, Atsushi; Goto-Koshino, Yuko; Fujino, Yasuhito; Tsujimoto, Hajime

    2011-12-15

    Although chemokines and their receptors play an integral role in the regulation of the immune response, there is very little information about their involvement in canine inflammatory bowel disease (IBD). The objective of this study was to evaluate the mRNA expression of 9 selected chemokines and 6 chemokine receptors by real-time reverse transcription PCR in the duodenal mucosa from 21 dogs with IBD and 25 control dogs. The transcription levels of monocyte chemotactic protein-1 (MCP-1)/CCL2, macrophage inflammatory protein-3 alpha (MIP-3?)/CCL20, thymus-expressed chemokine (TECK)/CCL25, mucosae-associated epithelial chemokine (MEC)/CCL28 and IL-8/CXCL8 mRNA in IBD dogs were significantly higher than the corresponding levels in control dogs, but there was no significant difference in the mRNA levels of the chemokine receptors between the 2 groups. In addition, the CCL2 and CXCL8 mRNA levels were significantly higher in the high clinical severity score group than in the low clinical severity score group. However, there was no correlation between chemokine or chemokine receptor mRNA expressions and histopathological severity score. The present results suggest that several chemokines may play important roles in the pathogenesis of canine IBD. PMID:21996024

  17. Early ultrastructural changes in rat duodenal mucosa associated with cysteamine-induced ulcer

    SciTech Connect

    Pfeiffer, C.J.; Pfeiffer, D.C.; Szabo, S.

    1987-02-01

    The early morphologic sequelae induced by the duodenal ulcerogen, cysteamine, have been studied in rats by transmission electron microscopy. Cysteamine was administered per os at 70 mg/100 g body wt to groups of female rats sacrificed at 30 min, 1, 2, 4, 8, 12, 20, and 24 hr after chemical treatment, and duodenal tissue sampled from the antimesenteric side of the proximal duodenum, where ulcers develop, was studied. Emphasis was placed on early times as our previous scanning electron microscopic data had demonstrated enhanced in situ cellular necrosis and surface cavitation at 2-4 hr after cysteamine treatment. Results indicated intracellular changes as early as 30 min after treatment and prior to damage of the columnar cell microvilli or epithelial tight junctions. A staging of observed cellular degenerative changes suggested early apical endoplasmic reticular swelling and loss of cytoplasmic ground substance, followed later by moderate internal disruption of mitochondria. Through these stages the cell surface microvilli remained morphologically normal. Subsequently, microvilli degenerated and mitochondrial fine structure became severely disrupted and cell contents were expelled. Deeper villous changes such as separation of columnar cells from the lamina propria and alterations of selected elements within the lamina propria were observed. These data suggest that intracellular cytotoxic reactions at the villous tips occur early and may precede the influence of intraluminal damaging factors induced by cysteamine.

  18. Changes in ketone body utilization by chick liver, duodenal mucosa and kidney during embryonic and postnatal development.

    PubMed

    Linares, A; Caamaño, G J; Diaz, R; Gonzalez, F J; Garcia-Peregrin, E

    1993-06-01

    1. Lipid synthesis from acetoacetate and 3-hydroxybutyrate in chick kidney and duodenal mucosa showed a clear decrease between 15 and 19 days of the embryonic phase, followed by an increase at hatching and a new decrease during the first neonatal period. The hepatic synthesis of lipids presented a different profile: a peak at 19-day-old embryo and a new increase during postnatal development. 2. These changes would be related to those in 3-hydroxybutyrate concentration in chick plasma throughout the perinatal period. 3. Phospholipids were the main kind of lipid formed in the three tissues. An appreciable percentage of radioactivity was also recovered as free cholesterol, especially during the embryonic phase. Triglycerides were also formed from acetoacetate in a high proportion in liver from neonatal animals. 4. Chick kidney showed the maximal ability to incorporate both precursors into amino acids. The peak obtained around hatching time would be related to the availability of the substrates. 5. Ketone body oxidation to CO2 was also maximal in kidney. In this tissue, a drastic decrease was observed during the final embryonic period, followed by a strong increase at day 1 after hatching and a new decrease at 4 days. PMID:8359015

  19. Human keratinocyte culture from the peritonsillar mucosa.

    PubMed

    Neugebauer, P; Bonnekoh, B; Wevers, A; Michel, O; Mahrle, G; Krieg, T; Stennert, E

    1996-01-01

    Tonsillectomy tissue can be used as a routine source for cultures of oropharyngeal keratinocytes. In so doing, a peritonsillar strip of unaltered mucosa was dissected in the upper submucosa. Subsequent trypsinization yielded 7.0 +/- 3.4 x 10(6) keratinocytes per bilateral tonsillectomy. Keratinocyte attachment and growth in primary culture were promoted by sublethally irradiated 3T3 murine fibroblasts. Three subcultures could be performed without a feeder layer and were characterized by a population doubling time of 4.5 days during log growth phase. Electrophoretic and immunoblot analysis of the third subculture revealed a strong expression of keratin pairs 5/14 and 6/16 as well as keratins 7 and 19, whereas keratins 8/18 were expressed less intensely. The lowest intensity, was found for keratin 13, which is known to be indicative of the differentiated mucosa. The culture technique thus provides an easily available in vitro model for morphological and functional studies on the epithelial compartment of human oropharyngeal mucosa. PMID:8737778

  20. Polymorphisms in TLR9 but not in TLR5 increase the risk for duodenal ulcer and alter cytokine expression in the gastric mucosa.

    PubMed

    Trejo-de la O, Alejandra; Torres, Javier; Sánchez-Zauco, Norma; Pérez-Rodríguez, Martha; Camorlinga-Ponce, Margarita; Flores-Luna, Lourdes; Lazcano-Ponce, Eduardo; Maldonado-Bernal, Carmen

    2015-10-01

    Colonization of the gastric mucosa by Helicobacter pylori can lead to peptic ulcer and gastric adenocarcinoma. TLRs are signaling receptors involved in the recognition of microorganisms, and polymorphisms in their genes may influence the innate and adaptive immune response to H. pylori, affecting the clinical outcomes of the infection. We assessed the association between single nucleotide polymorphisms in TLR9 and TLR5 and gastroduodenal diseases. All patients were genotyped by allelic discrimination in regions 1174C>T and 1775A>G of TLR5 and -1237T>C and 2848G>A of TLR9. The 2848A allele of TLR9 was more frequent in duodenal ulcer and showed an association of risk with this pathology. Polymorphisms in TLR5 were not found to be associated with disease. Patients with polymorphisms in TLR9 and TLR5 expressed significantly lower levels of IL-1β and TNF-α, whereas polymorphisms in TLR5 also decreased the expression of IL-6 and IL-10. Our findings suggest that 2848G>A polymorphism in TLR9 increases the risk for the development of duodenal ulcer probably by modifying the inflammatory response to H. pylori infection. This is the first study to show an association of 2848A allele of TLR9 with duodenal ulcer and with altered expression of inflammatory cytokines in the gastric mucosa. PMID:25995217

  1. Honey and Apoptosis in Human Gastric Mucosa

    PubMed Central

    Ghaffari, Aida; Somi, Mohammad H; Safaiyan, Abdolrasoul; Modaresi, Jabiz; Ostadrahimi, Alireza

    2012-01-01

    Background: Gastric cancer is the fourth most common malignancy in the world. Honey is a complex mixture of special biological active constituents. Honey possesses antioxidant and antitumor properties. Nutritional studies have indicated that consumption of honey modulates the risk of developing gastric cancer. On the other hand, apoptosis has been reported to play a decisive role in precancerous changes. Our chief study was conducted to assess the relationship between consumption of honey and apoptosis in human gastric mucosa. Method: This cross-sectional study was conducted on 98 subjects over 18 years old, referred to two hospitals in Tabriz, Iran. Subjects were undergone an upper gastrointestinal endoscopy, 62 subjects were finally enrolled. Honey consumption was assessed by a Food Frequency Questionnaire (FFQ) and apoptosis was detected by TUNEL technique. We tested polynomial curve to find the best fit between honey consumption and apoptosis. Results: A positive relation between honey consumption and apoptosis was found (P=0.024). Our results indicated that the final and the best fit curve was: apoptosis = 1.714+1.648(honey amount) - 0.533(honey amount)2 +1.83310-5(honey amount)7. Conclusion: Honey consumption had positive effects on gastric cancer by inducing apoptosis in gastric mucosa. PMID:24688918

  2. [Mastocytes in the human intestinal mucosa].

    PubMed

    Drumcheva, M; Todorov, D; Sto?nov, S; Nikolov, N; Boneva, M

    1986-01-01

    A method has been for counting the mastocytes on 0.1 mm2 of intestinal mucosa in patients with chronic enterocolitis, gluten enteropathy, ulcerous colitis in a stage of exacerbation and in controls. The comparison of the results obtained in the separate groups of patients reveal an increased number of mastocytes in gluten enteropathy--mean = 21.01 +/- 6 as compared with the chronic enterocolitis, where mean = 9.79 +/- 3.83 (p = 0.002). Higher values of mastocytes in rectal mucosa were observed in the patients with ulcerous mucosa--mean = 15.83 +/- 4.49 as compared with the control subjects with means = 3.67 +/- 0.99 (p = 0.001). those data admit the participation of mastocytes in the morbid process in patients with gluten enteropathy and with ulcerous colitis. PMID:3716371

  3. Identification of the transcriptional response of human intestinal mucosa to Lactobacillus plantarum WCFS1 in vivo

    PubMed Central

    Troost, Freddy J; van Baarlen, Peter; Lindsey, Patrick; Kodde, Andrea; de Vos, Willem M; Kleerebezem, Michiel; Brummer, Robert-Jan M

    2008-01-01

    Background There is limited knowledge on the extent and dynamics of the mucosal response to commensal and probiotic species in the human intestinal lumen. This study aimed to identify the acute, time-dependent responses of intestinal mucosa to commensal Lactobacillus plantarum WCFS1 in vivo in two placebo-controlled human intervention studies in healthy volunteers. Transcriptional changes in duodenal mucosa upon continuous intraduodenal infusion of L. plantarum WCFS1 for one- and six h, respectively, were studied using oro- and nasogastric intubations with dedicated orogastric catheters and tissue sampling by standard flexible gastroduodenoscopy. Results One- and six-h exposure of small intestinal mucosa to L. plantarum WCFS1 induced differential expression of 669 and 424 gene reporters, respectively. While short-term exposure to L. plantarum WCFS1 inhibited fatty acid metabolism and cell cycle progression, cells switched to a more proliferative phase after prolonged exposure with an overall expression profile characterized by upregulation of genes involved in lipid metabolism, cellular growth and development. Cell death and immune responses were triggered, but cell death-executing genes or inflammatory signals were not expressed. Proteome analysis showed differential expression of several proteins. Only the microsomal protein 'microsomal triglyceride transfer protein' was regulated on both the transcriptional and the protein level in all subjects. Conclusion Overall, this study showed that intestinal exposure to L. plantarum WCFS1 induced consistent, time-dependent transcriptional responses in healthy intestinal mucosa. This extensive exploration of the human response to L. plantarum WCFS1 could eventually provide molecular support for specific or probiotic activity of this strain or species, and exemplifies the strength of the applied technology to identify the potential bio-activity of microbes in the human intestine. PMID:18681965

  4. Parameters of proliferation and apoptosis of epithelial cells in the gastric mucosa in indigenous and non-indigenous residents of Khakassia with Helicobacter pylori positive duodenal ulcer disease.

    PubMed

    Tsukanov, V V; Shtygasheva, O V; Vasyutin, A V; Amel'chugova, O S; Butorin, N N; Ageeva, E S

    2015-02-01

    We evaluated parameters of apoptosis in the mucosa of the gastric antrum and body of indigenous and non-indigenous residents of Khakassia with duodenal ulcer disease associated with Helicobacter pylori infection. In the gastric antrum, apoptotic index was significantly increased in patients with ulcer disease in comparison with healthy individuals in both populations. The ratio of proliferation index to apoptotic index was lower in patients with ulcer disease in comparison with healthy individuals in both populations. Similar, but less pronounced processes were recorded in the body of the stomach. Significant changes in the parameters of proliferation and apoptosis were noted in the gastric antrum and body of the stomach in both populations, but they were more pronounced in Caucasians in comparison with Khakasses. PMID:25711663

  5. Microstructure imaging of human rectal mucosa using multiphoton microscopy

    NASA Astrophysics Data System (ADS)

    Liu, N. R.; Chen, G.; Chen, J. X.; Yan, J.; Zhuo, S. M.; Zheng, L. Q.; Jiang, X. S.

    2011-01-01

    Multiphoton microscopy (MPM) has high resolution and sensitivity. In this study, MPM was used to image microstructure of human rectal mucosa. The morphology and distribution of the main components in mucosa layer, absorptive cells and goblet cells in the epithelium, abundant intestinal glands in the lamina propria and smooth muscle fibers in the muscularis mucosa were clearly monitored. The variations of these components were tightly relevant to the pathology in gastrointestine system, especially early rectal cancer. The obtained images will be helpful for the diagnosis of early colorectal cancer.

  6. [Submicroscopic structure of the jejunal mucosa of human fetuses].

    PubMed

    Várkonyi, T; Gergely, G; Varró, V

    1977-04-01

    Authors investigated the submicroscopic structure of the jejunal mucosa of 6--12 week old human foetuses, obtained from arteficial abortions. It was established, that in this age the jejunal mucosa differentiates and develops intensively. In the third month it is build up of morphological units enterocytes. Their structure is morphologically similar to that of the enterocytes of the adult, although in this age they have no function at all. PMID:876258

  7. Scanning electron microscopic study of surface of human oral mucosa.

    PubMed

    Kullaa-Mikkonen, A

    1986-02-01

    The surface ultrastructure of the healthy oral mucosa of humans was studied using SEM as follows: dorsum of the tongue (10 specimens), buccal mucosa (5), floor of the mouth (3), hard palate (5), and gingiva (10). One part of each formalin-fixed sample was processed routinely using the system of critical point drying for scanning electron microscopy. The other part of the specimen was embedded in paraffin blocks and stained with hematoxylin-eosin for light microscopy. With SEM at low magnification, the surface structure of the oral mucosa at different areas of the oral cavity was smooth with some desquamating cells. Only the tongue mucosa with its papillae formed a specialized mucosa. The hairs of the filiform papillae were covered by microorganisms, whereas on the oral mucosa there usually was little or no colonization by microorganisms. At high magnification, the surface structure of the superficial epithelial cells was pitted or microplicated. On keratinized epithelium the surface structure was pitted, whereas on non-keratinized epithelium it was microplicated. On cell boundaries some variation could also be seen; in keratinized epithelium these boundaries were overlapping and in non-keratinized epithelium they were tight. PMID:3458280

  8. Characterizing lamina propria of human gastric mucosa by multiphoton microscopy

    NASA Astrophysics Data System (ADS)

    Liu, Y. C.; Yang, H. Q.; Chen, G.; Zhuo, S. M.; Chen, J. X.; Yan, J.

    2011-01-01

    Lamina propria (LP) of gastric mucosa plays an important role in progression of gastric cancer because of the site at where inflammatory reactions occur. Multiphoton imaging has been recently employed for microscopic examination of intact tissue. In this paper, using multiphoton microscopy (MPM) based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG), high resolution multiphoton microscopic images of lamina propria (LP) are obtained in normal human gastric mucosa at excitation wavelength λex = 800 nm. The main source of tissue TPEF originated from the cells of gastric glands, and loose connective tissue, collagen, produced SHG signals. Our results demonstrated that MPM can be effective for characterizing the microstructure of LP in human gastric mucosa. The findings will be helpful for diagnosing and staging early gastric cancer in the clinics.

  9. Evaluation of repair in duodenal perforation with human amniotic membrane: An animal model (dog)

    PubMed Central

    Ghahramani, Leila; Jahromi, Ali Bagherpour; Dehghani, Mohammad Reza; Ashraf, Mohammad Javad; Rahimikazerooni, Salar; Rezaianzadeh, Abbas; Safarpour, Ali Reza; Hosseini, Seyed Vahid

    2014-01-01

    Background: There is a growing tendency toward application of human amniotic membrane (HAM) as a biologic substitute in various tissue injuries where a significant tissue loss is a matter of concern. In gastrointestinal injuries especially duodenal ones, some potential limitations in current surgical techniques contribute to not fully acceptable healing outcomes. Thus, this study was carried out to assess repair with HAM patch for duodenal defect in comparison with simple duodenoraphy in an animal model (dog). Materials and Methods: A total of 15 male German shepherd dogs weighing 23-27 kg were randomly divided into two groups. Group A with 10 dogs, which were a candidate for duodenal repair by amniotic membrane patch and Group B consisted of 5 dogs perform simple duodenorraphy. A precise control was made to match all conditions except surgical technique. Macroscopic and microscopic features of the healed duodenal lumen in both groups were recorded. Results: Gross evaluation revealed no difference in luminal diameter in both groups. Statistical analysis of duodenal diameter between both groups after operation also showed no significant difference (Pv = 0.789). Histological assessment indicated less inflammation with better wound healing in Group A. Conclusion: It seems that repairing duodenal wall defect with HAM would result in better histological outcomes compared with what is seen in simple duodenoraphy in animal models. However, there is no significant difference regarding surgical findings. PMID:24804187

  10. Duodenal luminal nutrient sensing.

    PubMed

    Rønnestad, Ivar; Akiba, Yasutada; Kaji, Izumi; Kaunitz, Jonathan D

    2014-12-01

    The gastrointestinal mucosa is exposed to numerous chemical substances and microorganisms, including macronutrients, micronutrients, bacteria, endogenous ions, and proteins. The regulation of mucosal protection, digestion, absorption and motility is signaled in part by luminal solutes. Therefore, luminal chemosensing is an important mechanism enabling the mucosa to monitor luminal conditions, such as pH, ion concentrations, nutrient quantity, and microflora. The duodenal mucosa shares luminal nutrient receptors with lingual taste receptors in order to detect the five basic tastes, in addition to essential nutrients, and unwanted chemicals. The recent 'de-orphanization' of nutrient sensing G protein-coupled receptors provides an essential component of the mechanism by which the mucosa senses luminal nutrients. In this review, we will update the mechanisms of and underlying physiological and pathological roles in luminal nutrient sensing, with a main focus on the duodenal mucosa. PMID:25113991

  11. Substance P and neurokinin A in human nasal mucosa

    SciTech Connect

    Baraniuk, J.N.; Lundgren, J.D.; Okayama, M.; Goff, J.; Mullol, J.; Merida, M.; Shelhamer, J.H.; Kaliner, M.A. )

    1991-03-01

    The tachykinins substance P (SP) and neurokinin A (NKA) were studied in human inferior turbinate nasal mucosa by radioimmunoassay, immunohistochemistry, and autoradiography and for their effect upon mucus release in an in vitro culture system in order to infer their potential functions in the upper respiratory tract. Similar amounts of SP (1.03 +/- 0.12 pmol/g wet weight; mean +/- SEM; n = 26) and NKA (0.76 +/- 0.23; n = 7) were found. NKA and SP immunoreactive nerve fibers were found in the walls of arterioles, venules, and sinusoids and as individual fibers in gland acini, near the basement membrane, and in the epithelium. ({sup 125}I)SP bound to arterioles, venules, and glands. ({sup 125}I)NKA bound only to arterioles. In short-term explant culture of fragments of human nasal mucosa, both 1 microM SP and 1 microM NKA stimulated release of ({sup 3}H)glucosamine-labeled respiratory glycoconjugates. These results indicate that SP and NKA have similar distributions in nociceptive sensory nerves in human nasal mucosa. The distribution of ({sup 125}I)SP binding sites is consistent with a role for SP as a vasodilator and mucous secretagogue. The presence of ({sup 125}I) NKA binding sites on vessels suggests a primary role for NKA in regulating vasomotor tone.

  12. Characterisation of human dental stem cells and buccal mucosa fibroblasts.

    PubMed

    Lindroos, Bettina; Mäenpää, Katja; Ylikomi, Timo; Oja, Hannu; Suuronen, Riitta; Miettinen, Susanna

    2008-04-01

    Human craniofacial stem cells are recently discovered sources of putative mesenchymal stem cells that hold great promise for autogenic or allogenic cell therapy and tissue engineering. Prior to employing these cells in clinical applications, they must be thoroughly investigated and characterized. In this study, the surface marker expression was investigated on dental pulp stem cells (DPSCs), dental follicle cells (DFCs), periodontal ligament stem cells (PDLSCs), and buccal mucosa fibroblasts (BMFs) utilising surface markers for flow cytometry. The osteogenic potential was also examined by bone-associated markers alkaline phosphatase, Runx2, collagen type I, osteocalcin, and osteopontin. The results from our study demonstrate that the dental cell sources exhibit comparable surface marker and bone-associated marker profiles parallel to those of other mesenchymal stem cell sources, yet distinct from the buccal mucosa fibroblasts. Our data support evidence towards clinical applicability of dental stem cells in hard tissue regeneration. PMID:18230338

  13. [Oral cholangiography and duodenal atresia].

    PubMed

    Baeza-Herrera, Carlos; Len-Cruz, Alberto; Sanjun-Fabin, Hctor; Garca-Cabello, Lus Manuel

    2006-01-01

    A newborn male patient with trisomy-21 presented with bilious hemesis. The patient was icteric with slight hepatomegaly. Simple abdominal X-ray and upper gastrointestinal series with barium showed a dilated duodenal loop and inflammatory changes involving the duodenal mucosa. This image known as "double bubble" is characteristic of congenital duodenal obstruction. Simultaneously the gallbladder and choledochus were visualized. The former X-ray finding is very unusual. An uneventful Kimura procedure was performed. PMID:16711553

  14. Low yield of routine duodenal biopsies for evaluation of abdominal pain

    PubMed Central

    Dubin, Sterling M; Kwong, Wilson T; Kalmaz, Denise; Savides, Thomas J

    2015-01-01

    AIM: To determine the yield of biopsying normal duodenal mucosa for investigation of abdominal pain. METHODS: This is a retrospective chart review of consecutive patients who underwent esophagogastroduodenoscopy (EGD) with duodenal biopsies of normal appearing duodenal mucosa for an indication that included abdominal pain. All the patients in this study were identified from an electronic endoscopy database at a single academic medical center and had an EGD with duodenal biopsies performed over a 4-year period. New diagnoses that were made as a direct result of duodenal biopsies were identified. All duodenal pathology reports and endoscopy records were reviewed for indications to perform the examination as well as the findings; all the medical records were reviewed. Exclusion criteria included age less than 18 years, duodenal mass, nodule, or polyp, endoscopic duodenitis, duodenal scalloping, known celiac disease, positive celiac serology, Crohns disease, or history of bone marrow transplant. Information was collected in a de-identified database with pertinent demographic information including human immunodeficiency virus (HIV) status, and descriptive statistics were performed. RESULTS: About 300 patients underwent EGD with biopsies of benign appearing or normal appearing duodenal mucosa. The mean age of patients was 44.1 16.8 years; 189 of 300 (63%) were female. A mean of 4.3 duodenal biopsies were performed in each patient. In the subgroup of patients with abdominal pain without anemia, diarrhea, or weight loss the mean age was 43.4 16.3 years. Duodenal biopsies performed for an indication that included abdominal pain resulting in 4 new diagnoses (3 celiac disease and 1 giardiasis) for an overall yield of 1.3%. 183 patients with abdominal pain without anemia, diarrhea, or weight loss (out of the total 300 patients) underwent duodenal biopsy of duodenal mucosa resulting in three new diagnoses (two cases of celiac disease and one giardiasis) for a yield of 1.6%. Duodenal biopsies of 19 HIV patients presenting for evaluation of abdominal pain did not reveal any new diagnoses. Information pertaining to new diagnoses is provided. CONCLUSION: Routine biopsy of normal appearing duodena in patients with abdominal pain should be reserved for those with a high pre-test probability given its low diagnostic yield. PMID:26139995

  15. Adherence of Entamoeba histolytica trophozoites to rat and human colonic mucosa.

    PubMed Central

    Ravdin, J I; John, J E; Johnston, L I; Innes, D J; Guerrant, R L

    1985-01-01

    We studied the adherence of [3H]thymidine-labeled axenic Entamoeba histolytica (strain HM1-IMSS) to in vitro preparations of rat and human colonic mucosa. Studies were performed with fixed or unfixed rat colonic mucosa, unfixed rat mucosa exposed to trypsin, unfixed rat submucosa, and fixed human colonic mucosa. Twenty percent of the amebae adhered to fixed rat colonic mucosa; adherence was specifically inhibited by N-acetyl-D-galactosamine (GalNAc), galactose, and asialofetuin. The adherence of amebae to fixed human colonic mucosa was also GalNAc inhibitable. Greater adherence was found with unfixed rat colonic mucosa (40.9%) and was not GalNAc inhibitable unless the tissue was first exposed to trypsin. However, GalNAc did inhibit the adherence of amebae to unfixed rat submucosa. Glutaraldehyde fixation of amebae inactivates known amebic adhesion proteins; there was a markedly decreased adherence of fixed amebae to trypsin-exposed mucosa or fixed rat colonic mucosa. However, fixed or viable amebae had equal levels of adherence to unfixed rat colonic mucosa, suggesting the presence of a host adhesion protein that binds to receptors on amebae. Human (10%) and rabbit (5%) immune sera reduced the adherence of viable amebae to fixed rat colonic mucosa. We concluded that the GalNAc-inhibitable adhesion protein on the surface of E. histolytica trophozoites mediated adherence to fixed rat mucosa, fixed human colonic mucosa, trypsin-exposed unfixed rat mucosa, and unfixed rat submucosa. The surface of unfixed rat colonic mucosa contained a glutaraldehyde- and trypsin-sensitive host adhesion protein, perhaps in the overlying mucus blanket, which bound viable or fixed E. histolytica trophozoites. Images PMID:2580787

  16. A novel dynamic scintigraphic technique for assessing duodenal contractions during gastric emptying in humans: a feasibility study.

    PubMed

    Kubo, Tadeu T A; Moraes, Eder R; Secaf, Marie; Troncon, Luiz E A

    2015-01-01

    Duodenal contractions are thought to play a role in the control of gastric emptying. Although noninvasive techniques, such as ultrasonography and MRI, have been proposed for studying duodenal contractile activity in humans, there are no reports on the use of scintigraphy for this purpose. This work aimed to describe a novel scintigraphic technique for assessing duodenal contractility during gastric emptying in humans, and to present preliminary data on the frequency and amplitude of contractions detected in three different duodenal segments. Fasted young healthy volunteers (N=12) were given either a liquid or a solid test meal of similar calorie content (400?kcal) labeled with 99mTc-phytate. Static images were collected to determine gastric emptying. Dynamic images of the anterior aspect of the abdomen (1?frame/s) were also acquired periodically in a standard position for 256?s at 15-30?min intervals. 'Activity versus time' curves were generated for regions of interest corresponding to the proximal, middle, and distal duodenal segments. Curves were digitally filtered and processed to estimate both dominant frequency (fast Fourier transform) and amplitude (mean ejection fraction) of postprandial duodenal contractions. There were no significant differences regarding dominant frequency among proximal, middle, and distal duodenal regions of interest. In addition, there were no significant differences between the liquid and the solid meal in terms of either frequency or amplitude of duodenal contractions. Characterization of duodenal contractions in humans using scintigraphy is feasible and yields consistent data for both the frequency and the amplitude of postprandial contractions, which seems to be rather independent of meal consistency. PMID:25299468

  17. Butyrate-Induced Transcriptional Changes in Human Colonic Mucosa

    PubMed Central

    Vanhoutvin, Steven A. L. W.; Troost, Freddy J.; Hamer, Henrike M.; Lindsey, Patrick J.; Koek, Ger H.; Jonkers, Daisy M. A. E.; Kodde, Andrea; Venema, Koen; Brummer, Robert J. M.

    2009-01-01

    Background Fermentation of dietary fiber in the colon results in the production of short chain fatty acids (mainly propionate, butyrate and acetate). Butyrate modulates a wide range of processes, but its mechanism of action is mostly unknown. This study aimed to determine the effects of butyrate on the transcriptional regulation of human colonic mucosa in vivo. Methodology/Principal Findings Five hundred genes were found to be differentially expressed after a two week daily butyrate administration with enemas. Pathway analysis showed that the butyrate intervention mainly resulted in an increased transcriptional regulation of the pathways representing fatty acid oxidation, electron transport chain and oxidative stress. In addition, several genes associated with epithelial integrity and apoptosis, were found to be differentially expressed after the butyrate intervention. Conclusions/Significance Colonic administration of butyrate in concentrations that can be achieved by consumption of a high-fiber diet enhances the maintenance of colonic homeostasis in healthy subjects, by regulating fatty acid metabolism, electron transport and oxidative stress pathways on the transcriptional level and provide for the first time, detailed molecular insight in the transcriptional response of gut mucosa to butyrate. PMID:19707587

  18. Characterization of intracellular pteroylpolyglutamate hydrolase (PPH) from human intestinal mucosa

    SciTech Connect

    Wang, T.T.Y.; Chandler, C.J.; Halsted, C.H.

    1986-03-01

    There are two forms of pteroylpolyglutamate hydrolase (PPH) in the human intestinal mucosa, one in the brush border membrane and the other intracellular; brush border PPH is an exopeptidase with optimal activity at pH 6.5 and a requirement for zinc. The presence study characterized human intracellular PPH and compared its properties to those of brush border PPH. Intracellular PPH was purified 30-fold. The enzyme had a MW of 75,000 by gel filtration, was optimally active at pH 4.5, and had an isoelectric point at pH 8.0. In contrast to brush border PPH, intracellular PPH was unstable at increasing temperatures, was unaffected by dialysis against chelating agents and showed no requirement for Zn/sup 2 +/. Using PteGlu/sub 2/(/sup 14/C)Glu as substrate, they demonstrated a K/sub m/ of 1.2 ..mu..M and increasing affinity for folates with longer glutamate chains. Intracellular PPH required the complete folic acid (PteGlu) moiety and a ..gamma..-glutamyl linkage for activity. Using ion exchange chromatography and an HPLC method to determine the hydrolytic products of the reaction, they found intracellular PPH could cleave both internal and terminal ..gamma..-glutamyl linkages, with PteGlu as an end product. After subcellular fractionation of the mucosa, PPH was found in the lysosomes. In summary, the distinct characteristics of brush border and intracellular PPH suggest that the two hydrolases serve different roles in folate metabolism.

  19. Duodenal atresia

    MedlinePLUS

    ... would. Many infants with duodenal atresia also have Down syndrome. Duodenal atresia is often associated with other birth ... abnormality. Other problems (such as those related to Down syndrome) must be treated as appropriate.

  20. Toxic rhinitis-induced changes of human nasal mucosa innervation.

    PubMed

    Groneberg, David A; Heppt, Werner; Cryer, Annette; Wussow, Anke; Peiser, Christian; Zweng, Martina; Dinh, Q Thai; Witt, Christian; Fischer, Axel

    2003-01-01

    Irritative toxic rhinitis is a nasal disorder induced by chemical compounds like ozone, formaldehyde, nickel, chrome, solvents and tobacco smoke. These noxious stimuli may have effects on the nasal innervation leading to a cascade of neuro-immune interactions and an augmentation of the symptoms. Here we examined changes in the neuropeptide content of mucosal parasympathetic, sympathetic and sensory nerves of patients with toxic rhinitis caused by chronic cigarette smoke exposure. Semiquantitative immunohistochemistry using antibodies against calcitonin gene-related peptide (CGRP), substance P (SP), neuropeptide tyrosine (NPY), and vasoactive intestinal peptide (VIP) was carried out on cryostat sections of human nasal mucosa obtained from normal subjects and patients with toxic rhinitis and revealed significant differences between both groups. Toxic rhinitis patients had significantly elevated expression scores for VIP (2.83 +/- 0.31 vs 1.27 +/- 0.47 control group) and NPY (3.17 +/- 0.31 vs 0.91 +/- 0.37 control group) revealing an increase of mediators in distinct subpopulations of airway nerves. In summary, the present studies indicate a differential participation of subclasses of mucosal nerves in the pathophysiology of toxic rhinitis. Airway innervation may have a major role in the pathophysiology of toxic rhinitis associated with chronic cigarette smoke exposure. PMID:12746121

  1. Supplementation of a grape seed and grape marc meal extract decreases activities of the oxidative stress-responsive transcription factors NF-κB and Nrf2 in the duodenal mucosa of pigs

    PubMed Central

    2013-01-01

    Background In pigs, enteric infections and the development of gut disorders such as diarrhoea are commonly observed, particularly after weaning. The present study investigated the hypothesis that feeding a grape seed and grape marc extract (GSGME) as a dietary supplement has the potential to suppress the inflammatory process in the small intestine of pigs by modulating the activities of NF-κB and Nrf2 due to its high content of flavonoids. Methods Twenty-four crossbred, 6 weeks old pigs were randomly assigned to 2 groups of 12 animals each and fed nutritionally adequate diets without or with 1% GSGME for 4 weeks. Results Pigs administered GSGME had a lower transactivation of NF-κB and Nrf2 and a lower expression of various target genes of these transcription factors in the duodenal mucosa than control pigs (P < 0.05). Concentrations of α-tocopherol and thiobarbituric acid reactive substances (TBARS) in liver and plasma and total antioxidant capacity of plasma and relative mRNA abundances of NF-κB and Nrf2 target genes in the liver did not differ between the two groups. However, the ratio of villus height:crypt depth and the gain:feed ratio was higher in the pigs fed GSGME than in control pigs (P < 0.05). Conclusions This study shows that dietary supplementation of a polyphenol rich GSGME suppresses the activity of NF-κB in the duodenal mucosa of pigs and thus might provide a useful dietary strategy to inhibit inflammation in the gut frequently occurring in pigs. Feeding GSGME did not influence vitamin E status and the antioxidant system of the pigs but improved the gain:feed ratio. In overall, the study suggests that polyphenol-rich plant extracts such GSGME could be useful feed supplements in pig nutrition, in order to maintain animal health and improve performance. PMID:23453040

  2. Human umbilical cord mesenchymal stem cells alleviate nasal mucosa radiation damage in a guinea pig model.

    PubMed

    Duan, Hong-Gang; Ji, Fang; Zheng, Chun-Quan; Wang, Chun-Hua; Li, Jing

    2015-02-01

    Nasal complications after radiotherapy severely affect the quality of life of nasopharyngeal carcinoma patients, and there is a compelling need to find novel therapies for nasal epithelial cell radiation damage. Therefore, we investigated the therapeutic effect of human umbilical cord mesenchymal stem cells (hUC-MSCs) in guinea pig model of nasal mucosa radiation damage and explored its therapeutic mechanism. Cultured hUC-MSCs were injected intravenously immediately after radiation in the nasal mucosa-radiation-damage guinea pig model. Migration of hUC-MSCs into the nasal mucosa and the potential for differentiation into nasal epithelial cells were evaluated by immunofluorescence. The therapeutic effects of hUC-MSCs were evaluated by mucus clearance time (MCT), degree of nasal mucosa edema, and the nasal mucosa cilia form and coverage ratio. Results indicate that the hUC-MSCs migrated to the nasal mucosa lamina propria and did not differentiate into nasal epithelial cells in this model. The MCT and degree of mucosal edema were improved at 1 week and 1 month after radiation, respectively, but no difference was found at 3 months and 6 months after radiation. The nasal mucosa cilia form and coverage ratio was not improved 6 months after radiation. Thus, hUC-MSCs can migrate to the nasal mucosa lamina propria and improve MCT and mucosa edema within a short time period, but these cells are unable to differentiate into nasal epithelial cells and improve nasal epithelial regeneration in the nasal mucosa radiation damage guinea pig model. PMID:25209829

  3. [Various mechanisms of cytoprotective effect of omeprazole and low intensity laser radiation on the gastroduodenal mucosa in the treatment of patients with duodenal ulcer].

    PubMed

    Akhmadkhodzhaev, A M

    2002-01-01

    Clinical studies were made in 130 patients with duodenal ulcer in the phase of exacerbation of the disease. There were 98 men and 32 women who ranged from 17 to 50 years old. Results of examination of 7 essentially healthy subjects were regarded as control. The patients were divided into three groups. Group I patients (n = 48) received a conventional therapy; in group II patients, the adopted therapy was supplemented by omeprazol, 20 mg twice daily, group III patients (n = 43) were (in addition to the above therapeutic regimen) exposed to a session of endoscopic low-intensity laser irradiation (LILI) for 5 min (overall 6 to 8 LILI procedures). It has been ascertained that omeprazol exerts a cytoprotective effect on the mucozal barrier of the gastroduodenal zone brought about by increase in the synthesis of glucoproteins in the mucous membrane, improvement of the water-and-elastic properties, and enhancement of resistance of the mucosal barrier to the action of the aggressive factors. Administration of endoscopic LILI treatments in DU patients has also been found out to have a cytoprotective effect but superior to omeprazol. A protective action of LILI is believed to be caused by stimulation of synthesis of the most important components of glycoproteins. A cytoprotective effect of omeprazol and endoscopic LILI is ccompanied by a significant shortening of time for the clinical symptoms to get dispelled, the ulcer cicatrization frequency increased. PMID:11944382

  4. Duodenal ulcer promoting gene 1 (dupA1) is associated with A2147G clarithromycin-resistance mutation but not interleukin-8 secretion from gastric mucosa in Iraqi patients

    PubMed Central

    Hussein, N.R.; Tunjel, I.; Majed, H.S.; Yousif, S.T.; Aswad, S.I.; Assafi, M.S.

    2015-01-01

    Helicobacter pylori causes peptic ulceration and gastric adenocarcinoma. The aims were to study the influence of dupA1 positivity upon interleukin-8 (IL-8) secretion from gastric mucosa and determine the prevalence of mutations responsible for clarithromycin and fluoroquinolone resistance. DNA was extracted from 74 biopsies and the virulence factors were studied. Levels of IL-8 in gastric mucosa were measured using ELISA and the mutations responsible for clarithromycin and fluoroquinolone resistance were determined using a GenoType-HelicoDR assay. The prevalence of cagA in strains isolated from gastric ulcer (GU) and duodenal ulcer (DU) was significantly higher than those isolated from non-ulcer disease (NUD) (90% and 57.9% versus 33.3%; p 0.01). The vacA s1m1 genotype was more prevalent in patients with DU (73.7%) and GU (70%) than in those with NUD (13.3%) (p 0.01). The prevalence of dupA1 was higher in DU patients (36.8%) than those with GU (10%) and NUD (8.9%) (p 0.01). Multivariate analysis showed that a cagA+/vacA s1i1m2 virulence gene combination was independently associated with the developing peptic ulcer disease (PUD) with increased odds of developing PUD (p 0.03; OR=2.1). We found no significant difference in the levels of IL-8 secretion in gastric mucosa infected with H.pylori dupA-negative and H.pylori dupA1-positive strains (dupA-negative: meanmedian: 2826 versus 3027.1 for dupA1; p 0.6). While 12 strains were clarithromycin resistant, only three isolates were levofloxacin resistant. A significant association was found between dupA1 genotype and A2147G clarithromycin resistance mutation (p <0.01). Further study is needed to explore the relationship between virulence factors and disease process and treatment failure. PMID:26042186

  5. [Inhibition of histamine-sensitive adenylate cyclase system of human gastric mucosa by cimetidine (author's transl)].

    PubMed

    Simon, B; Kather, H

    1977-12-01

    Human gastric mucosa contains a histamin-sensitive adenylate cyclase system. The activation of this enzyme system by histamine is competititively inhibited by the H2-receptor blocking agent cimetidine. Our results underscore the rational basis for the use 0f H2-receptor antagonists in the therapy of peptic ulcer. PMID:593028

  6. Effect of dexamethasone and ACC on bacteria-induced mucin expression in human airway mucosa.

    PubMed

    Hauber, Hans-Peter; Goldmann, Torsten; Vollmer, Ekkehard; Wollenberg, Barbara; Zabel, Peter

    2007-11-01

    Gram-negative bacteria can stimulate mucin production, but excessive mucus supports bacterial infection and consequently leads to airway obstruction. Therefore, the effect of dexamethasone (DEX) and the antioxidant acetyl-cysteine (ACC) on bacteria-induced mucus expression was investigated. Explanted human airway mucosa and mucoepidermoid cells (Calu-3) were stimulated with lipopolysaccharide (LPS) or PAM3 (a synthetic lipoprotein). DEX or ACC were added to either LPS- or PAM3-stimulated airway mucosa or Calu-3 cells. Mucin mRNA expression (MUC5AC) and total mucus glycoconjugates (mucin protein) were quantified using real-time PCR and periodic acid Schiff staining. LPS and PAM3 significantly increased mucin expression in airway mucosa and Calu-3 cells (P < 0.05). DEX alone had no significant effect on mucin expression in airway mucosa or Calu-3 cells (P > 0.05). In contrast, DEX significantly reduced LPS- and PAM3-induced mucin expression in explanted mucosal tissue and mucin expression in Calu-3 cells (P < 0.05). In explanted human airway mucosa ACC alone significantly increased mucin expression (P < 0.05). In contrast, ACC significantly decreased LPS- and PAM3-induced mucin expression (P < 0.05). In Calu-3 cells ACC alone had no significant effect on mucin expression (P > 0.05). ACC decreased LPS- and PAM3-induced mucin expression, but this effect was not significant (P > 0.05). These data suggest that DEX can effectively reduce bacteria-induced mucin expression in the airways. ACC alone may increase mucin expression in noninfected mucosa, but it decreased bacteria-induced mucin expression. Further studies are warranted to evaluate whether the effect of DEX or ACC is clinically relevant. PMID:17600317

  7. Lung Mucosa Lining Fluid Modification of Mycobacterium tuberculosis to Reprogram Human Neutrophil Killing Mechanisms.

    PubMed

    Arcos, Jess; Diangelo, Lauren E; Scordo, Julia M; Sasindran, Smitha J; Moliva, Juan I; Turner, Joanne; Torrelles, Jordi B

    2015-09-15

    We have shown that human alveolar lining fluid (ALF) contains homeostatic hydrolases capable of altering the Mycobacterium tuberculosis cell wall and subsequently its interaction with human macrophages. Neutrophils are also an integral part of the host immune response to M. tuberculosis infection. Here we show that the human lung mucosa influences M. tuberculosis interaction with neutrophils, enhancing the intracellular killing of ALF-exposed M. tuberculosis and up-regulating the expression of tumor necrosis factor and interleukin 8. In contrast, ALF-exposed M. tuberculosis does not induce neutrophil apoptosis or necrosis, degranulation, or release of extracellular traps, and it decreases the oxidative response. These results suggest an important role for the human alveolar mucosa: increasing the innate capacity of the neutrophil to recognize and kill M. tuberculosis by favoring the use of intracellular mechanisms, while at the same time limiting neutrophil extracellular inflammatory responses to minimize their associated tissue damage. PMID:25748325

  8. Duodenal polyposis secondary to portal hypertensive duodenopathy

    PubMed Central

    Gurung, Ananta; Jaffe, Philip E; Zhang, Xuchen

    2015-01-01

    Portal hypertensive duodenopathy (PHD) is a recognized, but uncommon finding of portal hypertension in cirrhotic patients. Lesions associated with PHD include erythema, erosions, ulcers, telangiectasia, exaggerated villous pattern and duodenal varices. However, duodenal polyposis as a manifestation of PHD is rare. We report a case of a 52-year-old man who underwent esophagogastroduodenoscopy and was found with multiple small duodenal polyps ranging in size from 1-8 mm. Biopsy of the representative polyps revealed polypoid fragments of duodenal mucosa with villiform hyperplasia lined by reactive duodenal/gastric foveolar epithelium and underlying lamina propria showed proliferating ectatic and congested capillaries. The features were diagnostic of polyps arising in the setting of PHD. PMID:26634042

  9. Genotoxicity of inorganic arsenic exposure: Micronuclei frequencies in exfoliated human oral mucosa cells

    SciTech Connect

    Gonsebatt, M.E.; Guzman, P.; Salazar, A.M.

    1995-11-01

    Micronuclei (MN) can be formed by acentric chromosome fragments or whole lagging chromosomes. When used in vivo, this assay can potentially detect the clastogenic effect of an exposure. MN are easier to score than chromosome aberrations although both biomarkers of effect are useful tools in risk estimation. We investigated the frequency of MN in exfoliated cells from the oral mucosa in 25-30 volunteers lifetime exposed to approximately 400 {mu}g/L of arsenic in their drinking water. A group of individuals with similar composition with respect to sex, age, and socioeconomic status, but with As levels in the drinking water between 29-32 {mu}g/L, was used as controls. Exposure was assessed by questionnaires and by determining the levels of arsenic in urine and water samples. Oral mucosa cells were collected scraping the mucosa with a premoistened wooden spatula and smeared on microscope slides. Feulgen stained samples were scored blind on slides. The frequency of MN in oral mucosa cells was 0.05% in controls and 0.25% in exposed individuals. Exposed males showed higher frequencies of MN than exposed females. Smoking habits did not account for the observed differences. These results demonstrate that buccal mucosa cells are a target tissue in inorganic arsenic exposure via drinking water. Several studies have also reported elevated frequencies of MN in oral mucosa cells from individuals exposed to substances or factors associated with increased cancer risk, which makes this non-invasive technique appropriate and sensitive to monitor human exposure to carcinogens such as inorganic arsenic.

  10. Classification of normal and malignant human gastric mucosa tissue with confocal Raman microspectroscopy and wavelet analysis

    NASA Astrophysics Data System (ADS)

    Hu, Yaogai; Shen, Aiguo; Jiang, Tao; Ai, Yong; Hu, Jiming

    2008-02-01

    Thirty-two samples from the human gastric mucosa tissue, including 13 normal and 19 malignant tissue samples were measured by confocal Raman microspectroscopy. The low signal-to-background ratio spectra from human gastric mucosa tissues were obtained by this technique without any sample preparation. Raman spectral interferences include a broad featureless sloping background due to fluorescence and noise. They mask most Raman spectral feature and lead to problems with precision and quantitation of the original spectral information. A preprocessed algorithm based on wavelet analysis was used to reduce noise and eliminate background/baseline of Raman spectra. Comparing preprocessed spectra of malignant gastric mucosa tissues with those of counterpart normal ones, there were obvious spectral changes, including intensity increase at ˜1156 cm -1 and intensity decrease at ˜1587 cm -1. The quantitative criterion based upon the intensity ratio of the ˜1156 and ˜1587 cm -1 was extracted for classification of the normal and malignant gastric mucosa tissue samples. This could result in a new diagnostic method, which would assist the early diagnosis of gastric cancer.

  11. Subversion of human intestinal mucosa innate immunity by a Crohn's disease-associated E. coli.

    PubMed

    Jarry, A; Crmet, L; Caroff, N; Bou-Hanna, C; Mussini, J M; Reynaud, A; Servin, A L; Mosnier, J F; Livin-Le Moal, V; Laboisse, C L

    2015-05-01

    Adherent-invasive Escherichia coli (AIEC), associated with Crohn's disease, are likely candidate contributory factors in the disease. However, signaling pathways involved in human intestinal mucosa innate host response to AIEC remain unknown. Here we use a 3D model of human intestinal mucosa explant culture to explore the effects of the AIEC strain LF82 on two innate immunity platforms, i.e., the inflammasome through evaluation of caspase-1 status, and NF?B signaling. We showed that LF82 bacteria enter and survive within a few intestinal epithelial cells and macrophages, without altering the mucosa overall architecture. Although 4-h infection with a Salmonella strain caused crypt disorganization, caspase-1 activation, and mature IL-18 production, LF82 bacteria were unable to activate caspase-1 and induce IL-18 production. In parallel, LF82 bacteria activated NF?B signaling in epithelial cells through I?B? phosphorylation, NF?Bp65 nuclear translocation, and TNF? secretion. In addition, NF?B activation was crucial for the maintenance of epithelial homeostasis upon LF82 infection. In conclusion, here we decipher at the whole-mucosa level the mechanisms of the LF82-induced subversion of innate immunity that, by maintaining host cell integrity, ensure intracellular bacteria survival. PMID:25269707

  12. The effects of two sodium lauryl sulphate-containing toothpastes with and without betaine on human oral mucosa in vivo.

    PubMed

    Rantanen, Irma; Jutila, Kirsti; Nicander, Ingrid; Tenovuo, Jorma; Sderling, Eva

    2003-01-01

    The aim was to compare the effects of two sodium lauryl sulphate (SLS)-containing toothpaste formulations with and without betaine on human oral mucosa in vivo. The results are compared with the effect of a dry mouth toothpaste without SLS. Twenty subjects participated in the double blind, crossover study. The toothpastes with 1.2% SLS, 1.2% SLS and 4% betaine and with 4% betaine but not with SLS were placed on buccal mucosa in a test chamber and kept in place for 15 min. The condition of the mucosa was studied both visually and using electrical impedance (EI) for up to 45 min. Both SLS-containing pastes had a similar, irritating effect on the mucosa as judged both by the appearance of the mucosa and the EI measurements. The dry mouth toothpaste (with betaine only) showed no significant irritation of the mucosa. Betaine did not reduce the mucosa-irritating effect of the SLS-containing toothpaste formulation. The surfactant-free toothpaste did thus not irritate the human oral mucosa in vivo while the SLS-containing pastes did. PMID:12704946

  13. Profiling of Olfactory Receptor Gene Expression in Whole Human Olfactory Mucosa

    PubMed Central

    Tarabichi, Maxime; Gregoire, Françoise; Dumont, Jacques E.; Chatelain, Pierre

    2014-01-01

    Olfactory perception is mediated by a large array of olfactory receptor genes. The human genome contains 851 olfactory receptor gene loci. More than 50% of the loci are annotated as nonfunctional due to frame-disrupting mutations. Furthermore haplotypic missense alleles can be nonfunctional resulting from substitution of key amino acids governing protein folding or interactions with signal transduction components. Beyond their role in odor recognition, functional olfactory receptors are also required for a proper targeting of olfactory neuron axons to their corresponding glomeruli in the olfactory bulb. Therefore, we anticipate that profiling of olfactory receptor gene expression in whole human olfactory mucosa and analysis in the human population of their expression should provide an opportunity to select the frequently expressed and potentially functional olfactory receptors in view of a systematic deorphanization. To address this issue, we designed a TaqMan Low Density Array (Applied Biosystems), containing probes for 356 predicted human olfactory receptor loci to investigate their expression in whole human olfactory mucosa tissues from 26 individuals (13 women, 13 men; aged from 39 to 81 years, with an average of 67±11 years for women and 63±12 years for men). Total RNA isolation, DNase treatment, RNA integrity evaluation and reverse transcription were performed for these 26 samples. Then 384 targeted genes (including endogenous control genes and reference genes specifically expressed in olfactory epithelium for normalization purpose) were analyzed using the same real-time reverse transcription PCR platform. On average, the expression of 273 human olfactory receptor genes was observed in the 26 selected whole human olfactory mucosa analyzed, of which 90 were expressed in all 26 individuals. Most of the olfactory receptors deorphanized to date on the basis of sensitivity to known odorant molecules, which are described in the literature, were found in the expressed olfactory receptors gene set. PMID:24800820

  14. MULTIPHOTON IMAGING CAN BE USED FOR MICROSCOPIC EXAMINATION OF INTACT HUMAN GASTROINTESTINAL MUCOSA EX VIVO

    PubMed Central

    Rogart, Jason N.; Nagata, Jun; Loeser, Caroline S.; Roorda, Robert D.; Aslanian, Harry; Robert, Marie E.; Zipfel, Warren R.; Nathanson, Michael H.

    2008-01-01

    Background & Aims The ability to observe cellular and subcellular detail during routine endoscopy is a major goal in the development of new endoscopic imaging techniques. Multiphoton microscopy, which relies on nonlinear infared optical processes, has the potential to identify cellular details by excitation of endogenous fluorescent molecules. We examined the feasibility of using multiphoton microscopy to characterize mucosal histology in the human gastrointestinal tract. Methods A multiphoton microscope was used to determine the optimal excitation wavelength for examination of gastrointestinal mucosa. Fresh, unfixed, and unstained biopsy specimens obtained during routine endoscopy in human subjects were then examined by confocal microscopy and multiphoton microscopy. Multiphoton images also were compared to standard H&E images obtained from paired biopsy specimens. A prototype miniaturized multiphoton probe was used to examine intact rat colon. Results Peak multiphoton autofluorescence intensity was detected in mucosa excited at 735 nm. Multiphoton microscopic examination of unstained biopsy specimens revealed improved cellular detail relative to either unstained or stained specimens examined by confocal imaging. Resolution of structures such as epithelial nuclei, goblet cells, and interstitial fibers and cells was comparable to what was obtained using standard H&E histology. Similar findings were observed when using a prototype miniaturized multiphoton probe. Conclusions Multiphoton microscopy can be used to examine gastrointestinal mucosa at the cellular level, without the need for fluorescent dyes. The construction of a multiphoton endomicroscope could therefore provide a practical means of performing virtual biopsies during the course of routine endoscopy, with advantages over currently available endomicroscopy technologies. PMID:18065276

  15. Gene Signature of Human Oral Mucosa Fibroblasts: Comparison with Dermal Fibroblasts and Induced Pluripotent Stem Cells

    PubMed Central

    Miyoshi, Keiko; Horiguchi, Taigo; Tanimura, Ayako; Hagita, Hiroko; Noma, Takafumi

    2015-01-01

    Oral mucosa is a useful material for regeneration therapy with the advantages of its accessibility and versatility regardless of age and gender. However, little is known about the molecular characteristics of oral mucosa. Here we report the first comparative profiles of the gene signatures of human oral mucosa fibroblasts (hOFs), human dermal fibroblasts (hDFs), and hOF-derived induced pluripotent stem cells (hOF-iPSCs), linking these with biological roles by functional annotation and pathway analyses. As a common feature of fibroblasts, both hOFs and hDFs expressed glycolipid metabolism-related genes at higher levels compared with hOF-iPSCs. Distinct characteristics of hOFs compared with hDFs included a high expression of glycoprotein genes, involved in signaling, extracellular matrix, membrane, and receptor proteins, besides a low expression of HOX genes, the hDFs-markers. The results of the pathway analyses indicated that tissue-reconstructive, proliferative, and signaling pathways are active, whereas senescence-related genes in p53 pathway are inactive in hOFs. Furthermore, more than half of hOF-specific genes were similarly expressed to those of hOF-iPSC genes and might be controlled by WNT signaling. Our findings demonstrated that hOFs have unique cellular characteristics in specificity and plasticity. These data may provide useful insight into application of oral fibroblasts for direct reprograming. PMID:26339586

  16. Endoscopic OCT for in-vivo imaging of precancer and cancer states of human mucosa

    NASA Astrophysics Data System (ADS)

    Sergeev, Alexander M.; Gelikonov, Valentin M.; Gelikonov, Grigory V.; Feldchtein, Felix I.; Kuranov, Roman V.; Gladkova, Natalia D.; Shakhova, Natalia M.; Kuznetzova, Irina N.; Snopova, Ludmila; Denisenko, Arkady; Almasov, Valentin

    1998-01-01

    First results of endoscopic applications of optical coherence tomography for in vivo studies of human mucosa in gastrointestinal and genital tracts are presented. A novel endoscopic OCT system has ben created that is based on the integration of a sampling arm of an all-optical-fiber interferometer into standard endoscopic devices using their biopsy channel to transmit low-coherence radiation to investigated tissue. We have studied mucous membranes of esophagus, stomach and uterine cervix as typical localization for carcinomatous processes. Images of tumor tissues versus healthy tissues have been recorded and analyzed. Violations of well-defined stratified healthy mucosa structure in cancerous tissue is distinctly seen by EOCT, thus making this technique promising for early diagnosis of tumors and precise guiding of excisional biopsy.

  17. In vivo endoscopic OCT imaging of precancer and cancer states of human mucosa

    NASA Astrophysics Data System (ADS)

    Sergeev, Alexander M.; Gelikonov, V. M.; Gelikonov, G. V.; Feldchtein, Felix I.; Kuranov, R. V.; Gladkova, N. D.; Shakhova, N. M.; Snopova, L. B.; Shakhov, A. V.; Kuznetzova, I. A.; Denisenko, A. N.; Pochinko, V. V.; Chumakov, Yu P.; Streltzova, O. S.

    1997-12-01

    First results of endoscopic applications of optical coherence tomography for in vivo studies of human mucosa in respiratory, gastrointestinal, urinary and genital tracts are presented. A novel endoscopic OCT (EOCT) system has been created that is based on the integration of a sampling arm of an all-optical-fiber interferometer into standard endoscopic devices using their biopsy channel to transmit low-coherence radiation to investigated tissue. We have studied mucous membranes of esophagus, larynx, stomach, urinary bladder, uterine cervix and body as typical localization for carcinomatous processes. Images of tumor tissues versus healthy tissues have been recorded and analyzed. Violations of well-defined stratified healthy mucosa structure in cancered tissue are distinctly seen by EOCT, thus making this technique promising for early diagnosis of tumors and precise guiding of excisional biopsy.

  18. Antioxidant effects of gastrointestinal digested purple carrot extract on the human cells of colonic mucosa.

    PubMed

    Olejnik, Anna; Rychlik, Joanna; Kidoń, Marcin; Czapski, Janusz; Kowalska, Katarzyna; Juzwa, Wojciech; Olkowicz, Mariola; Dembczyński, Radosław; Moyer, Mary Pat

    2016-01-01

    Purple carrot (PC) is a potential dietary constituent, which represents a valuable source of antioxidants and can modulate the reactive oxygen species (ROS) level in the gastrointestinal tract. Antioxidant capacity of a PC extract subjected to digestion process simulated in the artificial alimentary tract, including the stomach, small intestine and colon, was analyzed in normal human cells of colon mucosa. Results indicated that the extract obtained upon passage through the gastrointestinal tract, which could come into contact with the colonic cells in situ, was less potent than the extract, which was not subjected to digestion process. Digested PC extract exhibited intracellular ROS-inhibitory capacity, with 1mg/mL showing the ROS clearance of 18.4%. A 20.7% reduction in oxidative DNA damage due to colon mucosa cells' treatment with digested PC extract was observed. These findings indicate that PC extract is capable of colonic cells' protection against the adverse effects of oxidative stress. PMID:26213078

  19. Recombinant Human Epidermal Growth Factor Accelerates Recovery of Mouse Small Intestinal Mucosa After Radiation Damage

    SciTech Connect

    Lee, Kang Kyoo; Jo, Hyang Jeong; Hong, Joon Pio; Lee, Sang-wook Sohn, Jung Sook; Moon, Soo Young; Yang, Sei Hoon; Shim, Hyeok; Lee, Sang Ho; Ryu, Seung-Hee; Moon, Sun Rock

    2008-07-15

    Purpose: To determine whether systemically administered recombinant human epidermal growth factor (rhEGF) accelerates the recovery of mouse small intestinal mucosa after irradiation. Methods and Materials: A mouse mucosal damage model was established by administering radiation to male BALB/c mice with a single dose of 15 Gy applied to the abdomen. After irradiation, rhEGF was administered subcutaneously at various doses (0.04, 0.2, 1.0, and 5.0 mg/kg/day) eight times at 2- to 3-day intervals. The evaluation methods included histologic changes of small intestinal mucosa, change in body weight, frequency of diarrhea, and survival rate. Results: The recovery of small intestinal mucosa after irradiation was significantly improved in the mice treated with a high dose of rhEGF. In the mice that underwent irradiation without rhEGF treatment, intestinal mucosal ulceration, mucosal layer damage, and severe inflammation occurred. The regeneration of villi was noticeable in mice treated with more than 0.2 mg/kg rhEGF, and the villi recovered fully in mice given more than 1 mg/kg rhEGF. The frequency of diarrhea persisting for more than 3 days was significantly greater in the radiation control group than in the rhEGF-treated groups. Conclusions: Systemic administration of rhEGF accelerates recovery from mucosal damage induced by irradiation. We suggest that rhEGF treatment shows promise for the reduction of small intestinal damage after irradiation.

  20. Duodenal mucosal injury with nonsteroidal antiinflammatory drugs.

    PubMed

    Eliakim, R; Ophir, M; Rachmilewitz, D

    1987-08-01

    The effect of nonsteroidal antiinflammatory drugs (NSAIDs) on duodenal mucosa was assessed both retrospectively and prospectively. In 444 patients with duodenal ulcer, the incidence of upper gastrointestinal bleeding was five times higher in 56 patients who were treated with NSAIDs than in those who did not receive NSAIDs. Indomethacin and naproxen had the most potent damaging effects. In a control group of patients with gastric ulcer, nine out of 134 had taken NSAIDs. The incidence of bleeding in these patients was three times higher than in those who were not on NSAIDs. The effect of indomethacin, 150 mg/day, on the upper gastrointestinal tract was examined in a prospective study of 75 patients with acute musculoskeletal disorders. Endoscopy after 1 week of therapy showed that 45% had mucosal damage in the duodenum, and this was as frequent and as severe as the gastric mucosal damage. In most instances, the duodenal damage was erosive duodenitis. PMID:3498747

  1. Geno- and cytotoxicity of salinomycin in human nasal mucosa and peripheral blood lymphocytes.

    PubMed

    Scherzad, Agmal; Hackenberg, Stephan; Schramm, Carolin; Froelich, Katrin; Ginzkey, Christian; Hagen, Rudolf; Kleinsasser, Norbert

    2015-06-01

    Salinomycin is usually applied in stock breading but has also been described as a promising agent against cancer stem cells (CSC). However, knowledge about the toxicity of this ionophor substance is incomplete. The aim of this study was to investigate cyto- and genotoxic effects of salinomycin in human non-malignant cells. Primary human nasal mucosa cells (monolayer and mini organ cultures) and peripheral blood lymphocytes from 10 individuals were used to study the cytotoxic effects of salinomycin (0.1-175 μM) by annexin-propidiumiodide- and MTT-test. The comet assay was performed to evaluate DNA damage. Additionally, the secretion of interleukin-8 was analyzed by ELISA. Flow cytometry and MTT assay revealed significant cytotoxic effects in nasal mucosa cells and lymphocytes at low salinomycin concentrations of 10-20 μM. No genotoxic effects could be observed. IL-8 secretion was elevated at 5 μM. Salinomycin-induced cytotoxic and pro-inflammatory effects were seen at concentrations relevant for anti-cancer treatment. Concurrent to the evaluation of salinomycin application in experimental oncology, adverse effects in non-malignant cells need to be monitored and reduced as much as possible. Further studies are also warranted to evaluate the toxic effects in a variety of human cell systems, e.g., liver, kidney and muscle cells. PMID:25769976

  2. Characterization and distribution of alpha 2-adrenergic receptors in the human intestinal mucosa.

    PubMed Central

    Valet, P; Senard, J M; Devedjian, J C; Planat, V; Salomon, R; Voisin, T; Drean, G; Couvineau, A; Daviaud, D; Denis, C

    1993-01-01

    The subtype and the expression of the alpha 2-adrenergic receptor were investigated in the normal mucosa from human intestine by means of radioligand binding, RNase mapping, and measurement of adenylate cyclase activity. The study of the binding of the alpha 2-adrenergic antagonist, [3H]RX821002, to epithelial cell membranes indicated the existence of a single class of noninteracting sites displaying a high affinity for the radioligand (Kd = 1.1 +/- 0.5 nM). The rank order of potency of antagonists to inhibit [3H]RX821002 binding (RX821002 > yohimbine = rauwolscine > phentolamine approximately idazoxan >> chlorpromazine > prazosin) suggested that the receptor is of the alpha 2A subtype. A conclusion which is confirmed by the fact that only alpha 2C10 transcripts were found in the human intestine mucosa. Competition curves with (-)-norepinephrine demonstrated that 60% of the receptor population exhibited high affinity for agonists. This high-affinity state was abolished by the addition of GTP plus Na+ or by prior treatment of the membranes with pertussis toxin indicating it corresponded to G protein-coupled receptors. [32P]ADP-ribosylation and immunoblotting experiments identified two pertussis toxin-sensitive G proteins corresponding to Gi2 and Gi3. The study of the distribution of the receptor indicated that (a) the proximal colon is the intestine segment exhibiting the highest receptor density and (b) the receptor is predominantly expressed in crypts and is preferentially located in the basolateral membrane of the polarized cell. The distribution of the receptor along the crypt-surface axis of the colon mucosa can be correlated with a higher level of alpha 2C10-specific mRNA and a higher efficiency of UK14304 to inhibit adenylate cyclase in crypt cells. Images PMID:8098045

  3. Histochemical and immunocytochemical study of nitrergic innervation in human nasal mucosa.

    PubMed

    Riederer, A; Held, B; Mayer, B; Wrl, J

    1999-09-01

    Nitric oxide (NO) is a free radical gas that has been found to be produced in neuronal cells by the action of the enzyme brain nitric oxide synthase (bNOS). The aim of this study was to identify NO-containing nerve structures in the human nasal mucosa by localizing bNOS and to find out whether NO production is attached to the parasympathetic system. For this purpose, immunocytochemistry with antibodies to bNOS and neurofilament was performed. Additionally, nicotinamide-adenine dinucleotide phosphate diaphorase (NADPH-d), an enzyme that correlates with the localization of NO synthase, and acetylcholinesterase were visualized in a histochemical double staining technique on frozen sections. The NADPH-d and bNOS reactions were found in axons of nerve bundles and in subepithelial, glandular, and vascular nerve fibers. Arteries showed a distinctly developed nitric innervation, whereas no activity was found in nerve fibers supplying veins. A high coexistence of NADPH-d in parasympathetic nerves could be detected. These findings suggest that NO takes part in the nerve control functions of the human nasal mucosa. PMID:10527278

  4. Differential diagnosis of human bladder mucosa pathologies in vivo with cross-polarization optical coherence tomography

    PubMed Central

    Kiseleva, Elena; Kirillin, Mikhail; Feldchtein, Felix; Vitkin, Alex; Sergeeva, Ekaterina; Zagaynova, Elena; Streltzova, Olga; Shakhov, Boris; Gubarkova, Ekaterina; Gladkova, Natalia

    2015-01-01

    Quantitative image analysis and parameter extraction using a specific implementation of polarization-sensitive optical coherence tomography (OCT) provides differential diagnosis of mucosal pathologies in in-vivo human bladders. We introduce a cross-polarization (CP) OCT image metric called Integral Depolarization Factor (IDF) to enable automatic diagnosis of bladder conditions (assessment the functional state of collagen fibers). IDF-based diagnostic accuracy of identification of the severe fibrosis of normal bladder mucosa is 79%; recurrence of carcinoma on the post-operative scar is 97%; and differentiation between neoplasia and acute inflammation is 75%. The promising potential of CP OCT combined with image analysis in human urology is thus demonstrated in vivo. PMID:25909028

  5. Differential diagnosis of human bladder mucosa pathologies in vivo with cross-polarization optical coherence tomography.

    PubMed

    Kiseleva, Elena; Kirillin, Mikhail; Feldchtein, Felix; Vitkin, Alex; Sergeeva, Ekaterina; Zagaynova, Elena; Streltzova, Olga; Shakhov, Boris; Gubarkova, Ekaterina; Gladkova, Natalia

    2015-04-01

    Quantitative image analysis and parameter extraction using a specific implementation of polarization-sensitive optical coherence tomography (OCT) provides differential diagnosis of mucosal pathologies in in-vivo human bladders. We introduce a cross-polarization (CP) OCT image metric called Integral Depolarization Factor (IDF) to enable automatic diagnosis of bladder conditions (assessment the functional state of collagen fibers). IDF-based diagnostic accuracy of identification of the severe fibrosis of normal bladder mucosa is 79%; recurrence of carcinoma on the post-operative scar is 97%; and differentiation between neoplasia and acute inflammation is 75%. The promising potential of CP OCT combined with image analysis in human urology is thus demonstrated in vivo. PMID:25909028

  6. Acute pancreatitis with an intramural duodenal hematoma.

    PubMed

    Chang, Chia-Ming; Huang, Hsien-Hao; How, Chorng-Kuang

    2015-01-01

    The patient was a 43-year-old man admitted to the hospital with intermittent epigastric pain and vomiting, without any evidence of trauma. Blood tests showed elevated lipase/amylase levels. Abdominal computed tomography (CT) revealed pancreatitis complicated by an intramural duodenal hematoma (IDH). He was conservatively treated, and one month after admission, follow-up panendoscopy showed normal duodenal mucosa without luminal narrowing. Non-traumatic IDH is typically associated with coagulation abnormalities. Abdominal CT is an excellent tool for diagnosis in cases of acute abdomen. However, the pathogenesis of and relationship between IDH and pancreatitis remain unknown. PMID:25832937

  7. Duodenal Chemosensing and Mucosal Defenses

    PubMed Central

    Akiba, Yasutada; Kaunitz, Jonathan D.

    2011-01-01

    The duodenal mucosa is exposed to endogenous and exogenous chemicals, including acid, CO2, bile acids and nutrients. Mucosal chemical sensors are necessary to exert physiological responses such as secretion, digestion, absorption, and motility. We propose a mucosal chemosensing system by which luminal chemicals are sensed via mucosal acid sensors and G-protein-coupled receptors. Luminal acid/CO2 sensing consists of ecto- and cytosolic carbonic anhydrases, epithelial ion transporters, and acid sensors expressed on the afferent nerves in the duodenum. Furthermore, a luminal L-glutamate signal is mediated via mucosal L-glutamate receptors, including metabotropic glutamate receptors and taste receptor 1 family heterodimers, with activation of afferent nerves and cyclooxygenase, whereas luminal Ca2+ is differently sensed via the calcium-sensing receptor in the duodenum. Recent studies also show the involvement of enteroendocrine G-protein-coupled receptors in bile acid and fatty acid sensing in the duodenum. These luminal chemosensors help activate mucosal defense mechanisms in or- der to maintain the mucosal integrity and physiological responses. Stimulation of luminal chemosensing in the duodenal mucosa may prevent mucosal injury, affect nutrient metabolism, and modulate sensory nerve activity. PMID:21389725

  8. A novel gene, GCRG224, is differentially expressed in human gastric mucosa

    PubMed Central

    Wang, Gang-Shi; Wang, Meng-Wei; Wu, Ben-Yan; You, Wei-Di; Yang, Xin-Yan

    2003-01-01

    AIM: To clone genes that may predispose us to human gastric cancer and to analyze its expression in gastric tissues. METHODS: Specimens of paired tumor, paratumor and normal gastric mucosa tissues collected from fifteen patients who suffered from stomach antrum adenocarcinoma were used for analysis. Seven out of the fifteen cases were first studied by fluorescent differential display reverse transcription polymerase chain reaction (DDTR-PCR) analysis. The differentially expressed bands of interest were cloned, analyzed by Northern blot, sequencing and RT-PCR. Through BLAST, the sequencing results were compared with GenBank database for homology analysis. In situ hybridization with DIG-labeled cRNA probes was used to analyze the expression of interesting cDNA bands in paraffin embedded paired normal gastric mucosa and cancer tissues isolated from 30 gastric adenocarcinoma patients. RESULTS: DDRT-PCR showed that one of the interesting cDNA bands, which was named W2, expressed much higher in all seven tested tumor and paratumor samples than in their normal counterparts, it was sub-cloned into a pGEM-T Easy vector. Two subclones were subsequently obtained. One of the subclone, GCRG224, was studied further. The sequencing result showed that GCRG224 consisted of 1159 base pairs and had one open reading frame (ORF). It located at human chromosome 11q14. No homologue was found in GenBank database with GCRG224-ORF. This nucleotide sequence data were submitted to GenBank with accession No. AF438406. RT-PCR showed that GCRG224 expressed higher in 11/15 gastric cancer tissues than in non-tumor tissues. However, the result of Northern blot analysis showed a higher GCRG224 expression in the non-tumor tissue than in the tumor one. Human multiple tissue Northern blot analysis revealed that GCRG224 also expressed in human normal colon tissue, and peripheral blood leukocyte. In situ hybridization analysis showed that only 5/30 adenocarcinoma, 3/18 dysplasia and 6/18 intestinal metaplasia showed higher GCRG224 expression level than the normal gastric glands. However, GCRG224 was over-expressed predominantly in 26/30 cases of normal mucosal epithelium. CONCLUSION: A novel gene named GCRG224 was identified from human gastric mucosal tissue. It overexpressed in almost all gastric mucosal epithelium but only a small portion of cancer and precancerous leisions. The role of GCRG224 expression in gastric epithelium needs further study. PMID:12508346

  9. T Lymphocyte Density and Distribution in Human Colorectal Mucosa, and Inefficiency of Current Cell Isolation Protocols

    PubMed Central

    Preza, Gloria Cuevas; Yang, Otto O.; Elliott, Julie; Anton, Peter A.; Ochoa, Maria T.

    2015-01-01

    Mucosal tissues are critical immune effector sites containing complex populations of leukocytes in a tissue microenvironment that remains incompletely understood. We identify and quantify in human distal colorectal tissue absolute mucosal CD3+ lymphocytes, including CD4+ and CD8+ subsets, by direct visualization using immunohistochemistry (IHC), immunofluorescence (IF), and an automated counting protocol (r2=0.90). Sigmoid and rectal mucosal tissues are both densely packed with T lymphocytes in the mucosal compartment. Both compartments had similar densities of CD3+ T lymphocytes with 37,400 2,801 cells/mm3 and 33,700 4,324 cell/mm3, respectively. Sigmoid mucosa contained 57% CD3+CD4+ and 40% CD3+CD8+ T lymphocytes which calculates to 21,300 1,476/mm3 and 15,000 275/mm3 T lymphocytes, respectively. Rectal mucosa had 57% CD3+CD4+ and 42% CD3+CD8+ or 21,577 332, and 17,090 1,206 cells/mm3, respectively. By comparison, sigmoid mucosal biopsies subjected to conventional collagenase digestion, mononuclear cell (MMC) isolation and staining for flow cytometry yielded 4,549 381/mm3 and 2,708 245/mm3 CD4+ and CD8+ T lymphocytes. These data suggest only ~20.7% recovery compared to IHC results for these markers. Further studies will determine if this reflects a selective bias in only CD3+, CD4+ and CD8+ T cells or can be generalized to all flow-analyzed cells from mucosal tissues for phenotyping and functional testing. PMID:25856343

  10. Hyperspectral hybrid method classification for detecting altered mucosa of the human larynx

    PubMed Central

    2012-01-01

    Background In the field of earth observation, hyperspectral detector systems allow precise target detections of surface components from remote sensing platforms. This enables specific land covers to be identified without the need to physically travel to the areas examined. In the medical field, efforts are underway to develop optical technologies that detect altering tissue surfaces without the necessity to perform an excisional biopsy. With the establishment of expedient classification procedures, hyperspectral imaging may provide a non-invasive diagnostic method that allows determination of pathological tissue with high reliability. In this study, we examined the performance of a hyperspectral hybrid method classification for the automatic detection of altered mucosa of the human larynx. Materials and methods Hyperspectral Imaging was performed in vivo and 30 bands from 390 to 680?nm for 5 cases of laryngeal disorders (2x hemorrhagic polyp, 3x leukoplakia) were obtained. Image stacks were processed with unsupervised clustering (linear spectral unmixing), spectral signatures were extracted from unlabeled cluster maps and subsequently applied as end-members for supervised classification (spectral angle mapper) of further medical cases with identical diagnosis. Results Linear spectral unmixing clearly highlighted altered mucosa as single spectral clusters in all cases. Matching classes were identified, and extracted spectral signatures could readily be applied for supervised classifications. Automatic target detection performed well, as the considered classes showed notable correspondence with pathological tissue locations. Conclusions Using hyperspectral classification procedures derived from remote sensing applications for diagnostic purposes can create concrete benefits for the medical field. The approach shows that it would be rewarding to collect spectral signatures from histologically different lesions of laryngeal disorders in order to build up a spectral library and to prospectively allow non-invasive optical biopsies. PMID:22720905

  11. A case of a duodenal duplication cyst presenting as melena

    PubMed Central

    Ko, Seung Yeon; Ko, Sun Hye; Ha, Sungeun; Kim, Mi Sung; Shin, Hyang Mi; Baeg, Myong Ki

    2013-01-01

    Duodenal duplication cysts are benign rare congenital anomalies reported mainly in the pediatric population, but seldom in adults. Symptoms depend on the type and location and can present as abdominal pain, distension, dysphagia or dyspepsia. They have been reported to be responsible for duodenal obstruction, pancreatitis and, in rare cases, gastrointestinal bleeding. We present a case of a duodenal duplication cyst in a 43-year-old man presenting as melena. Initial gastroduodenoscopy and colonoscopy did not reveal any bleeding focus. However, the patient began passing melena after 3 d, with an acute decrease in hemoglobin levels. Subsequent studies revealed a duplication cyst in the second portion of the duodenum which was surgically resected. Histology revealed a duodenal duplication cyst consisting of intestinal mucosa. There was no further bleeding and the patient recovered completely. In rare cases, duodenal duplication cysts might cause gastrointestinal bleeding and should be included in the differential diagnosis. PMID:24151370

  12. Presentation and Surgical Management of Duodenal Duplication in Adults

    PubMed Central

    Jadlowiec, Caroline C.; Lobel, Beata E.; Akolkar, Namita; Bourque, Michael D.; Devers, Thomas J.; McFadden, David W.

    2015-01-01

    Duodenal duplications in adults are exceedingly rare and their diagnosis remains difficult as symptoms are largely nonspecific. Clinical presentations include pancreatitis, biliary obstruction, gastrointestinal bleeding from ectopic gastric mucosa, and malignancy. A case of duodenal duplication in a 59-year-old female is presented, and her treatment course is reviewed with description of combined surgical and endoscopic approach to repair, along with a review of historic and current recommendations for management. Traditionally, gastrointestinal duplications have been treated with surgical resection; however, for duodenal duplications, the anatomic proximity to the biliopancreatic ampulla makes surgical management challenging. Recently, advances in endoscopy have improved the clinical success of cystic intraluminal duodenal duplications. Despite these advances, surgical resection is still recommended for extraluminal tubular duplications although combined techniques may be necessary for long tubular duplications. For duodenal duplications, a combined approach of partial excision combined with mucosal stripping may offer advantage. PMID:26844004

  13. A role for CCL28-CCR3 in T-cell homing to the human upper airway mucosa.

    PubMed

    Danilova, E; Skrindo, I; Gran, E; Hales, B J; Smith, W A; Jahnsen, J; Johansen, F E; Jahnsen, F L; Baekkevold, E S

    2015-01-01

    Lymphocyte recruitment to peripheral tissues is fundamental for immune surveillance and homeostasis, but the chemokines and chemokine receptors responsible for tissue-specific homing of T cells to the upper airway mucosa have not been determined. To address this, we analyzed the chemokines expressed in the normal human nasal mucosa and found that CCL28 is preferentially expressed at a high level on the lumenal face of vascular endothelial cells in the mucosa. Analysis of the cognate chemokine receptors revealed that close to 50% of the CD4(+) T cells in the human nasal mucosa expressed the CCL28 receptor CCR3, whereas CCR3 was hardly detectable on T cells in the small intestine and skin. In the circulation, CCR3(+) T cells comprised a small subset that did not express homing receptors to the intestine or skin. Moreover, depletion of CCR3(+)CD4(+) T cells abrogated the proliferative response of human blood CD4(+) T cells against the opportunistic nasopharyngeal pathogen Haemophilus influenzae, indicating that the CCR3(+)CD4(+) T-cell subset in the circulation contains antigen specificities relevant for the upper airways. Together, these findings indicate that CCL28-CCR3 interactions are involved in the homeostatic trafficking of CD4(+) T cells to the upper airways. PMID:24917456

  14. A comparison of linaclotide and lubiprostone dosing regimens on ion transport responses in human colonic mucosa

    PubMed Central

    Kang, Sang Bum; Marchelletta, Ronald R; Penrose, Harrison; Docherty, Michael J; McCole, Declan F

    2015-01-01

    Linaclotide, a synthetic guanylyl cyclase C (GC-C) agonist, and the prostone analog, Lubiprostone, are approved to manage chronic idiopathic constipation and constipation-predominant irritable bowel syndrome. Lubiprostone also protects intestinal mucosal barrier function in ischemia. GC-C signaling regulates local fluid balance and other components of intestinal mucosal homeostasis including epithelial barrier function. The aim of this study was to compare if select dosing regimens differentially affect linaclotide and lubiprostone modulation of ion transport and barrier properties of normal human colonic mucosa. Normal sigmoid colon biopsies from healthy subjects were mounted in Ussing chambers. Tissues were treated with linaclotide, lubiprostone, or vehicle to determine effects on short-circuit current (Isc). Subsequent Isc responses to the cAMP agonist, forskolin, and the calcium agonist, carbachol, were also measured to assess if either drug caused desensitization. Barrier properties were assessed by measuring transepithelial electrical resistance. Isc responses to linaclotide and lubiprostone were significantly higher than vehicle control when administered bilaterally or to the mucosal side only. Single versus cumulative concentrations of linaclotide showed differences in efficacy while cumulative but not single dosing caused desensitization to forskolin. Lubiprostone reduced forskolin responses under all conditions. Linaclotide and lubiprostone exerted a positive effect on TER that was dependent on the dosing regimen. Linaclotide and lubiprostone increase ion transport responses across normal human colon but linaclotide displays increased sensitivity to the dosing regimen used. These findings may have implications for dosing protocols of these agents in patients with constipation. PMID:26038704

  15. The expression profile of filaggrin-2 in the normal and pathologic human oral mucosa.

    PubMed

    Makino, Teruhiko; Mizawa, Megumi; Inoue, Sayaka; Noguchi, Makoto; Shimizu, Tadamichi

    2016-04-01

    The epithelial cells of the oral cavity show a remarkable degree of regional variation with respect to their morphology and keratinization status. In the oral cavity, the tongue and palate contain keratinizing stratified epithelia, while the buccal mucosa contains non-keratinizing stratified epithelia. We herein examined the expression of filaggrin-2, a member of the S100 fused-type protein family, in the oral mucosa. Filaggrin-2 was weakly expressed in the normal epithelium of the palate, but not in the buccal mucosa or tongue, although filaggrin protein was observed in the epithelium of the buccal mucosa and the palate. We next examined the expression of filaggrin-2 in the oral mucosa of subjects with hyperkeratotic diseases. The expression of filaggrin-2 was markedly increased in the epithelium of the oral mucosa in patients with lichen planus, leukokeratosis and leukoplakia. Filaggrin-2 positivity was observed in granules, some of which were co-localized with those of filaggrin. These results indicate that filaggrin-2 was expressed in the oral mucosa under certain pathological conditions, demonstrating that an aberrant protein expression, together with filaggrin, indicates the altered differentiation program including hyperkeratosis that occurs in these diseases. PMID:26858109

  16. Human Embryonic Stem Cell-Derived Epithelial Cells in a Novel In Vitro Model of Vocal Mucosa

    PubMed Central

    Leydon, Ciara; Selekman, Joshua A.; Palecek, Sean

    2013-01-01

    A satisfactory in vitro model of vocal fold mucosa does not exist, thus precluding a systematic, controlled study of vocal fold biology and biomechanics. We sought to create a valid, reproducible three-dimensional (3D) in vitro model of human origin of vocal fold mucosa of human origin. We hypothesized that coculture of human embryonic stem cell (hESC)-derived simple epithelial cells with primary vocal fold fibroblasts under appropriate conditions would elicit morphogenesis of progenitor cells into vocal fold epithelial-like cells and creation of a basement membrane. Using an in vitro prospective study design, hESCs were differentiated into cells that coexpressed the simple epithelial cell marker, keratin 18 (K18), and the transcription factor, p63. These simple epithelial cells were cocultured with primary vocal fold fibroblasts seeded in a collagen gel scaffold. The cells were cultured for 3 weeks in a keratinocyte medium at an air–liquid interface. After that time, the engineered mucosa demonstrated a stratified, squamous epithelium and a continuous basement membrane recapitulating the key morphologic and phenotypic characteristics of native vocal fold mucosa. hESC-derived epithelial cells exhibited positive staining for vocal fold stratified, squamous epithelial markers, keratin 13 (K13) and 14 (K14), as well as tight junctions, adherens junctions, gap junctions, and desmosomes. Despite the presence of components critical for epithelial structural integrity, the epithelium demonstrated greater permeability than native tissue indicating compromised functional integrity. While further work is warranted to improve functional barrier integrity, this study demonstrates that hESC-derived epithelial progenitor cells can be engineered to create a replicable 3D in vitro model of vocal fold mucosa featuring a multilayered, terminally differentiated epithelium. PMID:23672433

  17. Human embryonic stem cell-derived epithelial cells in a novel in vitro model of vocal mucosa.

    PubMed

    Leydon, Ciara; Selekman, Joshua A; Palecek, Sean; Thibeault, Susan L

    2013-10-01

    A satisfactory in vitro model of vocal fold mucosa does not exist, thus precluding a systematic, controlled study of vocal fold biology and biomechanics. We sought to create a valid, reproducible three-dimensional (3D) in vitro model of human origin of vocal fold mucosa of human origin. We hypothesized that coculture of human embryonic stem cell (hESC)-derived simple epithelial cells with primary vocal fold fibroblasts under appropriate conditions would elicit morphogenesis of progenitor cells into vocal fold epithelial-like cells and creation of a basement membrane. Using an in vitro prospective study design, hESCs were differentiated into cells that coexpressed the simple epithelial cell marker, keratin 18 (K18), and the transcription factor, p63. These simple epithelial cells were cocultured with primary vocal fold fibroblasts seeded in a collagen gel scaffold. The cells were cultured for 3 weeks in a keratinocyte medium at an air-liquid interface. After that time, the engineered mucosa demonstrated a stratified, squamous epithelium and a continuous basement membrane recapitulating the key morphologic and phenotypic characteristics of native vocal fold mucosa. hESC-derived epithelial cells exhibited positive staining for vocal fold stratified, squamous epithelial markers, keratin 13 (K13) and 14 (K14), as well as tight junctions, adherens junctions, gap junctions, and desmosomes. Despite the presence of components critical for epithelial structural integrity, the epithelium demonstrated greater permeability than native tissue indicating compromised functional integrity. While further work is warranted to improve functional barrier integrity, this study demonstrates that hESC-derived epithelial progenitor cells can be engineered to create a replicable 3D in vitro model of vocal fold mucosa featuring a multilayered, terminally differentiated epithelium. PMID:23672433

  18. Daily and Seasonal Rhythms in Human Mucosa Phospholipid Fatty Acid Composition.

    PubMed

    Ruf, Thomas; Arnold, Walter

    2015-08-01

    Fatty acids (FAs) can exert important physiological effects: for example, as precursors of eicosanoids, as signaling molecules, and, in particular, as parts of phospholipids, the major constituents of cell membranes. Animals can remodel cell membranes in terms of their FA composition in response to environmental conditions, and even endothermic mammals exhibit seasonal cycles in the FA makeup of membranes. Previous evidence pointed to the existence of both seasonal and daily cycles in phospholipid composition of human cell membranes. Therefore, we used a noninvasive method to collect human mucosa cells over 1 year in 20 healthy subjects, and we determined seasonal and daily rhythmicity of phospholipid FA content. Our results show that significant daily rhythms were detectable in 11 of 13 FAs and were largely synchronous among subjects. Also, these daily rhythms showed stable phase relationships between different FAs within subjects. In contrast, yearly rhythms in phospholipid FA content were statistically significant in only ~50% of subjects and were asynchronous between subjects. These results support the view that while human physiology is still dominated by geophysical sunrise and sunset, resulting in strong daily cycles, seasonal rhythms are less well defined, at least in Western societies. We suggest that the main physiological function underlying rhythms in cell membrane composition is the regulation of the activity of transmembrane proteins, such as ion pumps, which can be strongly affected by the fatty acyl chains of phospholipids in the surrounding membrane bilayer. Hence, among a multitude of other functions, cycles in membrane FA composition may be involved in generating the daily rhythm of metabolic rate. Rhythms in certain membrane FAs, namely polyunsaturated and monounsaturated FAs that are known to affect health, could be also involved in daily and seasonal rhythms of diseases and death. PMID:26045067

  19. Glycosylated compounds from okra inhibit adhesion of Helicobacter pylori to human gastric mucosa.

    PubMed

    Lengsfeld, Christian; Titgemeyer, Fritz; Faller, Gerhard; Hensel, Andreas

    2004-03-24

    In Asian medicine the fruit of the okra plant, Abelmoschus esculentus (L.) Moench., is used as a mucilaginous food additive against gastric irritative and inflammative diseases. To find a rational basis for its use against these diseases, several crude and purified carbohydrate-containing fractions from immature okra fruits were isolated and analyzed, and their effects against Helicobacter pylori in an in situ adhesion model on sections of human gastric mucosa were determined. Pretreatment of the bacteria with a fresh juice preparation inhibited the bacterial adhesion almost completely. Lyophilization and reconstitution of an extract solution led to a reduction of this effect. A crude polysaccharide (RPS) isolated from the fresh juice by ethanolic precipitation showed strong inhibitory effects. Further fractionation of RPS revealed a purified, highly acidic subfraction (AF III) with high antiadhesive qualities. Carbohydrate analysis revealed the presence of rhamnogalacturonans with a considerable amount of glucuronic acid, whereas other inactive subfractions contained little glucuronic acid or were glucuronic acid-free. After heat denaturation of the fresh juice or protein precipitation with 5% TCA the antiadhesive activity of the fresh extract was reduced, indicating that besides polysaccharides, protein fractions also exhibited antiadhesive properties. SDS-PAGE analysis of the precipitate revealed several bands of glycosylated proteins between 25 and 37 kDa that were almost diminished in the nonactive supernatant. Preincubations of gastric tissue with any of the active fractions did not lead to reduced bacterial binding. The antiadhesive activity is therefore due to the blocking capacity of specific Helicobacter surface receptors that coordinate the interaction between host and bacterium. Neither of the active fractions showed inhibitory effects on bacterial growth in vitro. The antiadhesive qualities of okra were assumed to be due to a combination of glycoproteins and highly acidic sugar compounds making up a complex three-dimensional structure that is fully developed only in the fresh juice of the fruit. PMID:15030201

  20. Anatomy and Cellular Constituents of the Human Olfactory Mucosa: A Review

    PubMed Central

    Chen, C. Russell; Kachramanoglou, Carolina; Li, Daqing; Andrews, Peter; Choi, David

    2014-01-01

    Studies using animal models have recently suggested that the olfactory mucosa may be a source of cells capable of stimulating and contributing to complex neurologic regeneration. Several groups have already transplanted cell derivatives from the olfactory mucosa into injury models, and the results so far have been promising. To fully appreciate the meaning of these experiments, a better understanding of the cellular biology and physiology of the olfactory system is necessary. It is therefore of utmost importance for us to first identify and understand its constituents. PMID:25302141

  1. Histamine and chondroitin sulfate E proteoglycan released by cultured human colonic mucosa: indication for possible presence of E mast cells

    SciTech Connect

    Eliakim, R.; Gilead, L.; Ligumsky, M; Okon, E.; Rachmilewitz, D.; Razin, E.

    1986-01-01

    An association between the release of histamine and chondroitin sulfate E proteoglycan (PG) was demonstrates in human colonic mucosa (HCM). Colonic biopsy samples incorporated (/sup 35/S)sulfate into PG, which was partially released into the culture medium during the incubation period. Ascending thin-layer chromatography of the released /sup 35/S-labeled PG after its digestion by chondroitin ABC lyase (chondroitinase, EC 4.2.2.4) followed by autoradiography yielded three products that migrated in the position of monosulfated disaccharides of N-acetylgalactosamine 4-sulfate and N-acetylgalactosoamine 6-sulfate and of an oversulfated disaccharide possessing N-acetylgalatosamine 4,6-disulfate. Cultured colonic mucosa released 23.6 +/- 3.7ng of histamine per mg of wet tissue without any special trigger. Comparison by linear regression analysis of the release of histamine and chondroitin (/sup 35/S)sulfate E PG revealed a correlation coefficient (r) of 0.7. Histological examination of the colonic biopsies revealed the presence of many mast cells in various degrees of degranulation in the mucosa and submucosa. The above correlation, the observation that most of the mast cells showed various degrees of degranulation, and the lack of heparin synthesis as opposed to the synthesis and immunological release of chondroitin sulfate E strongly suggest that the E mast cell exists in the human colon.

  2. Reduced expression of aquaporins in human intestinal mucosa in early stage inflammatory bowel disease

    PubMed Central

    Ricanek, Petr; Lunde, Lisa K; Frye, Stephan A; Støen, Mari; Nygård, Ståle; Morth, Jens P; Rydning, Andreas; Vatn, Morten H; Amiry-Moghaddam, Mahmood; Tønjum, Tone

    2015-01-01

    Objectives The aim of this study was to investigate the relationship between aquaporin (AQP) water channel expression and the pathological features of early untreated inflammatory bowel disease (IBD) in humans. Methods Patients suspected to have IBD on the basis of predefined symptoms, including abdominal pain, diarrhea, and/or blood in stool for more than 10 days, were examined at the local hospital. Colonoscopy with biopsies was performed and blood samples were taken. Patients who did not meet the diagnostic criteria for IBD and who displayed no evidence of infection or other pathology in the gut were included as symptomatic non-IBD controls. AQP1, 3, 4, 5, 7, 8, and 9 messenger RNA (mRNA) levels were quantified in biopsies from the distal ileum and colon by quantitative real-time polymerase chain reaction. Protein expression of selected AQPs was assessed by confocal microscopy. Through multiple alignments of the deduced amino acid sequences, the putative three-dimensional structures of AQP1, 3, 7, and 8 were modeled. Results AQP1, 3, 7, and 8 mRNAs were detected in all parts of the intestinal mucosa. Notably, AQP1 and AQP3 mRNA levels were reduced in the ileum of patients with Crohn’s disease, and AQP7 and AQP8 mRNA levels were reduced in the ileum and the colon of patients with ulcerative colitis. Immunofluorescence confocal microscopy showed localization of AQP3, 7, and 8 at the mucosal epithelium, whereas the expression of AQP1 was mainly confined to the endothelial cells and erythrocytes. The reduction in the level of AQP3, 7, and 8 mRNA was confirmed by immunofluorescence, which also indicated a reduction of apical immunolabeling for AQP8 in the colonic surface epithelium and crypts of the IBD samples. This could indicate loss of epithelial polarity in IBD, leading to disrupted barrier function. Conclusion AQPs 1 and 8 and the aquaglyceroporins AQPs 3 and 7 are the AQPs predominantly expressed in the lower intestinal tract of humans. Their expression is significantly reduced in patients with IBD, and they are differentially expressed in specific bowel segments in patients with Crohn’s disease and ulcerative colitis. The data present a link between gut inflammation and water/solute homeostasis, suggesting that AQPs may play a significant role in IBD pathophysiology. PMID:25624769

  3. Performance of full-pupil line-scanning reflectance confocal microscopy in human skin and oral mucosa in vivo

    PubMed Central

    Larson, Bjorg; Abeytunge, Sanjeewa; Rajadhyaksha, Milind

    2011-01-01

    Point-scanning reflectance confocal microscopes continue to be successfully translated for detection of skin cancer. Line-scanning, with the use of a single scanner and a linear-array detector, offers a potentially smaller, simpler and lower cost alternative approach, to accelerate widespread dissemination into the clinic. However, translation will require an understanding of imaging performance deep within scattering and aberrating human tissues. We report the results of an investigation of the performance of a full-pupil line-scanning reflectance confocal microscope in human skin and oral mucosa, in terms of resolution, optical sectioning, contrast, signal-to-noise ratio, imaging and the effect of speckle noise. PMID:21750780

  4. Human intestinal lumen and mucosa-associated microbiota in patients with colorectal cancer.

    PubMed

    Chen, Weiguang; Liu, Fanlong; Ling, Zongxin; Tong, Xiaojuan; Xiang, Charlie

    2012-01-01

    Recent reports have suggested the involvement of gut microbiota in the progression of colorectal cancer (CRC). We utilized pyrosequencing based analysis of 16S rRNA genes to determine the overall structure of microbiota in patients with colorectal cancer and healthy controls; we investigated microbiota of the intestinal lumen, the cancerous tissue and matched noncancerous normal tissue. Moreover, we investigated the mucosa-adherent microbial composition using rectal swab samples because the structure of the tissue-adherent bacterial community is potentially altered following bowel cleansing. Our findings indicated that the microbial structure of the intestinal lumen and cancerous tissue differed significantly. Phylotypes that enhance energy harvest from diets or perform metabolic exchange with the host were more abundant in the lumen. There were more abundant Firmicutes and less abundant Bacteroidetes and Proteobacteria in lumen. The overall microbial structures of cancerous tissue and noncancerous tissue were similar; however the tumor microbiota exhibited lower diversity. The structures of the intestinal lumen microbiota and mucosa-adherent microbiota were different in CRC patients compared to matched microbiota in healthy individuals. Lactobacillales was enriched in cancerous tissue, whereas Faecalibacterium was reduced. In the mucosa-adherent microbiota, Bifidobacterium, Faecalibacterium, and Blautia were reduced in CRC patients, whereas Fusobacterium, Porphyromonas, Peptostreptococcus, and Mogibacterium were enriched. In the lumen, predominant phylotypes related to metabolic disorders or metabolic exchange with the host, Erysipelotrichaceae, Prevotellaceae, and Coriobacteriaceae were increased in cancer patients. Coupled with previous reports, these results suggest that the intestinal microbiota is associated with CRC risk and that intestinal lumen microflora potentially influence CRC risk via cometabolism or metabolic exchange with the host. However, mucosa-associated microbiota potentially affects CRC risk primarily through direct interaction with the host. PMID:22761885

  5. Megaduodenum with Duodenal Diospyrobezoars

    PubMed Central

    Park, Hyun Woo

    2015-01-01

    Bezoars are retained masses of ingested materials accumulating within the gastrointestinal track. While gastric bezoars are often observed, duodenal bezoars are rarely reported. A 77-year-old man who had frequently consumed persimmons and had never undergone gastric surgery had symptoms of epigastric pain and early satiety for 10 days. Esophagogastroduodenoscopy showed many diospyrobezoars in a severely distended duodenal bulb, otherwise known as megaduodenum. The patient's treatment consisted of repeated endoscopic removal of the bezoars by using a retrieval net. PMID:26473129

  6. High Expression of Antiviral Proteins in Mucosa from Individuals Exhibiting Resistance to Human Immunodeficiency Virus

    PubMed Central

    Feria, Manuel Gernimo; Arcia, David; Aguilar-Jimnez, Wbeimar; Zapata, Wildeman; Rugeles, Mara Teresa

    2015-01-01

    Background Several soluble factors have been reported to have the capacity of inhibiting HIV replication at different steps of the virus life cycle, without eliminating infected cells and through enhancement of specific cellular mechanisms. Yet, it is unclear if these antiviral factors play a role in the protection from HIV infection or in the control of viral replication. Here we evaluated two cohorts: i) one of 58 HIV-exposed seronegative individuals (HESNs) who were compared with 59 healthy controls (HCs), and ii) another of 13 HIV-controllers who were compared with 20 HIV-progressors. Peripheral blood, oral and genital mucosa and gut-associated lymphoid tissue (GALT) samples were obtained to analyze the mRNA expression of ELAFIN, APOBEC3G, SAMHD1, TRIM5?, RNase 7 and SerpinA1 using real-time PCR. Results HESNs exhibited higher expression of all antiviral factors in peripheral blood mononuclear cells (PBMCs), oral or genital mucosa when compared with HCs. Furthermore, HIV-controllers exhibited higher levels of SerpinA1 in GALT. Conclusions These findings suggest that the activity of these factors is compartmentalized and that these proteins have a predominant role depending on the tissue to avoid the infection, reduce the viral load and modulate the susceptibility to HIV infection. PMID:26091527

  7. Failure of frusemide to increase production of prostaglandin E2 in human nasal mucosa in vivo.

    PubMed Central

    Mullol, J; Ramis, I; Prat, J; Rosell-Catafau, J; Xaubet, A; Piera, C; Gelp, E; Picado, C

    1993-01-01

    BACKGROUND: It has been suggested that inhaled frusemide protects subjects with asthma against bronchoconstriction by enhancing the synthesis of prostaglandin E2 (PGE2). To evaluate this hypothesis the effect of frusemide on PGE2 production from nasal mucosa was studied. METHODS: Two main arachidonic acid metabolites produced by epithelial cells, PGE2 and 15-hydroxy 5,8,11,13-eicosatetraenoic acid (15-HETE), were measured by radioimmunoassay in nasal secretions obtained by nasal lavages with saline. Eleven healthy volunteers were randomly assigned to two study days, one week apart, in a double blind crossover study. Nasal instillation with three increasing doses of frusemide (5, 10, and 20 mg) or placebo was carried out at intervals of 15 minutes. Nasal lavages were performed immediately before nasal instillations and 15, 30, and 60 minutes after the last instillation. RESULTS: Baseline concentrations of 15-HETE were at least six times higher than PGE2. No differences between frusemide and placebo were detected either on PGE2 or 15-HETE release. CONCLUSIONS: The findings do not support the hypothesis that the antiasthmatic effect of frusemide may be due to increased synthesis of PGE2 or release in the respiratory mucosa. PMID:8497826

  8. Duodenal histology, ulceration, and Helicobacter pylori in the presence or absence of non-steroidal anti-inflammatory drugs.

    PubMed Central

    Taha, A S; Dahill, S; Nakshabendi, I; Lee, F D; Sturrock, R D; Russell, R I

    1993-01-01

    Duodenitis and gastric metaplasia, which is often colonised by Helicobacter pylori (H pylori), are increasingly recognised for their importance in the pathogenesis of duodenal ulcers. The situation is not clear in patients receiving non-steroidal anti-inflammatory drugs (NSAIDs), who have a higher risk of peptic ulceration. The aim of this study was to identify the duodenal histological abnormalities in the presence or absence of NSAIDs, H pylori, and duodenal ulceration. Endoscopic duodenal biopsy specimens were taken from healthy looking mucosa of 172 patients (74 took NSAIDs, and 98 did not). Duodenitis was graded according to the degree of neutrophilic and plasma cell infiltration, villus height, Brunner's gland prolapse, and gastric metaplasia. The activity of duodenitis was dependent on the neutrophilic infiltration. A global score covering all the above factors was constructed, and H pylori in both the stomach and duodenum, was also assessed. The results showed that duodenitis with varying degrees of neutrophilic infiltration and gastric metaplasia was found in 20 patients (27%) taking NSAIDs, compared with 56 patients (57%) not taking NSAIDs (chi 2 = 16.24, p < 0.001). This degree of duodenitis was also found in 20 of 25 patients (80%) with duodenal ulcers, regardless of NSAID intake (chi 2 = 15.38, p < 0.001). Gastric metaplasia was identified in 20 patients (27%) receiving NSAIDs and 38 (39%) not receiving NSAIDs. Duodenal H pylori was only seen in patients with gastric metaplasia 10 (50%) receiving NSAIDs, and 34 (89%) not receiving NSAIDs. H pylori positive gastritis, and the combination of active duodenitis and gastric metaplasia were independent predictors of duodenal ulceration. It is concluded that active duodenitis is less common in patients taking NSAIDs but is strongly associated with gastric metaplasia, H pylori positive gastritis, and duodenal ulceration. These findings are relevant to the pathogenesis and treatment of duodenal ulcers in patients taking NSAIDs. PMID:8406146

  9. Gastric metaplasia and duodenal ulcer disease in children infected by Helicobacter pylori.

    PubMed Central

    Gormally, S M; Kierce, B M; Daly, L E; Bourke, B; Carroll, R; Durnin, M T; Drumm, B

    1996-01-01

    BACKGROUND--Helicobacter pylori infection of the gastric mucosa is vital in the pathogenesis of duodenal ulcer disease. H pylori will only colonise gastric epithelium and its association with duodenal disease is therefore not easily explained. AIMS--To determine if gastric metaplasia in the duodenum increases the risk of duodenal ulcer disease in children infected with H pylori. PATIENTS--All children undergoing upper endoscopy over a 20 month period in a children's hospital in Ireland. METHODS--Two biopsy specimens were obtained from the antral mucosa and two from the first part of the duodenum. One antral biopsy specimen was used in a rapid urease test (Clo Test). Biopsy sections were stained with haematoxylin and eosin and also with cresyl violet for identification of H pylori. Periodic acid Schiff (PAS) stain was performed to identify areas of gastric metaplasia. RESULTS--Gastric and duodenal biopsy specimens were obtained from 148 patients (M:F 1:2:1). Twenty five children (17%) had H pylori positive gastritis. Thirty four children (23%) had gastric metaplasia in the duodenum. Nine per cent of children under the age of 8 years had gastric metaplasia compared with 38% in those 12 years of age or over (p < 0.005). Seven children had duodenal ulcer disease. Gastric metaplasia was present in six of seven (86%) children with duodenal ulcer disease compared with 28 of 141 (20%) without ulceration (p < 0.001). While both H pylori and gastric metaplasia were each significant risk factors for duodenal ulcer disease, the combined presence of both factors was associated with a pronounced increase in duodenal ulcer disease. Duodenal ulcer disease occurred in over 50% of children with both H pylori infection and gastric metaplasia. In contrast duodenal disease did not occur in children (0 of 100) when both were absent. CONCLUSION--The presence of gastric metaplasia in the duodenum is the major risk factor for duodenal ulcer disease in patients colonised by H pylori. PMID:8707079

  10. Parallel interleukin 5 synthesis by eosinophils in duodenal and skin lesions of a patient with dermatitis herpetiformis.

    PubMed Central

    Desreumaux, P; Janin, A; Delaporte, E; Dubucquoi, S; Piette, F; Cortot, A; Capron, M; Colombel, J F

    1995-01-01

    A 59 year old man is presented with a diagnosis of dermatitis herpetiformis. Duodenal and skin biopsy specimens from blisters of both recent and late onset were collected before treatment. Electron microscopy, immunohistochemistry, and in situ hybridisation were performed to analyse the presence of activated eosinophils and the local synthesis of interleukin 5 (IL5). Parallel state of eosinophil activation and IL5 synthesis was found in the duodenal mucosa with total flat mucosa and in skin vesicles of recent onset. It is suggested that duodenal and cutaneous eosinophils can synthesise IL5 and then participate in small bowel and skin lesions. Images Figure 1 Figure 2 Figure 3 PMID:7672663

  11. Prebiotic carbohydrates modify the mucosa associated microflora of the human large bowel

    PubMed Central

    Langlands, S J; Hopkins, M J; Coleman, N; Cummings, J H

    2004-01-01

    Background and aims: The mucosa associated flora of the large intestine is important in determining mucosal function although what controls its composition is unknown. This study has determined the effect of the prebiotic carbohydrates oligofructose and inulin on the mucosal flora. Methods: An in vitro chemostat model of both planktonic and surface associated bacteria was used followed by an intervention study in 29 subjects undergoing colonoscopy. Subjects: Fourteen subjects, recruited from colonoscopy waiting lists, supplemented their diet for two weeks with a mix of 7.5 g of oligofructose and 7.5 g inulin. Fifteen subjects were recruited at the time of colonoscopy and given no supplement. Multiple endoscopic biopsies were taken from the caecum, transverse and descending colon, and rectum. The mucosal flora was characterised by culture and to species level by cellular fatty acid profiles. Cell proliferation was assessed by immunohistochemical staining for minichromosome maintenance protein 2, Ki67, and proliferating cell nuclear antigen. Results: In vitro prebiotics increased surface counts of bifidobacteria from 6.6 to 7.3 log10 colony forming units (CFU) per slide (p<0.0006) with no significant changes in planktonic bacteria. In the feeding study, prebiotics increased mucosal bifidobacteria (log CFU/g mucosa (SEM)) in both the proximal (control 5.3 (0.4) v prebiotic 6.3 (0.3)) (p = 0.059) and distal (control 5.2 (0.3) v prebiotic 6.4 (0.3)) colon (p = 0.01). Lactobacilli were also increased (3.0 (0.1) v 3.7 (0.2) (p = 0.02) in the proximal and 3.1 (0.1) v 3.6 (0.2) (p = 0.04) in the distal colon, respectively). There were significantly more eubacteria in fed subjects but no changes in total anaerobes clostridia, bacteroides, or coliforms, nor in proliferation indices. Conclusion: Prebiotic carbohydrates can change the composition of the mucosa associated flora significantly. PMID:15479681

  12. Olfactory sensations produced by high-energy photon irradiation of the olfactory receptor mucosa in humans

    SciTech Connect

    Sagar, S.M.; Thomas, R.J.; Loverock, L.T.; Spittle, M.F. )

    1991-04-01

    During irradiation of volumes that incorporate the olfactory system, a proportion of patients have complained of a pungent smell. A retrospective study was carried out to determine the prevalence of this side-effect. A questionnaire was sent to 40 patients whose treatment volumes included the olfactory region and also to a control group treated away from this region. The irradiated tumor volumes included the frontal lobe, whole brain, nasopharynx, pituitary fossa, and maxillary antrum. Of the 25 patients who replied, 60% experienced odorous symptoms during irradiation. They described the odor as unpleasant and consistent with ozone. Stimulation of olfactory receptors is considered to be caused by the radiochemical formation of ozone and free radicals in the mucus overlying the olfactory mucosa.

  13. Effects of Ginkgo biloba extract on cytoprotective factors in rats with duodenal ulcer

    PubMed Central

    Chao, Jane C.-J.; Hung, Huei-Chen; Chen, Sheng-Hsuan; Fang, Chia-Lang

    2004-01-01

    AIM: To investigate the effects of Ginkgo biloba extract on cytoprotective factors in rats with duodenal ulcer. METHODS: Sprague-Dawley rats were randomly divided into four groups: sham operation without ginkgo, sham operation with ginkgo, duodenal ulcer without ginkgo, and duodenal ulcer with ginkgo. Rats with duodenal ulcer were induced by 500 mL/L acetic acid. Rats with ginkgo were intravenously injected with Ginkgo biloba extract from the tail at a dose of 0.5 mg/(kgd) for 7 and 14 days. RESULTS: Pathological result showed that duodenal ulcer rats with ginkgo improved mucosal healing and inflammation compared with those without ginkgo after 7 d treatment. After 14 d treatment, duodenal ulcer rats with ginkgo significantly increased weight gain (34.0 4.5 g versus 24.5 9.5 g, P < 0.05) compared with those without ginkgo. Duodenal ulcer rats significantly increased cell proliferation (27.4 4.0 and 27.8 2.3 BrdU-labeled cells in duodenal ulcer rats with and without ginkgo versus 22.4 3.5 and 20.8 0.5 BrdU-labeled cells in sham operation rats with and without ginkgo, P < 0.05) compared with sham operation rats. Mucosal prostaglandin E2 concentration significantly increased by 129% (P < 0.05) in duodenal ulcer rats with ginkgo compared with that in those without ginkgo. Duodenal ulcer rats without ginkgo significantly decreased superoxide dismutase activity in the duodenal mucosa and erythrocytes (19.4 6.7 U/mg protein versus 38.1 18.9 U/mg protein in the duodenal mucosa, and 4.87 1.49 U/mg protein versus 7.78 2.16 U/mg protein in erythrocytes, P < 0.05) compared with sham operation rats without ginkgo. However, duodenal ulcer rats with ginkgo significantly increased erythrocyte superoxide dismutase activity (8.22 1.92 U/mg protein versus 4.87 1.49 U/mg protein, P < 0.05) compared with those without ginkgo. Duodenal ulcer rats without ginkgo significantly increased plasma lipid peroxides (4.18 1.12 ?mol/mL versus 1.60 1.10 ?mol/mL and 1.80 0.73 ?mol/mL, P < 0.05) compared with sham operation rats without ginkgo and duodenal ulcer rats with ginkgo during the experimental period. CONCLUSION: Ginkgo biloba extract can improve weight gain and mucosal healing in duodenal ulcer rats by the actions of cytoprotection and antioxidation. PMID:14966917

  14. Astrocyte-like cells derived from human oral mucosa stem cells provide neuroprotection in vitro and in vivo.

    PubMed

    Ganz, Javier; Arie, Ina; Ben-Zur, Tali; Dadon-Nachum, Michal; Pour, Sammy; Araidy, Shareef; Pitaru, Sandu; Offen, Daniel

    2014-03-01

    Human oral mucosa stem cells (hOMSC) are a recently described neural crest-derived stem cell population. Therapeutic quantities of potent hOMSC can be generated from small biopsies obtained by minimally invasive procedures. Our objective was to evaluate the potential of hOMSC to differentiate into astrocyte-like cells and provide peripheral neuroprotection. We induced hOMSC differentiation into cells showing an astrocyte-like morphology that expressed characteristic astrocyte markers as glial fibrillary acidic protein, S100?, and the excitatory amino acid transporter 1 and secreted neurotrophic factors (NTF) such as brain-derived neurotrophic factor, vascular endothelial growth factor, glial cell line-derived neurotrophic factor, and insulin-like growth factor 1. Conditioned medium of the induced cells rescued motor neurons from hypoxia or oxidative stress in vitro, suggesting a neuroprotective effect mediated by soluble factors. Given the neuronal support (NS) ability of the cells, the differentiated cells were termed hOMSC-NS. Rats subjected to sciatic nerve injury and transplanted with hOMSC-NS showed improved motor function after transplantation. At the graft site we found the transplanted cells, increased levels of NTF, and a significant preservation of functional neuromuscular junctions, as evidenced by colocalization of ?-bungarotoxin and synaptophysin. Our findings show for the first time that hOMSC-NS generated from oral mucosa exhibit neuroprotective effects in vitro and in vivo and point to their future therapeutic use in neural disorders. PMID:24477074

  15. Astrocyte-Like Cells Derived From Human Oral Mucosa Stem Cells Provide Neuroprotection In Vitro and In Vivo

    PubMed Central

    Ganz, Javier; Arie, Ina; Ben-Zur, Tali; Dadon-Nachum, Michal; Pour, Sammy; Araidy, Shareef; Offen, Daniel

    2014-01-01

    Human oral mucosa stem cells (hOMSC) are a recently described neural crest-derived stem cell population. Therapeutic quantities of potent hOMSC can be generated from small biopsies obtained by minimally invasive procedures. Our objective was to evaluate the potential of hOMSC to differentiate into astrocyte-like cells and provide peripheral neuroprotection. We induced hOMSC differentiation into cells showing an astrocyte-like morphology that expressed characteristic astrocyte markers as glial fibrillary acidic protein, S100β, and the excitatory amino acid transporter 1 and secreted neurotrophic factors (NTF) such as brain-derived neurotrophic factor, vascular endothelial growth factor, glial cell line-derived neurotrophic factor, and insulin-like growth factor 1. Conditioned medium of the induced cells rescued motor neurons from hypoxia or oxidative stress in vitro, suggesting a neuroprotective effect mediated by soluble factors. Given the neuronal support (NS) ability of the cells, the differentiated cells were termed hOMSC-NS. Rats subjected to sciatic nerve injury and transplanted with hOMSC-NS showed improved motor function after transplantation. At the graft site we found the transplanted cells, increased levels of NTF, and a significant preservation of functional neuromuscular junctions, as evidenced by colocalization of α-bungarotoxin and synaptophysin. Our findings show for the first time that hOMSC-NS generated from oral mucosa exhibit neuroprotective effects in vitro and in vivo and point to their future therapeutic use in neural disorders. PMID:24477074

  16. Dietary manipulation of oncogenic microRNA expression in human rectal mucosa: a randomized trial.

    PubMed

    Humphreys, Karen J; Conlon, Michael A; Young, Graeme P; Topping, David L; Hu, Ying; Winter, Jean M; Bird, Anthony R; Cobiac, Lynne; Kennedy, Nicholas A; Michael, Michael Z; Le Leu, Richard K

    2014-08-01

    High red meat (HRM) intake is associated with increased colorectal cancer risk, while resistant starch is probably protective. Resistant starch fermentation produces butyrate, which can alter microRNA (miRNA) levels in colorectal cancer cells in vitro; effects of red meat and resistant starch on miRNA expression in vivo were unknown. This study examined whether a HRM diet altered miRNA expression in rectal mucosa tissue of healthy volunteers, and if supplementation with butyrylated resistant starch (HRM+HAMSB) modified this response. In a randomized cross-over design, 23 volunteers undertook four 4-week dietary interventions; an HRM diet (300 g/day lean red meat) and an HRM+HAMSB diet (HRM with 40 g/day butyrylated high amylose maize starch), preceded by an entry diet and separated by a washout. Fecal butyrate increased with the HRM+HAMSB diet. Levels of oncogenic mature miRNAs, including miR17-92 cluster miRNAs and miR21, increased in the rectal mucosa with the HRM diet, whereas the HRM+HAMSB diet restored miR17-92 miRNAs, but not miR21, to baseline levels. Elevated miR17-92 and miR21 in the HRM diet corresponded with increased cell proliferation, and a decrease in miR17-92 target gene transcript levels, including CDKN1A. The oncogenic miR17-92 cluster is differentially regulated by dietary factors that increase or decrease risk for colorectal cancer, and this may explain, at least in part, the respective risk profiles of HRM and resistant starch. These findings support increased resistant starch consumption as a means of reducing risk associated with an HRM diet. PMID:25092886

  17. Derivation of Epithelial Cells from Human Embryonic Stem Cells as an In Vitro Model of Vocal Mucosa.

    PubMed

    Lungova, Vlasta; Leydon, Ciara; Thibeault, Susan

    2016-01-01

    Vocal fold epithelial cells are very difficult to study as the vocal fold epithelial cell lines do not exist and they cannot be removed from the healthy larynx without engendering a significant and unacceptable risk to vocal fold function. Here, we describe the procedure to create an engineered vocal fold tissue construct consisting of the scaffold composed of the collagen 1 gel seeded with human fibroblasts and simple epithelial progenitors seeded on the scaffold and cultivated at air-liquid interface for 19-21 days to derive the stratified squamous epithelium. This model of vocal fold mucosa is very similar in morphology, gene expression, and phenotypic characteristics to native vocal fold epithelial cells and the underlying lamina propria and, therefore, offers a promising approach to studying vocal fold biology and biomechanics in health and disease. PMID:25403465

  18. Comparative study of gene expression by cDNA microarray in human colorectal cancer tissues and normal mucosa.

    PubMed

    Bianchini, Michele; Levy, Estrella; Zucchini, Cinzia; Pinski, Victor; Macagno, Carlos; De Sanctis, Paola; Valvassori, Luisa; Carinci, Paolo; Mordoh, Jos

    2006-07-01

    The causative molecular pathways underlying the pathogenesis of colorectal cancer (CRC) need to be better characterized. The purpose of our study was to better understand the genetic mechanism of oncogenesis for human colorectal cancer and to identify new potential tumor markers of use in clinical practice. We used cDNA microarrays to compare gene expression profiles of colorectal biopsies from 25 CRC patients and 13 normal mucosa from adjacent non-cancerous tissues. Findings were validated by real-time PCR; in addition, western blotting and immunochemistry analysis were carried out as further confirmation of differential expression at a protein level. Comparing cancerous tissues with normal colonic mucosa we identified 584 known genes differentially expressed to a significant degree (p<0.001). Many of the transcripts that were more abundant in tumors than in non-neoplastic tissues appear to reflect important events for colon carcinogenesis. For example, a significant number of these genes serve as apoptotic inhibitors (e.g. BFAR, BIRC1, BIRC6). Furthermore, we observed the simultaneous up-regulation of HLA-E and the down-regulation of beta2-microglobulin; these genes strongly support a potential tumor escape strategy from immune surveillance in colon cancer tissues. Our study provides new gene candidates in the pathogenesis of human CRC disease. From our results we hypothesize that CRC cells escape immune surveillance through a specific gene expression alteration; moreover, over-expression of several survival genes seems to confer a more anti-apoptotic phenotype. These genes are involved in pathways not previously implicated in CRC pathogenesis and they may provide new targets for therapy. PMID:16773188

  19. Raman fiberoptic probe for monitoring human tissue engineered oral mucosa constructs

    NASA Astrophysics Data System (ADS)

    Khmaladze, Alexander; Kuo, Shiuhyang; Okagbare, Paul; Marcelo, Cynthia L.; Feinberg, Stephen E.; Morris, Michael D.

    2013-02-01

    In oral and maxillofacial surgery, there is a need for tissue engineered constructs for dental implants, reconstructions due to trauma, oral cancer or congenital defects. A non-invasive quality monitoring of the fabrication of tissue engineered constructs during their production and implantation is a required component of any successful tissue engineering technique. We demonstrate the design and application of a Raman spectroscopic probe for rapid and noninvasive monitoring of Ex Vivo Produced Oral Mucosa Equivalent constructs (EVPOMEs). We conducted in vivo studies to identify Raman spectroscopic failure indicators for EVPOMEs (already developed in vitro), and found that Raman spectra of EVPOMEs exposed to thermal stress showed correlation of the band height ratio of CH2 deformation to phenylalanine ring breathing modes, providing a Raman metric to distinguish between viable and nonviable constructs. This is the first step towards the ultimate goal to design a stand-alone system, which will be usable in a clinical setting, as the data processing and analysis will be performed with minimal user intervention, based on already established and tested Raman spectroscopic indicators for EVPOMEs.

  20. Tissue-engineered constructs of human oral mucosa examined by Raman spectroscopy.

    PubMed

    Khmaladze, Alexander; Ganguly, Arindam; Kuo, Shiuhyang; Raghavan, Mekhala; Kainkaryam, Raghu; Cole, Jacqueline H; Izumi, Kenji; Marcelo, Cynthia L; Feinberg, Stephen E; Morris, Michael D

    2013-04-01

    A noninvasive quality monitoring of tissue-engineered constructs is a required component of any successful tissue-engineering technique. During a 2-week production period, ex vivo produced oral mucosa-equivalent constructs (EVPOMEs) may encounter adverse culturing conditions that might compromise their quality and render them ineffective. We demonstrate the application of near-infrared Raman spectroscopy to in vitro monitoring of EVPOMEs during their manufacturing process, with the ultimate goal of applying this technology in situ to monitor the grafted EVPOMEs. We identify Raman spectroscopic failure indicators for less-than optimal EVPOMEs that are stressed by higher temperature and exposure to higher than normal concentration of calcium ions. Raman spectra of EVPOMEs exposed to thermal and calcium stress showed correlation of the band height ratio of CH(2) deformation to phenylalanine ring breathing modes, providing a Raman metric to distinguish between viable and nonviable constructs. We compared these results to histology and glucose consumption measurements, demonstrating that Raman spectroscopy is more sensitive and specific to changes in proteins' secondary structure not visible by H&E histology. We also exposed the EVPOMEs to rapamycin, a cell growth inhibitor and cell proliferation capacity preserver, and distinguished between EVPOMEs pretreated with 2 nM rapamycin and controls, using the ratio of the Amide III envelope to the phenylalanine band as an indicator. PMID:22992065

  1. Probiotics modify human intestinal mucosa-associated microbiota in patients with colorectal cancer.

    PubMed

    Gao, Zhiguang; Guo, Bomin; Gao, Renyuan; Zhu, Qingchao; Wu, Wen; Qin, Huanlong

    2015-10-01

    Studies using animal models have demonstrated that probiotics may have a beneficial role in the prevention of colorectal cancer (CRC); however, the underlying mechanism of the beneficial effects of interventional probiotic treatment on gut microbiota has remained elusive. In the present study, pyrosequencing of the V3 region of the 16S rRNA genes was conducted in order to determine the extent to which probiotics alter the microbiota. The observations of the present study indicated that the microbial structure of cancerous tissue differed significantly from that of healthy individuals and that the CRC microbiota exhibited lower diversity. It was indicated that interventional treatment with probiotics increased the density and diversity of mucosal microbes, and altered the mucosa‑associated microbiota. Pyrosequencing demonstrated that probiotics significantly reduced (5‑fold) the abundance of a bacterial taxon assigned to the genus Fusobacterium, which had been previously suggested to be a contributing factor to increase tumorigenesis. Accordingly, interventional probiotic therapy is suggested to be able to improve the composition of the mucosal microbial flora and significantly reduce the abundance of mucosa-associated pathogens in patients with CRC. PMID:26238090

  2. Uncomplicated Diverticular Disease: Innate and Adaptive Immunity in Human Gut Mucosa before and after Rifaximin

    PubMed Central

    Cesaro, Paola; Petruzziello, Lucio; Casciano, Fabio; Costamagna, Guido; Pandolfi, Franco

    2014-01-01

    Background/Aim. Uncomplicated diverticular disease (UDD) is a frequent condition in adults. The pathogenesis of symptoms remains unknown. Bacteria are able to interact with Toll-like receptors (TLRs) and to induce inflammation through both innate immunity and T-cell recruitment. We investigated the pattern of TLRs 2 and 4 and the intestinal homing in patients with UDD before and after a course of Rifaximin. Methods. Forty consecutive patients with UDD and 20 healthy asymptomatic subjects were enrolled. Among UDD patients, 20 were assigned to a 2-month course of treatment with Rifaximin 1.2?g/day for 15 days/month and 20 received placebo. Blood sample and colonic biopsies were obtained from patients and controls. The samples were collected and analyzed at baseline and at the end of treatment. Flow cytometry was performed using monoclonal antibodies (CD3, CD4, CD8, CD103, TCR-gamma/delta, CD14, TLR2, and TLR4). Results. In UDD, TLR2 and TLR4 expression on immune cell subpopulations from blood and mucosa of the affected colon are altered as compared with controls. Rifaximin treatment induced significant modifications of altered conditions. Conclusions. Our data show the role of TLRs in the development of inflammation in UDD. TLRs distribution is altered in UDD and these alterations are reversed after antibiotic treatment. This trial is registered with ClinicalTrials.gov: NCT02068482. PMID:25133198

  3. In vivo analysis of tissue by Raman microprobe: examination of human skin lesions and esophagus Barrett's mucosa on an animal model

    NASA Astrophysics Data System (ADS)

    Tfayli, Ali; Piot, Olivier; Derancourt, Sylvie; Cadiot, Guillaume; Diebold, Marie D.; Bernard, Philippe; Manfait, Michel

    2006-02-01

    In the last few years, Raman spectroscopy has been increasingly used for the characterization of normal and pathological tissues. A new Raman system, constituted of optic fibers bundle coupled to an axial Raman spectrometer (Horiba Jobin Yvon SAS), was developed for in vivo investigations. Here, we present in vivo analysis on two tissues: human skin and esophagus mucosa on a rat model. The skin is a directly accessible organ, representing a high diversity of lesions and cancers. Including malignant melanoma, basal cell carcinoma and the squamous cell carcinoma, skin cancer is the cancer with the highest incidence worldwide. Several Raman investigations were performed to discriminate and classify different types of skin lesions, on thin sections of biopsies. Here, we try to characterize in vivo the different types of skin cancers in order to be able to detect them in their early stages of development and to define precisely the exeresis limits. Barrett's mucosa was also studied by in vivo examination of rat's esophagus. Barrett's mucosa, induced by gastro-esophageal reflux, is a pretumoral state that has to be carefully monitored due to its high risk of evolution in adenocarcinoma. A better knowledge of the histological transformation of esophagus epithelium in a Barrett's type will lead to a more efficient detection of the pathology for its early diagnosis. To study these changes, an animal model (rats developing Barrett's mucosa after duodenum - esophagus anastomosis) was used. Potential of vibrational spectroscopy for Barrett's mucosa identification is assessed on this model.

  4. Effect of prostaglandin E2 on eicosanoid release by human bronchial biopsy specimens from normal and inflamed mucosa.

    PubMed Central

    Schäfer, D.; Lindenthal, U.; Wagner, M.; Bölcskei, P. L.; Baenkler, H. W.

    1996-01-01

    BACKGROUND: Eicosanoids such as prostaglandin E2 (PGE2), thromboxane A2 (TXA2), and peptidoleukotrienes (pLT) are known to be biologically highly active lipid mediators, especially in human lung epithelium. PGE2 is thought to have mostly bronchoprotective effects, whereas pLT and TXA2 are bronchoconstrictive. This study was undertaken to assess the release and interaction of eicosanoids in human bronchial biopsy specimens of normal and inflamed mucosa. METHODS: Bronchial biopsy specimens were obtained from 16 patients, seven controls without signs of inflammation and nine patients with severe inflammatory processes in the epithelium. The release of pLT, TXA2 (measured as TXB2), and PGE2 was investigated using a "functional in vitro test" and the addition of several stimuli. RESULTS: Specimens incubated with arachidonic acid released higher amounts of pLT, TXB2, and PGE2 than unstimulated specimens. Preincubation with PGE2 revealed significant inhibition of arachidonic acid-induced release of pLT and TXB2 (> 50%). The inhibitory effect was higher in normal than in inflamed epithelium. CONCLUSIONS: Exogenous PGE2 has inhibitory effects on the release of pLT and TXB2 in human bronchial biopsy specimens. This finding could explain the bronchoprotective effect of inhaled PGE2 in normal subjects and asthmatic subjects as direct eicosanoid interactions. It also supports the concept of PGE2 as a bronchoprotective endogenous substance. The complex effects of PGE2 as a modulating mediator in inflammation may be worth investigating. PMID:8984703

  5. Acute duodenal ulcer.

    PubMed Central

    Hsu, H Y; Chang, M H; Wang, T H; Hsu, J Y; Wang, C Y; Lin, M I; Wu, M H

    1989-01-01

    A series of 31 infants and children with acute duodenal ulcer verified by endoscopy was studied over an eight year period. Eighteen (58%) of them were under 2 years of age. The most common symptom was upper gastrointestinal bleeding (n = 27, 87%). Twenty nine patients (94%) had a preceding illness characterised by diarrhoea, upper respiratory tract infection, or fever, which was not necessarily treated with antipyretic drugs. Initial endoscopy showed that ulcer lesions were solitary in 14 patients and present on the anterior wall (n = 11), posterior wall (n = 2), or both (n = 1). Multiple ulcers were found in 17 patients, and present in the bulb with (n = 6) or without (n = 11) extension into the second part of duodenum. The most conspicuous finding was the irregularly shaped ulcers seen in eight young children with similar clinical and endoscopic features. Sixteen patients were re-endoscoped one to two weeks after the initial examination; the ulcers had entirely disappeared in 13, and there were only small residual ulcers in three. Thirty patients were treated medically and only one (with uncontrollable haemorrhage) required operation. Most patients were symptom free two to six years after the initial diagnosis. Our results suggest that young children may develop acute duodenal ulcers after viral illnesses whether or not they are treated with drugs, mainly antipyretics. This kind of acute duodenal ulcer usually heals quickly irrespective of the morphology, site, and number of ulcers. Images Figure PMID:2774612

  6. Enriched Human Pancreatic Ductal Cultures Obtained from Selective Death of Acinar Cells Express Pancreatic and Duodenal Homeobox Gene-1 Age-Dependently

    PubMed Central

    Street, Cale N.; Lakey, Jonathan R.T.; Rajotte, Ray V.; Shapiro, A.M. James; Kieffer, Timothy J.; Lyon, James G.; Kin, Tatsuya; Korbutt, Gregory S.

    2004-01-01

    Adult pancreatic ductal cells are believed to be islet precursors. Our aim was to obtain an enriched human ductal cell population in defined culture conditions, and to characterize these cultures for the presence of pancreatic developmental transcription factors. Non-endocrine adult human pancreatic digest was cultured for 4 days in serum-containing and serum-free media. During this time, analysis was done for phenotypic changes, cell death, and expression of islet and islet precursor markers. Culture in serum-supplemented and serum-free media gave similar recoveries of an enriched ductal population after 4 days. Extensive cell death due to apoptosis and necrosis was also observed over this time period. A donor-age dependent expression of pancreatic and duodenal homeobox gene-1 (PDX-1) in ductal cells was seen at 4 days whereby donors <25 yr expressed significantly more than donors >25 yr. Analysis of gene expression by RT-PCR showed the presence of islet developmental transcription factors neuroD, Nkx6.1, and PDX-1, as well as mature islet hormones. While acinar-ductal transdifferentiation of some cells cannot be ruled out, we provide evidence that the predominant mechanism for the derivation of enriched human ductal cultures in our culture conditions is selective acinar cell death. Furthermore, we have shown that ductal cultures from younger donors exhibit greater plasticity through expression of PDX-1, and may be of greater value in attempts to induce islet neogenesis. The presence, however, of insulin and glucagon mRNA indicates that contaminating endocrine cells remain in these cultures and underscores the need to use caution when assessing differentiation potential. PMID:17491668

  7. Transcriptome Profiling of Human Ulcerative Colitis Mucosa Reveals Altered Expression of Pathways Enriched in Genetic Susceptibility Loci

    PubMed Central

    Li, Jin; Zhu, Junfei; Gu, Mengnan; Baldassano, Robert N.; Grant, Struan F. A.; Hakonarson, Hakon

    2014-01-01

    Human colonic mucosa altered by inflammation due to ulcerative colitis (UC) displays a drastically altered pattern of gene expression compared with healthy tissue. We aimed to understand the underlying molecular pathways influencing these differences by analyzing three publically-available, independently-generated microarray datasets of gene expression from endoscopic biopsies of the colon. Gene set enrichment analysis (GSEA) revealed that all three datasets share 87 gene sets upregulated in UC lesions and 8 gene sets downregulated (false discovery rate <0.05). The upregulated pathways were dominated by gene sets involved in immune function and signaling, as well as the control of mitosis. We applied pathway analysis to genotype data derived from genome-wide association studies (GWAS) of UC, consisting of 5,584 cases and 11,587 controls assembled from eight European-ancestry cohorts. The upregulated pathways derived from the gene expression data showed a highly significant overlap with pathways derived from the genotype data (33 of 56 gene sets, hypergeometric P?=?1.491019). This study supports the hypothesis that heritable variation in gene expression as measured by GWAS signals can influence key pathways in the development of disease, and that comparison of genetic susceptibility loci with gene expression signatures can differentiate key drivers of inflammation from secondary effects on gene expression of the inflammatory process. PMID:24788701

  8. Effect of sodium bicarbonate on aspirin-induced damage and potential difference changes in human gastric mucosa

    PubMed Central

    Bowen, Bruce K; Krause, William J; Ivey, Kevin J

    1977-01-01

    Two aspirin tablets in 100 ml fluid will produce microscopical damage to the human stomach. A study was performed to determine whether a small amount of sodium bicarbonate (equivalent to one-third of a teaspoonful of baking soda) could protect against this damage. Sequential gastric biopsy specimens were taken from 15 healthy subjects before, during, and after intragastric instillation of one of the following isotonic solutions: saline; sodium bicarbonate; 600 mg aspirin suspended in sodium bicarbonate; and aspirin suspended in saline. On a separate day the same solutions were instilled, but gastric transmucosal potential differences were monitored. Light microscopy and scanning electron microscopy of the biopsy specimens showed occasional mucous degranulation of mucosal surface cells, but no cell damage during instillation of sodium bicarbonate. Light microscopy studies 10 minutes after aspirin in saline showed damage in 20% of surface cells, with focal areas of cellular disruption and microscopic erosions, but only 34% of cells were damaged after aspirin in bicarbonate and there were no erosions. Electron microscopy showed a damaged honeycombed appearance of surface epithelium after aspirin in saline and a normal cobblestone appearance after aspirin in bicarbonate. Aspirin dissolved in bicarbonate failed to induce the usual fall in potential difference. These findings indicate that sodium bicarbonate in amounts equivalent to one-third of a teaspoonful of baking soda protects the gastric mucosa against aspirin-induced damage and prevents the usual fall in potential difference after aspirin. ImagesFIG 2FIG 3FIG 4 PMID:922417

  9. Comparison of divided and full pupil configurations for line-scanning confocal microscopy in human skin and oral mucosa

    NASA Astrophysics Data System (ADS)

    Larson, Bjorg; Abeytunge, Sanjeewa; Glazowski, Chris; Rajadhyaksha, Milind

    2012-02-01

    Confocal point-scanning microscopy has been showing promise in the detection, diagnosing and mapping of skin lesions in clinical settings. The noninvasive technique allows provides optical sectioning and cellular resolution for in vivo diagnosis of melanoma and basal cell carcinoma and pre-operative and intra-operative mapping of margins. The imaging has also enabled more accurate "guided" biopsies while minimizing the otherwise large number of "blind" biopsies. Despite these translational advances, however, point-scanning technology remains relatively complex and expensive. Line-scanning technology may offer an alternative approach to accelerate translation to the clinic. Line-scanning, using fewer optical components, inexpensive linear-array detectors and custom electronics, may enable smaller, simpler and lower-cost confocal microscopes. A line is formed using a cylindrical lens and scanned through the back focal plane of the objective with a galvanometric scanner. A linear CCD is used for detection. Two pupil configurations were compared for performance in imaging human tissue. In the full-pupil configuration, illumination and detection is made through the full objective pupil. In the divided pupil approach, half the pupil is illuminated and the other half is used for detection. The divided pupil configuration loses spatial and axial resolution due to a diminished NA, but the sectioning capability and rejection of background is improved. Imaging in skin and oral mucosa illustrate the performance of the two configurations.

  10. Alternative types of duodenal ulcer induced in mice by partial X irradiation of the thorax

    SciTech Connect

    Michalowski, A.; Uehara, S.; Yin, W.B.; Burgin, J.; Silvester, J.A.

    1983-07-01

    The present study extends our earlier observations on gastrointestinal pathology in thorax-irradiated female CFLP mice. It shows that exposure of the lower mediastinum to single doses of 14-30 Gy X rays results in the formation of the proximal duodenal ulcer accompanied frequently by erosion of the antral gastric mucosa. X irradiation of the lateral thoracic fields is responsible for single ulcers in the proximity of duodenal papilla, often associated with a circumscribed area of degeneration of the fundic mucosa of the stomach. In view of the small amount of radiation received by the subdiaphragmatic parts of the alimentary tract, these gastro-duodenal lesions represent abscopal effects of thoracic irradiation.

  11. Alternative types of duodenal ulcer induced in mice by partial x irradiation of the thorax

    SciTech Connect

    Michalowski, A.; Uehara, S.; Yin, W.B.; Burgin, J.; Silvester, J.A.

    1983-07-01

    The present study extends our earlier observations on gastrointestinal pathology in thorax-irradiated female CFLP mice. It shows that exposure of the lower mediastinum to single doses of 14 to 30 Gy x rays results in the formation of the proximal duodenal ulcer accompanied frequently by erosion of the antral gastric mucosa. X irradiation of the lateral thoracic fields is responsible for single ulcers in the proximity of duodenal papilla, often associated with a circumscribed area of degeneration of the fundic mucosa of the stomach. In view of the small amount of radiation received by the subdiaphragmatic parts of the alimentary tract, these gastro-duodenal lesions represent abscopal effects of thoracic irradiation.

  12. Nano- and microscaled particles for drug targeting to inflamed intestinal mucosa: a first in vivo study in human patients.

    PubMed

    Schmidt, Carsten; Lautenschlaeger, Christian; Collnot, Eva-Maria; Schumann, Michael; Bojarski, Christian; Schulzke, Jrg-Dieter; Lehr, Claus-Michael; Stallmach, Andreas

    2013-01-28

    Most of the drugs used in the treatment of inflammatory bowel disease (IBD) become systemically bioavailable and potentially bear strong adverse effects. Targeting the inflamed areas of the intestine and keeping the drug localised at its site of action can reduce adverse effects. In animal studies, luminal uptake into inflamed mucosal areas has been shown to be size dependent. We investigated the potential of nano- and microparticle uptake into the rectal mucosa of human IBD patients. Fluorescently labelled placebo nanoparticles (NP) 250nm in size and microparticles (MP) 3.0?m in size were prepared. 2h after rectal application to patients with Crohn's disease (CD) or ulcerative colitis (UC), confocal laser endomicroscopy was performed to visualise the particles in inflamed mucosal areas. In biopsies, ex vivo mucosal transport processes were investigated in miniaturised Ussing chambers. We examined 33 patients with IBD (19 patients with CD, 14 patients with UC) and 6 healthy controls. A significantly enhanced accumulation of MP in ulcerous lesions was observed (covered area=1.28% (range 0.83%-3.45%) vs. 0% in controls; p=0.011), while NP were visible only in traces on mucosal surfaces of all patients. The Ussing chamber experiments suggest persorption of particles through cellular voids; statistical significance was only reached for NP. Drug-containing particles may have great potential to more specifically target intestinal lesions to maximise therapeutic efficacy and minimise potential side effects. Nanoparticles may not be required for local drug delivery to intestinal lesions in humans, thereby minimising the risk of unintended translocation into the blood system. PMID:23127508

  13. Inhibition of Heidenhain Pouch Pepsin Secretion by Commercial Cholecystokinin and Duodenal Fat in Dogs

    PubMed Central

    Nakajima, Sumio; Magee, Donal F.

    1974-01-01

    In unanesthetized dogs with Heidenhain pouches and separated duodenal pouches, intravenous infusion of commercial cholecystokinin (1.0 IDU per min) produced a significant depression of pouch acid and pepsin secretion stimulated by pentagastrin (1.0 g per min) or by methacholine (2.0 g per min). Acid response to methacholine was temporarily augmented. Irrigation of the duodenal pouches with emulsified fat produced similar patterns of depression of acid secretion in response to pentagastrin and pepsin secretion in response to pentagastrin or methacholine. Acid secretion stimulated by methacholine was temporarily augmented after the irrigation. It is concluded that fat releases endogenous cholecystokinin from the duodenal mucosa and that cholecystokinin, or duodenal fat, powerfully depresses Heidenhain pouch pepsin secretion in dogs. The involvment of the gastric inhibitory polypeptide (GIP) cannot be assessed from the present experiments. PMID:4601962

  14. [Peculiarities of the strategy for the treatment of elderly patients with duodenal ulcer and concomitant metabolic syndrome].

    PubMed

    Rapoport, S I; Il'nitski?, A N; Proshchaev, K I; Stoiakov, A M; Pozdniakova, N M; Kivetski?, V V; Varavina, l Iu

    2014-01-01

    The study showed that ulcer disease in patients with metabolic syndrome is characterized by painless clinical course, bowel disorders in the form of constipation, enhanced appetite, unmotivated requirement for hypoglycemic therapy predisposition to complications along with activation of the inflammatory process in duodenal mucosa, high H. pylori count. The data obtained were used to develop the age-specific strategy for the treatment of elderly patients with duodenal ulcer and concomitant metabolic syndrome. PMID:25269207

  15. Antimicrobial decapeptide KSL-W attenuates Candida albicans virulence by modulating its effects on Toll-like receptor, human ?-defensin, and cytokine expression by engineered human oral mucosa.

    PubMed

    Semlali, A; Leung, K P; Curt, S; Rouabhia, M

    2011-05-01

    We investigated the toxicity of synthetic antimicrobial decapeptide KSL-W on normal human gingival epithelial cell cultures, its effect on Candida albicans adhesion and growth, and the activation of epithelial cell innate immunity. Our results indicate that KSL-W had no toxic effect on cell adhesion or growth, suggesting its safe use with human cells. Pre-treating C. albicans with KSL-W attenuated the yeast's virulence as demonstrated by its reduced adhesion and growth on engineered human oral mucosa epithelium and the subsequent decreased expression of some innate defense molecules by targeted epithelial cells. Indeed, the expression of Toll-like receptors and human ?-defensins was reduced in tissues infected with KSL-W-treated Candida. Proinflammatory cytokine secretion (IL-1? and IL-6) by the epithelial cells was also regulated by KSL-W in a manner similar to that of antifungal molecule amphotericin B. These findings therefore show that KSL-W is safe for use with human cells and is able to attenuate Candida virulence by modulating its effects on host innate immunity. This study proposes the potential application of KSL-W peptide as an alternative antifungal agent. PMID:21291939

  16. DOK, a cell line established from human dysplastic oral mucosa, shows a partially transformed non-malignant phenotype.

    PubMed

    Chang, S E; Foster, S; Betts, D; Marnock, W E

    1992-12-01

    There are many reports of cell lines being established from human oral squamous-cell carcinomas but apparently none of cell lines from dysplastic or "pre-malignant" oral mucosa. We describe here the isolation and characterization of a cell line, DOK (dysplastic oral keratinocyte), from a piece of dorsal tongue showing epithelial dysplasia. The tissue was obtained from a 57-year-old man who was a heavy smoker prior to the appearance of a white patch on his tongue. Eleven years later a squamous-cell carcinoma developed at the site and was excised. Subsequently the remaining dysplasia was removed, and it was from a piece of this that the primary cell cultures which eventually gave rise to DOK were initiated. The DOK line has been single-cell cloned and is apparently immortal. It grows in the absence of 3T3 feeder cells, is anchorage-dependent for growth and is non-tumorigenic in nude mice. The keratin profile of the cells shows a striking similarity to that of the original tongue dysplasia. The karyotype of DOK is aneuploid and complex. By PCR and oligonucleotide hybridization on dot blots, codons 12, 13 and 61 of Ha-ras, Ki-ras and N-ras in DNA extracted from DOK cells were shown to be normal. Immunohistochemistry showed no abnormal, i.e., elevated expression of the onco-suppressor protein p53. Because of its origin and partially transformed phenotype, DOK presents an opportunity to study whether specific carcinogens associated with tobacco and areca nut can cause malignant transformation of oral keratinocytes in vitro. PMID:1459732

  17. From cysteamine to MPTP: structure-activity studies with duodenal ulcerogens

    SciTech Connect

    Szabo, S.; Cho, C.H.

    1988-01-01

    Cysteamine is the first chemical identified that induces acute and chronic duodenal ulcers in rodents. Structure-activity studies with cysteamine, propionitrile and their derivatives, as well as with analogues of toluene, revealed numerous alkyl and aryl duodenal ulcerogens. Among these, one of the most interesting from an etiologic and pathogenetic point of view is the dopaminergic neurotoxin MPTP, which shows structural similarities with toluene. The chemically-induced duodenal ulcers are similar and localized on the anterior and posterior wall of the duodenal bulb. Both cysteamine and MPTP affect endogenous dopamine; MPTP is especially potent in depleting central dopamine and inducing lesions in the substantia nigra. MPTP given in high doses induces Parkinson's disease-like syndrome and gastric ulcers. Cysteamine and propionitrile also cause dyskinesia in large and multiple doses. The motility disorders and duodenal ulcers are abolished by dopamine agonists. Cysteamine and MPTP have been known to increase and decrease gastric acid secretion, respectively. However, both compounds induced duodenal dysmotility, decreased bicarbonate production, and reduced its delivery from distal to proximal duodenum. These factors decrease acid neutralization in the duodenal bulb and contribute to duodenal ulceration. Thus, studies with animal models may reveal endogenous mediators and specific receptors which might be involved in the pathogenesis of duodenal ulceration. Specific structure-activity studies in toxicology may lead to new insights in the pathogenesis and pharmacology of a poorly understood human disorder such as duodenal ulceration. 39 references.

  18. Pre-Analytical Determination of the Effect of Extended Warm or Cold Ischaemia on RNA Stability in the Human Ileum Mucosa.

    PubMed

    Lee, Serene M L; Schelcher, Celine; Thasler, Reinhard; Schiergens, Tobias S; Thasler, Wolfgang E

    2015-01-01

    The use of banked human tissue, obtained with informed consent after elective surgical procedures, represents a powerful model for understanding underlying mechanisms of diseases or therapeutic interventions and for establishing prognostic markers. However, donated tissues typically have varying times of warm ischaemia in situ due to blood arrest or cold ischaemia due to procurement and transportation. Hence, before using these tissues, it is important to carry out pre-analytical studies to ensure that they are representative of the in vivo state. In particular, tissues of the gastrointestinal tract have been thought to have low RNA stability. Therefore, this study aimed to determine if extended warm or cold ischaemia times and snap-freezing or banking in RNA stabilization solution affects RNA integrity or gene expression in human ileum mucosa. In short, ileum mucosa was collected for up to 1.5 h and 6 h of simulated warm or cold ischaemia respectively. Subsequently, RNA integrity and gene expressions were determined. It was found that RNA integrity remained high over the course of warm and cold ischaemia examined and there were in general no significant differences between snap-freezing and banking in RNA stabilization solution. Following the same trend, there were in general no significant changes in gene expressions measured (MYC, HIF1?, CDX, HMOX1 and IL1?). In conclusion, RNA in the ileum mucosa is maintained at a high integrity and has stable gene expression over the examined time course of warm or cold ischaemia when banked in RNA stabilization solution or snap-frozen in liquid nitrogen. As the average warm and cold ischaemia times imposed by surgery and the process of tissue banking are shorter than the time period examined in this study, human ileum mucosa samples collected after surgeries could be used for gene expression studies. PMID:26371767

  19. Pre-Analytical Determination of the Effect of Extended Warm or Cold Ischaemia on RNA Stability in the Human Ileum Mucosa

    PubMed Central

    Thasler, Reinhard; Schiergens, Tobias S.; Thasler, Wolfgang E.

    2015-01-01

    The use of banked human tissue, obtained with informed consent after elective surgical procedures, represents a powerful model for understanding underlying mechanisms of diseases or therapeutic interventions and for establishing prognostic markers. However, donated tissues typically have varying times of warm ischaemia in situ due to blood arrest or cold ischaemia due to procurement and transportation. Hence, before using these tissues, it is important to carry out pre-analytical studies to ensure that they are representative of the in vivo state. In particular, tissues of the gastrointestinal tract have been thought to have low RNA stability. Therefore, this study aimed to determine if extended warm or cold ischaemia times and snap-freezing or banking in RNA stabilization solution affects RNA integrity or gene expression in human ileum mucosa. In short, ileum mucosa was collected for up to 1.5 h and 6 h of simulated warm or cold ischaemia respectively. Subsequently, RNA integrity and gene expressions were determined. It was found that RNA integrity remained high over the course of warm and cold ischaemia examined and there were in general no significant differences between snap-freezing and banking in RNA stabilization solution. Following the same trend, there were in general no significant changes in gene expressions measured (MYC, HIF1α, CDX, HMOX1 and IL1β). In conclusion, RNA in the ileum mucosa is maintained at a high integrity and has stable gene expression over the examined time course of warm or cold ischaemia when banked in RNA stabilization solution or snap-frozen in liquid nitrogen. As the average warm and cold ischaemia times imposed by surgery and the process of tissue banking are shorter than the time period examined in this study, human ileum mucosa samples collected after surgeries could be used for gene expression studies. PMID:26371767

  20. Analysis of the expression of SDF-1 splicing variants in human colorectal cancer and normal mucosa tissues

    PubMed Central

    ALLAMI, RISALA HUSSAIN; GRAF, CLAUDINE; MARTCHENKO, KSENIA; VOSS, BEATRICE; BECKER, MARC; BERGER, MARTIN R.; GALLE, PETER R.; THEOBALD, MATTHIAS; WEHLER, THOMAS C.; SCHIMANSKI, CARL C.

    2016-01-01

    C-X-C motif chemokine ligand 12 (CXCL12), also termed stromal cell-derived factor-1 (SDF-1) is a small protein 8–14 kDa in length that is expressed as six isoforms, consisting of SDF-1α, SDF-1β, SDF-1γ, SDF-1δ, SDF-1ε and SDF-1θ. All six isoforms are encoded by the single CXCL12 gene on chromosome 10. This gene regulates leukocyte trafficking and is variably expressed in a number of normal and cancer tissues. The potential role of the novel CXCL12 splice variants as components of the CXCR4 axis in cancer development is not fully understood. The present study aimed to analyze the expression profile of the various SDF-1 isoforms and SDF-1 polymorphisms, and the association with the clinicopathological features and overall survival of patients with colorectal cancer (CRC). SDF-1 polymorphism analysis was performed using restriction fragment length polymorphism (RFLP) analysis in 73 histologically confirmed human CRC tissue samples at various stages of disease. The expression pattern of the SDF-1 isoforms was analyzed by reverse transcription-polymerase chain reaction in 40 histologically confirmed human CRC tissue samples obtained at various stages of disease, as well as in matched adjacent normal mucosa samples. The presence of the CXCL12 gene polymorphism rs1801157 demonstrated an association with local progression of the primary tumor, as indicated by the T stage. The frequency of the GG genotype was slightly increased in patients with stage 3 and 4 tumors (78.0%) compared with the incidence of the GA/AA genotype (69.5%; P=0.067). The expression of SDF-1β was associated with the presence of metastases (P=0.0656) and the expression of SDF-1γ was significantly associated with tumor size (P=0.0423). The present study is the first to analyze the association between the expression profile of the chemokine CXCL12 splice variants in human CRC tissues and their clinical relevance. The present results reveal that the CXCL12 G801A polymorphism is a low-penetrance risk factor for the development of CRC, and was associated with the T stage. All six isoforms of SDF-1 were expressed in CRC tissues. The expression of SDF-1β was found to be associated with metastases and SDF-1γ appears to be a possible tumor marker for local tumor progression. PMID:26998092

  1. High degree of duodenal inflammation in Nigerians with functional dyspepsia

    PubMed Central

    Nwokediuko, Sylvester Chuks; Ijoma, Uchenna N; Obienu, Olive; Anigbo, Gideon E; Okafor, Okechukwu

    2014-01-01

    Background Functional dyspepsia (FD) is a heterogeneous disorder associated with diverse pathophysiological mechanisms, including immune activation and low-grade mucosal inflammation. Genetic factors, physiological functions, and environmental factors may determine the relative importance of various pathophysiological mechanisms. This study was designed to determine the histological alterations in the duodenal mucosa of Nigerian patients with FD. Methods Consecutive patients with dyspepsia seen over a 27-month period in two gastrointestinal endoscopy facilities in Enugu, South-East Nigeria were further evaluated with upper gastrointestinal endoscopy and duodenal mucosal biopsies if no lesion was found in the upper gastrointestinal tract. Patients with heartburn and/or regurgitation who did not have any dyspeptic symptoms and did not have any lesion in the upper gastrointestinal tract on endoscopy were presumed to have non-erosive reflux disease (NERD) and they served as controls. The control subjects also had duodenal biopsies. The histopathological findings in the cases and controls were compared. Results There were 68 patients with FD and 52 patients with NERD. The total inflammatory score was 242 in FD and 66 in NERD (Mann-Whitney U =1168, P=0.0011). Similarly, the scores for chronic inflammation, gastric metaplasia, neutrophilic activity, eosinophilic infiltration, and Helicobacter pylori were significantly higher in FD than NERD. Conclusion Functional dyspepsia is associated with a high degree of inflammation in the duodenal mucosa. This may reflect the high prevalence of gastrointestinal infections in a tropical environment such as Nigeria. These findings may have therapeutic potential that further studies might elucidate. PMID:24403840

  2. Endoscopic duodenal "windsock" diverticulotomy.

    PubMed

    Stevens, Tyler; Chand, Bipan; Winans, Charles

    2013-04-01

    A 49-year-old woman presented with a 3-month history of nausea, vomiting, and weight loss. Her symptoms were severe, and she required total parenteral nutrition for nutrition support. Both CT and barium upper GI series demonstrated a large "windsock" diverticulum that obstructed the duodenal lumen. The patient was referred to undergo a surgical diverticulectomy. After a multidisciplinary discussion, a less invasive endoscopic diverticulotomy was recommended, and the patient agreed. The linked video demonstrates the endoscopic findings and therapeutic technique. Upper endoscopy showed the diverticulum arising from the proximal duodenum. The scope could not traverse the true lumen due to compression by the diverticulum. A guidewire was passed to delineate the true lumen. At that point, the diverticulum spontaneously inverted into a proximal position. The tip of the diverticulum was then clipped to the duodenal wall to increase exposure and to allow a more controlled incision. Clips were placed on the vascular pedicle of the diverticulum to prevent bleeding. An incremental incision was performed using a needle-knife to divide the diverticulum completely. Mild bleeding occurred twice and was managed with clips. A complete diverticulotomy was accomplished, allowing easy passage of the endoscope. The patient had an uneventful postprocedural recovery and was discharged the same day with instructions for dietary advancement. After 2 months, the patient reported complete symptom resolution. She was eating well, had gained weight, and had discontinued total parenteral nutrition. A repeat endoscopy confirmed a patent lumen and no recurrence of the diverticulum. This case demonstrates the feasibility and effectiveness of endoscopic diverticulotomy performed from a proximally inverted position. This "top-down" approach provided very good exposure for the incision and easy treatment of bleeding complications. PMID:23076458

  3. Duodenal stump leak following a duodenal switch: A case report

    PubMed Central

    Nelson, Lars; Moon, Rena C.; Teixeira, Andre F.; Jawad, Muhammad A.

    2015-01-01

    Introduction Duodenal switch (DS) is a superior choice for surgical weight loss in the super obese patient population. However, there is an associated risk of adverse events following a DS procedure including vitamin deficiencies, bleeding, obstruction, stricture, and leakage. Presentation of Case A 37-year-old female with body mass index of 67kg/m2 and multiple comorbidities underwent a Da Vinci-assisted, laparoscopic, one-stage, single-anastomosis DS procedure. On postoperative day 11, the patient developed persistent nausea, fatigue, and severe abdominal pain. She underwent diagnostic laparoscopy and was found to have hemoperitoneum, which was evacuated, but active bleeding source was not identifiable. Three days later, the patient underwent exploratory laparotomy, for bleeding with duodenal stump blowout. Discussion Duodenal stump blowout is the result from increased pressure caused by distal obstruction with the back up of duodenal contents. Anastomotic leakage/blow-out following surgery when suspected, should be individualized and management strategy should be implemented according to the size of the leak, extent of the abscess, and status of the patient. Conclusion Duodenal stump leaks must be diagnosed as early as possible, and treated appropriately with operative intervention. Regardless of the operative technique the key to appropriate treatment is stabilize the patient, repair the duodenal stump, and adequate drainage. PMID:26210718

  4. Involvement of B2 Receptor in Bradykinin-Induced Proliferation and Proinflammatory Effects in Human Nasal Mucosa-Derived Fibroblasts Isolated from Chronic Rhinosinusitis Patients

    PubMed Central

    Tsai, Yih-Jeng; Hao, Sheng-Po; Chen, Chih-Li; Lin, Brian J.; Wu, Wen-Bin

    2015-01-01

    Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the sinonasal mucosa either accompanied by polyp formation (CRSwNP) or without polyps (CRSsNP). CRSsNP accounts for the majority of CRS cases and is characterized by fibrosis and neutrophilic inflammation. However, the pathogenesis of CRS, especially CRSsNP, remains unclear. Immunohistochemistry of CRSsNP specimens in the present study showed that the submucosa, perivascular areas, and the mucous glands were abundant in fibroblasts. Therefore, we investigated the effects bradykinin (BK), an autacoid known to participate in inflammation, on human CRSsNP nasal mucosa-derived fibroblasts (NMDFs). BK increased CXCL1 and -8 secretion and mRNA expression with EC50 ranging from 0.15~0.35 μM. Moreover, BK enhanced cell proliferation and upregulated the expressions of proinflammatory molecules, including cell adhesion molecules (CAMs) and cyclooxygenase (COX)-1 and -2. These functionally caused an increase in monocyte adhesion to fibroblast monolayer. Using pharmacological intervention and BKR siRNA knockdown, we demonstrated that the BK-induced CXCL chemokine release, cell proliferation and COX and CAM expressions were mainly through the B2 receptor (B2R). Accordingly, the B2R was preferentially expressed in the NMDFs than B1R. The B2R was highly expressed in the CRSsNP than the control specimens, while the B1R and kininogen (KNG)/BK expression slightly increased in the CRSsNP mucosa. Collectively, we report here for the first time that fibroblasts, KNG/BK, and BKRs are overexpressed in CRSsNP mucosa and BK upregulates chemokine expression, proliferation, and proinflammatory molecule expression in NMDFs via B2R activation, which lead to a functional increase in monocyte-fibroblast interaction. Our findings reveal a critical role of fibroblast, KNG/BK, and BKRs in the development of CRSsNP. PMID:25970620

  5. Human adenoid organ culture: a model to study the interaction of influenza A with human nasopharyngeal mucosa.

    PubMed

    Edwards, K M; Snyder, P N; Stephens, D S; Wright, P F

    1986-01-01

    Previous studies of infections with influenza A in animal models have stressed the tropism of this virus for the upper respiratory tract. To assess the interaction of influenza A virus with human respiratory tissue, we maintained adenoids, consisting of ciliated epithelium with underlying lymphoid follicles, in organ culture. When the organ cultures were inoculated with wild-type influenza A/Alaska (H3N2), epithelial damage and migration of inflammatory cells from the follicles into the lamina propria were seen. Growth of the virus and ciliary damage in infected organ cultures from seronegative donors were significantly greater than that seen in organ cultures from seropositive donors. Adenoidal lymphocytes were then studied to determine which factors might modulate infectivity. Specific in vitro production of antibody to influenza A/Alaska was demonstrated by adenoidal lymphocytes from seropositive donors, whereas lymphocytes from seronegative donors did not produce antibody. The human adenoid organ culture provides an attractive model to study the pathogenesis of influenza A infections and the resultant local immune response. PMID:3510261

  6. [Traumatic perforation of a duodenal diverticulum].

    PubMed

    Valenzuela Martnez, M Jos; Bonasa, Elma; Snchez, Jos Manuel; Arribas, M Dolores; Crdoba, Elena; Santero, M Pilar; Albiach, Manuel; Martnez, Fernando

    2006-10-01

    Duodenal diverticulum is a frequent abnormality that is usually diagnosed incidentally. Clinical manifestations usually mimic highly varied entities. Among the complications of duodenal diverticulum, perforation is fairly rare and rupture due to blunt trauma is even rarer. We describe the case of a male patient who presented a perforated duodenal diverticulum after an accidental fall. PMID:17040673

  7. Mucosal pemphigus vulgaris anti-Dsg3 IgG are pathogenic to the oral mucosa of humanized Dsg3 mice

    PubMed Central

    Culton, Donna A.; McCray, Suzanne K.; Park, Moonhee; Roberts, James C.; Li, Ning; Zedek, Daniel C.; Anhalt, Grant J.; Cowley, Dale; Liu, Zhi; Diaz, Luis A.

    2015-01-01

    There are two major clinical subsets of pemphigus vulgaris (PV), mucosal PV (mPV) and mucocutaneous PV (mcPV). The mPV subset exhibits anti-human desmoglein (Dsg) 3 autoantibodies that fail to recognize murine Dsg3; thus, passive transfer experiments of mPV IgG into WT mice have been unsuccessful at inducing disease. We therefore generated a fully humanized Dsg3 (hDSG3) murine model utilizing a human Dsg3 transgenic animal crossed to the murine Dsg3 knockout line. Expression of hDsg3 in the mucosa rescues the murine Dsg3 knockout phenotype. Well characterized mPV sera bind mucosal epithelia from the hDsg3 mice, but not mucosal tissues from WT mice by as detected by indirect immunofluorescence. The majority of mPV sera preferentially recognize hDsg3 compared to mDsg3 by immunoprecipitation as well. Passive transfer of mPV IgG into adult hDsg3 mice, but not WT mice, induces suprabasilar acantholysis in mucosal tissues, thus confirming pathogenicity of mPV anti-hDsg3 IgG in vivo. Human anti-hDsg3 antibodies are detected in perilesional mucosa as well as in sera of recipient mice by immunofluorescence. These findings suggest that the Dsg3 epitopes targeted by pathogenic mPV IgG are human specific. This hDsg3 mouse model will be invaluable in studying the clinical transition from mPV to mcPV. PMID:25695683

  8. An approach to duodenal biopsies

    PubMed Central

    Serra, S; Jani, P A

    2006-01-01

    The introduction of endoscopy of the upper digestive tract as a routine diagnostic procedure has increased the number of duodenal biopsy specimens. Consequently, the pathologist is often asked to evaluate them. In this review, a practical approach to the evaluation of a duodenal biopsy specimen is discussed. An overview of the handling of specimens is given and the normal histology and commonly encountered diseases are discussed. Finally, a description of commonly seen infections is provided, together with an algorithmic approach for diagnosis. PMID:16679353

  9. A 3D co-culture of three human cell lines to model the inflamed intestinal mucosa for safety testing of nanomaterials.

    PubMed

    Susewind, Julia; de Souza Carvalho-Wodarz, Cristiane; Repnik, Urska; Collnot, Eva-Maria; Schneider-Daum, Nicole; Griffiths, Gareth Wyn; Lehr, Claus-Michael

    2016-02-01

    Oral exposure to nanomaterials is a current concern, asking for innovative biological test systems to assess their safety, especially also in conditions of inflammatory disorders. Aim of this study was to develop a 3D intestinal model, consisting of Caco-2 cells and two human immune cell lines, suitable to assess nanomaterial toxicity, in either healthy or diseased conditions. Human macrophages (THP-1) and human dendritic cells (MUTZ-3) were embedded in a collagen scaffold and seeded on the apical side of transwell inserts. Caco-2 cells were seeded on top of this layer, forming a 3D model of the intestinal mucosa. Toxicity of engineered nanoparticles (NM101 TiO2, NM300 Ag, Au) was evaluated in non-inflamed and inflamed co-cultures, and also compared to non-inflamed Caco-2 monocultures. Inflammation was elicited by IL-1β, and interactions with engineered NPs were addressed by different endpoints. The 3D co-culture showed well preserved ultrastructure and significant barrier properties. Ag NPs were found to be more toxic than TiO2 or Au NPs. But once inflamed with IL-1β, the co-cultures released higher amounts of IL-8 compared to Caco-2 monocultures. However, the cytotoxicity of Ag NPs was higher in Caco-2 monocultures than in 3D co-cultures. The naturally higher IL-8 production in the co-cultures was enhanced even further by the Ag NPs. This study shows that it is possible to mimic inflamed conditions in a 3D co-culture model of the intestinal mucosa. The fact that it is based on three easily available human cell lines makes this model valuable to study the safety of nanomaterials in the context of inflammation. PMID:25738417

  10. Mucosal pemphigus vulgaris anti-Dsg3 IgG is pathogenic to the oral mucosa of humanized Dsg3 mice.

    PubMed

    Culton, Donna A; McCray, Suzanne K; Park, Moonhee; Roberts, James C; Li, Ning; Zedek, Daniel C; Anhalt, Grant J; Cowley, Dale O; Liu, Zhi; Diaz, Luis A

    2015-06-01

    There are two major clinical subsets of pemphigus vulgaris (PV)-mucosal PV (mPV) and mucocutaneous PV (mcPV). The mPV subset exhibits anti-human desmoglein (Dsg) 3 autoantibodies that fail to recognize murine Dsg3 (mDsg3); thus, passive transfer experiments of mPV IgG into wild-type (WT) mice have been unsuccessful at inducing disease. We therefore generated a fully humanized Dsg3 (hDSG3) murine model utilizing a hDsg3 transgenic animal crossed to the mDsg3 knockout line. Expression of hDsg3 in the mucosa rescues the mDsg3 knockout phenotype. Well-characterized mPV sera bind mucosal epithelia from the hDsg3 mice, but not mucosal tissues from WT mice, as detected by indirect immunofluorescence (IF). The majority of mPV sera preferentially recognize hDsg3 compared with mDsg3 by immunoprecipitation as well. Passive transfer of mPV IgG into adult hDsg3 mice, but not WT mice, induces suprabasilar acantholysis in mucosal tissues, thus confirming the pathogenicity of mPV anti-hDsg3 IgG in vivo. Human anti-hDsg3 antibodies are detected in perilesional mucosa as well as in sera of recipient mice by IF. These findings suggest that the Dsg3 epitopes targeted by pathogenic mPV IgG are human specific. This hDsg3 mouse model will be invaluable in studying the clinical transition from mPV to mcPV. PMID:25695683

  11. Highly Tissue Substructure-Specific Effects of Human Papilloma Virus in Mucosa of HIV-Infected Patients Revealed by Laser-Dissection Microscopy-Assisted Gene Expression Profiling

    PubMed Central

    Baumgarth, Nicole; Szubin, Richard; Dolganov, Greg M.; Watnik, Mitchell R.; Greenspan, Deborah; Da Costa, Maria; Palefsky, Joel M.; Jordan, Richard; Roederer, Mario; Greenspan, John S.

    2004-01-01

    Human papilloma virus (HPV) causes focal infections of epithelial layers in skin and mucosa. HIV-infected patients on highly active antiretroviral therapy (HAART) appear to be at increased risk of developing HPV-induced oral warts. To identify the mechanisms that allow long-term infection of oral epithelial cells in these patients, we used a combination of laser-dissection microscopy (LDM) and highly sensitive and quantitative, non-biased, two-step multiplex real-time RT-PCR to study pathogen-induced alterations of specific tissue subcompartments. Expression of 166 genes was compared in three distinct epithelial and subepithelial compartments isolated from biopsies of normal mucosa from HIV-infected and non-infected patients and of HPV32-induced oral warts from HIV-infected patients. In contrast to the underlying HIV infection and/or HAART, which did not significantly elaborate tissue substructure-specific effects, changes in oral warts were strongly tissue substructure-specific. HPV 32 seems to establish infection by selectively enhancing epithelial cell growth and differentiation in the stratum spinosum and to evade the immune system by actively suppressing inflammatory responses in adjacent underlying tissues. With this highly sensitive and quantitative method tissue-specific expression of hundreds of genes can be studied simultaneously in a few cells. Because of its large dynamic measurement range it could also become a method of choice to confirm and better quantify results obtained by microarray analysis. PMID:15331396

  12. Short-term oxycodone treatment does not affect electrogenic ion transport in isolated mucosa from the human rectosigmoid colon.

    PubMed

    Nilsson, Matias; Brock, Christina; Lykke Poulsen, Jakob; Bindslev, Niels; Berner Hansen, Mark; Louring Christrup, Lona; Drewes, A M

    2016-05-01

    Objective Opioid therapy is associated with altered secretion and motility of the gut. The relative contribution of decreased secretion to the development of opioid-induced constipation remains unknown. Materials and methods Twenty-five healthy males were treated with oxycodone for 5 d in a placebo-controlled, randomised cross-over design. Gastrointestinal adverse effects were assessed with validated questionnaires (bowel function index and gastrointestinal symptom rating scale). Rectosigmoid mucosal biopsies were taken at baseline and on day 5 during both treatments and mounted in Ussing chambers. Electrogenic ion transport parameters (short circuit current (SCC) and slope conductance) were measured after addition of secretagogues (prostaglandin E2 (PGE2) (6 μm), theophylline (400 μm)), and an inhibitor (ouabain (200 μm)). Additionally, morphine (50 μm) was added to investigate the direct opioid effect on colonic mucosa. Results Questionnaires showed pronounced bowel symptoms, including constipation during oxycodone treatment (eight-fold increase in bowel function index score from day 1 to day 5 (p < 0.001) while no significant change occurred during placebo treatment (p = 0.47). Basal SCC and slope conductance did not differ between treatments (all p > 0.05) and application with PGE2, theophylline, and ouabain yielded comparable results on all examinations (all p > 0.05). Morphine application consistently did not evoke a change in ion transport. Conclusion Compared to placebo, epithelial electrogenic ion transport is not altered in mucosal biopsies from the rectosigmoid colon following 5-d oxycodone treatment. The secretory mechanisms in isolated mucosa appear to play a negligible role in the development of opioid-induced constipation. PMID:26610166

  13. Inhibition of water absorption and selective damage to human colonic mucosa induced by Shiga toxin-2 are enhanced by Escherichia coli O157:H7 infection.

    PubMed

    Albanese, Adriana; Gerhardt, Elizabeth; Garca, Hugo; Amigo, Natalia; Cataldi, Angel; Zotta, Elsa; Ibarra, Cristina

    2015-05-01

    Shiga toxin-producing Escherichia coli (STEC) strains are responsible for a variety of clinical syndromes including bloody and non-bloody diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). Although multiple serotypes of STEC have been isolated from hemorrhagic colitis cases, E. coli O157:H7 is by far the most prevalent serotype associated with HUS. Shiga toxin is the major virulence factor of E. coli O157:H7 and is responsible for the more severe symptoms of the infection. However, the mechanisms involved in the pathogenesis of diarrhea mediated by Stx2 are not well known. In this study, we have determined the effects of E. coli O157:H7 strain 125/99 wild type (wt) on the human colonic mucosa mounted in an Ussing chamber. In response to 125/99wt, an inhibition of water absorption across human colonic mucosa was observed. Histological sections showed severe necrosis with detachment of the surface epithelium, mononuclear inflammatory infiltrate and loss of goblet cells after 1h of incubation with 125/99wt. These alterations were not observed with the isogenic mutant strain lacking stx2 or with the filter-sterilized culture supernatant from the 125/99wt strain. These results indicate that the cell damages in human colon are induced by Stx2, and that Stx2 production is increased by the interaction with bacterial cells. Identification of host cell-derived factors responsible for increasing Stx2 can lead to new strategies for modulating STEC infections. PMID:25794836

  14. A case report of duodenal carcinoid tumor associated with early gastric cancer.

    PubMed

    Kawano, Youichi; Tajiri, Takashi; Akimaru, Koho; Tokunaga, Akira; Uchida, Eiji; Yoshiyuki, Toshiro; Yoshida, Hiroshi; Mamada, Yasuhiro; Taniai, Nobuhiko; Shinji, Seiichi; Naito, Zenya

    2004-06-01

    A rare case of carcinoid tumor in the duodenal bulb associated with early gastric carcinoma is reported. An 85-year-old asymptomatic male was admitted to our hospital, referred by his neighboring doctor because of early gastric carcinoma shown by endoscopic examination. X-ray studies of the upper gastrointestinal tract showed irregular lesser curvature of the gastric antrum and a filling defect (phi1 cm) at the duodenal bulb. Gastric biopsy revealed the histological findings of Group V. Distal gastrectomy including the duodenal bulb with D2 lymph node dissection was performed. A resected specimens showed superficial depressed type carcinoma at the lesser curvature of the antrum, and an isolated submucosal tumor of 7x7 mm in size at the duodenal bulb. Histological examination disclosed papillary adenocarcinoma in the gastric mucosa and a carcinoid tumor of the duodenal bulb in the submucosal layer without high malignant findings. The patient has been well for 5 years since the surgery. In conclusion, we discussed 46 collected cases of carcinoid tumor of the duodenum associated with gastric carcinoma in Japan. Preoperative diagnosis of carcinoid tumor of the duodenum is very difficult, and thorough examinations are needed for submucosal lesion. PMID:15226611

  15. A Controlled Challenge Study on Di(2-ethylhexyl) Phthalate (DEHP) in House Dust and the Immune Response in Human Nasal Mucosa of Allergic Subjects

    PubMed Central

    Deutschle, Tom; Reiter, Rudolf; Butte, Werner; Heinzow, Birger; Keck, Tilman; Riechelmann, Herbert

    2008-01-01

    Background Few studies have yet addressed the effects of di(2-ethylhexyl) phthalate (DEHP) in house dust on human nasal mucosa. Objectives We investigated the effects of house dust containing DEHP on nasal mucosa of healthy and house dust mite (HDM)–allergic subjects in a short-term exposure setting. Methods We challenged 16 healthy and 16 HDM-allergic subjects for 3 hr with house dust at a concentration of 300 μg/m3 containing either low (0.41 mg/g) or high (2.09 mg/g) levels of DEHP. Exposure to filtered air served as control. After exposure, we measured proteins and performed a DNA microarray analysis. Results Nasal exposure to house dust with low or high DEHP had no effect on symptom scores. Healthy subjects had almost no response to inhaled dust, but HDM-allergic subjects showed varied responses: DEHPlow house dust increased eosinophil cationic protein, granulocyte-colony–stimulating factor (G-CSF), interleukin (IL)-5, and IL-6, whereas DEHPhigh house dust decreased G-CSF and IL-6. Furthermore, in healthy subjects, DEHP concentration resulted in 10 differentially expressed genes, whereas 16 genes were differentially expressed in HDM-allergic subjects, among them anti-Müllerian hormone, which was significantly up-regulated after exposure to DEHPhigh house dust compared with exposure to DEHPlow house dust, and fibroblast growth factor 9, IL-6, and transforming growth factor-β1, which were down-regulated. Conclusions Short-term exposure to house dust with high concentrations of DEHP has attenuating effects on human nasal immune response in HDM-allergic subjects, concerning both gene expression and cytokines. PMID:19057701

  16. Distribution of cytochrome P450 2C, 2E1, 3A4, and 3A5 in human colon mucosa

    PubMed Central

    Bergheim, Ina; Bode, Christiane; Parlesak, Alexandr

    2005-01-01

    Background Despite the fact that the alimentary tract is part of the body's first line of defense against orally ingested xenobiotica, little is known about the distribution and expression of cytochrome P450 (CYP) enzymes in human colon. Therefore, expression and protein levels of four representative CYPs (CYP2C(8), CYP2E1, CYP3A4, and CYP3A5) were determined in human colon mucosa biopsies obtained from ascending, descending and sigmoid colon. Methods Expression of CYP2C, CYP2E1, CYP3A4, and CYP3A5 mRNA in colon mucosa was determined by RT-PCR. Protein concentration of CYPs was determined using Western blot methods. Results Extensive interindividual variability was found for the expression of most of the genes. However, expression of CYP2C mRNA levels were significantly higher in the ascending colon than in the sigmoid colon. In contrast, mRNA levels of CYP2E1 and CYP3A5 were significantly lower in the ascending colon in comparison to the descending and sigmoid colon. In sigmoid colon protein levels of CYP2C8 were significantly higher by ~73% than in the descending colon. In contrast, protein concentration of CYP2E1 was significantly lower by ~81% in the sigmoid colon in comparison to the descending colon. Conclusion The current data suggest that the expression of CYP2C, CYP2E1, and CYP3A5 varies in different parts of the colon. PMID:16253141

  17. Human Mucosa-Associated Invariant T Cells Accumulate in Colon Adenocarcinomas but Produce Reduced Amounts of IFN-γ.

    PubMed

    Sundström, Patrik; Ahlmanner, Filip; Akéus, Paulina; Sundquist, Malin; Alsén, Samuel; Yrlid, Ulf; Börjesson, Lars; Sjöling, Åsa; Gustavsson, Bengt; Wong, S B Justin; Quiding-Järbrink, Marianne

    2015-10-01

    Mucosa-associated invariant T (MAIT) cells are innate-like T cells with a conserved TCR α-chain recognizing bacterial metabolites presented on the invariant MHC-related 1 molecule. MAIT cells are present in intestinal tissues and liver, and they rapidly secrete IFN-γ and IL-17 in response to bacterial insult. In colon cancer, IL-17-driven inflammation promotes tumor progression, whereas IFN-γ production is essential for antitumor immunity. Thus, tumor-associated MAIT cells may affect antitumor immune responses by their secreted cytokines. However, the knowledge of MAIT cell presence and function in tumors is virtually absent. In this study, we determined the frequency, phenotype, and functional capacity of MAIT cells in colon adenocarcinomas and unaffected colon lamina propria. Flow cytometric analyses showed significant accumulation of MAIT cells in tumor tissue, irrespective of tumor stage or localization. Colonic MAIT cells displayed an activated memory phenotype and expression of chemokine receptors CCR6 and CCR9. Most MAIT cells in unaffected colon tissues produced IFN-γ, whereas only few produced IL-17. Colonic MAIT cells also produced TNF-α, IL-2, and granzyme B. In the tumors, significantly lower frequencies of IFN-γ-producing MAIT cells were seen, whereas there were no differences in the other cytokines analyzed, and in vitro studies showed that secreted factors from tumor tissue reduced IFN-γ production from MAIT cells. In conclusion, MAIT cells infiltrate colon tumors but their ability to produce IFN-γ is substantially reduced. We suggest that MAIT cells have the capacity to promote local immune responses to tumors, but factors in the tumor microenvironment act to reduce MAIT cell IFN-γ production. PMID:26297765

  18. Traumatic perforation of duodenal diverticulum.

    PubMed

    Poostizadeh, A; Gow, K W; Al-Mahmeed, T; Allardyce, D B

    1997-08-01

    A fragile 72-year-old female with previous coronary artery disease sustained blunt abdominal trauma in a motor vehicle crash. A ruptured duodenum was identified by computed tomography scanning. Exploratory laparotomy revealed that the duodenal rupture was caused by perforation of a diverticulum in the second portion of the duodenum. The surgical management of the injury to the duodenum is described in detail. PMID:9291392

  19. Management of complicated duodenal diverticula.

    PubMed

    Oukachbi, N; Brouzes, S

    2013-06-01

    The duodenum is the second most common location of intestinal diverticula after the colon. Duodenal diverticulum (DD) is usually located in the second portion of the duodenum (D2), close to the papilla. Most duodenal diverticula are extraluminal and acquired rather than congenital; more rare is the congenital, intraluminal diverticulum. DD is usually asymptomatic and discovered incidentally, but can become symptomatic in 1% to 5% of cases when complicated by gastroduodenal, biliary and/or pancreatic obstruction, by perforation or by hemorrhage. Endoscopic treatment is the most common first-line treatment for biliopancreatic complications caused by juxtapapillary diverticula and also for bleeding. Conservative treatment of perforated DD based on fasting and broad-spectrum antibiotics may be offered in some selected cases when diagnosis is made early in stable patients, or in elderly patients with comorbidities who are poor operative candidates. Surgical treatment is currently reserved for failure of endoscopic or conservative treatment. The main postoperative complication of diverticulectomy is duodenal leak or fistula, which carries up to a 30% mortality rate. PMID:23810155

  20. Double-blind randomised clinical trial of a pepsin-inhibitory pentapeptide (pepstatin) in the treatment of duodenal ulcer.

    PubMed Central

    Bonnevie, O; Svendsen, L B; Holst-Christensen, J; Johansen, T S; Sltoft, J; Christiansen, P M

    1979-01-01

    In a double-blind randomised clinical trial a specific inhibition of peptic activity with a pentapeptide, pepstatin, had no significant advantage over placebo in the ulcer healing and symptomatology of duodenal ulcer. Thus, the inhibition of pepsin in human gastric juice does not appear to have a major influence on the healing of duodenal ulcer. PMID:385457

  1. Viable human buccal mucosa cells do not yield typical nucleoids: impacts on the single-cell gel electrophoresis/Comet assay.

    PubMed

    Pinhal, Danillo; Gontijo, Alisson Marques de Miranda Cabral; Reyes, Victor Alexis Valenzuela; Salvadori, Daisy Maria Favero

    2006-03-01

    Buccal mucosa (BM) cells have been used in human biomonitoring studies for detecting DNA adducts and chromosomal damage in an epithelial cell population. In the present study, we have investigated if human BM cells are suitable for use in the single-cell gel electrophoresis (SCGE)/Comet assay as an approach for estimating the exposure of epithelial cells to DNA-damaging agents. Our results indicate that only a few cells from BM cell samples yield comets that can be analyzed by current methods, and that the yield of cells with comets is independent of the percentage of viable BM cells in the sample. Data generated after enzymatic enrichment of viable cells and immunomagnetic separation of epithelial cells suggest that most of the BM cells that do form comets are probably leukocytes. Moreover, by reevaluating specific cells after running the Comet assay, we found that viable epithelial BM cells give rise to atypical comets that are not included in the analysis. Comparing DNA migration patterns between small groups of smokers and nonsmokers indicated that long-term smoking had no effect on the subpopulation of cells that yield typical comets. Our results indicate that the SCGE assay, as it is commonly performed, may not be useful for genotoxicity monitoring in human epithelial BM cells. PMID:16258922

  2. Abdominal compartment syndrome from bleeding duodenal diverticulum.

    PubMed

    Tchantchaleishvili, Vakhtang; Groth, Shawn S; Leon, Jorge A; Mohr, William J

    2012-04-01

    Duodenal diverticuli are acquired false diverticuli of unknown etiology. Although mostly asymptomatic, they can occasionally cause upper gastrointestinal hemorrhage, rarely with massive bleeding. In this report, we present (to the best of our knowledge) the first reported case of duodenal diverticular bleeding, causing abdominal compartment syndrome. Albeit a rare event, duodenal diverticular bleeding should be included in the differential diagnosis of upper gastrointestinal bleeding. As with our case, a multidisciplinary approach to managing such patients is crucial. PMID:22787350

  3. Bio-physical characteristics of gastrointestinal mucosa of celiac patients: comparison with control subjects and effect of gluten free diet-

    PubMed Central

    2011-01-01

    Background Intestinal mucosa is leaky in celiac disease (CD), and this alteration may involve changes in hydrophobicity of the mucus surface barrier in addition to alteration of the epithelial barrier. The aims of our study were i) to compare duodenal hydrophobicity as an index of mucus barrier integrity in CD patients studied before (n = 38) and during gluten- free diet (GFD, n = 68), and in control subjects (n = 90), and ii) to check for regional differences of hydrophobicity in the gastro-intestinal tract. Methods Hydrophobicity was assessed by measurement of contact angle (CA) (Rame Hart 100/10 goniometer) generated by a drop of water placed on intestinal mucosal biopsies. Results CA (mean SD) of distal duodenum was significantly lower in CD patients (56 10)) than in control subjects (69 9, p < 0.0001), and persisted abnormal in patients studied during gluten free diet (56 9; p < 0.005). CA was significantly higher (62 9) in histologically normal duodenal biopsies than in biopsies with Marsh 1-2 (58 10; p < 0.02) and Marsh 3 lesions (57 10; p < 0.02) in pooled results of all patients and controls studied. The order of hydrofobicity along the gastrointestinal tract in control subjects follows the pattern: gastric antrum > corpus > rectum > duodenum > oesophagus > ileum. Conclusions We conclude that the hydrophobicity of duodenal mucous layer is reduced in CD patients, and that the resulting decreased capacity to repel luminal contents may contribute to the increased intestinal permeability of CD. This alteration mirrors the severity of the mucosal lesions and is not completely reverted by gluten-free diet. Intestinal hydrophobicity exhibits regional differences in the human intestinal tract. PMID:22060617

  4. Helicobacter pylori downregulates expression of human β-defensin 1 in the gastric mucosa in a type IV secretion-dependent fashion

    PubMed Central

    Patel, SR; Smith, K; Letley, DP; Cook, KW; Memon, AA; Ingram, RJM; Staples, E; Backert, S; Zaitoun, AM; Atherton, JC; Robinson, K

    2013-01-01

    Helicobacter pylori establishes a chronic lifelong infection in the human gastric mucosa, which may lead to peptic ulcer disease or gastric adenocarcinoma. The human beta-defensins (hβDs) are antimicrobial peptides, hβD1 being constitutively expressed in the human stomach. We hypothesized that H. pylori may persist, in part, by downregulating gastric hβD1 expression. We measured hβD1 and hβD2 expression in vivo in relation to the presence, density and severity of H. pylori infection, investigated differential effects of H. pylori virulence factors, and studied underlying signalling mechanisms in vitro. Significantly lower hβD1 and higher hβD2 mRNA and protein concentrations were present in gastric biopsies from infected patients. Those patients with higher-level bacterial colonization and inflammation had significantly lower hβD1 expression, but there were no differences in hβD2. H. pylori infection of human gastric epithelial cell lines also downregulated hβD1. Using wild-type strains and isogenic mutants, we showed that a functionalcag pathogenicity island-encoded type IV secretion system induced this downregulation. Treatment with chemical inhibitors or siRNA revealed that H. pylori usurped NF-κB signalling to modulate hβD1 expression. These data indicate that H. pylori downregulates hβD1 expression via NF-κB signalling, and suggest that this may promote bacterial survival and persistence in the gastric niche. PMID:23870035

  5. Differential Cathelicidin Expression in Duodenal and Gastric Biopsies from Tanzanian and German Patients

    PubMed Central

    Rogoll, Dorothee; Schauber, Juergen; Mheta, Koy K.; Stich, August; Scheppach, Wolfgang

    2011-01-01

    Background Epithelial surfaces such as the gastrointestinal mucosa depend on expression of antimicrobial peptides like cathelicidin for immune defence against pathogens. The mechanisms behind mucosal cathelicidin regulation are incompletely understood. Methods Cathelicidin expression was analysed in duodenal, antral and corpus/fundic mucosal biopsies from African and German patients. Additionally, cathelicidin expression was correlated with Helicobacter pylori (HP) infection and the inflammatory status of the mucosa. Results High cathelicidin transcript abundance was detected in duodenal biopsies from African subjects. On the contrary, cathelicidin mRNA expression was either undetectable or very low in tissue specimens from German patients. Also, in the antrum and corpus/fundus regions of the stomach significantly higher cathelicidin transcript levels were measured in Tanzanian compared to German patients. In gastric biopsies from African patients cathelicidin expression was increased in HP positive compared to HP negative subjects. Additionally, the inflammatory status measured by IL-8 expression correlated well with the HP infection status. Conclusions A higher duodenal and gastric cathelicidin expression in African (compared with European) individuals may be due to upregulation by antigenic stimulation and may confer a higher resistance against enteric infections. PMID:21811558

  6. High Transcript Levels of Vitamin D Receptor Are Correlated with Higher mRNA Expression of Human Beta Defensins and IL-10 in Mucosa of HIV-1-Exposed Seronegative Individuals

    PubMed Central

    Aguilar-Jimnez, Wbeimar; Zapata, Wildeman; Caruz, Antonio; Rugeles, Mara T.

    2013-01-01

    Vitamin D (VitD) is an endogenous immunomodulator that could protect from HIV-1 infection reducing immune activation and inducing the expression of anti-HIV-1 peptides. To establish a correlation between VitD and natural resistance to HIV-1 infection, a case-control study using blood and mucosa samples of 58 HIV-1-exposed but seronegative (HESN) individuals, 43 HIV-1 seropositives (SPs) and 59 non-exposed healthy controls (HCs) was carried out. The VitD concentration in plasma was determined by ELISA, and mRNA relative units (RU) of VDR, IL-10, TGF-?, TNF-? and IL-1? in peripheral blood mononuclear cells (PBMCs), oral and genital mucosa was quantified by qRT-PCR. mRNA levels of human beta-defensin (HBD) -2 and -3 were previously reported and used for correlations. Significantly higher levels of VitD were found in plasma as well as higher mRNA RU of VDR in PBMCs, and in genital mucosa from HESN compared to HCs. In addition, higher mRNA RU of TNF-?, IL-1? and IL-10, and lower mRNA RU of TGF-? were found in PBMC from HESNs compared to HCs. We also observed higher IL-10 mRNA RU in genital mucosa of HESNs compared to HCs, and the mRNA levels of TNF-? in oral and genital mucosa of SPs were higher compared to HESNs. Furthermore, positive correlations between VDR and IL-10 mRNA RU in PBMCs and genital mucosa of HESNs were found. Finally, HBD-2 and HBD-3 mRNA RU were positively correlated with VDR mRNA expression in oral mucosa from HESNs. These results suggest that high levels of VitD and its receptor are associated with natural resistance to HIV-1 infection. Up-regulation of the anti-inflammatory IL-10, and the induction of anti-HIV-1 defensins in mucosa might be part of the mechanisms involved in this association. However, further studies are required to define causal associations. PMID:24349345

  7. Intracellular distribution, geno- and cytotoxic effects of nanosized titanium dioxide particles in the anatase crystal phase on human nasal mucosa cells.

    PubMed

    Hackenberg, Stephan; Friehs, Gudrun; Froelich, Katrin; Ginzkey, Christian; Koehler, Christian; Scherzed, Agmal; Burghartz, Marc; Hagen, Rudolf; Kleinsasser, Norbert

    2010-05-19

    Nanomaterials are defined as substances with at least one dimension smaller than 100nm in size and are used for a multitude of purposes. Titanium dioxide nanoparticles (TiO(2)-NPs) are an important material used as an additive in pharmaceutical and cosmetic products. Due to their high surface-to-mass index, TiO(2) nanoparticles show different physical and chemical characteristics compared to the bulk substance. The knowledge about geno- or cytotoxic effects of TiO(2)-NPs is incomplete since existing studies show contrary results. Human nasal mucosa cells were obtained from 10 donors and exposed to TiO(2)-NPs in increasing concentrations of 10, 25, 50 und 100mug/ml. Transmission electron microscopy (TEM) was applied to document particle morphology and size distribution, the degree of particle aggregation and the distribution of particles in inter- and intracellular spaces. Furthermore, DNA fragmentation and cytotoxicity caused by TiO(2)-NPs were evaluated. DNA strand breakage was detected by single-cell microgel electrophoresis (comet) assay. Cytotoxic effects were analyzed by trypan blue exclusion test and fluorescein diacetate (FDA) assay. TiO(2) particles used in this study were mainly nanosized but also showed a strong tendency to aggregate in spite of sonication of the suspension. Particles entered the cytoplasm in 11% and the cell nucleus in 4%. The trypan blue exclusion test and the FDA assay did not show any loss of cell viability. In the comet assay, there was no evidence of increased DNA damage for TiO(2)-NPs. In this pilot project, no cyto- or genotoxic effects could be shown for TiO(2)-NPs on human nasal epithelial cells. Further investigations will focus on a variety of metal oxide nanoparticles to describe the biocompatibility in the human organism. PMID:20206675

  8. Differentiation between human normal colon mucosa and colon cancer tissue using ToF-SIMS imaging technique and principal component analysis

    NASA Astrophysics Data System (ADS)

    Park, Ji-Won; Shon, Hyun Kyong; Yoo, Byong Chul; Kim, In Hoo; Moon, Dae Won; Lee, Tae Geol

    2008-12-01

    Human normal colon mucosa and colon cancer tissue were studied using the time-of-flight secondary ion mass spectroscopy (ToF-SIMS) and principal component analysis (PCA) techniques. The surfaces of the tissues were successfully cleaned by C 602+ cluster-ion beams before the ToF-SIMS images were obtained. A PCA on the spectra and images were performed to compare differences in the peaks and images of normal and cancer tissues. Significant differences in principal component 1 (PC 1) score values for normal and cancer tissues were observed, and each PC 1 loadings had a specific peak profile of proteins. In addition, the PC images obtained from the ToF-SIMS images for normal and cancer tissues were clearly distinguishable, and the amino acid fragments associated with normal and cancer tissues were found to have originated from the lamina propria region and the epithelium cells, respectively. Based on the PCA results, structural distortion of the crypts in the cancer colon tissue could be attributed to the proliferation of the cancerous epithelium cells. This work shows that the application of the ToF-SIMS imaging technique with PCA could be a useful method of obtaining valuable information for cancer analysis.

  9. Histamine concentration of gastric mucosa in Helicobacter pylori positive and negative children.

    PubMed Central

    Queiroz, D M; Mendes, E N; Rocha, G A; Barbosa, A J; Carvalho, A S; Cunha-Melo, J R

    1991-01-01

    The histamine concentration was determined by enzymatic isotopic method in biopsy specimens of oxyntic mucosa from 37 children. Nineteen of the 37 had Helicobacter pylori associated gastritis (9 with duodenal ulcer). The histamine concentration in the H pylori negative group was mean (SD) 54.1 (23.1) micrograms/g fresh weight, and that in the H pylori positive group was 26.3 (14.2) micrograms/g (p less than 0.01). There was also a significant difference between H pylori positive patients with duodenal ulcer (19.8 (6.3) micrograms/g) and those without ulcer (31.4 (17.9) micrograms/g) (p less than 0.05). These results suggest that H pylori positive patients, especially those with duodenal ulcer, have reduced 'stored' histamine, perhaps because of increased histamine liberation. PMID:2040464

  10. Appearance of compound cilia in the nasal mucosa of normal human subjects following acute, in vivo exposure to sulfur dioxide

    SciTech Connect

    Carson, J.L.; Collier, A.M.; Hu, S.C.; Smith, C.A.; Stewart, P.

    1987-02-01

    Electron microscopic examination of ultrathin sections of ciliated nasal epithelium obtained from seven normal, healthy human volunteers indicated increases in the prevalence of compound cilia following controlled, acute exposure to 0.75 ppm sulfur dioxide (SO/sub 2/). Morphometric analyses of the specimens confirmed a statistically significant association between SO/sub 2/ exposure and compounding of nasal epithelial cilia in four of the seven subjects. Concomitant freeze-fracture replicas prepared from these samples also revealed the occurrence of compound cilia with accompanying evidence of abnormal ciliary membrane ultrastructure in the nasal epithelium. These studies indicate that SO/sub 2/ may be implicated as a causative agent in ciliary compounding in the upper respiratory tract and that compound cilia represent a form of acquired ciliary defect which may serve as a readily quantifiable marker of epithelial injury.

  11. Morphological and histochemical observations on the duodenal glands of eight wild ungulate species native to North America.

    PubMed

    Krause, W J

    1981-10-01

    The duodenal glands of the species examined (Alces alces, Ovis canadensis, Cervus canadensis, Oreamnos americanus, Bison bison, Antilocapra americana, Odocoileus virginianas, Odocoileus heminous) are confined primarily to the submucosa of the small intestine. In one species, the moose, a significant population of secretory tubules also is observed in the mucosa. The ducts of the duodenal glands pierce the overlying muscularis mucosae to empty most often independently into the intestinal lumen. Those of the bison, unlike the other species examined, drain into intestinal glands. The duodenal glands consist primarily of a simple columnar epithelium, the cells of which contain basally positioned round or oval nuclei. The lumina of scattered duodenal glands in the pronghorn and to some extent those of the moose, white-tailed deer, and mule deer may be extremely dilated, and the surrounding epithelium thin and attenuated. Component cells of the duodenal glands of all the species examined show remarkably similar ultrastructural features. They exhibit scattered profiles of rough endoplasmic reticulum, dilated cisternae of which contain an electron-dense, amorphous material. Numerous well-developed Golgi complexes occupy the supranuclear region together with transport vesicles and forming secretory granules. Electron-dense, membrane-bound secretory granules generally are concentrated in the apical cytoplasm immediately subjacent to the cell membrane. The apical cell membrane exhibits short, scattered microvilli; and the basal cell membrane is smooth without apparent specialization. Histochemically, the duodenal glands of most species examined in this study consist of a heterogeneous population. The majority of the glands of the moose, elk, mountain goat, bison, pronghorn, and white-tailed deer elaborate a neutral mucin, whereas scattered individual glands, tubules or cells also produce acid mucins. Cells near the terminations of the ducts of the bighorn sheep are the only elements to produce acid mucins in the duodenal glands of this species. The duodenal glands of the bison are unusual in that only the peripheral portions of individual glands produce acid mucins. The remainder of the glands elaborate neutral mucins. Morphological differences between the two regions were not observed. The duodenal glands of the mule deer secrete both acid and neutral mucins. The structural and histochemical observations appear unrelated to the diet of individual species. PMID:6171158

  12. Raman spectroscopic analysis of human tissue engineered oral mucosa constructs (EVPOME) perturbed by physical and biochemical methods

    NASA Astrophysics Data System (ADS)

    Khmaladze, Alexander; Ganguly, Arindam; Raghavan, Mekhala; Kuo, Shiuhyang; Cole, Jacqueline H.; Marcelo, Cynthia L.; Feinberg, Stephen E.; Izumi, Kenji; Morris, Michael D.

    2012-01-01

    We show the application of near-infrared Raman Spectroscopy to in-vitro monitoring of the viability of tissue constructs (EVPOMEs). During their two week production period EVPOME may encounter thermal, chemical or biochemical stresses that could cause development to cease, rendering the affected constructs useless. We discuss the development of a Raman spectroscopic technique to study EVPOMEs noninvasively, with the ultimate goal of applying it in-vivo. We identify Raman spectroscopic failure indicators for EVPOMEs, which are stressed by temperature, and discuss the implications of varying calcium concentration and pre-treatment of the human keratinocytes with Rapamycin. In particular, Raman spectra show correlation of the peak height ratios of CH2 deformation to phenylalanine ring breathing, providing a Raman metric to distinguish between viable and nonviable constructs. We also show the results of singular value decomposition analysis, demonstrating the applicability of Raman spectroscopic technique to both distinguish between stressed and non-stressed EVPOME constructs, as well as between EVPOMEs and bare AlloDerm substrates, on which the oral keratinocytes have been cultured. We also discuss complications arising from non-uniform thickness of the AlloDerm substrate and the cultured constructs, as well as sampling protocols used to detect local stress and other problems that may be encountered in the constructs.

  13. Mucosal-Associated Invariant T Cells in the Human Gastric Mucosa and Blood: Role in Helicobacter pylori Infection

    PubMed Central

    Booth, Jayaum S.; Salerno-Goncalves, Rosangela; Blanchard, Thomas G.; Patil, Seema A.; Kader, Howard A.; Safta, Anca M.; Morningstar, Lindsay M.; Czinn, Steven J.; Greenwald, Bruce D.; Sztein, Marcelo B.

    2015-01-01

    Mucosal-associated invariant T (MAIT) cells represent a class of antimicrobial innate-like T cells that have been characterized in human blood, liver, lungs, and intestine. Here, we investigated, for the first time, the presence of MAIT cells in the stomach of children, adults, and the elderly undergoing routine endoscopy and assessed their reactivity to Helicobacter pylori (H. pylori – Hp), a major gastric pathogen. We observed that MAIT cells are present in the lamina propria compartment of the stomach and display a similar memory phenotype to blood MAIT cells. We then demonstrated that gastric and blood MAIT cells are able to recognize H. pylori. We found that CD8+ and CD4−CD8− (double negative) MAIT cell subsets respond to H. pylori-infected macrophages stimulation in a MR-1 restrictive manner by producing cytokines (IFN-γ, TNF-α, IL-17A) and exhibiting cytotoxic activity. Interestingly, we observed that blood MAIT cell frequency in Hp+ve individuals was significantly lower than in Hp−ve individuals. However, gastric MAIT cell frequency was not significantly different between Hp+ve and Hp−ve individuals, demonstrating a dichotomy between blood and gastric tissues. Further, we observed that the majority of gastric MAIT cells (>80%) expressed tissue-resident markers (CD69+ CD103+), which were only marginally present on PBMC MAIT cells (<3%), suggesting that gastric MAIT cells are readily available to respond quickly to pathogens. These results contribute important new information to the understanding of MAIT cells function on peripheral and mucosal tissues and its possible implications in the host response to H. pylori. PMID:26441971

  14. Giant duodenal diverticulum: presentation by blunt trauma.

    PubMed

    Michalsky, M P; Ritota, P; Swan, K G

    1999-06-01

    Most duodenal diverticula are asymptomatic, small (i.e., less than 5 cm in greatest dimension), acquired, extraluminal, and false. The only report of a massive or giant duodenal diverticulum (i.e., 10 cm or more), in the current literature, included severe nocturnal diarrhea. The present case report is the incidental finding of a massive duodenal diverticulum in a 34-year-old male trauma victim. The insidious nature of this case and the patient's age suggest a congenital etiology. We believe this is the first report of such a case. PMID:10372639

  15. Photosensitisation and photodynamic therapy of oesophageal, duodenal, and colorectal tumours using 5 aminolaevulinic acid induced protoporphyrin IX--a pilot study.

    PubMed Central

    Regula, J; MacRobert, A J; Gorchein, A; Buonaccorsi, G A; Thorpe, S M; Spencer, G M; Hatfield, A R; Bown, S G

    1995-01-01

    The first study of photodynamic therapy in the human gastrointestinal tract using 5 aminolaevulinic acid (ALA) induced protoporphyrin IX as the photosensitising agent is described. Eighteen patients with colorectal, duodenal, and oesophageal tumours were studied. After 30-60 mg/kg of ALA given orally, biopsy specimens of tumour and adjacent normal mucosa were taken 1-72 hours later. These specimens were examined by quantitative fluorescence microscopy for assessment of sensitisation with protoporphyrin IX. Ten patients were given a second dose of ALA a few weeks later and their tumours were treated with red laser light (628 nm). With 30 mg/kg ALA, the highest fluorescence values were detected in the duodenum and oesophagus, and the lowest in the large bowel. Doubling the ALA dose in patients with colorectal tumours gave protoporphyrin IX fluorescence intensities similar to those in patients with upper gastrointestinal lesions and improved the tumour:normal mucosa protoporphyrin IX sensitisation ratio. The treated patients showed superficial mucosal necrosis in the areas exposed to laser light. Six patients had transient rises in serum aspartate aminotransferases, two mild skin photosensitivity reactions, and five mild nausea and vomiting. In conclusion, photodynamic therapy with systemically administered ALA may be a promising technique for the treatment of small tumours and areas of dysplasia such as in Barrett's oesophagus. Images Figure 2 Figure 3 Figure 5 PMID:7890239

  16. Antigen-Presenting Cell Candidates for HIV-1 Transmission in Human Distal Colonic Mucosa Defined by CD207 Dendritic Cells and CD209 Macrophages

    PubMed Central

    Preza, Gloria C.; Tanner, Karen; Elliott, Julie; Yang, Otto O.; Anton, Peter A.

    2014-01-01

    Abstract A common route for HIV-1 infection is sexual transmission across colorectal mucosa, which is thought to be 102,000 times more vulnerable to infection than that of the female genital tract. Mucosal surfaces are the first line of defense against many pathogens but the antigen-presenting cells (APCs), key regulators of innate immunity and determinants of adaptive immunity, are not well defined in these target tissues. Using immunohistochemistry, dendritic cells expressing Langerin (CD207+), a lectin known to bind and internalize HIV-1, were detected in the periphery of colonic glands and sparsely scattered in the submucosa similarly in colorectal mucosa. This cell type, well known in skin, has generally not been reported in colonic/rectal mucosa. Unexpectedly, the largest APC population observed was a macrophage-like population expressing the well-characterized tissue macrophage markers CD68 and CD163. Confocal microscopy of these cells revealed colocalization of CD209 (DC-SIGN), a presumed dendritic cell marker believed to facilitate HIV-1 transmission, but not other dendritic cell markers. These results show evidence of the unconfirmed presence of Langerhans cells in colorectal mucosa and a predominance of macrophage-like APCs that express CD209 (DC-SIGN). These findings define potential target cells in the pathogenesis of HIV-1 transmission, which may have key implications for the study of early transmission events in normal colorectal mucosa, as well as other infectious diseases and primary immune diseases involving the gut. PMID:24134315

  17. Duodenal involvement by seminomatous tumors.

    PubMed

    Rodriguez-Lopez, Mario; Velasco-López, Rosalía; Mambrilla-Herrero, Sara; Bailon-Cuadrado, Martin; Plua, Katherine T; Diez-González, Luis M; Blanco-Álvarez, Jose I; Asensio-Díaz, Enrique; Gonzalo-Martín, Marta; Pérez-Saborido, Baltasar; Marcos-Rodríguez, Jose L

    2015-10-01

    Testicular germ cell tumors, though rare (1%), represent the most common neoplasm among young men. Gastrointestinal involvement from these malignancies usually presents as bowel obstruction and digestive bleeding, but their frequency is low (5%). The patterns of this involvement are: infiltration from affected retroperitoneal lymph nodes or, less frequently, by peritoneal seeding and direct hematogenous spread. Particularly, infiltration of duodenum is also rare, though its real frequency is not well defined. Moreover, the affinity for GI tract differs among the histological types of GCT, being seminomatous tumors an exceedingly unfrequent cause of duodenal infiltration. We herein present a recent case in our institution of severe anemia due to gastrointestinal bleeding in the context of giant retroperitoneal bulky metastatic mass infiltrating duodenum as first manifestation of a testicular pure seminoma. PMID:26437983

  18. Laparoscopic duodenoduodenostomy for duodenal atresia.

    PubMed

    Bax, N M; Ure, B M; van der Zee, D C; van Tuijl, I

    2001-02-01

    A 3,220-g newborn baby with trisomy 21 presented with duodenal atresia. No other congenital malformations were diagnosed. Informed consent for a laparoscopic approach was obtained. The child was placed in a supine, head-up position slightly rotated to the left at the end of a shortened operating table. The surgeon stood at the bottom end with the cameraperson to his left and the scrub nurse to his right. The screen was at the right upper end. Open insertion of a cannula for a 5-mm 30 degrees telescope through the inferior umbilical fold was performed. A carbon dioxide (CO2) pneumoperitoneum with a pressure of 8 mmHg and a flow of 2l/min was established. Two 3.3-mm working cannulas were inserted; one in the left hypogastrium and one pararectally on the right at the umbilical level. Two more such cannulas were inserted; one under the xyphoid for a liver elevator and one in the right hypogastrium for a sucker. Mobilization of the dilated upper and collapsed lower duodenum was easy. After transverse enterotomy of the upper duodenum and longitudinal enterotomy of the distal duodenum, a diamond-shaped anastomosis with interrupted 5 zero Vicryl sutures were performed. The absence of air in the bowel beyond the atresia increased the working space and greatly facilitated the procedure. The technique proved to be easy, and the child did very well. Laparoscopic bowel anastomosis in newborn babies had not been described previously. Recently, a diamond-shaped duodenoduodenostomy for duodenal atresia was performed. The technique proved to be simple and is described in detail. The child did very well. PMID:12200660

  19. Duodenal hematoma following endoscopic duodenal biopsy: A case report and review of the literature

    PubMed Central

    Diniz-Santos, Daniel R; de Andrade Cairo, Romilda C; Braga, Hlio; Arajo-Neto, Cesar; Paes, Igelmar B; Silva, Luciana R

    2006-01-01

    Duodenal hematoma is a rare complication of endoscopic duodenal biopsy that occurs mainly in children or adults with impaired coagulation. The clinical presentation consists of signs of intestinal obstruction, and pancreatitis and direct hyperbilirubinemia are possible complications caused by ampullary obstruction. A case of a six-year-old girl who presented with a duodenal hematoma and acute pancreatitis after having an endoscopic duodenal biopsy is reported. A review of the literature and data from all similar cases reported so far are briefly presented and discussed. PMID:16432559

  20. Biomechanics of oral mucosa

    PubMed Central

    Chen, Junning; Ahmad, Rohana; Li, Wei; Swain, Michael; Li, Qing

    2015-01-01

    The prevalence of prosthodontic treatment has been well recognized, and the need is continuously increasing with the ageing population. While the oral mucosa plays a critical role in the treatment outcome, the associated biomechanics is not yet fully understood. Using the literature available, this paper provides a critical review on four aspects of mucosal biomechanics, including static, dynamic, volumetric and interactive responses, which are interpreted by its elasticity, viscosity/permeability, apparent Poisson's ratio and friction coefficient, respectively. Both empirical studies and numerical models are analysed and compared to gain anatomical and physiological insights. Furthermore, the clinical applications of such biomechanical knowledge on the mucosa are explored to address some critical concerns, including stimuli for tissue remodelling (interstitial hydrostatic pressure), pressure–pain thresholds, tissue displaceability and residual bone resorption. Through this review, the state of the art in mucosal biomechanics and their clinical implications are discussed for future research interests, including clinical applications, computational modelling, design optimization and prosthetic fabrication. PMID:26224566

  1. [Duodenal somatostatinomas associated with von Recklinghausen disease].

    PubMed

    Blaser, A; Vajda, P; Rosset, P

    1998-12-12

    A case of von Recklinghausen's disease with double somatostatin producing neuroendocrine tumour of the ampulla and duodenum is reported. A search of the world's literature revealed 28 patients with immunohistologically proven duodenal somatostatinoma associated with type I neurofibromatosis. These tumours are seldom associated with a recognizable "somatostatin syndrome", but often present with obstructive jaundice, duodenal obstruction, weight loss or gastrointestinal bleeding. Histologically, psammoma bodies are frequently encountered in the glandular lumina of duodenal somatostatinomas (66%), whereas their presence in other neuroendocrine tumours of the gastrointestinal tract is very rare. Metastatization is rare (27%) and mainly confined to lymph nodes (88%). In the world literature duodenal somatostatinoma is associated with von Recklinghausen's disease in 50%. PMID:9888169

  2. Robotic Surgery for Benign Duodenal Tumors

    PubMed Central

    Downs-Canner, Stephanie; Van der Vliet, Wald J.; Thoolen, Stijn J. J.; Boone, Brian A.; Zureikat, Amer H.; Hogg, Melissa E.; Bartlett, David L.; Callery, Mark P.; Kent, Tara S.; Zeh, Herbert J.

    2015-01-01

    Introduction Benign duodenal and periampullary tumors are uncommon lesions requiring careful attention to their complex anatomic relationships with the major and minor papillae as well as the gastric outlet during surgical intervention. While endoscopy is less morbid than open resection, many lesions are not amenable to endoscopic removal. Robotic surgery offers technical advantages above traditional laparoscopy, and we demonstrate the safety and feasibility of this approach for a variety of duodenal lesions. Methods We performed a retrospective review of all robotic duodenal resections between April 2010 and December 2013 from two institutions. Demographic, clinicopathologic, and operative details were recorded with special attention to the post-operative course. Results Twenty-six patients underwent robotic duodenal resection for a variety of diagnoses. The majority (88 %) were symptomatic at presentation. Nine patients underwent transduodenal ampullectomy, seven patients underwent duodenal resection, six patients underwent transduodenal resection of a mass, and four patients underwent segmental duodenal resection. Median operative time was 4 h with a median estimated blood loss of 50 cm3 and no conversions to an open operation. The rate of major Clavien-Dindo grades 3–4 complications was 15 % at post-operative days 30 and 90 without mortality. Final pathology demonstrated a median tumor size of 2.9 cm with a final histologic diagnoses of adenoma (n=13), neuroendocrine tumor (n=6), gastrointestinal stromal tumor (GIST) (n=2), lipoma (n=2), Brunner’s gland hamartoma (n=1), leiomyoma (n=1), and gangliocytic paraganglioma (n=1). Conclusion Robotic duodenal resection is safe and feasible for benign and premalignant duodenal tumors not amenable to endoscopic resection. PMID:25348238

  3. Gastric emptying abnormal in duodenal ulcer

    SciTech Connect

    Holt, S.; Heading, R.C.; Taylor, T.V.; Forrest, J.A.; Tothill, P.

    1986-07-01

    To investigate the possibility that an abnormality of gastric emptying exists in duodenal ulcer and to determine if such an abnormality persists after ulcer healing, scintigraphic gastric emptying measurements were undertaken in 16 duodenal ulcer patients before, during, and after therapy with cimetidine; in 12 patients with pernicious anemia, and in 12 control subjects. No difference was detected in the rate or pattern of gastric emptying in duodenal ulcer patients before and after ulcer healing with cimetidine compared with controls, but emptying of the solid component of the test meal was more rapid during treatment with the drug. Comparison of emptying patterns obtained in duodenal ulcer subjects during and after cimetidine treatment with those obtained in pernicious anemia patients and controls revealed a similar relationship that was characterized by a tendency for reduction in the normal differentiation between the emptying of solid and liquid from the stomach. The similarity in emptying patterns in these groups of subjects suggests that gastric emptying of solids may be influenced by changes in the volume of gastric secretion. The failure to detect an abnormality of gastric emptying in duodenal ulcer subjects before and after ulcer healing calls into question the widespread belief that abnormally rapid gastric emptying is a feature with pathogenetic significance in duodenal ulcer disease.

  4. Occupational mortality from gastric and duodenal ulcer.

    PubMed Central

    Sonnenberg, A; Sonnenberg, G S

    1986-01-01

    The pronounced geographical and temporal variations in gastric and duodenal ulcer suggest that important environmental factors must play a part in their aetiology. To determine the nature of possible factors, the Registrar General's decennial supplement and the vital statistics special reports of the United States Department of Health, Education, and Welfare on occupational mortality were analysed for occupation-specific mortality from peptic ulcer. The data disclose a high mortality from both types of ulcer among manual workers and a low mortality among sedentary occupations. This general pattern runs parallel to a low mortality from gastric and duodenal ulcer among the high social classes and a high mortality in the low social classes. Married women displayed a gradient of gastric ulcer mortality increasing from social class 1 to social class 5 but gave no evidence of social class correlation with respect to duodenal ulcer. The significant correlation between mortality from gastric and duodenal ulcer among different occupations could suggest that both types of ulcer hold some of the precipitating environmental risks in common. In duodenal ulcer the varying extent of energy expenditure among different occupations may be responsible for the different risk of contracting duodenal ulcer and dying from it. The association between energy expenditure and peptic ulcer mortality seems to be less important for gastric ulcer where additional factors associated with social class may also be operating. PMID:3947561

  5. Future directions of duodenal endoscopic submucosal dissection

    PubMed Central

    Matsumoto, Satohiro; Miyatani, Hiroyuki; Yoshida, Yukio

    2015-01-01

    Endoscopic therapies for lesions of the duodenum are technically more difficult than those for lesions of the other parts of the gastrointestinal tract due to the anatomical features of the duodenum, and the incidence rate of complications such as perforation and bleeding is also higher. These aforementioned trends were especially noticeable for the case of duodenal endoscopic submucosal dissection (ESD). The indication for ESD of duodenal tumors should be determined by assessment of the histopathology, macroscopic morphology, and diameter of the tumors. The three types of candidate lesions for endoscopic therapy are adenoma, carcinoma, and neuroendocrine tumors. For applying endoscopic therapies to duodenal lesions, accurate preoperative histopathological diagnosis is necessary. The most important technical issue in duodenal ESD is the submucosal dissection process. In duodenal ESD, a short needle-type knife is suitable for the mucosal incision and submucosal dissection processes, and the Small-caliber-tip Transparent hood is an important tool. After endoscopic therapies, the wound should be closed by clipping in order to prevent complications such as secondary hemorrhage and delayed perforation. At present, the criteria for selection between ESD and EMR vary among institutions. The indications for ESD should be carefully considered. Duodenal ESD should have limitations, such as the need for its being performed by experts with abundant experience in performing the procedure. PMID:25901218

  6. Bioengineered vocal fold mucosa for voice restoration.

    PubMed

    Ling, Changying; Li, Qiyao; Brown, Matthew E; Kishimoto, Yo; Toya, Yutaka; Devine, Erin E; Choi, Kyeong-Ok; Nishimoto, Kohei; Norman, Ian G; Tsegyal, Tenzin; Jiang, Jack J; Burlingham, William J; Gunasekaran, Sundaram; Smith, Lloyd M; Frey, Brian L; Welham, Nathan V

    2015-11-18

    Patients with voice impairment caused by advanced vocal fold (VF) fibrosis or tissue loss have few treatment options. A transplantable, bioengineered VF mucosa would address the individual and societal costs of voice-related communication loss. Such a tissue must be biomechanically capable of aerodynamic-to-acoustic energy transfer and high-frequency vibration and physiologically capable of maintaining a barrier against the airway lumen. We isolated primary human VF fibroblasts and epithelial cells and cocultured them under organotypic conditions. The resulting engineered mucosae showed morphologic features of native tissue, proteome-level evidence of mucosal morphogenesis and emerging extracellular matrix complexity, and rudimentary barrier function in vitro. When grafted into canine larynges ex vivo, the mucosae generated vibratory behavior and acoustic output that were indistinguishable from those of native VF tissue. When grafted into humanized mice in vivo, the mucosae survived and were well tolerated by the human adaptive immune system. This tissue engineering approach has the potential to restore voice function in patients with otherwise untreatable VF mucosal disease. PMID:26582902

  7. Duodenal-Mucosal Bacteria Associated with Celiac Disease in Children

    PubMed Central

    Sánchez, Ester; Donat, Ester; Ribes-Koninckx, Carmen; Fernández-Murga, Maria Leonor

    2013-01-01

    Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of cereal gluten proteins. This disorder is associated with imbalances in the gut microbiota composition that could be involved in the pathogenesis of CD. The aim of this study was to characterize the composition and diversity of the cultivable duodenal mucosa-associated bacteria of CD patients and control children. Duodenal biopsy specimens from patients with active disease on a gluten-containing diet (n = 32), patients with nonactive disease after adherence to a gluten-free diet (n = 17), and controls (n = 8) were homogenized and plated on plate count agar, Wilkins-Chalgren agar, brain heart agar, or yeast, Casitone, and fatty acid agar. The isolates were identified by partial 16S rRNA gene sequencing. Renyi diversity profiles showed the highest diversity values for active CD patients, followed by nonactive CD patients and control individuals. Members of the phylum Proteobacteria were more abundant in patients with active CD than in the other child groups, while those of the phylum Firmicutes were less abundant. Members of the families Enterobacteriaceae and Staphylococcaceae, particularly the species Klebsiella oxytoca, Staphylococcus epidermidis, and Staphylococcus pasteuri, were more abundant in patients with active disease than in controls. In contrast, members of the family Streptococcaceae were less abundant in patients with active CD than in controls. Furthermore, isolates of the Streptococcus anginosus and Streptococcus mutans groups were more abundant in controls than in both CD patient groups, regardless of inflammatory status. The findings indicated that the disease is associated with the overgrowth of possible pathobionts that exclude symbionts or commensals that are characteristic of the healthy small intestinal microbiota. PMID:23835180

  8. Duodenal-mucosal bacteria associated with celiac disease in children.

    PubMed

    Snchez, Ester; Donat, Ester; Ribes-Koninckx, Carmen; Fernndez-Murga, Maria Leonor; Sanz, Yolanda

    2013-09-01

    Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of cereal gluten proteins. This disorder is associated with imbalances in the gut microbiota composition that could be involved in the pathogenesis of CD. The aim of this study was to characterize the composition and diversity of the cultivable duodenal mucosa-associated bacteria of CD patients and control children. Duodenal biopsy specimens from patients with active disease on a gluten-containing diet (n = 32), patients with nonactive disease after adherence to a gluten-free diet (n = 17), and controls (n = 8) were homogenized and plated on plate count agar, Wilkins-Chalgren agar, brain heart agar, or yeast, Casitone, and fatty acid agar. The isolates were identified by partial 16S rRNA gene sequencing. Renyi diversity profiles showed the highest diversity values for active CD patients, followed by nonactive CD patients and control individuals. Members of the phylum Proteobacteria were more abundant in patients with active CD than in the other child groups, while those of the phylum Firmicutes were less abundant. Members of the families Enterobacteriaceae and Staphylococcaceae, particularly the species Klebsiella oxytoca, Staphylococcus epidermidis, and Staphylococcus pasteuri, were more abundant in patients with active disease than in controls. In contrast, members of the family Streptococcaceae were less abundant in patients with active CD than in controls. Furthermore, isolates of the Streptococcus anginosus and Streptococcus mutans groups were more abundant in controls than in both CD patient groups, regardless of inflammatory status. The findings indicated that the disease is associated with the overgrowth of possible pathobionts that exclude symbionts or commensals that are characteristic of the healthy small intestinal microbiota. PMID:23835180

  9. Duodenal microbiota composition and mucosal homeostasis in pediatric celiac disease

    PubMed Central

    2013-01-01

    Background Celiac disease (CD) is an autoimmune disorder of the small intestine which is triggered by dietary gluten in genetically predisposed (HLA-DQ2/DQ8 positive) individuals. Only a fraction of HLA-DQ2/DQ8 positive individuals develop CD indicating that other factors have a role in the disorder. Several studies have addressed intestinal microbiota aberrancies in pediatric CD, but the results are inconsistent. Previously, we demonstrated that pediatric CD patients have lower duodenal expression of TLR2 and higher expression of TLR9 as compared to healthy controls (HC) indicating that microbiota may have a role in CD. Methods We used bacterial phylogenetic microarray to comprehensively profile the microbiota in duodenal biopsies of CD (n = 10) and HC (n = 9) children. The expression of selected mucosa-associated genes was assessed by qRT-PCR in CD and HC children and in treated CD adults (T-CD, n = 6) on gluten free diet. Results The overall composition, diversity and the estimated microbe associated molecular pattern (MAMP) content of microbiota were comparable between CD and HC, but a sub-population profile comprising eight genus-like bacterial groups was found to differ significantly between HC and CD. In HC, increased TLR2 expression was positively correlated with the expression of tight junction protein ZO-1. In CD and T-CD, the expression of IL-10, IFN-g and CXCR6 were higher as co5mpared to HC. Conclusions The results suggest that microbiota and altered expression of mucosal receptors have a role in CD. In CD subjects, the increased expression of IL-10 and IFN-g may have partly resulted from the increased TLR9 expression and signaling. PMID:23844808

  10. Eviendep reduces number and size of duodenal polyps in familial adenomatous polyposis patients with ileal pouch-anal anastomosis

    PubMed Central

    Calabrese, Carlo; Pratic, Chiara; Calafiore, Andrea; Coscia, Maurizio; Gentilini, Lorenzo; Poggioli, Gilberto; Gionchetti, Paolo; Campieri, Massimo; Rizzello, Fernando

    2013-01-01

    AIM: To evaluate if 3 mo oral supplementation with Eviendep was able to reduce the number of duodenal polyps in familial adenomatous polyposis (FAP) patients with ileal pouch-anal anastomosis (IPAA). METHODS: Eleven FAP patients with IPAA and duodenal polyps were enrolled. They underwent upper gastrointestinal (GI) endoscopy at the baseline and after 3 mo of treatment. Each patient received 5 mg Eviendep twice a day, at breakfast and dinner time, for 3 mo. Two endoscopists evaluated in a blinded manner the number and size of duodenal polyps. Upper GI endoscopies with biopsies were performed at the baseline (T0) with the assessment of the Spigelman score. Polyps > 10 mm were removed during endoscopy and at the end of the procedure a new Spigelman score was determined (T1). The procedure was repeated 3 mo after the baseline (T2). Four photograms were examined for each patient, at T1 and T2. The examined area was divided into 3 segments: duodenal bulb, second and third portion duodenum. Biopsy specimens were taken from all polyps > 10 mm and from all suspicious ones, defined by the presence of a central depression, irregular surface, or irregular vascular pattern. Histology was classified according to the updated Vienna criteria. RESULTS: At baseline the mean number of duodenal detected polyps was 27.7 and mean sizes were 15.8 mm; the mean Spigelman score was 7.1. After polypectomy the mean number of duodenal detected polyps was 25.7 and mean sizes were 7.6 mm; the mean Spigelman score was 6.4. After 3 mo of Eviendep bid, all patients showed a reduction of number and size of duodenal polyps. The mean number of duodenal polyps was 8 (P = 0.021) and mean size was 4.4 mm; the mean Spigelman score was 6.6. Interrater agreement was measured. Lesions > 1 cm found a very good degree of concordance (kappa 0.851) and a good concordance was as well encountered for smaller lesions (kappa 0.641). CONCLUSION: Our study demonstrated that short-term (90 d) supplementation with Eviendep in FAP patients with IPAA and with recurrent adenomas in the duodenal mucosa, resulted effective in reducing polyps number of 32% and size of 51%. PMID:24039360

  11. Patchiness and duodenal-jejunal variation of the mucosal abnormality in coeliac disease and dermatitis herpetiformis.

    PubMed Central

    Scott, B B; Losowsky, M S

    1976-01-01

    The incidence and degree of patchiness of mucosal abnormality in both coeliac disease (CD) and dermatitis herpetiformis (DH) is documented. As judged by both stereomicroscopy and subjective histology, patchiness occurred frequently in both CDand DH patients. In most cases the difference of abnormality was of only one grade, but in approximately 25% as assessed by stereomicroscopy and 10% as assessed by histology the difference was of two or more grades. In control subjects with normal small bowel mucosa the variation of the mucosal appearance between the duodenum and proximal jejunum was studied. Contrary to popular belief, no significant difference of villous and crypt measurements or of apparent villous "bridging" and "branching" between these two sites was found, if only well-orientated sections were studied. The stereomicroscopic appearances were also similar at these two sites, although villi tended to be broader in the duodenal biopsies. The duodenal-jejunal variation was also studied in CD and DH patients and although by both stereomicroscopy and subjective histology the appearances were similar in most patients, in approximately 33% the duodenal abnormality was the most severe and, surprisingly, the jejunal abnormality was more severe in approximately 15%. It is concluded that multiple, precisely located biopsies of both the duodenum and proximal jejunum are invaluable in the investigation of small bowel disease and in assessing response to treatment. Images Fig. 2 Fig. 3 PMID:1017719

  12. Preoperative endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors, including magnifying endoscopy

    PubMed Central

    Tsuji, Shigetsugu; Doyama, Hisashi; Tsuji, Kunihiro; Tsuyama, Sho; Tominaga, Kei; Yoshida, Naohiro; Takemura, Kenichi; Yamada, Shinya; Niwa, Hideki; Katayanagi, Kazuyoshi; Kurumaya, Hiroshi; Okada, Toshihide

    2015-01-01

    Superficial non-ampullary duodenal epithelial tumor (SNADET) is defined as a sporadic tumor that is confined to the mucosa or submucosa that does not arise from Vaters papilla, and it includes adenoma and adenocarcinoma. Recent developments in endoscopic technology, such as high-resolution endoscopy and image-enhanced endoscopy, may increase the chances of detecting SNADET lesions. However, because SNADET is rare, little is known about its preoperative endoscopic diagnosis. The use of endoscopic resection for SNADET, which has no risk of metastasis, is increasing, but the incidence of complications, such as perforation, is significantly higher than in any other part of the digestive tract. A preoperative diagnosis is required to distinguish between lesions that should be followed up and those that require treatment. Retrospective studies have revealed certain endoscopic findings that suggest malignancy. In recent years, several new imaging modalities have been developed and explored for real-time diagnosis of these lesion types. Establishing an endoscopic diagnostic tool to differentiate between adenoma and adenocarcinoma in SNADET lesions is required to select the most appropriate treatment. This review describes the current state of knowledge about preoperative endoscopic diagnosis of SNADETs, such as duodenal adenoma and duodenal adenocarcinoma. Newer endoscopic techniques, including magnifying endoscopy, may help to guide these diagnostics, but their additional advantages remain unclear, and further studies are required to clarify these issues. PMID:26557007

  13. Duodenal adenomatosis in Japanese patients with familial adenomatous polyposis.

    PubMed

    Maehata, Yuji; Esaki, Motohiro; Hirahashi, Minako; Kitazono, Takanari; Matsumoto, Takayuki

    2014-04-01

    Duodenal adenomatosis is the most frequent extracolonic manifestation of familial adenomatous polyposis (FAP), and duodenal cancer has been assumed to be the second most significant cause of death in patients with the disease. To stratify the risk of duodenal cancer, Spigelman's classification was proposed for the staging of duodenal adenomatosis. According to Western guidelines, patients with stage IV of the classification are candidates for prophylactic duodenectomy. Since our institutional experience disclosed only 2% of duodenal or ampullary cancers among 130 patients with FAP, and because most duodenal adenomatosis remains unchanged under endoscopic surveillance, it seems likely that aggressive endoscopic or surgical removal is unnecessary for most FAP patients with duodenal adenomatosis. In the present article, we demonstrate our data and present our strategy for duodenal adenomatosis of FAP. PMID:24750145

  14. Prostaglandin pathways in duodenal chemosensing

    PubMed Central

    Akiba, Yasutada; Kaunitz, Jonathan D

    2015-01-01

    Acid-sensing pathways, which trigger mucosal defense mechanisms in response to luminal acid, involve the rapid afferent-mediated capsaicin pathway and the sustained, prostaglandin (PG) pathway. Luminal acid quickly increases protective PG synthesis and release from epithelia, although the mechanism by which luminal acid induces PG synthesis is still mostly unknown. Acid exposure augments purinergic ATP-P2Y signaling by inhibition of intestinal alkaline phosphatase (IAP) activity. Since P2Y activation increases intracellular Ca2+, we further hypothesized that ATP-P2Y signals increase the generation of H2O2 derived from dual oxidase (Duox), a member of the NADPH oxidase family activated by Ca2+. Our recent studies suggest that acid exposure increases H2O2 output, followed by phospholipase A2 (PLA2) and cyclooxygenase (COX) activation, increasing PG synthesis. Released PGE2 augments protective HCO3? and mucus secretion via EP4 receptor activation. Thus, the PG pathway as a component of duodenal acid sensing consists of acid-related IAP inhibition, ATP-P2Y signals, Duox2-derived H2O2 production, PLA2 activation, PGE2 synthesis and EP4 receptor activation. The PG pathway is also involved in luminal bacterial sensing in the duodenum via activation of pattern recognition receptors, including Toll-like receptors (TLRs) and NOD2. The presence of acute mucosal responses to luminal bacteria suggests that the duodenum is important for host defenses and may reduce bacterial loading to the hindgut using H2O2, complementing gastric acidity and anti-bacterial bile acids. PMID:25521740

  15. Complete duodenogastric reflux: A scintigraphic sign of significant duodenal pathology

    SciTech Connect

    Drane, W.E.; Hanner, J.S. )

    1989-09-01

    Complete reflux of duodenal contents into the stomach with persistent retention on hepatobiliary scintigraphy or radionuclide gastrointestinal bleeding studies is a relatively rare occurrence. Two cases of complete duodenogastric reflux are reported: one case in a patient with a perforated duodenal diverticulum and the other in a patient with an inflamed, bleeding duodenal ulcer. The finding of complete duodenogastric reflux and persistent retention in the stomach should instigate a thorough evaluation for significant duodenal pathology.

  16. Prognostic characteristics of duodenal gastrointestinal stromal tumours

    PubMed Central

    Zhang, Q; Shou, C-H; Yu, J-R; Yang, W-L; Liu, X-S; Yu, H; Gao, Y; Shen, Q-Y; Zhao, Z-C

    2015-01-01

    Background This study evaluated the clinical characteristics, surgical procedures and prognosis of duodenal gastrointestinal stromal tumours (GISTs). Methods Patients with a diagnosis of primary duodenal GIST treated between January 2000 and December 2012 were analysed. Patients with gastric and small intestinal GISTs were chosen as control groups according to the following parameters: age, tumour size, mitotic index and adjuvant imatinib therapy. Operative procedures for patients with duodenal GIST included pancreaticoduodenectomy or limited resection. Disease-free survival (DFS) was calculated using KaplanMeier analysis. Results Some 71 patients with duodenal, 71 with gastric and 70 with small intestinal GISTs were included in the study. DFS of patients with duodenal GIST was shorter than that of patients with gastric GIST (3-year DFS 84 versus 94 per cent; hazard ratio (HR) 3.67, 95 per cent c.i. 1.21 to 11.16; P?=?0.014), but was similar to that of patients with small intestinal GIST (3-year DFS 84 versus 81 per cent; HR 0.75, 0.37 to 1.51; P?=?0.491). Patients who underwent pancreaticoduodenectomy were older, and had larger tumours and a higher mitotic index than patients who had limited resection. The 3-year DFS was 93 per cent among patients who had limited resection compared with 64 per cent for those who underwent PD (HR 0.18, 0.06 to 0.59; P?=?0.001). Conclusion The prognosis of duodenal GISTs is similar to that of small intestinal GISTs. Prognosis no different than for small bowel gastrointestinal stromal tumours PMID:25980461

  17. Duodenal diverticula: potential complications and common imaging pitfalls.

    PubMed

    Schroeder, T C; Hartman, M; Heller, M; Klepchick, P; Ilkhanipour, K

    2014-10-01

    A duodenal diverticulum is a commonly encountered entity in gastrointestinal radiology with a wide variety of appearances. The purpose of this review is to describe the normal anatomy and embryology of the duodenum, discuss the differences between a true versus intraluminal duodenal diverticulum, and to highlight the normal appearance, potential complications, and imaging pitfalls of duodenal diverticula. PMID:25110301

  18. Impact of familial amyloid associated polyneuropathy on duodenal endocrine cells.

    PubMed Central

    el-Salhy, M; Suhr, O; Stenling, R; Wilander, E; Grimelius, L

    1994-01-01

    Duodenal endocrine cells in 11 patients with familial amyloid associated polyneuropathy (FAP) were compared with those in 12 healthy volunteers by means of immunohistochemistry and morphometry. The total endocrine cell content, determined by the argyrophilic reaction and chromogranin A immunoreactivity, was significantly reduced in FAP patients compared with controls. There was a significant reduction in the serotonin, cholecystokinin/gastrin, and secretin immunoreactive cell content. A decreased cell content was also noted for somatostatin and gastric inhibitory polypeptide immunoreactive cells but this was not statistically significant. Amyloid deposits were noted in seven of the 11 biopsy specimens from FAP patients, but otherwise the duodenum was histologically normal in both groups. The reduction in endocrine cell content was not correlated with the degree of amyloid deposit in the duodenum. These findings indicate that patients with FAP have reduced intestinal endocrine cells. This does not seem to be related to amyloid deposits in the mucosa or to villous or crypt abnormalities. The observed changes in endocrine cells may contribute to the development of intestinal motility dysfunction and maldigestion in these patients. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:7959197

  19. Formulation and evaluation of omeprazole tablets for duodenal ulcer.

    PubMed

    Choudhury, A; Das, S; Bahadur, S; Saha, S; Roy, A

    2010-07-01

    Omeprazole pellets containing mucoadhesive tablets were developed by direct punch method. Three mucoadhesive polymers namely hydroxypropylemethylcellulose K4M, sodium carboxy methylcellulose, carbopol-934P and ethyl cellulose were used for preparation of tablets which intended for prolong action may be due to the attachment with intestinal mucosa for relief from active duodenal ulcer. Mucoadhesive tablets were coated with respective polymer and coated with Eudragit L100 to fabricate enteric coated tablets. The prepared tablets were evaluated for different physical parameters and dissolution study were performed in three dissolution mediums like 0.1N hydrochloric acid for 2h, pH 6.5 and pH 7.8 phosphate buffer solution for 12hr. Sodium carboxymethylcellulose showed above 95% release within 10 h where as carbopol-934P showed slow release about 88% to 92% over a period of 12 h. having excellent mucoadhesive strength but ethyl cellulose containing tablets showed less than 65% release. The release mechanism of all formulation was diffusion controlled confirmed from Higuchi's plot. Thus, the present study concluded that, carbopol-934P containing mucoadhesive tablets of omeprazole pellets can be used for local action in the ulcer disease as well as for oral controlled release drug delivery. PMID:21218061

  20. Feasibility and safety of endoscopic cryoablation at the duodenal papilla: Porcine model

    PubMed Central

    Yang, Dennis; Reinhard, Mary K; Wagh, Mihir S

    2015-01-01

    AIM: To assess the feasibility and safety of liquid nitrogen spray cryoablation at the duodenal papilla in a porcine model. METHODS: This prospective study protocol was approved by the University of Florida Institutional Animal Care and Use Committee. Six pigs underwent liquid nitrogen spray cryotherapy at the duodenal papilla. Freeze time of 20-s was applied per cycle (4 cycles/session). Survival animals (n = 4) were monitored for adverse events. Hemoglobin, white blood count, liver tests, and lipase were obtained at baseline and post-treatment. EGD was performed on day#7 to evaluate the papilla and for histology. All animals were euthanized and necropsy was performed at the end of the one-week survival period. Feasibility was defined as successful placement of the decompression tube in the duodenum, followed by delivery of spray cryotherapy to the duodenal papilla. Safety was determined by monitoring post-treatment blood tests and clinical course. Treatment effect was defined as endoscopic and histologic changes after cryotherapy. This was established by comparing endoscopic and histologic findings from mucosal biopsies prior to cryotherapy and on post-operative day (POD)#7. Full-thickness specimen was obtained post-mortem to assess depth of injury. RESULTS: Spray cryotherapy was feasible and successfully performed in all 6/6 (100%) animals. Cryospray with liquid nitrogen (four 20-s freeze-thaw cycles) at the duodenal papilla resulted in white frost formation at and around the target region. The mean procedural time was 54.5 min (range 50-58 min). All six animals studied had stable blood pressure, heart rate, and pulse oximetry measurements during the procedure. There were no significant intra-procedural adverse events. There were no significant differences in hemoglobin, white cell count, liver tests or lipase from baseline to post-cryotherapy. Survival animals were monitored daily post-operatively without any clinical ill effects from the cryotherapy. There was no bleeding, infection, or perforation on necropsy. Endoscopic on POD#7 showed edema and ulceration at the duodenal papilla. On histology, there was loss of crypt architecture with moderate to severe necrosis and acute mixed inflammatory infiltration in each specimen following cryotherapy. The extent of cryogen-induced tissue necrosis (depth of injury) was limited to the mucosa on full-thickness specimen evaluation. CONCLUSION: Endoscopic liquid nitrogen spray cryotherapy is feasible and safe for ablation at the duodenal papilla in a porcine model. PMID:26140100

  1. Duodenal obstruction following acute pancreatitis caused by a large duodenal diverticular bezoar.

    PubMed

    Kim, Ji Hun; Chang, Jae Hyuck; Nam, Sung Min; Lee, Mi Jeong; Maeng, Il Ho; Park, Jin Young; Im, Yun Sun; Kim, Tae Ho; Park, Il Young; Han, Sok Won

    2012-10-14

    Bezoars are concretions of indigestible materials in the gastrointestinal tract. It generally develops in patients with previous gastric surgery or patients with delayed gastric emptying. Cases of periampullary duodenal divericular bezoar are rare. Clinical manifestations by a bezoar vary from no symptom to acute abdominal syndrome depending on the location of the bezoar. Biliary obstruction or acute pancreatitis caused by a bezoar has been rarely reported. Small bowel obstruction by a bezoar is also rare, but it is a complication that requires surgery. This is a case of acute pancreatitis and subsequent duodenal obstruction caused by a large duodenal bezoar migrating from a periampullary diverticulum to the duodenal lumen, which mimicked pancreatic abscess or microperforation on abdominal computerized tomography. The patient underwent surgical removal of the bezoar and recovered completely. PMID:23082068

  2. AUTOMATIVE QUANTIFICATION OF RAT DUODENAL RHYTHMIC CONTRACTION

    EPA Science Inventory

    The pacemaker activity of longitudinal muscle, as reflected by in vitro rhythmic contractions of the adult male rat's duodenum, has been examined in terms of intercontraction intervals that were collected using a microprocessor-based system. For each duodenal segment studied, 512...

  3. Helicobacter pylori and associated duodenal ulcer.

    PubMed Central

    Yeung, C K; Fu, K H; Yuen, K Y; Ng, W F; Tsang, T M; Branicki, F J; Saing, H

    1990-01-01

    Twenty three children with coexistent duodenal ulcer and Helicobacter pylori infection were treated with either two weeks of amoxycillin (25 mg/kg/day) in addition to six weeks of cimetidine, or cimetidine alone. Endoscopy with antral and duodenal biopsies for urease test, microaerophilic culture, and histological studies were performed at entry, six weeks, 12 weeks, and at six months. Children with persistent H pylori infection at six weeks were given a further two weeks' course of amoxycillin. H pylori persisted in all children not receiving amoxycillin treatment but cleared in six of the 13 children (46%) treated with amoxycillin. With failure of H pylori clearance at six months, only two out of six (33%) ulcers had healed and 50% of patients had experienced ulcer recurrence. In contrast, when H pylori remained cleared all ulcers healed and no ulcer recurred. Persistent H pylori infection was associated with persistent gastritis and duodenitis despite endoscopic evidence of ulcer healing. Detection and eradication of H pylori deserves particular attention in the routine management of duodenal ulceration in children. PMID:2248531

  4. Ursodeoxycholic acid counteracts celecoxib in reduction of duodenal polyps in patients with familial adenomatous polyposis: a multicentre, randomized controlled trial

    PubMed Central

    2013-01-01

    Background Due to prophylactic colectomy, mortality in patients with familial adenomatous polyposis (FAP) has changed, with duodenal cancer currently being the main cause of death. Although celecoxib reduces duodenal polyp density in patients with FAP, its long-term use may increase the risk of cardiovascular events and alternatives need to be explored. Preclinical studies suggest that the combination of celecoxib with ursodeoxycholic acid (UDCA) is a potentially effective strategy. We performed a randomized, double-blind, placebo-controlled trial to investigate the effect of celecoxib and UDCA co-treatment on duodenal adenomatosis in patients with FAP. Methods Patients with FAP received celecoxib (400 mg twice daily) and UDCA (1000-2000 mg daily, ~20-30 mg/kg/day, n=19) or celecoxib and placebo (n=18) orally for 6 months. Primary outcome was drug efficacy, assessed by comparing duodenal polyp density at pre- and post-intervention by blinded review of endoscopic recordings. As secondary outcomes, cell proliferation, apoptosis, and COX-2 levels in normal duodenal mucosa were assessed by immunohistochemistry or real-time quantitative polymerase chain reaction. Results In intention-to-treat analysis, deceased polyp density was observed after celecoxib/placebo treatment (p=0.029), whereas increased polyp density was observed after celecoxib/UDCA treatment (p=0.014). The difference in change in duodenal polyp density was statistically significant between the groups (p=0.011). No changes in secondary outcomes were observed. Thirty patients (81%) reported one or more adverse events, 16 patients (84%, Common Toxicity Criteria for Adverse Events version 3.0 (CTCAE) grade 1–3) treated with celecoxib/UDCA and 14 patients (78%, CTCAE grade 1–2) treated with celecoxib/placebo. Nine patients (24%) discontinued intervention prematurely, 5 patients (26%) treated with celecoxib/UDCA and 4 patients (22%) treated with celecoxib/placebo. Conclusions Celecoxib reduces duodenal polyp density in patients with FAP, and unexpectedly, high dose UDCA co-treatment counteracts this effect. The benefit of long term use of celecoxib for duodenal cancer prevention needs to be weighed against the (risk of) adverse events. Trial registration http://ClinicalTrials.gov, identifier NCT00808743 PMID:23919274

  5. Prevalence of human papillomaviruses in the healthy oral mucosa of women with high-grade squamous intra-epithelial lesion and of their partners as compared to healthy controls.

    PubMed

    Tatár, Tímea Zsófia; Kis, Andrea; Szabó, Éva; Czompa, Levente; Boda, Róbert; Tar, Ildikó; Szarka, Krisztina

    2015-10-01

    Oral human papillomavirus (HPV) carriage rates were investigated in relation to genital HPV carriage in women with HPV-associated cervical lesions and male partner of such women, including several couples, in comparison with healthy individuals. Buccal and lingual mucosa of 60 males and 149 females with healthy oral mucosa and without known genital lesion, genital and oral mucosa of further 40 females with cervical high-grade squamous intraepithelial lesion (HSIL) and 34 male sexual partners of women with HSIL (including 20 couples) were sampled. HPV DNA was detected using MY/GP PCR. Genotype was determined by sequencing or restriction fragment length polymorphism. Virus copy numbers were determined by real-time PCR. Overall, oral HPV carriage rate was 5.7% (12/209) in healthy individuals; average copy number was 5.8 × 10(2) copies/1 μg DNA; male and female rates were comparable. Oral carriage in women with HSIL was significantly higher, 20.0% (8/40, P = 0.003); males with partners with HSIL showed a carriage rate of 17.6% (6/34), copy numbers were similar to the healthy controls. In contrast, genital carriage rate (52.9%, 18/34 vs. 82.5%, 33/40; P = 0.006) and average copy number were lower in males (5.0 × 10(5) vs. 7.8 × 10(5) copies/1 μg DNA; P = 0.01). Oral copy numbers in these groups and in healthy individuals were comparable. High-risk genotypes were dominant; couples usually had the same genotype in the genital sample. In conclusion, genital HPV carriage is a risk factor of oral carriage for the individual or for the sexual partner, but alone is not sufficient to produce an oral HPV infection in most cases. PMID:25495524

  6. Endoscopic appearance and significance of functional lymphangiectasia of the duodenal mucosa.

    PubMed

    Patel, A S; DeRidder, P H

    1990-01-01

    Intestinal lymphangiectasia is found in a wide variety of pathologic conditions. Functional lymphangiectasia has not been well characterized. We report 20 patients followed for 9 to 55 months (mean 30 months) after incidental detection at endoscopy of lymphangiectasia. Our study indicates that functional lymphangiectasia is not pathologic and does not warrant repeat endoscopy in the absence of other clinical indications. PMID:2210279

  7. Toll-like receptor 2 (TLR) -196 to 174del polymorphism in gastro-duodenal diseases in Japanese population.

    PubMed

    Tahara, Tomomitsu; Arisawa, Tomiyasu; Wang, Fangyu; Shibata, Tomoyuki; Nakamura, Masakatsu; Sakata, Mikijyu; Hirata, Ichiro; Nakano, Hiroshi

    2008-04-01

    Toll-like receptors (TLRs) play important roles in the signaling of many pathogen-related molecules and endogenous proteins associated with immune activation. -196 to -174del polymorphism affects the TLR2 gene and alters its promoter activity. We investigated the influence of TLR2 -196 to -174del polymorphism on the risk of gastro-duodenal diseases, on the severity of Helicobacter pylori-induced gastritis in a Japanese population. The study was performed on 309 patients with abdominal discomfort and 146 healthy controls. -196 to -174del polymorphism of TLR2 was investigated by allele-specific polymerase chain reaction method in all of the subjects. Gastritis scores of antral gastric mucosa were assessed according to the updated Sydney system in H. pylori-positive subjects (n = 156). Patients with abdominal discomfort was consisted of 80 gastric ulcers (25.9%), 38 duodenal ulcers (12.3%), five gastric + duodenal ulcers (1.6%), 105 patients with gastritis (34.0%) and 81 normal healthy stomachs (26.2%). We did not find any association between TLR2 polymorphism and risk of gastric ulcer, duodenal ulcer, gastric and duodenal ulcer and gastritis compared to healthy controls. However, the TLR2-196 to -174ins allele was associated with severity of intestinal metaplasia in more than 60 years of ages (P = 0.02). The same allele also increased the risks of developing more severe gastric mucosal atrophy and intestinal metaplasia in female subjects (P < 0.05, P = 0.07 respectively). No association was observed between TLR2 polymorphism and severity of neutrophil and mononuclear cell infiltration. Our data suggest that the TLR2-196 to -174ins allele was associated with more severe intestinal metaplasia in patients older than was correlated with severity of gastric mucosal atrophy and intestinal metaplasia in female subjects. PMID:17934843

  8. Palliation double stenting for malignant biliary and duodenal obstruction

    PubMed Central

    ZHAO, LIANG; XU, HAITAO; ZHANG, YUBAO

    2016-01-01

    The surgical management of patients with malignant biliary and duodenal obstruction is complex. Tumor excision is no longer possible in the majority of patients with malignant obstructive jaundice and duodenal obstruction. The aim of the present study was to evaluate the effectiveness of intraluminal dual stent placement in malignant biliary and duodenal obstruction. In total, 20 patients with malignant obstructive jaundice and duodenal obstruction, including 6 with pancreatic carcinoma, 11 with cholangiocarcinoma, 1 with duodenal carcinoma and 2 with abdominal lymph node metastasis, were treated with intraluminal stent placement. Bile duct obstruction with late occurrence of duodenal obstruction was observed in 16 cases, and duodenal obstruction followed by a late occurrence of bile duct obstruction was observed in 3 cases, while, in 1 case, bile duct obstruction and duodenal obstruction occurred simultaneously. After X-ray fluoroscopy revealed obstruction in the bile duct and duodenum, stents were placed into the respective lumens. Percutaneous transhepatic placement was employed for the biliary stent, while the duodenal stent was placed perioraly. The clinical outcomes, including complications associated with the procedures and patency of the stents, were evaluated. The biliary and duodenal stents were successfully implanted in 18 patients and the technical success rate was 90% (18/20). A total of 39 stents were implanted in 20 patients. In 2 cases, duodenal stent placement failed following biliary stent placement. Duodenal obstruction remitted in 15 patients, and 1 patient succumbed to aspiration pneumonia 5 days after the procedure. No severe complications were observed in any other patient. The survival time of the 18 patients was 521 months (median, 9.6 months), and 6 of those patients survived for >12 months. The present study suggests that X-ray fluoroscopy-guided intraluminal stent implantation is an effective procedure for the treatment of malignant biliary and duodenal obstruction. PMID:26889267

  9. Human duodenum responses to vitamin D metabolites of TRPV6 and other genes involved in calcium absorption.

    PubMed

    Balesaria, Sara; Sangha, Sonia; Walters, Julian R F

    2009-12-01

    Calcium absorption by the intestine is necessary for bone mineralization. Much has been learned about this process and the role of vitamin D metabolites in gene transcription from animal studies, but the molecular mechanisms in humans are less well understood. We have used samples of normal human duodenal mucosa, obtained at endoscopy, to investigate the effects of the vitamin D metabolites, 1alpha-dihydroxycholecalciferol [1,25(OH)(2)D(3)] and 25-hydroxycholecalciferol (25OHD), on transcripts on genes involved in calcium absorption and vitamin D metabolism. TRPV6 transcripts were significantly higher after incubation for 6 h with 1,25(OH)(2)D(3) (10(-9) mol/l) than after control incubations (median difference 3.1-fold, P < 0.001). Unexpectedly, TRPV6 expression was also higher (2.4-fold, P < 0.02) after incubation with 25OHD (10(-7) mol/l). Transcripts for the calcium-ATPase, PMCA1, were significantly higher with 1,25(OH)(2)D(3); CYP24 transcripts were reliably detected after incubation with either metabolite, but calbindin-D9k transcripts were unaffected. The response of TRPV6 to 25OHD and the expression of transcripts for CYP27B1, the 25OHD-1alpha-hydroxylase, were significantly correlated (r = 0.82, P < 0.02). Basal duodenal expression of TRPV6 and CYP27B1 were significantly associated (r = 0.72, P < 0.001) in a separate previously reported series of subjects. Multiple regression analysis of the associations with basal duodenal TRPV6 expression identified CYP27B1 expression and serum 1,25(OH)(2)D as major factors. Expression of the CYP27B1 protein was demonstrated immunohistochemically in duodenal mucosa. This study has shown that human duodenal TRPV6, PMCA1, and CYP24 transcripts respond rapidly to 1,25(OH)(2)D(3) and provides evidence suggesting that local duodenal production of 1,25(OH)(2)D(3) by 25OHD-1alpha-hydroxylase may have a role in human calcium absorption. PMID:19779013

  10. Pancreatic-induced intramural duodenal haematoma.

    PubMed

    Ma, Julius K; Ng, Kelvin K; Poon, Ronnie T; Fan, Sheung Tat

    2008-04-01

    Spontaneous intramural duodenal haematoma (IDH) is an uncommon pathology and it is usually related to anticoagulant therapy. Other causes include various pancreatic diseases, connective tissue disease, peptic ulcer disease and pancreaticoduodenal aneurysm. IDH of pancreatic origin has been infrequently reported. The disease course can be life-threatening and serious complications may occur, including gastric outlet obstruction, duodenal perforation and septicaemia. A case of pancreatic-induced IDH is presented, for which pancreaticoduodenectomy was performed as definitive treatment. In general, medical treatment with continuous nasogastric aspiration and total parenteral nutrition is recommended as initial management strategy. Surgical interventions (evacuation of blood clot or surgical resection) are reserved for patients in whom medical treatment fails or complications occur. PMID:18490220

  11. A Metagenomic Investigation of the Duodenal Microbiota Reveals Links with Obesity

    PubMed Central

    Carrière, Frédéric; Bachar, Dipankar; Laugier, René; Lagier, Jean-Christophe; Robert, Catherine; Michelle, Caroline; Henrissat, Bernard; Raoult, Didier

    2015-01-01

    Background Few studies have tested the small intestine microbiota in humans, where most nutrient digestion and absorption occur. Here, our objective was to examine the duodenal microbiota between obese and normal volunteers using metagenomic techniques. Methodology/Principal Findings We tested duodenal samples from five obese and five normal volunteers using 16S rDNA V6 pyrosequencing and Illumina MiSeq deep sequencing. The predominant phyla of the duodenal microbiota were Firmicutes and Actinobacteria, whereas Bacteroidetes were absent. Obese individuals had a significant increase in anaerobic genera (p < 0.001) and a higher abundance of genes encoding Acyl-CoA dehydrogenase (p = 0.0018) compared to the control group. Obese individuals also had a reduced abundance of genes encoding sucrose phosphorylase (p = 0.015) and 1,4-alpha-glucan branching enzyme (p = 0.05). Normal weight people had significantly increased FabK (p = 0.027), and the glycerophospholipid metabolism pathway revealed the presence of phospholipase A1 only in the control group (p = 0.05). Conclusions/Significance The duodenal microbiota of obese individuals exhibit alterations in the fatty acid and sucrose breakdown pathways, probably induced by diet imbalance. PMID:26356733

  12. Management of Perforated Duodenal Diverticulum: Report of Two Cases.

    PubMed

    Song, Sanghyun

    2015-09-01

    Duodenal diverticula are common, but perforated duodenal diverticulum is rare. Because of the disease rarity, there is no standard management protocol for perforated duodenal diverticulum. To properly manage this rare complication, a clear preoperative diagnosis and clinical disease severity assessment are important. An abdomino-pelvic CT is an unquestionably crucial diagnostic tool. Perforation is considered a surgical emergency, although conservative treatment based on fasting and broad-spectrum antibiotics may be offered in some selected cases. Herein, we report two cases of perforated duodenal diverticulum, one case managed with surgical treatment and one with conservative treatment. PMID:26387699

  13. [Mechanisms of neutral red transport through the mucosa of the gastrointestinal tract].

    PubMed

    Groĭsman, S D; Khomenko, T A; Shishova, S V

    1981-04-01

    The conditions of the passage of neutral red into the cavity of gastro--intestinal tract were investigated during the atropine blockade of the stomach secretory activity in the dogs with fundal, antral and duodenal fistulas. The neutral red begins to cross the gastric mucosa only after the PH of the perfusing solution has achieved 2.5 and for intestine--5.0. The intensity of the neutral red passage increases with further decrease of the perfusing solution pH. During perfusion of acid solutions through the stomach and particularly through the duodenum, retrodiffusion of H+ occurs into the mucosa. The excretion of neutral red into the cavity of gastro--intestinal tract seems to be a process of passive diffusion. The role of the H+ retrodiffusion in this process is discussed. PMID:7250432

  14. Genetic errors of the human caspase recruitment domain-B-cell lymphoma 10-mucosa-associated lymphoid tissue lymphoma-translocation gene 1 (CBM) complex: Molecular, immunologic, and clinical heterogeneity.

    PubMed

    Prez de Diego, Rebeca; Snchez-Ramn, Silvia; Lpez-Collazo, Eduardo; Martnez-Barricarte, Rubn; Cubillos-Zapata, Carolina; Ferreira Cerdn, Antonio; Casanova, Jean-Laurent; Puel, Anne

    2015-11-01

    Three members of the caspase recruitment domain (CARD) family of adaptors (CARD9, CARD10, and CARD11) are known to form heterotrimers with B-cell lymphoma 10 (BCL10) and mucosa-associated lymphoid tissue lymphoma-translocation gene 1 (MALT1). These 3 CARD-BCL10-MALT1 (CBM) complexes activate nuclear factor ?B in both the innate and adaptive arms of immunity. Human inherited defects of the 3 components of the CBM complex, including the 2 adaptors CARD9 and CARD11 and the 2 core components BCL10 and MALT1, have recently been reported. Biallelic loss-of-function mutant alleles underlie several different immunologic and clinical phenotypes, which can be assigned to 2 distinct categories. Isolated invasive fungal infections of unclear cellular basis are associated with CARD9 deficiency, whereas a broad range of clinical manifestations, including those characteristic of T- and B-lymphocyte defects, are associated with CARD11, MALT1, and BCL10 deficiencies. Interestingly, human subjects with these mutations have some features in common with the corresponding knockout mice, but other features are different between human subjects and mice. Moreover, germline and somatic gain-of-function mutations of MALT1, BCL10, and CARD11 have also been found in patients with other lymphoproliferative disorders. This broad range of germline and somatic CBM lesions, including loss-of-function and gain-of-function mutations, highlights the contribution of eachof the components of the CBM complex to human immunity. PMID:26277595

  15. High-fat diet causes iron deficiency via hepcidin-independent reduction of duodenal iron absorption.

    PubMed

    Sonnweber, Thomas; Ress, Claudia; Nairz, Manfred; Theurl, Igor; Schroll, Andrea; Murphy, Anthony T; Wroblewski, Victor; Witcher, Derrick R; Moser, Patrizia; Ebenbichler, Christoph F; Kaser, Susanne; Weiss, Gnter

    2012-12-01

    Obesity is often associated with disorders of iron homeostasis; however, the underlying mechanisms are not fully understood. Hepcidin is a key regulator of iron metabolism and may be responsible for obesity-driven iron deficiency. Herein, we used an animal model of diet-induced obesity to study high-fat-diet-induced changes in iron homeostasis. C57BL/6 mice were fed a standard (SD) or high-fat diet (HFD) for 8 weeks, and in addition, half of the mice received high dietary iron (Fe+) for the last 2 weeks. Surprisingly, HFD led to systemic iron deficiency which was traced back to reduced duodenal iron absorption. The mRNA and protein expressions of the duodenal iron transporters Dmt1 and Tfr1 were significantly higher in HFD- than in SD-fed mice, indicating enterocyte iron deficiency, whereas the mRNA levels of the duodenal iron oxidoreductases Dcytb and hephaestin were lower in HFD-fed mice. Neither hepatic and adipose tissue nor serum hepcidin concentrations differed significantly between SD- and HFD-fed mice, whereas dietary iron supplementation resulted in increased hepatic hepcidin mRNA expression and serum hepcidin levels in SD as compared to HFD mice. Our study suggests that HFD results in iron deficiency which is neither due to intake of energy-dense nutrient poor food nor due to increased sequestration in the reticulo-endothelial system but is the consequence of diminished intestinal iron uptake. We found that impaired iron absorption is independent of hepcidin but rather results from reduced metal uptake into the mucosa and discordant oxidoreductases expressions despite enterocyte iron deficiency. PMID:22444869

  16. Human discs large and scrib are localized at the same regions in colon mucosa and changes in their expression patterns are correlated with loss of tissue architecture during malignant progression.

    PubMed

    Gardiol, Daniela; Zacchi, Alberto; Petrera, Francesca; Stanta, Giorgio; Banks, Lawrence

    2006-09-15

    Loss of cell polarity is one of the hallmarks of malignant carcinomas. Most of the understanding about the link between cell polarity and proliferation control comes from studies on the Drosophila tumor suppressors discs large (Dlg), scribble (Scrib) and lethal giant larvae (lgl). Mammalian homologues of these proteins have been described and are conserved in sequence and function. Human Dlg (hDlg) and Scrib were independently shown to be down-regulated during malignant progression. This, and other lines of evidence, points toward the participation of both hDlg and hScrib in a common pathway involved in polarity control and tumor suppression. We investigated the correlation between the expression of both proteins in tissues and their relative contributions to the maintenance of tissue architecture during colon cancer development. We analyzed the levels and distribution of hDlg and hScrib by immunohistochemistry, using serial sections of the same sample. We used normal and neoplastic colon mucosa, since it offers a good model for analyzing these features in progressive dysplastic stages. The results demonstrate that both proteins localize at the same regions in polarized colon epithelia, and that in normal samples the proteins' distribution varies as cells differentiate at the surface mucosa. In neoplasia, alterations in the expression pattern of hDlg and of hScrib increase during tumor progression; down-regulation of both proteins being associated with lack of epithelial cell polarity and disorganized tissue architecture. The results, therefore, demonstrate that there is an inverse relationship between the levels of hDlg and hScrib expression and the loss of cell polarity and tissue architecture in the colon. PMID:16619250

  17. Parallel expression of macrophage metalloelastase (MMP-12) in duodenal and skin lesions of patients with dermatitis herpetiformis

    PubMed Central

    Salmela, M; Pender, S; Reunala, T; MacDonald, T; Saarialho-Kere, U

    2001-01-01

    BACKGROUNDDermatitis herpetiformis (DH) is a specific dermatological manifestation of coeliac disease and 80% of DH patients have gluten sensitive enteropathy manifested by crypt hyperplasia and villous atrophy. Matrix degradation mediated by collagenase 1(MMP-1) and stromelysin 1(MMP-3) has previously been implicated in the pathobiology of coeliac intestine and cutaneous DH blisters.?AIMSTo study expression of stromelysin 2,metalloelastase, collagenase 3,and matrilysin in the intestine and skin of DH patients.?METHODSIn situ hybridisation using 35S labelled cRNA probes was performed on duodenal biopsies of 15DH patients, three samples each of control duodenal or jejunal mucosa, fetal ileal explants, lesional DH skin, and 19serial biopsies of experimental DH blisters. Immunostaining was used to examine type IV collagen, macrophages (CD68), and 92kDa gelatinase (MMP-9) in the specimens.?RESULTSMetalloelastase (MMP-12) was abundantly expressed by subepithelial macrophages in both coeliac intestine and spontaneous and induced DH rash. It was also upregulated in the experimental model of coeliac disease (staphylococcal endotoxin B stimulated fetal explants). The only other MMP detected was MMP-9 which did not colocalise with MMP-12.?CONCLUSIONSUpregulation of metalloelastase is associated with T cell mediated immune responses both in the intestine and skin. In addition to modulating macrophage migration, it may contribute to degradation of proteoglycans or basement membrane components in the subepithelial mucosa.???Keywords: coeliac disease; metalloproteinase; dermatitis herpetiformis PMID:11247893

  18. Duodenal mucosal bicarbonate secretion in man. Stimulation by acid and inhibition by the alpha 2-adrenoceptor agonist clonidine.

    PubMed Central

    Knutson, L; Flemstrm, G

    1989-01-01

    A multi-channel small diameter tube was used to study the secretion of bicarbonate by 3 cm long segments of the proximal duodenum isolated between balloons. The tube had an outer diameter of 5.3 mm and two central and four smaller, peripheral channels. Measurements of infused phenol red, 14C-PEG and vitamin B12 and of trypsin activity were performed to rule out contamination of the perfusate by gastric and pancreatic secretions. Basal secretion of bicarbonate by the duodenal mucosa in healthy subjects varied between 135 and 220 mumol/cm of intestine per hour. Perfusion of the lumen with acid (100 mM HCl for five minutes) increased the secretion to greater than 400 mumol/cm/h and the alpha 2-adrenoreceptor agonist clonidine (150 micrograms iv) decreased the HCO3- secretion by 70 mumol/cm/h. Clonidine simultaneously reduced the mean arterial blood pressure and plasma noradrenaline concentration, but did not affect the plasma glucose or adrenaline concentration. Duodenal bicarbonate secretion is important in the protection of this mucosa against acid discharged from the stomach. Increased sympathetic activity may, by inhibiting the bicarbonate secretion, decrease the protection in proximal duodenum in man and facilitate ulceration. Images Fig. 2 PMID:2558985

  19. Prophylactic pancreaticoduodenectomy for premalignant duodenal polyposis in familial adenomatous polyposis.

    PubMed

    Causeret, S; Franois, Y; Griot, J B; Flourie, B; Gilly, F N; Vignal, J

    1998-01-01

    The frequency of duodenal adenomas in patients with, familial adenomatous polyposis is high. Duodenal adenoma has malignant potential, and duodenal adenocarcinoma is one of the main causes of death in patients who have had previous proctocolectomy. A conservative approach to the treatment of duodenal adenomas (nonsteroidal anti-inflammatory drugs, endoscopy, polypectomy through duodenotomy) is inefficient and unsafe. When invasive cancer occurs in duodenal adenomas, the result of surgery is poor. We have performed prophylactic pancreaticoduodenal resection (PDR) for nonmalignant severe duodenal polyposis in five patients since 1991. No operative mortality was observed. One patient developed a pancreatic fistula which was successfully managed by medical treatment. The mean follow-up was 35 months. All five patients are still alive and have a good functional outcome. Prophylactic PDR may be indicated in familial adenomatous polyposis when duodenal polyposis is severe. Stages III and IV of Spigelman's classification, periampullary adenoma, age above 40, and family history of duodenal cancer are factors that may lead to the decision to perform prophylactic PDR. PMID:9548099

  20. Laparoscopic biliopancreatic diversion with duodenal switch.

    PubMed

    Feng, John J; Gagner, Michel

    2002-06-01

    The biliopancreatic diversion with duodenal switch combines a sleeve gastrectomy with a duodenoileal switch to achieve maximum weight loss. Consistent excess weight loss between 70% to 80% is achieved with acceptable decreased long-term nutritional complications. With a higher entry weight, the super obese patient (body mass index [BMI] >50 kg/m(2)) benefits the greatest from a procedure that produces a higher mean excess weight loss. The laparoscopic approach to this procedure has successfully created a surgical technique with optimum benefit and minimal morbidity, especially in the super obese patient. PMID:12152155

  1. Endoscopic retrieval of a duodenal perforating teaspoon.

    PubMed

    Bokoski, Ivo; Tringali, Andrea; Landi, Rosario; Familiari, Pietro; Contini, Anna Chiara Iolanda; Pintus, Claudio; Costamagna, Guido

    2013-04-16

    Foreign objects ingestion occur commonly in pediatric patients. The majority of ingested foreign bodies pass spontaneously the gastrointestinal tract and surgery is rarely required for extraction. Endoscopic removal of foreign bodies larger than 10 cm has not yet been described. We present the case of a 16 years old bulimic girl that swallowed a 12 cm long teaspoon in order to provoke vomiting. The teaspoon perforated the duodenum. However, it was removed during gastroscopy and the site of perforation was closed endoscopically. This particular case shows the importance of endoscopy for retrieval of large foreign bodies, and the possibility to endoscopically close a perforated duodenal wall. PMID:23596543

  2. Endoscopic retrieval of a duodenal perforating teaspoon

    PubMed Central

    Bokoski, Ivo; Tringali, Andrea; Landi, Rosario; Familiari, Pietro; Contini, Anna Chiara Iolanda; Pintus, Claudio; Costamagna, Guido

    2013-01-01

    Foreign objects ingestion occur commonly in pediatric patients. The majority of ingested foreign bodies pass spontaneously the gastrointestinal tract and surgery is rarely required for extraction. Endoscopic removal of foreign bodies larger than 10 cm has not yet been described. We present the case of a 16 years old bulimic girl that swallowed a 12 cm long teaspoon in order to provoke vomiting. The teaspoon perforated the duodenum. However, it was removed during gastroscopy and the site of perforation was closed endoscopically. This particular case shows the importance of endoscopy for retrieval of large foreign bodies, and the possibility to endoscopically close a perforated duodenal wall. PMID:23596543

  3. Endoscopic Treatments of Endoscopic Retrograde Cholangiopancreatography-Related Duodenal Perforations

    PubMed Central

    Han, Joung-Ho; Park, Sang-Heum

    2013-01-01

    Iatrogenic duodenal perforation associated with endoscopic retrograde cholangiopancreatography (ERCP) is a very uncommon complication that is often lethal. Perforations during ERCP are caused by endoscopic sphincterotomy, placement of biliary or duodenal stents, guidewire-related causes, and endoscopy itself. In particular, perforation of the medial or lateral duodenal wall usually requires prompt diagnosis and surgical management. Perforation can follow various clinical courses, and management depends on the cause of the perforation. Cases resulting from sphincterotomy or guidewire-induced perforation can be managed by conservative treatment and biliary diversion. The current standard treatment for perforation of the duodenal free wall is early surgical repair. However, several reports of primary endoscopic closure techniques using endoclip, endoloop, or newly developed endoscopic devices have recently been described, even for use in direct perforation of the duodenal wall. PMID:24143315

  4. Duodenal Adenocarcinoma Metastatic to the Breast: A Case Report.

    PubMed

    Yu, Haibo; Song, Hongliang; Jiang, Yi

    2016-03-01

    Duodenal adenocarcinoma, a very rare malignant gastrointestinal tumor, mainly metastasizes via the lymphatic system. Metastases from duodenal adenocarcinomas to the breast are very uncommon.A 31-year-old woman presented at our department with a left breast tumor. She had a past medical history of duodenal adenocarcinoma. Physical examination on admission confirmed a 2.5-cm-diameter tumor in the outer lower quadrant of the left breast. Computed tomography (CT) examination showed a soft lesion with tissue-like density and enlarged axillary lymph nodes. Local excision was performed to remove the breast lesion. The findings of cytologic, histologic, and immunohistochemistry examination indicated a breast metastasis from the previous duodenal adenocarcinoma. The patient was treated with palliative chemotherapy.Metastases from duodenal adenocarcinoma to the breast are rare. The diagnosis depends on medical history, imaging, and pathologic examination including immunohistochemistry. An accurate diagnosis is important to avoid unnecessary surgery. PMID:26986146

  5. Dynamic change in natural killer cell type in the human ocular mucosa in situ as means of immune evasion by adenovirus infection.

    PubMed

    Yawata, N; Selva, K J; Liu, Y-C; Tan, K P; Lee, A W L; Siak, J; Lan, W; Vania, M; Arundhati, A; Tong, L; Li, J; Mehta, J S; Yawata, M

    2016-01-01

    The most severe form of virus-induced inflammation at the ocular surface is epidemic keratoconjunctivitis (EKC), often caused by group D human adenoviruses (HAdVs). We investigated the dynamics and mechanisms of changes in natural killer (NK) cell types in the human ocular mucosal surface in situ over the course of infection. In the acute phase of infection, the mature CD56(dim)NK cells that comprise a major subpopulation in the normal human conjunctiva are replaced by CD56(bright)NK cells recruited to the ocular surface by chemokines produced by the infected epithelium, and NKG2A-expressing CD56(dim) and CD56(bright) NK cells become the major subpopulations in severe inflammation. These NK cells attracted to the mucosal surface are however incapable of mounting a strong antiviral response because of upregulation of the inhibitory ligand human leukocyte antigen-E (HLA-E) on infected epithelium. Furthermore, group D HAdVs downregulate ligands for activating NK cell receptors, thus rendering even the mature NKG2A(-)NK cells unresponsive, an immune-escape mechanism distinct from other adenoviruses. Our findings imply that the EKC-causing group D HAdVs utilize these multiple pathways to inhibit antiviral NK cell responses in the initial stages of the infection. PMID:26080707

  6. Approach to the endoscopic resection of duodenal lesions

    PubMed Central

    Gaspar, Jonathan P; Stelow, Edward B; Wang, Andrew Y

    2016-01-01

    Duodenal polyps or lesions are uncommonly found on upper endoscopy. Duodenal lesions can be categorized as subepithelial or mucosally-based, and the type of lesion often dictates the work-up and possible therapeutic options. Subepithelial lesions that can arise in the duodenum include lipomas, gastrointestinal stromal tumors, and carcinoids. Endoscopic ultrasonography with fine needle aspiration is useful in the characterization and diagnosis of subepithelial lesions. Duodenal gastrointestinal stromal tumors and large or multifocal carcinoids are best managed by surgical resection. Brunner’s gland tumors, solitary Peutz-Jeghers polyps, and non-ampullary and ampullary adenomas are mucosally-based duodenal lesions, which can require removal and are typically amenable to endoscopic resection. Several anatomic characteristics of the duodenum make endoscopic resection of duodenal lesions challenging. However, advanced endoscopic techniques exist that enable the resection of large mucosally-based duodenal lesions. Endoscopic papillectomy is not without risk, but this procedure can effectively resect ampullary adenomas and allows patients to avoid surgery, which typically involves pancreaticoduodenectomy. Endoscopic mucosal resection and its variations (such as cap-assisted, cap-band-assisted, and underwater techniques) enable the safe and effective resection of most duodenal adenomas. Endoscopic submucosal dissection is possible but very difficult to safely perform in the duodenum. PMID:26811610

  7. Characterization of xenobiotic metabolizing enzymes in bovine small intestinal mucosa.

    PubMed

    Virkel, G; Carletti, M; Cantiello, M; Della Donna, L; Gardini, G; Girolami, F; Nebbia, C

    2010-06-01

    The intestinal mucosa plays a capital role in dictating the bioavailability of a large array of orally ingested drugs and toxicants. The activity and the expression of several xenobiotic metabolizing enzymes were measured in subcellular fractions from the duodenal mucosa of male veal calves and beef cattle displaying a functional rumen but differing in both age (about 8 months vs. 18 to 24 months) and dietary regimens (i.e., milk replacer plus hay and straw vs. corn and concentrated meal). Intestinal microsomes showed cytochrome P450 (CYP) 2B, 2C- and 3A-mediated activities and the presence of the corresponding immunorelated proteins, but no proof of CYP1A expression and/or functions could be provided. Intestinal microsomes were also active in performing reactions typically mediated by carboxylesterases (indophenylacetate hydrolysis), flavin-containing monooxygenases (methimazole S-oxidation), and uridindiphosphoglucuronyltransferases (1-naphthol glucuronidation), respectively. Cytosolic fractions displayed the glutathione S-transferase (GST)-dependent conjugation of 1-chloro-2,4-dinitrobenzene; besides, the GST-mediated conjugation of ethacrinic acid (GSTpi) or cumene hydroperoxide (GSTalpha) was matched by the presence of the corresponding immunorelated proteins. Conversely, despite the lack of measurable activity with 3,4-dichloronitrobenzene, a protein cross reacting with anti-rat GSTmu antibodies could be clearly detected. Although, as detected by densitometry, CYPs and GST isoenzymes tended to be more expressed in beef cattle than in veal calf preparations, there was a general poor correlation with the rate of the in vitro metabolism of the selected diagnostic probes. PMID:20557447

  8. Gene Expression Profiling of Human Vaginal Cells In Vitro Discriminates Compounds with Pro-Inflammatory and Mucosa-Altering Properties: Novel Biomarkers for Preclinical Testing of HIV Microbicide Candidates

    PubMed Central

    Zalenskaya, Irina A.; Joseph, Theresa; Bavarva, Jasmin; Yousefieh, Nazita; Jackson, Suzanne S.; Fashemi, Titilayo; Yamamoto, Hidemi S.; Settlage, Robert; Fichorova, Raina N.; Doncel, Gustavo F.

    2015-01-01

    Background Inflammation and immune activation of the cervicovaginal mucosa are considered factors that increase susceptibility to HIV infection. Therefore, it is essential to screen candidate anti-HIV microbicides for potential mucosal immunomodulatory/inflammatory effects prior to further clinical development. The goal of this study was to develop an in vitro method for preclinical evaluation of the inflammatory potential of new candidate microbicides using a microarray gene expression profiling strategy. Methods To this end, we compared transcriptomes of human vaginal cells (Vk2/E6E7) treated with well-characterized pro-inflammatory (PIC) and non-inflammatory (NIC) compounds. PICs included compounds with different mechanisms of action. Gene expression was analyzed using Affymetrix U133 Plus 2 arrays. Data processing was performed using GeneSpring 11.5 (Agilent Technologies, Santa Clara, CA). Results Microarraray comparative analysis allowed us to generate a panel of 20 genes that were consistently deregulated by PICs compared to NICs, thus distinguishing between these two groups. Functional analysis mapped 14 of these genes to immune and inflammatory responses. This was confirmed by the fact that PICs induced NFkB pathway activation in Vk2 cells. By testing microbicide candidates previously characterized in clinical trials we demonstrated that the selected PIC-associated genes properly identified compounds with mucosa-altering effects. The discriminatory power of these genes was further demonstrated after culturing vaginal cells with vaginal bacteria. Prevotella bivia, prevalent bacteria in the disturbed microbiota of bacterial vaginosis, induced strong upregulation of seven selected PIC-associated genes, while a commensal Lactobacillus gasseri associated to vaginal health did not cause any changes. Conclusions In vitro evaluation of the immunoinflammatory potential of microbicides using the PIC-associated genes defined in this study could help in the initial screening of candidates prior to entering clinical trials. Additional characterization of these genes can provide further insight into the cervicovaginal immunoinflammatory and mucosal-altering processes that facilitate or limit HIV transmission with implications for the design of prevention strategies. PMID:26052926

  9. The ΔF508-CFTR mutation inhibits wild-type CFTR processing and function when co-expressed in human airway epithelia and in mouse nasal mucosa

    PubMed Central

    2012-01-01

    Background Rescue or correction of CFTR function in native epithelia is the ultimate goal of CF therapeutics development. Wild-type (WT) CFTR introduction and replacement is also of particular interest. Such therapies may be complicated by possible CFTR self-assembly into an oligomer or multimer. Results Surprisingly, functional CFTR assays in native airway epithelia showed that the most common CFTR mutant, ΔF508-CFTR (ΔF-CFTR), inhibits WT-CFTR when both forms are co-expressed. To examine more mechanistically, both forms of CFTR were transfected transiently in varying amounts into IB3-1 CF human airway epithelial cells and HEK-293 human embryonic kidney cells null for endogenous CFTR protein expression. Increasing amounts of ΔF-CFTR inhibited WT-CFTR protein processing and function in CF human airway epithelial cells but not in heterologous HEK-293 cells. Stably expressed ΔF-CFTR in clones of the non-CF human airway epithelial cell line, CALU-3, also showed reduction in cAMP-stimulated anion secretion and in WT-CFTR processing. An ultimate test of this dominant negative-like effect of ΔF-CFTR on WT-CFTR was the parallel study of two different CF mouse models: the ΔF-CFTR mouse and the bitransgenic CFTR mouse corrected in the gut but null in the lung and airways. WT/ΔF heterozygotes had an intermediate phenotype with regard to CFTR agonist responses in in vivo nasal potential difference (NPD) recordings and in Ussing chamber recordings of short-circuit current (ISC) in vitro on primary tracheal epithelial cells isolated from the same mice. In contrast, CFTR bitransgenic +/− heterozygotes had no difference in their responses versus +/+ wild-type mice. Conclusions Taken altogether, these data suggest that ΔF-CFTR and WT-CFTR co-assemble into an oligomeric macromolecular complex in native epithelia and share protein processing machinery and regulation at the level of the endoplasmic reticulum (ER). As a consequence, ΔF-CFTR slows WT-CFTR protein processing and limits its expression and function in the apical membrane of native airway epithelia. Implications of these data for the relative health of CF heterozygous carriers, for CFTR protein processing in native airway epithelia, and for the relative efficacy of different CF therapeutic approaches is significant and is discussed. PMID:22999299

  10. Thyroid Storm Precipitated by Duodenal Ulcer Perforation

    PubMed Central

    Natsuda, Shoko; Nakashima, Yomi; Horie, Ichiro; Kawakami, Atsushi

    2015-01-01

    Thyroid storm is a rare and life-threatening complication of thyrotoxicosis that requires prompt treatment. Thyroid storm is also known to be associated with precipitating events. The simultaneous treatment of thyroid storm and its precipitant, when they are recognized, in a patient is recommended; otherwise such disorders, including thyroid storm, can exacerbate each other. Here we report the case of a thyroid storm patient (a 55-year-old Japanese male) complicated with a perforated duodenal ulcer. The patient was successfully treated with intensive treatment for thyroid storm and a prompt operation. Although it is believed that peptic ulcer rarely coexists with hyperthyroidism, among patients with thyroid storm, perforation of a peptic ulcer has been reported as one of the causes of fatal outcome. We determined that surgical intervention was required in this patient, reported despite ongoing severe thyrotoxicosis, and reported herein a successful outcome. PMID:25838951

  11. Current medical management of duodenal ulcer disease.

    PubMed Central

    Badley, B. W.

    1977-01-01

    Each of three agents used in the treatment of duodenal ulcer--magnesium--aluminum antacids in high doses, cimetidine and carbenoxolone sodium--appears to enhance the rate at which ulcers heal, although their ability to control symptoms has been less clearly demonstrated. Since a large proportion of ulcers heal either without treatment or when the patient is given a placebo, a rational management plan should emphasize the removal of known irritants and the provision of symptomatic relief while spontaneous healing is allowed to occur. Lack of response to such a regimen warrants more specific investigation and therapy. On the basis of current evidence, cimetidine appears to be the preferred therapeutic agent. PMID:603851

  12. Two-dimensional gel proteome reference map of human small intestine

    PubMed Central

    Simula, Maria Paola; Cannizzaro, Renato; Marin, Maria Dolores; Pavan, Alessandro; Toffoli, Giuseppe; Canzonieri, Vincenzo; De Re, Valli

    2009-01-01

    Background The small intestine is an important human organ that plays a central role in many physiological functions including digestion, absorption, secretion and defense. Duodenal pathologies include, for instance, the ulcer associated to Helicobacter Pylori infection, adenoma and, in genetically predisposed individuals, celiac disease. Alterations in the bowel reduce its capability to absorb nutrients, minerals and fat-soluble vitamins. Anemia and osteopenia or osteoporosis may develop as a consequence of vitamins malabsorption. Adenoma is a benign tumor that has the potential to become cancerous. Adult celiac disease patients present an overall risk of cancer that is almost twice than that found in the general population. These disease processes are not completely known. To date, a two dimensional (2D) reference map of proteins expressed in human duodenal tissue is not yet available: the aim of our study was to characterize the 2D protein map, and to identify proteins of duodenal mucosa of adult individuals without duodenal illness, to create a protein database. This approach, may be useful for comparing similar protein samples in different laboratories and for the molecular characterization of intestinal pathologies without recurring to the use of surgical material. Results The enrolled population comprised five selected samples (3 males and 2 females, aged 19 to 42), taken from 20 adult subjects, on their first visit at the gastroenterology unit for a suspected celiac disease, who did not turn to be affected by any duodenal pathology after gastrointestinal and histological evaluations. Proteins extracted from the five duodenal mucosal specimens were singly separated by 2D gel electrophoresis. After image analysis of each 2D gel, 179 protein spots, representing 145 unique proteins, from 218 spots tested, were successfully identified by MALDI-TOF ms analysis. Normalized volumes, for each protein, have been reported for every gel. Proteins have been grouped according to their biological/metabolic functions. Conclusion This study represents to date the first detailed and reproducible 2D protein map of human duodenum. Spots identifications, reported in a database, will be helpful to identify the variability in protein expression levels, in isoforms expression, or in post-translational modifications associated to pathology or to a therapy. PMID:19298663

  13. Essential role of the electroneutral Na+-HCO3- cotransporter NBCn1 in murine duodenal acid-base balance and colonic mucus layer build-up in vivo.

    PubMed

    Singh, Anurag Kumar; Xia, Weiliang; Riederer, Brigitte; Juric, Marina; Li, Junhua; Zheng, Wen; Cinar, Ayhan; Xiao, Fang; Bachmann, Oliver; Song, Penghong; Praetorius, Jeppe; Aalkjaer, Christian; Seidler, Ursula

    2013-04-15

    Duodenal epithelial cells need efficient defence strategies during gastric acidification of the lumen, while colonic mucosa counteracts damage by pathogens by building up a bacteria-free adherent mucus layer. Transport of HCO3(-) is considered crucial for duodenal defence against acid as well as for mucus release and expansion, but the transport pathways involved are incompletely understood. This study investigated the significance of the electroneutral Na(+)-HCO3(-) cotransporter NBCn1 for duodenal defence against acid and colonic mucus release. NBCn1 was localized to the basolateral membrane of duodenal villous enterocytes and of colonic crypt cells, with predominant expression in goblet cells. Duodenal villous enterocyte intracellular pH was studied before and during a luminal acid load by two-photon microscopy in exteriorized, vascularly perfused, indicator (SNARF-1 AM)-loaded duodenum of isoflurane-anaesthetized, systemic acid-base-controlled mice. Acid-induced HCO3(-) secretion was measured in vivo by single-pass perfusion and pH-stat titration. After a luminal acid load, NBCn1-deficient duodenocytes were unable to recover rapidly from intracellular acidification and could not respond adequately with protective HCO3(-) secretion. In the colon, build-up of the mucus layer was delayed, and a decreased thickness of the adherent mucus layer was observed, suggesting that basolateral HCO3(-) uptake is essential for optimal release of mucus. The electroneutral Na(+)-HCO3(-) cotransporter NBCn1 displays a differential cellular distribution in the murine intestine and is essential for HCO3(-)-dependent mucosal protective functions, such as recovery of intracellular pH and HCO3(-) secretion in the duodenum and secretion of mucus in the colon. PMID:23401617

  14. Telomere length in non-neoplastic gastric mucosa and its relationship to H. pylori infection, degree of gastritis, and NSAID use.

    PubMed

    Tahara, Tomomitsu; Shibata, Tomoyuki; Kawamura, Tomohiko; Ishizuka, Takamitsu; Okubo, Masaaki; Nagasaka, Mitsuo; Nakagawa, Yoshihito; Arisawa, Tomiyasu; Ohmiya, Naoki; Hirata, Ichiro

    2016-02-01

    Telomere shortening occurs with human aging in many organs and tissues and is accelerated by rapid cell turnover and oxidative injury. We measured average telomere length using quantitative real-time PCR in non-neoplastic gastric mucosa and assessed its relationship to H. pylori-related gastritis, DNA methylation, ulcer disease, and nonsteroidal anti-inflammatory drug (NSAID) usage. Gastric biopsies were obtained from 151 cancer-free subjects including 49 chronic NSAID users and 102 nonusers. Relative telomere length in genomic DNA was measured by real-time PCR. H. pylori infection status, histological severity of gastritis, and serum pepsinogens (PGs) were also investigated. E-cadherin (CDH1) methylation status was determined by methylation-specific PCR (MSP). Average relative telomere length of H. pylori-infected subjects was significantly shortened when compared to H. pylori-negative subjects (p = 0.002) and was closely associated with all histological parameter of gastritis (all p values <0.01) and CDH1 methylation (p = 0.0002). In H. pylori-negative subjects, NSAID users presented significantly shorter telomere length than nonusers (p = 0.028). Shorter telomere length was observed in duodenal and gastric ulcer patients compared with non-ulcer subjects among NSAID users. Telomere shortening is closely associated with severity of H. pylori-induced gastritis and CDH1 methylation status. Also, telomere shortening is accelerated by NSAID usage especially in H. pylori-negative subjects. PMID:25563818

  15. Prenatal diagnosis of duodenal atresia: does it make any difference?

    PubMed

    Romero, R; Ghidini, A; Costigan, K; Touloukian, R; Hobbins, J C

    1988-05-01

    The outcome of infants with duodenal atresia diagnosed antenatally is compared with that of infants diagnosed after birth. The incidence of neonatal morbidity was higher and preoperative conditions were poorer in the second group. PMID:3282192

  16. Duodenal adenoma surveillance in patients with familial adenomatous polyposis.

    PubMed

    Campos, Fbio Guilherme; Sulbaran, Marianny; Safatle-Ribeiro, Adriana Vaz; Martinez, Carlos Augusto Real

    2015-08-10

    Familial adenomatous polyposis (FAP) is a hereditary disorder caused by Adenomatous Polyposis Gene mutations that lead to the development of colorectal polyps with great malignant risk throughout life. Moreover, numerous extracolonic manifestations incorporate different clinical features to produce varied individual phenotypes. Among them, the occurrence of duodenal adenomatous polyps is considered an almost inevitable event, and their incidence rates increase as a patient's age advances. Although the majority of patients exhibit different grades of duodenal adenomatosis as they age, only a small proportion (1%-5%) of patients will ultimately develop duodenal carcinoma. Within this context, the aim of the present study was to review the data regarding the epidemiology, classification, genetic features, endoscopic features, carcinogenesis, surveillance and management of duodenal polyps in patients with FAP. PMID:26265988

  17. Duodenal adenoma surveillance in patients with familial adenomatous polyposis

    PubMed Central

    Campos, Fbio Guilherme; Sulbaran, Marianny; Safatle-Ribeiro, Adriana Vaz; Martinez, Carlos Augusto Real

    2015-01-01

    Familial adenomatous polyposis (FAP) is a hereditary disorder caused by Adenomatous Polyposis Gene mutations that lead to the development of colorectal polyps with great malignant risk throughout life. Moreover, numerous extracolonic manifestations incorporate different clinical features to produce varied individual phenotypes. Among them, the occurrence of duodenal adenomatous polyps is considered an almost inevitable event, and their incidence rates increase as a patients age advances. Although the majority of patients exhibit different grades of duodenal adenomatosis as they age, only a small proportion (1%-5%) of patients will ultimately develop duodenal carcinoma. Within this context, the aim of the present study was to review the data regarding the epidemiology, classification, genetic features, endoscopic features, carcinogenesis, surveillance and management of duodenal polyps in patients with FAP. PMID:26265988

  18. Analyzing the value of monitoring duodenal mucosal perfusion using photoplethysmography.

    PubMed

    Fink, Mitchell P

    2014-01-01

    Photoplethysmography (PPG) is a technique that permits noninvasive measurement of changes in the volume of tissues. A novel device uses PPG to assess changes in duodenal mucosal perfusion. When tested in septic piglets, data obtained using this device correlate with the blood lactate concentration and duodenal serosal microvascular blood flow as measured with a laser Doppler flowmeter. This new PPG-based approach for continuously monitoring gut mucosal perfusion warrants further development, leading to prospective clinical trials in patients. PMID:25672458

  19. [Perforated juxta-papillary duodenal diverticula: two cases].

    PubMed

    Atmani, Abdelhakim; Lachachi, Fouzi; Sodji, Maxime; Durand-Fontanier, Sylvaine; Moumouni, Issifou; Pech De La Clause, Bertrand; Valleix, Denis; Descottes, Bernard

    2002-03-01

    Perforation of juxta-ampullary duodenal diverticula, occurring spontaneously or after abdominal trauma, is a severe condition. Diagnosis is difficult to establish and is based on tomodensitometry, which is the most reliable diagnostic tool. Treatment consists in diverticulectomy that can be associated with drainage of the duodenum or anastomosis between digestive and biliary tract. We report two cases of perforated juxta-ampullary duodenal diverticula. Perforation was spontaneous in one case and complicated a blunt abdominal trauma in the other case. PMID:11981473

  20. Combined Gastric and Duodenal Perforation Through Blunt Abdominal Trauma

    PubMed Central

    Kaur, Adarshpal; Singla, Archan Lal; Kumar, Ashwani; Yadav, Manish

    2015-01-01

    Blunt abdominal traumas are uncommonly encountered despite their high prevalence, and injuries to the organ like duodenum are relatively uncommon (occurring in only 3%-5% of abdominal injuries) because of its retroperitoneal location. Duodenal injury combined with gastric perforation from a single abdominal trauma impact is rarely heard. The aim of this case report is to present a rare case of blunt abdominal trauma with combined gastric and duodenal injuries. PMID:25738037

  1. Malignant duodenal somatostatinoma presenting in association with von Recklinghausen disease.

    PubMed

    Patel, Vijaykumar G; Henderson, Vernon J; Fairweather, David A; Fortson, James K; Weaver, William L; Martin, David M; Lyons, Ralph; Hamami, Amir

    2003-12-01

    Somatostatinomas are extremely rare periampullary malignant neuroendocrine tumors that may be associated with von Recklinghausen disease or type-I neurofibromatosis. Duodenal somatostatinomas are distinguished from pancreatic somatostatinomas by their frequent association with type-I neurofibromatosis and typically absence of somatostatinoma syndrome. We report a very rare and atypical case of malignant duodenal somatostatinoma presenting with somatostatinoma syndrome in association with type-I neurofibromatosis. PMID:14700294

  2. Prevalence of duodenal diverticulum in South indians: a cadaveric study.

    PubMed

    Sakthivel, Sulochana; Kannaiyan, Kavitha; Thiagarajan, Sivakami

    2013-01-01

    Background. Duodenum is the second most common site of diverticula after the colon. Diagnosis of duodenal diverticula is incidental and found during other therapeutic procedures. In 90% of cases, they are asymptomatic, and less than 10% develop clinical symptoms. The difficulty to ascertain the true incidence of duodenal diverticula demanded for the present study to elucidate the prevalence of the duodenal diverticulum in South Indians. Materials and Methods. One hundred and twenty specimens of duodenum were utilized for the study. The prevalence, anatomical location, and dimension of duodenal diverticulum were studied. Results. Among the 120 specimens of duodenum, five specimens had solitary, extraluminal, and globular-shaped diverticula in the medial wall of the duodenum. In three (60%) cases, it was found in the second part of duodenum and in two (40%) cases in the third part. The mean size of the diverticula was 1.4?cm. Conclusion. In the present study in South Indian people, the prevalence (4.2%) of duodenal diverticula is low comparable to other studies in the literature. Even though most of the duodenal diverticula are asymptomatic, the knowledge about its frequency and location is of great importance to prevent complications like diverticulitis, hemorrhage, obstructive jaundice, and perforation. PMID:25938103

  3. Endoscopic Web Localization for Laparoscopic Duodenal Web Excision.

    PubMed

    Bruns, Nicholas E; Gibbons, Alexander T; Wyneski, Matthew J; Ponsky, Todd A

    2015-12-01

    When performing an open duodenal web excision, it is helpful to identify the web using a nasogastric tube because it is often difficult to determine where the web origin is located when looking at the serosal side of the bowel. However, it may be challenging to navigate the nasogastric tube to the web during laparoscopy. We present a novel technique that utilizes intraoperative endoscopy to precisely identify the location of the duodenal web, facilitating laparoscopic excision. Intraoperative endoscopy was implemented in the case of a 3-month-old boy undergoing laparoscopic excision of a duodenal web. With endoscopic visualization and transillumination, the duodenal web was precisely identified and excised laparoscopically. A supplemental video of the case presentation and technique is provided in the online version of this manuscript (Supplemental Digital Content 1, http://links.lww.com/SLE/A134). The procedure was completed successfully and the patient did well postoperatively. Flexible endoscopy is a useful adjunct for duodenal web localization during laparoscopy, improving on the previous method of estimating the location based on a change in duodenal caliber. PMID:26551236

  4. Increased expression of IL-10 and IL-12 (p40) mRNA in Helicobacter pylori infected gastric mucosa: relation to bacterial cag status and peptic ulceration.

    PubMed Central

    Hida, N; Shimoyama, T; Neville, P; Dixon, M F; Axon, A T; Shimoyama, T; Crabtree, J E

    1999-01-01

    AIMS: To investigate interleukin (IL)-12 (p40) and IL-10 mRNA expression levels in the gastric mucosa in relation to H pylori cag status, peptic ulceration, and histopathology. METHODS: In 81 dyspeptic patients, antral and corpus biopsies were taken for reverse transcriptase polymerase chain reaction (RT-PCR) and histology. G3PDH (control) and IL-10 and IL-12 were coamplified in a duplex PCR and the ratios of cytokines to G3PDH were determined. Bacterial ureA and cagA status was determined by RT-PCR. RESULTS: IL-10 mRNA expression in both the antral and corpus mucosa was greater (p < 0.01) in cagA positive infection than in H pylori negative patients with histologically normal mucosa. No increase in IL-10 mRNA expression was observed in cagA negative infection. Both in the antral and corpus mucosa, IL-12 mRNA expression was greater (p < 0.05) in cagA positive than in cagA negative infection and uninfected patients with normal gastric mucosa. In cagA positive infection, there was a correlation between IL-10 and IL-12 mRNA expression in both the antral mucosa (r = 0.515, p < 0.01) and the corpus mucosa (r = 0.6, p < 0.005). IL-12 mRNA expression in the antral mucosa was significantly more frequent in H pylori positive patients with duodenal ulcer than in those with gastric ulcer or nonulcer dyspepsia. No difference was observed in IL-10 mRNA expression in relation to endoscopic diagnosis. CONCLUSIONS: CagA positive H pylori infection is associated with increased IL-10 and IL-12 mRNA expression. The increased expression of IL-12 mRNA in the majority of patients with duodenal ulcer suggests that Th1 responses may predominate and play a role in the pathogenesis of duodenal ulceration. Images PMID:10655986

  5. Helicobacter pylori and gastric or duodenal ulcer.

    PubMed

    2016-01-01

    In patients with gastric or duodenal ulcer associated with Helicobacter pylori, treatment of the infection improves healing and prevents complications and recurrences. The drug regimen generally consists of a high-dose proton-pump inhibitor (PPI) such as omeprazole plus antibiotics. Using the standard Prescrire methodology, we conducted a review of the literature in order to determine the standard empirical antibiotic regimen for H. pylori infection in adults with gastric or duodenal ulcer in France. In 2015, due to an increase in H. pylori resistance to clarithromycin, a 7-day course of the PPI + clarithromycin + amoxicillin combination is effective in only about 70% of cases. A Cochrane systematic review and meta-analysis of trials involving thousands of patients suggests that prolonging treatment with a PPI + amoxicillin + clarithromycin or a PPI + amoxicillin + metronidazole to 10 or 14 days improves the rate of H. pylori eradication by 5% to 10%. A metanalysis of seven trials including a total of about 1000 patients showed that combination therapy with a PPI + amoxicillin + clarithromycin + metronidazole for 5 days eradicates H. pylori in about 90% of cases, compared to about 80% of cases with a PPI + amoxicillin + clarithromycin given for 7 days. Sequential treatment with amoxicillin for 5 days, followed by clarithromycin + metronidazole for 5 days, has also been tested in thousands of patients. Efficacy and adverse effects were similar to those observed when the same antibiotics were taken simultaneously for 5 days. In randomised trials, replacing clarithromycin or amoxicillin with a fluoroquinolone yielded conflicting results. In 2009, nearly 20% of H. pylori isolates were resistant to levofloxacin in France. Tetracycline has only been evaluated in combination with bismuth. The few available data on doxycycline suggest that its efficacy is similar to that of tetracycline. A fixed-dose combination of bismuth subcitrate potassium + metronidazole + tetracycline is authorised in the European Union for use in combination with omeprazole for 10 days. It seems effective, even in case of clarithromycin resistance. However, bismuth can cause encephalopathy, and its value when added to antibiotics and a PPI is poorly documented. We found no robust comparative data on second-line empirical treatments. In patients with gastric or duodenal ulcer associated with H. pylori, eradication of the bacterium reduces the risk of complications and recurrence. In mid-2015, the choice of antibiotics is based on trials in which the primary endpoint was a negative urea breath test, which is an acceptable surrogate criterion. In previously untreated patients, the first-choice empirical treatment consists of three antibiotics: amoxicillin (2 g daily), clarithromycin (1 g daily) and metronidazole (1 g daily), plus a PPI (in practice, omeprazole 40 mg daily), with each drug taken in two divided doses per day. The antibiotics may be taken either simultaneously for five days, or sequentially (amoxicillin for 5 days, followed by clarithromycin + metronidazole for 5 days). The adverse effects of these antibiotic combinations correspond to those of their component drugs, which mainly consist of gastrointestinal disorders and the disulfiram-like reaction of metronidazole. Amoxicillin can be replaced by a fluoroquinolone in patients allergic to beta-lactam antibiotics, but there is a higher risk of resistance. Tetracycline and doxycycline appear effective, as few H. pylori strains are resistant in vitro. Bismuth can cause encephalopathy and should only be used in special cases. PMID:26942258

  6. Inferoposterior duodenal approach for laparoscopic pancreaticoduodenectomy

    PubMed Central

    Wang, Xiao-Ming; Sun, Wei-Dong; Hu, Ming-Hua; Wang, Gua-Nan; Jiang, Ya-Qi; Fang, Xiao-San; Han, Meng

    2016-01-01

    AIM: To investigate the advantages of inferoposterior duodenal approach (IPDA) for laparoscopic pancreaticoduodenectomy (LPD). METHODS: A total of 36 patients subjected to LPD were admitted to the Affiliated Yijishan Hospital of Wannan Medical College from December 2009 to February 2015. These patients were diagnosed with an ampullary tumour or a pancreatic head tumour through computed tomography, magnetic resonance imaging or endoscopic retrograde cholangiopancreatography preoperatively. The cases were selected on the basis of the following criteria: tumour diameter < 4 cm; no signs of peripheral vascular invasion; evident lymph node swelling; and distant metastasis. Of the 36 cases, 20 were subjected to anterior approach (AA; AA group) and 16 were subjected to IPDA (IPDA group). Specimen removal time, intraoperative blood loss and postoperative complications in the two groups were observed, and their differences were compared. RESULTS: During the operation, 2 cases in the AA group and 2 cases in the IPDA group were converted to laparotomy; these cases were excluded from statistical analysis. The remaining 32 cases successfully completed the surgery. The AA group and IPDA group exhibited the specimen removal time of 205 ± 52 and 160 ± 35 min, respectively, and the difference was significant (P < 0.01). The AA group and IPDA group revealed the intraoperative blood loss of 360 ± 210 mL and 310 ± 180 mL, respectively, but these values were not significantly different. Postoperative pathological results revealed 4 cases of inferior common bile duct cancer, 8 cases of duodenal papillary cancer, 6 cases of ampullary cancer, 13 cases of pancreatic cancer, 3 cases of chronic pancreatitis accompanied with cyst formation or duct expansion, and 2 cases of mucinous cystic tumour in the pancreatic head. The postoperative complications were pulmonary Staphylococcus aureus infection, incision faulty union, ascites induced poor drainage accompanied with infection, bile leakage, pancreatic leakage and delayed abdominal bleeding. CONCLUSION: In IPDA, probing for important steps can be performed in early stages, surgical procedures can be optimised and operation time can be shortened. PMID:26877619

  7. Effect of aspirin on prostaglandin E2 formation and transforming growth factor alpha expression in human rectal mucosa from individuals with a history of adenomatous polyps of the colon.

    PubMed

    Barnes, C J; Hamby-Mason, R L; Hardman, W E; Cameron, I L; Speeg, K V; Lee, M

    1999-04-01

    Colorectal cancer is the second-most frequent cause of cancer mortality in the United States. Human epidemiology and laboratory studies indicate that aspirin may be an effective colorectal cancer chemopreventive agent. This study was designed to determine whether treatment with 81 mg of aspirin per day for 3 months would alter two putative surrogate end point biomarkers of chemoprevention of colorectal cancer [i.e., mucosal prostaglandin E2 (PGE2) formation and transforming growth factor alpha (TGF-alpha) expression] in normal-appearing rectal mucosa from individuals with a history of adenomatous polyps. Rectal biopsies were obtained by flexible sigmoidoscopy at three sequential time points: (a) after a 1-month placebo run-in period (baseline), (b) after 3 months of ingesting 81 mg of aspirin (as a single tablet) once per day, and (c) after 3 months of ingesting a placebo tablet once per day (washout period). Daily aspirin significantly suppressed PGE2 formation, but this significant suppression was completely reversed when aspirin was withdrawn. The extent of TGF-alpha staining in rectal crypts was also reduced significantly (P = 0.039) by daily aspirin. After a 3-month placebo-washout period, however, the mean extent of TGF-alpha staining was not significantly different from either baseline or the aspirin time point. Thus, 81 mg of aspirin daily significantly reduced rectal mucosal PGE2 formation and TGF-alpha expression in patients with a history of adenomatous polyps. These putative surrogate end point biomarkers may be useful intermediate end points in future colorectal cancer chemoprevention trials. PMID:10207634

  8. A human homologue to the yeast omnipotent suppressor 45 maps 100 kb centromeric to HLA-A

    SciTech Connect

    Chauvel, B.; Dorval, I.; Fergelot, P.

    1995-04-01

    Idipathic hemochromatosis is a common autosomal recessive inherited disorder of iron metabolism. The molecular defect is unknown. However, the gene responsible for the disease (HFE) has been localized on the short arm of chromosome 6. It is closely linked to the HLA class I genes and possibly within a 350 kilobase (kb) region around the HLA-A locus. In order to identify candidate genes for hemochromatosis, we applied a cDNA selection technique to isolate transcribed sequences encoded on yeast artificial chromosomes (YAC). At first, we screened a cDNA library derived from normal human duodenal mucosa with the YAC B30 H3. This YAC contains a 320 kb DNA insert including the HLA-A gene and spanning 150 kb of the 350 kb zone where the hemochromatosis gene is in linkage disequilibrium with restriction fragment length polymorphism (RFLP) markers. Preparation of the cDNA library of duodenal mucosa in Lambda Zap II phage and library screening with YAC B30 were carried out as previously described. In this way, we isolated seven non-HLA-A cDNAs corresponding to seven new genomic sequences. These potential genes were named hemochromatosis candidate gene (HCG) and numbered I to VII. The survey of all these cDNAs and their corresponding genomic sequences is in progress. In this work, we are especially interested in one of the seven non-HLA class I cDNA clones, named clone 58. 12 refs., 2 figs.

  9. Determination of thickness of palatal mucosa

    PubMed Central

    Kolliyavar, Bharati; Setty, Swati; Thakur, Srinath L.

    2012-01-01

    Background: The palatal masticatory mucosa is widely used as a donor material in periodontal plastic surgery. The thickness of graft tissue is an important factor for the graft survival. The purpose of this study was to determine the thickness of palatal mucosa by a bone sounding technique. The association of age and gender with the thickness of palatal mucosa was also examined. Materials and Methods: Twenty four healthy subjects had participated in the study. The younger age group of 16-30 years consisted of 12 subjects of 7 females and 5 males, and the older age group of 31-54 years consisted of 12 subjects, of 5 females and 7 males. A bone sounding method using a periodontal probe was done to assess the thickness of palatal mucosa at 15 measurement sites defined according to the gingival margin and palatal line. Mann-Whitney test was used to determine the difference in mucosal thickness between both the groups. Results: The younger age group had thinner mucosa ranged from 2 to 3.1 mm in thickness than the older age group which ranged from 3.2 to 3.7 mm. In the same age group, females had thinner mucosa than males in the same age group. The mean thickness of palatal masticatory mucosa ranged from 2.5 to 3.7 mm. Conclusion: The younger subjects had thinner mucosa than older subjects. The canine and premolar areas appeared to be the most appropriate donor site for grafting procedures. PMID:22628968

  10. Laser Treatment of Oral Mucosa Tattoo

    PubMed Central

    Gojkov-Vukelic, Mirjana; Hadzic, Sanja; Pasic, Enes

    2011-01-01

    The most common oral solitary pigmented lesion is the dental amalgam tattoo. It occurs as a result of colouring of the tissue by alien pigment which was administered intra or subepidermaly either intentionally or accidentally. The most common material used for the colouring of the oral mucosa is amalgam from amalgam fillings and metal particles from prosthetic restorations which are absorbed accidentally. The oral mucosa tattoos are most often found in the area of the marginal gingiva or the buccal mucosa. The metal particles may accidentally reach the area of the oral mucosa during various dentistry interventions. The therapy most often involves surgical intervention with excisional biopsy while in the recent period the low power laser therapy has provided exceptional results. The aim of the paper was to present the successful removal of the oral mucosa tattoo in a single visit. PMID:23408182

  11. Integrating-Sphere Measurements for Determining Optical Properties of Tissue-Engineered Oral Mucosa

    NASA Astrophysics Data System (ADS)

    Ionescu, A. M.; Cardona, J. C.; Garzn, I.; Oliveira, A. C.; Ghinea, R.; Alaminos, M.; Prez, M. M.

    2015-02-01

    Surgical procedures carried out in the oral and maxillofacial region can result in large tissue defects. Accounting for the shortage of oral mucosa to replace the excised tissues, different models of an organotypic substitute of the oral mucosa generated by tissue engineering have recently been proposed. In this work, the propagation of light radiation through artificial human oral mucosa substitutes based on fibrin-agarose scaffolds (fibrin, fibrin-0.1% agarose, fibrin-0.2%agarose) is investigated, and their optical properties are determined using the inverse adding-doubling (IAD) method based on integrating-sphere measurements. Similar values for the absorption and scattering coefficients between the fibrin and fibrin-0.1% agarose bioengineered tissues and the native oral mucosa were found. These results suggest the adequacy of these biomaterials for potential clinical use in human oral mucosa applications. These optical properties represent useful references and data for applications requiring the knowledge of the light transport through this type of tissues, applications used in clinical practice. It also provides a new method of information analysis for the quality control of the development of the artificial nanostructured oral mucosa substitutes and its comparison with native oral mucosa tissues.

  12. microRNA profiles in coeliac patients distinguish different clinical phenotypes and are modulated by gliadin peptides in primary duodenal fibroblasts.

    PubMed

    Vaira, Valentina; Roncoroni, Leda; Barisani, Donatella; Gaudioso, Gabriella; Bosari, Silvano; Bulfamante, Gaetano; Doneda, Luisa; Conte, Dario; Tomba, Carolina; Bardella, Maria Teresa; Ferrero, Stefano; Locatelli, Martina; Elli, Luca

    2014-03-01

    CD (coeliac disease) is a frequent autoimmune disorder of the small bowel, which is characterized by an immunological reaction against gluten and transglutaminase in genetically predisposed subjects. However, the molecular determinants underpinning CD pathogenesis are yet to be fully elucidated and little data are available about the involvement of miRNAs (microRNAs) in CD. In the present study, the duodenal mucosa miRNA expression was profiled in adult untreated CD presenting with a classic phenotype or iron-deficiency anaemia, treated patients with or without duodenal normalization, and non-CD subjects as controls. Deregulation of seven miRNAs (miR-31-5p, miR-192-3p, miR-194-5p, miR-551a, miR-551b-5p, miR-638 and miR-1290) was determined in a larger series of CD patients with different clinical phenotypes compared with non-CD subjects. These seven microRNAs were then analysed in duodenal fibroblasts obtained from CD patients and incubated with gliadin peptides (13- and 33-mer). The miRNA cluster miR-192/194, involved in matrix remodelling, was deregulated in CD according to the different clinical presentations, and miR-192-3p levels were modulated by gliadin peptides in vitro. In conclusion, the analysis of miRNAs deserves further consideration for its potential use in the treatment and management of CD. PMID:24063611

  13. Duodenal metastasis from lung adenocarcinoma: A rare cause of melena

    PubMed Central

    AlSaeed, Eyad Fawzi; Tunio, Mutahir A.; AlSayari, Khalid; AlDandan, Sadiq; Riaz, Khalid

    2015-01-01

    Introduction We report a rare case of duodenal metastasis from primary lung adenocarcinoma presented with history of melena and weight loss. Presentation of case A 52-year-old smoker man presented with six months history of epigastric pain, melena and weight loss. Esophago-gastroduodenoscopy revealed a 10mm ulcerative lesion in the fourth part of duodenum. Histopathology of resected lesion showed poorly differentiated adenocarcinoma. Tumor cells showed immunopositivity for cytokeratin-7 (CK7), thyroid transcription factor 1 (TTF-1), and immunonegativity for CK20, Villin, CDX2 and thyroglobulin, supporting the diagnosis of metastatic adenocarcinoma of the lung origin. Computed tomography (CT) of chest revealed left hilar mass encasing the main pulmonary artery associated with ipsilateral hilar and contralateral mediastinal lymphadenopathy. Bronchoscopy assisted biopsy of lung mass confirmed the diagnosis of primary adenocarcinoma. Patient was staged as T4N3M1. After the resection of duodenal metastasis followed by three cycles of cisplatinum based chemotherapy with Bevacizumab, melena resolved completely. Discussion Duodenal metastases from lung adenocarcinoma are extremely uncommon, and rarely produce symptoms. Most of cases require duodenectomy or pancreatico-duodenectomy for symptomatic relief. For smaller duodenal metastatic lesions (?1cm) endoscopic resection is a feasible therapeutic option. Conclusion Although rare, duodenal metastasis from lung adenocarcinoma should also be included in the differential diagnosis of melena. Smaller lesions (?1cm) can safely be managed with endoscopic resection. PMID:26177377

  14. Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter

    SciTech Connect

    Oh, Jung Suk Lee, Hae Giu Chun, Ho Jong; Choi, Byung Gil; Lee, Sang Hoon; Hahn, Seong Tai; Ohm, Joon Young

    2013-10-15

    Purpose: This study was designed to evaluate retrospectively the safety and efficacy of the percutaneous management of duodenal stump leakage with a Foley catheter after subtotal gastrectomy. Methods: Ten consecutive patients (M:F = 9:1, median age: 64 years) were included in this retrospective study. The duodenal stump leakages were diagnosed in all the patients within a median of 10 days (range, 6-20). At first, the patients underwent percutaneous drainage on the day of or the day after confirmation of the presence of duodenal stump leakage, and then the Foley catheters were replaced at a median of 9 days (range, 6-38) after the percutaneous drainage. Results: Foley catheters were placed successfully in the duodenal lumen of all the patients under a fluoroscopic guide. No complication was observed during and after the procedures in all the patients. All of the patients started a regular diet 1 day after the Foley catheter placement. The patients were discharged at a median of 7 days (range, 5-14) after the Foley catheter placement. The catheters were removed in an outpatient clinic 10-58 days (median, 28) after the Foley catheter placement. Conclusions: Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites.

  15. Upper gastrointestinal barium evaluation of duodenal pathology: A pictorial review

    PubMed Central

    Gupta, Pankaj; Debi, Uma; Sinha, Saroj Kant; Prasad, Kaushal Kishor

    2014-01-01

    Like other parts of the gastrointestinal tract (GIT), duodenum is subject to a variety of lesions both congenital and acquired. However, unlike other parts of the GIT viz. esophagus, rest of the small intestine and large intestine, barium evaluation of duodenal lesions is technically more challenging and hence not frequently reported. With significant advances in computed tomography technology, a thorough evaluation including intraluminal, mural and extramural is feasible in a single non-invasive examination. Notwithstanding, barium evaluation still remains the initial and sometimes the only imaging study in several parts of the world. Hence, a thorough acquaintance with the morphology of various duodenal lesions on upper gastrointestinal barium examination is essential in guiding further evaluation. We reviewed our experience with various common and uncommon barium findings in duodenal abnormalities. PMID:25170399

  16. Duodenal varices successfully treated with cyanoacrylate injection therapy

    PubMed Central

    Malik, Ahsan; Junglee, Naushad; Khan, Anwar; Sutton, Jonathon; Gasem, Jaber; Ahmed, Waqar

    2011-01-01

    Duodenal varices are a rare complication of portal hypertension secondary to liver cirrhosis. Compared to oesophageal varices, they bleed less often but are also more difficult to diagnose and treat. There is no established treatment for bleeding duodenal varices and different treatment strategies have been employed with variable results. The authors present a case of 52-year-old male who was admitted with melaena. Upper gastrointestinal endoscopy was performed which identified bleeding varices in the second part of duodenum. The varices were injected with cyanoacrylate and the outcome was favourable. Subsequent endoscopies showed complete resolution of the varices. The authors conclude that cyanoacrylate injection is an effective first-line treatment for bleeding duodenal varices. PMID:22694885

  17. Isolated duodenal varices as the initial presentation of hepatocellular carcinoma

    PubMed Central

    Okoli, Amara; Raymond, Pascale; Ammannagari, Nischala; Merrell, Nancy

    2013-01-01

    Duodenal varices are an uncommon, life-threatening cause of acute gastrointestinal (GI) bleeding commonly caused by portal hypertension. Though generally regarded as a complication of advanced cirrhosis and portal hypertension, often overlooked is that in about 2.7% of cases, it can be the first presenting symptom of advanced hepatocellular carcinoma (HCC). We report a case of an isolated, duodenal variceal bleeding as the first clinical manifestation of HCC, complicated by portal venous thrombosis. Diagnosis of HCC was established by a markedly elevated ?-fetoprotein, hepatitis B surface and core antibody positivity and consistent radiological findings. Although not the first choice, variceal bleeding was successfully arrested with endoclips. The patient thereafter declined further evaluation and unsurprisingly died within a few weeks from a massive GI bleed. An initial bleed from a duodenal varix often confers a poor prognosis. Patients with HCC who present with variceal bleeding reportedly have a median survival of 71?days. PMID:24347452

  18. Duodenal adenocarcinoma: Advances in diagnosis and surgical management.

    PubMed

    Cloyd, Jordan M; George, Elizabeth; Visser, Brendan C

    2016-03-27

    Duodenal adenocarcinoma is a rare but aggressive malignancy. Given its rarity, previous studies have traditionally combined duodenal adenocarcinoma (DA) with either other periampullary cancers or small bowel adenocarcinomas, limiting the available data to guide treatment decisions. Nevertheless, management primarily involves complete surgical resection when technically feasible. Surgery may require pancreaticoduodenectomy or segmental duodenal resection; either are acceptable options as long as negative margins are achievable and an adequate lymphadenectomy can be performed. Adjuvant chemotherapy and radiation are important components of multi-modality treatment for patients at high risk of recurrence. Further research would benefit from multi-institutional trials that do not combine DA with other periampullary or small bowel malignancies. The purpose of this article is to perform a comprehensive review of DA with special focus on the surgical management and principles. PMID:27022448

  19. A Rare Cause of Acute Pancreatitis: Intramural Duodenal Hematoma

    PubMed Central

    Goyal, Hemant; Singla, Umesh; Agrawal, Roli R.

    2012-01-01

    We describe an interesting case of intramural duodenal hematoma in an otherwise healthy male who presented to emergency room with gradually progressive abdominal pain, nausea, and vomiting. This condition was missed on initial evaluation and patient was discharged from emergency room with diagnosis of acute gastritis. After 3 days, patient came back to emergency room and abdominal imaging studies were conducted which showed that patient had intramural duodenal hematoma associated with gastric outlet obstruction and pancreatitis. Hematoma was the cause of acute pancreatitis as pancreatic enzymes levels were normal at the time of first presentation, but later as the hematoma grew in size, it caused compression of pancreas and subsequent elevation of pancreatic enzymes. We experienced a case of pancreatitis which was caused by intramural duodenal hematoma. This case was missed on initial evaluation. We suggest that physicians should be more vigilant about this condition. PMID:23091743

  20. [Duodenal metastatic leiomyosarcoma of the uterus. A case report].

    PubMed

    M'sakni, I; Bouraoui, S; Ben slama, S; Lahmar-boufaroua, A; Goutallier ben fadhel, C; Ben sassi, L; Arfa, N; Khalfallah, M T; Mzabi-regaya, S

    2005-10-01

    The digestive metastases of uterine leiomyosarcoma are rare. We report a case of a duodenal tumor detected in a 50 year-old woman, 3 years after she underwent a total hysterectomy for uterine leiomyosarcoma. The stenosing duodenal mass was thought to be a mesenchymal tumor. A pancreaticoduodenectomy was performed. The resected lesion was morphologically similar to the uterine leiomyosarcoma. In fact, the histopathological study confirmed a submucosal tumor with typical features of the uterine leiomyosarcoma. Immunohistochemistry was performed and it showed negative CD117 and CD 34. Markers displayed positivity for actin smooth muscle and desmin. Considering the patient history and the immunohistochemical observations, we diagnosed a duodenal metastasis of uterine leiomysarcoma. Through this exceptional observation we want to emphasize the epidemiological and the pathological features of the metastatic uterine leiomyosarcoma. We will also point out the progress of tumoral cells and the histopathological distinctive criteria with a primitive digestive mesenchymal tumor. PMID:16202885

  1. [Radiologic aspects of the complications of duodenal diverticula].

    PubMed

    Oddo, F; Chevallier, P; Souci, J; Baque, J; Buckley, M J; Fabiani, P; Diaine, B; Coussement, A

    1999-02-01

    The duodenum is the second most common site, after the colon, for intestinal diverticulae. This condition is most often asymptomatic and is usually an accidental finding. Complications, with variable clinical presentations, may occur in up to 5% of such individuals. We report a retrospective analysis of 5 patients who presented with complicated duodenal diverticular disease. The complications, either isolated or multiple, consisted of bezoar formation (n = 2), diverticulitis (n = 2), extrinsic compression of the common bile duct (n = 3), perforation (n = 1), choledocholithiasis (n = 1), and an abnormality of the bilio-pancreatic ductal convergence (n = 1). The radiological aspects, in particular, the magnetic resonance imaging (MRI) features are reviewed. These are, to our knowledge, the first descriptions of MRI and magnetic resonance cholangiopancreatographic (MRCP) findings in complicated duodenal diverticular disease. MRI facilitates precise delineation of the complicated duodenal diverticulum while MRCP allows assessment of the effects on the biliary and pancreatic ducts. PMID:10209709

  2. Duodenal adenocarcinoma: Advances in diagnosis and surgical management

    PubMed Central

    Cloyd, Jordan M; George, Elizabeth; Visser, Brendan C

    2016-01-01

    Duodenal adenocarcinoma is a rare but aggressive malignancy. Given its rarity, previous studies have traditionally combined duodenal adenocarcinoma (DA) with either other periampullary cancers or small bowel adenocarcinomas, limiting the available data to guide treatment decisions. Nevertheless, management primarily involves complete surgical resection when technically feasible. Surgery may require pancreaticoduodenectomy or segmental duodenal resection; either are acceptable options as long as negative margins are achievable and an adequate lymphadenectomy can be performed. Adjuvant chemotherapy and radiation are important components of multi-modality treatment for patients at high risk of recurrence. Further research would benefit from multi-institutional trials that do not combine DA with other periampullary or small bowel malignancies. The purpose of this article is to perform a comprehensive review of DA with special focus on the surgical management and principles.

  3. Spiral bacteria in the human stomach: the gastric helicobacters.

    PubMed Central

    Dubois, A.

    1995-01-01

    During the past decade, Helicobacter pylori has become recognized as one of the most common human pathogens, colonizing the gastric mucosa of almost all persons exposed to poor hygienic conditions from childhood. It also is often found, albeit with a lower frequency, in groups of high socioeconomic status. H. pylori causes chronic active gastritis and is a major factor in the pathogenesis of duodenal ulcers and, to a lesser extent, gastric ulcers. In addition, the presence of this bacterium is now recognized as a risk factor for gastric adenocarcinoma and lymphoma. Nevertheless, most infections appear without clinical consequences. In this second decade of intensive research, it is important to understand why H. pylori is sometimes a dangerous pathogen, and to determine how it can be eradicated in those at highest risk for severe disease. PMID:8903168

  4. Intestinal mucosa in nephropathic cystinosis.

    PubMed

    Iancu, T C; Lerner, A; Shiloh, H

    1987-01-01

    The major manifestations of nephropathic cystinosis are renal tubular acidosis, vitamin D-resistant rickets, and dwarfism. Cystine crystals are deposited in a variety of cells, mainly phagocytic, including macrophages of the intestinal lamina propria. Previously, ultrastructural changes were suggested to occur in the absorptive epithelium as well, possibly as a result of local cystine toxicity. We report here on the light- and electron-microscopic findings in the jejunal mucosa of two patients, aged 4 and 9 years with nephropathic cystinosis. Cystine crystals were easily identified in semithin sections of plastic-embedded specimens as brick- and hexagon-shaped spaces in macrophages. Electron microscopy showed that all crystals were in single-membrane-limited bodies (lysosomes), within phagocytic cells, and exclusively located in the lamina propria. In contrast to previous findings, the absorptive epithelium showed no abnormalities. We conclude that the growth failure in cystinosis is not a consequence of morphological toxic alterations in the intestinal epithelium, but is related to the known metabolic abnormalities of this condition. The use of rectal suction biopsy as a means of diagnosing cystinosis is also suggested as an alternative to other diagnostic methods. PMID:3430244

  5. Precancerous lesions of oral mucosa.

    PubMed

    Yardimci, Gurkan; Kutlubay, Zekayi; Engin, Burhan; Tuzun, Yalcin

    2014-12-16

    Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, are consists of a group of diseases, which should be diagnosed in the early stage. Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate. Oral lichen planus is one of the potentially malignant disorders that may be seen in six different subtypes including papular, reticular, plaque-like, atrophic, erosive, and bullous type, clinically. Atrophic and erosive subtypes have the greater increased malignant transformation risk compared to another subtypes. Although there are various etiological studies, the etiology of almost all these diseases is not fully understood. Geographically, etiologic factors may vary. The most frequently reported possible factors are tobacco use, alcohol drinking, chewing of betel quid containing areca nut, and solar rays. Early diagnosis is very important and can be lifesaving, because in late stages, they may be progressed to severe dysplasia and even carcinoma in situ and/or squamous cell carcinoma. For most diseases, treatment results are not satisfactory in spite of miscellaneous therapies. While at the forefront of surgical intervention, topical and systemic treatment alternatives such as corticosteroids, calcineurin inhibitors, and retinoids are widely used. PMID:25516862

  6. Precancerous lesions of oral mucosa

    PubMed Central

    Yardimci, Gurkan; Kutlubay, Zekayi; Engin, Burhan; Tuzun, Yalcin

    2014-01-01

    Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, are consists of a group of diseases, which should be diagnosed in the early stage. Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate. Oral lichen planus is one of the potentially malignant disorders that may be seen in six different subtypes including papular, reticular, plaque-like, atrophic, erosive, and bullous type, clinically. Atrophic and erosive subtypes have the greater increased malignant transformation risk compared to another subtypes. Although there are various etiological studies, the etiology of almost all these diseases is not fully understood. Geographically, etiologic factors may vary. The most frequently reported possible factors are tobacco use, alcohol drinking, chewing of betel quid containing areca nut, and solar rays. Early diagnosis is very important and can be lifesaving, because in late stages, they may be progressed to severe dysplasia and even carcinoma in situ and/or squamous cell carcinoma. For most diseases, treatment results are not satisfactory in spite of miscellaneous therapies. While at the forefront of surgical intervention, topical and systemic treatment alternatives such as corticosteroids, calcineurin inhibitors, and retinoids are widely used. PMID:25516862

  7. Duodenal intussusception secondary to web presenting as recurrent pancreatitis in a 7-year-old girl.

    PubMed

    Tu, Long H; Villalona, Gustavo A; Cowles, Robert A; Silva, Cicero T

    2016-03-01

    Duodenal intussusception is a rare entity in children, with 32 cases reported in the English literature to our knowledge. Most reported cases are associated with endoluminal tubes or polyps, and the presenting symptoms are chronic and nonspecific. We report a case of duodenal intussusception in a 7-year-old girl secondary to a duodenal web and review the imaging findings. PMID:26553449

  8. [Heterotopic gastric mucosa of the gastrointestinal tract].

    PubMed

    Schmidt, G; Brsch, G; Wegener, M

    1985-10-01

    Islets of heterotopic gastric mucosa can occur in the whole alimentary tract as well as in the gallbladder, the extrahepatic bile ducts and the pancreatic tissue. In most cases they have incidentally been discovered in autopsies and surgical specimens. Ectopic gastric mucosa is known to cause gastrointestinal bleeding in Meckel's diverticulum and duplications of the intestine, and, in exceptional cases may show a malignant transformation. In endoscopy of the gastrointestinal tract ectopic gastric epithelium can often be conjectured from certain morphological phenomena. In this paper we review pathogenesis, localization, clinical significance as well as diagnostic and therapeutic aspects of heterotopic gastric mucosa. PMID:4082686

  9. MRI Findings of Intrinsic and Extrinsic Duodenal Abnormalities and Variations.

    PubMed

    Dusunceli Atman, Ebru; Erden, Ayse; Ustuner, Evren; Uzun, Caglar; Bektas, Mehmet

    2015-01-01

    This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma. MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery. PMID:26576112

  10. Isolated perforation of a duodenal diverticulum following blunt abdominal trauma.

    PubMed

    Metcalfe, Matthew J; Rashid, Tanwir G; Bird, Richard le R

    2010-01-01

    Only 10% of duodenal diverticula are symptomatic. We present the case of a man who fell from a height of 6 ft, landing on his abdomen and presenting 4 h later with severe back pain and a rigid abdomen. At laparotomy, a perforated retroperitoneal duodenal diverticulum was found and repaired with an omental patch. No other injury was noted. Not only is this perforation unusual, but the absence of other injuries sustained during this minor blunt trauma makes this case unique. This case highlights the need for a high index of suspicion when managing patients with back or abdominal pain following minor trauma. PMID:20165728

  11. A Lethal Complication of Endoscopic Therapy: Duodenal Intramural Hematoma

    PubMed Central

    Calhan, Turan; Kahraman, Resul; Soyda?, Bar??; Tosun, Ali; Cebeci, Egemen

    2015-01-01

    Duodenal intramural hematoma (DIH) usually occurs in childhood and young adults following blunt abdominal trauma. It may also develop in the presence of coagulation disorders and may rarely be an iatrogenic outcome of endoscopic procedures. Management of DIH is usually a conservative approach. A case of intramural duodenal hematoma that developed following endoscopic epinephrine sclerotherapy and/or argon plasma coagulation and that was nonresponsive to conservative therapy in a patient with chronic renal failure who died from sepsis is being discussed in this report. Clinicians should be aware of such possible complications after endoscopic hemostasis in patients with coagulation disorders. PMID:26697240

  12. MRI Findings of Intrinsic and Extrinsic Duodenal Abnormalities and Variations

    PubMed Central

    Erden, Ayse; Ustuner, Evren; Uzun, Caglar; Bektas, Mehmet

    2015-01-01

    This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma. MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery. PMID:26576112

  13. Gastric and duodenal antiulcer and cytoprotective effects of proglumide in rats

    SciTech Connect

    Tariq, M.; Parmar, N.S.; Ageel, A.M.

    1987-05-01

    Proglumide has been studied for its ability to inhibit gastric secretion and to protect the gastroduodenal mucosa against the injuries caused by pyloric ligation, hypothermic restraint stress, acetic acid, nonsteroid anti-inflammatory drugs, reserpine, cysteamine and the cytodestructing agents: 80% ethanol, 0.6 M HCl, 0.2 M NaOH, 25% NaCl and 30 mg of acetylsalicylic acid in 0.35 M HCl in rats. The results of this study demonstrate that proglumide has both prophylactic and curative effects on various experimentally induced ulcers. It produced a dose-dependent inhibition of gastric secretion in the pylorus-ligated rats and reduced significantly the intensity of gastric lesions induced by pyloric ligation, hypothermic restraint stress, acetic acid, mucosal damaging agents and that of duodenal ulcers induced by cysteamine. The intensity of gastric lesions induced by nonsteroid anti-inflammatory drugs and reserpine was also reduced significantly by proglumide. Cimetidine, which was used as a standard antiulcer drug for comparison, also produced a similar protective effect in most of the models used by us. It was found to have a more potent antisecretory effect but failed to protect the rats against the gastric mucosal damage induced by hyperthermic restraint stress and 0.2 M NaOH. Our findings suggest that proglumide exerts these antiulcer effects by its antisecretory, gastric mucosal resistance increasing and cytoprotective activities. Further studies are required to find out its exact mechanism of action and therapeutic usefulness.

  14. Cimetidine decreases indomethacin induced duodenal mucosal damage in patients with acute musculoskeletal disorders.

    PubMed

    Stalnikowicz, R; Pollak, D; Eliakim, A; Wengrower, D; Fich, A; Goldin, E; Ligumsky, M; Rachmilewitz, D

    1988-11-01

    The effect of two doses of cimetidine, 400 mg at night and 400 mg bd, on the protection of indomethacin (50 mg tid) induced mucosal damage was evaluated in a double blind study in patients with acute musculoskeletal disorders. Endoscopic mucosal lesions were scored before and after five to seven days of treatment. One hundred and ninety one patients were endoscoped before the trial, 34 (17.8%) had greater than one erosion and were not recruited. Forty patients were excluded for non-compliance, or lost to follow up. At the second endoscopy, oesophageal, and fundic damage was negligible. Gastric and duodenal lesion score in patients treated with cimetidine 400 mg bd: 2.7 (0.5) (SE); n = 42) was significantly lower (p less than 0.0122) than in placebo treated patients: 6.1 (0.9) (n = 50) or in patients treated with cimetidine 400 mg at night 7.1 (0.8) (n = 21). Cimetidine 400 mg bd provided significant protection for the duodenum, but its protection of antral mucosa did not reach statistical significance. There was no correlation between upper gastrointestinal symptoms and endoscopic findings. PMID:3061885

  15. Endoscopic appearance of irradiated gastric mucosa.

    PubMed

    De Sagher, L I; Van den Heule, B; Van Houtte, P; Engelholm, L; Balikdjan, D; Bleiberg, H

    1979-09-01

    Irradiation of the epigastric area for gastric cancer may induce actinic lesions of the stomach characterized on endoscopic examination by ulcerations, haemorrhagic gastritis, fragility of the mucosa, thickening and congestion of the gastric folds. PMID:488012

  16. A duodenal gastrointestinal stromal tumor with a large central area of fluid and gas due to fistulization into the duodenal lumen, mimicking a large duodenal diverticulum.

    PubMed

    Okasha, Hussein Hassan; Amin, Hoda Mahmoud; Al-Shazli, Mostafa; Nabil, Ahmed; Hussein, Hossam; Ezzat, Reem

    2015-01-01

    Gastrointestinal stromal tumors (GISTs) can occur anywhere along the gastrointestinal tract especially the stomach and upper small bowel. They are usually solid, but cystic degeneration, necrosis, and focal hemorrhage have been described in larger tumors leading to central necrotic cavitation. The most sensitive marker of GIST is CD117 (c-kit). In computed tomography (CT) scan, it is often difficult to decide the origin of the primary tumor, especially in large GISTs. We report an incidental case of a large duodenal GIST fistulizing into the second part of the duodenum with a large amount of fluid and gas inside, mistaken for a cystic pancreatic neoplasm by CT and mistaken for a duodenal diverticulum by endoscopic ultrasound. PMID:26374586

  17. Amylase polymorphism: studies of sera and duodenal aspirates in normal individuals and in cystic fibrosis.

    PubMed Central

    Townes, P L; Moore, W D; White, M R

    1976-01-01

    Prior genetic studies of the human pancreatic amylase (Amy2) locus have been directed principally to the electrophoretic analysis of serum and urine, on the assumption that these fluids receive negligible contributions from the salivary (Amy 1) locus. In support of that assumption was the observation that the isozyme bands were lacking in patients with cystic fibrosis and in a postpancreatectomy patient. We have examined the sera of 97 patients having cystic fibrosis and find normal levels of serum amylase. On electrophoresis, three-quarters of the cystic fibrosis patients have a pattern (F-pattern) not observed in normal sera. The pattern is characterized by the absence of Pa 1. Comparative electrophoresis and mixing experiments indicate that the F-pattern is of salivary origin and is unmasked in cystic fibrosis by the absence of a pancreatic contribution. The normal serum pattern is considered to be an admixture of salivary and pancreatic amylase. On the assumption that duodenal fluids might more closely reflect the pancreatic (Amy 2) locus, electrophoretic studies were performed on 148 normal individuals and 37 individuals with cystic fibrosis. Electrophoretic phenotypes in duodenal aspirates are more complex than previously reported in studies of urine and serum; presumably because of the higher concentrations of amylase in the aspirates. Comparative electrophoresis and mixing experiments indicate that the phenotypes observed in duodenal aspirates also reflect admixture of pancreatic and salivary amylase. This recognition of pancreatic and salivary admixture in sera fortunately does not alter our prior understanding of the genetics of the Amy 2 polymorphism. The extensive studies which led to the delineation of the Amy 2 polymorphism were essentially based on the presence or absence of a variant band which proves now to be outside the zone of admixture. Images Fig. 1 Fig. 3 PMID:941905

  18. Delayed perforation of a duodenal diverticulum by a biliary endoprosthesis.

    PubMed

    Elder, J; Stevenson, G

    1993-02-01

    A 73-year-old woman with cholangitis due to stricture of the bile duct and the presence of stones was treated by the placement of a biliary endoprosthesis. However, 8 weeks later the lower end of the stent had retracted into a duodenal diverticulum and penetrated its inferior wall. The patient was readmitted to hospital for treatment of a retroperitoneal abscess. PMID:8425156

  19. DUODENAL CYTOCHROME B: A NOVEL FERRIREDUCTASE IN AIRWAY EPITHELIAL CELLS

    EPA Science Inventory

    Catalytically active iron in the lung causes oxidative stress and promotes microbial growth that can be limited by intracellular sequestration of iron within ferritin. Because cellular iron uptake requires membrane ferrireductase activity that in the gut can be provided by duoden...

  20. Congenital duodenal web: successful management with endoscopic dilatation

    PubMed Central

    Poddar, Ujjal; Jain, Vikas; Yachha, Surender Kumar; Srivastava, Anshu

    2016-01-01

    Background and study aims: Congenital duodenal web (CDW) is an uncommon cause of duodenal obstruction and endoscopic balloon dilatation has been reported in just eight pediatric cases to date. Here we are reporting three cases of CDW managed successfully with balloon dilatation. Cases and methods: In 2014 we diagnosed three cases of CDW on the basis of typical radiological and endoscopic findings. Endoscopic balloon dilatation was done under conscious sedation with a through-the-scope controlled radial expansion (CRE) balloon. Results: All three children presented late (median age 8 [range 2 – 9] years) with bilious vomiting, upper abdominal distension, and failure to thrive. One of them had associated Down syndrome and another had horseshoe kidney. In all cases, CDW was observed in the second part of the duodenum beyond the ampulla, causing partial duodenal obstruction. After repeated endoscopic dilatation (2 – 4 sessions), all three patients became asymptomatic. None of the patients experienced complications after balloon dilatation. Conclusions: Duodenal diaphragm should be suspected in patients with abdominal distension with bilious vomiting, even in relatively older children. Endoscopic balloon dilatation is a simple and effective method of treating this condition. PMID:27004237

  1. Nonampullary duodenal adenoma: Current understanding of its diagnosis, pathogenesis, and clinical management.

    PubMed

    Lim, Chul-Hyun; Cho, Young-Seok

    2016-01-14

    Nonampullary duodenal adenomas are relatively common in familial adenomatous polyposis (FAP), but nonampullary sporadic duodenal adenomas (SDAs) are rare. Emerging evidence shows that duodenal adenomas, regardless of their anatomic location and whether they are sporadic or FAP-related, share morphologic and molecular features with colorectal adenomas. The available data suggest that duodenal adenomas develop to duodenal adenocarcinomas via similar mechanisms. The optimal approach for management of duodenal adenomas remains to be determined. The techniques for endoscopic resection of duodenal adenoma include snare polypectomy, endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and argon plasma coagulation ablation. EMR may facilitate removal of large duodenal polyps. Although several studies have reported cases of successful ESD for duodenal adenomas, the procedure is technically difficult to perform safely because of the anatomical properties of the duodenum. Although current clinical practice recommends endoscopic resection of all large duodenal adenomas in patients with FAP, endoscopic treatment is usually insufficient to guarantee a polyp-free duodenum. Surgery is indicated for FAP patients with severe polyposis or nonampullary SDAs or FAP-related polyps not amenable to endoscopic resection. Further studies are needed to develop newer endoscopic techniques to guide diagnostic and therapeutic decisions for future management of nonampullary duodenal adenomas. PMID:26811631

  2. Nonampullary duodenal adenoma: Current understanding of its diagnosis, pathogenesis, and clinical management

    PubMed Central

    Lim, Chul-Hyun; Cho, Young-Seok

    2016-01-01

    Nonampullary duodenal adenomas are relatively common in familial adenomatous polyposis (FAP), but nonampullary sporadic duodenal adenomas (SDAs) are rare. Emerging evidence shows that duodenal adenomas, regardless of their anatomic location and whether they are sporadic or FAP-related, share morphologic and molecular features with colorectal adenomas. The available data suggest that duodenal adenomas develop to duodenal adenocarcinomas via similar mechanisms. The optimal approach for management of duodenal adenomas remains to be determined. The techniques for endoscopic resection of duodenal adenoma include snare polypectomy, endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and argon plasma coagulation ablation. EMR may facilitate removal of large duodenal polyps. Although several studies have reported cases of successful ESD for duodenal adenomas, the procedure is technically difficult to perform safely because of the anatomical properties of the duodenum. Although current clinical practice recommends endoscopic resection of all large duodenal adenomas in patients with FAP, endoscopic treatment is usually insufficient to guarantee a polyp-free duodenum. Surgery is indicated for FAP patients with severe polyposis or nonampullary SDAs or FAP-related polyps not amenable to endoscopic resection. Further studies are needed to develop newer endoscopic techniques to guide diagnostic and therapeutic decisions for future management of nonampullary duodenal adenomas. PMID:26811631

  3. Duodenal Toxicity After Fractionated Chemoradiation for Unresectable Pancreatic Cancer

    SciTech Connect

    Kelly, Patrick; Das, Prajnan; Pinnix, Chelsea C.; Beddar, Sam; Briere, Tina; Pham, Mary; Krishnan, Sunil; Delclos, Marc E.; Crane, Christopher H.

    2013-03-01

    Purpose: Improving local control is critical to improving survival and quality of life for patients with locally advanced unresectable pancreatic cancer (LAPC). However, previous attempts at radiation dose escalation have been limited by duodenal toxicity. In order to guide future studies, we analyzed the clinical and dosimetric factors associated with duodenal toxicity in patients undergoing fractionated chemoradiation for LAPC. Methods and Materials: Medical records and treatment plans of 106 patients with LAPC who were treated with chemoradiation between July 2005 and June 2010 at our institution were reviewed. All patients received neoadjuvant and concurrent chemotherapy. Seventy-eight patients were treated with conventional radiation to 50.4 Gy in 28 fractions; 28 patients received dose-escalated radiation therapy (range, 57.5-75.4 Gy in 28-39 fractions). Treatment-related toxicity was graded according to Common Terminology Criteria for Adverse Events, version 4.0. Univariate and multivariate analyses were performed to assess prognostic influence of clinical, pathologic, and treatment-related factors by using Kaplan-Meier and Cox regression methods. Results: Twenty patients had treatment-related duodenal toxicity events, such as duodenal inflammation, ulceration, and bleeding. Four patients had grade 1 events, 8 had grade 2, 6 had grade 3, 1 had grade 4, and 1 had grade 5. On univariate analysis, a toxicity grade ≥2 was associated with tumor location, low platelet count, an absolute volume (cm{sup 3}) receiving a dose of at least 55 Gy (V{sub 55} {sub Gy} > 1 cm{sup 3}), and a maximum point dose >60 Gy. Of these factors, only V{sub 55} {sub Gy} ≥1 cm{sup 3} was associated with duodenal toxicity on multivariate analysis (hazard ratio, 6.7; range, 2.0-18.8; P=.002). Conclusions: This study demonstrates that a duodenal V{sub 55} {sub Gy} >1 cm{sup 3} is an important dosimetric predictor of grade 2 or greater duodenal toxicity and establishes it as a dosimetric constraint when treating patients with unresectable pancreatic cancer with concurrent chemoradiation.

  4. Nested PCR for detection of HSV-1 in oral mucosa

    PubMed Central

    Jalouli, Miranda-Masoumeh; Jalouli, Jamshid; Hassus, Bengt; hman, Jenny; Hirsch, Jan-Michal

    2015-01-01

    Background It has been estimated that 15%-20% of human tumours are driven by infection and inflammation, and viral infections play an important role in malignant transformation. The evidence that herpes simplex virus type 1 (HSV-1) could be involved in the aetiology of oral cancer varies from weak to persuasive. This study aimed to investigate by nested PCR (NPCR) the prevalence of HSV-1 in samples from normal oral mucosa, oral leukoplakia, and oral squamous cell carcinoma (OSCC). Material and Methods We investigated the prevalence of HSV-1 in biopsies obtained from 26 fresh, normal oral mucosa from healthy volunteers as well as 53 oral leukoplakia and 27 OSCC paraffin-embedded samples. DNA was extracted from the specimens and investigated for the presence of HSV-1 by nested polymerase chain reaction (NPCR) and DNA sequencing. Results HSV-1 was detected in 14 (54%) of the healthy samples, in 19 (36%) of the oral leukoplakia samples, and in 14 (52%) of the OSCC samples. The differences were not statistically significant. Conclusions We observed a high incidence of HSV-1 in healthy oral mucosa, oral leukoplakia, and OSCC tissues. Thus, no connection between OSCC development and presence of HSV-1 was detected. Key words:HSV-1, nested PCR, PCR. PMID:26449432

  5. Evaluation of Microbial Load in Oropharyngeal Mucosa from Tannery Workers

    PubMed Central

    Castellanos-Arvalo, Diana C.; Castellanos-Arvalo, Andrea P.; Camarena-Pozos, David A.; Colli-Mull, Juan G.; Maldonado-Vega, Mara

    2014-01-01

    Background Animal skin provides an ideal medium for the propagation of microorganisms and it is used like raw material in the tannery and footware industry. The aim of this study was to evaluate and identify the microbial load in oropharyngeal mucosa of tannery employees. Methods The health risk was estimated based on the identification of microorganisms found in the oropharyngeal mucosa samples. The study was conducted in a tanners group and a control group. Samples were taken from oropharyngeal mucosa and inoculated on plates with selective medium. In the samples, bacteria were identified by 16S ribosomal DNA analysis and the yeasts through a presumptive method. In addition, the sensitivity of these microorganisms to antibiotics/antifungals was evaluated. Results The identified bacteria belonged to the families Enterobacteriaceae, Pseudomonadaceae, Neisseriaceae, Alcaligenaceae, Moraxellaceae, and Xanthomonadaceae, of which some species are considered as pathogenic or opportunistic microorganisms; these bacteria were not present in the control group. Forty-two percent of bacteria identified in the tanners group are correlated with respiratory diseases. Yeasts were also identified, including the following species: Candida glabrata, Candida tropicalis, Candida albicans, and Candida krusei. Regarding the sensitivity test of bacteria identified in the tanners group, 90% showed sensitivity to piperacillin/tazobactam, 87% showed sensitivity to ticarcillin/clavulanic acid, 74% showed sensitivity to ampicillin/sulbactam, and 58% showed sensitivity to amoxicillin/clavulanic acid. Conclusion Several of the bacteria and yeast identified in the oropharyngeal mucosa of tanners have been correlated with infections in humans and have already been reported as airborne microorganisms in this working environment, representing a health risk for workers. PMID:25830072

  6. [Acute duodenal obstruction due to incomplete duodenal diaphragm and foreign bodies in a two-year old child (author's transl)].

    PubMed

    Ruiz Jimnez, J I; Gualda Cantn, J; Snchez, E B

    1977-03-01

    A case of congenital incomplete duodenal diaphragm associated to foreign bodies, in a 28 months child with Down's syndrom is reported. This case had an acute beginning of the symptoms and a severe clinical picture. We discuss the clinical features diagnostic and therapeutic aspects. PMID:145197

  7. Optimum Topical Delivery of Adrenergic Agonists to Oral Mucosa Vasculature

    PubMed Central

    Soref, Cheryl M.

    2015-01-01

    Purpose Identify an orotopical vehicle to deliver an ?-adrenergic vasoconstrictor to submucosal vasculature that is readily palatable to cancer/bone marrow transplant patients that suppresses chemo-radiotherapy-associated oral mucositis. Methods A [3H] norepinephrine ligand binding assay was developed to quantify receptor binding in hamster oral mucosa. Vehicle components (alcohols, polyols, cellulose, PVP) were tested versus [3H] norepinephrine binding. Vehicle refinement was also done to mask phenylephrine bitter taste and achieve human subject acceptance. The optimized vehicle was tested with ?-adrenergic active agents to suppress radiation-induced oral mucositis in mice. Results The ligand binding assay quantified dose- and time-dependent, saturable binding of [3H] norepinephrine. An ethanol:glycerol:propylene glycol:water (6:6:8:80) vehicle provided the best delivery and binding. Further vehicle modification (flavoring and sucralose) yielded a vehicle with excellent taste scores in humans. Addition of phenylephrine, norepinephrine or epinephrine to the optimized vehicle and painting into mouse mouths 20 min before 19 Gy irradiation conferred significant suppression of the weight loss (P < 0.001) observed in mice who received oral vehicle. Conclusion We identified a highly efficient vehicle for the topical delivery of phenylephrine to the oral mucosa of both hamster and human subjects. This will enable its testing to suppress oral mucositis in an upcoming human clinical trial. PMID:25079392

  8. A study of the pathogenesis of Helicobacter pylori negative chronic duodenal ulceration.

    PubMed Central

    McColl, K E; el-Nujumi, A M; Chittajallu, R S; Dahill, S W; Dorrian, C A; el-Omar, E; Penman, I; Fitzsimons, E J; Drain, J; Graham, H

    1993-01-01

    In the past five years 12 patients have been identified presenting with chronic duodenal ulcer (DU) disease and with no evidence of current or recent Helicobacter pylori (H pylori) infection. Four of them were taking regular non-steroidal anti inflammatory agents, one was subsequently found to have Crohn's disease of the duodenum, and one to have the Zollinger-Ellison syndrome. The remaining six patients with idiopathic DU disease were remarkable for their absence of the A1 blood antigen gene. Detailed studies of gastric function were performed in these six patients and compared with H pylori positive patients with DU and with healthy volunteers. The median integrated gastrin response in the patients with idiopathic DU (2810 (range 750-8750) ng/l min) was similar to that of the H pylori positive patients with DU (3355 (550-8725)) and higher than that of the H pylori negative healthy volunteers (560 (225-1125)). The median peak acid output in the patients with idiopathic DU (37 mmol/h, range 17-52) was similar to that of the H pylori positive patients with DU (40 (15-57)) and higher than that of the non-ulcer controls (22 (16-29)). The median percentage of a liquid meal retained in the stomach at 60 minutes was less in the patients with idiopathic DU (23 (15-33)) than in H pylori negative healthy volunteers (34 (30-53) p < 0.01). The median percentage of a solid meal retained at 60 minutes was less in the patients with idiopathic DU (54 (9-83)) than in either H pylori negative healthy volunteers (87 (49-95) p<0.01) or H pylori positive patients with DU (79 (51-100) p<0.01). In conclusion, three abnormalities of gastric function are prevalent in patients with H pylori negative idiopathic DU disease - hypergastrinaemia, increased acid secretion, and the one feature distinguishing them from H pylori positive patients with DU - rapid gastric emptying of both liquids and solids. Each of these abnormalities will increase the exposure of the duodenal mucosa to acid and thus explain its ulceration. The absence of the blood group A1 antigen gene is consistent with a genetic basis for the disturbed gastric function linked to the ABO blood group antigen genes. PMID:8314508

  9. Endoscopic mucosal resection and endoscopic submucosal dissection in the treatment of sporadic nonampullary duodenal adenomatous polyps.

    PubMed

    Marques, Joana; Baldaque-Silva, Francisco; Pereira, Pedro; Arnelo, Urban; Yahagi, Naohisa; Macedo, Guilherme

    2015-06-25

    Although uncommon, sporadic nonampullary duodenal adenomas have a growing detection due to the widespread of endoscopy. Endoscopic therapy is being increasingly used for these lesions, since surgery, considered the standard treatment, carries significant morbidity and mortality. However, the knowledge about its risks and benefits is limited, which contributes to the current absence of standardized recommendations. This review aims to discuss the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in the treatment of these lesions. A literature review was performed, using the Pubmed database with the query: "(duodenum or duodenal) (endoscopy or endoscopic) adenoma resection", in the human species and in English. Of the 189 retrieved articles, and after reading their abstracts, 19 were selected due to their scientific interest. The analysis of their references, led to the inclusion of 23 more articles for their relevance in this subject. The increased use of EMR in the duodenum has shown good results with complete resection rates exceeding 80% and low complication risk (delayed bleeding in less than 12% of the procedures). Although rarely used in the duodenum, ESD achieves close to 100% complete resection rates, but is associated with perforation and bleeding risk in up to one third of the cases. Even though literature is insufficient to draw definitive conclusions, studies suggest that EMR and ESD are valid options for the treatment of nonampullary adenomas. Thus, strategies to improve these techniques, and consequently increase the effectiveness and safety of the resection of these lesions, should be developed. PMID:26140099

  10. Neurogenic inflammation of the upper airway mucosa.

    PubMed

    Lacroix, J S; Landis, B N

    2008-09-01

    Chronic inflammation of the upper airway mucosa is most likely caused by multiple factors, but is frequently associated with local neurogenic inflammation. This phenomenon can be induced by the inhalation of exogenous particles and chemicals present in our environment, as well as irritants produced endogenously. These irritants, i.e. histamine, H+ or bradykinin, can stimulate the abundant afferent sensory nerves endings, epithelial and neuroendocrine cells present in the upper airways mucosa. These structures can interact with our immune and neural cells by producing pro-inflammatory neuropeptides, cytokines, chemokines and neurotrophins. This short review summarizes some of our current knowledge with regard to the role of airborne chemical stimuli and their possible implications in the development of chronic inflammation of the upper airways mucosa. PMID:18853864

  11. Radiation tolerance of the vaginal mucosa

    SciTech Connect

    Hintz, b.L.; Kagan, A.R.; Chan, P.; Gilbert, H.A.; Nussbaum, H.; Rao, A.R.; Wollin, M.

    1980-06-01

    Sixteen patients with cancer of the vagina that were controlled locally for a minimum of eighteen months after teletherpay (T) or brachytherapy (B) or both (T and B), were analyzed for radiation tolerance of the vaginal mucosa. The site of vaginal necrosis did not always coincide with the site of the tumor. The posterior wall appeared more vulnerable than the anterior or lateral walls. For the distal vaginal mucosa, necrosis requiring surgical intervention occurred following combined T and B, if summated rad exceeded9800. The upper vagina tolerated higher dosages. No patient surgery for upper vaginal necrosis even though summated (T and B) dosage up to 14,000 rad was applied. Placing radioactive needles on the surface of the vaginal cylinder with or without interstitial perincal needles should be avoided. Further accumulation of data is needed to define these vaginal mucosa tolerance limits more closely.

  12. An improved cryopreservation method for porcine buccal mucosa in ex vivo drug permeation studies using Franz diffusion cells.

    PubMed

    Amores, Sonia; Domenech, Jos; Colom, Helena; Calpena, Ana C; Clares, Beatriz; Gimeno, lvaro; Lauroba, Jacinto

    2014-08-18

    The use of isolated animal models to assess percutaneous absorption of molecules is frequently reported. The porcine buccal mucosa has been proposed as a substitute for the buccal mucosa barrier on ex vivo permeability studies avoiding unnecessary sacrifice of animals. But it is not always easy to obtain fresh buccal mucosa. Consequently, human and porcine buccal mucosa is sometimes frozen and stored in liquid nitrogen, but this procedure is not always feasible. One cheaper and simpler alternative is to freeze the buccal mucosa of freshly slaughtered pigs in a mechanical freezer, using DMSO and albumin as cryoprotective agents. This study compared the ex vivo permeability parameters of propranolol hydrochloride through porcine buccal mucosa using a Franz diffusion cell system and HPLC as detection method. The freezing effects on drug permeability parameters were evaluated. Equally histological studies were performed. Furthermore, the use of the parameter transmucosal water loss (TMWL) as an indicator of the buccal mucosa integrity was evaluated just as transepidermal water loss (TEWL) is utilized for skin integrity. The results showed no difference between fresh and frozen mucosal flux, permeability coefficient or lag time of propranolol. However, statistical significant difference in TMWL between fresh and frozen mucosa was observed. PMID:24813111

  13. Heterotopic Pancreas Presented as Duodenal Tumor with Obstruction

    PubMed Central

    Kim, Sung Heun

    2015-01-01

    Heterotopic pancreas (HP) is defined as pancreatic tissue lacking anatomic and vascular continuity with the main body of the pancreas. Most are asymptomatic, but can cause ulcer, bleeding, intussusception, and mechanical obstruction. Herein, we presented one case of HP presented as duodenal tumor causing duodenal obstruction. A 7-year-old girl visited the emergency room for abdominal pain with vomiting for 24 hours. Computed tomography and upper gastrointestinal series revealed a polypoid mass with short stalk in the 2nd portion of duodenum. We attempted an endoscopic removal. However, the lumen was nearly obstructed by the mass and the stalk was too broad and hard to excise. The mass was surgically removed via duodenotomy. It was confirmed as a HP with ductal and acini components (type 2 by Heinrich classification). Postoperatively, the patient has been well without any complication and recurrence. PMID:26770904

  14. [New methods of vagotomy in the treatment of duodenal ulcer].

    PubMed

    Za?tsev, V T; Lagoda, A E; Dudenko, G I; Molotiagin, G E; Lagoda, O G; Bo?ko, V V

    1993-01-01

    The experience to use in the treatment of duodenal ulcer disease the new methods of vagotomy: selective distal antral cellular vagotomy (SDAV) and selective distal vagotomy with pyloroplasty (SDV) is substantiated. By means of these operations, the suppression of phase II of gastric secretion is achieved due to denervation of gastrin-producing antral portion of the stomach. The results of experimental studies in 15 dogs, and the results of treatment of 37 patients with duodenal ulcer disease caused by the increased production at phase II of alimentation are presented. SDAV was performed in 20 patients, SDV--in 17. A result of treatment was studied in 34 patients at the period of up to 3 years. A pronounced acid inhibiting effect of the new methods of vagotomy was noted. No ulcer recurrence was revealed. PMID:8158916

  15. Intraluminal duodenal diverticulum with malposition of the ampulla of Vater.

    PubMed

    Ishizuka, D; Shirai, Y; Tsukada, K; Hatakeyama, K

    1997-01-01

    Intraluminal duodenal diverticulum is a rare congenital anomaly, sometimes associated with malposition of the ampulla of Vater. When the diverticulum is excised, the position of the ampulla should be determined carefully to avoid injury to pancreaticobiliary ducts. We report two patients with symptomatic intraluminal duodenal diverticulum and malposition of the ampulla. The ampulla was located on the rim of the diverticulum in one patient; in the others, the ampullary site was the posterior wall of the duodenum. Both patients underwent successful excision of the diverticulum without ductal injuries. As we have been unable to find any case with an ampullary location on the anterior wall of the duodenum, anterior duodenotomy followed by identification of the ampulla must precede excision of the diverticulum in order to avoid pancreaticobiliary ductal injuries. PMID:9222678

  16. Perforated duodenal diverticulae: importance for the surgeon and gastroenterologist.

    PubMed

    Haboubi, Danya; Thapar, Ankur; Bhan, Chetan; Oshowo, Ayo

    2014-01-01

    We present the case of a 78-year-old woman who was admitted for an elective left hemicolectomy for diverticular disease. Two days following the elective procedure, bilious fluid was noted in her pelvic drain. The patient returned to theatre, where a perforated duodenal diverticulum was excised and the defect primarily repaired. The patient then developed a low output enterocutaneous fistula which was treated conservatively with nasojejunal feeding and resolved spontaneously. PMID:25270157

  17. Duodenal phytobezoar: a case report and review of the literature.

    PubMed

    Arda, K; Yilmaz, S; Calikoglu, U; Oler, T

    1995-01-01

    Phytobezoars are an unusual cause of small bowel obstruction. We report a case of small bowel obstruction due to phytobezoar in a 63 year-old female patient who had undergone gastric surgery (truncal vagotomy with pyloroplasty) for duodenal ulcer disease complicated by gastric outlet obstruction 10 years ago. We diagnosed this bezoar case by radiologic methods and these methods keep their importance for the diagnosis of small bowel obstruction with phytobezoars. PMID:8776004

  18. [Chronic Duodenitis and Celiac Disease: a path between the nonspecific and the early stages of Marsh].

    PubMed

    Passera, Andrea Helena; Passera, Mario Luis; Higa, Antonio Luis; Nuez, Maria; Armando, Lucas; Barzn, Silvia

    2015-01-01

    Given the advances in diagnosis for CD, some patients are detected with symptoms and signs of food intolerance, which have positive antibodies and autoantibodies for coeliac disease, whom present proximal bowel biopsies with chronic nonspecific duodenitis and are not associated with stages 0 and 1 Marsh. On the other hand, patients with bloating, abdominal pain, pondostatural delay, negative antibodies for CD, and chronic nonspecific duodenitis in whom removing cow's milk or gluten, the symptoms remit. There are also celiac patients with biopsies before diagnosis, with chronic nonspecific duodenitis. In this paper, we summarize three brothers with different degrees of chronic duodenitis, one with chronic nonspecific duodenitis, and two with histopathological sings of coeliac disease. It is an invitation to think that chronic nonspecific duodenitis in some patients may be an earlier manifestation of celiac disease. PMID:26544059

  19. Perforated duodenal ulcer: An unusual manifestation of allergic eosinophilic gastroenteritis

    PubMed Central

    Riggle, Kevin M; Wahbeh, Ghassan; Williams, Elizabeth M; Riehle, Kimberly J

    2015-01-01

    Spontaneous perforation of a duodenal ulcer secondary to allergic eosinophilic gastroenteritis (EGE) has not been previously reported. We present such a case in a teenager who presented with peritonitis. After exploration and operative repair of his ulcer, he continued to experience intermittent abdominal pain, and further evaluation revealed eosinophilic gastroenteritis in the setting of multiple food allergies. His EGE resolved after adhering to a restrictive diet. Both duodenal ulcers and EGE are very rarely seen in pediatric patients. EGE has a variable presentation depending on the layer(s) of bowel wall affected and the segment of the gastrointestinal tract that is involved. Once diagnosed, it may respond to dietary changes in patients with recognized food allergies, or to steroids in patients in whom an underlying cause is not identified. Our case highlights the need to keep EGE in the differential diagnosis when treating pediatric patients with duodenal ulcers. The epidemiology, pathophysiology, and treatment of EGE are also discussed, along with a review of the current literature. PMID:26640348

  20. Perforated duodenal diverticulum: Surgical treatment and literature review

    PubMed Central

    Costa Simes, Vitor; Santos, Bruno; Magalhes, Sara; Faria, Gil; Sousa Silva, Donzlia; Davide, Jos

    2014-01-01

    INTRODUCTION Duodenum is the second most frequent location for a diverticulum in the digestive tract. Complications are rare and perforation was only reported in less than 200 cases. PRESENTATION OF CASE A 79-year-old female was admitted to Emergency Department with abdominal pain and vomiting for the last 24h. A CT scan was performed and moderated extra-luminal air was identified. During surgery a fourth portion perforated duodenal diverticulum was diagnosed and duodenal resection was performed. DISCUSSION First reported in 1710, the incidence of duodenal diverticula can be as high as 22%. Nevertheless complications are extremely rare and include haemorrhage, inflammation, compression of surrounding organs, neoplastic progression, cholestasis and perforation. As perforations are often retroperitoneal, symptoms are nonspecific and rarely include peritoneal irritation, making clinical diagnose a challenge. CT scan will usually present extra-luminal retroperitoneal air and mesenteric fat stranding, providing clues for the diagnosis. Although non-operative treatment has been reported in selected patients, standard treatment is surgery and alternatives are diverse including diverticulectomy or duodenopancreatectomy. CONCLUSION Perforated diverticula of the fourth portion of the duodenum are extremely rare and current evidence still supports surgery as the primary treatment modality. PMID:25016082

  1. Endoscopic duodenal perforation: surgical strategies in a regional centre

    PubMed Central

    2014-01-01

    Background Duodenal perforation is an uncommon complication of endoscopic retrograde cholangio-pancreatography (ERCP) and a rare complication of upper gastrointestinal endoscopy. Most are minor perforations that settle with conservative management. A few perforations however result in life-threatening retroperitoneal necrosis and require surgical intervention. There is a relative paucity of references specifically describing the surgical interventions required for this eventuality. Methods Five cases of iatrogenic duodenal perforation were ascertained between 2002 and 2007 at Cairns Base Hospital. Clinical features were analyzed and compared, with reference to a review of ERCP at that institution for the years 2005/2006. Results One patient recovered with conservative management. Of the other four, one died after initial laparotomy. The other three survived, undergoing multiple procedures and long inpatient stays. Conclusions Iatrogenic duodenal perforation with retroperitoneal necrosis is an uncommon complication of endoscopy, but when it does occur it is potentially life-threatening. Early recognition may lead to a better outcome through earlier intervention, although a protracted course with multiple procedures should be anticipated. A number of surgical techniques may need to be employed according to the individual circumstances of the case. PMID:24461069

  2. Groove pancreatitis and pancreatic heterotopia in the minor duodenal papilla.

    PubMed

    Chatelain, Denis; Vibert, Eric; Yzet, Thierry; Geslin, Guillaume; Bartoli, Eric; Manaouil, David; Delcenserie, Richard; Brevet, Marie; Dupas, Jean-Louis; Regimbeau, Jean-Marc

    2005-05-01

    Groove pancreatitis is a rare form of segmental chronic pancreatitis that involves the anatomic space between the head of the pancreas, the duodenum, and the common bile duct. We report 2 cases of groove pancreatitis with pancreatic heterotopia in the minor papilla. Patients were a 44-year-old woman and a 47-year-old man. Both had a past history of alcohol consumption and presented with abdominal pain, vomiting, and weight loss caused by duodenal stenosis. Abdominal computed tomography revealed thickening of the duodenal wall and enlargement of the pancreatic head in both patients. In 1 patient, ultrasound endoscopy showed a dilated duct in the head of the pancreas. Pancreaticoduodenectomy was performed to rule out pancreatic adenocarcinoma and because of the severity of the symptoms. In both cases, gross and microscopic examinations showed fibrous scar of the groove area. The Santorini duct was dilated and contained protein plugs in both patients, with abscesses in 1 of them. In both cases, there were microscopic foci of heterotopic pancreas with mild fibrosis in the wall of the minor papilla. Groove pancreatitis is often diagnosed in middle-aged alcoholic men presenting with clinical symptoms caused by duodenal stenosis. The pathogenesis of this rare entity could be because of disturbance of the pancreatic secretion through the minor papilla. Pancreatitis in heterotopic pancreas located in the minor papilla and chronic consumption of alcohol seem to be important pathogenic factors. PMID:15841034

  3. Duodenal gastrointestinal stromal tumor: From clinicopathological features to surgical outcomes.

    PubMed

    Marano, L; Boccardi, V; Marrelli, D; Roviello, F

    2015-07-01

    Duodenal gastrointestinal tumors represent an extremely rare subset of stromal tumors arising from interstitial cells of Cajal. In the last 30 years the comprehension of the pathophysiology and natural history of this previously misunderstood clinical entity, in association with developments in endoscopy, imaging technology, and immunohistochemistry has resulted in novel diagnostic and treatment approaches. This is a comprehensive review of the current data of the literature on the various aspects of the diagnosis and treatment of these tumors. The duodenum is the less commonly involved site for these tumors in the digestive tract. Endoscopy and computed tomography can usually establish the diagnosis, confirmed by immunohistochemical staining and occasionally molecular genetic analysis. Endoscopic ultrasound with fine needle aspiration has been recently found to be the gold diagnostic standard with high sensitivity and specificity rates, diagnosing GIST in up to 80% of patients. Due to the complex anatomy of the pancreatico-duodenal region optimal therapeutic strategy of duodenal GISTs are challenging. Nevertheless surgical resection with microscopically clear resection margins seems to be the only potentially curative treatment for non-metastatic primary GISTs of the duodenum. Imatinib mesylate plays a key role in the management of GISTs both as neoadjuvant therapy and in patients with recurrent and metastatic disease. Meanwhile, the advances in the comprehension of the pathophysiology and natural history of this previously misunderstood clinical entity as well as the treatment of these tumors may render feasible, in the near future, the advent of newer and more effective treatment options. PMID:25956211

  4. Glycosphingolipids of guinea pig gastric mucosa.

    PubMed

    Kojima, K; Slomiany, A; Murty, V L; Galicki, N I; Slomiany, B L

    1980-08-11

    Glycosphingolipids have beenn isolated from guinea pig gastric mucosa and their composition and content determined. The neutral glycospingolipids were found to consist of mono-, di-, tri- and pentaglycosylceramide. The acidic glycosphingolipids wee represented by galactosyl and lactosyl sulfatides, and GM4, GM3 and GD3 gangliosides. None of the analyzed glycolipids contained N-acetylglucosamine and fucose. PMID:7407221

  5. Endoscopy in patients with diarrhea during treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitors: Is the cause in the mucosa?

    PubMed

    Boers-Sonderen, Marye J; Mulder, Sasja F; Nagtegaal, Iris D; Derikx, Lauranne A A P; Wanten, Geert J A; Mulders, Peter F A; van der Graaf, Winette T A; Hoentjen, Frank; van Herpen, Carla M L

    2016-04-01

    Background Diarrhea is a frequently occurring adverse event during treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR TKIs) and is mostly accompanied by abdominal cramps, flatulence and pyrosis. These complaints impair quality of life and lead to dose reductions and treatment interruptions. It is hypothesized that the diarrhea might be due to ischemia in bowel mucosa or inflammation, but the exact underlying pathophysiological mechanism of the diarrhea is still unknown. We aimed at exploring the mechanism for diarrhea in these patients by thorough endoscopic and histological assessment. Materials and methods Endoscopies of the upper and lower gastrointestinal (GI) tract in 10 patients with metastatic renal cell carcinoma (mRCC) who developed diarrhea during treatment with VEGFR TKIs were performed. Results Ten patients were included. The results showed endoscopically normal mucosa in the lower GI tract in seven patients without signs of ischemic colitis or inflammation. Gastroduodenoscopy revealed gastro-esophageal reflux disease, bulbitis and/or duodenitis with ulcers in eight patients. In three selected patients with bulbitis/duodenitis additional video capsule endoscopy was performed but revealed no additional intestinal abnormalities. Conclusion We observed frequent mucosal abnormalities in the upper GI tract in VEGFR TKI-treated mRCC patients with diarrhea. Although these abnormalities provide insufficient explanation for the occurrence of diarrhea, we suggest to perform routine upper GI endoscopy in VEGFR TKI-treated patients with GI complaints. PMID:26959411

  6. Optical detection of (pre-)malignant lesions of the oral mucosa: autofluorescence characteristics of healthy mucosa

    NASA Astrophysics Data System (ADS)

    de Veld, Diana C. G.; Witjes, Max; Roodenburg, Jan L.; Star, Willem M.; Sterenborg, Hericus J. C. M.

    2001-10-01

    Previous clinical results demonstrate the potential of in vivo autofluorescence spectroscopy for early detection of (pre-)malignant lesions of the oral mucosa. For reliable diagnosis, it is necessary to study autofluorescence spectra of healthy mucosa first. We measured excitation-emission maps in healthy subjects and subjects with a history of cancer in the head -neck region. Our results show that different anatomical locations produce distinct autofluorescence spectra. Influences of, among others, smoking and drinking habits require further investigation.

  7. L-Glutamate supplementation improves small intestinal architecture and enhances the expressions of jejunal mucosa amino acid receptors and transporters in weaning piglets.

    PubMed

    Lin, Meng; Zhang, Bolin; Yu, Changning; Li, Jiaolong; Zhang, Lin; Sun, Hui; Gao, Feng; Zhou, Guanghong

    2014-01-01

    L-Glutamate is a major oxidative fuel for the small intestine. However, few studies have demonstrated the effect of L-glutamate on the intestinal architecture and signaling of amino acids in the small intestine. The aim of this study was to investigate the effects of dietary L-glutamate supplementation on the intestinal architecture and expressions of jejunal mucosa amino acid receptors and transporters in weaning piglets. A total of 120 weaning piglets aged 35 ± 1 days with an average body weight at 8.91 ± 0.45 kg were randomly allocated to two treatments with six replicates of ten piglets each, fed with diets containing 1.21% alanine, or 2% L-glutamate. L-Glutamate supplementation increased the activity of glutamate oxaloacetate transaminase (GOT) in the jejunal mucosa. Also, the mRNA expression level of jejunal mucosa glutamine synthetase (GS) was increased by L-glutamate supplementation. The height of villi in duodenal and jejunal segments, and the relative mRNA expression of occludin and zonula occludens protein-1 (ZO-1) in jejunal mucosa were increased by dietary L-glutamate supplementation. L-Glutamate supplementation increased plasma concentrations of glutamate, arginine, histidine, isoleucine, leucine, methionine, phenylalanine and threonine. L-Glutamate supplementation also increased the relative mRNA expression of the jejunal mucosa Ca(2+)-sensing receptor (CaR), metabotropic glutamate receptor 1 (mGluR1) and metabotropic glutamate receptor 4 (mGluR4), and neutral amino acid transporter B(0)-like (SLC1A5) in the jejunal mucosa. These findings suggest that dietary addition of 2% L-glutamate improves the intestinal integrity and influences the expression of amino acid receptors and transporters in the jejunum of weaning, which is beneficial for the improvement of jejunal nutrients for digestion and absorption. PMID:25368996

  8. Case report of bacteremia due to Neisseria mucosa.

    PubMed

    Mechergui, Arij; Achour, Wafa; Baaboura, Rekaya; Ouertani, Hela; Lakhal, Amal; Torjemane, Lamia; Othman, Tarek Ben; Hassen, Assia Ben

    2014-04-01

    Neisseria mucosa, a Gram-negative diplococcus, is part of normal nasopharyngeal flora. We report a case of bacteremia caused by N. mucosa in a 50-year-old neutropenic patient suffering from non-secretory multiple myeloma stage IIIA. This case underscores that mostly nonpathogenic N. mucosa can cause bacteremia in neutropenic patients who developed mucositis after hematopoietic stem cell transplantation. PMID:23905778

  9. Selective culturing of swine gastrointestinal bacteria on substrates simulating the intestinal mucosa

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Many gastrointestinal (GI) microbes are in intimate contact with the host tissues, and characterizing these tissue-associated communities is important for elucidating their role in animal and human health. The GI mucosa is an environment distinct from the intestinal lumen and is covered by a mucus l...

  10. Evolution of nonspecific duodenal lymphocytosis over 2 years of follow-up

    PubMed Central

    Losurdo, Giuseppe; Piscitelli, Domenico; Giangaspero, Antonio; Principi, Mariabeatrice; Buffelli, Francesca; Giorgio, Floriana; Montenegro, Lucia; Sorrentino, Claudia; Amoruso, Annacinzia; Ierardi, Enzo; Di Leo, Alfredo

    2015-01-01

    AIM: To assess the evolution of duodenal lymphocytosis (DL), a condition characterized by increased intraepithelial lymphocytes (IELs), over 2 years of follow-up. METHODS: Consecutive patients undergoing upper endoscopy/histology for abdominal pain, diarrhea, weight loss, weakness or other extraintestinal features compatible with celiac disease (CD) were included. Evaluation of IELs infiltrate in duodenal biopsy samples was carried out by CD3-immunohistochemistry and expressed as number of positive cells/100 enterocytes. Diagnostic agreement on the IELs count was tested by calculating the weighted k coefficient. All patients underwent serological detection of autoantibodies associated with CD: IgG and IgA anti-tissue transglutaminase and endomysium. Each patient underwent further investigations to clarify the origin of DL at baseline and/or in the course of 2 years of follow-up every six months. Autoimmune thyroiditis, intestinal infections, parasitic diseases, bacterial intestinal overgrowth, hypolactasia and wheat allergy were detected. Colonoscopy and enteric magnetic resonance imaging were performed when necessary. Risk factors affecting the final diagnosis were detected by multinomial logistic regression and expressed as OR. RESULTS: Eighty-five patients (16 males, 69 females, aged 34.1 12.5 years) were followed up for a mean period of 21.7 11.7 mo. At baseline, endoscopy/duodenal biopsy, CD3 immunohistochemistry revealed: > 25 IELs/100 enterocytes in 22 subjects, 15-25 IELs in 37 and < 15 IELs in 26. They all had negative serum anti-transglutaminase and anti-endomysium, whilst 5 showed IgG anti-gliadin positivity. In the course of follow-up, 23 developed CD seropositivity and gluten sensitivity (GS) was identified in 19. Other diagnoses were: 5 Helicobacter pylori infections, 4 jejunal Crohns disease, 1 lymphocytic colitis and 1 systemic sclerosis. The disease in the remaining 32 patients was classified as irritable bowel syndrome because of the lack of diagnostic evidence. At multivariate analysis, the evolution towards CD was associated with an IELs infiltrate > 25 (OR = 1640.4) or 15-25 (OR = 16.95), human leukocyte antigen (HLA) DQ2/8 (OR = 140.85) or DQA1*0501 (OR = 15.36), diarrhea (OR = 5.56) and weakness (OR = 11.57). GS was associated with IELs 15-25 (OR = 28.59), autoimmune thyroiditis (OR = 87.63), folate deficiency (OR = 48.53) and diarrhea (OR = 54.87). CONCLUSION: DL may have a multifactorial origin but the IELs infiltrate and HLA are strong predictive factors for CD development and a clinical diagnosis of GS. PMID:26140001

  11. Placebo effect in the treatment of duodenal ulcer

    PubMed Central

    de Craen, Anton J M; Moerman, Daniel E; Heisterkamp, Simon H; Tytgat, Guido N J; Tijssen, Jan G P; Kleijnen, Jos

    1999-01-01

    Aims To assess whether frequency of placebo administration is associated with duodenal ulcer healing. Methods A systematic literature review of randomized clinical trials was undertaken. 79 of 80 trials that met the inclusion criteria. The pooled 4 week placebo healing rate of all duodenal ulcer trials that employed a four times a day regimen was compared with the rate obtained from trials with a twice a day regimen. Results The pooled 4 week healing rate of the 51 trials with a four times a day regimen was 44.2% (805 of 1821 patients) compared with 36.2% (545 of 1504 patients) in the 28 trials with a twice a day regimen (difference, 8.0% [equal effects model]; 95% confidence interval, 4.6% to 11.3%). Depending on the statistical analysis, the rate difference ranged from 6.0% (multivariable random effects model) to 8.0% (equal effects model). A number of sensitivity analyses showed comparable differences between the two regimens. Most of these sensitivity analyses were not significant, probably because a number of trials were excluded resulting in a loss of power. Conclusions We found a relation between frequency of placebo administration and healing of duodenal ulcer. We realize that the comparison was based on nonrandomized data. However, we speculate that the difference between regimens was induced by the difference in frequency of placebo administration. A better knowledge of various placebo effects is required in order to make clinically relevant assessments of treatment effects derived from placebo-controlled trials. PMID:10594490

  12. Interspecies comparison of stellate cell-containing macula flavae and vitamin A storage in vocal fold mucosa.

    PubMed

    Toya, Yutaka; Riabroy, Napaporn; Davis, Christopher R; Kishimoto, Yo; Tanumihardjo, Sherry A; Bless, Diane M; Welham, Nathan V

    2014-09-01

    The macula flavae (MF), populated by vitamin A-storing stellate cells (SCs), are believed to play a fundamental role in development, maintenance and repair of the vocal fold (VF) mucosa; however, to date, they have mostly been examined in observational human cadaver studies. Here, we conducted an interspecies comparison of MF and SC phenotype, as well as vitamin A quantification and localization, in human, pig, dog, rabbit and rat VF mucosae. MF containing vitamin A-positive SCs were only identified in human and rat specimens. Pig, dog and rabbit VF mucosae contained no discernable MF, but rather exhibited preferential vitamin A localization to mucous (pig), serous (dog) or mixed (rabbit) glands. This glandular vitamin A storage corresponded to exceedingly high concentrations of retinol in pig and dog mucosae, and retinyl ester in dog mucosa. These findings have significant implications for the presumed role of the MF and SCs in VF biology, the nature of vitamin A storage within the VF mucosa, and the selection of an appropriate animal model for future experimental studies. PMID:25040030

  13. Optical reconstruction of murine colorectal mucosa at cellular resolution.

    PubMed

    Liu, Cambrian Y; Dub, Philip E; Girish, Nandini; Reddy, Ajay T; Polk, D Brent

    2015-05-01

    The mucosal layer of the colon is a unique and dynamic site where host cells interface with one another and the microbiome, with major implications for physiology and disease. However, the cellular mechanisms mediating colonic regeneration, inflammation, dysplasia, and dysbiosis remain undercharacterized, partly because the use of thin tissue sections in many studies removes important volumetric context. To address these challenges in visualization, we have developed the deep mucosal imaging (DMI) method to reconstruct continuous extended volumes of mouse colorectal mucosa at cellular resolution. Use of ScaleA2 and SeeDB clearing agents enabled full visualization of the colonic crypt, the fundamental unit of adult colon. Confocal imaging of large colorectal expanses revealed epithelial structures involved in repair, inflammation, tumorigenesis, and stem cell function, in fluorescent protein-labeled, immunostained, paraffin-embedded, or human biopsy samples. We provide freely available software to reconstruct and explore on computers with standard memory allocations the large DMI datasets containing in toto representations of distal colonic mucosal volume. Extended-volume imaging of colonic mucosa through the novel, extensible, and readily adopted DMI approach will expedite mechanistic investigations of intestinal physiology and pathophysiology at intracrypt to multicrypt length scales. PMID:25721303

  14. A Case Report of Primary Duodenal Tuberculosis Mimicking a Malignant Tumor

    PubMed Central

    Jung, Ji Hye; Kim, Min Jeong; Cho, Young Kwan; Ahn, Sang Bong; Son, Byoung Kwan; Jo, Yun Ju; Park, Young Sook

    2014-01-01

    Tuberculosis remains a serious infectious disease with primary features of pulmonary manifestation in Korea. However, duodenal tuberculosis is rare in gastrointestinal cases of extrapulmonary tuberculosis. Here, we report a case of primary duodenal tuberculosis mistaken as a malignant tumor and diagnosed with QuantiFERON-TB GOLD (Cellestis Ltd.) in an immunocompetent male patient. PMID:25133123

  15. Supraduodenal Branch of the Left Hepatic Artery: A Rare Cause of Bleeding Duodenal Ulcer

    SciTech Connect

    Kapoor, Baljendra S.; Berscheid, Bruce; Saddekni, Souheil

    2009-07-15

    This is a case report describing a rare cause of massive duodenal ulcer hemorrhage resulting from the erosion of the supraduodenal branch of the left hepatic artery. This arterial branch is not a well known variation and is rarely recognized as a source of duodenal bleeding.

  16. Liver penetration by a duodenal ulcer in a young woman.

    PubMed

    Novacek, G; Geppert, A; Kramer, L; Wrba, F; Herbst, F; Schima, W; Gangl, A; Ptzi, R

    2001-07-01

    Liver penetration is a rare but serious complication of peptic ulcer disease. We report a case of a 33-year-old woman who took large doses of nonsteroidal antiinflammatory drugs and developed a giant duodenal ulcer that penetrated into her liver. The diagnosis was based on histologic examination of endoscopic biopsies. She was initially treated with a proton pump inhibitor, but, within 5 weeks, she developed a symptomatic postbulbar stricture that required surgical correction. We also review 11 other reported cases of endoscopically and histologically diagnosed peptic ulcer penetration into the liver. PMID:11418793

  17. Paraesophageal hernia with incarceration of the gastric antrum and duodenal bulb: a case report

    PubMed Central

    2013-01-01

    Background In cases of esophageal hernia, incarceration of peritoneal organs other than the stomach is rare. Case presentation An 84-year-old female was admitted to our institution with a complaint of nausea and vomiting. Abdominal computed tomography revealed an esophageal hiatal hernia with incarceration of the gastric antrum and duodenal bulb. Gastrofluorography under gastroendoscopy confirmed prolapse of the antrum and duodenal bulb into the esophageal hernial sac. Although gastroendoscopy guided repositioning of the prolapsed organs was successful, reprolapse occurred immediately. Therefore, surgical treatment was indicated. The gastric antrum and duodenal bulb were associated with a paraesophageal hernia. Therefore, they were repositioned, and passage from the duodenal bulb to the descending portion of the duodenum was improved. Conclusion We report a rare case of paraesophageal hernia with incarceration of the gastric antrum and duodenal bulb. PMID:24207166

  18. Effects of propofol and fentanyl on duodenal motility activity in pigs

    PubMed Central

    2005-01-01

    Abstract To investigate the effects of propofol and fentanyl on the postprandial duodenal motility the intraluminal impedance technique was used. Six pigs were instrumented with a central venous catheter, a percutaneous enterogastrostomy (PEG), and an impedance catheter, which was introduced via the PEG into the duodenum through endoscopy. Over the following 3 d, duodenal motility was measured for 8-hour periods. Measurements were taken on each subject under 3 different sets of conditions: in the conscious unrestrained pig, during propofol sedation, and during sedation with propofol-fentanyl. Both, after morning feeding and during gastric nutrition via the PEG, duodenal feeding patterns and duodenal phase II of the migrating motor cycle were shortened during propofol and propofol-fentanyl sedation. In contrast, the duration of phase I was prolonged by propofol and propofol-fentanyl. In conclusion, either propofol or propofol-fentanyl sedation shortens duodenal feeding patterns, as well as phase II of the migrating motor cycle. PMID:16363326

  19. Duodenal calcium absorption in vitamin D receptor-knockout mice: functional and molecular aspects.

    PubMed

    Van Cromphaut, S J; Dewerchin, M; Hoenderop, J G; Stockmans, I; Van Herck, E; Kato, S; Bindels, R J; Collen, D; Carmeliet, P; Bouillon, R; Carmeliet, G

    2001-11-01

    Rickets and hyperparathyroidism caused by a defective vitamin D receptor (VDR) can be prevented in humans and animals by high calcium intake, suggesting that intestinal calcium absorption is critical for 1,25(OH)(2) vitamin D [1,25(OH)(2)D(3)] action on calcium homeostasis. We assessed the rate of serum (45)Ca accumulation within 10 min of oral gavage in two strains of VDR-knockout (KO) mice (Leuven and Tokyo KO) and observed a 3-fold lower area under the curve in both KO strains. Moreover, we evaluated the expression of intestinal candidate genes involved in transcellular calcium transport. The calcium transport protein1 (CaT1) was more abundantly expressed at mRNA level than the epithelial calcium channel (ECaC) in duodenum, but both were considerably reduced (CaT1>90%, ECaC>60%) in the two VDR-KO strains on a normal calcium diet. Calbindin-D(9K) expression was decreased only in the Tokyo KO, whereas plasma membrane calcium ATPase (PMCA(1b)) expression was normal in both VDR-KOs. In Leuven wild-type mice, a high calcium diet inhibited (>90%) and 1,25(OH)(2)D(3) injection or low calcium diet induced (6-fold) duodenal CaT1 expression and, to a lesser degree, ECaC and calbindin-D(9K) expression. In Leuven KO mice, however, high or low calcium intake decreased calbindin-D(9K) and PMCA(1b) expression, whereas CaT1 and ECaC expression remained consistently low on any diet. These results suggest that the expression of the novel duodenal epithelial calcium channels (in particular CaT1) is strongly vitamin D-dependent, and that calcium influx, probably interacting with calbindin-D(9K), should be considered as a rate-limiting step in the process of vitamin D-dependent active calcium absorption. PMID:11687634

  20. Duodenal calcium absorption in vitamin D receptorknockout mice: Functional and molecular aspects

    PubMed Central

    Van Cromphaut, Sophie J.; Dewerchin, Mieke; Hoenderop, Joost G. J.; Stockmans, Ingrid; Van Herck, Erik; Kato, Shigeaki; Bindels, Ren J. M.; Collen, Dsir; Carmeliet, Peter; Bouillon, Roger; Carmeliet, Geert

    2001-01-01

    Rickets and hyperparathyroidism caused by a defective vitamin D receptor (VDR) can be prevented in humans and animals by high calcium intake, suggesting that intestinal calcium absorption is critical for 1,25(OH)2 vitamin D [1,25(OH)2D3] action on calcium homeostasis. We assessed the rate of serum 45Ca accumulation within 10 min of oral gavage in two strains of VDR-knockout (KO) mice (Leuven and Tokyo KO) and observed a 3-fold lower area under the curve in both KO strains. Moreover, we evaluated the expression of intestinal candidate genes involved in transcellular calcium transport. The calcium transport protein1 (CaT1) was more abundantly expressed at mRNA level than the epithelial calcium channel (ECaC) in duodenum, but both were considerably reduced (CaT1>90%, ECaC>60%) in the two VDR-KO strains on a normal calcium diet. Calbindin-D9K expression was decreased only in the Tokyo KO, whereas plasma membrane calcium ATPase (PMCA1b) expression was normal in both VDR-KOs. In Leuven wild-type mice, a high calcium diet inhibited (>90%) and 1,25(OH)2D3 injection or low calcium diet induced (6-fold) duodenal CaT1 expression and, to a lesser degree, ECaC and calbindin-D9K expression. In Leuven KO mice, however, high or low calcium intake decreased calbindin-D9K and PMCA1b expression, whereas CaT1 and ECaC expression remained consistently low on any diet. These results suggest that the expression of the novel duodenal epithelial calcium channels (in particular CaT1) is strongly vitamin D-dependent, and that calcium influx, probably interacting with calbindin-D9K, should be considered as a rate-limiting step in the process of vitamin D-dependent active calcium absorption. PMID:11687634

  1. Palliation of Malignant Biliary and Duodenal Obstruction with Combined Metallic Stenting

    SciTech Connect

    Akinci, Devrim Akhan, Okan; Ozkan, Fuat; Ciftci, Turkmen; Ozkan, Orhan S.; Karcaaltincaba, Musturay; Ozmen, Mustafa N.

    2007-11-15

    Purpose. The purpose of this study is to evaluate the efficacy of palliation of malignant biliary and duodenal obstruction with combined metallic stenting under fluoroscopy guidance. Materials and Methods. A retrospective analysis of 9 patients (6 men and 3 women) who underwent biliary and duodenal stenting was performed. The mean age of patients was 61 years (range: 42-80 years). The causes of obstruction were pancreatic carcinoma in 7 patients, cholangiocellular carcinoma in one, and duodenal carcinoma in the other. Biliary and duodenal stents were placed simultaneously in 4 patients. In other 5 patients dudodenal stents were placed after biliary stenting when the duodenal obstruction symptoms have developed. In two patients duodenal stents were advanced via transgastric approach. Results. Technical success rate was 100 %. After percutaneous biliary drainage and stenting bilirubin levels decreased to normal levels in 6 patients and in remaining 3 patients mean reduction of 71% in bilirubin levels was achieved. Tumoral ingrowth occurred in one patient and percutaneous biliary restenting was performed 90 days after the initial procedure. Of the 9 patients, 6 patients were able to tolerate solid diet, whereas 2 patients could tolerate liquid diet and one patient did not show any improvement. Mean survival periods were 111 and 73 days after biliary and duodenal stenting, respectively. Conclusion. Combined biliary and duodenal stent placement which can be performed under fluoroscopic guidance without assistance of endoscopy is feasible and an effective method of palliation of malignant biliary and duodenal obstructions. If transoral and endoscopic approaches fail, percutaneous gastrostomy route allows duodenal stenting.

  2. Broad MICA/B expression in the small bowel mucosa: a link between cellular stress and celiac disease.

    PubMed

    Allegretti, Yessica L; Bondar, Constanza; Guzman, Luciana; Cueto Rua, Eduardo; Chopita, Nestor; Fuertes, Mercedes; Zwirner, Norberto W; Chirdo, Fernando G

    2013-01-01

    The MICA/B genes (MHC class I chain related genes A and B) encode for non conventional class I HLA molecules which have no role in antigen presentation. MICA/B are up-regulated by different stress conditions such as heat-shock, oxidative stress, neoplasic transformation and viral infection. Particularly, MICA/B are expressed in enterocytes where they can mediate enterocyte apoptosis when recognised by the activating NKG2D receptor present on intraepithelial lymphocytes. This mechanism was suggested to play a major pathogenic role in active celiac disease (CD). Due to the importance of MICA/B in CD pathogenesis we studied their expression in duodenal tissue from CD patients. By immunofluorescence confocal microscopy and flow cytometry we established that MICA/B was mainly intracellularly located in enterocytes. In addition, we identified MICA/B(+) T cells in both the intraepithelial and lamina propria compartments. We also found MICA/B(+) B cells, plasma cells and some macrophages in the lamina propria. The pattern of MICA/B staining in mucosal tissue in severe enteropathy was similar to that found in in vitro models of cellular stress. In such models, MICA/B were located in stress granules that are associated to the oxidative and ER stress response observed in active CD enteropathy. Our results suggest that expression of MICA/B in the intestinal mucosa of CD patients is linked to disregulation of mucosa homeostasis in which the stress response plays an active role. PMID:24058482

  3. Broad MICA/B Expression in the Small Bowel Mucosa: A Link between Cellular Stress and Celiac Disease

    PubMed Central

    Allegretti, Yessica L.; Bondar, Constanza; Guzman, Luciana; Cueto Rua, Eduardo; Chopita, Nestor; Fuertes, Mercedes; Zwirner, Norberto W.; Chirdo, Fernando G.

    2013-01-01

    The MICA/B genes (MHC class I chain related genes A and B) encode for non conventional class I HLA molecules which have no role in antigen presentation. MICA/B are up-regulated by different stress conditions such as heat-shock, oxidative stress, neoplasic transformation and viral infection. Particularly, MICA/B are expressed in enterocytes where they can mediate enterocyte apoptosis when recognised by the activating NKG2D receptor present on intraepithelial lymphocytes. This mechanism was suggested to play a major pathogenic role in active celiac disease (CD). Due to the importance of MICA/B in CD pathogenesis we studied their expression in duodenal tissue from CD patients. By immunofluorescence confocal microscopy and flow cytometry we established that MICA/B was mainly intracellularly located in enterocytes. In addition, we identified MICA/B+ T cells in both the intraepithelial and lamina propria compartments. We also found MICA/B+ B cells, plasma cells and some macrophages in the lamina propria. The pattern of MICA/B staining in mucosal tissue in severe enteropathy was similar to that found in in vitro models of cellular stress. In such models, MICA/B were located in stress granules that are associated to the oxidative and ER stress response observed in active CD enteropathy. Our results suggest that expression of MICA/B in the intestinal mucosa of CD patients is linked to disregulation of mucosa homeostasis in which the stress response plays an active role. PMID:24058482

  4. Calcium transport by rat duodenal villus and crypt basolateral membranes

    SciTech Connect

    Walters, J.R.F.; Weiser, M.M.

    1987-02-01

    Rat duodenal cells were isolated sequentially to give fractions enriched for villus and crypt cells. From each of these fractions, basolateral-enriched membrane vesicles were prepared and ATP-dependent calcium uptake was studied. Calcium uptake was sensitive to temperature, was inhibited by vanadate and by A23187, and was lower in vitamin D-deficient animals. In normal animals, (UVCa)-transport was approximately twofold greater in villus-tip than in crypt cell-fraction basolateral membranes though the affinity of the uptake for calcium was similar (K/sub m/ = 0.3 M). In vitamin D-deficient animals, the crypt-to-villus gradient was reduced, and in all fractions, calcium transport was similar to or lower than that in the crypts of normal animals. Six hours after vitamin D-deficient animals were repleted with 1,25-dihydroxycholecalciferol, a significant increase in calcium transport by everted gut sacs was present; however, basolateral calcium transport was significantly increased in only the mid-villus fractions, and no change was seen in the villus-tip fractions. Thus vitamin D appears necessary for the development of increased basolateral membrane calcium pump activity in duodenal villus cells, but not all cells in vitamin D-deficient rats are able to respond to 1,25-dihydroxycholecalciferol.

  5. Gastric and Duodenal Stents: Follow-Up and Complications

    SciTech Connect

    Pinto Pabon, Isabel Teresa; Paul Diaz, Laura; Ruiz de Adana, Juan Carlos; Lopez Herrero, Julio

    2001-05-15

    Purpose: To assess the efficacy of self-expanding metallic stents in treating inoperable gastric and duodenal stenoses during follow-up and to evaluate the complications encountered.Methods: A total of 31 patients suffering from gastroduodenal obstruction (29 malignant, 2 benign) were treated with a self-expanding metallic stent (Wallstent). In 24 cases insertion was by the peroral route, in seven cases via gastrostomy.Results: All the strictures were successfully negotiated under fluoroscopic guidance without having to resort to endoscopy. A total of 27 patients (87%) were able to resume a regular diet, a soft diet, or a liquid diet orally. Complications included one case of stent malpositioning, one case of leakage of ascitic fluid through the gastrostomy orifice, one case of perforation and fistula to the biliary tree, and two cases of hematemesis. In two patients (6%) additional stents were implanted to improve patency. In all patients follow-up was maintained until death. Recurrence of symptoms immediately before death occurred in seven cases (23%). Mean survival time of patients was 13.3 weeks (SE {+-} 4.6).Conclusions: The deployment of gastroduodenal stents resulted in good palliation of inoperable gastric and duodenal stenoses. Certain technical aspects, e.g., adaptation of stents to bowel morphology, is critical to proper stent function and avoidance of complications.

  6. Adenoid cystic carcinoma of buccal mucosa

    PubMed Central

    Kumar, Anoop N; Harish, M; Alavi, Yasin A; Mallikarjuna, Rachappa

    2013-01-01

    Adenoid cystic carcinoma is a malignant neoplasm most commonly originating in the salivary glands of head and neck region. The clinical and pathological findings typical of this tumour include slow growth, perineural invasion and potential local recurrence. Up to 50% of these tumours occur in the intraoral minor salivary glands usually in the hard palate. We present a case report of a 26-year-old woman who was diagnosed with adenoid cystic carcinoma of the right buccal mucosa. The peculiarity of the lesion and the approach we made is the key factor in the presentation. PMID:23761566

  7. Expression and distribution of epithelial sodium channel in nasal polyp and nasal mucosa.

    PubMed

    Jiang, Yiming; Xu, Ji; Chen, Yanqing; Shi, Jiali; Zhang, Chun; Li, Jiping

    2015-11-01

    To evaluate the expression and location of epithelial sodium channels (ENaCs) in human nasal polyp and normal nasal mucosa, and to characterize the relevance of ENaCs to the development of NPs. Nasal polyp tissue from 17 patients and nasal mucosa from ten patients were obtained through endoscopic sinus surgery. The mRNA concentrations of ENaC-α, β, and γ were detected by real-time polymerase chain reaction. The expression of ENaC-α was detected using western blot and immunofluorescence techniques. The distribution of ENaC-α in mucosal tissue was observed using a laser scanning confocal microscope. The transcriptional expression of three subunits of ENaC was in the following order: α > β > γ, in both groups. The transcriptional expression of α, β, and γ subunits of ENaC was elevated in nasal polyp compared to nasal mucosa (p < 0.01). ENaC-α expression was higher in nasal polyp than in nasal mucosa (p < 0.05). Immunofluorescent staining indicated that ENaC-α protein was distributed in the epithelial cell apical membrane. The expression of ENaC is upregulated in human nasal polyp, which might in turn facilitate the formation and development of nasal polyp. PMID:25559464

  8. Alteration of Polymeric Immunoglobulin Receptor and Neonatal Fc Receptor Expression in the Gut Mucosa of Immunodeficiency Virus-Infected Rhesus Macaques.

    PubMed

    Wang, Y; Yang, Gb

    2016-04-01

    Polymeric immunoglobulin receptors (pIgR) and neonatal Fc receptors (FcRn) are crucial immunoglobulin (Ig) receptors for the transcytosis of immunoglobulins, that is IgA, IgM and IgG, the levels of which in mucosal secretions were altered in both HIV- and SIV-infected individuals. To gain an insight into the changes of pIgR and FcRn expression after immunodeficiency virus (SHIV/SIV) infection, real-time RT-PCR methods were established and the mRNA levels of pIgR and FcRn in normal and SHIV/SIV-infected rhesus macaques were quantitatively examined. It was found that the levels of pIgR mRNA were within a range of 10(7) copies per million copies of GAPDH mRNA in the gut mucosa of rhesus macaques, which were up to 55 times higher than that in the oral mucosa, the highest among the non-gut tissues examined. Levels of FcRn mRNA were generally lower than that of pIgR, and the levels of FcRn mRNA in the gut mucosa were also lower than that in most non-gut tissues examined. Notably, the levels of pIgR mRNA in the duodenal mucosa were positively correlated with that of IL-17A in normal rhesus macaques. Both pIgR and FcRn mRNA levels were significantly reduced in the duodenal mucosa during acute SHIV infection and in the jejunum and caecum during chronic SHIV/SIV infection. These data expanded our knowledge on the expression of pIgR and FcRn in the gastrointestinal tract of rhesus macaques and demonstrated altered expression of pIgR and FcRn in SHIV/SIV, and by extension HIV infections, which might have contributed to HIV/AIDS pathogenesis. PMID:26860548

  9. Histology of chronic gastritis with and without duodenitis in patients with Helicobacter pylori infection.

    PubMed Central

    Phull, P S; Price, A B; Stephens, J; Rathbone, B J; Jacyna, M R

    1996-01-01

    AIM: To compare the histological characteristics of Helicobacter pylori positive chronic gastritis in patients with and without associated duodenitis. METHODS: Gastric mucosal biopsy specimens were obtained from patients undergoing endoscopy for dyspepsia. Severity of gastritis and density of H pylori infection were graded according to the Sydney system. RESULTS: Of the 69 patients studied, 15 had normal histology, 22 had chronic gastritis only (77.3% H pylori positive), 21 had duodenitis (90.5% H pylori positive), and 11 had other diagnoses. In the H pylori positive patients, the median gastritis score was higher in the duodenitis group (6, range 3-9) than in the chronic gastritis only group (5, range 2-8), because of greater neutrophil activity scores in patients with duodenitis (median score 2 v 1). There were no differences in the density of H pylori infection, inflammation, atrophy, or intestinal metaplasia between patients with chronic gastritis only and those with duodenitis. CONCLUSIONS: These results suggest that H pylori positive patients with duodenitis have a more severe form of gastritis than those without associated duodenal inflammation. This is because of increased neutrophil activity, which seems to be independent of the density of H pylori infection. PMID:8707950

  10. Duodenal epithelial transport in functional dyspepsia: Role of serotonin

    PubMed Central

    Witte, Anne-Barbara; DAmato, Mauro; Poulsen, Steen Seier; Laurent, Agneta; Knuhtsen, Svend; Bindslev, Niels; Hansen, Mark Berner; Schmidt, Peter Thelin

    2013-01-01

    AIM: To investigate functional duodenal abnormalities in functional dyspepsia (FD) and the role of serotonin (5-hydroxytryptamine, 5-HT) in mucosal ion transport and signalling. METHODS: Duodenal mucosal biopsies were obtained from 15 patients with FD and 18 healthy controls. Immunohistochemistry was used to study the number of 5-HT-containing cells and real-time polymerase chain reaction for expression of 5-HT receptors 1A, 1B, 2A, 2B, 3A, 3B, 3C, 3D, 3E, 4 and 7, as well as expression of the serotonin re-uptake transporter (SERT) gene SLC6A4 and tryptophan hydroxylase 1 (TPH1). Biopsies were mounted in Ussing chambers for evaluation of basal and 5-HT-stimulated short-circuit current (SCC). RESULTS: Conductance was lower in FD [42.4 4.7 mS/cm2 (n = 15) vs 62.5 4.5 mS/cm2 (n = 18), P = 0.005]. 5-HT induced a dose dependent rise in SCC in both FD (n = 8) and controls (n = 9), the rise was lower in FD (P < 0.001). Mean number of 5-HT stained cells per high power field was the same [34.4 8.4 in FD (n = 15) and 30.4 3.7 in controls (n = 18), P = 0.647]. The following genes were highly expressed: 5-HT receptor HTR3E, HTR4, HTR7, SERT gene (SLC6A4) and TPH1. Differences in expression levels were observed for HTR3E (higher expression in FD, P = 0.008), HTR7 (lower expression in FD, P = 0.027), SLC6A4 (higher expression in FD, P = 0.033) and TPH1 (lower expression in FD, P = 0.031). CONCLUSION: Duodenal ion transport in response to exogenous 5-HT is abnormal in FD patients and associated with high expression of the HTR3E receptor and the serotonin transporter. PMID:23755368

  11. CANCER MUCOSA ANTIGENS A NOVEL PARADIGM IN CANCER IMMUNOTHERAPEUTICS

    PubMed Central

    Snook, Adam E; Waldman, Scott A

    2011-01-01

    Employing antigens with expression restricted to normal intestinal mucosa and derivative colorectal tumors cancer mucosa antigens (CMAs) represents a novel paradigm in anti-tumor immunotherapy. Immune compartmentalization limits tolerance to CMAs and restricts mucosa-targeted autoimmunity, allowing safe and effective immunotherapy for metastatic colorectal cancer. Guanylyl cyclase C (GCC), an intestine/colorectal cancer-restricted protein, is poised for clinical evaluation as the index CMA.

  12. Perforated Duodenal Ulcer –A Rare Cause of Acute Abdomen in Pregnancy

    PubMed Central

    Rani, Jyotsna; Huria, Anju; Gupta, Pratiksha; Dalal, Usha

    2014-01-01

    Acute abdomen during pregnancy is a medico-surgical emergency demanding concerted, synchronized specialties approach of obstetrician, surgeon and gastroenterologist. Duodenal perforation is one of the rarer causes of acute abdomen in pregnancy. Here, we report a case of duodenal perforation with peritonitis in third trimester of pregnancy requiring surgical management. Our aim of reporting this case is to stress the physicians to keep the differential of duodenal perforation also in mind while dealing with cases of acute abdomen in pregnancy and to proceed with multidisciplinary approach for better feto-maternal outcome. PMID:25386494

  13. Pneumoretroperitoneum and pneumoperitoneum following argon plasma coagulation for a bleeding duodenal diverticulum: a case report.

    PubMed

    Su, Pei-Yuan; Yen, Hsu-Heng

    2010-02-01

    Duodenal diverticula are usually asymptomatic, with an incidence of 0.16% to 22%. Symptomatic bleeding from a duodenal diverticulum is an even rarer event. The management of such a hemorrhage is almost entirely surgically based. Since the first reported case of endoscopic therapy for duodenal diverticular bleeding (DDB) by Sim et al, only two case series have been reported in the literature regarding endoscopic therapy for DDB. Hence, the optimal therapy modality for DDB remains unclear. A rare case involving massive pneumoretroperitoneum and pneumoperitoneum following argon plasma coagulation treatment for DDB is presented. A short discussion of the optimal endoscopic therapy for this rare disease is provided. PMID:20065903

  14. A case of duodenal atresia with apple peel appearance: challenging the current embryology.

    PubMed

    Pathak, Manish; Narula, Dipanshu

    2014-04-01

    Classically, embryology of duodenal atresia has been linked to defect in recanalization process, while apple-peal atresia of small bowel has been considered as due to vascular accident during embryonic life. We present a 33 week preterm neonate with duodenal atresia with the apple-peal appearance of proximal jejunum for which resection of the jejunum with apple-peal configuration, plication of the duodenum, and duodono-jejunal anastomosis was done. Thus, this rare case of ours questions the embryology of duodenal atresia with the apple-peal appearance suggesting it to be due to a vascular disruption phenomenon during embryonic life. PMID:25024980

  15. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-01-01

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended. PMID:26698210

  16. The vagus, the duodenal brake, and gastric emptying.

    PubMed Central

    Shahidullah, M; Kennedy, T L; Parks, T G

    1975-01-01

    It has been suggested that an intact vagal supply is essential for the normal function of the recptors in the duodenum and proximal small bowel, which influence the rate of gastric emptying. This paper reports the effect of vagal denervation on gastric emptying and also examines the site and mode of action of receptors in the proximal small bowel.It has been demonstrated in the dog that most, if not all, the receptors controlling gastric emptying lie in the proximal 50 cm of the small bowel. Following truncal vagotomy the emptying time of each instillation increased significantly and the differential rate of emptying of different instillations remained unchanged. The proximal 50 cm of small bowel was capable to differentiating between different instillates even after selective extragastric vagotomy, in which the duodenum was vagally denervated and, therefore, duodenal braking receptors function independently of vagal innervation. PMID:1140630

  17. Gastric and duodenal squamous cell carcinoma: metastatic or primary?

    PubMed

    Hu, Jian-Bin; Zhu, Yan-Hong; Jin, Mei; Sun, Xiao-Nan

    2013-01-01

    Either metastatic or primary squamous cell carcinoma in the gastrointestinal tract is extremely rare, with very few cases reported in the literature. In this paper, we report a case in which the patient presented with dysphagia during the course of radiotherapy for recurrent lung cancer in a mediastinal lymph node. Although the dysphagia mimicked radiation esophagitis, the ultimate cause proved to be gastric and duodenal metastases from primary lung squamous cell carcinoma. Taking into account the value of identification of metastatic or primary SCC in the stomach and duodenum on the prognosis and treatment options, it is imperative that the correct diagnosis be established. This report is followed by a discussion of the differential diagnosis between metastatic and primary squamous cell carcinoma in the stomach and duodenum. PMID:23957943

  18. Isolated Blunt Duodenal Trauma: Simple Repair, Low Mortality.

    PubMed

    Siboni, Stefano; Benjamin, Elizabeth; Haltmeier, Tobias; Inaba, Kenji; Demetriades, Demetrios

    2015-10-01

    Optimal surgical management of traumatic duodenal injury (DI) remains controversial. The National Trauma Data Bank was queried for all blunt trauma patients with DI. Patients with isolated injury were identified by excluding chest and head Abbreviated Injury Score > 3 and nonduodenal intra-abdominal Organ Injury Scale ? 3. Demographics, OIS, and operative intervention were collected. Outcomes included mortality and hospital length of stay (HLOS). During the study period, 3,456,098 blunt trauma patients were entered into the National Trauma Data Bank, 388,137 of which had abdominal trauma. Overall, 1.0 per cent patients with abdominal trauma had DI with isolated DI in only 0.6 per cent (n = 2220). The majority of isolated DI was low grade with only 158 patients sustaining severe injury and overall mortality was 5.2 per cent. Overall 743 patients were operated, of which 353 (47.5%) patients underwent duodenal operation, 280 (37.7%) had primary repair (PR), and 68 (9.2%) had gastroenterostomy (GE). Patients with PR had similar mortality to those with GE (6.6% vs 4.5%, P = 0.777); however, HLOS was shorter (median 11 days, vs 18 days, P < 0.001). In only OIS 4 and 5 injuries, PR was also associated with shorter HLOS (P = 0.004) and similar mortality (P = 1.000) when compared with GE. Isolated DI after blunt abdominal trauma is rare. In severe injuries, PR is associated with a shorter HLOS without effecting mortality when compared with GE. PMID:26463289

  19. A modified Rendezvous ERCP technique in duodenal diverticulum

    PubMed Central

    Odabasi, Mehmet; Yildiz, Mehmet Kamil; Abuoglu, Haci Hasan; Eris, Cengiz; Ozkan, Erkan; Gunay, Emre; Aktekin, Ali; Muftuoglu, MA Tolga

    2013-01-01

    AIM: To postoperative endoscopic retrograde cholangiopancreatography (ERCP) failure, we describe a modified Rendezvous technique for an ERCP in patients operated on for common bile duct stone (CBDS) having a T-tube with retained CBDSs. METHODS: Five cases operated on for CBDSs and having retained stones with a T-tube were referred from other hospitals located in or around Istanbul city to the ERCP unit at the Haydarpasa Numune Education and Research Hospital. Under sedation anesthesia, a sterile guide-wire was inserted via the T-tube into the common bile duct (CBD) then to the papilla. A guide-wire was held by a loop snare and removed through the mouth. The guide-wire was inserted into the sphincterotome via the duodenoscope from the tip to the handle. The duodenoscope was inserted down to the duodenum with a sphincterotome and a guide-wire in the working channel. With the guidance of a guide-wire, the ERCP and sphincterotomy were successfully performed, the guide-wire was removed from the T-tube, the stones were removed and the CBD was reexamined for retained stones by contrast. RESULTS: An ERCP can be used either preoperatively or postoperatively. Although the success rate in an isolated ERCP treatment ranges from up to 87%-97%, 5%-10% of the patients require two or more ERCP treatments. If a secondary ERCP fails, the clinicians must be ready for a laparoscopic or open exploration. A duodenal diverticulum is one of the most common failures in an ERCP, especially in patients with an intradiverticular papilla. For this small group of patients, an antegrade cannulation via a T-tube can improve the success rate up to nearly 100%. CONCLUSION: The modified Rendezvous technique is a very easy method and increases the success of postoperative ERCP, especially in patients with large duodenal diverticula and with intradiverticular papilla. PMID:24255749

  20. Duodenal nutrient exclusion improves metabolic syndrome and stimulates villus hyperplasia

    PubMed Central

    Habegger, Kirk M; Al-Massadi, Omar; Heppner, Kristy M; Myronovych, Andriy; Holland, Jenna; Berger, Jose; Yi, Chun-Xia; Gao, Yuanging; Lehti, Maarit; Ottaway, Nickki; Amburgy, Sarah; Raver, Christine; Mller, Timo D; Pfluger, Paul T; Kohli, Rohit; Perez-Tilve, Diego; Seeley, Randy J; Tschp, Matthias H

    2014-01-01

    Objective Surgical interventions that prevent nutrient exposure to the duodenum are among the most successful treatments for obesity and diabetes. However, these interventions are highly invasive, irreversible and often carry significant risk. The duodenal-endoluminal sleeve (DES) is a flexible tube that acts as a barrier to nutrient-tissue interaction along the duodenum. We implanted this device in Zucker Diabetic Fatty (ZDF) rats to gain greater understanding of duodenal nutrient exclusion on glucose homeostasis. Design ZDF rats were randomised to four groups: Naive, sham ad libitum, sham pair-fed, and DES implanted. Food intake, body weight (BW) and body composition were measured for 28 days postoperatively. Glucose, lipid and bile acid metabolism were evaluated, as well as histological assessment of the upper intestine. Results DES implantation induced a sustained decrease in BW throughout the study that was matched by pair-fed sham animals. Decreased BW resulted from loss of fat, but not lean mass. DES rats were also found to be more glucose tolerant than either ad libitum-fed or pair-fed sham controls, suggesting fat mass independent metabolic benefits. DES also reduced circulating triglyceride and glycerol levels while increasing circulating bile acids. Interestingly, DES stimulated a considerable increase in villus length throughout the upper intestine, which may contribute to metabolic improvements. Conclusions Our preclinical results validate DES as a promising therapeutic approach to diabetes and obesity, which offers reversibility, low risk, low invasiveness and triple benefits including fat mass loss, glucose and lipid metabolism improvement which mechanistically may involve increased villus growth in the upper gut. PMID:24107591

  1. Involvement of glutamate-cystine/glutamate transporter system in aspirin-induced acute gastric mucosa injury.

    PubMed

    Du, Jie; Li, Xiao-Hui; Zhang, Wang; Yang, Yong-Mei; Wu, Yue-Han; Li, Wen-Qun; Peng, Jun; Li, Yuan-Jian

    2014-07-18

    Large-dose or long-term use of aspirin tends to cause gastric mucosa injury, which is recognized as the major side effect of aspirin. It has been demonstrated that glutamate exerts a protective effect on stomach, and the level of glutamate is critically controlled by cystine/glutamate transporter (Xc(-)). In the present study, we investigated the role of glutamate-cystine/glutamate transporter system in aspirin-induced acute gastric mucosa injury in vitro and in vivo. Results showed that in human gastric epithelial cells, aspirin incubation increased the activity of LDH and the number of apoptotic cells, meanwhile down-regulated the mRNA expression of Xc(-) accompanied with decreased glutamate release. Similar results were seen in a rat model. In addition, exogenous l-glutamate attenuated the gastric mucosa injury and cell damage induced by aspirin both in vitro and in vivo. Taken together, our results demonstrated that acute gastric mucosa injury induced by aspirin is related to reduction of glutamate-cystine/glutamate transporter system activity. PMID:24866234

  2. Infectivity of Giardia duodenalis Assemblages A and E for the gerbil and axenisation of duodenal trophozoites.

    PubMed

    Bnr, Ely; Geurden, Thomas; Robertson, Lucy; Van Assche, Tim; Cos, Paul; Maes, Louis

    2010-12-01

    Establishing in vitro cultures of Giardia duodenalis trophozoites from faecal cysts remains very difficult due to poor excystation and bacterial contamination. This study investigated an alternative approach starting from duodenal trophozoites of gerbils that were artificially infected with field isolates from humans (Assemblages A and B) and cattle (Assemblage E and mixed E/A). Gerbil infection was successful for Assemblages A (1/1) and B (1/3) from humans, and for E (1/2) and mixed E/A (6/6) from cattle. Despite the fact that some isolates subsequently failed or were difficult to establish in vitro, several Assemblage A and Assemblage E in vitro trophozoite cultures were successful, however, subsequent cloning required adaptation of the standard TYI-S-33 medium whereby different medium supplements were required for promoting growth. Excess of l-cysteine (2mg/ml) and ascorbic acid (0.2mg/ml) supported cloning of Assemblage A, while l-glutathione (7.8 mg/ml) was required for Assemblage E. This is a first description of in vitro axenisation of Assemblage E trophozoites from cattle. PMID:20696269

  3. [The gastric mucosa barrier and gastropathy].

    PubMed

    Speranza, V; Lezoche, E

    1978-05-15

    In addition to a layer of mucus, the gastric mucosa barrier is mainly formed of a tight junction consisting of the surface membranes of epithelial cells. It is this that mainly impedes the flowback of H+ ions. Buffers conveyed by the blood neutralise the small numbers of ions that do flow back, even under physiological conditions. Damage to the barrier results in a considerable backflow of ions that enhance acid secretion and release of histamine and other vasoactive substances, so that further mucosal lesions occur. Such damage may be of exogenous or endogenous origin. Alcohol and acetylsalicylic acid are two examples. The latter is undissociated and hence liposoluble in the highly milieu of the stomach and can easily enter the cells and damage them. Severe hypovolaemia, stress and sepsis are instances of endogenous sources of damage. In the final analysis, the damage caused by sepsis is linked to cell anoxia. PMID:78472

  4. Acute pancreatitis as an adverse event in patients with the duodenal-jejunal bypass liner.

    PubMed

    Betzel, Bark; Homan, Jens; Aarts, Edo; Janssen, Ignace; Spanier, Marcel; Wahab, Peter; Groenen, Marcel; Berends, Frits

    2015-11-01

    Placement of the duodenal-jejunal bypass liner (DJBL) is a minimally invasive technique for the management of patients with type 2 diabetes mellitus and obesity. Acute pancreatitis was seen in 5 of 167 patients (3?%) in our series. It is suggested that acute pancreatitis in patients with the DJBL results from either direct blockage or edema of the major duodenal papilla, which may be caused by the following: migration of the anchor of the DJBL, accumulation of food debris between the liner and the duodenal wall, or reflux of duodenal contents into the pancreatic duct due to intraluminal hypertension caused by the liner. Early removal of the DJBL resulted in fast and complete recovery, whereas delayed diagnosis and removal led to severe, necrotizing acute pancreatitis. PMID:26021308

  5. Modeling data for pancreatitis in presence of a duodenal diverticula using logistic regression

    NASA Astrophysics Data System (ADS)

    Dineva, S.; Prodanova, K.; Mlachkova, D.

    2013-12-01

    The presence of a periampullary duodenal diverticulum (PDD) is often observed during upper digestive tract barium meal studies and endoscopic retrograde cholangiopancreatography (ERCP). A few papers reported that the diverticulum had something to do with the incidence of pancreatitis. The aim of this study is to investigate if the presence of duodenal diverticula predisposes to the development of a pancreatic disease. A total 3966 patients who had undergone ERCP were studied retrospectively. They were divided into 2 groups-with and without PDD. Patients with a duodenal diverticula had a higher rate of acute pancreatitis. The duodenal diverticula is a risk factor for acute idiopathic pancreatitis. A multiple logistic regression to obtain adjusted estimate of odds and to identify if a PDD is a predictor of acute or chronic pancreatitis was performed. The software package STATISTICA 10.0 was used for analyzing the real data.

  6. Intraluminal duodenal diverticula: collective review with report of a laparoscopic excision.

    PubMed

    Meinke, Alan Kurt; Meighan, Dennis M; Meinke, Mary E; Mirza, Nadia; Parris, Tchaiko M; Meinke, Richard K

    2013-02-01

    A comprehensive review of intraluminal duodenal diverticulum (IDD) is presented, along with a report of a completely laparoscopic excision of this duodenal abnormality as well as a report of magnetic resonance cholangiopancreatography demonstrating the classic fluoroscopic "wind sock sign" pathognomonic appearance of IDD. IDD may easily be missed unless one specifically considers this entity in patients presenting with symptoms of foregut disease. Patients with IDD typically present in the fourth decade of life with duration of symptoms less than 5 years that typically include pain, nausea and vomiting, pancreatitis, and gastrointestinal bleeding. Diagnosis usually requires imaging studies and upper gastrointestinal endoscopy. Laparoscopic excision is recommended because of superior visualization of significant intestinal anatomic abnormalities, the need for accurate ampullary localization, and the ability to facilitate complete diverticular excision while maintaining biliary and pancreatic ductal integrity. Review of surgical literature suggests that IDD results from congenital duodenal developmental abnormalities matured by long-term duodenal peristalsis. PMID:23256586

  7. Massive duodenal variceal bleed; complication of extra hepatic portal hypertension: Endoscopic management and literature review

    PubMed Central

    Steevens, Christopher; Abdalla, Maisa; Kothari, Truptesh H; Kaul, Vivek; Kothari, Shivangi

    2015-01-01

    Bleeding from duodenal varices is reported to be a catastrophic and often fatal event. Most of the cases in the literature involve patients with underlying cirrhosis. However, approximately one quarter of duodenal variceal bleeds is caused by extrahepatic portal hypertension and they represent a unique population given their lack of liver dysfunction. The authors present a case where a 61-year-old male with history of remote crush injury presented with bright red blood per rectum and was found to have bleeding from massive duodenal varices. Injection sclerotherapy with ethanolamine was performed and the patient experienced a favorable outcome with near resolution of his varices on endoscopic follow-up. The authors conclude that sclerotherapy is a reasonable first line therapy and review the literature surrounding the treatment of duodenal varices secondary to extrahepatic portal hypertension. PMID:26558159

  8. Increased Production of Lysozyme Associated with Bacterial Proliferation in Barrett's Esophagitis, Chronic Gastritis, Gluten-induced Atrophic Duodenitis (Celiac Disease), Lymphocytic Colitis, Collagenous Colitis, Ulcerative Colitis and Crohn's Colitis.

    PubMed

    Rubio, Carlos A

    2015-12-01

    The mucosa of the esophagus, the stomach, the small intestine, the large intestine and rectum are unremittingly challenged by adverse micro-environmental factors, such as ingested pathogenic and non-pathogenic bacteria, and harsh secretions with digestive properties with disparate pH, as well as bacteria and secretions from upstream GI organs. Despite the apparently inauspicious mixture of secretions and bacteria, the normal GI mucosa retains a healthy state of cell renewal. To by-pass the tough microenvironment, the epithelia of the GI react by speeding-up cell exfoliation, by increasing peristalsis, eliminating bacteria through secretion of plasma cell-immunoglobulins and by increasing production of natural antibacterial enzymes (lysozyme) and host defense peptides (defensin-5). Lysozyme was recently found up-regulated in Barrett's esophagitis, in chronic gastritis, in gluten-induced atrophic duodenitis (celiac disease), in collagenous colitis, in lymphocytic colitis and in Crohn's colitis. This up-regulation is a response directed towards the special types of bacteria thriving in the microenvironment in each of the aforementioned clinical inflammatory maladies. The purpose of that up-regulation is to protect the mucosa affected by the ongoing chronic inflammation. Bacterial antibiotic resistance continues to exhaust our supply of effective antibiotics. The future challenge is how to solve the increasing menace of bacterial resistance to anti-bacterial drugs. Further research on natural anti-bacterial enzymes such as lysozyme, appears mandatory. PMID:26637845

  9. Gastric Duplication Cyst in Association with Duodenal Atresia in a Neonate

    PubMed Central

    Mirshemirani, Alireza; Roshanzamir, Fatollah; Razavi, Sajad; Sarafi, Mehdi

    2016-01-01

    Concurrence of duodenal atresia and gastric duplication cyst is extremely rare entity. We report a 6-day-old female neonate who presented with neonatal intestinal obstruction. X-ray abdomen showed double bubble sign. At laparotomy, a huge cystic structure attached to greater curvature of the stomach along with duodenal atresia of second part of duodenum was found. The cystic structure was excised and duodeno-duodenostomy performed. Histopathology report confirmed it gastric duplication cyst. PMID:26816679

  10. Ghrelin accelerates the healing of cysteamine-induced duodenal ulcers in rats

    PubMed Central

    Warzecha, Zygmunt; Ceranowicz, Dagmara; Dembi?ski, Artur; Ceranowicz, Piotr; Cieszkowski, Jakub; Kuwahara, Atsukazu; Kato, Ikuo; Dembi?ski, Marcin; Konturek, Peter C.

    2012-01-01

    Summary Background Previous studies have shown that administration of ghrelin exhibits protective and therapeutic effects in the gut. The aim of the present investigation was to examine the influence of ghrelin administration on the course of cysteamine-induced duodenal ulcers, as well as effects on mucosal production of oxygen free radicals and duodenal antioxidant defense. Material/Methods Duodenal ulcers were induced in male Wistar rats by cysteamine administered intragastrically at the dose of 200 mg/kg in 1 ml of saline, 3 times at 4-h intervals. Starting 24 h after the first dose of cysteamine, rats were treated intraperitoneally twice a day with saline or ghrelin given at the dose of 4, 8 or 16 nmol/kg/dose. Seven days after administration of the first dose of cysteamine, the study was terminated. Results Induction of ulcers by cysteamine was accompanied by a reduction in duodenal blood flow, mucosal DNA synthesis and mucosal activity of superoxide dismutase (SOD); whereas mucosal concentration of interleukin-1? and malonyldialdehyde (MDA an index of lipid peroxidation) were increased. Treatment with ghrelin increased healing rate of duodenal ulcers and enhanced duodenal blood flow, mucosal DNA synthesis and mucosal activity of SOD, and reduced mucosal concentration of interleukin-1? and MDA. Conclusions Treatment with ghrelin increases the healing rate of duodenal ulcers and this effect is related, at least in part, to improvement of duodenal mucosal blood flow, mucosal cell proliferation and antioxidant defense, as well as being related to reduction in mucosal oxidative stress and inflammatory response. PMID:22534700

  11. Simple diversion by duodenojejunostomy for a retroperitoneal perforation of the second portion of the duodenal diverticulum.

    PubMed

    Fujisaki, Shigeru; Takashina, Motoi; Sakurai, Kenichi; Tomita, Rhyouichi; Takayama, Tadatoshi

    2014-01-01

    We herein describe that a Roux-en-Y duodenojejunostomy is a simple and secure procedure for perforated diverticulum in the second portion of the duodenum. The surgical technique for perforated duodenal diverticulum can be adaptable when it is difficult to achieve closure of the perforated site easily. Patients who undergo the operation may be able to eat meals, even if duodenal fistula occurs in the postoperative course. PMID:25216433

  12. Traumatic Rupture of a Duodenal Diverticulum: Case Report and Review of the Literature.

    PubMed

    Majerus, B; Mathonet, P; Haxhe, J-P

    2015-01-01

    Duodenal diverticula are relatively common and usually asymptomatic (95%). Their perforation is a rare but harmful event. Traumatic perforation is exceptional. We report the case of a patient with such a lesion following a blunt trauma secondary to a car accident, and review the literature. Clinical presentation is aspecific and diagnosis is based upon CT scan imaging. Surgery is the recommended treatment consisting of diverticulectomy with transverse duodenal closure of the duodenum associated with retroperitoneal drainage. PMID:26324035

  13. [Post-traumatic intramural duodenal hematoma as a cause of high ileus in a child].

    PubMed

    Soudek, K; Husek, J; Randa, V; Dan?k, J

    1989-04-01

    The authors describe the case of an intramural duodenal haematoma caused a high ileus after a seven-day post-traumatic interval. The authors recommend surgical revision, in particular in children because the mechanism of injury is the same in intramural haematoma and in duodenal perforation. Only thus it is possible to prevena a fatal course, while the operation is easy and healing after drainage of the haematoma is rapid. PMID:2749389

  14. Septic Complication After Balloon-Occluded Retrograde Transvenous Obliteration of Duodenal Variceal Bleeding

    SciTech Connect

    Akasaka, Thai; Shibata, Toshiya Isoda, Hiroyoshi; Taura, Kojiro; Arizono, Shigeki; Shimada, Kotaro; Togashi, Kaori

    2010-12-15

    We report a 64-year-old woman with duodenal varices who underwent balloon-occluded retrograde transvenous obliteration (B-RTO) complicated by intraprocedural variceal rupture. The patient developed shivering and a fever higher than 40{sup o}C 3 days after the B-RTO procedure. A blood culture grew Entereobacter cloacoe. This case represents a rare septic complication of B-RTO for duodenal varices.

  15. Relation between gastric acid output, Helicobacter pylori, and gastric metaplasia in the duodenal bulb.

    PubMed Central

    Harris, A W; Gummett, P A; Walker, M M; Misiewicz, J J; Baron, J H

    1996-01-01

    BACKGROUND: Factors that determine gastric metaplasia in the duodenal bulb are ill defined. It is more common and extensive in the presence of high acid output and possibly in the presence of Helicobacter pylori. However, no quantitative relation between acid output and the extent of gastric metaplasia has been demonstrated and its relation to H pylori is uncertain. AIM: To determine the relation between H pylori infection and acid output and the presence and extent of gastric metaplasia in the duodenal bulb. subjects: H pylori positive and negative patients with duodenal ulcer and healthy controls were studied. METHODS: Quadrantic duodenal bulb biopsy specimens were taken and the presence and extent of gastric metaplasia determined using a computer enhanced image intensifier. Basal and stimulated acid outputs were measured. RESULTS: gastric metaplasia was significantly (p < 0.05 more common and significantly (p < 0.05) greater in extent in patients with duodenal ulcer than in controls. Neither the prevalence or extent of gastric metaplasia was affected by H pylori status. There were significant (p < 0.01) direct correlations between acid output and extent of gastric metaplasia. CONCLUSIONS: Prevalence and extent of gastric metaplasia are not related to H pylori in controls, or in patients with duodenal ulcer. Rather, high acid response to gastrin may be more important. Images Figure 1 PMID:8944558

  16. Successful mucosal incision-assisted biopsy for the histological diagnosis of duodenal lymphoma: A case report

    PubMed Central

    MORISHITA, ASAHIRO; MORI, HIROHITO; KOBARA, HIDEKI; NISHIYAMA, NORIKO; FUJIHARA, SHINTARO; YACHIDA, TATSUO; AYAKI, MAKI; MATSUNAGA, TAE; SAKAMOTO, TEPPEI; MAEDA, EMIKO; NOMURA, TAKAKO; TANI, JOJI; MIYOSHI, HISAAKI; YONEYAMA, HIROHITO; HIMOTO, TAKASHI; KAGAWA, SEIKO; HABA, REIJI; MASAKI, TSUTOMU

    2016-01-01

    Tissue sampling of primary duodenal lymphoma is essential for its histological diagnosis. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), which is frequently used for submucosal tumor (SMT)-like duodenal tumors, is adequate for cytological diagnosis, but not for histological diagnosis. Therefore, in the present study, a mucosal incision-assisted biopsy (MIAB) was performed in an 81-year-old woman for the diagnosis of an SMT-like duodenal mass, as tissue sampling for histological analysis using a regular endoscopic biopsy had failed to establish a definite diagnosis of malignant lymphoma. EUS-FNA had also led to poor tissue sampling due to the difficult location of the duodenal tumor. The pathological examination of biopsy samples using MIAB revealed the presence of a diffuse proliferation of atypical lymphocytes, and the expression of cluster of differentiation (CD)20 and CD79a, but no expression of CD3 in the tumor specimens. The patient was diagnosed with diffuse large B-cell lymphoma. To the best of knowledge, this is first report of a case using MIAB as a sampling method for the histological diagnosis of SMT-like primary duodenal lymphoma. This case suggests that MIAB may be an essential method for obtaining tissue samples from SMT-like duodenal tumors. PMID:26870243

  17. Digested and fermented green kiwifruit increases human β-defensin 1 and 2 production in vitro.

    PubMed

    Bentley-Hewitt, Kerry L; Blatchford, Paul A; Parkar, Shanthi G; Ansell, Juliet; Pernthaner, Anton

    2012-09-01

    The intestinal mucosa is constantly exposed to a variety of microbial species including commensals and pathogens, the latter leaving the host susceptible to infection. Antimicrobial peptides (AMP) are an important part of the first line of defense at mucosal surfaces. Human β-defensins (HBD) are AMP expressed by colonic epithelial cells, which act as broad spectrum antimicrobials. This study explored the direct and indirect effects of green kiwifruit (KF) on human β-defensin 1 and 2 (HBD-1 and 2) production by epithelial cells. In vitro digestion of KF pulp consisted of a simulated gastric and duodenal digestion, followed by colonic microbial fermentation using nine human faecal donors. Fermenta from individual donors was sterile filtered and independently added to epithelial cells prior to analysis of HBD protein production. KF products obtained from the gastric and duodenal digestion had no effect on the production of HBD-1 or 2 by epithelial cells, demonstrating that KF does not contain substances that directly modulate defensin production. However, when the digested KF products were further subjected to in vitro colonic fermentation, the fermentation products significantly up-regulated HBD-1 and 2 production by the same epithelial cells. We propose that this effect was predominantly mediated by the presence of short-chain fatty acids (SCFA) in the fermenta. Exposure of cells to purified SCFA confirmed this and HBD-1 and 2 production was up-regulated with acetate, propionate and butyrate. In conclusion, in vitro colonic fermentation of green kiwifruit digest appears to prime defense mechanisms in gut cells by enhancing the production of antimicrobial defensins. PMID:22872469

  18. Effects of tea from Turnera ulmifolia L. on mouse gastric mucosa support the Turneraceae as a new source of antiulcerogenic drugs.

    PubMed

    Gracioso, Juliano de Souza; Vilegas, Wagner; Hiruma-Lima, Cllia Akiko; Souza Brito, Alba Regina Monteiro

    2002-04-01

    Turnera ulmifolia is a plant belonging to the family Turneraceae, popularly known in Brazil as chanana. This species is distributed from Guyana to southern Brazil where it is considered a weed. The plant occurs in tropical rain forest, fields, and gardens. Chanana tea is used in Brazilian folk medicine for the treatment of diseases related mainly to gastric dysfunction including gastric and duodenal ulcers. In this study, the ability of a lyophilized infusion, as an aqueous fraction (AqF) of the aerial parts of T. ulmifolia, was investigated for its ability to prevent ulceration of the gastric and duodenal mucosa was examined in mice and rats, respectively. The AqF significantly reduced the formation of lesions associated with HCl/ethanol administration by 39% and 46%, respectively, at doses of 500 mg/kg and 1000 mg/kg, p.o. The AqF also significantly reduced the incidence of gastric lesions induced by a combination of indomethacin and bethanechol by 58% and 72% at doses of 500 mg/kg and 1000 mg/kg, respectively. In stress-induced gastric ulcer, the inhibition by the AqF was 48%, 57%, and 58% at doses of 250 mg/kg, 500 mg/kg, and 1000 mg/kg, respectively (p<0.05). A pyloric ligature experiment showed that the highest dose of the AqF significantly affected the gastric juice parameters by increasing the pH from 2.5 (control) to 5.3 and decreasing the acid output from 11.3 (control) to 3.7 mEq/ml/4 h. The AqF had no significant effect on duodenal ulcers induced by cysteamine. Preliminary phytochemical screening confirmed that flavonoids were the major constituents of the AqF of T. ulmifolia. These results indicate that this extract has a significant antiulcerogenic effect, as popularly believed. PMID:11995930

  19. Aberrant gene expression in mucosa adjacent to tumor reveals a molecular crosstalk in colon cancer

    PubMed Central

    2014-01-01

    Background A colorectal tumor is not an isolated entity growing in a restricted location of the body. The patients gut environment constitutes the framework where the tumor evolves and this relationship promotes and includes a complex and tight correlation of the tumor with inflammation, blood vessels formation, nutrition, and gut microbiome composition. The tumor influence in the environment could both promote an anti-tumor or a pro-tumor response. Methods A set of 98 paired adjacent mucosa and tumor tissues from colorectal cancer (CRC) patients and 50 colon mucosa from healthy donors (246 samples in total) were included in this work. RNA extracted from each sample was hybridized in Affymetrix chips Human Genome U219. Functional relationships between genes were inferred by means of systems biology using both transcriptional regulation networks (ARACNe algorithm) and protein-protein interaction networks (BIANA software). Results Here we report a transcriptomic analysis revealing a number of genes activated in adjacent mucosa from CRC patients, not activated in mucosa from healthy donors. A functional analysis of these genes suggested that this active reaction of the adjacent mucosa was related to the presence of the tumor. Transcriptional and protein-interaction networks were used to further elucidate this response of normal gut in front of the tumor, revealing a crosstalk between proteins secreted by the tumor and receptors activated in the adjacent colon tissue; and vice versa. Remarkably, Slit family of proteins activated ROBO receptors in tumor whereas tumor-secreted proteins transduced a cellular signal finally activating AP-1 in adjacent tissue. Conclusions The systems-level approach provides new insights into the micro-ecology of colorectal tumorogenesis. Disrupting this intricate molecular network of cell-cell communication and pro-inflammatory microenvironment could be a therapeutic target in CRC patients. PMID:24597571

  20. Gastrointestinal Hemorrhage Due to Duodenal Erosion by a Biliary Wallstent

    SciTech Connect

    Roebuck, Derek J.; Stanley, Philip; Katz, Michael D.; Parry, Robert L.; Haight, Michael A.

    1998-01-15

    A self-expanding metallic stent (Wallstent) was used to relieve obstruction of the common bile duct in a young male with a desmoplastic small cell tumor of the abdomen. Two months after insertion and following a course of chemotherapy the lower end of the stent eroded the mucosa of the second part of the duodenum causing severe gastrointestinal hemorrhage which necessitated laparotomy and trimming of the stent. This complication may have been due to shrinking of the tumor as well as thrombocytopenia following chemotherapy.

  1. [Antiulcer activity of dibunol in experimental stomach and duodenal ulcers].

    PubMed

    Shatalov, V N; Korman, D B; Krutova, T V; Sokolov, L K; Andrianova, O P

    1988-01-01

    The antiulcer effect of two medicinal forms (oil solution, liniment) of dibunol in rats with different models of the stomach and duodenum ulcers was studied. The therapeutic activity of dibunol was evaluated by determining the index of ulcer formation as well as during the morphological and histochemical studies. The two medicinal forms of dibunol possessed equal antiulcer activity by all studied criteria. One should note a characteristic property of dibunol--its ability to produce pronounced epithelialization of ulceroerosive and ulceronecrotic lesions of the mucosa without rough scarring. PMID:3410030

  2. Filariasis of the buccal mucosa: A diagnostic dilemma

    PubMed Central

    Kurup, Seema; Veeraraghavan, Ravi; Jose, Renju; Puthalath, Ushass

    2013-01-01

    Filariasis is an endemic disease in tropical and subtropical countries. Filarial nematodes can infect humans through vectors, commonly mosquitoes. Human infection can manifest as lymphatic filariasis, subcutaneous or pulmonary nodules and with eye involvement. Intra-oral presentation is very rare and often poses a diagnostic dilemma to the dentist. We report a case of intra-oral Dirofilaria repens infection in a 54-year-old female patient, involving the buccal mucosa. History was unremarkable and on clinical examination, a diffuse swelling with no significant signs and symptoms was seen. Laboratory investigations and radiographs were non-contributory to diagnosis. Ultrasound findings revealed a hypo-echoic lesion in the muscular layer of the left cheek. Differential diagnoses considered were minor salivary gland tumor, parotid sialolith, and cysticercosis among others. The presence of a Dirofilaria worm in the excised nodule confirmed the diagnosis. Medical awareness of the risk of intra-oral nematode infection is essential. A detailed travel history, awareness of endemic status of certain diseases, proper diagnosis and management helps in better prognosis for the patient. PMID:24015022

  3. The mucosa-kidney axis in IgA nephropathy.

    PubMed

    Floege, Jrgen; Feehally, John

    2016-03-01

    Links between IgA nephropathy (IgAN) and the mucosa have been recognized since the 1970s. In particular, the observation of visible haematuria induced by respiratory infections in patients with IgAN and the association of IgAN with diseases in which the mucosa plays a part, especially coeliac disease, have been taken as evidence of a mucosa-kidney axis. Here, we review current evidence that links the mucosa, in particular the gastrointestinal mucosa, and IgA produced by the bone marrow with IgAN. Genome-wide association studies in patients with IgAN have identified risk loci in genes involved in the intestinal mucosal integrity and immune network. Furthermore, the systemic immune response to mucosal antigens in IgAN is increased. Moreover, patients with IgAN have an increased reactivity to dietary proteins associated with subclinical intestinal mucosal inflammation. Associations between IgAN and gastrointestinal diseases have also been reported in a small number of patients, but whether these diseases share a common pathogenesis or whether gastrointestinal inflammation exacerbates IgAN is uncertain. Indeed, mucosal alterations such as infections could activate the innate immune system, aggravate a pre-existing IgAN and promote disease manifestations such as macrohaematuria. Various clinical interventions and trials targeting the mucosa or presumed mucosa-associated mechanisms have so far not yielded consistent findings and the results of ongoing trials are eagerly awaited. PMID:26714580

  4. Effect of sucralfate on gastric emptying in duodenal ulcer patients

    SciTech Connect

    Petersen, J.M.; Caride, V.J.; Prokop, E.K.; Troncale, F.; McCallum, R.W.

    1985-05-01

    Duodenal ulcer (DU) patients may have accelerated gastric emptying (GE) suggesting that there is an increase in unbuffered gastric acid reaching the duodenum contributing to DU disease. Aluminum-containing antacids were shown to delay GE. The authors' aim was to investigate whether another aluminum-containing compound, Sucralfate, affects GE in normal and DU patients. Nine normal volunteers and 10 patients with documented DU disease were studied. For each test the subject ingested a meal composed of chicken liver Tc-99m-S-C mixed with beef stew and eaten with 4 oz. of water labelled with 100..mu..Ci of III-in-DTPA. On two separate days, subjects received 1 gram of Sucralfate (190 mg of aluminum per gram) or placebo in a randomized double-blind fashion one hour prior to the test meal. GE of liquids and solids in normal subjects was not significantly changed by Sucralfate. Sucralfate in the DU patients significantly slowed liquid emptying in the initial 40 min and solid food throughout the study compared to placebo (p<0.05). This paper summarizes that; GE of solids but not liquids is accelerated in DU patients compared to normal subjects; and sucralfate delays GE of both liquid and solid components of a meal in DU patients but has no effect on GE in normals. The authors conclude that a slowing of gastric emptying possibly mediated by aluminum ions, may be one mechanism by which Sucralfate enhances healing and decreases recurrence of DU.

  5. [Gas ventilation through middle ear mucosa].

    PubMed

    Ohno, F; Imakiire, T; Nobori, T; Ohyama, M

    1993-11-01

    The possible effects of gas ventilation via the middle ear mucosa on middle ear pressure changes with N2O inhalation were studied. Sixty-seven ears without otologic problems were selected from among cases undergoing ENT surgery under general anesthesia. Anesthesia was induced by isoflurane or sevoflurane, and inhalation with a gas mixture of 21/min O2 and 31/min N2O was started under controlled respiration via endotracheal tube. Middle ear pressure was measured each minute with tympanometry just before and during N2O inhalation. Changes in pressure were plotted against time on an X-Y plotter, and the rate of middle ear pressure change and pressure change in 10 minutes were calculated. The following results were obtained; 1. In all cases, the middle ear pressure rose with N2O inhalation. However, the same concentration of N2O created different middle ear pressure changes in different individuals varying from 1.6 mmH2O to 107.8 mmH2O per minute. 2. The rate of middle ear pressure elevation tended to be greater in younger subjects, especially in children aged 4 to 7. 3. There was a negative correlation between the middle ear pressure change and pneumatization of the middle ear. 4. Sex, pulmonary function, and the N2O expiratory flow concentration did not contribute to the variability in the rate of the middle ear pressure elevation. PMID:8283337

  6. Helicobacter pylori eradication in the African setting, with special reference to reinfection and duodenal ulcer recurrence.

    PubMed Central

    Louw, J A; Lucke, W; Jaskiewicz, K; Lastovica, A J; Winter, T A; Marks, I N

    1995-01-01

    The aim of this study was to determine the effect of Helicobacter pylori eradication on the natural history of duodenal ulcer disease, and to determine the incidence of reinfection in adult patients where H pylori had been eradicated in a community with a high prevalence of the infection. An investigator blinded study, with 24 month endoscopic follow up, in subjects where H pylori had been eradicated, and similarly treated subjects where it had not been eradicated was conducted at a tertiary referral hospital. The patients consisted of a volunteer sample of 48 patients with endoscopically proved active duodenal ulcer disease. Duodenal ulcers were healed with omeprazole, 20 mg/day. After endoscopically confirmed healing, patients were treated with either one (17 patients) or two weeks (31 patients) of 'triple therapy'. H pylori status (urease reaction, histological tests, and culture of antral biopsy specimens) was determined at entry, four weeks after the finish of triple therapy and six, 12, and 24 months after this, or whenever an endoscopically proved recurrent duodenal ulcer was found. The main outcome measures were the recurrence of duodenal ulceration, over 24 months in the eradicated and non-eradicated groups and the incidence of reinfection by H pylori in the eradicated group during this follow up period. Five patients in the eradicated group experienced a duodenal ulcer relapse, of which only three were unexplained (1 = reinfected, 1 = gastrinoma). Fifteen of 21 patients in the non-eradicated group relapsed over the same period (p < 0.001). Only two of 27 patients in the eradicated group were reinfected during the 24 month follow up period. It is concluded that H pylori eradication is an effective treatment strategy for the longterm treatment of duodenal ulcer disease, even in the high prevalence, African setting. Reinfection is uncommon. PMID:7737561

  7. Emotion profile and behaviour pattern of patients with active duodenal ulcer compared with acute coronary patients.

    PubMed

    Catipovi?-Veselica, K; Mi?unovi?, N; Ilakovac, V; Catipovi?, B; Muji?, N; Lauc, A

    1993-01-01

    The authors examined personality profiles and type A/B behaviour in 100 patients with active duodenal ulcer, and a mean age of 39 years, using the Bortner scale and the Plutchnik Emotional Profile Index (EPI). The authors compared them with acute coronary patients and healthy controls. The mean EPI percentages for the duodenal ulcer patients, compared with acute coronary patients and healthy controls, display the trustful dimension (84.1 +/- 27.4--69.1 +/- 20.4--69.3 +/- 20.0), the aggressive dimension (56.7 +/- 9.3--41.3 +/- 19.2--37.6 +/- 17.3), the depressed dimension (84.5 +/- 12.3--52.8 +/- 19.1--51.4 +/- 23.1) and the dyscontrol dimension (73.5 +/- 32.2--48.4 +/- 27.7--50.2 +/- 17.5) to be significantly higher (P < 0.005). The mean percent scores of the gregarious dimension (44.2 +/- 13.2--72.7 +/- 22.7--68.0 +/- 22.0), control dimension (25.2 +/- 91.--39.1 +/- 31.9--44.3 +/- 15.5) and timid dimension (26.2 23.3--56.0 +/- 19.9--59.8 +/- 29.5), are significantly lower in duodenal ulcer patients than in acute coronary patients and controls (P < 0.005). Behaviour type A was found in 95 (95%) duodenal ulcer patients, in 76 (73.7%) acute coronary patients and in 58 (68%) healthy controls (P < 0.001). The Bortner scale was significantly higher in duodenal ulcer patients than in coronary and control subjects (P < 0.005). The EPI of duodenal ulcer patients in comparison to acute coronary patients and healthy controls, are sadder, more impulsive, do more risky things and are more disorganized and dependent. Type A behaviour was more often in duodenal ulcer patients than in the coronary and control groups. PMID:7505135

  8. Acute effects of irradiation on middle ear mucosa

    SciTech Connect

    Ohashi, Y.; Nakai, Y.; Esaki, Y.; Ikeoka, H.; Koshimo, H.; Onoyama, Y.

    1988-03-01

    Single field, fixed irradiation of bilateral tympanic cavities using 200-kV x-rays was administered to five guinea pigs. The irradiation dose was 30 Gy. They were killed immediately after irradiation, and bilateral middle ear mucosa was examined for ciliary activity and epithelial structure. Significant deterioration of the ciliary activity in the middle ear mucosa was observed, proximal as well as distal to the eustachian tube. Electron microscopy showed various changes in the irradiated middle ear mucosa. The most conspicuous findings were hyperreactivity in secretion, vacuolation of ciliated cells, and stomal edema.

  9. Application of single-layer mucosa-to-mucosa pancreaticojejunal anastomosis in pancreaticoduodenectomy

    PubMed Central

    Hu, Bing-Yang; Leng, Jian-Jun; Wan, Tao; Zhang, Wen-Zhi

    2015-01-01

    AIM: To investigate the simplicity, reliability, and safety of the application of single-layer mucosa-to-mucosa pancreaticojejunal anastomosis in pancreaticoduodenectomy. METHODS: A retrospective analysis was performed on the data of patients who received pancreaticoduodenectomy completed by the same surgical group between January 2011 and April 2014 in the General Hospital of the Peoples Liberation Army. In total, 51 cases received single-layer mucosa-to-mucosa pancreaticojejunal anastomosis and 51 cases received double-layer pancreaticojejunal anastomosis. The diagnoses of pancreatic fistula and clinically relevant pancreatic fistula after pancreaticoduodenectomy were judged strictly by the International Study Group on pancreatic fistula definition. The preoperative and intraoperative data of these two groups were compared. ?2 test and Fishers exact test were used to analyze the incidences of pancreatic fistula, peritoneal catheterization, abdominal infection and overall complications between the single-layer anastomosis group and double-layer anastomosis group. Rank sum test were used to analyze the difference in operation time, pancreaticojejunal anastomosis time, postoperative hospitalization time, total hospitalization time and hospitalization expenses between the single-layer anastomosis group and double-layer anastomosis group. RESULTS: Patients with grade A pancreatic fistula accounted for 15.69% (8/51) vs 15.69% (8/51) (P = 1.0000), and patients with grades B and C pancreatic fistula accounted for 9.80% (5/51) vs 52.94% (27/51) (P = 0.0000) in the single-layer and double-layer anastomosis groups. Although there was no significant difference in the percentage of patients with grade A pancreatic fistula, there was a significant difference in the percentage of patients with grades B and C pancreatic fistula between the two groups. The operation time (220.059 60.602 min vs 379.412 90.761 min, P = 0.000), pancreaticojejunal anastomosis time (17.922 5.145 min vs 31.333 7.776 min, P = 0.000), postoperative hospitalization time (18.588 5.285 d vs 26.373 15.815 d, P = 0.003), total hospitalization time (25.627 6.551 d vs 33.706 15.899 d, P = 0.002), hospitalization expenses (116787.667 31900.927 yuan vs 162788.608 129732.500 yuan, P = 0.001), as well as the incidences of pancreatic fistula [13/51 (25.49%) vs 35/51 (68.63%), P = 0.0000], peritoneal catheterization [0/51 (0%) vs 6/51 (11.76%), P = 0.0354], abdominal infection [1/51 (1.96%) vs 11/51 (21.57%), P = 0.0021], and overall complications [21/51 (41.18%) vs 37/51 (72.55%), P = 0.0014] in the single-layer anastomosis group were all lower than those in the double-layer anastomosis group. CONCLUSION: Single-layer mucosa-to-mucosa pancreaticojejunal anastomosis appears to be a simple, reliable, and safe method. Use of this method could reduce the postoperative incidence of complications. PMID:26649157

  10. THEMIS and PTPRK in celiac intestinal mucosa: coexpression in disease and after in vitro gliadin challenge

    PubMed Central

    Bondar, Constanza; Plaza-Izurieta, Leticia; Fernandez-Jimenez, Nora; Irastorza, Iaki; Withoff, Sebo; Wijmenga, Cisca; Chirdo, Fernando; Bilbao, Jose Ramon

    2014-01-01

    Celiac disease (CD) is an immune mediated, polygenic disorder, where HLA-DQ2/DQ8 alleles contribute around 35% to genetic risk, but several other genes are also involved. Genome-wide association studies (GWASs) and the more recent immunochip genotyping projects have fine-mapped 39 regions of genetic susceptibility to the disease, most of which harbor candidate genes that could participate in this disease process. We focused our attention to the GWAS peak on chr6: 127.99128.38?Mb, a region including two genes, thymocyte-expressed molecule involved in selection (THEMIS) and protein tyrosine phosphatase, receptor type, kappa (PTPRK), both of which have immune-related functions. The aim of this work was to evaluate the expression levels of these two genes in duodenal mucosa of active and treated CD patients and in controls, and to determine whether SNPs (rs802734, rs55743914, rs72975916, rs10484718 and rs9491896) associated with CD have any influence on gene expression. THEMIS showed higher expression in active CD compared with treated patients and controls, whereas PTPRK showed lower expression. Our study confirmed the association of this region with CD in our population, but only the genotype of rs802734 showed some influence in the expression of THEMIS. On the other hand, we found a significant positive correlation between THEMIS and PTPRK mRNA levels in CD patients but not in controls. Our results suggest a possible role for both candidate genes in CD pathogenesis and the existence of complex, regulatory relationships that reside in the vast non-coding, functional intergenic regions of the genome. Further investigation is needed to clarify the impact of the disease-associated SNPs on gene function. PMID:23820479

  11. Molecular Genotyping of Anisakis Larvae in Middle Eastern Japan and Endoscopic Evidence for Preferential Penetration of Normal over Atrophic Mucosa

    PubMed Central

    Arai, Toshio; Akao, Nobuaki; Seki, Takenori; Kumagai, Takashi; Ishikawa, Hirofumi; Ohta, Nobuo; Hirata, Nobuto; Nakaji, So; Yamauchi, Kenji; Hirai, Mitsuru; Shiratori, Toshiyasu; Kobayashi, Masayoshi; Fujii, Hiroyuki; Ishii, Eiji; Naito, Mikio; Saitoh, Shin-ichi; Yamaguchi, Toshikazu; Shibata, Nobumitsu; Shimo, Masamune; Tokiwa, Toshihiro

    2014-01-01

    Background Anisakiasis is a parasitic disease caused primarily by Anisakis spp. larvae in Asia and in Western countries. The aim of this study was to investigate the genotype of Anisakis larvae endoscopically removed from Middle Eastern Japanese patients and to determine whether mucosal atrophy affects the risk of penetration in gastric anisakiasis. Methods In this study, 57 larvae collected from 44 patients with anisakiasis (42 gastric and 2 colonic anisakiasis) were analyzed retrospectively. Genotyping was confirmed by restriction fragment length polymorphism (RFLP) analysis of ITS regions and by sequencing the mitochondrial small subunit (SSU) region. In the cases of gastric anisakiasis, correlation analyses were conducted between the frequency of larval penetration in normal/atrophic area and the manifestation of clinical symptoms. Results Nearly all larvae were A. simplex seusu stricto (s.s.) (99%), and one larva displayed a hybrid genotype. The A. simplex larvae penetrated normal mucosa more frequently than atrophic area (p = 0.005). Finally, patients with normal mucosa infection were more likely to exhibit clinical symptoms than those with atrophic mucosa infection (odds ratio, 6.96; 95% confidence interval, 1.52–31.8). Conclusions In Japan, A. simplex s.s. is the main etiological agent of human anisakiasis and tends to penetrate normal gastric mucosa. Careful endoscopic examination of normal gastric mucosa, particularly in the greater curvature of the stomach will improve the detection of Anisakis larvae. PMID:24586583

  12. Nitric oxide prevents rat duodenal contractions induced by potentially noxious agents.

    PubMed

    Hellgren, S; Flemstrm, G; Nylander, O

    2000-07-01

    After abdominal surgery, luminal HCl fails to induce duodenal contractions in anaesthetized rats. Elevated tissue levels of nitric oxide (NO) and prostaglandins possibly contribute to this observation. The aim of this study was to compare the effects of luminal capsaicin (1.2 mg mL-1), ethanol (15%) and high partial pressure of CO2 (>250 mmHg) with those of HCl (10 mM) in anaesthetized rats. Motility (intraluminal pressure), mucosal permeability [blood-to-lumen clearance of 51Cr-EDTA (51Chromium-labelled ethylenediaminetetraacetate)] and duodenal mucosal bicarbonate secretion (DMBS) were recorded. Three groups of animals were studied: (1) controls, (2) pretreatment with the NO synthase inhibitor N-nitro-L-arginine-methyl-ester (L-NAME) and (3) pretreatment with the cyclo-oxygenase inhibitor indomethacin. Neither capsaicin, ethanol, CO2 nor HCl induced duodenal contractions or affected DMBS in control rats. However, L-NAME induced duodenal contractions that were augmented by capsaicin, ethanol and HCl, but not by CO2. Indomethacin also induced contractions that were reversibly diminished by capsaicin and HCl, but not by ethanol or CO2. Significant increases in mucosal permeability occurred during ethanol perfusion in indomethacin- and L-NAME pretreated rats. In conclusion, NO probably plays a key role in preventing duodenal contractions in response to luminally HCl, capsaicin and ethanol. The HCl-induced effect on motility appears to be independent of CO2 and is not caused by alteration in mucosal integrity. PMID:10886038

  13. Duodenal ileus caused by a calf feeding nipple in a cow

    PubMed Central

    2011-01-01

    Background The aim of this report was to describe duodenal obstruction caused by a rubber foreign body in a cow. Case Presentation The clinical, biochemical and ultrasonographic findings in a five-year-old Swiss Braunvieh cow with duodenal ileus caused by a calf feeding nipple are described. The main clinical signs were anorexia, ruminal tympany, decreased faecal output and abomasal reflux syndrome. Ultrasonographic examination revealed reticular hyperactivity and a dilated duodenum. A diagnosis of duodenal ileus was made and the cow underwent right-flank laparotomy, which revealed a dilation of the cranial part of the duodenum because of obstruction by a pliable foreign body. This was identified via enterotomy as a calf feeding nipple. The cow was healthy at the time of discharge four days after surgery and went on to complete a successful lactation. Conclusions To our knowledge, this is the first description of duodenal obstruction by a calf feeding nipple. This is an interesting case, which broadens the spectrum of the causes of duodenal ileus, which is usually caused by obstruction of the duodenum by a phytobezoar. PMID:21211012

  14. Relation between HLA-DQA1 genes and genetic susceptibility to duodenal ulcer in Wuhan Hans

    PubMed Central

    Du, Yi-Ping; Deng, Chang-Sheng; Lu, De-Yin; Huang, Mei-Fang; Guo, Shu-Fang; Hou, Wei

    2000-01-01

    AIM: To study the genetic susceptibility of HLA-DQA1 alleles to duodenal ulcer in Wuhan Hans. METHODS: Seventy patients with duodenal ulcer and fifty health y controls were examined for HLA-DQA1 genotypes. HLA-DQA1 typing was carried out by digesting the locus specific polymerase chain reaction amplified products with alleles specific restriction enzymes (PCR-RFLP), i.e. Apal I, Bsaj I, Hph I, Fok I, Mbo II and Mnl I. RESULTS: The allele frequencies of DQA1*0301 and DQA1*0102 in patients with duodenal ulcer were significantly higher and lower respectivel y than those in healthy controls (0.40 vs 0.20, P = 0.003, Pc orret = 0.024) and (0.05 vs 0.14, P = 0.012, but P corret > 0.05), respectively. CONCLUSION: DQA1*0301 is a susceptible gene for duodenal ulcer in Wuhan Hans, and there are immunogenetic differences in HLA-DQA1 locus between duodenal ulcer patients and healthy controls. PMID:11819534

  15. Duodenal stump fistula after gastrectomy for gastric cancer: risk factors, prevention, and management

    PubMed Central

    Paik, Hyun-June; Lee, Si-Hak; Choi, Chang-In; Kim, Dae-Hwan; Jeon, Tae-Yong; Kim, Dong-Heon; Jeon, Ung-Bae; Choi, Cheol-Woong

    2016-01-01

    Purpose A duodenal stump fistula is one of the most severe complications after gastrectomy for gastric cancer. We aimed to analyze the risk factors for this problem, and to identify the methods used for its prevention and management. Methods We retrospectively reviewed the clinical data of 716 consecutive patients who underwent curative gastrectomy with a duodenal stump for gastric cancer between 2008 and 2013. Results A duodenal stump fistula occurred in 16 patients (2.2%) and there were 2 deaths in this group. Univariate analysis revealed age >60 years (odds ratio [OR], 3.09; 95% confidence interval [CI], 0.99–9.66), multiple comorbidities (OR, 4.23; 95% CI, 1.50–11.92), clinical T stage (OR, 2.91; 95% CI, 1.045-8.10), and gastric outlet obstruction (OR, 8.64; 95% CI, 2.61–28.61) to be significant factors for developing a duodenal stump fistula. Multivariate analysis identified multiple comorbidities (OR, 3.92; 95% CI, 1.30–11.80) and gastric outlet obstruction (OR, 5.62; 95% CI, 1.45–21.71) as predictors of this complication. Conclusion Multiple comorbidities and gastric outlet obstruction were the main risk factors for a duodenal stump fistula. Therefore, preventive methods and aggressive management should be applied for patients at high risk. PMID:26942159

  16. Famotidine in the treatment of duodenal ulcers resistant to other histamine H2-receptor antagonists.

    PubMed

    Chen, P H; Wang, T H; Wang, C Y; Chen, C Y; Cheng, T C; Tsai, Y T; Siauw, C P; Yang, K C; Chen, G H; Sung, J L

    1989-01-01

    In 20% of patients with duodenal ulcers, treatment is ineffective. Ulcers are considered resistant when they fail to heal following 8-12 weeks of treatment with full dose duodenal ulcer therapy. The present study reviewed the records and endoscopic findings of 73 patients who were considered by their physicians to have resistant duodenal ulcers. From this population, 15 patients with documented, active duodenal ulcers were chosen to participate in this study. Each had failed treatment with cimetidine or ranitidine at recommended doses administered for from 56 days to more than 2 years. After up to 6 weeks' treatment with 20 mg famotidine given twice daily, eight patients showed endoscopic evidence of healing (S1 or S2) based on the criteria established by the Japanese Society of Digestive Endoscopy. Five others showed moderate to marked improvement H1-H3). No patient experienced side-effects during famotidine treatment. The greater antisecretory effect of famotidine may be useful in treating duodenal ulcer patients who fail to heal with cimetidine or ranitidine. PMID:2566541

  17. Characterization of dopamine receptor subtypes involved in experimentally induced gastric and duodenal ulcers in rats.

    PubMed

    Desai, J K; Goyal, R K; Parmar, N S

    1999-02-01

    There are conflicting reports about the role of dopamine in gastric and duodenal ulcers. This investigation was undertaken to characterize the specific subtypes of dopamine receptor involved in gastric and duodenal ulceration. Administration of dopamine D1 agonist fenoldopam and dopamine D2 antagonist sulpiride elicited a significant decrease in acid secretion, total acid output, pepsin output and histamine content in the gastric juice, and reduced ulcer-index values, in pylorus-ligated rats. However, dopamine D1 receptor antagonist SCH 39166 ((-)-trans-6,7,7a,8,9,13b-hexahydro-3-chloro-2-hydroxy-N-methyl-5H -benzo (d) naptho -(2,1-b) azepine) and the D2 receptor agonist quinpirole led to significant augmentation of these parameters compared with respective controls. In the restraint plus water-immersion stress model the score for intraluminal bleeding and the cumulative gastric lesion length was significantly lower for rats treated with fenoldopam and sulpiride. The opposite effects were observed after pretreatment of rats with SCH 39166 and quinpirole. In the cysteamine-induced duodenal ulcer model the mean ulcer area and the score for intensity were significantly lower for fenoldopam and sulpiride and higher for SCH 39166 and quinpirole. Our data suggest that the dopamine D1 and D2 receptors have opposite effects on gastric and duodenal ulcers. Whereas stimulation of dopamine D1 receptors inhibits the formation of gastric and duodenal ulcers, stimulation of dopamine D2 receptors has a pro-ulcerogenic effect. PMID:10217318

  18. Simultaneous pancreas-kidney transplantation with duodeno-duodenal anastomosis.

    PubMed

    Khubutia, M; Pinchuk, A; Dmitriev, I; Storozhev, R

    2014-01-01

    Simultaneous pancreas-kidney transplantation (SPKT) is now accepted as the method of choice for patients with insulin-dependent diabetes mellitus (type I) who have end-stage renal disease (ESRD). We believe that retroperitoneal positioning of the donor pancreas with the formation of duodeno-duodenal anastomosis is the most physiologically relevant. Starting in January 2008, the SPKT was chosen as the treatment method of 32 patients with diabetes mellitus. In 15 cases comprising group I (46.9%), the pancreas was placed intra-abdominally (including the formation of the duodeno-jejunal anastomosis). In the remaining 17 patients (53.1%) comprising group II, the pancreas was positioned retroperitoneally (including the formation of the duodeno-duodenal anastomosis). We compared the main parameters of the early postoperative period in these groups. There were no substantial differences between the groups in the prevalence of immunological (13.3% and 11.8%, P = .9), surgical (20% and 23.5%, P = .81), and infectious complications (20% and 5.9%, P = .23). On discharge there were no significant differences in the values of the following between the two groups, respectively: serum creatinine values, 112.7 ± 31.2 and 104.8 ± 54.6 μmol/L, P = .17; glomerular filtration rate, 73.5 ± 28.6 and 78.7 ± 24.9 mL/min, P = .55; α-amylase, 121.9 ± 63.6 and 150.1 ± 72.1 U/L, P = .27; pancreatic amylase, 102 ± 51.5 and 122.5 ± 75.4 U/L, P = .6; lipase, 115.4 ± 67.3 and 96 ± 65.7 U/L, P = .5; С-peptide, 4.44 ± 1.9 and 4.02 ± 2.4 ng/mL, P = .47; HbA1c, 5.45 ± 0.8% and 5.56 ± 1.12%, P = .9; and intact insulin, 12.2 ± 5.4 and 12.9 ± 8.8 mcIU/mL, P = .95). SPKT remains the best method of medical and social rehabilitation for patients who have diabetes mellitus (type-I) with ESRD. Compared to the classic method, we have seen no significant deviations in either of the following: the qualitative features marking the restoration of function of the two transplanted organs and/or the quality of compensation of carbohydrate metabolism, incidence of rejection, and graft loss. At the same time, retroperitoneal positioning of the pancreas exhibited lower repeat surgery rates. PMID:25131067

  19. Duodenal Obstruction Caused by Acute Appendicitis with Intestinal Malrotation in a Child

    PubMed Central

    Biçer, Şenol; Çelik, Ali

    2015-01-01

    Patient: Male, 14 Final Diagnosis: Duodenal obstruction Symptoms: Bilious vomiting Medication: None Clinical Procedure: Laparotomy Specialty: Surgery Objective: Rare disease Background: In patients with intestinal malrotation, the diagnosis of acute appendicitis can be difficult due to atypical presentation. Duodenal obstruction caused by acute appendicitis with the presence of malrotation has rarely been reported in children. Case Report: We report the case of a 14-year-old male patient with bilious vomiting and abdominal distension. A diagnosis could not be made by computed tomography, ultrasonography, or endoscopy. We observed a dilated stomach and malrotation in laparotomy. The caecum was in the right upper quadrant, and an inflamed appendix was located in the subhepatic region. After the appendectomy, the cecum was mobilized and fixed in the right lower quadrant. Conclusions: In children with intestinal malrotation, acute appendicitis can present as duodenal obstruction without abdominal pain, and standard imaging methods can miss the correct diagnosis. PMID:26317163

  20. Unduly extensive uncinate process of pancreas in conjunction with pancreatico-duodenal fold.

    PubMed

    Gandhi, Swati; Sharma, Mona; Pakhiddey, Rohini; Thakur, Avinash; Mehta, Vandana; Suri, Rajesh K; Rath, Gayatri

    2015-03-01

    Anatomical variations of pancreatic head and uncinate process are rarely encountered in clinical practice. These variations are primarily attributed to the complex development of the pancreas. An unduly enlarged uncinate process of the pancreas overlapping the third part of duodenum was discovered during dissection. This malformation of the pancreatic uncinate process was considered to be due to excessive fusion between the ventral and dorsal buds during embryonic development. On further dissection, an avascular pancreatico-duodenal fold guarding the pancreatico-duodenal recess was observed. The enlarged uncinate process can cause compression of neurovascular structures and also cause compression of adjoining viscera. The pancreatico-duodenal recess becomes a potential site for internal herniation. This case is of particular interest to the gastroenterologists and surgeons performing surgical resections. Precise knowledge of embryogenesis of such pancreatic anomalies is necessary for understanding and thus treating many diseases of the pancreas. PMID:25806126

  1. Predicting Chemically Induced Duodenal Ulcer and Adrenal Necrosis with Classification Trees

    NASA Astrophysics Data System (ADS)

    Giampaolo, Casimiro; Gray, Andrew T.; Olshen, Richard A.; Szabo, Sandor

    1991-07-01

    Binary tree-structured statistical classification algorithms and properties of 56 model alkyl nucleophiles were brought to bear on two problems of experimental pharmacology and toxicology. Each rat of a learning sample of 745 was administered one compound and autopsied to determine the presence of duodenal ulcer or adrenal hemorrhagic necrosis. The cited statistical classification schemes were then applied to these outcomes and 67 features of the compounds to ascertain those characteristics that are associated with biologic activity. For predicting duodenal ulceration, dipole moment, melting point, and solubility in octanol are particularly important, while for predicting adrenal necrosis, important features include the number of sulfhydryl groups and double bonds. These methods may constitute inexpensive but powerful ways to screen untested compounds for possible organ-specific toxicity. Mechanisms for the etiology and pathogenesis of the duodenal and adrenal lesions are suggested, as are additional avenues for drug design.

  2. Duodenal Duplication Cyst: A Rare Differential Diagnosis in a Neonate with Bilious Vomiting

    PubMed Central

    upan?i?, Boidar; Gliha, Andro; Fuenzalida, Jose Varas; Vinji?, Stjepan

    2015-01-01

    Bilious vomiting is a relevant sign in neonates that requires immediate evaluation and diagnosis. A duplication of the intestinal tract is a possible cause of obstruction if located distally to the major duodenal papilla of Vater and most of them involve the jejunum, stomach, or colon. Duodenal duplications are very rare and can have an endoscopic or surgical treatment after diagnosis. We present a case of a 16-day-old term newborn that consulted because of bilious vomiting and after evaluation with imaging and upper endoscopy, a duodenal duplication cyst was found at the level of the third portion causing compression of the intestinal lumen that required surgical resolution with duodenocystostomy. PMID:26788454

  3. A Case of Acute Ischemic Duodenal Ulcer Associated with Superior Mesenteric Artery Dissection After Transarterial Chemoembolization for Hepatocellular Carcinoma

    SciTech Connect

    Jang, Eun Sun; Jeong, Sook-Hyang Kim, Jin Wook; Lee, Sang Hyub; Yoon, Chang Jin; Kang, Sung Gwon

    2009-03-15

    We report a case of transarterial chemoembolization (TACE)-related acute ischemic duodenal ulcer that developed in association with dissection of the superior mesenteric artery. We conclude that the acute duodenal ulcer was developed by ischemia related to superior mesenteric artery dissection during TACE. TACE should be conducted carefully with continuous observation of abdominal arteries.

  4. Reduced secretion of epidermal growth factor in duodenal ulcer patients with Helicobacter pylori infection

    PubMed Central

    Chen, Xue-Qing; Zhang, Wan-Dai; Jiang, Bo; Song, Yu-Gang; Reng, Ri-Zi; Zhou, Dian-Yuan

    1997-01-01

    AIM: To investigate the concentration changes of epidermal growth factor (EGF) in duodenal ulcer patients with Helicobacter pylori (H. pylori) infection. METHODS: Immunoreactive concentration of somatostatin, gastrin and epidermal growth factor of gastric and saliva juice in healthy volunteers, and chronic gastritis and duodenal ulcer patients with H. pylori infection were measured by radioimmunoassay. RESULTS: Gastrin concentration of gastric juice in H. pylori-positive chronic gastritis (P > 0.05) and duodenal ulcer patients (P < 0.01) was higher than that of healthy volunteers (P < 0.05), whereas som atostatin concentration of gastric juice in chronic gastritis (P < 0.05) and duodenal ulcer patients (P < 0.01) was lower than that in healthy volunteers. Furthermore, EGF levels of gastric and saliva juice in duodenal ulcer patients with H. pylori infection (n = 10, 272.0 ng/L ± 96.3 ng/L and 8.3 ng/L ± 2.4 ng/L, respectively) were significantly lower than that in healthy volunteers (n = 12, 405.6 ng/L ± 35.6 ng/mL and 22.0 ng/L ± 17.0 ng/L, respectively) and in H. pylori-positive chronic gastritis patients (n = 25, 423.0 ng/L ± 104.0 ng/L and 22.0 ng/L ± 11.1 ng/L, respectively (P < 0.05). CONCLUSION: A lower secretion of EGF may be a causative factor in the pathogenesis of H. pylori-positive duodenal ulcer. PMID:27006581

  5. Quantitative Proteogenomics and the Reconstruction of the Metabolic Pathway in Lactobacillus mucosae LM1.

    PubMed

    Pajarillo, Edward Alain B; Kim, Sang Hoon; Lee, Ji-Yoon; Valeriano, Valerie Diane V; Kang, Dae-Kyung

    2015-01-01

    Lactobacillus mucosae is a natural resident of the gastrointestinal tract of humans and animals and a potential probiotic bacterium. To understand the global protein expression profile and metabolic features of L. mucosae LM1 in the early stationary phase, the QExactive(TM) Hybrid Quadrupole-Orbitrap Mass Spectrometer was used. Characterization of the intracellular proteome identified 842 proteins, accounting for approximately 35% of the 2,404 protein-coding sequences in the complete genome of L. mucosae LM1. Proteome quantification using QExactive(TM) Orbitrap MS detected 19 highly abundant proteins (> 1.0% of the intracellular proteome), including CysK (cysteine synthase, 5.41%) and EF-Tu (elongation factor Tu, 4.91%), which are involved in cell survival against environmental stresses. Metabolic pathway annotation of LM1 proteome using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database showed that half of the proteins expressed are important for basic metabolic and biosynthetic processes, and the other half might be structurally important or involved in basic cellular processes. In addition, glycogen biosynthesis was activated in the early stationary phase, which is important for energy storage and maintenance. The proteogenomic data presented in this study provide a suitable reference to understand the protein expression pattern of lactobacilli in standard conditions. PMID:26761899

  6. Aggregation factor as an inhibitor of bacterial binding to gut mucosa.

    PubMed

    Lukic, Jovanka; Strahinic, Ivana; Milenkovic, Marina; Nikolic, Milica; Tolinacki, Maja; Kojic, Milan; Begovic, Jelena

    2014-10-01

    Modern research in the area of probiotics is largely devoted to discovering factors that promote the adherence of probiotic candidates to host mucosal surfaces. The aim of the present study was to test the role of aggregation factor (AggL) and mucin-binding protein (MbpL) from Lactococcus sp. in adhesion to gastrointestinal mucosa. In vitro, ex vivo, and in vivo experiments in rats were used to assess the adhesive potential of these two proteins expressed in heterologous host Lactobacillus salivarius BGHO1. Although there was no influence of MbpL protein expression on BGHO1 adhesion to gut mucosa, expression of AggL had a negative effect on BGHO1 binding to ileal and colonic rat mucosa, as well as to human HT29-MTX cells and porcine gastric mucin in vitro. Because AggL did not decrease the adhesion of bacteria to intestinal fragments in ex vivo tests, where peristaltic simulation conditions were missing, we propose that intestinal motility could be a crucial force for eliminating aggregation-factor-bearing bacteria. Bacterial strains expressing aggregation factor could facilitate the removal of pathogens through the coaggregation mechanism, thus balancing gut microbial ecosystems in people affected by intestinal bacteria overgrowth. PMID:24823989

  7. Quantitative Proteogenomics and the Reconstruction of the Metabolic Pathway in Lactobacillus mucosae LM1

    PubMed Central

    Lee, Ji-Yoon

    2015-01-01

    Lactobacillus mucosae is a natural resident of the gastrointestinal tract of humans and animals and a potential probiotic bacterium. To understand the global protein expression profile and metabolic features of L. mucosae LM1 in the early stationary phase, the QExactiveTM Hybrid Quadrupole-Orbitrap Mass Spectrometer was used. Characterization of the intracellular proteome identified 842 proteins, accounting for approximately 35% of the 2,404 protein-coding sequences in the complete genome of L. mucosae LM1. Proteome quantification using QExactiveTM Orbitrap MS detected 19 highly abundant proteins (> 1.0% of the intracellular proteome), including CysK (cysteine synthase, 5.41%) and EF-Tu (elongation factor Tu, 4.91%), which are involved in cell survival against environmental stresses. Metabolic pathway annotation of LM1 proteome using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database showed that half of the proteins expressed are important for basic metabolic and biosynthetic processes, and the other half might be structurally important or involved in basic cellular processes. In addition, glycogen biosynthesis was activated in the early stationary phase, which is important for energy storage and maintenance. The proteogenomic data presented in this study provide a suitable reference to understand the protein expression pattern of lactobacilli in standard conditions. PMID:26761899

  8. Diagnosis of obstructive jaundice in infants: Tc-99m DISIDA in duodenal juice

    SciTech Connect

    Jaw, T.S.; Wu, C.C.; Ho, Y.H.; Huang, B.L.; Lu, C.C.

    1984-03-01

    Technetium-99m di-isopropylphenylcarbamoylmethylimidodiacetic acid cholescintigraphy, together with measurements of radioactivity in duodenal juice, was used to evaluate 23 infants with prolonged obstructive jaundice. Four patients proved to have biliary atresia. The remainder had neonatal hepatitis. There was distinct differentiation of biliary atresia from neonatal hepatitis when the time-activity curves were analyzed. In neonatal hepatitis the radioactivity in duodenal juice is obviously higher, peaking above 1500 cpm/100 ..mu..l per mCi dose. In biliary atresia the pattern is flattened, with maximal activity below 500 cpm/100 ..mu..l per mCi dose.

  9. Functional imaging of colonic mucosa with a fibered confocal microscope for real time in vivo pathology

    PubMed Central

    Wang, Thomas D.; Friedland, Shai; Sahbaie, Peyman; Soetikno, Roy; Hsiung, Pei-Lin; Liu, Jonathan T.C.; Crawford, James M.; Contag, Christopher H.

    2007-01-01

    Background & Aims Histological interpretation of disease is currently performed with static images of excised tissues, and is limited by processing artifact, sampling error, and interpretive variability. To demonstrate use of functional optical imaging of viable mucosa for quantitative evaluation of colonic neoplasia in real time. Methods Fluorescein (5 mg/ml) was topically administered in (n=54) human subjects undergoing screening colonoscopy. Fluorescence images were collected with 488 nm excitation at 12 frames/second with the confocal microendoscopy system. Movement of fluorescein in the transient period (<5 sec) and the lamina propria:crypt contrast ratio in the steady state phase (>5 sec) were quantified. Results Normal mucosa showed circular crypts with uniform size, hyperplasia revealed proliferative glands with serrated lumens, and adenomas displayed distorted, elongated glands. For t<5 sec, fluorescein passed through normal epithelium with a peak speed of 1.14±0.09 μm/sec at t=0.5 sec, and accumulated into lamina propria as points-of-fluorescence that moved through the interglandular space with an average speed of 41.7±3.4 μm/sec. Passage of fluorescein through adenomatous mucosa was substantially delayed. For t>5 sec, high sensitivity, specificity, and accuracy was achieved using a discriminant function to evaluate the contrast ratio to distinguish normal from lesional mucosa (91%, 87%, and 89%, respectively; p<0.001), hyperplasia from adenoma (97%, 96%, and 96%, respectively; p<0.001), and tubular from villous adenoma (100%, 92%, and 93%, respectively; p<0.001). Conclusion Confocal imaging can be performed in vivo to assess the functional behavior of tissue in real time for providing pathological interpretation, representing a new method for histological evaluation. PMID:17936692

  10. Epidemiology of oral HPV in the oral mucosa in women without signs of oral disease from Yucatan, Mexico

    PubMed Central

    Gonzalez-Losa, Mara del Refugio; Barrera, Ernesto Soria; Herrera-Pech, Vernica; Conde-Ferrez, Laura; Puerto-Sols, Marylin; Ayora-Talavera, Guadalupe

    2015-01-01

    High-risk human papillomaviruses (HR-HPV) are considered necessary for the development of cervical cancer. Furthermore, there is no doubt that some types of oral squamous cell carcinoma are associated with HR-HPV. The epidemiology of oral HPV infections in healthy subjects remains unclear due to a lack of knowledge. The objective of this study was to investigate the epidemiology of human papillomavirus infections of the oral mucosa without pathology. A cross-sectional study was performed; samples from 390 women seeking prenatal care, Pap smears, family planning or gynecological diseases were studied. Oral cells were collected by direct swab sampling. Information regarding sociodemographic status, sexual behavior, infectious diseases, contraceptive history and tobacco and alcohol consumption were obtained through direct interviews. HPV and genotypes were detected by type-specific polymerase chain reaction. Our results revealed that 14% of the women studied had an oral HPV infection. Women ? 20 years of age had the highest HPV prevalence (24.5%). In total, seven genotypes were identified, including the high-risk genotypes 16, 18, 58 and 59 and the low-risk genotypes 6, 81 and 13, the latter of which is a type exclusive to oral mucosa. Sexual behavior was not associated with the presence of genital HPV types in the oral mucosa. Genital HPV types were present in the oral mucosa of women without associated clinical manifestations; however, sexual behavior was not associated with infection, and therefore others routes of transmission should be explored. PMID:26221121

  11. Helicobacter pylori in humans: Where are we now?

    PubMed Central

    Hussain, Syed Arshad; Hamid, Shamila

    2014-01-01

    Helicobacter pylori has been associated with colonization of gastro duodenal mucosa of humans from millions of years. The main burden of the disese is in the developing countries, due to overcrowding and poor hygiene. If left untreated it leads to lot of sequlae from minor to sinister diseases over a period of time. The main challenges that remain are prevention of H. pylori-related diseases by effective treatment and screening procedures and development of a vaccine, which can address all these issues including beneficial aspects of H. pylori. The literature pertaining to different aspects of H. pylori were scrutinized from Pubmed. Material on clinical behavior, complications of chronic gastric involvement, and prevention besides role of H. pylori in nongastric diseases and the latest trends of management was collected for research and review. We continue to face many challenges. The prevention of cancer of the stomach, a worst sequlae of H. pylori continues to be a big challenge despite population screening and prevention surveys being underway in many countries. On the other hand continued scientific work has now unfolded involvement of H. pylori in extragastric diseases like cerebrovascular, cardiovascular, idiopathic thrombocytopenia, sideroblastic anemia, mental diseases, and collagen vascular diseases. In contrast, the beneficial effects of H. pylori with respect to allergic diseases and obesity are now clear. Moreover, problem of drug resistance for eradication of H. pylori has arisen for which novel treatments are being tried. Lactobacillus reuteri having anti H. pylori action is emerging as one of the promising treatment. PMID:24627871

  12. Drug-induced lesions of the oesophageal mucosa.

    PubMed

    2015-09-01

    Lesions of the oesophageal mucosa are observed in various situations: most often with gastrooesophageal reflux disease, but also with infections, cancer, contact with a toxic substance, etc. When they are symptomatic, these lesions provoke burning sensations, dysphagia, regurgitation and sometimes dorsal pain. The changes to the oesophageal mucosa may take various forms: inflammation, erosion, ulceration or necrosis. Serious or even fatal complications can develop but are rare; they include oesophageal perforation, stricture and haemorrhage. Some oral drugs damage the oesophageal mucosa through direct contact. The symptoms often develop several hours after ingestion. The pain is of sudden onset. The resulting lesions are solitary or multiple ulcers that vary in depth and usually occur in the upper portion of the oesophagus. Various factors prolong contact between a drug and the oesophageal mucosa, in particular: swallowing the drug with insufficient liquid or just before lying down; capsule forms; and oesophageal abnormalities. The drugs most frequently implicated are tetracyclines, particularly doxycycline, bisphosphonates and various nonsteroidal anti-inflammatory drugs (NSAIDs). Many drugs, used in various situations, provoke gastro-oesophageal reflux disease, sometimes causing mucosal lesions in the lower oesophagus: calcium-channel blockers, nitrates, exenatide and liraglutide, drugs with antimuscarinic effects, theophylline, etc. Some drugs affect all mucous membranes in the body, including the oesophageal mucosa, irrespective of their route of administration: cancer drugs, isotretinoin, and nicorandil. PMID:26417631

  13. Protocol for the nonoperative treatment of obstructing intramural duodenal hematoma during childhood.

    PubMed

    Touloukian, R J

    1983-03-01

    A prospective plan for the nonoperative treatment of obstructing intramural duodenal hematoma was developed to (1) promptly establish the diagnosis and rule out transmural leaks by obtaining a contrast roentgenogram on admission and to subsequently study evolution of the obstructing intramural duodenal hematoma with sequential roentgenograms at 5 to 7 day intervals; (2) identify associated pancreatic injury with ultrasonography and serum amylase and lipase determinations; and (3) to determine effectiveness of nasogastric suction and total parenteral nutrition. Twelve children, who ranged in age from 2 to 15 years, with obstructing intramural duodenal hematoma following blunt injury were admitted over the past 9 years. The two youngest were battered children and two others had subsequently diagnosed clotting disorders (idiopathic thrombocytopenic purpura and von Willebrand's disease). Significant resolution of the obstruction allowed resumption of oral intake by the end of the first week of treatment in eight patients, whereas the remaining four required 13, 14, 22, and 38 days of nasogastric suction and total parenteral nutrition. Residual deformity seen on roentgenograms did not interfere with achieving adequate oral nutrition. Excellent results in this series substantiate the conclusion that a management plan that assesses the evolution of an obstructing intramural duodenal hematoma and provides adequate nutrition is a successful alternative to surgical treatment. The presence of underlying hematologic disorders and child abuse must be suspected. PMID:6837855

  14. Blood, urine, and ruminal fluid changes associated with metabolic alkalosis induced by duodenal obstruction.

    PubMed

    Avery, T B; Nagaraja, T G; Frey, R A

    1986-04-01

    Two Holstein heifers and a steer fitted with ruminal and duodenal cannulas were used to determine acid-base and electrolyte changes associated with metabolic alkalosis induced by duodenal obstruction. Obstruction was induced distally to the pylorus, but proximally to the common bile duct entrance. Ruminal fluid, blood, and urine samples were obtained before and after obstruction was induced. Duodenal obstruction resulted in increased blood pH, bicarbonate concentration, and base-excess values. Severe hypochloremia and hypokalemia were evident in 48 hours. Serum sodium concentration decreased only slightly. Packed cell volume and serum concentrations of urea nitrogen, creatinine, glucose, and inorganic phosphate increased, whereas calcium concentration showed no change. Renal chloride excretion reached near zero in 24 hours, whereas sodium and potassium excretions decreased in the steer, but were unchanged in the heifers. Urine creatinine concentration increased markedly in the heifers and steers. Acid urine was not evident up to 96 hours. Ruminal fluid pH decreased and chloride concentration increased in the steer, but remained unaffected in the heifers. Duodenal obstruction had no effect on rumen sodium, calcium, and magnesium concentrations, but the potassium concentration increased in the heifers. The degrees of alkalosis and electrolyte changes were greater in the steer than in the heifers. PMID:3963593

  15. Isolated Duodenal Rupture due to Go-Karting Accidents Braking News

    PubMed Central

    Thomas, Milan; Basu, Narendra Nath; Gulati, Manpreet Singh; Oke, Tayo; Constantinescu, Gabriel; Siddiqui, Midhat

    2009-01-01

    INTRODUCTION Isolated duodenal injury due to blunt abdominal trauma is extremely rare. We present a series of three such injuries due to go-karting accidents, which presented to our hospital over 5 months. CASE REPORTS Between October 2007 and February 2008, three cases of D3/D4 duodenal rupture presented to our hospital after go-karting accidents. Trauma occurred as a result of the steering wheel impacting on the abdomen. All patients presented similarly with symptoms of epigastric and right upper quadrant pain. In all cases, computed tomography scanning was highly suggestive of duodenal injury and, in particular, demonstrated presence of retroperitoneal air centred around the duodenum. Treatment required laparotomy and operative repair in all cases. CONCLUSIONS Duodenal injury presents insidiously due to its retroperitoneal position. A low threshold for investigating patients presenting with epigastric and right upper quadrant pain should be adopted along with active clinical vigilance to exclude serious and life-threatening trauma after go-karting accidents. PMID:19344555

  16. [A case of recurrent duodenal carcinoma successfully controlled with FOLFOX treatment].

    PubMed

    Yasui, Toshiaki; Mukubo, Hideyo; Nakanuma, Shinichi; Sato, Nariatsu; Kita, Ichiro

    2013-11-01

    A 60-year-old woman was diagnosed as having duodenal cancer by upper gastrointestinal endoscopy and biopsy. Pylorus-preserving pancreatoduodenectomy was performed. Pathological findings suggested T4(CBD)N1M0 primary duodenal carcinoma. Adjuvant chemotherapy with S-1(80 mg/m of S-1 administered for 2 weeks followed by a 1-week drug-free period)was administered after surgery. One year after the surgery, computed tomography(CT)scans showed swelling of the paraaortic lymph nodes. Recurrence of the duodenal carcinoma was diagnosed, and gemcitabine chemotherapy was initiated. Eight months later, CT scans revealed lung metastasis. The patient was then treated with oxaliplatin in combination with infusional 5-fluorouracil/Leucovorin(FOLFOX regimen). After completing 6 courses of the chemotherapy regimen, CT scans showed a partial response(PR). Currently, at 1 year, PR has been maintained. Therefore, we suggest that the FOLFOX regimen can be highly effective for the treatment of patients with duodenal carcinoma. PMID:24393902

  17. Duodenal Atresia In Utero in Association With Down's Syndrome and Annular Pancreas

    PubMed Central

    Clark, John F.J.; Hales, Earle; Ma, Peter; Rosser, Samuel B.

    1984-01-01

    A 28-weeks' gestational trisomic-21 male, with duodenal atresia due to annular pancreas, is presented. The atresia was diagnosed in utero by sonographic techniques. A review of the pertinent literature and discussion of management are presented. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:6231382

  18. [Traumatic rupture of duodenal diverticulum. Report of a case and literature review].

    PubMed

    Souza Jnior, A de L; Poggetti, R S; Fontes, B; Bernini, C O; Figueiredo, A M; Branco, P D; Birolini, D

    1996-01-01

    Duodenal diverticulum is a common anatomic abnormality. Its inflammatory perforation is a rare complication, with less than 100 cases reported in the available literature. Traumatic perforation is exceedingly rare (only 3 cases reported). In this report one more case of traumatic perforation is presented, and the literature is reviewed focusing on the pathogenic, diagnostic and therapeutic aspects of this severe disease. PMID:9239899

  19. [Pseudoaneurysm of gastroduodenal artery due to duodenal ulcer causing jaundice and interstitial pancreatitis but not bleeding].

    PubMed

    Jovanovi?, Miodrag; Colovi?, Radoje; Grubov, Nikica; Perisi?, Mirjana; Radak, Vladimir

    2004-01-01

    Aneurysms and pseudoaneurysms of the gastroduodenal artery are rare with less then 50 cases reported. Most frequently they are one of the consequences of pancreatitis much rarer duodenal ulcer or operative trauma during gastrectomy for duodenal ulcer or choledochotomy. We report on a 47 year-old man, chronic heavy alcohol consumer in whom a chronic postbulbar duodenal ulcer destroyed much of the back wall of the duodenum, eroded gastroduodenal artery causing pseudoaneurysm but without noticeable gastrointestinal bleeding. The patient had jaundice of obstructive type and elevated amilase. After Billroth II gastrectomy, suture of the gastroduodenal artery, cholecystectomy and T tube drainage of the common bile duct the patient developed intestinal obstruction caused by two interintestinal abscesses so that he had to be reoperated. After that he had a successful recovery, his general health greatly improved, he gained 15 kg in weight but two years after surgery he again started with heavy drinking and soon died due to serious brain damage. The case is rare and unusual at least for few reasons: First, the pseudoaneurysm was caused by duodenal ulcer. Second, a serious gastrointestinal bleeding did not take place. Third, the pseudoaneurysm was diagnosed by Doppler ultrasonography while angiography failed to opacify it due to thrombosis of the artery. PMID:15307314

  20. Laparoscopic drainage of an intramural duodenal haematoma: a novel technique and review of the literature

    PubMed Central

    2011-01-01

    Intramural Duodenal Haematoma (IDH) is an uncommon complication of blunt abdominal trauma. IDH's are most often treated non-operatively. We describe laparoscopic treatment of an IDH after failed conservative management. To our knowledge, successful laparoscopic drainage of an IDH in an adult has not been described previously in the literature. PMID:22185364

  1. Intramucosal nevus of buccal mucosa in a male child

    PubMed Central

    Pandey, Pallavi; Chaudhary, Chandra P; Ansari, Afroz Alam; Singh, Raghvendra

    2013-01-01

    Nevus (mole or birthmark) is a benign tumour of skin and mucosa characterised by the presence of melanin-producing, neuroectodermally derived cells, which can be light to dark brown, reddish brown, blue or flesh coloured. It varies in shape from oval to round. Oral melanotic nevi are uncommon oral lesions causing focal pigmentation. They were found only in 0.1% of population in a large survey. Nevi can be acquired over time or congenital. Acquired nevi are considered benign neoplasms whereas congenital nevi are hamartomas. They are located usually on the palate but less commonly on buccal mucosa, gingiva and lips. This article presents a case report of an intramucosal nevus of buccal mucosa in a 5-year-old boy with its surgical removal. PMID:23887988

  2. Intramucosal nevus of buccal mucosa in a male child.

    PubMed

    Pandey, Pallavi; Chaudhary, Chandra P; Ansari, Afroz Alam; Singh, Raghvendra

    2013-01-01

    Nevus (mole or birthmark) is a benign tumour of skin and mucosa characterised by the presence of melanin-producing, neuroectodermally derived cells, which can be light to dark brown, reddish brown, blue or flesh coloured. It varies in shape from oval to round. Oral melanotic nevi are uncommon oral lesions causing focal pigmentation. They were found only in 0.1% of population in a large survey. Nevi can be acquired over time or congenital. Acquired nevi are considered benign neoplasms whereas congenital nevi are hamartomas. They are located usually on the palate but less commonly on buccal mucosa, gingiva and lips. This article presents a case report of an intramucosal nevus of buccal mucosa in a 5-year-old boy with its surgical removal. PMID:23887988

  3. Cytogenetic biomonitoring of oral mucosa cells of crack cocaine users.

    PubMed

    das Graas Alonso de Oliveira, Maria; Dos Santos, Jean Nunes; Cury, Patrcia Ramos; da Silva, Victor Hugo Pereira; Oliveira, Nara Rejane Cruz; da Costa Padovani, Ricardo; Tucci, Adriana Marcassa; Ribeiro, Daniel Araki

    2014-04-01

    The aim of the present study was to comparatively evaluate genomic damage (micronucleus) and cellular death (pyknosis, karyolysis, and karyorrhexis) in exfoliated oral mucosa cells from crack cocaine users by micronucleus test. A total of 30 crack cocaine users and 30 health controls (non-exposed individuals) were included in this setting. Individuals had epithelial cells from cheek mechanically exfoliated, placed in fixative, and dropped in clean slides, which were checked for the above nuclear phenotypes. The results pointed out significant statistical differences (p?mucosa cells from crack cocaine users. Exposure to crack cocaine caused an increase of other nuclear alterations closely related to cytotoxicity such as karyolysis in oral cells as well. In summary, these data indicate that crack cocaine is able to induce chromosomal breakage and cellular death in oral mucosa cells of users. PMID:24430497

  4. Harvesting oral mucosa for one-stage anterior urethroplasty

    PubMed Central

    Kulkarni, Sanjay Balwant; Barbagli, Guido; Sansalone, Salvatore; Joshi, Pankaj Mangalkumar

    2014-01-01

    Oral mucosa has been the most popular substitute material for urethral reconstructive surgery because it is easy to harvest, is easy to access, has a concealed donor site scar, and obviates most of the problems associated with other grafts. However, the success of using oral mucosa for urethral surgery is mainly attributed to the biological properties of this tissue. Herein, the surgical steps of harvesting oral mucosa from the inner cheek are presented with an emphasis on tips and tricks to render the process easier and more reproducible and to prevent intra and post-operative complications. The following steps are emphasized: Nasal intubation, ovoid shape graft, delicate harvesting leaving the muscle intact, donor site closure and removal of submucosal tissue. PMID:24497698

  5. Harvesting oral mucosa for one-stage anterior urethroplasty.

    PubMed

    Kulkarni, Sanjay Balwant; Barbagli, Guido; Sansalone, Salvatore; Joshi, Pankaj Mangalkumar

    2014-01-01

    Oral mucosa has been the most popular substitute material for urethral reconstructive surgery because it is easy to harvest, is easy to access, has a concealed donor site scar, and obviates most of the problems associated with other grafts. However, the success of using oral mucosa for urethral surgery is mainly attributed to the biological properties of this tissue. Herein, the surgical steps of harvesting oral mucosa from the inner cheek are presented with an emphasis on tips and tricks to render the process easier and more reproducible and to prevent intra and post-operative complications. The following steps are emphasized: Nasal intubation, ovoid shape graft, delicate harvesting leaving the muscle intact, donor site closure and removal of submucosal tissue. PMID:24497698

  6. Comparative microscopical study of the gall bladder mucosa.

    PubMed

    Kamel, I; Nawar, N N

    1975-01-01

    The gall bladder from 6 Psammophis sibilans, 10 Bufo regularis and 10 Albino mice were extracted and prepared for microscopic examination. It was found that the mucosa of Psammophis sibilans consisted of ovoid and polygonal cells which were occasionally binucleated cells with darkly stained nuclei and occasionally pear-shaped cells with vesicular nuclei and fine processes. These cells were arranged in three layers. Apossible explanation for the different types of cells encountered and their arrangement was given. The gall bladder mucosa of Bufo regularis and Albino mouse were thrown into folds covered with simple columnar epithelium. However, the epithelium of the frog was higher than that of the mouse, with the nuclei situated midway between basement membrane and the lumen. Vacuolated cells were detected in the gall bladder mucosa of the mouse. The significance of the mucosal folds was discussed. PMID:1136701

  7. Reflectance confocal endomicroscope with optical axial scanning for in vivo imaging of the oral mucosa

    PubMed Central

    Jabbour, Joey M.; Bentley, Julie L.; Malik, Bilal H.; Nemechek, John; Warda, John; Cuenca, Rodrigo; Cheng, Shuna; Jo, Javier A.; Maitland, Kristen C.

    2014-01-01

    This paper presents the design and evaluation of a reflectance confocal laser endomicroscope using a miniature objective lens within a rigid probe in conjunction with an electrically tunable lens for axial scanning. The miniature lens was characterized alone as well as in the endoscope across a 200 µm axial scan range using the tunable lens. The ability of the confocal endoscope to probe the human oral cavity is demonstrated by imaging of the oral mucosa in vivo. The results indicate that reflectance confocal endomicroscopy has the potential to be used in a clinical setting and guide diagnostic evaluation of biological tissue. PMID:25426310

  8. Modulation of the Interaction of Enteric Bacteria with Intestinal Mucosa by Stress-Related Catecholamines.

    PubMed

    Stevens, Mark P

    2016-01-01

    Stress associated with parturition, transport or mixing has long been correlated with enhanced faecal excretion of diarrhoeal zoonotic pathogens in animals such as Salmonella enterica and Escherichia coli. It may also predispose humans to infection and/or be associated with more severe outcomes. One possible explanation for this phenomenon is the ability of enteric bacterial pathogens to sense and respond to host stress-related catecholamines. This article reviews evidence of the ability of catecholamine hormones to modulate interactions between Gram-negative diarrhoeal pathogens and intestinal mucosa, as well as the molecular mechanisms that may be at work. PMID:26589217

  9. Glanuloplasty with Oral Mucosa Graft following Total Glans Penis Amputation

    PubMed Central

    Appiah, Kwaku; Amoah, George; Azorliade, Roland; Gyasi-Sarpong, Kofi; Aboah, Ken; Nyamekye, Baah; Maison, Patrick; Twumasi-Frimpong, Benjamin; Opoku Antwi, Issac; Yenli, Edwin

    2014-01-01

    This is a report on the technique of neoglans reconstruction in a patient with amputated glans penis following guillotine neonatal circumcision. A 4?cm long and 2?cm wide lower lip oral mucosa graft was harvested and used to graft the distal 2?cm of the corporal bodies after 2?cm of the distal penile skin had been excised. One edge of the lower lip oral mucosa graft was anastomosed to the urethral margins distally and proximally to the skin. At six months of followup, patient had both satisfactory cosmetic and functional outcomes. PMID:25184073

  10. The Induction of Pattern-Recognition Receptor Expression against Influenza A Virus through Duox2-Derived Reactive Oxygen Species in Nasal Mucosa.

    PubMed

    Kim, Hyun Jik; Kim, Chang-Hoon; Kim, Min-Ji; Ryu, Ji-Hwan; Seong, Sang Yeop; Kim, Sujin; Lim, Su Jin; Holtzman, Michael J; Yoon, Joo-Heon

    2015-10-01

    We studied the relative roles of Duox2-derived reactive oxygen species (ROS) in host defense against influenza A virus (IAV) infection in normal human nasal epithelial cells and mouse nasal mucosa. We found that Duox2 primarily generated ROS rapidly after IAV infection in normal human nasal epithelial cells and that knockdown of Duox2 aggravated IAV infection. In addition, Duox2-derived ROS enhancement significantly suppressed IAV infection in nasal epithelium. In particular, Duox2-derived ROS were required for the induction of retinoic acid-inducible gene (RIG)-I and melanoma differentiation-associated protein 5 (MDA5) transcription. After intranasal IAV inoculation into mice, viral infection was significantly aggravated from 3 days postinoculation (dpi) in the nasal mucosa, and the IAV viral titer was highest at 7 dpi. Both RIG-I and MDA5 messenger RNA levels increased dominantly in mouse nasal mucosa from 3 dpi; consistent with this, RIG-I and MDA5 proteins were also induced after IAV infection. RIG-I and MDA5 messenger RNA levels were induced to a lower extent in the nasal mucosa of the mice that were inoculated with Duox2 short hairpin RNA, and the IAV viral titer was significantly higher in nasal lavage. Taken together, Duox2-derived ROS are necessary for the innate immune response and trigger the induction of RIG-I and MDA5 to resist IAV infection in human nasal epithelium and mouse nasal mucosa. PMID:25751630

  11. History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer

    PubMed Central

    Graham, David Y

    2014-01-01

    Helicobacter pylori (H. pylori) infection underlies gastric ulcer disease, gastric cancer and duodenal ulcer disease. The disease expression reflects the pattern and extent of gastritis/gastric atrophy (i.e., duodenal ulcer with non-atrophic and gastric ulcer and gastric cancer with atrophic gastritis). Gastric and duodenal ulcers and gastric cancer have been known for thousands of years. Ulcers are generally non-fatal and until the 20th century were difficult to diagnose. However, the presence and pattern of gastritis in past civilizations can be deduced based on the diseases present. It has been suggested that gastric ulcer and duodenal ulcer both arose or became more frequent in Europe in the 19th century. Here, we show that gastric cancer and gastric ulcer were present throughout the 17th to 19th centuries consistent with atrophic gastritis being the predominant pattern, as it proved to be when it could be examined directly in the late 19th century. The environment before the 20th century favored acquisition of H. pylori infection and atrophic gastritis (e.g., poor sanitation and standards of living, seasonal diets poor in fresh fruits and vegetables, especially in winter, vitamin deficiencies, and frequent febrile infections in childhood). The latter part of the 19th century saw improvements in standards of living, sanitation, and diets with a corresponding decrease in rate of development of atrophic gastritis allowing duodenal ulcers to become more prominent. In the early 20th century physician’s believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for “surgical disease” or for “Sippy” diets. We show that while H. pylori remained common and virulent in Europe and the United States, environmental changes resulted in changes of the pattern of gastritis producing a change in the manifestations of H. pylori infections and subsequently to a rapid decline in transmission and a rapid decline in all H. pylori-related diseases. PMID:24833849

  12. Hemorrhagic gastric and duodenal ulcers after the Great East Japan Earthquake Disaster

    PubMed Central

    Yamanaka, Kenichi; Miyatani, Hiroyuki; Yoshida, Yukio; Asabe, Shinichi; Yoshida, Toru; Nakano, Misaki; Obara, Shin; Endo, Hidehiko

    2013-01-01

    AIM: To elucidate the characteristics of hemorrhagic gastric/duodenal ulcers in a post-earthquake period within one medical district. METHODS: Hemorrhagic gastric/duodenal ulcers in the Iwate Prefectural Kamaishi Hospital during the 6-mo period after the Great East Japan Earthquake Disaster were reviewed retrospectively. The subjects were 27 patients who visited our hospital with a chief complaint of hematemesis or hemorrhagic stool and were diagnosed as having hemorrhagic gastric/duodenal ulcers by upper gastrointestinal endoscopy during a 6-mo period starting on March 11, 2011. This period was divided into two phases: the acute stress phase, comprising the first month after the earthquake disaster, and the chronic stress phase, from the second through the sixth month. The following items were analyzed according to these phases: age, sex, sites and number of ulcers, peptic ulcer history, status of Helicobacter pylori (H. pylori) infection, intake of non-steroidal anti-inflammatory drugs, and degree of impact of the earthquake disaster. RESULTS: In the acute stress phase from 10 d to 1 mo after the disaster, the number of patients increased rapidly, with a nearly equal male-to-female ratio, and the rate of multiple ulcers was significantly higher than in the previous year (88.9% vs 25%, P < 0.005). In the chronic stress phase starting 1 mo after the earthquake disaster, the number of patients decreased to a level similar to that of the previous year. There were more male patients during this period, and many patients tended to have a solitary ulcer. All patients with duodenal ulcers found in the acute stress phase were negative for serum H. pylori antibodies, and this was significantly different from the previous years positive rate of 75% (P < 0.05). CONCLUSION: Severe stress caused by an earthquake disaster may have affected the characteristics of hemorrhagic gastric/duodenal ulcers. PMID:24259974

  13. H2S modulates duodenal motility in male rats via activating TRPV1 and KATP channels

    PubMed Central

    Lu, Wen; Li, Jing; Gong, Liping; Xu, Xiaomeng; Han, Ting; Ye, Yanfang; Che, Tongtong; Luo, Yan; Li, Jingxin; Zhan, Renzhi; Yao, Wei; Liu, Kejing; Cui, Shuang; Liu, Chuanyong

    2014-01-01

    Background and Purpose H2S induces vasodilatation by opening KATP channels but it may also affect other ion channels. The aim of this study was to investigate the effect of H2S on intestinal motility in rats and its underlying mechanism. Experimental Approach The tension of intestinal muscle strips, afferent firing of intestinal mesenteric nerves, length of duodenal smooth muscle cells and whole-cell membrane potential of dorsal root ganglion (DRG) neurons were monitored. H2S-producing enzymes were located by immunofluorescence staining. Key results NaHS exerted early transient excitation and late long-lasting inhibition on the intestinal contraction. The excitation was attenuated by TRPV1 antagonists capsazepine, A784168, SB-366791 and NK1 receptor antagonist L703606, while the inhibition was attenuated by glibenclamide. NaHS increased duodenal afferent nerve firing and depolarized DRG neurons. These effects were reduced by capsazepine and A784168. NaHS relaxed isolated duodenal smooth muscle cells. The KATP channels were expressed in smooth muscle cells. Cystathionine β-synthase and cystathionine γ-lyase were expressed in rat duodenal myenteric neurons. L-cysteine and S-adenosyl-L-methionine increased the contraction of duodenal muscle strips, an effect attenuated by capsazepine and L703606. Conclusions and Implications NaHS induces biphasic effects on intestinal motility in rats while endogenous H2S only exerts an excitatory effect. This transient excitatory effect might be mediated by activation of TRPV1 channels in sensory nerve terminals with the consequent release of substance P. The long-lasting inhibitory effect might be mediated by activation of KATP channels in the smooth muscle cells. These findings reveal a novel mechanism for the excitatory effect of H2S on gastrointestinal motility. PMID:24345161

  14. Epigenetic maturation in colonic mucosa continues beyond infancy in mice.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Monozygotic twin and other epidemiologic studies indicate that epigenetic processes may play an important role in the pathogenesis of inflammatory bowel diseases that commonly affect the colonic mucosa. The peak onset of these disorders in young adulthood, suggests that epigenetic changes normally o...

  15. Micro- and Nanosized Particles in Nasal Mucosa: A Pilot Study

    PubMed Central

    2015-01-01

    Objective. The aim of this prospective study is to evaluate presence and quantity of micro- and nanosized particles (NPs) and interindividual differences in their distribution and composition in nasal mucosa. Methods. Six samples of nasal mucosa obtained by mucotomy from patients with chronic hypertrophic rhinosinusitis were examined. Samples divided into 4 parts according to the distance from the nostrils were analyzed by scanning electron microscopy and Raman microspectroscopy to detect solid particles and characterize their morphology and composition. A novel method of quantification of the particles was designed and used to evaluate interindividual differences in distribution of the particles. The findings were compared with patients' employment history. Results. In all the samples, NPs of different elemental composition were found (iron, barium, copper, titanium, etc.), predominantly in the parts most distant from nostrils, in various depths from the surface of the mucosa and interindividual differences in their quantity and composition were found, possibly in relation to professional exposition. Conclusions. This study has proven the possibility of quantification of distribution of micro- and nanosized particles in tissue samples and that the NPs may deposit in deeper layers of mucosa and their elemental composition may be related to professional exposition to the sources of NPs. PMID:26125023

  16. Draft Genome Sequence of the Lactobacillus mucosae Strain Marseille

    PubMed Central

    Drissi, Fatima; Merhej, Vicky; Blanc-Tailleur, Caroline

    2015-01-01

    Lactobacillus mucosae strain Marseille, isolated from stool samples of a child suffering from a malnutrition disorder called Kwashiorkor, produces bacteriocin and seems to have specific carbohydrate and lipid metabolisms different from those of other Lactobacillus organisms. The draft genome sequence of this strain is presented here. PMID:26227603

  17. Rapid Accumulation of CD14+CD11c+ Dendritic Cells in Gut Mucosa of Celiac Disease after in vivo Gluten Challenge

    PubMed Central

    Beitnes, Ann-Christin Rberg; Rki, Melinda; Brottveit, Margit; Lundin, Knut Erik Aslaksen

    2012-01-01

    Background Of antigen-presenting cells (APCs) expressing HLA-DQ molecules in the celiac disease (CD) lesion, CD11c+ dendritic cells (DCs) co-expressing the monocyte marker CD14 are increased, whereas other DC subsets (CD1c+ or CD103+) and CD163+CD11c? macrophages are all decreased. It is unclear whether these changes result from chronic inflammation or whether they represent early events in the gluten response. We have addressed this in a model of in vivo gluten challenge. Methods Treated HLA-DQ2+ CD patients (n?=?12) and HLA-DQ2+ gluten-sensitive control subjects (n?=?12) on a gluten-free diet (GFD) were orally challenged with gluten for three days. Duodenal biopsies obtained before and after gluten challenge were subjected to immunohistochemistry. Single cell digests of duodenal biopsies from healthy controls (n?=?4), treated CD (n?=?3) and untreated CD (n?=?3) patients were analyzed by flow cytometry. Results In treated CD patients, the gluten challenge increased the density of CD14+CD11c+ DCs, whereas the density of CD103+CD11c+ DCs and CD163+CD11c? macrophages decreased, and the density of CD1c+CD11c+ DCs remained unchanged. Most CD14+CD11c+ DCs co-expressed CCR2. The density of neutrophils also increased in the challenged mucosa, but in most patients no architectural changes or increase of CD3+ intraepithelial lymphocytes (IELs) were found. In control tissue no significant changes were observed. Conclusions Rapid accumulation of CD14+CD11c+ DCs is specific to CD and precedes changes in mucosal architecture, indicating that this DC subset may be directly involved in the immunopathology of the disease. The expression of CCR2 and CD14 on the accumulating CD11c+ DCs indicates that these cells are newly recruited monocytes. PMID:22438948

  18. Breast Cancer-Associated pS2 Protein: Synthesis and Secretion by Normal Stomach Mucosa

    NASA Astrophysics Data System (ADS)

    Rio, M. C.; Bellocq, J. P.; Daniel, J. Y.; Tomasetto, C.; Lathe, R.; Chenard, M. P.; Batzenschlager, A.; Chambon, P.

    1988-08-01

    The human pS2 gene is specifically expressed under estrogen transcriptional control in a subclass of estrogen receptor-containing human breast cancer cells. The pS2 gene encodes an 84-amino acid protein that is secreted after signal peptide cleavage. The distribution of pS2 protein in normal human tissues was studied with antibodies to pS2; pS2 was specifically expressed and secreted by mucosa cells of the normal stomach antrum and body of both female and male individuals. Moreover, no estrogen receptor could be detected in these cells, indicating that pS2 gene expression is estrogen-independent in the stomach. The function of the pS2 protein in the gastrointestinal tract is unknown. However, the pS2 protein is similar in sequence to a porcine pancreatic protein that has been shown to inhibit gastrointestinal motility and gastric secretion.

  19. Expression of Toll-like receptor 2 in duodenal biopsies from dogs with inflammatory bowel disease is associated with severity of disease.

    PubMed

    McMahon, L A; House, A K; Catchpole, B; Elson-Riggins, J; Riddle, A; Smith, K; Werling, D; Burgener, I A; Allenspach, K

    2010-05-15

    There is growing evidence that aberrant innate immune responses towards the bacterial flora of the gut play a role in the pathogenesis of canine inflammatory bowel disease (IBD). Toll-like receptors (TLR) play an important role as primary sensors of invading pathogens and have gained significant attention in human IBD as differential expression and polymorphisms of certain TLR have been shown to occur in ulcerative colitis (UC) and Crohn's disease (CD). The aim of the current study was to evaluate the expression of two TLR important for recognition of commensals in the gut. TLR2 and TLR4 mRNA expression in duodenal biopsies from dogs with IBD was measured and correlated with clinical and histological disease severity. Endoscopic duodenal biopsies from 20 clinical cases and 7 healthy control dogs were used to extract mRNA. TLR2 and TLR4 mRNA expression was assessed using quantitative real-time PCR. TLR2 mRNA expression was significantly increased in the IBD dogs compared to controls, whereas TLR4 mRNA expression was similar in IBD and control cases. In addition, TLR2 mRNA expression was mildly correlated with clinical severity of disease, however, there was no correlation between TLR2 expression and histological severity of disease. PMID:20034678

  20. Cadmium inhibits acid secretion in stimulated frog gastric mucosa

    SciTech Connect

    Gerbino, Andrea; Debellis, Lucantonio; Caroppo, Rosa; Curci, Silvana; Colella, Matilde

    2010-06-01

    Cadmium, a toxic environmental pollutant, affects the function of different organs such as lungs, liver and kidney. Less is known about its toxic effects on the gastric mucosa. The aim of this study was to investigate the mechanisms by which cadmium impacts on the physiology of gastric mucosa. To this end, intact amphibian mucosae were mounted in Ussing chambers and the rate of acid secretion, short circuit current (I{sub sc}), transepithelial potential (V{sub t}) and resistance (R{sub t}) were recorded in the continuous presence of cadmium. Addition of cadmium (20 {mu}M to 1 mM) on the serosal but not luminal side of the mucosae resulted in inhibition of acid secretion and increase in NPPB-sensitive, chloride-dependent short circuit current. Remarkably, cadmium exerted its effects only on histamine-stimulated tissues. Experiments with TPEN, a cell-permeant chelator for heavy metals, showed that cadmium acts from the intracellular side of the acid secreting cells. Furthermore, cadmium-induced inhibition of acid secretion and increase in I{sub sc} cannot be explained by an action on: 1) H{sub 2} histamine receptor, 2) Ca{sup 2+} signalling 3) adenylyl cyclase or 4) carbonic anhydrase. Conversely, cadmium was ineffective in the presence of the H{sup +}/K{sup +}-ATPase blocker omeprazole suggesting that the two compounds likely act on the same target. Our findings suggest that cadmium affects the functionality of histamine-stimulated gastric mucosa by inhibiting the H{sup +}/K{sup +}-ATPase from the intracellular side. These data shed new light on the toxic effect of this dangerous environmental pollutant and may result in new avenues for therapeutic intervention in acute and chronic intoxication.

  1. Pyloro-duodenal hernia with formation of enterocutaneous fistula in a buffalo calf following a dog attack

    PubMed Central

    Kamalakar, G.; Prasad, V. Devi; Devaratnam, J.; Ganeshan, A.

    2015-01-01

    A body wall hernia entrapping abomasum and concurrent duodenal fistula in a buffalo calf aged about 8 months, secondary to a dog bite was successfully treated by closure of fistulous orifice and ventro lateral herniorrhaphy. PMID:26623378

  2. Validation of methylation biomarkers that distinguish normal colon mucosa from cancer patients from normal colon mucosa of patients without cancer

    PubMed Central

    Cesaroni, Matteo; Powell, Jasmine; Sapienza, Carmen

    2014-01-01

    We have validated differences in DNA methylation levels of candidate genes previously reported to discriminate between normal colon mucosa of colon cancer patients and normal colon mucosa of individuals without cancer. Here, we report that CpG sites in 16 of the 30 candidate genes selected show significant differences in mean methylation level in normal colon mucosa of 24 cancer patients and 24 controls. A support vector machine trained on these data and data for an additional 66 CpGs yielded an 18-gene signature, composed of 10 of the validated candidate genes plus eight additional candidates. This model exhibited 96% sensitivity and 100% specificity in a 40-sample training set and classified all eight samples in the test set correctly. Moreover, we found a moderate-strong correlation (Pearson coefficients r=0.253-0.722) between methylation levels in colon mucosa and methylation levels in peripheral blood for seven of the 18 genes in the support vector model. These seven genes, alone, classified 44 of the 48 patients in the validation set correctly and five CpGs selected from only two of the seven genes classified 41 of the 48 patients in the discovery set correctly. These results suggest that methylation biomarkers may be developed that will, at minimum, serve as useful objective and quantitative diagnostic complements to colonoscopy as a cancer-screening tool. These data also suggest that it may be possible to monitor biomarker methylation levels in tissues collected much less invasively than by colonoscopy. PMID:24806665

  3. Cholecystokinin release and biliopancreatic secretion in response to selective perfusion of the duodenal loop with aminoacids in man.

    PubMed

    Colombel, J F; Sutton, A; Chayvialle, J A; Modigliani, R

    1988-09-01

    The aim of this study was to measure the role of the duodenal loop in biliopancreatic secretion in man by infusing various stimuli at the ampulla of Vater and collecting duodenal contents at the ligament of Treitz, above an occluding balloon. Perfusion at 10 ml/min of a first mixture of aminoacids - phenylalanine (47.2 mmol), methionine (38.2 mmol), tryptophan (11 mmol), valine (61.6 mmol) - increased cholecystokinin (CCK) plasma concentrations and duodenal bile salt output (p less than 0.005) as compared with a control electrolyte solution, but did not change pancreatic enzyme secretion significantly; duodenal infusion of another aminoacid mixture - arginine (32.4 mmol), histidine (14.1 mmol), leucine (36 mmol), isoleucine (21.5 mmol), lysine (31 mmol), threonine (23 mmol) - did not change CCK plasma concentrations, bile salt or pancreatic enzyme output. The respective role of duodenal distension and endogenous CCK was investigated by perfusing the first aminoacid solution and the control solution at 2, 5, and 10 ml/min. Changing the perfusion rate of control solution from 2 to 5 ml/min led to a significant increase (p less than 0.01) in pancreatic secretion with no further increase at 10 ml/min. Bile salt output was not influenced by the perfusion rate of control solution. During the perfusion of the aminoacid solution, despite a stepwise increase in CCK release, the only significant change in pancreatic secretion was an increase of lipase output (p less than 0.05) when the infusion rate was raised from 2 to 5 ml/min. Our results suggest that duodenal CCK release (1) depends on the nature of aminoacids (2) has predominant role in the regulation of pancreatic secretion at low perfusion rate but is less effective when superimposed on a mechanical stimulus caused by duodenal distension (3) is a major stimulus for gall bladder contraction which is not influenced by duodenal distension. PMID:3197988

  4. Evaluation of endoscopically obtained duodenal biopsy samples from cats and dogs in an adapter-modified Ussing chamber

    PubMed Central

    DeBiasio, John V.; Suchodolski, Jan S.; Newman, Shelley; Musch, Mark W.; Steiner, Jrg M.

    2014-01-01

    This study was conducted to evaluate an adapter-modified Ussing chamber for assessment of transport physiology in endoscopically obtained duodenal biopsies from healthy cats and dogs, as well as dogs with chronic enteropathies. 17 duodenal biopsies from five cats and 51 duodenal biopsies from 13 dogs were obtained. Samples were transferred into an adapter-modified Ussing chamber and sequentially exposed to various absorbagogues and secretagogues. Overall, 78.6% of duodenal samples obtained from cats responded to at least one compound. In duodenal biopsies obtained from dogs, the rate of overall response ranged from 87.5% (healthy individuals; n = 8), to 63.6% (animals exhibiting clinical signs of gastrointestinal disease and histopathological unremarkable duodenum; n = 15), and 32.1% (animals exhibiting clinical signs of gastrointestinal diseases and moderate to severe histopathological lesions; n = 28). Detailed information regarding the magnitude and duration of the response are provided. The adapter-modified Ussing chamber enables investigation of the absorptive and secretory capacity of endoscopically obtained duodenal biopsies from cats and dogs and has the potential to become a valuable research tool. The response of samples was correlated with histopathological findings. PMID:24378587

  5. Effect of folic Acid supplementation on the folate status of buccal mucosa and lymphocytes.

    PubMed

    Basten, Graham P; Hill, Marilyn H; Duthie, Susan J; Powers, Hilary J

    2004-07-01

    Folate deficiency may be associated with an increased risk of cancer at certain sites. There is a need to measure folate status and putative biomarkers of cancer risk in the same target tissue, or in surrogate tissues. A study was carried out to develop a method for the rapid measurement of folate in human buccal mucosa and lymphocytes and to evaluate the responsiveness of this measurement in both tissues to folic acid supplementation in healthy subjects, relative to conventional markers of folate status. Three hundred and twenty-three adults, ages between 20 and 60 years, were screened for RBC folate concentrations. Sixty-five subjects with red cell folate between 200 and 650 nmol/L participated in a randomized, double blind, placebo-controlled, folic acid (1.2 mg) intervention trial, lasting 12 weeks. As anticipated, a significant baseline correlation (r = 0.36, P < 0.01) was observed between red cell folate and plasma 5-methyltetrahydrofolate (5-MeTHF). Lymphocyte total folate was significantly associated with plasma 5-MeTHF (r = 0.28, P < 0.05) and plasma total homocysteine concentration (r = -0.34, P < 0.05). Buccal mucosa total folate showed no correlation with either red cell folate or 5-MeTHF, but was significantly associated with lymphocyte total folate (r = 0.35, P < 0.01). Supplementation elicited a significant increase in lymphocyte total folate (P < 0.01), and this was strongly associated with the increase in RBC total folate (P < 0.01) and plasma 5-MeTHF (P < 0.01). Buccal mucosa total folate was not influenced by folate supplementation. Methods have been developed for the rapid measurement of lymphocyte and buccal mucosal total folate. Lymphocyte folate is sensitive to folate intake and is reflected by plasma 5-MeTHF. PMID:15247137

  6. The buccal mucosa as a route for TiO2 nanoparticle uptake.

    PubMed

    Teubl, Birgit Johanna; Leitinger, Gerd; Schneider, Marc; Lehr, Claus-Michael; Fröhlich, Eleonore; Zimmer, Andreas; Roblegg, Eva

    2015-03-01

    The oral cavity, although part of the aero-digestive tract, is still neglected in terms of risk assessment with respect to nanoparticle uptake. If nanoparticles enter the oral cavity, either via oral products or inhaled materials, it is not clear whether they rapidly interact with the mucosae or are swallowed. In this study, interactions of three distinct titanium dioxide (TiO2) particles (i.e. NM 100, NM 101 and NM 105) with oral tissues are presented. Physicochemical properties were addressed in relevant media, and particle penetration was investigated with an ex vivo model using porcine mucosa. To avoid modification of the particle surfaces via labeling, multiphoton microscopy was introduced as an accurate method to detect TiO2 particles within the tissue. The spatiotemporal aspects of nanoparticle uptake, as well as the intracellular localization in human epithelial cells, were studied and potential toxic effects were evaluated. Although TiO2 particles formed large aggregates once dispersed in media, 10-50% remained in the nanoscale range, rapidly interacting with the mucus layer and infecting the epithelium. However, differences in the penetration depth were observed depending on the particle characteristics. NM 100 and NM 105 were found in both the upper part and the lower part of the buccal mucosa, while NM 101 (smallest particle sizes) only penetrated the upper parts. Transport studies revealed that TiO2 nanoparticles were found in vesicles, as well as freely distributed in the cytoplasm. Cell viability/integrity was not affected negatively; however, NM 105 triggered the production of reactive oxygen species. These data clearly suggest that the oral cavity should be considered in further risk assessment studies. PMID:24873758

  7. Binding of cholera toxin to pig intestinal mucosa glycosphingolipids: relationship with the ABO blood group system.

    PubMed

    Bennun, F R; Roth, G A; Monferran, C G; Cumar, F A

    1989-03-01

    A search for compounds from intestinal mucosa of pigs carrying and not carrying blood group A-active substances (A+ and A- pigs, respectively) capable of binding cholera toxin (CT) was performed. Glycolipid extracts from a pool of pig intestinal mucosa resolved in thin-layer chromatography (TLC) revealed the presence of six to eight compounds capable of binding 125I-CT, two of them running as the ganglioside standards GM1 and GD1b. When intestinal mucosa glycolipids from single pigs were assayed by TLC for CT-binding capacity, two different patterns of labeling were observed. The main difference was at the level of compounds running below GD1b. The A+ pigs but not the A- pigs showed CT binding at this level. The major CT-binding compound detected only in A+ pigs was purified and some properties were determined. After TLC developed with different solvent systems, the purified compound bound CT and also immunoreacted with anti-A and anti-AB antisera but not with anti-B antiserum. The compound was also able to inhibit the hemagglutination of human A erythrocytes caused by anti-A antiserum, but inhibition was not observed with the B-anti-B or O (H)-Ulex europaeus lectin systems. A partial chemical characterization indicated that the active compound is a neutral glycosphingolipid containing glucose, fucose, galactose, and hexosamine. The existence of a blood group-active substance(s) able to interact with CT may help to explain the relationship between ABO blood groups and the diarrheal disease caused by infection with Vibrio cholerae. PMID:2917796

  8. The adhesiometer: a simple device to measure adherence of barium sulfate to intestinal mucosa.

    PubMed

    Salomonowitz, E; Frick, M P; Cragg, A H; Lund, G

    1984-04-01

    A simple, inexpensive device assessing barium sulfate adherence to alimentary tract mucosa was tested in an animal study using pigs and dogs. Interaction of gastric, intestinal, and colonic mucosal lining with three different barium preparations was studied. In both pigs and dogs, barium adherence to gastric mucosa was significantly stronger when compared with colonic mucosa. PMID:6608230

  9. Upper ureteric transitional cell carcinoma, extending to the renal pelvis, presenting as duodenal obstruction.

    PubMed

    Stroman, Luke Andrew; Sharma, Naomi; Sullivan, Mark

    2015-01-01

    A 61-year-old man presented with weight loss, dysphagia and vomiting. A barium swallow revealed a duodenal obstruction at D3. CT of the abdomen and pelvis showed a left upper ureteric tumour extending to the renal pelvis compressing the duodenum and causing left-sided hydronephrosis. Cystoscopy and left-sided ureteroscopy proved difficult and were unable to visualise or biopsy the mass, but a left ureteric stent was placed. Laparoscopic biopsy of the mass was completed and histology revealed transitional cell carcinoma. The patient went on to receive palliative chemotherapy, which relieved the small bowel obstruction, and the patient was able to eat solid food 8?weeks later. This case highlights a previously unreported cause of duodenal obstruction. PMID:26564110

  10. Endoscopic fibrin sealant closure of duodenal perforation after endoscopic retrograde cholangiopancreatography

    PubMed Central

    Yang, Hsin-Yeh; Chen, Jui-Hao

    2015-01-01

    Traditionally, perivaterian duodenal perforation can be managed conservatively or surgically. If a large volume of leakage results in fluid collection in the retroperitoneum, surgery may be necessary. Our case met the surgical indication for perivaterian duodenal perforation after endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and endoscopic papillary balloon dilatation. The patient developed a retroperitoneal abscess after the procedures, and a perivaterian perforation was suggested on computed tomography (CT). CT-guided abscess drainage was performed immediately. We unsuccessfully attempted to close the perforation with hemoclips initially. Subsequently, we used fibrin sealant (Tisseel) injection to occlude the perforation. Fibrin sealant injections have been previously used during endoscopy for wound closure and fistula repair. Based on our report, fibrin sealant injection can be considered as an alternative method for the treatment of ERCP-related type II perforations. PMID:26668519

  11. [The use of the atropine test in patients with duodenal peptic ulcer].

    PubMed

    Moroz, G Z

    1997-01-01

    Results of the studies made showed that among the examined patients who took part in the elimination of the aftermath of the Chernobyl accident, a positive atropin test was recordable in 38 (63%), a negative one in 16 (27%), weakly positive in 6(10%). In the control group of patients with duodenal ulcer a positive atropin test was in 73%, a negative one in 9%, and weakly positive in 18%. The difference between the frequency of a negative atropin test in the main and control groups was statistically significant (P < 0.05). The results obtained attest to the need for the atropin test to be done in patients with duodenal ulcer to prescribe pathogenetically substantiated therapy treatments tailored to the individual. PMID:9491689

  12. Gastrojejunostomy without partial gastrectomy to manage duodenal stenosis in a dog.

    PubMed

    Nel, Johannes J; Du Plessis, Cornelius J; Coetzee, Gert L

    2015-01-01

    A nine-year-old female Rottweiler with a history of repeated gastrointestinal ulcerations and three previous surgical interventions related to gastrointestinal ulceration presented with symptoms of anorexia and intermittent vomiting. Benign gastric outflow obstruction was diagnosed in the proximal duodenal area. The initial surgical plan was to perform a pylorectomy with gastroduodenostomy (Billroth I procedure), but owing to substantial scar tissue and adhesions in the area a palliative gastrojejunostomy was performed. This procedure provided a bypass for the gastric contents into the proximal jejunum via the new stoma, yet still allowed bile and pancreatic secretions to flow normally via the patent duodenum. The gastrojejunostomy technique was successful in the surgical management of this case, which involved proximal duodenal stricture in the absence of neoplasia. Regular telephonic followup over the next 12 months confirmed that the patient was doing well. PMID:26824343

  13. Endoscopic treatment of intraluminal duodenal ("windsock") diverticulum: varying techniques from five cases.

    PubMed

    Law, R; Topazian, M; Baron, T H

    2012-12-01

    The optimal endoscopic approach to intraluminal duodenal diverticulum (IDD) has not been established. We report on our experience of endoscopic resection of symptomatic IDD in five patients (three men, two women; mean age 37 years) who were treated between August 2004 and April 2012.?Four patients underwent endoscopic diverticulectomy using a standard polypectomy snare. Following diverticulectomy, the remaining duodenal septum was incised using a needle-knife in two patients. The fifth patient underwent endoscopic diverticulotomy using a needle-knife. In four cases the IDD was resected and reviewed histologically and demonstrated substantial vascularity. All patients developed clinically significant, post-procedural bleeding, which was managed endoscopically. Endoscopic management of symptomatic IDD can be achieved using various approaches. Post-procedural bleeding appears to be a common adverse event, but this complication can be managed endoscopically. PMID:23188665

  14. [A case of enterolith ileus secondary to acute pancreatitis associated with a juxtapapillary duodenal diverticulum].

    PubMed

    Morii, Shinji; Doi, Yoko; Makita, Tomoo; Takeda, Shinichiro; Miura, Seiki; Kaneko, Takaaki; Saito, Shuichi; Okabe, Shinichiro

    2015-05-01

    A 63-year-old woman with abdominal pain was referred to our hospital. Her pancreatic enzymes were elevated, and an abdominal computed tomography (CT) scan showed an enlarged pancreas, consistent with pancreatitis, and gas collection containing an impacted stone adjacent to Vater's papilla. This finding raised the suspicion of a duodenal diverticulum. A subsequent ERCP showed a juxtapapillary duodenal diverticulum (JPDD) filled with calculi and pus. The pancreatitis improved with 2 weeks of conservative treatment. Subsequently, the patient underwent resection of the uterus and bilateral adnexa to remove a large ovarian cyst that was also identified on the admission CT scan. On the third postoperative day, she developed abdominal pain and vomiting. CT revealed small bowel obstruction caused by an enterolith expelled from JPDD. Enterotomy was performed to remove the stone. To our knowledge, only three similar cases have been previously reported in Japan. PMID:25947022

  15. Effects of tripotassium dicitrato bismuthate (TDB) tablets or cimetidine in the treatment of duodenal ulcer.

    PubMed Central

    Hamilton, I; Worsley, B W; O'Connor, H J; Axon, A T

    1983-01-01

    Forty patients with duodenal ulcer were randomly allocated to treatment with either tripotassium dicitrato bismuthate tablets or cimetidine for six weeks. Endoscopically confirmed healing of the ulcer occurred in 80% treated with tripotassium dicitrato bismuthate tablets and in 85% treated with cimetidine. Symptomatic improvement was also similar in the two groups. Treatment with cimetidine was associated with an increase in pH of gastric aspirate during treatment and increased numbers of bacteria were isolated from the gastric aspirate during treatment, while the pH and bacterial flora of gastric aspirate did not change during tripotassium dicitrato bismuthate treatment. Serum and urinary bismuth levels rose during treatment with tripotassium dicitrato bismuthate and urinary excretion remained raised two weeks after cessation of treatment. Tripotassium dicitrato bismuthate tablets appear to be as effective as cimetidine in the treatment of duodenal ulcer without the potentially undesirable effects of a reduction in gastric acid secretion. PMID:6357964

  16. Structure-activity relations between alkyl nucleophilic chemicals causing duodenal ulcer and adrenocortical necrosis

    SciTech Connect

    Szabo, S.; Reynolds, E.S.; Unger, S.H.

    1982-10-01

    Structure-activity relationships were qualitatively and quantitatively examined for 56 chemicals (e.g., derivatives of propionitrile, acrylonitrile and cysteamine) which caused duodenal ulcer and/or adrenocortical necrosis in rats. For the first time the duodenal ulcerogenic property of numerous chemicals has been studied in a rational and predictive manner. Ulcerogenic activity was most intense in the carbonitriles attached to two or three carbon backbones and diminished by shortening, lengthening, branching, unsaturating, halogenating or hydroxylating the carbon chains. Different modes of action are implied. Adrenocorticolytic potency was associated with unsaturation of the carbon chain and substitution of the nitrile by thiol or amine radicals. An action of these chemicals on the central nervous system has been suggested.

  17. How diet and lifestyle affect duodenal ulcers. Review of the evidence.

    PubMed Central

    Ryan-Harshman, Milly; Aldoori, Walid

    2004-01-01

    OBJECTIVE: To demonstrate the role of diet in reducing or aggravating risk of duodenal ulcer (DU). QUALITY OF EVIDENCE: MEDLINE was searched from January 1966 to December 2001 for articles on the relationship between diet and lifestyle and DU using the key words duodenal ulcer and diet, fibre, or lifestyle. Evidence that these factors are associated with DU arose mainly from three case-control and three prospective studies (level II evidence) and from expert opinion (level III evidence). MAIN MESSAGE: A high-fibre diet appears to reduce risk of DU; soluble fibre might be associated with reduced risk also. Vitamin A intake is associated with lower risk of DU. Little evidence indicates that fat, type of fat, protein intake, or consumption of alcohol or caffeine affect the etiology of DU. CONCLUSION: A high-fibre diet, particularly if the fibre comes from fruit and vegetables, could reduce risk of DU; vitamin A might also be beneficial. PMID:15171675

  18. Variant on Manifestation of Duodenal Metastasis 26 Years after Initial Diagnosis of Primary Cutaneous Melanoma

    PubMed Central

    Kitajima, Kumiko; Bardier-Dupas, Armelle; Breton, Sylvie; Rousseau, Graldine; Siksik, Jean-Michel; Vaillant, Jean-Christophe; Hannoun, Laurent

    2010-01-01

    Malignant duodenal neoplasms are relatively rare, and the diagnosis is often delayed because of their vague and nonspecific symptoms. We report the case of a 79-year-old female who had a medical history of malignant melanoma of the cheek that had initially been diagnosed at 53 years of age. Work-up revealed severe stenosis of the duodenum caused by a large mass with ulceration at the tip of its mucosal surface. Tumor biopsy led to a histological diagnosis of extremely poorly differentiated carcinoma, but it was impossible to determine whether the lesion was a primary neoplasm or represented secondary involvement. Pancreatoduodenectomy was performed, and the surgical specimen showed a protuberant tumor in the nonampullary region of the second portion of the duodenum. Final diagnosis of metastatic duodenal melanoma was made by immunohistological examination. She is currently alive without recurrence 28 months after the surgical treatment. PMID:21103234

  19. Endoscopic fibrin sealant closure of duodenal perforation after endoscopic retrograde cholangiopancreatography.

    PubMed

    Yang, Hsin-Yeh; Chen, Jui-Hao

    2015-12-01

    Traditionally, perivaterian duodenal perforation can be managed conservatively or surgically. If a large volume of leakage results in fluid collection in the retroperitoneum, surgery may be necessary. Our case met the surgical indication for perivaterian duodenal perforation after endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and endoscopic papillary balloon dilatation. The patient developed a retroperitoneal abscess after the procedures, and a perivaterian perforation was suggested on computed tomography (CT). CT-guided abscess drainage was performed immediately. We unsuccessfully attempted to close the perforation with hemoclips initially. Subsequently, we used fibrin sealant (Tisseel) injection to occlude the perforation. Fibrin sealant injections have been previously used during endoscopy for wound closure and fistula repair. Based on our report, fibrin sealant injection can be considered as an alternative method for the treatment of ERCP-related type II perforations. PMID:26668519

  20. Down syndrome: Molecular mapping of the congenital heart disease and duodenal stenosis

    SciTech Connect

    Korenburg, J.R. ); Bradley, C.; Disteche, C.M. )

    1992-02-01

    Down syndrome (DS) is a major cause of congenital heart and gut disease and mental retardation. DS individuals also have characteristic facies, hands, and dermatoglyphics, in addition to abnormalities of the immune system, and increased risk of leukemia, and an Alzheimer-like dementia. Although their molecular basis is unknown, recent work on patients with DS and partial duplications of chromosome 21 has suggested small chromosomal regions located in band q22 that are likely to contain the genes for some of these features. The authors now extend these analyses to define molecular markers for the congenital heart disease, the duodenal stenosis, and an 'overlap' region for the facial and some of the skeletal features. They report the clinical, cytogenetic, and molecular analysis of two patients. These studies provide the molecular basis for the construction of a DS phenotypic map and focus the search for genes responsible for the physical features, congenital heart disease, and duodenal stenosis of DS.

  1. [Postoperative early enteral nutrition in a patient with polytrauma and late duodenal perforation].

    PubMed

    Nicolau, A E; Merlan, V; Ciupan, R; Br?di?, Alexandra; Marin, Mihaela; Plugaru, G; Marinescu, L; Micu, B

    2008-01-01

    We present the case of a 51 years old multiple injured female patient who was transferred from another hospital. She suffered a car accident and at admission, the diagnosis was anterior flail chest with fractured sternum, blunt abdominal trauma with IIIrd grade kidney laceration, multiple extremities fractures, ISS = 50. We performed emergency nephrectomy, surgical fixation of the flail chest and bilateral pleurostomy. Postoperatively the evolution was difficult, she was intubated and mechanically ventilated. We started early enteral nutrition (EEN), at 24 hours with 20 ml/hour Fresubin (Fresenius-Kabi, Bad Hamburg, Germany) and then with 40 ml/hour. In the fourth postoperative day, CT scan identified no supplementary lesions. In the seventh postoperative day, jaundice became apparent and the CT exam identified gas in the retroperitoneum. At surgery, we identified a IInd degree D2 rupture. We practiced duodenal suture, pyloric exclusion, latero-lateral gastro-entero-anastomosis. We passed a naso-gastro-entero-duodenal tube into D2 for active suction and we performed a fine needle catheter jejunostomy. Difficult postoperative evolution, intubated, febrile, with hemodynamic instability. EEN on the jejunostomy at 20-40-60 ml/hour. 10 days after the reoperation, the general condition ameliorated. Enteral nutrition was continued for 22 days after reoperation. The patient was discharged after 44 days. The particularities of this case are the complexity of the traumatic lesions: anterior costal flail chest, left kidney rupture, late duodenal perforation, multiple extremities fractures (APACHE II score = 34). The treatment involved internal pneumatic stabilization and surgical fixation of the flail chest, duodenal suture with pyloric exclusion and fine needle catheter jejunostomy, left nephrectomy. We consider that the use of EEN was of real help in this case and we recommend it in all polytraumatised patients and in all the cases where it can be used. PMID:18459508

  2. Usefulness of duodenal biopsy during routine upper gastrointestinal endoscopy for diagnosis of celiac disease

    PubMed Central

    Riestra, S; Domnguez, F; Fernndez-Ruiz, E; Garca-Riesco, E; Nieto, R; Fernndez, E; Rodrigo, L

    2006-01-01

    AIM: To describe the trend in duodenal biopsy performance during routine upper gastrointestinal endoscopy in an adult Spanish population, and to analyze its value for the diagnosis of celiac disease in clinical practice. METHODS: A 15 year-trend (1990 to 2004) in duo-denal biopsy performed when undertaking upper gastrointestinal endoscopy was studied. We analysed the prevalence of celiac disease in the overall group, and in the subgroups with anaemia and/or chronic diarrhoea. RESULTS: Duodenal biopsy was performed in 1033 of 13?678 upper gastrointestinal endoscopies (7.6%); an increase in the use of such was observed over the study period (1.9% in 1990-1994, 5% in 1995-1999 and 12.8% in 2000-2004). Celiac disease was diagnosed in 22 patients (2.2%), this being more frequent in women than in men (3% and 1% respectively). Fourteen out of 514 (2.7%) patients with anaemia, 12 out of 141 (8.5%) with chronic diarrhoea and 8 out of 42 (19%) with anaemia plus chronic diarrhoea had celiac disease. A classical clinical presentation was observed in 55% of the cases, 23% of the patients had associated dermatitis herpetiformis and 64% presented anaemia; 9% were diagnosed by familial screening and 5% by cryptogenetic hypertransaminasaemia. CONCLUSION: Duodenal biopsy undertaken during routine upper gastrointestinal endoscopy in adults, has been gradually incorporated into clinical practice, and is a useful tool for the diagnosis of celiac disease in high risk groups such as those with anaemia and/or chronic diarrhoea. PMID:16937500

  3. Superior mesenteric arteryduodenal fistula secondary to a gunshot wound

    PubMed Central

    Fielding, Cory M.; Krohmer, Steven; Flomenhoft, Deborah

    2016-01-01

    Arterioenteric fistulas are a rare cause of massive gastrointestinal hemorrhage. We present a patient who developed a fistula between a middle colic artery pseudoaneurysm, a proximal branch of the superior mesenteric artery (SMA), and the third part of the duodenum 2 weeks after a self-inflicted gunshot wound to the abdomen. The patient's presentation, evaluation, treatment, and prognosis are discussed. All prior published cases of SMA-duodenal fistulas are reviewed. PMID:26722161

  4. Resveratrol activates duodenal Sirt1 to reverse insulin resistance in rats through a neuronal network.

    PubMed

    Ct, Clmence D; Rasmussen, Brittany A; Duca, Frank A; Zadeh-Tahmasebi, Melika; Baur, Joseph A; Daljeet, Mira; Breen, Danna M; Filippi, Beatrice M; Lam, Tony K T

    2015-05-01

    Resveratrol improves insulin sensitivity and lowers hepatic glucose production (HGP) in rat models of obesity and diabetes, but the underlying mechanisms for these antidiabetic effects remain elusive. One process that is considered a key feature of resveratrol action is the activation of the nicotinamide adenine dinucleotide (NAD(+))-dependent deacetylase sirtuin 1 (SIRT1) in various tissues. However, the low bioavailability of resveratrol raises questions about whether the antidiabetic effects of oral resveratrol can act directly on these tissues. We show here that acute intraduodenal infusion of resveratrol reversed a 3 d high fat diet (HFD)-induced reduction in duodenal-mucosal Sirt1 protein levels while also enhancing insulin sensitivity and lowering HGP. Further, we found that duodenum-specific knockdown of Sirt1 expression for 14 d was sufficient to induce hepatic insulin resistance in rats fed normal chow. We also found that the glucoregulatory role of duodenally acting resveratrol required activation of Sirt1 and AMP-activated protein kinase (Ampk) in this tissue to initiate a gut-brain-liver neuronal axis that improved hypothalamic insulin sensitivity and in turn, reduced HGP. In addition to the effects of duodenally acting resveratrol in an acute 3 d HFD-fed model of insulin resistance, we also found that short-term infusion of resveratrol into the duodenum lowered HGP in two other rat models of insulin resistance--a 28 d HFD-induced model of obesity and a nicotinamide (NA)-streptozotocin (STZ)-HFD-induced model of mild type 2 diabetes. Together, these studies highlight the therapeutic relevance of targeting duodenal SIRT1 to reverse insulin resistance and improve glucose homeostasis in obesity and diabetes. PMID:25849131

  5. Hemoclip-assisted endoscopic polypectomy of large superior duodenal angle polyp using a needle knife.

    PubMed

    Lin, L F; Siauw, C P; Ho, K S; Tung, J C

    2001-12-01

    Endoscopic polypectomy of a large polyp can be difficult due to inability to snare the polyp. The difficulty may increase when the polyp is located at turning corner of the bowel. We presented a case of a 3 cm-sized large pedunculated polyp located at the superior duodenal angle that was not amenable to conventional snare polypectomy, but was instead successfully resected by hemoclip-assisted and needle knife method. Such experience has not been reported in the English literature. PMID:11922495

  6. Comparison between uncovered and covered self-expandable metal stent placement in malignant duodenal obstruction

    PubMed Central

    Kim, Ji Won; Jeong, Ji Bong; Lee, Kook Lae; Kim, Byeong Gwan; Ahn, Dong Won; Lee, Jae Kyung; Kim, Su Hwan

    2015-01-01

    AIM: To compare the clinical outcomes of uncovered and covered self-expandable metal stent placements in patients with malignant duodenal obstruction. METHODS: A total of 67 patients were retrospectively enrolled from January 2003 to June 2013. All patients had symptomatic obstruction characterized by nausea, vomiting, reduced oral intake, and weight loss. The exclusion criteria included asymptomatic duodenal obstruction, perforation or peritonitis, concomitant small bowel obstruction, or duodenal obstruction caused by benign strictures. The technical and clinical success rate, complication rate, and stent patency were compared according to the placement of uncovered (n = 38) or covered (n = 29) stents. RESULTS: The technical and clinical success rates did not differ between the uncovered and covered stent groups (100% vs 96.6% and 89.5% vs 82.8%). There were no differences in the overall complication rates between the uncovered and covered stent groups (31.6% vs 41.4%). However, stent migration occurred more frequently with covered than uncovered stents [20.7% (6/29) vs 0% (0/38), P < 0.05]. Moreover, the overall cumulative median duration of stent patency was longer in uncovered than in covered stents [251 d (95%CI: 149.8 d-352.2 d) vs 139 d (95%CI: 45.5 d-232.5 d), P < 0.05 by log-rank test] The overall cumulative median survival period was not different between the uncovered stent (70 d) and covered stent groups (60 d). CONCLUSION: Uncovered stents may be preferable in malignant duodenal obstruction because of their greater resistance to stent migration and longer stent patency than covered stents. PMID:25663777

  7. Duodenal control of gastric emptying in the milk-fed calf.

    PubMed

    Bell, F R; Mostaghni, K

    1975-02-01

    1. It has been ascertained experimentally that an open duodenal cannula does not cause any marked variation in emptying of the abomasum when compared to the rate of emptying of the normal viscus or when the cannulae are closed. 2. Duodenal re-entrant cannulae provide a preparation whereby it is possible to infuse the duodenum via the distal cannula and to collect simultaneously the effluent fluid of the abomasum from the proximal arm of the cannula (Fig. 1). 3. With this preparation the duodenal infusate is not contaminated by the gastric effluent and thus the duodenal stimulus can be restricted to the single non-varying effect of the infusate. 4. In the milk-fed calf using this preparation the following facts have been established. (a) On infusion into the duodenum, hypotonic and isotonic solutions of sodium chloride and sodium bicarbonate increase abomasal emptying; bicarbonate being the more effective stimulus. (b) Potassium chloride, calcium chloride, glucose and hydrochloric acid inhibit gastric emptying when infused into the duodenum. (c) Ammonium chloride, urea, lactose and acetic acid have little effect. (d) Hypertonic solutions of all substances tested were inhibitory to gastric emptying when infused into the duodenum. 5. It has been demonstrated unequivocally that it is the effect of the infusate in the duodenum which controls gastric emptying for when the stomach is isolated from the duodenum, gastric emptying can be manipulated from the duodenum whatever the stomach contents may be. 6. Our results bring firm experimental confirmation of the views discussed by Hunt & Knox (1968) that gastric outflow is regulated by mechanisms initiated from receptors situated in the duodenum. PMID:1142171

  8. Agarose gel electrophoresis of duodenal juice in normal condition and in children with malabsorption.

    PubMed

    Borulf, S; Lindberg, T; Hansson, L

    1979-01-01

    Agarose gel electrophoresis (at pH 8.6) was used for qualitative determination of pancreatic enzymes in duodenal juice. The various enzymes were identified by staining techniques with specific chromogenic substrates, by quantitative determination of enzymes in eluates of gel slices, and by immunoelectrophoresis. The various protein bands corresponded to the following enzymes (from the anode to the cathode): chymotrypsin, trypsin, carboxypeptidase A, chymotrypsin, amylase (around the slit), lipase, elastase, and trypsin. The method was applied to a study of exocrine pancreatic function in 10 adults and 83 children suspected of having malabsorption. The duodenal juice, also analyzed for trypsin and amylase content, was collected in fasting condition and after a test meal of water. In patients with normal pancreatic function, all the enzyme bands were present and easy to recognize. In 87 patients carboxypeptidase A was present as two bands in 68 (80%), anodal trypsin as two bands in 39 (45%), and cathodal trypsin as two bands in 85 (97%). Electrophoresis of duodenal juice gave as much information from the fasting sample as after the test meal. Six children with pancreatic insufficiency (cystic fibrosis and Shwachmar's syndrome) had no or only faintly stained enzyme bands and a strongly stained albumin-containing band most anodally. The method is simple, rapid, and useful in routine work. The combination of this qualitative test with a quantitative one (e.g. trypsin determination) provides good information about exocrine pancreatic function. PMID:432537

  9. Case report: pancreas graft with a duodenal complication rescued using total duodenectomy.

    PubMed

    Uva, P D; Villavicencio Fornaciari, S; Giunippero, A E; Cabrera, I C; Casadei, D H

    2014-11-01

    Simultaneous pancreas-kidney (SPK) transplantation is the treatment of choice for type 1 diabetics with end-stage renal disease. Recently patients with type 2 diabetes have been considered for transplantation. Despite that the patient and graft survival rates have improved over the past years, it continues to be a procedure with high surgical complication rates. We herein report a case of a pancreatic graft with a duodenal complication rescued using a total duodenectomy, a procedure that is seldom used. A 57-year-old type 2 diabetic underwent a SPK transplantation with systemic-enteric drainage. He was converted to a Roux en Y at day 7 for a small duodenal fistula without peritonitis. At day 13, with good graft function, he presented with gastrointestinal and abdominal bleeding. At laparotomy he had a congestive duodenum with intraluminal bleeding and an anastomotic fistula. We performed a total duodenectomy with enteric drainage. The patient was discharged home on day 39 with a pancreatic fistula on intramuscular Octretotide that lasted for 3 months. He was never readmitted and has good pancreas and kidney function at 16 months of follow-up. We think this is an option to rescue a pancreas graft with duodenal complications in selected cases. PMID:25420824

  10. Duodenal carcinoma in a 37-year-old man with Cowden/Bannayan syndrome.

    PubMed

    de Leon, Maurizio Ponz; Di Gregorio, Carmela; Giunti, Laura; Roncucci, Luca; Pedroni, Monica; Tinca, Antonela Camelia; Crucianelli, Francesca; Tricarico, Rossella; Genuardi, Maurizio

    2013-01-01

    A 37-year-old man was hospitalised because of anaemia and fatigue due to an infiltrating adenocarcinoma of the Treitz angle (duodenum), together with gastric, duodenal and colorectal polyps. After the operation, removal of colorectal lesions revealed the presence of ganglioneuromatosis of the large bowel. Further investigations showed lack of MLH1 protein expression and microsatellite instability in the duodenal neoplasm, while the gene was normally expressed in the polyps. MLH1 sequence and Multiple Ligation-dependent Probes Amplification analysis (from constitutional DNA) were normal. Analysis of the PTEN gene revealed the presence of a constitutional mutation (c.510 T>A; p.Ser170Arg) which had been associated with the Cowden phenotype. Further detailed clinical investigations revealed macrocephaly (63 cm), melanotic spots of the penis, small angiomas, millimetric trichilemmomas in the nose and multiple lipomas, which led to the diagnosis of Cowden/Bannayan disease. The unusual appearance of a duodenal carcinoma as the first symptom rendered the identification of the syndrome extremely difficult. PMID:23117110

  11. Duodenal perforation by an inferior vena cava filter in a polyarteritis nodosa sufferer

    PubMed Central

    Dat, Anthony; McCann, Andrew; Quinn, John; Yeung, Shinn

    2014-01-01

    INTRODUCTION Inferior vena cava (IVC) filters are currently used in the management of pulmonary embolism (PE) and lower limb venous thromboembolism (VTE). Despite their widespread use, associated complications including duodenal perforation have been reported. PRESENTATION OF CASE We describe a unique case of duodenal perforation 2 years post IVC filter insertion in a patient with polyarteritis nodosa (steroid dependent) and thrombocytopenia secondary to chronic cyclophosphamide use. DISCUSSION IVC filters are commonly employed in the management of VTE. Associated complications have been reported including filter migration, fracture and adjacent organ perforation. There is growing consensus that temporary IVC filters should be retrieved as soon as possible with dedicated IVC filter registries to ensure patients are not lost to follow-up post insertion. CONCLUSION Duodenal perforation is a rare complication of IVC filter insertion. This case however illustrates the potentially catastrophic consequences of a relatively common endovascular procedure. Caution should be taken when considering the insertion of IVC filters in patients with longstanding vasculopathies who are on immunosuppressants. PMID:25437665

  12. [The effect of omeprazole on healing of duodenal ulcers, Helicobacter pylori and gastritis].

    PubMed

    Zelenkov, J; Souckov, A; Drbek, J; Hanika, J; Vejvalka, J; Zeman, V

    1993-06-20

    Losec (omeprazole) Astra Co. is a blocker of the proton pump of the parietal cell. It inhibits basal and stimulated HCl secretion. It is used for treatment of gastroduodenal ulcers, reflux oesophagitis and Zollinger Ellison's syndrome. In a group of 17 patients with duodenal ulcers the authors investigated the effect of omeprazole on (1) healing of duodenal ulcers and bulbitis after 2-4 weeks of therapy, (2) elimination of Helicobacter pylori in the antrum, (3) chronic antral gastritis. Ad 1. After two weeks of treatment the authors found that 5 of 17 chronic duodenal ulcers were healed in the remainder substantial regression was found. Four-week treatment led to healing of 16 from a total of 17 ulcers (P < 0.001), i. e. 94%. In subjects with ulcers and bulbitis (12 patients) the ulcer healed in 11 instances, in 7 patients residual bulbitis persisted. Ad 2. H. pylori was detected before treatment in 16 of 17 patients, after treatment only in 5 (P < 0.001). Ad 3. Chronic gastritis was recorded before treatment in all patients. Treatment reduced its activity and the presence of H. pylori. PMID:8358765

  13. Mechanisms involved in increased iron uptake across rat duodenal brush-border membrane during hypoxia.

    PubMed Central

    O'Riordan, D K; Debnam, E S; Sharp, P A; Simpson, R J; Taylor, E M; Srai, S K

    1997-01-01

    1. Chronic hypoxia enhances intestinal iron transport but the cellular processes involved are poorly understood. In order to assess the effects of 3 days of hypoxia on iron uptake across the duodenal brush-border membrane, we have measured the membrane potential difference (Vm) of villus-attached enterocytes by direct microelectrode impalement and have used semi-quantitative autoradiography to study changes in expression of iron uptake during enterocyte maturation. 2. Hypoxia increased duodenal Vm (-57.7 vs. -49.3 mV, P < 0.001). Ion substitution experiments revealed that hyperpolarization was due, at least in part, to a reduction in brush-border Na+ permeability. 3. Autoradiography revealed that hypoxia increased by 6-fold the rate of iron accumulation during enterocyte transit along the lower villus and enhanced by 3-fold the maximal accumulation of iron. Depolarization of the brush border, using a high-K(+)-containing buffer, caused a proportionally greater reduction in iron uptake in control compared with hypoxic tissue suggesting that the raised iron uptake is only partly driven by brush-border hyperpolarization. 4. We conclude that hypoxia increases the expression of iron transport in duodenal brush-border membrane and an enhanced electrical driving force may be involved in this response. Images Figure 1 PMID:9147325

  14. Cryosectioning Method for Microdissection of Murine Colonic Mucosa

    PubMed Central

    Farkas, Attila E.; Gerner-Smidt, Christian; Lili, Loukia; Nusrat, Asma; Capaldo, Christopher T.

    2015-01-01

    The colonic mucosal tissue provides a vital barrier to luminal antigens. This barrier is composed of a monolayer of simple columnar epithelial cells. The colonic epithelium is dynamically turned over and epithelial cells are generated in the stem cell containing crypts of Lieberkühn. Progenitor cells produced in the crypt-bases migrate toward the luminal surface, undergoing a process of cellular differentiation before being shed into the gut lumen. In order to study these processes at the molecular level, we have developed a simple method for the microdissection of two spatially distinct regions of the colonic mucosa; the proliferative crypt zone, and the differentiated surface epithelial cells. Our objective is to isolate specific crypt and surface epithelial cell populations from mouse colonic mucosa for the isolation of RNA and protein. PMID:26274554

  15. Cryosectioning Method for Microdissection of Murine Colonic Mucosa.

    PubMed

    Farkas, Attila E; Gerner-Smidt, Christian; Lili, Loukia; Nusrat, Asma; Capaldo, Christopher T

    2015-01-01

    The colonic mucosal tissue provides a vital barrier to luminal antigens. This barrier is composed of a monolayer of simple columnar epithelial cells. The colonic epithelium is dynamically turned over and epithelial cells are generated in the stem cell containing crypts of Lieberkhn. Progenitor cells produced in the crypt-bases migrate toward the luminal surface, undergoing a process of cellular differentiation before being shed into the gut lumen. In order to study these processes at the molecular level, we have developed a simple method for the microdissection of two spatially distinct regions of the colonic mucosa; the proliferative crypt zone, and the differentiated surface epithelial cells. Our objective is to isolate specific crypt and surface epithelial cell populations from mouse colonic mucosa for the isolation of RNA and protein. PMID:26274554

  16. Exposure to a social stressor disrupts the community structure of the colonic mucosa-associated microbiota

    PubMed Central

    2014-01-01

    Background The microbiota of the mammalian gastrointestinal (GI) tract consists of diverse populations of commensal bacteria that interact with host physiological function. Dysregulating these populations, through exogenous means such as antibiotics or dietary changes, can have adverse consequences on the health of the host. Studies from laboratories such as ours have demonstrated that exposure to psychological stressors disrupts the population profile of intestinal microbiota. To date, such studies have primarily focused on prolonged stressors (repeated across several days) and have assessed fecal bacterial populations. It is not known whether shorter stressors can also impact the microbiota, and whether colonic mucosa-associated populations can also be affected. The mucosa-associated microbiota exist in close proximity to elements of the host immune system and the two are tightly interrelated. Therefore, alterations in these populations should be emphasized. Additionally, stressors can induce differential responses in anxiety-like behavior and corticosterone outputs in variant strains of mice. Thus, whether stressor exposure can have contrasting effects on the colonic microbiota in inbred C57BL/6 mice and outbred CD-1 mice was also examined. Results In the present study, we used high throughput pyrosequencing to assess the effects of a single 2-hour exposure to a social stressor, called social disruption (SDR), on colonic mucosa-associated microbial profiles of C57BL/6 mice. The data indicate that exposure to the stressor significantly changed the community profile and significantly reduced the relative proportions of two genera and one family of highly abundant intestinal bacteria, including the genus Lactobacillus. This finding was confirmed using a quantitative real-time polymerase chain reaction (qPCR) technique. The use of qPCR also identified mouse strain-specific differences in bacterial abundances. L. reuteri, an immunomodulatory species, was decreased in stressor-exposed CD-1 mice, but not C57BL/6 mice. Conclusions These data illustrate that stressor exposure can affect microbial populations, including the lactobacilli, that are closely associated with the colonic mucosa. Because the lactobacilli can have beneficial effects on human health, stressor-induced reductions of their population could have important health implications. PMID:25028050

  17. Varices of the descending duodenum explored during emergency gastro-duodenal resection for upper gastrointestinal haemorrhage. Case report.

    PubMed

    Rudzki, S?awomir; Dryka, Tadeusz; Wilczy?ski, Piotr; Bernat, Pawe?; Bicki, Jacek; Furmaga, Jacek; Pi?at, Jacek

    2013-05-01

    Upper gastrointestinal haemorrhage is a major medical emergency and accounts for approximately 7,000 admissions to hospitals in Scotland each year. Over the last 10 years there has been a number of improvements in diagnosis and conservative management of the condition, which significantly reduced the ratio of life-threatening cases requiring an emergency surgery. Despite these achievements surgical intervention or, if accessible, endovascular procedures must be undertaken as emergency actions, should conservative management fail. Vascular malformations of the duodenum are less frequent causes of upper GI bleeding. Duodenal varices found endoscopically occur in 0.4% of patients with portal hypertension (PHT) and are believed to be caused mainly by liver cirrhosis, idiopathic PHT, extrahepatic PHT, or previous surgical trauma. The duodenal bulb is their most common site, followed by the second portion of the duodenum. Forty per cent of patients with PHT have duodenal varices at angiography; however, their penetration unusually affects submucosa, hence no symptoms develop. Isolated bleeding duodenal varices are scarcely reported in literature, although present a significant surgical problem: massive haemorrhage combined with failure to identify them as a source has led to catastrophic outcomes with mortality rate of 40%. The case hereby presented is unique in several aspects. Duodenal varices were explored on emergency laparotomy rather than on prior endoscopies, which, performed by the same well-established endoscopists, were twice negative. This corresponds to the study by Cottam et al. stating that duodenal varices may not penetrate the submucosa, hence haemorrhages of their origin may even be more difficult to diagnose on endocsopy. Secondly, the haemorrhage here reported was undoubtedly a life-threatening condition that required a multidisciplinary team to be managed successfully. Along with Shirashi et al. we confirm that surgical ligation followed by the excision of duodenal / small intestinal varices may be an effective method of their management--both cases have been free of recurrence at 15 months postoperatively. In contrast to the study by Hashizume et al. the duodenal varices here presented were not associated with portal hypertension (PTH). Finally, duodenal varices located in the posterolateral aspect of the descending duodenum are less common as the majority of cases reported so far were of duodenal bulb location. PMID:23770528

  18. Zur Struktur der Solenocyten (Cyrtocyten) von Anaitides mucosa (Annelida, Polychaeta)

    NASA Astrophysics Data System (ADS)

    Hausmann, K.

    1981-12-01

    Based on electron microscopic observations, the structure of the solenocytes of A. mucosa is described. The tube of the solenocyte is made up of 14 15 rods. These rods, which are filled with regularly packed filaments, are interconnected by an amorphous to filamentous substance. A single flagellum, lying in the tube, is surrounded by a sheet of amorphous material. The functional organization of the solenocytes is discussed.

  19. Untersuchungen zur Regeneration des Hinterendes bei Anaitides mucosa (Polychaeta, Phyllodocidae)

    NASA Astrophysics Data System (ADS)

    Rhrkasten, A.

    1983-06-01

    Caudal regeneration was investigated in decerebrate Anaitides mucosa and in brain-intact individuals. Both groups show an identical capacity to regenerate lost caudal segments. Furthermore there is no difference in males and females. Low temperature (5 C) inhibits the regeneration of caudal segments, but it is necessary for normal oogenesis. Under conditions of high temperature (15 C), caudal regeneration is very extensive. At the same time degeneration of most oocytes occurs.

  20. Method of expression of certain bacterial microflora mucosa olfactory area

    NASA Astrophysics Data System (ADS)

    Avrunin, Oleg G.; Nosova, Yana V.; Shushlyapina, Natalia O.; Surtel, Wojciech; Burlibay, Aron; Zhassandykyzy, Maral

    2015-12-01

    The article is devoted to the actual problem - the development of new express diagnostic methods, based on which a doctor-otolaryngologist can quickly and efficiently determine a violation of smell. The work is based on the methods of processing and analysis of medical images and signals. We have also identified informative indicators of endoscopic image of the olfactory region of the nasal mucosa of the upper course.

  1. l-Menthol sprayed on gastric mucosa causes edematous change

    PubMed Central

    Mori, Akihiro; Hachiya, Hiroki; Yumura, Takayuki; Ito, Shun; Hayashi, Shintaro; Nozaki, Masashi; Yoshida, Atsui; Ohashi, Noritsugu

    2014-01-01

    Background and study aims: l-Menthol (LM), sprayed on the distal gastric mucosa, is a safe antispasmodic agent used during esophagogastroduodenoscopy (EGD). However, it seems to affect gastric mucosal endoscopic findings. Therefore, we evaluated whether LM causes specific changes and impacts the endoscopic morphology of gastric lesions. Patients and methods: A total of 98 patients scheduled to undergo EGD were randomly assigned to receive LM solution (160?mg of 0.8?% LM added to 2.5?mL of indigo carmine [IC]; n?=?49; LM group) or decuple-diluted IC solution without LM (n?=?49; placebo group). We compared the incidence of specific mucosal changes and the difference in the endoscopic findings of several gastric lesions between these groups. Results: Annular-reticular like mucosal changes appeared immediately after the administration of LM solution. This change was observed in 71.4?% of the LM group compared with 12.2?% of the placebo group (P?mucosa into edematous mucosa, and this occurs more frequently in atrophic gastric mucosa than in pathologic lesions. LM may facilitate the demarcation of pathologic gastric lesions without intestinal metaplasia. PMID:26135260

  2. Treatment of Type 1 Diabetes With Adipose Tissue–Derived Stem Cells Expressing Pancreatic Duodenal Homeobox 1

    PubMed Central

    Lin, Ching-Shwun

    2009-01-01

    Due to the limited supply of donor pancreas, it is imperative that we identify alternative cell sources that can be used to treat diabetes mellitus (DM). Multipotent adipose tissue–derived stem cells (ADSC) can be abundantly and safely isolated for autologous transplantation and therefore are an ideal candidate. Here, we report the derivation of insulin-producing cells from human or rat ADSC by transduction with the pancreatic duodenal homeobox 1 (Pdx1) gene. RT-PCR analyses showed that native ADSC expressed insulin, glucagon, and NeuroD genes that were up-regulated following Pdx1 transduction. ELISA analyses showed that the transduced cells secreted increasing amount of insulin in response to increasing concentration of glucose. Transplantation of these cells under the renal capsule of streptozotocin-induced diabetic rats resulted in lowered blood glucose, higher glucose tolerance, smoother fur, and less cataract. Histological examination showed that the transplanted cells formed tissue-like structures and expressed insulin. Thus, ADSC-expressing Pdx1 appear to be suitable for treatment of DM. PMID:19245309

  3. Extensive DNA methylation in normal colorectal mucosa in hyperplastic polyposis

    PubMed Central

    Minoo, P; Baker, K; Goswami, R; Chong, G; Foulkes, W D; Ruszkiewicz, A R; Barker, M; Buchanan, D; Young, J; Jass, J R

    2006-01-01

    Background Hyperplastic polyposis of the colorectum is a precancerous condition that has been linked with DNA methylation. The polyps in this condition have been distinguished from typical small hyperplastic polyps and renamed sessile serrated adenomas. Sessile serrated adenomas also occur sporadically and appear to be indistinguishable from their counterparts in hyperplastic polyposis. Aims and methods The existence of distinguishing molecular features was explored in a series of serrated polyps and matched normal mucosa from patients with and without hyperplastic polyposis by assessing mutation of BRAF, DNA methylation in 14 markers (MINTs 1, 2 and 31, p16, MGMT, MLH1, RASSF1, RASSF2, NORE1 (RASSF5), RKIP, MST1, DAPK, FAS, and CHFR), and immunoexpression of MLH1. Results There was more extensive methylation in sessile serrated adenomas from subjects with hyperplastic polyposis (p<0.0001). A more clearcut difference in patients with hyperplastic polyposis was the finding of extensive DNA methylation in normal mucosa from the proximal colon. Conclusions A genetic predisposition may underlie at least some forms of hyperplastic polyposis in which the earliest manifestation may be hypermethylation of multiple gene promoters in normal colorectal mucosa. Additionally, some of the heterogeneity within hyperplastic polyposis may be explained by different propensities for MLH1 inactivation within polyps. PMID:16469793

  4. Local Immunoglobulin E in the Nasal Mucosa: Clinical Implications

    PubMed Central

    De Schryver, Els; Devuyst, Lien; Derycke, Lara; Dullaers, Melissa; Van Zele, Thibaut; Bachert, Claus

    2015-01-01

    Immunoglobulin E (IgE) can be highly elevated in the airway mucosa independently of IgE serum levels and atopic status. Mostly, systemic markers are assessed to investigate inflammation in airway disease for research or clinical practice. A more accurate but more cumbersome approach to determine inflammation at the target organ would be to evaluate markers locally. We review evidence for local production of IgE in allergic rhinitis (AR) and chronic rhinosinusitis with nasal polyps (CRSwNP). Diagnostic and therapeutic consequences in clinical practice are discussed. We describe that the airway mucosa has the intrinsic capability to produce IgE. Moreover, not only do IgE-positive B cells reside within the mucosa, but all tools are present locally for affinity maturation by somatic hypermutation (SHM), clonal expansion, and class switch recombination to IgE. Recognizing local IgE in the absence of systemic IgE has diagnostic and therapeutic consequences. Therefore, we emphasize the importance of local IgE in patients with a history of AR or CRSwNP. PMID:25749769

  5. Local immunoglobulin e in the nasal mucosa: clinical implications.

    PubMed

    De Schryver, Els; Devuyst, Lien; Derycke, Lara; Dullaers, Melissa; Van Zele, Thibaut; Bachert, Claus; Gevaert, Philippe

    2015-07-01

    Immunoglobulin E (IgE) can be highly elevated in the airway mucosa independently of IgE serum levels and atopic status. Mostly, systemic markers are assessed to investigate inflammation in airway disease for research or clinical practice. A more accurate but more cumbersome approach to determine inflammation at the target organ would be to evaluate markers locally. We review evidence for local production of IgE in allergic rhinitis (AR) and chronic rhinosinusitis with nasal polyps (CRSwNP). Diagnostic and therapeutic consequences in clinical practice are discussed. We describe that the airway mucosa has the intrinsic capability to produce IgE. Moreover, not only do IgE-positive B cells reside within the mucosa, but all tools are present locally for affinity maturation by somatic hypermutation (SHM), clonal expansion, and class switch recombination to IgE. Recognizing local IgE in the absence of systemic IgE has diagnostic and therapeutic consequences. Therefore, we emphasize the importance of local IgE in patients with a history of AR or CRSwNP. PMID:25749769

  6. Protection of Gastrointestinal Mucosa from Acute Heavy Alcohol Consumption: The Effect of Berberine and Its Correlation with TLR2, 4/IL1?-TNF? Signaling

    PubMed Central

    Du, Feng; Chai, Yu-Shuang; Jiang, Jing-Fei; Wang, Yu-Gang; Yu, Xuan; Yan, Xiao-Jin; Xing, Dong-Ming; Du, Li-Jun

    2015-01-01

    The purpose of the present study is to confirm the protective effect of berberine (BBR) on gastrointestinal injury caused by acute heavy alcohol exposure, an effect that has not been reported previously. Our research details how BBR protects against gastrointestinal injuries from acute alcohol exposure using both in vivo and in vitro experiments. Acute high alcohol concentrations lead to obvious damage to the gastrointestinal mucosa, resulting in necrosis of the intestinal mucosa. Oral administration of BBR was able to significantly reduce this alcohol-induced damage, inhibit increases of alcohol-induced TNF? and IL-1? expression in gastrointestinal mucosa as well as their upstream signals TLR2 and TLR4, and regulate cytokines that modulate tight junctions. Alcohol consumption is a popular human social behavior worldwide, and the present study reports a comprehensive mechanism by which BBR protects against gastrointestinal injuries from alcohol stress, providing people with a novel application of BBR. PMID:26226164

  7. Applying Convolution-Based Processing Methods To A Dual-Channel, Large Array Artificial Olfactory Mucosa

    NASA Astrophysics Data System (ADS)

    Taylor, J. E.; Che Harun, F. K.; Covington, J. A.; Gardner, J. W.

    2009-05-01

    Our understanding of the human olfactory system, particularly with respect to the phenomenon of nasal chromatography, has led us to develop a new generation of novel odour-sensitive instruments (or electronic noses). This novel instrument is in need of new approaches to data processing so that the information rich signals can be fully exploited; here, we apply a novel time-series based technique for processing such data. The dual-channel, large array artificial olfactory mucosa consists of 3 arrays of 300 sensors each. The sensors are divided into 24 groups, with each group made from a particular type of polymer. The first array is connected to the other two arrays by a pair of retentive columns. One channel is coated with Carbowax 20 M, and the other with OV-1. This configuration partly mimics the nasal chromatography effect, and partly augments it by utilizing not only polar (mucus layer) but also non-polar (artificial) coatings. Such a device presents several challenges to multi-variate data processing: a large, redundant dataset, spatio-temporal output, and small sample space. By applying a novel convolution approach to this problem, it has been demonstrated that these problems can be overcome. The artificial mucosa signals have been classified using a probabilistic neural network and gave an accuracy of 85%. Even better results should be possible through the selection of other sensors with lower correlation.

  8. Metabolism of model organic pollutants in canine respiratory tract mucosa slices

    SciTech Connect

    Thornton-Manning, J.R.; Gerde, P.; Chen, S.T.; Dahl, A.R.

    1994-11-01

    The high incidence of human bronchial tumors has been correlated with the high fractional deposition of inhaled particles in the bronchi. Polycyclic aromatic hydrocarbons (PAHs) are frequently bound to airborne particles due to their low vapor pressures. It is thought that tumorigenicity may result from the release and subsequent bioactivation of these particle-associated organic compounds in the respiratory tract. Previous studies at ITRI examined the clearance of organic toxicants from various regions of the canine respiratory tract. Their results indicated that, while clearance of a highly lipophilic PAH such as benzo(a)pyrene (BaP) from the thin alveolar epithelium took only a few minutes, clearance through the thicker epithelium of the conducting airways took hours. Slower, diffusion-limited clearance results in higher concentrations of lipophilic compounds in the epithelium of the bronchi. Hence, the ability of these tissues to metabolize organic compounds to water-soluble metabolites or reactive intermediates may be extremely important in their clearance from the respiratory tract and the potential susceptibility of this region of the respiratory tract to cancer. The purpose of the present study was to evaluate the ability of bronchial mucosa to metabolize a model organic pulmonary carcinogen, BaP, to reactive and nonreactive metabolites and to evaluate the diffusion of the parent compound and metabolites through the bronchial mucosa.

  9. Translational potential of olfactory mucosa for the study of neuropsychiatric illness

    PubMed Central

    Borgmann-Winter, K; Willard, S L; Sinclair, D; Mirza, N; Turetsky, B; Berretta, S; Hahn, C-G

    2015-01-01

    The olfactory mucosa (OM) is a unique source of regenerative neural tissue that is readily obtainable from living human subjects and thus affords opportunities for the study of psychiatric illnesses. OM tissues can be used, either as ex vivo OM tissue or in vitro OM-derived neural cells, to explore parameters that have been difficult to assess in the brain of living individuals with psychiatric illness. As OM tissues are distinct from brain tissues, an understanding of the neurobiology of the OM is needed to relate findings in these tissues to those of the brain as well as to design and interpret ex vivo or in vitro OM studies. To that end, we discuss the molecular, cellular and functional characteristics of cell types within the olfactory mucosa, describe the organization of the OM and highlight its role in the olfactory neurocircuitry. In addition, we discuss various approaches to in vitro culture of OM-derived cells and their characterization, focusing on the extent to which they reflect the in vivo neurobiology of the OM. Finally, we review studies of ex vivo OM tissues and in vitro OM-derived cells from individuals with psychiatric, neurodegenerative and neurodevelopmental disorders. In particular, we discuss the concordance of this work with postmortem brain studies and highlight possible future approaches, which may offer distinct strengths in comparison to in vitro paradigms based on genomic reprogramming. PMID:25781226

  10. Translational potential of olfactory mucosa for the study of neuropsychiatric illness.

    PubMed

    Borgmann-Winter, K; Willard, S L; Sinclair, D; Mirza, N; Turetsky, B; Berretta, S; Hahn, C-G

    2015-01-01

    The olfactory mucosa (OM) is a unique source of regenerative neural tissue that is readily obtainable from living human subjects and thus affords opportunities for the study of psychiatric illnesses. OM tissues can be used, either as ex vivo OM tissue or in vitro OM-derived neural cells, to explore parameters that have been difficult to assess in the brain of living individuals with psychiatric illness. As OM tissues are distinct from brain tissues, an understanding of the neurobiology of the OM is needed to relate findings in these tissues to those of the brain as well as to design and interpret ex vivo or in vitro OM studies. To that end, we discuss the molecular, cellular and functional characteristics of cell types within the olfactory mucosa, describe the organization of the OM and highlight its role in the olfactory neurocircuitry. In addition, we discuss various approaches to in vitro culture of OM-derived cells and their characterization, focusing on the extent to which they reflect the in vivo neurobiology of the OM. Finally, we review studies of ex vivo OM tissues and in vitro OM-derived cells from individuals with psychiatric, neurodegenerative and neurodevelopmental disorders. In particular, we discuss the concordance of this work with postmortem brain studies and highlight possible future approaches, which may offer distinct strengths in comparison to in vitro paradigms based on genomic reprogramming. PMID:25781226

  11. T-Cell Depletion in the Colonic Mucosa of Patients With Idiopathic CD4+ Lymphopenia.

    PubMed

    Kovacs, Stephen B; Sheikh, Virginia; Thompson, William L; Morcock, David R; Perez-Diez, Ainhoa; Yao, Michael D; Rupert, Adam W; Utay, Netanya S; Roby, Gregg; Freeman, Alexandra F; Estes, Jacob D; Sereti, Irini

    2015-11-15

    Idiopathic CD4(+) lymphopenia (ICL) is a rare syndrome characterized by low peripheral CD4(+) T-cell counts that can lead to serious opportunistic infections. The pathogenesis of ICL remains unclear, and whether effector sites are also lymphopenic is unknown. In this study, rectosigmoid mucosal biopsy specimens from patients with ICL and healthy controls were evaluated. Significant T-cell lymphopenia was observed in the mucosal tissue of patients with ICL by flow cytometry and immunohistochemistry, compared with healthy controls. Functional capacity of T cells, assessed by production of interferon ? and interleukin 17, was preserved in the mucosa of patients with ICL. In contrast to T lymphocytes, the frequency of myeloid cells (neutrophils and macrophages) was elevated in the colonic mucosa of patients with ICL. Despite the observed mucosal abnormalities, plasma levels of intestinal fatty acid binding protein, a marker of enterocyte turnover and other inflammatory biomarkers, including interleukin 6, C-reactive protein, and tumor necrosis factor, were not elevated in patients with ICL, compared with healthy controls, whereas soluble CD14 levels were minimally elevated. These data suggest that patients with ICL, despite gut mucosal lymphopenia and local tissue inflammation, have preserved enterocyte turnover and T-helper type 17 cells with minimal systemic inflammation. These observations highlight differences from patients with human immunodeficiency virus infection, with or without AIDS, and may partially explain their distinct clinical prognosis. PMID:25995198

  12. Cultured fibroblasts from alveolar and gingival mucosae are biologically and biochemically different

    SciTech Connect

    Lanz, J.; Banes, A.

    1986-05-01

    Tissues removed from the alveolar or gingival mucosa of 5 patients were separated into cell populations to assess the relative contributions each might make in wound healing intraorally. Growth curves and protein synthetic patterns of fibroblasts, free of epithelial cells, were obtained at pass 5. The morphologies of the two cell types were not grossly different. However, the AM cells (alveolar mucosa) had a generation time (gt) of 18.7 hrs. whereas the gt for KG cells (keratinized gingiva) was 49.6 hrs. Cells labeled in vitro with /sup 35/S-methionine had distinct patterns of protein synthesis. The AM cells had more of the 275, 220, 92, 80, 50 and 46 kd bands on the autoradiogram of a 7.5% PAGE slab gel than did the KG cells. The KG cells contained more of the 165, 84, 68, 60, 54, 51, 43, 36, and 32a kd bands. In a wound healing situation, the AM cells may be the first fibroblasts to rapidly divide to fill a defect, whereas the KG cells may require a longer time period to divide. This is the first report of biochemical and biological differences in these two fibroblast populations from cultured, human tissues.

  13. Umami Receptor Activation Increases Duodenal Bicarbonate Secretion via Glucagon-Like Peptide-2 Release in Rats

    PubMed Central

    Wang, Joon-Ho; Inoue, Takuya; Higashiyama, Masaaki; Guth, Paul H.; Engel, Eli; Kaunitz, Jonathan D.

    2011-01-01

    Luminal nutrient chemosensing during meal ingestion is mediated by intestinal endocrine cells, which regulate secretion and motility via the release of gut hormones. We have reported that luminal coperfusion of l-Glu and IMP, common condiments providing the umami or proteinaceous taste, synergistically increases duodenal bicarbonate secretion (DBS) possibly via taste receptor heterodimers, taste receptor type 1, member 1 (T1R1)/R3. We hypothesized that glucose-dependent insulinotropic peptide (GIP) or glucagon-like peptide (GLP) is released by duodenal perfusion with l-Glu/IMP. We measured DBS with pH and CO2 electrodes through a perfused rat duodenal loop in vivo. GIP, exendin (Ex)-4 (GLP-1 receptor agonist), or GLP-2 was intravenously infused (0.011 nmol/kg/h). l-Glu (10 mM) and IMP (0.1 mM) were luminally perfused with or without bolus intravenous injection (3 or 30 nmol/kg) of the receptor antagonists Pro3GIP, Ex-3(9-39), or GLP-2(3-33). GIP or GLP-2 infusion dose-dependently increased DBS, whereas Ex-4 infusion gradually decreased DBS. Luminal perfusion of l-Glu/IMP increased DBS, with no effect of Pro3GIP or Ex-3(9-39), whereas GLP-2(3-33) inhibited l-Glu/IMP-induced DBS. Vasoactive intestinal peptide (VIP)(628) intravenously or NG-nitro-l-arginine methyl ester coperfusion inhibited the effect of l-Glu/IMP. Perfusion of l-Glu/IMP increased portal venous concentrations of GLP-2, followed by a delayed increase of GLP-1, with no effect on GIP release. GLP-1/2 and T1R1/R3 were expressed in duodenal endocrine-like cells. These results suggest that luminal l-Glu/IMP-induced DBS is mediated via GLP-2 release and receptor activation followed by VIP and nitric oxide release. Because GLP-1 is insulinotropic and GLP-2 is intestinotrophic, umami receptor activation may have additional benefits in glucose metabolism and duodenal mucosal protection and regeneration. PMID:21846840

  14. A Dosimetric Model of Duodenal Toxicity After Stereotactic Body Radiotherapy for Pancreatic Cancer

    SciTech Connect

    Murphy, James D.; Christman-Skieller, Claudia; Kim, Jeff; Dieterich, Sonja; Chang, Daniel T.; Koong, Albert C.

    2010-12-01

    Introduction: Dose escalation for pancreas cancer is limited by the tolerance of adjacent normal tissues, especially with stereotactic body radiotherapy (SBRT). The duodenum is generally considered to be the organ at greatest risk. This study reports on the dosimetric determinants of duodenal toxicity with single-fraction SBRT. Methods and Materials: Seventy-three patients with locally advanced unresectable pancreatic adenocarcinoma received 25 Gy in a single fraction. Dose-volume histogram (DVH) endpoints evaluated include V{sub 5} (volume of duodenum that received 5 Gy), V{sub 10}, V{sub 15}, V{sub 20}, V{sub 25}, and D{sub max} (maximum dose to 1 cm{sup 3}). Normal tissue complication probability (NTCP) was evaluated with a Lyman model. Univariate and multivariate analyses were conducted with Kaplan-Meier and Cox regression models. Results: The median time to Grade 2-4 duodenal toxicity was 6.3 months (range, 1.6-11.8 months). The 6- and 12-month actuarial rates of toxicity were 11% and 29%, respectively. V{sub 10}-V{sub 25} and D{sub max} all correlated significantly with duodenal toxicity (p < 0.05). In particular, V{sub 15} {>=} 9.1 cm{sup 3} and V{sub 15} < 9.1 cm{sup 3} yielded duodenal toxicity rates of 52% and 11%, respectively (p = 0.002); V{sub 20} {>=} 3.3 cm{sup 3} and V{sub 20} < 3.3 cm{sup 3} gave toxicity rates of 52% and 11%, respectively (p = 0.002); and D{sub max} {>=} 23 Gy and D{sub max} < 23 Gy gave toxicity rates of 49% and 12%, respectively (p = 0.004). Lyman NTCP model optimization generated the coefficients m = 0.23, n = 0.12, and TD{sub 50} = 24.6 Gy. Only the Lyman NTCP model remained significant in multivariate analysis (p = 0.001). Conclusions: Multiple DVH endpoints and a Lyman NTCP model are strongly predictive of duodenal toxicity after SBRT for pancreatic cancer. These dose constraints will be valuable in future abdominal SBRT studies.

  15. Outcome of buccal mucosa and lingual mucosa graft urethroplasty in the management of urethral strictures: A comparative study

    PubMed Central

    Chauhan, Sharad; Yadav, Sher Singh; Tomar, Vinay

    2016-01-01

    Objective: The objective of the study was to compare the outcome of buccal and lingual mucosa graft (LMG) augmentation urethroplasty along with donor sites morbidities in anterior urethra stricture. Subjects and Methods: From September 2010 to January 2014, 125 patients underwent single stage augmentation urethroplasty. They were randomly divided into two groups to receive either buccal mucosa graft (BMG) or LMG. The patients were prospectively followed for complications and outcome. Results: Baseline characteristics such as mean age, etiology, stricture length, and location were comparable in both groups. Overall success rate for Group 1 and Group 2 were 69.2% and 80%, respectively. Mean follow-up periods were 28.2 and 25 months in Group 1 and Group 2, respectively. Conclusions: LMG provides the better outcome with fewer immediate and delayed complications as compared to BMG. The length of stricture and width of graft were main factors affecting the outcome. PMID:26834399

  16. Advancing forensic RNA typing: On non-target secretions, a nasal mucosa marker, a differential co-extraction protocol and the sensitivity of DNA and RNA profiling.

    PubMed

    van den Berge, Margreet; Bhoelai, Bryan; Harteveld, Joyce; Matai, Anuska; Sijen, Titia

    2016-01-01

    The forensic identification of human body fluids and tissues by means of messenger RNA (mRNA) profiling is a long studied methodology that is increasingly applied to casework samples. Previously, we have described an mRNA multiplex system that targets blood, saliva, semen, menstrual secretion, vaginal mucosa and skin (Lindenbergh et al. and van den Berge et al.) [1-2]. In this study we consider various topics to improve this mRNA profiling system or its use and adapt the method accordingly. Bodily secretions that may be encountered at a crime scene whilst not targeted by the multiplex-id est nasal mucosa, sweat, tears, faeces and urine-were examined for false positive signals. The results prompted us to identify a nasal mucosa marker that allows the discrimination of nasal mucosa from saliva or vaginal mucosa and nosebleed blood from peripheral blood. An updated version of the multiplex was prepared to which the nasal mucosa marker was added and in which markers for semen, vaginal mucosa and blood were replaced. Lactobacillus markers were regarded unsuitable as replacement for vaginal mucosa mRNA markers because of background signals on penile swabs that appeared devoid of female DNA. Furthermore, we provide approaches to deal with highly unbalanced mixtures. First, a differential extraction protocol was incorporated into a co-extraction protocol to allow DNA and RNA analysis of separated non-sperm and sperm fractions. In a second approach, besides the standard multiplex, a customized multiplex is used which excludes markers for prevailing cell types. This allows the use of lower cDNA inputs for the prevailing cell types and higher inputs for cell types that appear masked. Additionally, we assessed the relation between the percentage of alleles or markers detected in DNA or RNA profiles when decreasing sample amounts are analysed. While blood, saliva, semen and menstrual secretion show the trend that DNA profiling is more sensitive than RNA profiling, the reverse is seen for skin and variable results occur for vaginal and nasal mucosa. Lastly, we show that replicates are useful for interpretation of RNA data, as variations can be found even for true technical replicates. Increased numbers of replicates (over four) do, however, not cancel out the impact of this variation on data interpretation. Overall, the results of this study further forensic RNA profiling. PMID:26590860

  17. Different effect of antiulcer agents on rat cysteamine-induced duodenal ulcer after sialoadenectomy, but not gastrectomy.

    PubMed

    Bedekovic, Vlado; Mise, Stjepan; Anic, Tomislav; Staresinic, Mario; Gjurasin, Miroslav; Kopljar, Mario; Kalogjera, Livije; Drvis, Petar; Boban Blagaic, Alenka; Batelja, Lovorka; Seiwerth, Sven; Sikiric, Predrag

    2003-09-01

    The focus was on salivary glands in cysteamine-induced duodenal ulcer and the different effects of antiulcer agents on cysteamine-induced duodenal ulcer in sialoadenectomized but not gastrectomized rats. We tested antiulcer agents on cysteamine-induced duodenal ulcer in rats (agents/kg i.p.) simultaneously with cysteamine 400 mg/kg s.c., rat killed 24 h thereafter subjected to no surgery (normal), to gastrectomy (24 h before) or sialoadenectomy, acute (24 h before) or chronic (21 days before). (i) Ulcerogenesis: cysteamine-induced duodenal ulcer had the same severity and incidence in normal, gastrectomized or acutely or chronically sialoadenectomized rats. (ii) Antiulcer effect under normal conditions or following gastrectomy: in normal or gastrectomized rats all agents tested, gastric pentadecapeptide BPC 157 [currently in clinical trials for inflammatory bowel disease (PL-10, PLD-116, PL-14736, Pliva) (10.0 microg or 10.0 ng), ranitidine (10 mg), atropine (10 mg), omeprazole (10 mg)] inhibited cysteamine-induced duodenal ulcers, acting through gastric acid-independent mechanisms. Following sialoadenectomy, acute or chronic: ranitidine, omeprazole and atropine were completely ineffective, while pentadecapeptide BPC 157 could protect. Thus, we found that contrary to stomach, salivary glands are implicated in cytoprotective agent activity (standard agents were ineffective after sialoadenectomy). Also, gastric pentadecapeptide BPC 157 was consistently associated with a cytoprotective effect, suggesting a beneficial activity distinctive from that of H2-receptor blockers, proton-pump inhibitors and anticholinergics; but probably replacing missing salivary glands factors. PMID:14512101

  18. Inactivation of corticosteroids in intestinal mucosa by 11 beta-hydroxysteroid: NADP oxidoreductase (EC 1. 1. 1. 146)

    SciTech Connect

    Burton, A.F.; Anderson, F.H.

    1983-10-01

    Activity of the enzyme 11 beta-hydroxysteroid:NADP oxidoreductase (EC 1.1.1.146) in human intestinal mucosa was determined by incubating scraped mucosa with /sup 3/H-cortisone and /sup 14/C-cortisol; these steroids were then extracted, separated chromatographically, and the radioactivity assayed to determine simultaneously both reductase and dehydrogenase activities. This was the only significant metabolic alteration which the substrate underwent. Only two cases had slight (5 and 13%) reductase activity. In 35 patients, 16 male and 19 female, including seven cases of Crohn's disease, three ulcerative colitis, five diverticulitis, two undergoing surgery for repair of injuries and 18 for carcinoma of colon or rectum, cortisol was converted to cortisone in 15 min with a wide range of values distributed uniformly up to 85% dehydrogenation, with a mean of 42%. When tissue homogenates were fortified with coenzymes, excess NADPH lowered dehydrogenase activity 81%; excess NADP increased dehydrogenase activity 2-fold in three cases. It is possible that a value is characteristic of an individual but perhaps more likely enzyme activity varies with metabolic events involving changes in the coenzyme levels in mucosa, and a random sampling might be expected to yield such a distribution of values. In any event, where activity is high most of the cortisol is inactivated within minutes. It is suggested that synthetic corticoids which escape such metabolic alteration might, except during pregnancy, prove superior in the treatment of conditions such as inflammatory bowel disease.

  19. Detection of complement C3 and factor B gene expression in normal colorectal mucosa, adenomas and carcinomas

    PubMed Central

    Andoh, A; Fujiyama, Y; Sakumoto, H; Uchihara, H; Kimura, T; Koyama, S; Bamba, T

    1998-01-01

    Local secretion of complement components in the human intestine has been previously reported. However, the cellular source has not been identified. In this study, we demonstrate complement C3 and factor B mRNA expression in the normal colonic mucosa by in situ hybridization analysis. C3 and factor B genes were found to be expressed at high levels in the epithelial cells of the lower parts of the crypts in colonic mucosa, and this expression decreased gradually from the crypt base to the luminal surface. At the upper crypt and the luminal surface, these genes almost disappeared. C3 and factor B genes were expressed in all crypts at the same level. Furthermore, C3 and factor B gene expression was also identified in adenomas and carcinomas. In these neoplastic tissues, C3 and factor B genes were expressed uniformly, and the polarized distribution observed in the normal crypts was not detected. It is likely that complement components are locally synthesized in the intestine, and that these complement components may actively participate in normal immune and inflammatory responses over the enormous surface area of the intestinal mucosa. PMID:9528886

  20. Platelet activating factor: release from colonic mucosa in patients with ulcerative colitis and its effect on colonic secretion.

    PubMed Central

    Wardle, T D; Hall, L; Turnberg, L A

    1996-01-01

    Inflammatory mediators have been implicated in the pathophysiology of ulcerative colitis. They may stimulate intestinal secretion and contribute to the production of diarrhoea. Platelet activating factor (PAF) may be responsible for a high proportion of this secretory response. Biopsy specimens from inflamed and quiescent mucosa of patients with ulcerative colitis and normal human colonic mucosa were cultured or co-cultured. The release of PAF, prostaglandin E2, and leukotriene D4 into the culture medium was measured and the ability of this culture medium, from inflamed and normal tissues, to influence secretion in rat colonic mucosa was assessed. PAF was liberated by inflamed tissue. Its release from quiescent but not normal tissue was stimulated by medium in which inflamed mucosal biopsy tissues had been cultured and by exogenous bradykinin and 5-hydroxytryptamine, but not by histamine. PAF stimulated eicosanoid production. The rise in short circuit current produced in vitro by inflamed tissue culture medium was inhibited by the PAF receptor antagonist (CV 6209) (46%) (32.4 (2.9) v 17.5 (1.19) muA.cm-2, p < 0.005) and further by combined cyclooxygenase and lipoxygenase inhibition (indomethacin plus ICI 207968) (58%) (32.4 (2.9) v 13.6 (1.9) muA.cm-2, p < 0.005). Mepacrine and hydrocortisone attenuated considerably the electrical response evoked by medium from inflamed mucosa to a similar extent (32.4 (2.9) v 6.3 (1.2) v 5.1 (0.9) muA.cm-2, p < 0.001). These data suggest that PAF accounted for 46% of the culture medium secretory effect. Thus, any attempt to block its release in patients with ulcerative colitis may have only a partial effect on their symptoms. PMID:8675086

  1. Engineered E. coli delivers therapeutic genes to the colonic mucosa.

    PubMed

    Castagliuolo, I; Beggiao, E; Brun, P; Barzon, L; Goussard, S; Manganelli, R; Grillot-Courvalin, C; Pal, G

    2005-07-01

    Taking advantage of the proximity of bowel mucosa to luminal bacteria, we have attempted to deliver a therapeutic gene to the colonic mucosa by oral administration of an invasive and non-pathogenic Escherichia coli. E. coli diamenopimelate (dap) auxotroph, harboring plasmid pGB2Omegainv-hly, express the inv gene from Yersinia pseudotubercolosis that confers the ability to invade nonprofessional phagocytic cells and the hly gene from Listeria monocytogenes that allows expression of lystreriolysin O, a perforin cytolysin able to perfore phagosomal membranes. This bacterial vector invades and transfers functional DNA to epithelial cells in vitro. We have shown that this strain carrying a therapeutic gene (pC1OmegaTGF-beta1) can significantly reduce the severity of experimental colitis in mice. However, as a consequence of mucosal barrier disruption during colitis, vector-specific mRNA transcripts could be recovered from the colon and also from extra-colonic tissues. We therefore replaced the constitutive CMV promoter in pC1OmegaTGF-beta1 by the inflammation-inducible interleukin-8 promoter generating plasmid pC1OmegaTGF-beta1IND. Plasmid-specific TGF-beta1 mRNA transcripts were detectable in mouse CMT-93 epithelial cells incubated with E. coli BM2710/pGB2Omegainv-hly carrying pC1OmegaTGF-beta1IND following exposure to inflammatory cytokines. Furthermore, the transcripts were detectable only within inflamed tissues and the therapeutic effects were comparable to those in animals treated with E. coli BM2710/pGB2Omegainv-hly+pC1OmegaTGF-beta1. In summary, engineered enteric bacteria can efficiently deliver in vivo therapeutic genes to the intact intestinal mucosa and regulation expression of the therapeutic gene by an inflammation-inducible promoter prevents its dissemination during colitis. PMID:15815705

  2. Comparative pathology of the nasal mucosa in laboratory animals exposed to inhaled irritants

    SciTech Connect

    Harkema, J.R. )

    1990-04-01

    The nasal cavity is susceptible to chemically induced injury as a result of exposure to inhaled irritants. Some responses of the nasal mucosa to inhaled toxicants are species specific. These species-related differences in response may be due to variations in structural, physiologic, and biochemical factors, such as gross nasal cavity structure, distribution of luminal epithelial cell populations along the nasal airway, intranasal airflow patterns, nasal mucociliary apparatus, and nasal xenobiotic metabolism among animal species. This paper reviews the comparative anatomy and irritant-induced pathology of the nasal cavity in laboratory animals. The toxicologist, pathologist, and environmental risk assessor must have a good working knowledge of the similarities and differences in normal nasal structure and response to injury among species before they can select animal models for nasal toxicity studies, recognize toxicant-induced lesions in the nasal airway, and extrapolate experimental results to estimate the possible effects of an inhaled toxicant on the human nasal airway.

  3. SIV Infection Induces Accumulation of Plasmacytoid Dendritic Cells in the Gut Mucosa

    PubMed Central

    Reeves, R. Keith; Evans, Tristan I.; Gillis, Jacqueline; Wong, Fay E.; Kang, Guobin; Li, Qingsheng; Johnson, R. Paul

    2012-01-01

    Multiple studies suggest that plasmacytoid dendritic cells (pDCs) are depleted and dysfunctional during human immunodeficiency virus/simian immunodeficiency virus (HIV/SIV) infection, but little is known about pDCs in the gutthe primary site of virus replication. Here, we show that during SIV infection, pDCs were reduced 3-fold in the circulation and significantly upregulated the gut-homing marker ?4?7, but were increased 4-fold in rectal biopsies of infected compared to naive macaques. These data revise the understanding of pDC immunobiology during SIV infection, indicating that pDCs are not necessarily depleted, but instead may traffic to and accumulate in the gut mucosa. PMID:22711907

  4. Hydatid cyst of the buccal mucosa: An unusual presentation.

    PubMed

    Lavanya, R M; Kamath, V V; Komali, Y; Krishnamurthy, Shruthi

    2015-01-01

    Hydatid cyst is a parasitic cyst caused by the tapeworm Echinococcus that occurs primarily in sheep grazing areas worldwide. It is a chronic disease, and the cysts can be localized in unusual anatomical and geographic locations. It is known to affect the head and neck region. Patients must undergo a thorough systemic investigation as 20-30% show multiorgan involvement. We report a case of hydatid cyst occurring in the buccal mucosa of a 45- year -old male presenting as a small asymptomatic lump and emphasize on its rarity and diagnostic issues. PMID:26392735

  5. Secretory immunoglobulin A: a protective factor in the genital mucosa.

    PubMed

    Giraldo, Paulo C; Gonalves, Ana Katherine; Eleutrio Junior, Jos

    2006-08-01

    The genital mechanisms of defense are not well understood and are therefore ignored during therapy. This fact results in a great number of cases of treatment failure. The mucosa is an important protective factor of the genital female system, through self-defense mechanisms, and secretor antibodies (immunoglobulin A). The lymphoid tissue exerts protective anti-inflammatory activity, besides inhibiting microorganism adherence, neutralizes viruses and toxins and stabilizes the mucosal flora. Although certain microorganisms, such as viruses and fungus, are controlled by cellular immunity, secretory IgA can also exert an important role in the control of these agents. PMID:17293901

  6. Hydatid cyst of the buccal mucosa: An unusual presentation

    PubMed Central

    Lavanya, R. M.; Kamath, V. V.; Komali, Y.; Krishnamurthy, Shruthi

    2015-01-01

    Hydatid cyst is a parasitic cyst caused by the tapeworm Echinococcus that occurs primarily in sheep grazing areas worldwide. It is a chronic disease, and the cysts can be localized in unusual anatomical and geographic locations. It is known to affect the head and neck region. Patients must undergo a thorough systemic investigation as 20–30% show multiorgan involvement. We report a case of hydatid cyst occurring in the buccal mucosa of a 45- year -old male presenting as a small asymptomatic lump and emphasize on its rarity and diagnostic issues. PMID:26392735

  7. Enhanced Transferrin Receptor Expression by Proinflammatory Cytokines in Enterocytes as a Means for Local Delivery of Drugs to Inflamed Gut Mucosa

    PubMed Central

    Harel, Efrat; Rubinstein, Abraham; Nissan, Aviram; Khazanov, Elena; Nadler Milbauer, Mirela; Barenholz, Yechezkel; Tirosh, Boaz

    2011-01-01

    Therapeutic intervention in inflammatory bowel diseases (IBDs) is often associated with adverse effects related to drug distribution into non-diseased tissues, a situation which attracts a rational design of a targeted treatment confined to the inflamed mucosa. Upon activation of immune cells, transferrin receptor (TfR) expression increases at their surface. Because TfR is expressed in all cell types we hypothesized that its cell surface levels are regulated also in enterocytes. We, therefore, compared TfR expression in healthy and inflamed human colonic mucosa, as well as healthy and inflamed colonic mucosa of the DNBS-induced rat model. TfR expression was elevated in the colonic mucosa of IBD patients in both the basolateral and apical membranes of the enterocytes. Increased TfR expression was also observed in colonocytes of the induced colitis rats. To explore the underlying mechanism CaCo-2 cells were treated with various proinflammatory cytokines, which increased both TfR expression and transferrin cellular uptake in a mechanism that did not involve hyper proliferation. These findings were then exploited for the design of targetable carrier towards inflamed regions of the colon. Anti-TfR antibodies were conjugated to nano-liposomes. As expected, iron-starved Caco-2 cells internalized anti-TfR immunoliposomes better than controls. Ex vivo binding studies to inflamed mucosa showed that the anti-TfR immunoliposomes accumulated significantly better in the mucosa of DNBS-induced rats than the accumulation of non-specific immunoliposomes. It is concluded that targeting mucosal inflammation can be accomplished by nano-liposomes decorated with anti-TfR due to inflammation-dependent, apical, elevated expression of the receptor. PMID:21915296

  8. Carcinogenic potential of duodenal reflux juice from patients with long-standing postgastrectomy

    PubMed Central

    Ma, Zhe-Fu; Wang, Zhong-Yu; Zhang, Jun-Ran; Gong, Peng; Chen, Hai-Long

    2001-01-01

    AIM: To determine whether study on the carcinogenic potential of reflux juice from patients with remote gastrectomy could clarify the inherent relationship between duodenal reflux and gastric stump cancer. METHODS: A total of 37 reflux juice samples (13 Billroth I, 24 Billroth II) were employed in the present study. A two-stage transformation assay using BALB/c 3T3 cells was carried out to test the initiating or promoting activity of these samples. RESULTS: Two of 18 (11.1%) reflux samples exerted initiating activities, whereas 9/19 (47.4%) samples enhanced the MNNG-initiating cell transformation, suggesting the duodenal reflux juice might more frequently possess the tumor-promoter activity (P = 0.029). In addition, there was no difference in initiating activities of the samples irrespective of surgical procedures (P = 0.488), while Billroth II samples exhibited stronger tumor-promoter activity than Billroth I samples (P = 0.027). Furthermore, the promoter activities were well correlated with the histological changes of the stomas (rs = 0.625, P = 0.004), but neither their cytotoxicities nor initiating activities had this correlation (Probabilities were 0.523 and 0.085, respectively). CONCLUSION: The duodenal reflux juice from patients with remote postgastrectomy did have carcinogenic potential, and suggested that tumor-promoting activity should principally account for the high incidence of gastric cancer in gastrectomy patients. In contrast, it is difficult to explain the high stump-cancer incidence with the "N-nitroso compounds" theory-a popular theory for the intact stomach carcinogenesis, and it seemed to be justified to focus chemoprevention of this cancer on the tumor-promoting potential of reflux juice. PMID:11819793

  9. Cancer-predicting gene expression changes in colonic mucosa of Western diet fed Mlh1+/- mice.

    PubMed

    Pussila, Marjaana; Sarantaus, Laura; Dermadi Bebek, Denis; Valo, Satu; Reyhani, Nima; Ollila, Saara; Pivrinta, Essi; Peltomki, Pivi; Mutanen, Marja; Nystrm, Minna

    2013-01-01

    Colorectal cancer (CRC) is the second most common cause of cancer-related deaths in the Western world and interactions between genetic and environmental factors, including diet, are suggested to play a critical role in its etiology. We conducted a long-term feeding experiment in the mouse to address gene expression and methylation changes arising in histologically normal colonic mucosa as putative cancer-predisposing events available for early detection. The expression of 94 growth-regulatory genes previously linked to human CRC was studied at two time points (5 weeks and 12 months of age) in the heterozygote Mlh1(+/-) mice, an animal model for human Lynch syndrome (LS), and wild type Mlh1(+/+) littermates, fed by either Western-style (WD) or AIN-93G control diet. In mice fed with WD, proximal colon mucosa, the predominant site of cancer formation in LS, exhibited a significant expression decrease in tumor suppressor genes, Dkk1, Hoxd1, Slc5a8, and Socs1, the latter two only in the Mlh1(+/-) mice. Reduced mRNA expression was accompanied by increased promoter methylation of the respective genes. The strongest expression decrease (7.3 fold) together with a significant increase in its promoter methylation was seen in Dkk1, an antagonist of the canonical Wnt signaling pathway. Furthermore, the inactivation of Dkk1 seems to predispose to neoplasias in the proximal colon. This and the fact that Mlh1 which showed only modest methylation was still expressed in both Mlh1(+/-) and Mlh1(+/+) mice indicate that the expression decreases and the inactivation of Dkk1 in particular is a prominent early marker for colon oncogenesis. PMID:24204690

  10. Systemically administered IgG anti-toxin antibodies protect the colonic mucosa during infection with Clostridium difficile in the piglet model.

    PubMed

    Cohen, Ocean R; Steele, Jennifer A; Zhang, Quanshun; Schmidt, Diane J; Wang, Yuankai; Hamel, Philip E S; Beamer, Gillian; Xu, Bingling; Tzipori, Saul

    2014-01-01

    The use of anti-toxin human monoclonal antibodies (HMab) as treatment for C. difficile infection has been investigated in animal models and human clinical trials as an alternative to or in combination with traditional antibiotic therapy. While HMab therapy appears to be a promising option, how systemically administered IgG antibodies protect the colonic mucosa during Clostridium difficile infection is unknown. Using the gnotobiotic piglet model of Clostridium difficile infection, we administered a mixture of anti-TcdA and anti-TcdB HMabs systemically to piglets infected with either pathogenic or non-pathogenic C. difficile strains. The HMabs were present throughout the small and large intestinal tissue of both groups, but significant HMabs were present in the lumen of the large intestines only in the pathogenic strain-infected group. Similarly, HMabs measured in the large intestine over a period of 2-4 days following antibody administration were not significantly different over time in the gut mucosa among the groups, but concentrations in the lumen of the large intestine were again consistently higher in the pathogenic strain-infected group. These results indicate that systemically administered HMab IgG reaches the gut mucosa during the course of CDI, protecting the host against systemic intoxication, and that leakage through the damaged colon likely protects the mucosa from further damage, allowing initiation of repair and recovery. PMID:25347821

  11. Life threatening bleeding from duodenal ulcer after Roux-en-Y gastric bypass: Case report and review of the literature.

    PubMed

    Ivanecz, Arpad; Sremec, Marko; Cerani?, Davorin; Potr?, Stojan; Skok, Pavel

    2014-12-16

    Acute upper gastrointestinal bleeding is a rare, but serious complication of gastric bypass surgery. The inaccessibility of the excluded stomach restrains postoperative examination and treatment of the gastric remnant and duodenum, and represents a major challenge, especially in the emergency setting. A 59-year-old patient with previous history of peptic ulcer disease had an upper gastrointestinal bleeding from a duodenal ulcer two years after having a gastric bypass procedure for morbid obesity. After negative upper endoscopy finding, he was urgently evaluated for gastrointestinal bleeding. At emergency laparotomy, the bleeding duodenal ulcer was identified by intraoperative endoscopy through gastrotomy. The patient recovered well after surgical hemostasis, excision of the duodenal ulcer and completion of the remnant gastrectomy. Every general practitioner, gastroenterologist and general surgeon should be aware of growing incidence of bariatric operations and coherently possible complications after such procedures, which modify patient's anatomy and physiology. PMID:25512773

  12. Conservative management of intestinal obstruction by isolated intramural duodenal hematoma. A case report and review of the literature.

    PubMed

    D'Arpa, Francesco; Orlando, Giuseppina; Tutino, Roberta; Salamone, Giuseppe; Battaglia, Emanuele Onofrio; Gulotta, Gaspare

    2015-01-01

    The duodenal injuries occur in the 3-5% of blunt abdominal traumas. The isolated intramural duodenal hematoma is a very rare lesion. An early diagnosis and an adequate therapy are crucial because a delay, beyond 24 hours, increases the mortality from the 11% to 40%. However, diagnosis is often hindered by a lack of specific symptoms. We report a case of a 21 years-old man with an intestinal obstruction from isolated intramural duodenal hematoma occurred after a blunt abdominal trauma in a sport competition. The patient was treated conservatively with total parenteral nutrition, gastric decompression and intravenous PPIs. The progressive spontaneous resolution of the hematoma was checked with periodical endoscopies. The discharge occurred after three weeks with no early complications. No late complications occurred at one-year follow-up. The endoscopy is a good and safe tool in the management of this intestinal obstructions with the possibility of conservative or interventional treatment. PMID:26675664

  13. Life threatening bleeding from duodenal ulcer after Roux-en-Y gastric bypass: Case report and review of the literature

    PubMed Central

    Ivanecz, Arpad; Sremec, Marko; Ćeranić, Davorin; Potrč, Stojan; Skok, Pavel

    2014-01-01

    Acute upper gastrointestinal bleeding is a rare, but serious complication of gastric bypass surgery. The inaccessibility of the excluded stomach restrains postoperative examination and treatment of the gastric remnant and duodenum, and represents a major challenge, especially in the emergency setting. A 59-year-old patient with previous history of peptic ulcer disease had an upper gastrointestinal bleeding from a duodenal ulcer two years after having a gastric bypass procedure for morbid obesity. After negative upper endoscopy finding, he was urgently evaluated for gastrointestinal bleeding. At emergency laparotomy, the bleeding duodenal ulcer was identified by intraoperative endoscopy through gastrotomy. The patient recovered well after surgical hemostasis, excision of the duodenal ulcer and completion of the remnant gastrectomy. Every general practitioner, gastroenterologist and general surgeon should be aware of growing incidence of bariatric operations and coherently possible complications after such procedures, which modify patient’s anatomy and physiology. PMID:25512773

  14. A rare case of duodenal ulcer perforation accompanied by Boerhaave syndrome

    PubMed Central

    Rokicki, Wojciech; Rokicki, Marek

    2015-01-01

    Esophageal perforation is the fastest progressing and the most life-threatening disruption of gastrointestinal tract continuity. It must be regarded as an emergency condition that requires early diagnosis as well as very aggressive and rapid implementation of treatment in order to avoid serious complications and death. Methods of treatment for spontaneous esophageal perforation continue to be a matter of controversy. However, all authors emphasize that ultimate success depends largely on the time taken to establish the diagnosis. The authors of this study describe a rare case of duodenal ulcer perforation accompanied by Boerhaave syndrome. PMID:26702287

  15. An Intraductal Papillary Neoplasm of the Bile Duct at the Duodenal Papilla

    PubMed Central

    Kawaguchi, Yoshiaki; Kawashima, Yohei; Maruno, Atsuko; Ito, Hiroyuki; Ogawa, Masami; Izumi, Hideki; Furukawa, Daisuke; Yazawa, Naoki; Nakagori, Toshio; Hirabayashi, Kenichi; Mine, Tetsuya

    2014-01-01

    In recent years, the disease concept of intraductal papillary neoplasm of the bile duct (IPNB) has been attracting attention as a biliary lesion that is morphologically similar to intraductal papillary mucinous neoplasm (IPMN), which is considered to be a counterpart of IPMN. However, there are few reports on IPNB, and a consensus regarding the features of this disease is thus lacking. We experienced an extremely rare case of IPNB occurring in the bile duct at the duodenal papilla, which is a tumor presentation that has not previously been reported. Herein, we report this interesting case and discuss the possible association between IPMN and IPNB. PMID:25126070

  16. Duodenal subepithelial hyperechoic lesions of the third layer: Not always a lipoma.

    PubMed

    Figueiredo, Pedro C; Pinto-Marques, Pedro; Mendona, Evelina; Oliveira, Pedro; Brito, Maria; Serra, David

    2013-10-16

    Endoscopic ultrasonography is the most accurate procedure for the evaluation of subepithelial lesions. The finding of a homogeneous, hyperechoic, well-delimited lesion, originating from the third layer of the gastrointestinal tract (submucosa) suggests a benign tumor, generally lipoma. As other differential diagnoses have not been reported, echoendoscopists might not pursue a definitive pathological diagnosis or follow-up the patient. This case series aims to broaden the spectrum of differential diagnosis for duodenal hyperechoic third layer subepithelial lesions by providing four different and relevant pathologies with this echoendoscopic pattern. PMID:24147196

  17. Duodenal subepithelial hyperechoic lesions of the third layer: Not always a lipoma

    PubMed Central

    Figueiredo, Pedro C; Pinto-Marques, Pedro; Mendona, Evelina; Oliveira, Pedro; Brito, Maria; Serra, David

    2013-01-01

    Endoscopic ultrasonography is the most accurate procedure for the evaluation of subepithelial lesions. The finding of a homogeneous, hyperechoic, well-delimited lesion, originating from the third layer of the gastrointestinal tract (submucosa) suggests a benign tumor, generally lipoma. As other differential diagnoses have not been reported, echoendoscopists might not pursue a definitive pathological diagnosis or follow-up the patient. This case series aims to broaden the spectrum of differential diagnosis for duodenal hyperechoic third layer subepithelial lesions by providing four different and relevant pathologies with this echoendoscopic pattern. PMID:24147196

  18. Epithelial turnover in duodenal familial adenomatous polyposis: A possible role for estrogen receptors?

    PubMed Central

    Di Leo, Alfredo; Nesi, Gabriella; Principi, Mariabeatrice; Piscitelli, Domenico; Girardi, Bruna; Pricci, Maria; Losurdo, Giuseppe; Iannone, Andrea; Ierardi, Enzo; Tonelli, Francesco

    2016-01-01

    AIM: To investigate estrogen receptors expression in duodenal familial adenomatous polyposis (FAP) and any relationship with epithelial proliferation/apoptosis markers. METHODS: Twenty-two patients affected by FAP undergoing duodenal resection for malignancies were recruited. Controls were 15 healthy subjects undergoing endoscopy for dyspeptic symptoms. ER-α, ER-α, Ki-67, TUNEL and caspase 3 expression (labeling index: percentage of positive cells) were evaluated by immunohistochemistry or immunofluorescence and examined by light or confocal microscopy. Samples were assigned to four groups: normal tissue, low (LGD) and high-grade dysplasia (HGD), adenocarcinoma (AC). One-way analysis of variance, corrected by Bonferroni’s test, and Pearson’s correlation test were applied for statistical analysis. RESULTS: ER-beta showed a progressive decline: normal tissue (23.5 ± 4.9), LGD (21.1 ± 4.8), HGD (9.3 ± 3.5), AC (7.1 ± 3.1). The normal tissue of FAP subjects expressed ER-beta like the controls (23.9 ± 6.2). Conversely, ER-α showed a progressive increase from normal tissue (24.8 ± 5.6) to AC (52.0 ± 8.2); the expression in normal tissue was similar to controls (22.5 ± 5.3). Ki67 demonstrated a statistically significant progressive increase at each disease stage up to AC. TUNEL did not reveal differences between controls and normal tissue of FAP subjects, but progressive decreases were observed in LGD, through HGD to AC. Pearson’s correlation test showed a direct relationship between ER-β and TUNEL LI (r = 0.8088, P < 0.0001). Conversely, ER-α was inversely correlated with TUNEL LI (r = - 0.7257, P < 0.0001). The co-expression of ER-β and caspase 3 declined progressively from normal to neoplastic tissue. CONCLUSION: This study confirmed that ER-β is strongly decreased in duodenal FAP carcinomas, declining in a multiple step fashion, thereby suggesting a putative anti-carcinogenic effect. ER-α showed the opposite trend. ER-β/caspase 3 co-expression suggests this hormone’s possible involvement in apoptosis. Hormonal influences in FAP duodenal tumorigenesis, and modulation of these as a possible chemoprevention strategy, may be a promising approach. PMID:27003997

  19. Entering the duodenal diverticulum: a method for cannulation of the intradiverticular papilla.

    PubMed

    Wang, Bao-Can; Shi, Wei-Bin; Zhang, Wen-Jie; Gu, Jun; Tao, Yi-Jing; Wang, Yu-Qin; Wang, Xue-Feng

    2012-12-28

    Successful cannulation of the common bile duct may be difficult in patients in whom the papilla is located entirely within a diverticulum. In this study, we report successful biliary cannulation in three patients following intubation of the distal tip of the duodenoscope into the duodenal diverticulum and locating the major papilla. No complications occurred during the operation or during the postoperative period. This method didn't need second incubation an endoscope and might lower the burden of patients. So this skill is useful to deal with the papilla hidden inside the large diverticulum because of its safety and convenience. PMID:23326150

  20. Retained foreign body: associations with elevated lead levels, pica, and duodenal anomaly.

    PubMed

    Sprinkle, J D; Hingsbergen, E A

    1995-01-01

    A 14-month-old girl presented with elevated lead levels and a metallic foreign body was detected on abdominal radiograph. Subsequent evaluation, performed after the child failed to pass the foreign body with cathartics, revealed a bezoar proximal to a partial duodenal obstruction. The metallic foreign body was later removed and found to contain lead, however, the patient has subsequently had recurrent elevations of lead levels with episodes of pica. This case reiterates the need to evaluate children with retained foreign bodies for lead poisoning due to associated pica. In addition, retained foreign bodies should point to possible congenital anomaly of the duodenum causing partial obstruction. PMID:8545182

  1. Ultrasound, CT and FDG PET-CT of a Duodenal Granuloma in a Dog

    PubMed Central

    JEON, Sunghoon; KWON, Seong Young; CENA, Rohani; LEE, Ju-hwan; CHO, Kyoung-Oh; MIN, Jung-Joon; CHOI, Jihye

    2014-01-01

    ABSTRACT A 12-year-old spayed female Yorkshire Terrier with intermittent vomiting was diagnosed with regional granulomatous enteritis through histopathological examination. On ultrasonography and computed tomography, a focal thickened duodenal wall showed a mass-like appearance with indistinct wall layers. Marked uptake of 18F-fluorodeoxyglucose was observed from the mass on positron emission tomography-computed tomography. Regional granulomatous enteritis is a rare form of inflammatory bowel disease and may have imaging features similar to intestinal tumors. This is the first study describing the diagnostic imaging features of ultrasonography, computed tomography and positron emission tomography-computed tomography for regional granulomatous enteritis in a dog. PMID:24748419

  2. Sufotidine 600 mg bd virtually eliminates 24 hour intragastric acidity in duodenal ulcer subjects.

    PubMed Central

    Smith, J T; Pounder, R E

    1990-01-01

    In a double blind study, 24 hour intragastric acidity and 24 hour plasma gastrin concentrations were measured simultaneously in seven duodenal ulcer subjects on the fifth day of receiving either sufotidine 600 mg bd or placebo. Compared with placebo, during treatment with sufotidine 600 mg bd the median integrated 24 hour intragastric acidity was decreased by 95% (range 74% to 99%) from 1000 to 51 mmol/h/l, whilst the median integrated 24 hour plasma gastrin concentration increased from 416 to 927 pmol/h/l. PMID:1969833

  3. Relationships between circulating plasma concentrations and duodenal flows of essential amino acids in lactating dairy cows.

    PubMed

    Patton, R A; Hristov, A N; Parys, C; Lapierre, H

    2015-07-01

    The objective of this study was to better define essential AA (EAA) requirements in lactating dairy cows through examination of the relationship between plasma essential AA concentration (p[EAA]) and predicted duodenal flow of essential AA (EAAduo). Our hypothesis was that at a given level of milk protein output, p[EAA] would remain steady in response to increasing EAAduo until the EAA requirement was met, at which point p[EAA] would increase rapidly in response to greater duodenal flow of EAA until p[EAA] reached a plateau as other body processes degraded excess EAA to avoid toxicity. Thus, the requirement of each EAA would be fulfilled when p[EAA] increased rapidly. To investigate this hypothesis, we compiled a literature database that included 102 studies with 420 treatment means that reported p[EAA], dietary nutrient content, body weight, and milk production. A second database was produced to validate relationships developed in the first database and included 32 studies with 98 treatment means. All relationships were evaluated as regression equations with study as a random factor. Breed, days in milk, body weight, and milk protein production had no effect on the plasma concentration of any EAA. Other than metabolizable protein supply, nutritional content of the rations did not affect p[EAA]. Only p[Arg] was affected by parity, with primiparous cows having higher concentrations of Arg than older cows. No break points in the relationship between p[EAA] versus EAAduo were detected as either steep increases or plateaus. Plasma Arg, Ile, Lys, Thr, and Val concentrations were best associated with their respective EAAduo as quadratic equations, whereas His, Leu, Met, and Phe were associated only linearly. Adding a quadratic term improved the adjusted R(2) or decreased the root mean square error marginally (<2.0%). Thus, we conclude that the main effect of EAAduo on p[EAA] is linear. Abomasal or duodenal infusions of Met, Lys, His, Lys+Met, and casein revealed that Met or Lys infused alone increased the plasma concentration of the infused EAA and lowered the concentration of other EAA, particularly His. Infusion of Lys+Met or His alone was associated with increases in concentrations of these EAA without affecting others. We conclude that over a wide range of protein intakes in lactating cows, plasma levels of EAA increase linearly with duodenal flow. No evidence was found that EAA requirements are reflected in blood plasma concentrations. PMID:25912872

  4. Alterations in the laryngeal mucosa after exposure to asbestos.

    PubMed Central

    Kambic, V; Radsel, Z; Gale, N

    1989-01-01

    The laryngeal mucosa of 195 workers in an asbestos cement factory (Salonit Anhovo, Yugoslavia) and in a control group was examined. The factory manufactures asbestos cement products containing about 13% of asbestos (8% amosite, 12% crocidolite, and 80% chrysotile) of different provenance. Alterations in the laryngeal mucosa were more frequent in the factory workers than in the control group. The changes, mostly consistent with chronic laryngitis, were closely related to the degree of workplace pollution and less so to the duration of employment Ten workers exhibiting the most severe clinical changes underwent biopsy, the results of which showed histomorphological changes characteristic of hyperplastic chronic laryngitis. Four tissue specimens were examined also by scanning electron microscopy and in three of them asbestos fibres were found on the epithelial surface. No case of laryngeal carcinoma was identified. On the basis of our results it is thought that asbestos related changes of the larynx should receive more attention and that the use of the term "laryngeal asbestosis" is justified. The clinical picture is non-specific but in view of their frequency such changes should be considered a consequence of exposure to asbestos. Images PMID:2489023

  5. Lipidomic profiling of sinus mucosa from patients with chronic rhinosinusitis.

    PubMed

    Fazlollahi, Farbod; Kongmanas, Kessiri; Tanphaichitr, Nongnuj; Mallen-St Clair, Jon; Gopen, Quinton; Faull, Kym F; Suh, Jeffrey D

    2015-04-01

    Sinusitis is a cause of significant morbidity, substantial healthcare costs, and negative effects on quality of life. The primary objective of this study is to characterize the previously unknown lipid profile of sinonasal mucosa from patients with chronic rhinosinusitis (CRS) and from controls. Sinus mucosa samples were analyzed from 9 CRS patients with concomitant nasal polyps, 11 CRS patients without polyps, and 12 controls. Ten lone polyp samples were also analyzed. Samples were subjected to a modified Bligh/Dyer lipid extraction, then high performance thin layer chromatography (HPTLC), combined gas chromatography/electron impact-mass spectrometry (GC/EI-MS), and flow-injection/electrospray ionization-tandem mass spectrometry (FI/ESI-MS/MS). Data was analyzed for identification and profiling of major components. HPTLC revealed an array of species reflecting the lipid complexity of the samples. GC/EI-MS revealed cholesterol and several fatty acids. FI/ESI-MSMS revealed numerous lipid species, namely a host of phosphatidylcholines, phosphatidylethanolamines, ceramides and cholesteryl esters, but no detectable amounts of phosphatidyinositols or sulfated lipids. These results are a first step to uncover unique molecular biomarkers in CRS. PMID:25588779

  6. Impedance spectroscopy for monitoring ischemic injury in the intestinal mucosa.

    PubMed

    Gonzlez, Csar A; Villanueva, Cleva; Othman, Salah; Narvez, Ral; Sacristn, Emilio

    2003-05-01

    This work evaluates the feasibility of monitoring ischemic injury in the gastrointestinal mucosa by impedance spectroscopy, using a minimally invasive intestinal catheter. The disruption of the intestinal mucosa plays a key role in the evolution of shock and is the 'motor of multiple organ failure'. Different technologies have been developed to monitor mucosal perfusion, oxygenation and/or ischemia, but no practical method exists to assess tissue damage, which may be crucial for preventing multiple organ failure. The experimental protocol of this study relied on an isobaric model of hypovolemic shock in 16 anaesthetized rabbits assigned to three groups: sham (n = 6), ischemia (n = 5) and ischemia + reperfusion (n = 5). Complex impedance spectra were recorded in the range of 0.05 to 300 kHz, with simultaneous measurements of tonometric pHi in the ileum every 30 min for 4 h. Impedance spectra were reproducible, and those of tissue under prolonged ischemia were clearly differentiable from those of normally perfused tissue. The dynamic changes in impedance did not correlate directly with either tissue perfusion or pHi, but instead correlated well with the duration of ischemia. It is concluded that impedance spectroscopy does indeed measure changes in tissue injury, and could be a very useful tool to guide therapy of patients in shock. PMID:12812414

  7. Autonomic Neurotransmitters Modulate Immunoglobulin A Secretion in Porcine Colonic Mucosa

    PubMed Central

    Schmidt, Lisa D.; Xie, Yonghong; Lyte, Mark; Vulchanova, Lucy; Brown, David R.

    2007-01-01

    Secretory immunoglobulin A (sIgA) plays a crucial role in mucosal surface defense. We tested the hypothesis that colonic sIgA secretion is under enteric neural control. Immunohistochemistry of the porcine distal colonic mucosa revealed presumptive cholinergic and adrenergic nerve fibers apposed to secretory component (SC)-positive crypt epithelial cells and neighboring IgA+ plasmacytes. The cholinomimetic drug carbamylcholine elicited rapid, atropine-sensitive IgA secretion into the luminal fluid bathing mucosal explants mounted in Ussing chambers. The adrenergic receptor agonist norepinephrine also increased IgA secretion, an action inhibited by phentolamine. These effects were independent of agonist-induced anion secretion. In Western blots of luminal fluid, both agonists increased the density of protein bands co-immunoreactive for IgA and SC. Mucosal exposure to enterohemorrhagic Escherichia coli did not affect IgA secretion, and carbamylcholine treatment did not affect mucosal adherence of this enteropathogen. Acetylcholine and norepinephrine, acting respectively through muscarinic cholinergic and alpha-adrenergic receptors in the colonic mucosa, stimulate sIgA secretion and may enhance mucosal defense in vivo. PMID:17320195

  8. Aberrant Gene Expression Profile of Unaffected Colon Mucosa from Patients with Unifocal Colon Polyp.

    PubMed

    Lian, Jingjing; Ma, Lili; Yang, Jiayin; Xu, Lili

    2015-01-01

    BACKGROUND The aim of this study was to evaluate gene expression profiles in unaffected colon mucosa and polyp tissue from patients with unifocal colon polyp to investigate the potential mucosa impairment in normal-appearing colon mucosa from these patients. MATERIAL AND METHODS Colon polyp patients were prospectively recruited. We obtained colon biopsies from the normal-appearing sites and polyp tissue through colonoscopy. Gene expression analysis was performed using microarrays. Gene ontology and clustering were evaluated by bioinformatics. RESULTS We detected a total of 711 genes (274 up-regulated and 437 down-regulated) in polyp tissue and 256 genes (170 up-regulated and 86 down-regulated) in normal-appearing colon mucosa, with at least a 3-fold of change compared to healthy controls. Heatmapping of the gene expression showed similar gene alteration patterns between unaffected colon mucosa and polyp tissue. Gene ontology analyses confirmed the overlapped molecular functions and pathways of altered gene expression between unaffected colon mucosa and polyp tissue from patients with unifocal colon polyp. The most significantly altered genes in normal-appearing tissues in polyp patients include immune response, external side of plasma membrane, nucleus, and cellular response to zinc ion. CONCLUSIONS Significant gene expression alterations exist in unaffected colon mucosa from patients with unifocal colon polyp. Unaffected colon mucosa and polyp tissue share great similarity and overlapping of altered gene expression profiles, indicating the potential possibility of recurrence of colon polyps due to underlying molecular abnormalities of colon mucosa in these patients. PMID:26675397

  9. Aberrant Gene Expression Profile of Unaffected Colon Mucosa from Patients with Unifocal Colon Polyp

    PubMed Central

    Lian, Jingjing; Ma, Lili; Yang, Jiayin; Xu, Lili

    2015-01-01

    Background The aim of this study was to evaluate gene expression profiles in unaffected colon mucosa and polyp tissue from patients with unifocal colon polyp to investigate the potential mucosa impairment in normal-appearing colon mucosa from these patients. Material/Methods Colon polyp patients were prospectively recruited. We obtained colon biopsies from the normal-appearing sites and polyp tissue through colonoscopy. Gene expression analysis was performed using microarrays. Gene ontology and clustering were evaluated by bioinformatics. Results We detected a total of 711 genes (274 up-regulated and 437 down-regulated) in polyp tissue and 256 genes (170 up-regulated and 86 down-regulated) in normal-appearing colon mucosa, with at least a 3-fold of change compared to healthy controls. Heatmapping of the gene expression showed similar gene alteration patterns between unaffected colon mucosa and polyp tissue. Gene ontology analyses confirmed the overlapped molecular functions and pathways of altered gene expression between unaffected colon mucosa and polyp tissue from patients with unifocal colon polyp. The most significantly altered genes in normal-appearing tissues in polyp patients include immune response, external side of plasma membrane, nucleus, and cellular response to zinc ion. Conclusions Significant gene expression alterations exist in unaffected colon mucosa from patients with unifocal colon polyp. Unaffected colon mucosa and polyp tissue share great similarity and overlapping of altered gene expression profiles, indicating the potential possibility of recurrence of colon polyps due to underlying molecular abnormalities of colon mucosa in these patients. PMID:26675397

  10. Comparative endoscopic evaluation of normal and ulcerated gastric mucosae in Thoroughbred foals

    PubMed Central

    OKAI, Kazuhiko; TAHARAGUCHI, Sadao; ORITA, Yasuhiro; YOKOTA, Hiroshi; TANIYAMA, Hiroyuki

    2015-01-01

    To contribute to early diagnosis and treatment of gastric ulcer of foals, we examined the gastric mucosa of healthy and affected foals using an endoscope. In healthy foals, the characteristic changes in the development of the squamous mucosa were seen mainly in the squamous mucosa, and maturation of the squamous mucosa in the greater curvature (GC-S) occurred more slowly than that of the squamous mucosa in the lesser curvature (LC-S). Epithelial desquamation in the LC-S and GC-S was observed between 6 and 90 days but was not observed in the LC-S at about 60 days, whereas it was observed in the GC-S until 90 days old. These findings suggest that there is a difference in the development of the gastric mucosa by region and that desquamation continues over a term longer than studies have reported in the past. In the affected foals, the minimum age at which gastric ulcer was observed was 4 days old. Gastric ulcers formed predominantly in the squamous mucosa (LC-S and GC-S) of foals with an immature mucosa before the weaning period, and the peak incidence occurred between 61 and 90 days old. The differences in the ulceration sites were considered to depend on the difference in the development (maturation) stage of the squamous mucosa. The grading score of the gastric ulcer increased with the growth of the affected foals. The gastric ulcer might be enhanced greatly by stress in the weaning period. PMID:25648790

  11. Functional perturbation of classical natural killer and innate lymphoid cells in the oral mucosa during SIV infection

    PubMed Central

    Li, Haiying; Reeves, R. Keith

    2012-01-01

    Despite the fact that the majority of human pathogens are transmitted across mucosal surfaces, including the oral mucosae, oral immunity is poorly understood. Furthermore, because the normal flora of the oral cavity is vast and significantly diverse, host immunity must balance a complex system of tolerance and pathogen recognition. Due to the rapid recognition and response to pathogens, the innate immune system, including natural killer (NK) cells, likely plays a critical role in mediating this balance. Because logistical and ethical restraints limit access to significant quantities of human mucosal tissues, non-human primate models offer one of the best opportunities to study mucosal NK cells. In this study we have identified both classical NK cells, as well as innate lymphoid cells (ILCs) in tonsillar and buccal tissues and oral-draining lymph nodes. Identified by mutually exclusive expression of NKG2A and NKp44, NK cells, and ILCs in the oral mucosa are generally phenotypically and functionally analogous to their gut counterparts. NKG2A+ NK cells were more cytotoxic while NKp44+ ILCs produced copious amounts of IL-17 and TNF-?. However, in contrast to gut, oral NK cells and ILCs both produced large quantities of IFN-? and the beta-chemokine, MIP-1?. Also in contrast to what we have previously found in gut tissues of SIV-infected macaques, we found no reduction in NK cells during chronic SIV infection, but rather an expansion of ILCs in oral-draining lymph nodes and tonsils. These data suggest that the lentivirus-induced depletion of the NK cell/ILC compartment in the gut may be absent in the oral mucosa, but the inherent differences and SIV-induced alterations are likely to have significant impact on preventing oral opportunistic infections in lentiviral disease. Furthermore, these data extend our understanding of the oral innate immune system in general and could aid future studies evaluating the regulation of both normal oral flora and limiting transmission of oral mucosal pathogens. PMID:23316201

  12. Duodenal and gallbladder metastasis of regressive melanoma: a case report and review of the literature

    PubMed Central

    Elomrani, Fadwa; Elkabous, Mustapha; Rimani, Mouna; Boutayeb, Saber; Mrabti, Hind; Errihani, Hassan

    2015-01-01

    Background Malignant melanoma involving the gastrointestinal (GI) tract may be primary or metastatic. Small bowel is the commonest site of GI metastases from cutaneous malignant melanoma, metastatic lesion in the gallbladder is extremely rare. Case presentation This case report describes the presentation of metastatic melanoma in duodenum and gallbladder. A 45-year-old man has presented melena with intermittent abdominal pain. On physical examination we found a small lesion between the fourth and fifth toes, associated with inguinal lymph node. An Abdominal ultrasound revealed diffuse duodenal thickening. Upper endoscopy was performed and discovered an ulcerative lesion in the second part of the duodenum. The biopsy with immunohistochemical stains was in favor of a duodenal location of melanoma. Computed tomography (CT) revealed many circumferential thickening of ileal loops associated with a nodular lesion in the anterior wall of the gallbladder. The patient was treated by palliative chemotherapy. Discussion Malignant melanoma of the GI tract may be primary or secondary. The small bowel is the most affected, but its rare in the gallbladder. The clinical presentation can mimic the other intestinal tumors, and the diagnosis is based on imaging; CT scan and GI endoscopy have a key role on the diagnosis, and the treatment depends on the location and the number of lesions. Conclusions Metastases of melanoma in the GI tract are uncommon, the diagnosis must be suspected in any patient with a history of melanoma with digestive signs. PMID:26487955

  13. Widespread lymph node recurrence of major duodenal papilla cancer following pancreaticoduodenectomy.

    PubMed

    Li, Bai-Sen; Shi, Hui; Wen, Min; Xiao, Ming-Yong; Wang, Jian

    2015-12-28

    Major duodenal papilla cancer (MDPC) represents the primary type of duodenal cancer, and is typically considered a periampullary carcinoma as most tumors arise in this region. This report describes an extremely rare case involving a patient with rapidly and extensively recurrent MDPC following pancreaticoduodenectomy, who achieved complete response by concurrent image-guided radiation and intravenous oxaliplatin plus oral capecitabine therapies. The patient was a 50-year-old female who was admitted to our hospital 6 wk after resection for MDPC for evaluation of a nontender and enlarged node in the left side of her neck. After clinical work-up, the patient was diagnosed with postoperatively recurrent MDPC with widespread lymph node metastases at the bilateral cervix, mediastinum, abdominal cavity, and retroperitoneal area. She was administered whole field image-guided radiation therapy along with four cycles of the intravenous oxaliplatin plus oral capecitabine regimen. A complete response by positron emission tomography with 18-fluorodeoxyglucose was observed 4 months after treatment. The patient continues to be disease-free 2 years after the diagnosis of recurrence. PMID:26730173

  14. Duodenal flow of digesta in preruminant calves fed clotting or nonclotting milk replacer.

    PubMed

    Petit, H V; Ivan, M; Brisson, G J

    1987-12-01

    Four Holstein male calves each were fitted with a reentrant duodenal cannula and fed a low heat milk replacer with or without an oxalate-NaOH buffer known to prevent curd formation in the abomasum. Animals were used in a crossover design to study the effect of milk clotting on duodenal flow of DM, fat, protein, lactose, and Ca. Clotting affected the flow of DM, protein N, total N, and fat as shown by the more uniform gastric emptying of the clotting milk replacer compared with the nonclotting one. For both treatments, the flow rate of these components reached a peak 2 h after feeding. Clotting did not alter the flow rate of free amino N, lactose, and Ca. The cumulative flow of DM, lactose, and Ca was similar for the clotting and nonclotting milk replacers rising gradually during the first 4 h postfeeding and tending to plateau thereafter. The clotting milk replacer resulted in a more linear cumulative flow of fat, protein N, and total N than the nonclotting one. Proteolysis of milk protein in the abomasum was the same for the two milk replacers as indicated by the total flow of free amino N measured over 24 h. Data suggest that milk clotting modifies abomasal flow of milk constituents retained in the abomasal clot but does not alter the flow of constituents in the whey fraction. PMID:3448108

  15. Widespread lymph node recurrence of major duodenal papilla cancer following pancreaticoduodenectomy

    PubMed Central

    Li, Bai-Sen; Shi, Hui; Wen, Min; Xiao, Ming-Yong; Wang, Jian

    2015-01-01

    Major duodenal papilla cancer (MDPC) represents the primary type of duodenal cancer, and is typically considered a periampullary carcinoma as most tumors arise in this region. This report describes an extremely rare case involving a patient with rapidly and extensively recurrent MDPC following pancreaticoduodenectomy, who achieved complete response by concurrent image-guided radiation and intravenous oxaliplatin plus oral capecitabine therapies. The patient was a 50-year-old female who was admitted to our hospital 6 wk after resection for MDPC for evaluation of a nontender and enlarged node in the left side of her neck. After clinical work-up, the patient was diagnosed with postoperatively recurrent MDPC with widespread lymph node metastases at the bilateral cervix, mediastinum, abdominal cavity, and retroperitoneal area. She was administered whole field image-guided radiation therapy along with four cycles of the intravenous oxaliplatin plus oral capecitabine regimen. A complete response by positron emission tomography with 18-fluorodeoxyglucose was observed 4 months after treatment. The patient continues to be disease-free 2 years after the diagnosis of recurrence. PMID:26730173

  16. [The results and problems of surgical treatment of cancer of the duodenal papilla of Vater].

    PubMed

    Nakao, A; Harada, A; Nonami, T; Kishimoto, W; Takeda, S; Kurokawa, T; Takagi, H

    1992-08-01

    Twenty six of 28 cases (92.9%) of cancer of duodenal papilla of Vater were resected from 1981 to 1990. Twenty five pancreatoduodenectomy and one total pancreatectomy were performed. Operative death and hospital death were not observed. Three year and five year cumulative survival rates of resected cases were 58% and 52% respectively. There was relatively good correlation between pathological cancer extension and postoperative prognosis. Postoperative prognosis of the cases which had cancer extension to the pancreas was extremely poor. But the prognosis of the cases of cancer within Oddi muscle was extremely good. Immunohistochemical staining using anti CEA, anti CA19-9 and anti DUPAN 2 was studied and Grade III staining pattern was observed only in the cases which had cancer invasion to the pancreas. Preoperative diagnosis of cancer extension using endoscopic ultrasonography and appropriate choice of the operative procedure are important. Extended operation and effective adjuvant therapy are necessary for advanced cases of cancer of the duodenal papilla. PMID:1359393

  17. Effect of Pithecellobium dulce (Roxb.) Benth. fruit extract on cysteamine induced duodenal ulcer in rats.

    PubMed

    Megala, Jayaraman; Geetha, Arumugam

    2015-10-01

    The edible fruits of Pithecellobium dulce (Roxb.) Benth. are traditionally used for various gastric complications in India. Here, we investigated the antiulcer activity of hydroalcoholic fruit extract of P. dulce (HAEPD) by applying cysteamine induced duodenal ulcer model in rats. Duodenal ulcer was induced in male albino Wistar rats by oral administration of cysteamine @ 420 mg/kg body wt. as a single dose. The rats were pre-administered orally with HAEPD @ 200 mg/kg body wt. for 30 days prior to ulcer induction. Rats pre-administered with ranitidine @ 30 mg/kg body wt. served as reference drug control. Ulcer score, thiobarbituric acid reactive substances (TBARS), glycoproteins, superoxide dismutase, catalase and glutathione peroxidase and reduced glutathione levels were measured in the duodenum. Rats pre-administered with the HAEPD showed significantly reduced ulcer score comparable to that of ranitidine pretreated rats. The co-administration of HAEPD lowered the TBARS level and also restored the levels of glycoproteins, enzymatic and non-enzymatic antioxidants. Histopathological observations confirmed the presence of inflammation, necrosis and hemorrhagic spots in the duodenum of ulcer control rats which were significantly reduced due to HAEPD treatment. No abnormal alterations were observed in normal rats treated with HAEPD at the dosage studied. The results demonstrated antioxidant and cytoprotective nature of P. dulce, and thereby its significant anti ulcer property. PMID:26665296

  18. Successful open abdomen treatment for multiple ischemic duodenal perforated ulcers in dermatomyositis

    PubMed Central

    2014-01-01

    Introduction Dermatomyositis is an autoimmune disease characterized by proximal myopathy, cutaneous Gottron papules and heliotrope rash; intestinal involvement associated to acute vasculitis is less common but could be a life-threatening condition. Methods